New diabetic numbers low late in day

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Puddensmom

Puddensmom

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My cat Pudden was diagnosed on the 5th of November with diabetes. Her glucose number was over 500. I was instructed to give one unit of PZI once in the morning with food. I have an appt. with the vet tomorrow to check how she is doing and what dosing changes should be made. I have been testing with a relion prime meter. Her numbers seem to be all over the place and on a few days she gets low very late in the day. I understand PZI should actually be taken every 12 hours, but I don't see how that is possible with Pudden. Would someone be willing to take a look and see what you think? Thanks so much!
 
Glad you came over to the forum. Everyone here uses or used your insulin and can help.

I would say the dose is too high - any time you get a long cycle like that, especially with a nice low green at the end. The reason not to shoot once daily is that, although she does get into nice numbers at the end of the first 12 hours, the second twelve hours means without a steady rise to a high number. It feels like a roller coaster. From a high to a low to a high again. Instead you want a smile curve every 12 hours - from a mid range preshot to a nice nadir number 5-7 hours after the shot and then slowly back up to the same range as the morning shot.

I'd like to see the vet reduce the dose (maybe to 0.5) to see if you could get two shootable preshots a day.

As I remember she is getting a steroid and that could likely be part of the reason for her having diabetic numbers?
 
She is on Prednisilone 2.5 a day for now. I am going to lower it to every other day on Wednesday. If all goes well she will be off completely on the 27th. I am hoping once off she will go into remission. I was thinking the dose may be to high. I don't know what my vet will say, but my trust in vets isn't the best. Their suggestions can be very inaccurate at times. I will run by you guys what she says before I do anything.
 
Welcome to the Prozinc forum - so glad that you moved over here.

I know that I replied on your thread a few days ago but just in case you lost it, here is what the Prozinc company says regarding dosage. I would mention this to your vet. Seems that we have had a few folks here lately being told this by their vets to dose 1 x per day, because they think that the kitty is retaining the insulin that only lasts 12 hours (maybe 14 at the very most). Good luck with your vet visit tomorrow.

Here is information from the Prozinc company that you can give to your vet and it states:

The initial recommended ProZinc dose is 0.1 – 0.3 IU insulin/pound of
body weight (0.2 – 0.7 IU/kg) every 12 hours. The dose should be given
concurrently with or right after a meal.

Here is the link to this document. If you go 2/3 down the page, there is a link to a downloadable PDF file. Once you download this document, this statement can be found under "Dosage and Administration." https://www.prozinc.us/prozinc.html
 
I took Pudden to the Vet today. An assistant checked her blood and then came back out telling me the vet said to up the dose to 1 unit every 12 hours. I didn't even get to speak to the vet due to an emergency that was going on in the back. I told the assistant about Pudden's numbers going under 200 late in the day and she told me to call in tomorrow if it keeps happening. No follow up was scheduled which I find odd to say the least.

So it looks like I am on my own. With the way Pudden's numbers are at their lowest very late I know I can't give 1 unit twice daily. Should I give the .5 unit tomorrow morning and just watch without giving the second dose to see when her lowest is? I have the needles that don't have the half units so I am going to have to do it by eye. I was wondering do you need a script to buy needles? I don't know if the vet will give them to me since I am not doing what I was told.
 
You are not on your own - we will help you sort out the dose!! I think it varies by state if you need a script or not to buy needles - I did a google search and it gives you the list of states and what they require. I order mine from ADW - its a diabetes supply website - doesn't make any sense to me that you can buy syringes without a prescription but you need one to order AlphaTrak test strips - go figure. Sorry I can't give dosing advice (still need it daily myself) We'll see what the experts say, but low numbers late in at the cycle (at the pre shots) can indicate the dose is too high - I have that frequently and always think of reducing the dose when I see that
 
Sorry, your experience at the vet was bad. It's always better to be listened to...

Let 's see where he is tonight. I suppose it's possible that he'd near 200 and you could stall and shoot. But if not, yes, I'd skip tonight and start 0.5 tomorrow am. While you are waiting to get other needles, can you try to mark halfway between one and zero with tape and use that as your guide syringe. The other thing you could try is to pull up one unit of colored water and let out drops until it is gone. Then next time, pull up one unit and let out half that many drops

Wonder if humans need prescription for needles in your state. If not, you could get U100 needles (which humans use) that measure 0.5. Then we ha e a conversion chart so you can give U40 insulin with U100 needles. U40 needles are usually sold by the vet because U40 insulin is animal insulin
 
Thanks for the help everyone! Unfortunately I need a script because I live in NY :banghead:. I made a template on some paper that I can hold up to the needle to get the .5 dose.

I will let you guys know what her numbers are at +12. I will be interested to see how she does on the lower dose tomorrow.

One thing I have noticed is that she is really active in the morning but becomes very lethargic after her insulin. Her numbers are not low, but she seems to not feel the best after the shot. Is this common?
 
I agree that it looks like your dose is too high. When will +12 be for you tonight (and what time zone are you in?).

I'm not sure about the lethargy....usually I think that happens when they are not feeling well. Is it immediately after the shot that she acts like that?
 
I am in the eastern time zone. +12 will be at 8:30. She eats, gets the shot and then goes straight into the dining room under the table and only gets up to eat and use the bathroom. She starts getting active again about 11 at night. She has a uti at the moment, but she really seems to go down after the shot. Could this be because the dose is too high and the numbers go down to fast? I hope she feels better when I lower it.
 
Hmmmm...it's possible. She could just be feeling ick because her numbers are high in the morning and then head pretty low during the day. That could make anyone feel a little under the weather.

I think that as you get her more regulated, she will feel better.
 
I just checked her levels and she was 523! I checked again thinking it was a false reading and it still came out high at 491. How can she be at 86 the same time yesterday and be at 491 today? Could this be because of stress from going to the vet?
 
It could be vet stress. It's surprising to see a number that high...but it happens.

I still think I'd go ahead and give .5. Since we don't know for sure what caused this number, but we DO know for sure that you haven't been able to give evening shots due to low numbers...I might assume tonight's number was an anomaly and just go with the .5 to see what happens. :) What are you thinking?
 
I was thinking of waiting until tomorrow just because of the stress from the vet, but I wasn't sure. Would one night with high levels be dangerous?
 
I don't know if it would be dangerous per se. In the end, it's just one cycle. Are you thinking that he is likely to drop on his own and that's why you don't want to give a shot tonight or is there another reason?
 
I was thinking she might lower once she calms down. She really hates the vet. I think I am nervous because it is late and I won't be up to check her at +5. I might change her morning shot to 6:30 am while I have the chance so when I give the second shot I know I will be awake.
 
If you feel nervous about it you can start the lower dose tomorrow. She might have higher numbers due to no shot tonight. But especially since it's late and you want to move her shot earlier...in the end you hold the syringe. You have to do what you think is right.
 
If you skip, it's a great opportunity to change your "normal" shot schedule in the morning.
 
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