New here and terrified

Lisa and little

Lisa and little

Very Active Member
12 days since my “little” was diagnosed. She has been on 1 unit of Prozinc 2x daily. I stayed resting last night and so far have run 4 tests in 15 hrs. Not fun for either of us and I’m oretty sure she hates my guts now. Results were 379 before food and insulin. 1 hour after food and insulin 319. This am before food and insulin she was at 433! 2 and a half hours after food and insulin 385. The vet recommends doubling the dose to 2 units am and pm. Sounds scary to me and worried about hypoglycemic reaction but my science brain says if 1 unit lowers her less than 100 pts than 2 shouldn’t take her too low but I’m not sure it works that way. I’m scared. Any advice? Also I am i jetting insulin while she eats so she does not have the opportunity to run and hide. Vet said that’s ok but I’ve read that perhaps should be a certain amount of time before injection after food. Any advice thoughts or comments would be so appreciated.
 
Hello and welcome!
For Prozinc, nadir (the lowest point in the curve) usually occurs between 4 and 8 hours. If you can, try to get several readings in that time to figure out how low she's actually going before increasing dose. Also, we recommend increasing by only 0.25u at a time, not full units. You are far more likely to overshoot the "perfect" dose if you increase in full units at a time. Prozinc has about 2 hours after dosing before it kicks in, so as long as she is interested in food and not outright rejecting it, she doesn't have to finish eating before dosing. With some of the other faster acting insulins, it is more important to have food on board, but its just fine with Prozinc to do it while she's eating.
 
Thank you all for your responses I am truly grateful. so I did up her dose to 1.5 and not 2 as dr recommended. I plan on testing for the low point today (Nadir?.. what does that stand for) had a rough time getting the blood to form a drop for testing last night so I unfortunately had to stop trying as she and I were stressed to the max. I set my alarm every few hours and overall she seemed to be less lethargic with the dose increase. I’ve heard people say use vaseline or neosporin to make the blood form a drop. How does that help if the drop is full of other stuff? Does this not effect the test? I’m confused.
 
Hi Lisa, and welcome!

“Nadir” means the lowest point in a curve. Since the impact of ProZinc usually lasts 10-12+ hours — as it takes effect, it lowers the BG number, and as it wears off, the number begins to come back up — a cat’s nadir will usually be between +5 hours and +7 hours after the injection. When we do a “curve” to see how the insulin is effecting the kitty over the course of the 12 hour shot cycle, we typically test every two hours. Since you’re starting out and testing is still tricky, you might try testing at +4 hours after the shot, then two hours later (+6 after the shot), then two hours later at +8.

We have personally not had good luck with using neosporin to get the blood to bead up, but last week, we started using a rice sock, and OMG what a difference...and Josie had always been a “good bleeder” we had thought! Using a rice sock to heat the ear makes a massive difference, and I highly highly recommend it.

Here’s what we do: we bought a pair of infant socks and put regular uncooked rice in them so that the sock of rice was maybe a little smaller than a golf ball. We did that with two of them. We put them in the microwave for 30 seconds (20 seconds if just heating one rice sock). When the rice sock is warmed up and she’s in her testing place, we put one of the warm rice socks against her ear on the inside and hold it there, gently rubbing the edge of her ear against the warm sock so that it heats up the ear. Meanwhile, we rub the other warm sock all around her face, jaw line, orbital bones, etc, just as a distraction, and she LOVES that. Who doesn’t want a warm facial massage? :)

We do that for about 20 seconds. We then do the test, and the blood has beaded right up with one tiny lancet prick every single time. We also use the rice sock during testing itself: we place a flat cotton round between the ear and the rice sock. It really helps to keep the ear steady and firm so that we can get a nice stick without the ear moving away from the lancet just due to the pressure of the lancet.

So I hope something like that will help, and in the meantime, please know that the ear *will* bleed more easily with every stick since the repeated sticks will cause kitty’s ear to form more capillaries.
 
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Lisa and little said:
my science brain says if 1 unit lowers her less than 100 pts than 2 shouldn’t take her too low but I’m not sure it works that way. I’m scared. Any advice?
Click to expand...
You're right - it often doesn't work that way. It's not a linear relationship (I'm a science geek too!). Because insulin is a hormone involved in a variety of complex processes a kitty's response can vary day to day and dose to dose. Some kitties are more variable than others.

This is a guide I put together for new people. There's a lot of info in it so read it over as often as you need to and ask a lot of questions:
__________________________________________________________________________________________________________________

It would help us if you set up your signature (light grey text under a post). Here's how: You've done your signature. s preadsheet would help us a lot.
  • click on your name in the upper right corner of this page
  • click on "signature" in the men that drops down
  • type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.
Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and look at it before offering advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

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Here's the basic testing routine we recommend:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
This is useful: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/ There's a ton of good tips here.

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Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high: This confounds new people a lot!
  1. BG goes low OR lower than usual OR drops too quickly.
  2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
  3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
  4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
  5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
  6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
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Here are some tips on how to do urine ketone testing (VERY important if BG is high and kitty isn't eating well!): This is worth learning to do for sure!
  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.
 
To speak to the vaseline/Neosporin question, it CAN help the blood bead up. It doesn't always for people, but it's worth a try, especially at first. I used neosporin with pain relief (the gel NOT the cream). I spread a bit on Gypsy's ear and poked. I felt like the neosporin made me think I was helping her a bit anyway and it seemed to work for the blood to bead up on top of. Since the blood doesn't really mix with the neosporin, it's fine to use.
 
Jenna Josie said:
Meanwhile, we rub the other warm sock all around her face, jaw line, orbital bones, etc, just as a distraction, and she LOVES that. Who doesn’t want a warm facial massage? :)
Click to expand...

Lol...oh my goodness what a spoiled kitty! :cat::cat::cat: I made my rice "socks" out of felt - I cut it into heart shapes, sewed them together, and then filled with rice and finished the sewing. I was just thinking it was time to make new ones and I might copy your idea. Sam would be in heaven!
 
Ok so her +5 on the new dose of 1 1/2 was 191. I am hoping that means we are heading in the right direction. I may try again at + 7 but i was a bit over aggressive on this past test and she bled a lot so I may give her a reprive. Thank for the advice on the rice socks I’ll give that a try.
 
Would you be able to set up a spreadsheet so we can look at the data? The patterns that the colors make in our spreadsheets really help us figure out dosing. Here is the link to the directions on how to get started: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/ The spreadsheet is already made for you. You just have to follow the directions to get it connected. If you need any help, just ask and we have folks who can help.

It sounds like you might have hit the vein when you poked? That happens sometimes and it make a lot of blood. When it happens, just take your cotton square or whatever you're using and pinch the spot for a few seconds until the bleeding stops. That also really helps to avoid bruising! I do it after each test so my guys ears don't start looking like he's been in a fight ;) You can also try poking a little closer to the edge to avoid the vein so that doesn't happen again.

You can also rotate where you're testing - so I test on the front edge, then the back edge, of both the right and left ears so he usually only gets poked once/day in each area so I'm not poking places that are sore from a previous test.
 
Ok so we are still struggling so I gave her a break from testing at vets recommendation. Today she seemed the best she been in days behavior wise. I tested her and +11 was 535! How can her symptoms say one Thing yet the reading dictate something different ?
 
So today’s +6 is 372. I guess I should have listened to my vet Friday night when she told me to go straight up to 2 units which scared me beacaue it was double dosing. Any thoughts? Last nights reading was 535 1 hr before next dose was due. She seems to have pretty bad neuropathy in her hind legs today although yesterday seemed better. This is so confusing. It seems what I am doing is not working. Any thoughts? Sorry I have not been able to do the spreadsheet yet but I will get to it. Now I’m going to go medicate myself as this is so stressful
 
Once you get the spreadsheet going, we'll be able to take a look and help sort out what's going on. It's really hard to make sense of numbers in a paragraph. Big hugs to you, Lisa. This is pretty stressful at first, but I promise it gets easier, and you're not alone. We are all here to help.
 
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