New Insulin Level - Please advise

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Lkldcatlady

Lkldcatlady

Member Since 2013
Hi again - thought I should start a new topic, but if that's not the way I should do things, please let me know. In my previous post, I did decide to follow my vet's advice. I do trust them and think they have a good record treating diabetic cats, especially after some of the scary things I've read on this message board. They advised me, after two weeks of jumping around with the units I was giving (anywhere from 1-5 based on pre-shot numbers), he decided to give 4 units twice a day for several days (unless he is at 200 or below pre-shot) and we will re-evaluate this week. I was a little nervous so I ran home at the 5 hour mark and tested his blood - it was 324 this am and then 201 5 hours later, which makes me happy because he managed to get into the 600's the last couple of days. I did a curve and he was just staying relatively high throughout the day even with the insulin. Just want to make sure things sound ok - the emergency kitty from Florida scared me.... :shock:
 
New topic is just fine.

Previous topic here: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=95166&p=1020385#p1020385

Those test numbers are safe numbers. Keep updating your spreadsheet (SS) and we will continue to read it.

Numbers under 50 are a hypo situation
50-120 are normal non-diabetic cat BG numbers
200 is the usual starting out shoot/no shoot insulin number
250 or 280 (vets differ on what this number is) is the renal threshold where excess glucose is spilling out into the urine. Ketone testing the urine daily at these higher numbers is a good idea. You can get test strips at the pharmacy.

You are using Prozinc. A jump in dose from 2 to 4 units is a big jump. Please post your number tonight before you shoot. What time zone are you in? What are your normal shot times? Maybe add the shot times to the spreadsheet, comments column?

I'd like to get some users more experienced with Prozinc to take a look. Hang on.

p.s. Would you please add some more information to your user control panel, profile tab, edit signature. Information like your name, cat name, meter used, insulin used, any complicating health issues your cat has, what food you are feeding. This goes in the free form text box, just before the spreadsheet (SS) link. Click on submit key to save the data.

If you would also update the location in the user control panel, that would be helpful. User control panel, edit profile, location field, type in location, click on submit key to save.
Thanks.
 
Thanks Deb - I updated my signature. We started out at 1 and 2 units each day, but then jumped around because even while Bob was getting 3 units regularly for a couple of days, he was going up in the 500's and he wasn't going really low at the 5-7 hour. I don't think my vet is used to people monitoring their cats at home but they are very supportive of it. After giving the 2 units, the lowest Bob went yesterday was 301 so when I called the vet and we went over the history, he said let's try 4 and 4 and then see how he does in a couple of days. Then we can lower (hopefully!) if we need to. I'm going to fill out the rest of my spreadsheet with my other data in a few minutes. I've been monitoring since 4/27.
 
Thanks so much for putting that information in your signature link. Once you do a new post, it gets harder to find the older posts and sort through them to find this info.

Would you add your state to the user control panel, profile, edit profile, location field and submit to save? I remember you are in Lakeland FL but not sure everyone would know this.

I've got a post going over in the PZI Insulin Support Group (ISG). Quite until this evening.

Please let us know what time tonight you are testing and shooting. Would you be sure not to shoot if the number is under 200? Do not feed, post the number here and retest in 20-30 minutes.

Prozinc is an in and out insulin, but I'm not sure what sort of duration you are getting. Would you be able to get a +10 number today?
 
I just updated my spreadhsheet with all the numbers since 5/1/2013. I thought I did update the profile information for my location, but I'll check and make sure everything is complete.

I ususally give him his shots at 7:00am and 7:00pm, give or take 10-15 minutes.

Let me see if I have this straight - I can test at 5:30 (which is actually 10.5 hours, but it's the best I can do!), then retest at 6:00, post those numbers here and then I should be ok to feed him? He's always very anxious to eat when I get home....

I would like to learn more about prozinc if you have any good references....my vet said they've always had really good results for it so that's really all I know.
 
Here is everything you'd want to know about ProZinc and more:

http://felinediabetes.com/FDMB/viewtopic.php?f=24&t=32799

I would rather see insulin increased .5 units at a time. There is less of a risk of hypo with a small increase. If you increase slowly, you can monitor and if after 3 cycles or so, increase again. That way you don't go over an ideal dose and you don't worry about giving too much. The other issue here is the food. If you are phasing out the dry, then his numbers come can steadily come down. If you add a dose increase in that mix, it may be a problem.

I appreciate that you want to work and like your vet. I like my vet but we didn't agree on food and she started me out on too much insulin. We agreed to disagree. When I got him into remission within 6 months with the protocol here, she was interested to hear about it and has incorporated it into her practice. My theory is that few vets are diabetic experts. They don't see all that many diabetic cats (we saw 8 new ones yesterday.....) and they have to know a little about a lot of things and a lot of species.

Again, it's up to you. You can always say you want to go slow with the increases as you change the food. It's your cat and they should respect going slow.
 
I don't plan on changing his food until he is a little regulated - right now he is 50% ur and 50% dm. I'm also trying to get him used to the fancy feast, but that's more like a treat. Im just too scared to change anything until he is a little more stable. I do have a phone consultation with a vet who only treats cats and seems to be pretty up-to-date on the treatments for diabetes (i.e. she advises only canned food). Unfortunately this vet is an hour away from me. I am going to send her everything I have from my vet on Bob and I have a list of questions. I'm just kind of torn - I gave him the 2 units yesterday that was advised, but I freaked out when he went over 600. Since he's already started receiving higher doses, I don't know how to go back to the smaller dose without making his numbers go way up. Also, my vet only uses the U40 needles. I asked today about the 1/2 unit needles and that's something they don't use. After talking with this new vet tomorrow or Wednesday, maybe I'll be a little more clear. I believe 100% that the people on this board probably know more than most vets about this issue. It's just really, really hard not to be able to trust my vet! But I so appreciate everyone's help - please be patient with me.

So Bob's number at 5:30 was 481 (10.5 hours after his 4 units). I'll check him again at 6:00 and post his number asDeb suggested earlier.
 
So, again Bob's number at 10.5 hours after his shot was 481. I just tested again 30 minutes later and it was 495. Deb - does that mean something to you compared to his numbers from earlier? (324 this am and 201 5 hours later).
 
I am going to guess (and it is just a guess) that he will stay in the 300-400 range as long as he is eating dry. It makes a huge difference in most cats. When we switched Oliver, overnight he came down 100 points. It's a little like having a diabetic eat donuts and continue to take high doses of insulin. But I get that you are worried about changing everything at once. And it's worrying to change the food and keep the insulin in the higher ranges also. The only idea I have is to change both a little at a time. Increase the wet food every day by a percentage and decrease the insulin by a little, depending on your numbers. Test before each shot and get midcycle tests in as often as you can.

But I think keeping the dry food in his diet and increasing the dose is never going to get him to good numbers unless someday the insulin is just too much and he crashes.

This is a good question for the new vet: How should I manage getting him on low carb food and not causing low numbers, when I am already giving a good amount of insulin?

Re your question: I think it means the insulin is working (he went downmore than 50%) but fighting the carbs in the dry food.
 
Hi there

I don't plan on changing his food until he is a little regulated - right now he is 50% ur and 50% dm.
Click to expand...

Thats the problem - he is unlikely going to be regulated properly until he is off the high carb food - although maybe if you keep increasing the insulin dose to a really high number you will achieve that.

Its like eating fatty foods (ie dry food) and taking heart medication to counter it (ie insulin). The heart medication will offset the fatty foods for a while but to solve the problem you really need to cut out the fatty foods. And over time you will have to keep increasing the heart meds just to keep up.

Wendy
 
So, for today, we have this so far: AMPS 324 +5 201 +10.5 481 +11 495

Yes, that number at +10.5 tells me that the insulin is probably done working. All used up. One of the things that makes numbers go back up is the insulin is used up. That tells us that the duration of this insulin is probably less than the +10.5 hours since his morning shot.

There are other factors that can make numbers go up too. Food for instance. The numbers can also go higher when the BG drops lower than a cat is used to. This lower number does not need to be into hypo territory, <50, simply a number that is lower than the system is used to.

The body can compensate for "lower than expected numbers" by adding sugars from the liver and other hormones to raise an unfamiliar low number back into what the cat's body is more used to.

Thank you very much for getting that +10.5 test. When you have some time during the day, it would be helpful to get a few more tests later in the cycle to try and find what the duration is. Maybe tests around +8, +9, +10, somewhere in that time frame. You probably will not be able to do this additional testing until you have some free time in your day.

The data from this today makes me feel a little more comfortable with the increased dose. Not completely comfortable because it was a big jump in dose all at one time, but a little bit more confident Bob is not in danger. He probably never went much below the 200 range of numbers.
 
well, that makes me feel a little better. since we have been jumping around with the insulin, all I want is to see that numbers are pretty consistent all day long when the insulin is the same for a few days. Then at least I know where to start from. I can start decreasing dry food and decreasing the insulin (hopefully!). Deb, I can def get those numbers on Friday or Saturday. Sue - I will definitely ask the vet that - hopefully I can talk to her tomorrow. I really want a "plan of action" and right now my vet is not really giving me that. I think they were not prepared for someone who tests their cat at home - they said they only have two other clients who do it and it's a pretty large/popular vet. so when they have me calling them every day and reporting numbers and asking what to do, everything got kind of crazy and they've been changing the insulin constantly. I just need a place to work from, if that makes sense. WEndy, I promise I'm working on the food issue - the feedback I got from Deb really helps me understand things a little better. And nobody worry - the vet also said to call them if Bob's numbers are below 200 pre-shot. I've also been coming home during lunch to check on him. Def don't ant a hypo situation! Thank you all so much!!! I really appreciate the help.
 
Give them the link to your SS - they can watch it themselves!

Let us know if he is under 200 before shot - it typically happens at night when the vet is closed! The trick is to not shoot and not feed and wait 30 minutes to see what happens naturally. Dont feed 2 hours before you shoot either so that the number you get isnt influenced by food

Wendy
 
Lkldcatlady said:
well, that makes me feel a little better. since we have been jumping around with the insulin, all I want is to see that numbers are pretty consistent all day long when the insulin is the same for a few days. Then at least I know where to start from. I can start decreasing dry food and decreasing the insulin (hopefully!). Deb, I can def get those numbers on Friday or Saturday. Sue - I will definitely ask the vet that - hopefully I can talk to her tomorrow. I really want a "plan of action" and right now my vet is not really giving me that. I think they were not prepared for someone who tests their cat at home - they said they only have two other clients who do it and it's a pretty large/popular vet. so when they have me calling them every day and reporting numbers and asking what to do, everything got kind of crazy and they've been changing the insulin constantly. I just need a place to work from, if that makes sense. WEndy, I promise I'm working on the food issue - the feedback I got from Deb really helps me understand things a little better. And nobody worry - the vet also said to call them if Bob's numbers are below 200 pre-shot. I've also been coming home during lunch to check on him. Def don't ant a hypo situation! Thank you all so much!!! I really appreciate the help.
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Hi Dara....

You are in the best place for advice. My sugar-cat (Rumpelteazer) is on ProZinc and I home-test with Relion Confirm meter too! Best thing is to get off the dry-food as soon as possible. RumpelT only gets Fancy Feast. I give her a few PureBites Chicken treats after every test.....got them at PetSmart....freeze-dried chicken (no other ingredients).

Deb + BJM + Sue + Carl + everyone else are awesome. If you have a chance, you can browse Rumpelteazr's ss and my posts/topics on the PZI board. I have a very crazy work schedule and 6 civvies in addition to my sugar-cat. You will be able to see how everyone has helped/supported me and calmed me down when I was at my wits end (during which a few times was real bad because I have not been getting enough sleep since RumpelT was diagnosed). Believe me....It Does Get Better. :smile:

My vet had upped RumpelT's dose to 1.5 and she went into hypo-mode....Oooops....don't panic about this hypo due to dose increase.....REMEBER....EVERY CAT IS DIFFERENT. Ever since, I have been getting advice from everyone here and things have been looking good. My ss tells the whole story pretty well.

I send :YMHUG: to you and Bob. I will follow you along on your journey too.
 
Hi Misty - thanks so much for the encouragement. Wow - that does freak me out a bit about the 1.5 causing hypo when Bob is on 4, but we have watched his numbers really close and so far so good giving 3 and 4 units. He's still not where he is supposed to be, but my vet said they have never had a cat they didn't eventually regulate - a couple of dogs :sad: but no cats. So I am hopeful. Is there anywhere on the site that deals with other issues? for instance, I have a cat who develops strivent (??) crystals in his urine and he is on special food. It's practically impossible to feed these 3 cats in my small apt separately. I hate to keep them apart all day and night. Just wondering if anyone has similar issues and how they handled having two cats on two different diets. I also wonder how canned food would be for my crystal kitty....
 
Just checking - Bob had his 4 units at 7:00 and then he munched on his food here and there - ate almost the entire 1/3 cup. He is 231 at +3. Is there any reason I should check him again at midnight? I usually pick up all of their food at midnight.
 
Yes! I will check at midnight, which is the 5 hour mark, so it should start going up after that, right?

YIKES!! :o I thought the candle meant "attention!!!". I don't know how to take it off!
 
Bob was 194. He did eat a few more bites before I picked up the food so I feel comfortable going to sleep. Thanks all!
 
Yes! Although I'm a nervous wreck today. He his AMPS was 336 and I gave him 4 units. Just like yesterday morning - it worked out ok yesterday, I'm just really nervous after reading about all the hypo incidents. UGH. I'm going home at noon again to check him. The vet thinks his numbers are good and we want to keep going with the 4 and 4 units. Any thoughts?
 
It is always wise to get at least a midcycle test. The more you can keep on top of the numbers, the less likely you will get a surprise low number.

Just to reassure you, it would be good to run off the Hypo directions above. Also get some gravy foods and mark them as high carb. My theory is once you are ready for something, the less likely it will happen. :-D
 
I will do that! I have my phone consult with the other vet tomorrow at 11:00am - I'll post an update tomorrow. Wow - this is so stressful. I hope we can get this under control soon.
 
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