Need help, please

[DD & Smokey & Sissy]

I posted this in the PZ thread by mistake...

I think I may have messed up. Getting used to my ReliOn (switching from AlphaTrak2) I tested Smokey BG and it was 71. I tested because he's been vomiting this morning (and hasn't since we began this last Friday), so I was obviously concerned. I freaked out because the number was so low, and I administered some Karo in my panic, thinking he was hypo. Honestly, I am not sure how much is ON him or IN him. I am home and watching him like a hawk. Now that I'm out of my panic, I am upset I didn't come HERE FIRST. I know his numbers for the rest of the day will be abnormally high, so I'll not dose him this evening until I check with you folks to get advice on if I should.

 

[Jacque- Tiger & Jazz Man]

I've been advised to ONLY adjust Prozinc units in .25 or .50 increments. And hold the dose for at least 3 cycles. Please take a look at Tiger's ss. Adjustments were made with their advice. The members are awesome here. Me and Tiger got so much help from them. I've had many many sleepless nights and still do.

 

[jt and trouble (GA)]

Hey better high one day than low one minuet.
WELCOME to FDMB!
Youve already have a footing so wait for more responses (I cannot give dosing advice)

 

[jt and trouble (GA)]

Looks like people are busy right now BUT they WILL come ok? I'm still looking.

 

[Jacque- Tiger & Jazz Man]

I posted this in the PZ thread by mistake...

I think I may have messed up. Getting used to my ReliOn (switching from AlphaTrak2) I tested Smokey BG and it was 71. I tested because he's been vomiting this morning (and hasn't since we began this last Friday), so I was obviously concerned. I freaked out because the number was so low, and I administered some Karo in my panic, thinking he was hypo. Honestly, I am not sure how much is ON him or IN him. I am home and watching him like a hawk. Now that I'm out of my panic, I am upset I didn't come HERE FIRST. I know his numbers for the rest of the day will be abnormally high, so I'll not dose him this evening until I check with you folks to get advice on if I should.

Also check out the Prozinc Forum Sticky Notes has alot of great advice and tips has helped me enormously

 

[DD & Smokey & Sissy]

Thank you!! I talked to my MIL (Who is a nurse as well as a member/former member of this board who cared for a diabetic cat for several years) and I actually probably did the right thing. (Thank you sweet baby Jesus) The lens of how to treat my boy is coming more into focus and the threads and advice given to others are beginning to sink in. My MIL really thinks he is trying to go into remission and that his pancreas may be starting to wake up. I pray this is so but for now, I'm testing every 30 minutes. What's happened TODAY:

5:30 - Fed him FF wet food.
8:00 - Tested - AlphaTrak - 262 - administered 1.5u (I now know this is not the correct thing to do. Test, Feed, Shoot. That has sunk in through my thick skull)
10:30-10:45 - vomited. Small amount. He was not acting strangely and I saw no signs of hypo.
11:20 - after lying with me, purring and acting normally, vomited again.
11:26 - Test with ReliOn - 71 (This is where I switched meters. My brain, however, didn't.)
11:30 - gave some Karo.
12:24 - Test BG - 46. Gave more Karo, some dry kibble, and a couple of Friskies Party Mix treats.
1:01 - 55
1:30 - 76
2:01 - 146
2:29 - 333
3:01 - 368
3:29 - 399
3:57 - 355
4:33 - 305
5:01 - 334
5:30 - 298
6:03 - 263 (Changing to every hour)
7:03 - 313
7:57 - 222

About to go in and test again. Thankfully he has more patience with me and is tolerant of his testing.

 

[DD & Smokey & Sissy]

Also check out the Prozinc Forum Sticky Notes has alot of great advice and tips has helped me enormously

I did that earlier. (The part of this that finally started to make sense and sink in through MY thick skull) And why I freaked out a bit at the 71 ReliOn reading because it was <90. Something clicked and I went into "He needs sugar" mode.

 

[jt and trouble (GA)]

And why I freaked out a bit at the 71 ReliOn reading because it was <90. Something clicked and I went into "He needs sugar" mode.

A little giggle here. So GLAD you have a MIL to confide with. I've been here since 2006 (or something like that) My diabetic kitty Trouble passed around 2009. And yes I'm still here because this is a HUGE family I belong to.
If you dont mind can you post your MIL name We might know her If she doesnt want you to thats ok no problem.

At this moment I'm still having trouble tagging people but will keep trying.
jeanne

 

[Elizabeth and Bertie]

About to go in and test again. Thankfully he has more patience with me and is tolerant of his testing. <3

Hi, firstly, good catch!
You're doing really well. I know how stressful this can feel. But it is a matter of giving syrup or food as necessary, re-testing... 'Wash, rinse, repeat' (so to speak!), until you know kitty is out of danger.
The karo should really be kicking in now, and the kibble may well start to get into his system too. The karo works fast but can wear off relatively fast, the kibble lasts longer in the system.
Do you have any high carb food in gravy? If so, the gravy from that may be better than giving kibble (assuming you may need to give again...)
And can you clarify which meter you're using? Is it the human meter at the moment? (If the Alphatrak then you really want to keep above 65 with that.)

Eliz

 

[Elizabeth and Bertie]

DD, @DD & Smokey & Sissy , ideally you want to keep testing until you get three rising numbers in succession that aren't influenced directly by food; so you know your kitty's blood glucose is rising on its own and will continue to rise.

 

[DD & Smokey & Sissy]

Hi, firstly, good catch!
You're doing really well. I know how stressful this can feel. But it is a matter of giving syrup or food as necessary, re-testing... 'Wash, rinse, repeat' (so to speak!), until you know kitty is out of danger.
The karo should really be kicking in now, and the kibble may well start to get into his system too. The karo works fast but can wear off relatively fast, the kibble lasts longer in the system.
Do you have any high carb food in gravy? If so, the gravy from that may be better than giving kibble (assuming you may need to give again...)
And can you clarify which meter you're using? Is it the human meter at the moment? (If the Alphatrak then you really want to keep above 65 with that.)

Eliz

I am using the ReliOn. I used the last AlphaTrak strip this morning and have switched to the human meter. I do have some gravy food (Which is all he ever wanted off of it was the gravy anyway). I tested him 15 minutes ago and it was coming up. I will test in 15 more and continue to until it gets to a more "comfortable" range.

 

[DD & Smokey & Sissy]

DD, @DD & Smokey & Sissy , ideally you want to keep testing until you get three rising numbers in succession that aren't influenced directly by food; so you know your kitty's blood glucose is rising on its own and will continue to rise.

That makes sense. Which means today's numbers are pretty much obsolete given that I've had to artificially inflate his numbers. Regardless, I'm keeping a very close eye on him.

 

[Elizabeth and Bertie]

Which means today's numbers are pretty much obsolete given that I've had to artificially inflate his numbers.

Not "obsolete", but food-inflated for a while. ...From the test data you have on your kitty's SS it looks like your kitty 'may' have quite a late nadir on Prozinc. So, are you OK to keep testing for a while, to ensure the numbers don't drop again?
You really are doing brilliantly! Well done, you!

Obviously a dose reduction will be needed after this... Any high numbers that you see in response to today's low numbers will be temporary, so don't be influenced by any high numbers that you see...

 

[DD & Smokey & Sissy]

Yes, I am comfortable testing. (And so is he, now) As of now, I will NOT be giving him a shot tonight and Test, Feed, Shoot in the morning. (I've been whopped on the head with the "I get it!!" wand today!!) The forums have been a GREAT resource this morning and, as I said, they make sense now. Also, definitely planning on pulling back on his dosage. I am in hopes @Deb & Wink can chime in.

 

[Chris & China (GA)]

I will NOT be giving him a shot tonight

As quickly as he's going up, I wouldn't skip tonight's shot. Just reduce the dose and get a couple tests in on the PM cycle

Some of those highs could be the kibble and treats, but they could also be the beginning of a killer bounce.

Bounces can take up to 6 cycles to clear ….if you skip tonight, you're not giving him any insulin to help shorten the amount of time he's bouncing high.

There's a lot of time between now and PMPS so let's see where he's at then.

 

[Jacque- Tiger & Jazz Man]

I did that earlier. (The part of this that finally started to make sense and sink in through MY thick skull) And why I freaked out a bit at the 71 ReliOn reading because it was <90. Something clicked and I went into "He needs sugar" mode.

I've been there and I'm sure we all have had freak outs. I had one recently too, I was told "calm down" just keep testing..and if it goes lower then Karo time

 

[DD & Smokey & Sissy]

As quickly as he's going up, I wouldn't skip tonight's shot. Just reduce the dose and get a couple tests in on the PM cycle

Some of those highs could be the kibble and treats, but they could also be the beginning of a killer bounce.

Bounces can take up to 6 cycles to clear ….if you skip tonight, you're not giving him any insulin to help shorten the amount of time he's bouncing high.

There's a lot of time between now and PMPS so let's see where he's at then.

That makes sense. Thank you!!

 

[Deb & Wink]

That 46 at +4 today earned Smokey Joe a dose reduction.
Please reduce at the PMPS shot tonight 4/3/2020, by 0.25U
Dose should go down to 1.25U.
Yes, he'll probably bounce tonight after that low, but you ABSOLUTELY need to reduce.
A 46 on an Alphatrak or a human meter is dangerous on ANY insulin and needs a reduction (except for long term feline diabetics, >1 year since diagnosis)

It's ok to feed Smokey Joe like you did at 5:30 this morning. That is because you did your test, shoot cycle 2.5 hours later. It's only the 2 hours before the pre-shot tests you want to be uninfluenced by food. All other tests, we expect to be food influenced (except if you are using the "stalling" technique).

You really are doing brilliantly! Well done, you!

I agree with Elizabeth. Good job! on bringing those BG numbers back up from that 46 this morning.

Cats can be more sensitive to insulin, after a low like that. So again, good idea to reduce.

In fact, you should have reduced when you got those 80's on 4/1 and KEPT the dose lower, because you are using the SLGS Prozinc dosing protocol. Any number below 90 with the PZI SLGS method is a dose reduction. You should not have gone back to the 1.5U dose, until you knew the dose reduction was a failure, which can take 3-6 cycles minimum. Hindsight I know, but so you know for next time.

Next time, try a bit of his low carb wet food first, 1 teaspoon or so, before reaching for the karo and dry treats. Dry takes longer to digest, which is why the wet food should be your first choice. Medium carb wet is your second choice. High carb wet is your third choice. Karo and dry treats if the BG's are NOT coming up, and are still dropping.

At low numbers, the Alphatrak and the human meters read much closer together. Good that you realized that 71 was a "take action" number. Excellent job!

Let's all chant "Before bed test, before bed test, before bed test, every cycle."

p.s. I think the 1.25U dose could even be a bit too much for Smokey Joe, but we'll see in 3-6 cycles.

 

[DD & Smokey & Sissy]

That 46 at +4 today earned Smokey Joe a dose reduction.
Please reduce at the PMPS shot tonight 4/3/2020, by 0.25U
Dose should go down to 1.25U.
Yes, he'll probably bounce tonight after that low, but you ABSOLUTELY need to reduce.
A 46 on an Alphatrak or a human meter is dangerous on ANY insulin and needs a reduction (except for long term feline diabetics, >1 year since diagnosis)

It's ok to feed Smokey Joe like you did at 5:30 this morning. That is because you did your test, shoot cycle 2.5 hours later. It's only the 2 hours before the pre-shot tests you want to be uninfluenced by food. All other tests, we expect to be food influenced (except if you are using the "stalling" technique).

I agree with Elizabeth. Good job! on bringing those BG numbers back up from that 46 this morning.

Cats can be more sensitive to insulin, after a low like that. So again, good idea to reduce.

In fact, you should have reduced when you got those 80's on 4/1 and KEPT the dose lower, because you are using the SLGS Prozinc dosing protocol. Any number below 90 with the PZI SLGS method is a dose reduction. You should not have gone back to the 1.5U dose, until you knew the dose reduction was a failure, which can take 3-6 cycles minimum. Hindsight I know, but so you know for next time.

Next time, try a bit of his low carb wet food first, 1 teaspoon or so, before reaching for the karo and dry treats. Dry takes longer to digest, which is why the wet food should be your first choice. Medium carb wet is your second choice. High carb wet is your third choice. Karo and dry treats if the BG's are NOT coming up, and are still dropping.

At low numbers, the Alphatrak and the human meters read much closer together. Good that you realized that 71 was a "take action" number. Excellent job!

Let's all chant "Before bed test, before bed test, before bed test, every cycle."

p.s. I think the 1.25U dose could even be a bit too much for Smokey Joe, but we'll see in 3-6 cycles.

Thank you very much. I will reduce to 1.25 AFTER I test this evening at our "normal" hour. Given he's such a good patient, I'm continuing to check every 30 minutes. (He doesn't mind at all, honestly, I think he kind of likes the extra pets i give him before and after the test.) Whatever happens, I WILL be checking with you folks tonight before any shot is given.

I just took a shower to calm myself and reset. Thank you, thank you, thank you for your insight.

 

[Deb & Wink]

I just took a shower to calm myself and reset.

Ooooh! Sounds like a nice way to relax. Or a good soak in the tub.

Whatever happens, I WILL be checking with you folks tonight before any shot is given.

I'm not here much after about 8 PM EST/EDT. So that is probably much later than your test, feed, shoot cycle since you are in CST/CDT time zone. Hopefully someone else will be able to help you.

Exhausted myself. Recovering from a cold.

 

[DD & Smokey & Sissy]

Ooooh! Sounds like a nice way to relax. Or a good soak in the tub.


I'm not here much after about 8 PM EST/EDT. So that is probably much later than your test, feed, shoot cycle since you are in CST/CDT time zone. Hopefully someone else will be able to help you.

Exhausted myself. Recovering from a cold.

I know you have not been feeling well, and given that fact, appreciate you jumping on and helping. I truly hope you are on the mend and staying safe.