Need help with dosing and monitoring!

Siobhan and Aslan

Siobhan and Aslan

New Member
Hi, my cat has recently been diagnosed with diabetes and we have been given ProZinc by the vets. We started giving it to him on the 5th Nov and were told to dose him with 1.8u. We've only just started monitoring BG and are using alphaTrack2 to test.
To start with he was fine on 1.8 and was much more himself and had more energy. We took him to the vets on the 16th Nov and they took a glucose curve which I've put in my spreadsheet. We went back to the vets to take another curve on the 3rd Dec and they aborted the curve as his BG went too low and we dropped his insulin to 1.5. On the 4th Dec he had 1.5u in the morning and started acting funny around 3.5-4+ after the insulin, we didn't have the alphatrack2 at the time so we just fed him and watched him carefully, he perked up.
We've now dropped his insulin to 0.8 (vets advised 1u but we've been worried and more cautious) but his blood glucose seems to keep going down so we rang the vets this morning who advised we skip the insulin and check his BG at 2pm.
I'm worried about giving him too much insulin as there isn't always someone around to monitor him, can anyone suggest when we should be testing him/how much insulin we should give him? The vets haven't been particularly helpful with their advice or aren't available when we need them.
When he was first diagnosed he was on dry food and it was high in carbs, we started to change his food around the 12th November to a low carb wet food, which is 1-2% carbs per pouch. (he has 2.5-3 a day)
Thanks,
Izzie
 
Welcome! Are you using U100 syringes to dose the ProZinc? I ask because that's the only way to measure doses like 1.8 u or 0.8 u. You might need those tiny fractions in the days ahead.
http://www.felinediabetes.com/insulin-conversions.htm

Congratulations on testing your kitty's BG at home and setting up the spreadsheet we use here! :) It seems that the switch to low carb wet food has had a big impact on his BG level. That's excellent!

That blue AMPS is a little too low to give insulin at this point in your journey, especially as measured with an AT meter. If it happens again you can try waiting about 20 minutes without feeding Asian, retesting and if BG is going up, give a full or partial dose. You can repeat the stall without feeding up to an hour without affecting your shot schedule. If BG is up quite a bit you could give the full dose. If it's on the way up but hasn't risen by a lot you can give a reduced dose. That's where it's tricky - how much to reduce is always a guess. At first you'd be more conservative and reduce to maybe a half or 2/3 dose. As you get experience you can reduce by less.

Keep posting here for help. It seems your kitty is moving in a really good direction.
 
Thanks for your reply! I'm using U40 syringes (the vets gave us those ones to use) at the moment but I'll ask the vet if they have U100s to give us/find out where to get them from and thank you for that link.

I think the food has made a big difference, he's always been a massive lover of food and I had no idea how bad dry food can be - I thought as long as it was grain free it was good for them so I think that has really helped his BG levels.

If I test him and his blood sugar stays within the blue should I not give him the injection then? And once I've given him the insulin how long after should I test to check his levels? Thanks for your response, it's been a nightmare trying to figure out what we should be doing and when!
 
It's fine to keep using the u40's. I'm curious how you're measuring 1.8 or 0.8 on a u40 though? Regardless, it's great to see your kitty getting such great numbers! Food really can make a huge difference, especially if the diabetes is caught quickly.

You'll want to test before each shot to make sure Aslan is high enough to shoot safely. Then you can test as much as you want in between the shots. In general cats hit their lowest point in the cycle between +4 and +7 (four to seven hours after the injection). Some cats will hit their lowest point a little earlier, some a little later. Scattering tests around at different times can help to give a good picture of how Aslan is responding. You can also do curves at home so you aren't paying the vet for that. (test every two hours throughout the cycle).

You can click on some of our spreadsheets to get a sense of how we each test. We're all a little different just depending on our work/life schedules. I agree with Kris: for right now don't shoot on a blue - let's give Aslan a couple of days to stabilize and get some data. Many of us do shoot on blue pre-shot numbers, but it takes some time to figure out what is safe.
 
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The vet just told us to judge 1.8u on the syringe. The syringe has 0.5 increments so it was not particularly accurate and I gave less rather than more. When the vet said to reduce to 1u, I was worried because he seems to drop quite a lot so measured the dose just under 1u. I didn't realise there were different syringes so I'm going to ask about them when I go back in.
This morning his bg was 9.6 (173) so no insulin, +6 he was 9.7 (175) so I'm going to check again in 4 hours. I'll avoid giving Aslan insulin on a blue at the moment, I just feel awful that I wasn't doing at home testing from the start because his bg might have been too low when I was injecting him.
 
Please don't feel badly. He's just fine, and you're testing now which is what's important. Vets don't do a very good job of managing treatment of FD, and most of us began this journey listening to our vets.

Honestly, I don't know that I would bother with switching syringes right now. You could wait and see where he's at when you run out of the u40's and then switch at that point. One way we distinguish between the syringes here is that with u40's we call doses by 0.25u and then add a "fat" or "skinny" if we are using a little more or less. So your dose would be 0.75F since it's a smidge more than 0.75, but not quite 1.0u. :)
 
Okay, I'll stick with the U40's for now and thanks for letting me know how you guys distinguish between the syringes.

I've just taken another BG and the result was 8.1, he hasn't had any insulin today, what does this mean in terms of dosing/what's going on? Should I leave the does for tonight and check his BG again in the morning? Thanks for all your help :)
 
It could mean that he's heading towards being a diet-controlled diabetic (not needing insulin, but needing great care in keeping his carb intake low). It's really too early to tell though. Some cats when they've received too much insulin will stay low for a couple of days afterwards, and then start to creep back up again. So let's wait and see. Keep posting as you get new numbers. If he stays in the mid to high blues, we may recommend a very tiny dose to try to nudge him closer to the dark greens. He's still on the high end or just above what would be considered "normal"
 
Hi, I spoke to the vets on Saturday who suggested we monitor his bg over the weekend without giving insulin and his bg has stayed relatively stable in the high blues (I've updated my spreadsheet). I've got an appointment with the vets tomorrow morning to discuss what we should be doing now after his results over the weekend, before going in I just wanted to asked your advice on whether you would advise giving a small dose of insulin to try and get his bg into the greens or whether you would wait a few more days to see what happens to his bg levels? Thanks for all your help so far :)
 
I would try a small dose on cycles when you can monitor. Those numbers are still a little too high to be confident that he's going to be okay. However, I think it very unlikely that a vet would agree because they usually say cats can run in higher numbers and be fine. And they tend to dose in whole units or half units and not be as familiar with the use of micro-doses, nor have confidence in care takers to test and manage lower numbers. Aslan's numbers certainly aren't terrible, but we find that healthy cats are usually between 68-150 on an AlphaTrak and between 50-120 on a human meter - with most numbers in the lower part of those ranges.
 
I agree with Djamila, he's still a bit higher than we would be comfortable with. Vets often think it's fine, but we find that the pancreas sometimes needs a bit of support still when they're in blues...helps make sure the pancreas isn't taxed trying to take care of things. I'd try a small dose too when you can monitor and see what it does.
 
How much would you say I should give him? Should I try 0.25 or 0.5? I can monitor him during his day doses it's just the evening doses that I can't watch closely. In regards to not dosing at all, what kind of number would you not give anything for and what would you give an increase for?
The vet seemed happy with the numbers but ideally I want lower numbers for him, I'll tell the vets in the morning that I want to try and lower his bg further. Thanks for all your information and help - I'd be totally overwhelmed without your support.
 
I would try 0.25u first, and see what that does. Believe it or not, there are two doses even below that. :) We call them 0.1u and "drop" - they are hard to get precise, but they can be helpful when guiding a kitty off of the insulin.

Siobhan and Aslan said:
what kind of number would you not give anything for
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It depends on how he's responding to the insulin. You're really looking more at the nadir (the lowest point in the cycle) more than the pre-shot. You don't want the nadir to drop below 68 on an AT2, or 50 on a human meter.

Siobhan and Aslan said:
what would you give an increase for?
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Pretty much the same answer as the previous one - it depends on how low he's getting. Ideally, given your current numbers, you would want the nadir to be in the dark greens. If they are blue, I'd try a little tiny bit more. But you need to wait a few cycles between the increases (if any are needed). My hunch is though that you'll be in those tiny doses pretty quickly.
 
Okay, I think I'll try and order some of the U100 syringes, do you think that'd make the doses easier to measure?
I'll give him 0.25 in the morning if he's in the blues and monitor him closely through the day. The nadir is generally between +5 and +7 isn't it? Should I try and get a couple of readings during the cycle?
 
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