Need help (edited to remove 911. Thanks for helping!)

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Charley

Charley

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Charley just had his insulin raised a few days ago to 2 units. Sorry keeping paper charts. This morning's ps Bg was 517. At 9am, 335. At noon 88. Just now 33. He is acting fine even jumped on the bed for the poke. Gave him half a can of Friskies shreds with gravy. He devoured it Will test again in ten minutes. Do I need to take him to the emergency vet?


Removing 911 from post. Bg is on the rise.
 
Re: Need help

for now, if he's acting ok, you don't have to run off to the ER unless you prefer to. with testing, and high carb food on hand, you actually are doing everything you should do.

test again like you said in a few minutes and post the next number ok. and when feeding the high carb, feed little bits at a time so as to keep kitty hungry.

how many hours after the shot is the 33? and remind me what insulin you are using.
 
Re: Need help

Cindy + Mousie said:
for now, if he's acting ok, you don't have to run off to the ER unless you prefer to. with testing, and high carb food on hand, you actually are doing everything you should do.

test again like you said in a few minutes and post the next number ok. and when feeding the high carb, feed little bits at a time so as to keep kitty hungry.

how many hours after the shot is the 33? and remind me what insulin you are using.
Click to expand...
Prozinc. Shot was at 5:30 am.
 
Re: Need help

When did you start the prozinc?
It sounds like 2 units might be too much
Can you please post some numbers for us that you have had over the last 2 days
so we can better assist you...
So the 33 is 8 hours after the morning shot?
 
Re: Need help

coming up a little. that's good. i'd go ahead and feed another few bites of that food and test again in another 10-15 minutes.

fwiw, my connection seems a bit sketchy so not sure if i will get cut off or not but others will see you.

the prozinc should be at the wearing off stage or close to it so kitty should go up from here.

agree that clearly the dose increase was probably too much
 
Re: Need help

ok so he is starting to rise, which is good, maybe give a little more food...
What was his dose before raising to 2 units?
how long has he been taking prozinc?
We can help you get a Spreadsheet together so we can see some history
 
Re: Need help

I have his numbers on a paper copy. He started Prozinc one unit twice daily 1/9. A week later the vet raised to 1.5, then two. At his next weekly visit Bg was 59. Vet had us stop insulin completely and that is when I started home testing on 1/28. On no insulin:1/28 291am, 301pm. On 1/29 370am, 357pm. On 1/30 vet has us start 1 unit. Bg was 417pm. 1/31 339amps, 466pmbs. 2/1 350amps, 126 pm Did not give insulin.
2/2 amps371, 297pmps. 2/3 201amps, 454pmps. 2/4 failed test, 321pmps. 2/5 387amps, 461pmps. 2/6 348amps, 277 pmps. 2/7 422amps, 383 pmps. 2/8 440amps, 414 pmps. Vet raised to 2 units. 2/9 370amps, 273pmps. 2/10 477 amps, 257pmps. 2/11 280amps.
Food is fancy feast classic pate. Going to test again.
76!! Are we ok?
 
Re: Need help

:-) yep, i'd say you're out of the woods for today. good job!

fwiw, and bear in mind this is just my opinion, there's not enough numbers there to justify raising the dose. as you can see from today, the preshot was high, but look where kitty went in the cycle. that very well could have been happening all along on the lower doses even. and anytime kitty drops uncomfortably low, they can rebound and bounce right back up, as high as they started or higher. like tonight's preshot most likely will be higher again. ideally a newly diagnosed kitty starts out higher than normal at preshot time, but then gently goes down and back up thru the day. what you don't want is big drops like you got today. that freaks kitty's body out. and it's a good indication the dose is too high.

anytime kitty drops hypo low, it calls for a dose reduction. barring any other cause for the low, i.e. vomiting, inappetance, etc..... soooooo, i'd drop back at least to the 1.5, possibly the 1, and get some spot checks on the numbers. if you can't do extra testing during the week, can you get an extra test in before you go to bed at night or if you get up to go to the bathroom can you grab a test or if not, do a little extra testing on the weekends and holidays like you are doing today? that will give you a better idea as to what a dose is doing and if it needs to be adjusted. and kitty will be safer then, knowing more about what the dose is doing.
 
Re: Need help

ok 76 is good....maybe wait 1/2 hour and test just to make sure that
he is still rising...
Thank you for the numbers...
It is really hard to determine anything if you dont have a nadir...which is how
low he goes after the am shot, which is usually around 6 hours after the first shot
If I were you I would not shoot 2 units again..I think I might start at one unit and gather
data...if you can get a small curve at home like you are doing today so you know
what is happening.
You are doing a wonderful jobtoday and I am so glad that you caught this.

I think you can breathe now....also there is a forum for PZI (prozinc users)
THey are a great group and they can help you through this (not that health cant)
but they are more experienced with prozinc
and will help guide you through the dosage...
 
Re: Need help

Thank you so much. I am beyond grateful. I think I went into high panic. I told the vet last Thursday that I was really concerned with two units. He told me Charley will be a 3 unit cat. My husband and I are both teachers. We leave at 6 am and get home around 4:30 pm. I am so fearful of what could happen during the day. When his Bg was 59 at the vet it was at noon, so basically same time. Vet said it was smyogi effect. I will let you know what pmps looks like. Thank you again.
 
Re: Need help

I will look for your post at around 5ish
but I definately would not give 2 units tonight
when a cat hypos they are more sensitive to insulin afterwards
 
Re: Need help

Great job today! That's scary even for those of us who have been doing it a long time.

I agree that the 2U may be too much for him. Also if the 1u was too little, and the 2u, too much, it makes perfect sense to try the 1.5u and see how he does after a few of days on that dose provided he doesn't go too low. His body will react to a change so give it a couple of days at least. We usually raise the dose by half units to be careful not to miss that perfect dose for the kitty . Cindy & Dmartini gave you great advice.

The tests I consider most important are amps, +6, and pmps, but until you know your kitty's low point which may wind up being +8, testing more often is a good idea if or when you can swing it. Also, most of us keep a pad or something near our testing spot to jot down the numbers and put them in the SS later. The link to the SS and directions is: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207.

Melanie
 
I'm with Denise on this one. They are more sensitive to insulin after a hypo. I would go back to the 1 unit for now.

The 1.5 unit makes me a little nervous because there are no mid cycle tests to see how the insulin was working at 1 unit so we don't know if those high PS's were because of not enough insulin or because of rebound from dropping low mid cycle. Once you get those mid cycle tests in you will know for sure what is happening and can go from there.

You did a great job today.
 
GREAT job on the Spreadsheet, that will be so helpful in giving advice..
Now, in looking at your SS, I have a funny feeling that one unit might have been too much to start
When I see 400 preshots to 100's preshots that looks like really BIG swings which could
mean too much insulin......and I say this because I just went through it with Shakespeare.
If it were my cat I think I would shoot .50 unit or .75 andd try to get a number or 2 tonight.
BUT because of the hypo he will most likely stay high all night and possibly tomorrow..
Are you testing for ketones?
 
Just coming on here and seeing this - I have no advice for you that hasn't already been given, so won't repeat it - you are doing a GREAT job - what a great catch - another testament for home testing.

Keep that high carb food on hand - I always have a can of it in the cupboard and have had to feed it to Dude on many an occasion - he's to the point now that if he drops, regular FF will raise his BG number.

Congrats on the spreadsheet also - as I said, you're doing a fantastic job - don't be too upset over the 500+ # tonight that I saw - that is a result of that "yummy" gravy-coated food you gave Charley - they do love it don't they?

You're doing a great job with this sugar dance - keep up the good work. Scritches to your Charley also.

Emmy & Dude (& Mittsi too)
 
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