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She's stayed above 40, which is good. Non-diabetics normal range is from 40-120 or so, so the goal of the night is to keep her safe.

One thing you've learned about insulin tonight is that once you put it back in, you can't take it back out. That's why most of us were shocked by the starting dose. We prefer more conservative initial doses to see how the kitty reacts. Some cats can drop very far on very small doses.

You're doing a great job so far and the fact that you knew 6u was too much and shot 3u is fantastic! Perhaps it would have been better posting here first before shooting, but how we're you to know what amazing people this board has until you experience it for the first time (unfortunately because of tonight's low numbers). So don't beat yourself up for it. Jezzie is doing fine and we're all here to help you keep her that way. One day soon, you'll be paying it forward like the rest if us. ;-)
 
Well ... you can test yourself to see if the stress has raised your glucose.

(ducks)
 
I just read your reply, her first test today 430 was 288. Then, she ate, but not dry, the fancy feast appetizer. At 730 I tested her she came up 73 at which point I decided to only give her 3 units. Before the last hour she hadn't had dry since mid-afternoon.
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Regardless, if was FF then it wasn't high carb, but there's still no good reason (except for insulin) that her BG would be 200 points lower at 7:30. The BG doesn't drop on it's own unless a cat goes hours and hours with no food at all. Either her pancreas produced insulin on her own, or the dose from this morning was still working well beyond the 12 hour point where it is usually all used up and gone from the system.

A high dose of insulin can work two ways. It can push the numbers really far down in the normal 5-7 hours after a shot (this is how it normally works), or it can push the numbers down well beyond that 5-7 hour time frame. (that happens, but not too often).

Do you think her numbers would be so low if I hadn't given her the 6 this morning?
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Unfortunately, it's impossible to know for sure. If you knew what her BG was before giving that 6u dose this morning, that would help in trying to figure it out, but there's no way to know that for sure. The bright side is that now that you have your meter, you'll know what she reads before a shot, and you can check her anytime you want to see where she's at. And you'll be able to see what any dose does whenever you want to know what it's doing. Now you know why one of the first questions a new member gets asked is "are you home testing?" ;-)

I don't know if you can sue for malpractice but if I could ask your vet three questions, they would be:
1 - how do you determine an appropriate starting dose for a diabetic cat?
2 - how many cats are you currently treating and how many have you treated for diabetes using this specific insulin?
3 - how many of your patients have gone into remission?

Bonus question:
"What is the best diet for a diabetic cat?"

I have a feeling I wouldn't like any of their answers...

She took out a little revenge on my hand, guess she figured if I was going to keep making her bleed she would return the favor.
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LOL, next time that happens, grab the meter and test your own BG.
 
It was the first time I had done a home test and thought I'd get a range a few hours before dinner and evening dose. I actually questioned whether or not to dose her, but not knowing any better reduced by half. You can rest assured I will never do this again! So any BG number below 200 and she doesn't get her shot? Is it skipped all together? Postponed ?

Say her BG is 180 an hour before she's due, do I just not inject? How do I handle that and how do I decide what to do in each situation?

If her pancreas is making her own sugar, so soon after being diagnosed, is it possible it was just a temporary thing or is that wishful thinking?

She's at 59 and holding...
 
Its test, feed, and shoot, within about 10-15 minutes of time.

You can stall 15-20 minutes without feeding and retest to see if the glucose number is rising before you shoot if the number is below your no shot level.
 
Say her BG is 180 an hour before she's due, do I just not inject? How do I handle that and how do I decide what to do in each situation?
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In a case like that, what you can do is stall. Don't give insulin yet, but don't feed her either. You wait an hour or so and see if the BG rises above 200 on its own. If it does, then you can give her food and insulin right afterwards.

If her pancreas is making her own sugar, so soon after being diagnosed, is it possible it was just a temporary thing or is that wishful thinking?
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To be clear, the pancreas is producing insulin, which is used to allow her cell walls in her whole body to absorb the glucose (sugar) out of her blood and into her cells, which is then used as energy to fuel her body. Sometimes with diabetes, it isn't that her pancreas completely stops working. It just doesn't work quite right. It either doesn't produce enough insulin on its own, or for whatever reason, her body can't use it right, and it doesn't get absorbed out of her bloodstream. And yes, diabetes can be a short term deal. My cat only needed insulin for 10 weeks. Some cats heal faster than that. Sometimes just a change to a low carb wet food diet does the trick. Some cats never heal completely, and others can do so after much longer than 10 weeks or 10 months. But it's never an "impossible" like it is for dogs or people.

She's at 59 and holding...
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That's good. This is 5.5 hours after the shot, right? Has she eaten lately or been given more karo?
 
When this first came to light, I asked about diet and told him when jezzi was getting and the part that still amazes me is that he said " I couldn't give her better food then what I'm already feeding her"! He doesn't have a clue, does he?

It's not my glucose I'm worried about! My blood boils thinking about that quack! He shouldn't be treating pets for fleas never mind diabetes! But I guess my own ignorance is partly to blame. I should have done my homework.
 
Here is the U40 to U100 syringe conversion chart:

http://www.felinediabetes.com/insulin-c ... rinter.htm

If you are using a U100, then you were giving 2.4 units of PZI. If you dosed 3u on a U100, you actually gave 1.2u of PZI.

What was the original BG number that provoked the vet to go with such a high dose? I once gave my cat a 2u shot of PZI (5u on U100) for a 700 BG and it carried over almost 17hrs. So you have probably been getting some overlap. The nice thing about higher shots is they sometimes drag out and take longer to get the job done. The 1.2 is much smaller and will work faster, so you saw some quicker results.

After tonight your cat might be more sensitive to insulin, so depending on your BG, I would wait at least 12 to 24 hrs before giving a shot, and test to see what's happening, especially to see how food is affecting her BG. You can probably expect a big bounce number, but don't let that worry you into giving a higher shot, it's just smoke and mirrors, and needs time to clear away before you see her actual BG. You might want to cut the shot down considerably, or see your new vet first before dosing.
 
We ssume a level of basic knowledge from professionals and the willingness to continue education and brush up.And we are sometimes mistaken in our trust.
 
She's been nibbling on dry food and chicken, she's in there now munching on crunchies, I can hear her and I'm 2 rooms away. I had to take a break from the floor, besides she's been giving me weird looks for a few hours now.

I can see she's thinking "what on earth are you doing and why do you keep sticking that sharp thing in my ear".

At least I'm armed with what to ask a new vet, and more importantly, what answers to look for. This would make a great ad for Angie's List! Matter of fact, that's on my To Do list for tomorrow...

Hey, thanks for explaining things to where I could understand it all. It helps. You have the patients of a Saint!
 
please clarify:
Are you using ProZinc (a U-40 insulin) or PZI (usually a U-100 insulin).
Are doses given as actual units or as converted markings on a U-100 syringe?
 
I also have a couple of questions on the U40 or U100 issue.


Are you using Prozinc, or is it compounded bovine PZI?

If compounded PZI, does the vial say U40, or U100 on it?

What color are the caps on your syringes?
 
Oh you can bet I'll be seeing a new vet before noon. I'm not playing this game. Vets here are actually very good, obviously with a few exceptions. There's a lady vet in the next town that caters to cats. My other cat was seeing here for a blocked UT. He passed right before X-mas 2011 at the age of 16.

You have me confused about marking vs units vs u100-u40.

I was told, by the vet, that the "6" mark on the syring was 6 units. Is that not correct?
 
The caps are orange.
The insulin bottle is brown and says Protamine Zinc Insulin.
I was told to go to Walgreens and get u100 and to fill to the 6 mark for a total of 6 units twice daily.

The bottle says 100units
 
Whew, okay it's all good.

U40 and U100 insulins are two different concentrations of insulin.

The U number on the insulin and on the syringes is supposed to match. Yours do, so it's all good. That means you really have been giving 6 units twice a day. THAT isn't good, as you now have found out. But at least the two products are made to work with each other.
 
U-100 has 100 units of insulin per 1 mL
U-40 has 40 units of insulin per mL.
They use U-matching syringes, unless you do the math to use U-100 syringes to measure U-40 insulin - its 40% of what the U-100 syringe marking.
 
So, if I am to understand this correctly, I am NOT giving her 6 units but 2.5? And since I thought I dropped it to 3, I actually only gave her 1.3? And if that's the case, I wonder why he told me it was 6 UNITS.

Also, if it was just 1.3 u, then why did her number drop so drastically?
 
Sorry about that, I saw Sue's post that it was ProZinc, that's what made me ask about the U100. It's as Carl said, you are giving 6 units.
 
So, if I am to understand this correctly, I am NOT giving her 6 units but 2.5? And since I thought I dropped it to 3, I actually only gave her 1.3? And if that's the case, I wonder why he told me it was 6 UNITS.
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No, sorry for all of the confusion. You are not giving 2.5u. You are giving 6 units. If your bottle said U40, but you used U100 needles, THEN it would convert to only 2.5u.

But since the bottle says "U100" and the syringes with the orange caps are also U100, then you are really shooting 6 units of insulin. Forget about all the conversion confusion. Your vet gave you the right needle prescription for the insulin that he gave you.

It is very odd to see a vet give U100 concentration PZI insulin though. Not something we seen often.
 
I'm so confused, lol.


Seriously I understand, she has been getting 6 units, right? I can understand how someone could be really confused by all this. I mean I've just been going by what Dr,Quack told me. The only true knowledge has come from people like yourself, who's cared enough to completely explain it all. But you had me worried there for a minute. I was starting to wonder if I messed up.

Took another test and she's at 79, good to hear
 
It's not common? Is it stronger than others? Is it old school? Is there something better that I should look at with the new vet?

I just want to go in tomorrow to the new vet and at least act like I know what I'm talking about.
 
Leah,
Just to try to lessen the confusion.

There is "PROZINC" insulin. It is made from human insulin, and it is genetically altered to be more like "cat insulin". It is called a recombant human insulin.

Then there is "PZI". It is derived from cow pancreatic cells. It is then turned into a powder, mixed with other junk, and is sold as "Compounded PZI". The reason they use cows is because their insulin closely matches that of a cat.

Today, PROZINC is more common, and what is usually prescribed by vets.

Compouned PZI is less common, but it used to be the only Protamine Zinc Insulin available before PROZINC was invented about 5 years ago.

Here on FDMB, the forum for PZI users was titled "PZI", and that's where users of PZI ended up posting, because everyone used the same stuff.
When PROZINC became popular, because it works the same way as PZI for the most part, users of PROZINC just posted in PZI, and everyone understood that while they weren't exactly the same, they worked the same, and everyone is good with that.

Over the years, as more people use PROZINC and fewer use PZI, it became standard for everyone here to refer to PROZINC and PZI like they were the same thing.

I used Compouned PZI with Bob (although mine was U40 concentration and not U100). Compounded PZI can come in U40, U50 or U100 strength. So because I used PZI, I have always considered it "different" than PROZINC, which is why I always try to find out if it's PROZINC or compounded PZI, just because to me they are two different things.


Now that we all know exactly what you are using, and that you are also using the proper syringes for that specific strenth PZI, there shouldn't be any more confusion. ;-)
 
It's not common? Is it stronger than others? Is it old school? Is there something better that I should look at with the new vet?

I just want to go in tomorrow to the new vet and at least act like I know what I'm talking about.
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No, it's not common. It isn't "stronger" really. It has a higher concentration, but as far as total dose... the way the needles are marked between the two concentrations is just different. But six units of U100 is the same as six units of U40 as long as the correct needles are being used.

You could ask your vet about PROZINC and tell him you are currently using U100 compounded bovine PZI. He'll probably suggest switching to PROZINC, and he will precribe the proper U40 syringes too if he wants you to switch.
 
Thank goodness, I was getting really confused thinking I had done something really wrong, again, thank you for clarifying it all.

No worries, no need to be sorry for anything. I'm just glad I've got people like yourself that can confuse me at 2am! lolol!

Kidding, she has decided its time to play with her box. I save big boxes for her and I guess she thinks she can dig through them, she's making a racket though, going to wake up my husband.
 
Oh, forgot to say...

the 79 is nice to see!

You are now beyond what should be the danger zone. By now, the effect of the insulin should be tapering off. That would be a "typical" cycle over the 12 hours.

It usually kicks in 2-3 hours after the shot, reaches it's peak 5-7 hours after the shot, and wears off by the 12 hour mark.

I think if you test in another 30-60 minutes, and she has come up a little bit more, then you should be able to leave out some food for her and catch some zzzzzs.

Nice that she seems oblivious about all of this and just wants to play in a box. Bob is a big box lover too!
 
That's really nice to see!

Now, don't be surprised if you test her in the morning and you see a higher number. A lot of the time, when a cat drops that low, their bodies will instinctively react - in "self preservation" mode, and what ends up happening is that their liver releases "sugar" into their blood to save itself from going hypoglycemic. That is what we call "bouncing". The numbers bounce way up. It's common, and it eventually "goes away". Many people see the high number and think "she needs more insulin", but that's not the case.

If you see a number over 200 in the morning, before breakfast, you can shoot 1 unit, but not more than that, no matter how high the number happens to be.

Then call the new vet and see how soon they can see you.
 
Carl, Mary, and BJ, thank you for being there in my hours of need. I won't forget this.

I'll stay up another hour or so, test her again, and God willing be able to get some sleep before I test her PRE-breakfast (6am).

I can't thank you all enough for the help, Jezzi thanks you too and if you were here I'm sure she'd bite you too!

Get some rest, I'll post updates tomorrow.

Thanks so much,
Leah & Jezzi
 
Leah (and Jezzi),

You are both very welcome. It was nice to "meet" you both!

There's a bright side to this, Leah. It was a "trial by fire" but having seen this so early in this "dance", you now know what to do if you see a low number like this again. And you can always post here for help, with any questions, or just when you need to vent.

And not sure if you have any children, but you do have a "fur kid", so I'd like to close by wishing you a Happy Mother's Day!

Carl (and Bob)
 
Thank you Carl, Jezzi is my kid, and acts every bit of a 2 year old most of the time.

I'll be around...a lot. A have a lot to pay forward! So glad to have found such a welcoming new family!
 
And BTW, I wouldn't have minded reading about all this instead of jumping right into the fire. My only help is that I hope other new people read this in its entirety and doesn't make the same mistake.

Heck, after tonight I feel like a pro! lol
 
Yay for the nice rise! I've got another hour I'll be up myself with my kitty (+5/88).

And I bet testing her has become much easier, too. :lol: ;-)
 
This blew my mind. I am so happy your kitty is ok. I went to bed worried about your baby. When I woke up, I checked and saw all of the exchange and I am so happy to see that they are out of danger. What an amazing group you all are. I am so happy that I googled and found you. Peace of mind with a diabetic kitty can't be underestimated!

Again, so happy your kitty is well!
 
Great news all, tested her BG this morning and its 255! 1 units given, then breakfast.

Climbing back in bed to catch a few more zzzz.

2 hors from now I'll contact a vet vet,
 
How lovely to read all the way through this thread and see that you did fine and Jezzi is doing well. Definitely a trial by fire. You can pay the help forward by posting your experience on other newbie threads - that your vet said to give 6 units and your cat hypoed the first day. So often the initial dose is too high. One of the many reasons we like to start low and go slow.

I would get a test at +3 or so and again at nadir (+6) to see how she is reacting to the insulin this morning. Her dose should have been okay but all bets are off after a hypo and we want to be cautious.
 
Good job Leah! Y' made it through the night :smile: (sounds like a song title, doesn't it?)
 
We have a few primers (see below) but the issue is that newbies dont know their way around the board to find them and tend to panic and post first before having found these. There is a ton of info we have to pass on and if we give too much at once they tend to get overwhelmed.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=46003
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

Maybe we need to greet each newbie with New to the board? When you have time and are feeling a bit less panicked... but as soon as you can, please carefully read through all this https://docs.google.com/document/d/1Rd6sMfsrNB41yQVEqpyjlHrJsDIbGEhbRIWR4QAwu3c/pub
 
My appologizes Wendy, I should have read the post you have listed, but when your new to feline diabetes things get overwhelming fast. There is a lot of information all over this website, and know matter how much you read, it's never enough.

When a situation like last night occures, you don't always have the time to read through scores of web pages to find the correct information pertaining to your current emergency. Which is why I posted under the forum Main Forum.

I feel bad keeping other members up so late helping me through my hour of need, but I would do it again if I felt doing so would save my Jezzi's life. I've been a member here for less than a week, I've been reading through posts before that maybe a little over a week. Could I have handled this differently, absolutely, but I didn't know any better (I do now).

I appologize for posting in the wrong forum, or for not reading the correct material to be able to handle this on my own. But as I stated, being new I didn't have the time last night between answering replies to my post and doing BG tests every 15-20 minutes. When I'm in panic mode, I didnt have my wits about me to search through pages of posts to read the right one to get me through last night.

The people here are absolutely increditable! You are a bunch of the most caring and generous people I've met. And I'm glad to say I am a part of it.

As soon as I get Jezzi in to a vet, I will make the time to read through the links you have provided so that an issue like last night doesn't happen again.

To everyone that sat up with me last night, please know you will forever hold a place in my heart for helping to keep my Jezzi alive. To me, that is the single most precious gift someone can offer.

I look forward to becoming a valuable member of this forum and maybe one of these days, I can help someone through a similar situation by sharing my story.

Thank you again.
 
Leah,
Sorry but I have to chuckle a little...You havent done anything different than A BUNCH of us have done.
You posted just fine. Wendy is one of the BEST here. You had the best of the best helping you last night. There are a HOST of others following along silently.

We are family...WELCOME

jeanne
 
You handled this situation last night exactly as we want members to. You yelled for help with that 911 icon.

I feel bad keeping other members up so late helping me through my hour of need, but I would do it again if I felt doing so would save my Jezzi's life.
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We will always sit up with you during a hypo situation. Always. If a person can't commit to that, they will go find someone who can. That is just the way we do things around here. You did not keep anyone up that was not willing to stay up. No apologies needed. If you need our help again, you can yell for help with that 911 icon. That is what it is for. Health emergencies.

I appologize for posting in the wrong forum, or for not reading the correct material to be able to handle this on my own.
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You didn't post in the wrong forum. And no way did you even know some of this reading material was even available. Think of the links that Wendy gave you as information for the future. The next lessons in this crash course, advanced graduate level,in dealing with feline diabetes.

There is no way for you to learn all this info in a couple of weeks. Some people are eager for more info right off the bat and others want little bits. We try not to overwhelm people with information because if they get overwhelmed, scared and leave, that doesn't help them or their cat.

By the way. You did a fantastic job last night. Three cheers hip-hip hooray! hip-hip hooray! hip-hip hooray!

:RAHCAT :RAHCAT :RAHCAT​

We are family...WELCOME

jeanne
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Yes, as Jeanne, Troubles mom said, you are part of the family as soon as you join and start posting. We'll try to be helpful and not drive you crazy or be too annoying like my Uncle Ed is with me. We are good family members to have around! ;-)
 
You would be surprised......

if you knew how many were watching out for you but were not posting :-D When a post like yours shows up we all click on it, then we see who has responded already, then we keep reading but do not post because there truly is nothing to add to advice already given. Then we make sure the responders are staying up with you or going to bed and if they are going to bed, then usually all involved or just reading will make sure someone else will take over. There are many of us that literally have stayed up all night, especially if we on the East coast are helping someone on the West coast that is 3 hrs. behind us.

You did fantastic last night and Jezzi is fine but so very hard to learn via trial by fire. Welcome to FDMB. No one is ever without at least one person to help them.
 
Ok, so it's been a long time since I've gotten this emotional over a situation. Call it gratitude, or pure appreciation, or lack of sleep from a stressful emergency, heck, I don't care if you call it menopause! But being welcomed into a community such as FDMB with such caring individuals in of itself is overwhelming.

If I could hug each and every one of you, I would ten fold!

So, I finall have an appointment for Jezzi at 11:30 tomorrow. After explaining the whole situation, in its entirety, to every vets office in a 30 mile radius. It's amazing how some vets treat diabetes. The one I chose, believes in a low carb diet (depending on cats individual tastes), home testing is good for ballpark numbers, and NEVER should she have been given any insulin last night with a reading of 73. I believe they like ProZinc.

So there we have it. I have 24 hours of "use my judgement" before seeing new vet. I'm going to test her at 1pm, her last BG was 327 at 9:41 am. That's about 2 1/2 hours after a 1unit shot. I'm going to get her some FF cans and give that a whirl. Maybe mix some of the FF appetizer in with the FF canded to ween her off slowly. Dry food is gone.

I'm beginning to sound like a broken record here, but you ALL are an amazing group of people. Thank you for such a warm welcome, you're stuck with me now!
 
Where in Florida are you located? We have several members in Florida and some may be nearby who can suggest a good vet for you to try.

You don't need help testing! ;-) As you now appear to be a pro at it.

You are not the first person who has come here with an emergency hypo and sadly you won't be the last. And one day, you too will read someone's cry for help and be there to help them out. It's what we all do, help in our own way. It's what this board is about.

The reason your cat kept looking at you like you were crazy, is really simple, being in normal BG range, she actually felt good and couldn't understand why you panicked.

Congrats on finding our group and congrats on successfully handling this emergency.

When you have time to rest and regroup, re-read this thread, so you can pick up on the links and other suggestions that were offered last night that you may have missed.

Also, when you go to the store, pick up a few cans of Fancy Feast Gravy Lovers - in whatever flavor she likes and put them in a safe place, just in case you ever need to use it again. You can use it instead of dry food and along with karo (or ice cream). It's a great high carb cat food option just for this purpose.
 
I'm getting to be good at this ear prick thing. She hardly even looked at me,(that or she's just so pissed off she doesn't want to look at me!) lol.

BG 274 ! And that's with 1 UNIT

I'm so happy!
 
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