? New Member: diet-induced steady low numbers, need dosing advice

[Lauren Smith]

EDITED due to changing info: If my cat's BG has slowly gone down to the blue zone and has been in the low 100s-200s, does he still need to be given a reduced dose of insulin if below 150? If on 1 unit of PZ, is it safe to give a half unit when BG is below 150, or am I correct to be skipping doses? Some people say skip, while others tell me he still needs insulin, and my vet just says shoot as long as he eats. I haven't been shooting when BG is in low 100s. I linked his spreadsheet to my signature. Thank you!

 

[Chris & China (GA)]

Today, his AMPS was 219, so should I try to give him a decreased dose?

How would you feel about doing .5 unit? Then test in about 2 hours and go from there.

 

[Chris & China (GA)]

With Jack dropping to 171 about 3 hours after his morning meal, it's better to skip now. 3 hours is a long time to make up

Just grab a few tests during the day to see how he does without insulin and if at all possible, get a urine ketone test in

Good that you're switching to ProZinc tonight too! That will be a better and safer insulin for Jack

If you want to change your shot times, tonight would be the best time to do it too.

 

[Ale & Bobo & Minnie (GA)]

Do you have 1/2 unit marked syringes to give the dose Chris is suggesting? It makes it easier but if not you can try your best to eye ball it

welcome btw and signature looks great! I’d add DKA and any other health conditions he has to it as well

 

[Lauren Smith]

Sorry for the delayed response, everybody - thank you for the suggestions! I may post again soon for dosing advice, but I do need to go to Walmart for those half-dose syringes! He may need to start going down, because he's not always high enough to give insulin at all. I don't give it if below 150, but maybe I should try a half dose if he's in the low 150's? Still trying to catch him going to the litter box, so I can test for ketones, but his BG is staying in the blues. Got a weird hypo reading on Monday, but I don't think it was accurate. Been looking for a new meter and think I'll try an Alphatrak to compare with my Relion when needed.

 

[Sienne and Gabby (GA)]

Please let us know if you need help getting Jack's spreadsheet set up. @Marje and Gracie can give you a hand.

 

[Marje and Gracie]

Sorry for the delayed response, everybody - thank you for the suggestions! I may post again soon for dosing advice, but I do need to go to Walmart for those half-dose syringes! He may need to start going down, because he's not always high enough to give insulin at all. I don't give it if below 150, but maybe I should try a half dose if he's in the low 150's? Still trying to catch him going to the litter box, so I can test for ketones, but his BG is staying in the blues. Got a weird hypo reading on Monday, but I don't think it was accurate. Been looking for a new meter and think I'll try an Alphatrak to compare with my Relion when needed.

Please send me a PM if you have any issues setting up the spreadsheet. Just click on “Marje and Gracie” to the left and then “start a conversation”.

 

[Lauren Smith]

Thank you! Chris Ronkoski helped me set it up. I’m hoping it saves my entries each time I edit, so that the link is up-to-date. It looks like it automatically saves it. Hopefully, lol!

 

[Lauren Smith]

So currently, Jack’s BG has been staying in the blue zone & is 113 this morning (we all woke up late). So I will feed him & recheck. Here is my predicament: When I switched him to ProZinc this week, the vet prescribed 2 units of ProZinc when she had him previously on 1 unit of Vetsulin. I have only been giving him one unit of ProZinc to start with, & it has felt the same as the Vetsulin: his BG does not always get back high enough for me to feel comfortable giving him a shot. He was 125 last night & 113 AMPS this morning. The vet wants me to use some U-100 syringes to get the markings to where I can go down to .8 instead of 1 unit when he’s not above 150 (she said that 2 units was the correct dose of ProZinc when compared to 1 u of Vetsulin, but I still only give 1 right now). So she is still suggesting I give him insulin even when he is lower BG as long as he eats, & food is her only basis for giving insulin. She has never glucose checks. What should I do? She doesn’t fight me on home testing, & she is supporting me that perhaps he can start reducing doses, but I want to ask here too! Sorry for

 

[Lauren Smith]

UPDATE: I had to talk to my vet a couple times to get my info straight before posting here again, and at the end I will link my spreadsheet. I've been trying to get more data, and the next time his BG is high enough to give insulin during the day, I will do a curve. When we switched him this week to ProZinc from the Vetsulin, the vet had prescribed 2 units of PZ vs the 1 u of Vetsulin he was previously on. I have only been giving 1 u of PZ to start with, because I was already thinking he may need to start reducing doses, so I didn't start with 2 units until talking to her. She says that is the correct dose of PZ vs Vetsulin per body weight. His BG does not always seem high enough to give insulin twice a day and some days not at all. I haven't been shooting if under 150. Is there a hard-and-fast rule on numbers to shoot? The vet doesn't fight me on home testing but doesn't recommend it, and her sole basis of shooting insulin is whether or not he eats. "If he eats, shoot." She did say I could try reducing the dose to .8 instead of 1 unit (I told her I'm only giving 1 to start), but it is working the same as 1 u of Vetsulin, where well into the next day he is still not high enough to give more (it seems). She will call in some U-100 syringes to convert to .8 for reduced doses, but I swear somebody said they sell half-marking U-40s at Walmart. I will check there first. Still trying to get a ketone test in but haven't caught him in the litter box yet. His AMPS this morning was 113 and PMPS last night was 125. What advice can you all give me, please? I will stay logged in today! Thank you!

https://docs.google.com/spreadsheets/d/1_R4bl8SWJM-yp7C5EVpXdGwA-EjMcaFWW67LRk05Hho/edit?usp=sharing

 

[Heather & Ducote]

So currently, Jack’s BG has been staying in the blue zone & is 113 this morning (we all woke up late). So I will feed him & recheck. Here is my predicament: When I switched him to ProZinc this week, the vet prescribed 2 units of ProZinc when she had him previously on 1 unit of Vetsulin. I have only been giving him one unit of ProZinc to start with, & it has felt the same as the Vetsulin: his BG does not always get back high enough for me to feel comfortable giving him a shot. He was 125 last night & 113 AMPS this morning. The vet wants me to use some U-100 syringes to get the markings to where I can go down to .8 instead of 1 unit when he’s not above 150 (she said that 2 units was the correct dose of ProZinc when compared to 1 u of Vetsulin, but I still only give 1 right now). So she is still suggesting I give him insulin even when he is lower BG as long as he eats, & food is her only basis for giving insulin. She has never glucose checks. What should I do? She doesn’t fight me on home testing, & she is supporting me that perhaps he can start reducing doses, but I want to ask here too! Sorry for

I am no expert and only diagnosed a little over a month ago but I recently switched from Vetsulin to Prozinc and I can see a few things that are contradictory. I am pretty sure that Prozinc is used with a U40 syringe. The lantus and levimere are your u100 syringes. Also, the glucose checks are crucial especially when making an insulin switch! Every cat is different but when Ducote was on Vetsulin he was on 4.5 units and still getting HI so it was time for him to go up in dose. I ended up changing insulins and now on Prozinc he is on 3 units and giving me blues and even greens. I did try to start the Prozinc at the same dose as he was getting on the Vetsulin but it just so happens that he needed less of the new insulin than the old. I don't think that I would have started at a higher dose especially since Jack is giving you blue numbers on the lower dose. I am new to this so hold off for more answers

 

[Panic]

(she said that 2 units was the correct dose of ProZinc when compared to 1 u of Vetsulin, but I still only give 1 right now)

Um no lol. Good call keeping the 1u.

This is just me but I usually ignored my vet and followed recommendations on here. They were following my spreadsheet and monitoring my girl, unlike my vet.

So I will feed him & recheck.

When you get a lower number, you want to stall feeding for about 20 minutes and then recheck. Rechecking after feeding will give you an elevated food-related number. I do not know what your spreadsheet looks like but I might skip, 113 is quite low for a new diabetic.

You can use U-100 syringes (lots of people with Prozinc/Vetsulin do because the needles are more comfortable for kitties) so if you want to switch that's fine, just remember to use the conversion chart here.

 

[Lauren Smith]

Um no lol. Good call keeping the 1u.

This is just me but I usually ignored my vet and followed recommendations on here. They were following my spreadsheet and monitoring my girl, unlike my vet.

When you get a lower number, you want to stall feeding for about 20 minutes and then recheck. Rechecking after feeding will give you an elevated food-related number. I do not know what your spreadsheet looks like but I might skip, 113 is quite low for a new diabetic.

You can use U-100 syringes (lots of people with Prozinc/Vetsulin do because the needles are more comfortable for kitties) so if you want to switch that's fine, just remember to use the conversion chart here.

Thank you for the conversion chart! I just rechecked his BG which is now still only 123, so I did not dose him this morning. At numbers like these, I still don't see how .8 wouldn't be risky for a hypo. I really want to avoid getting to that point to find out that it was too much insulin...it feels like diet is bringing his BG down naturally and keeping it in these ranges, but the next time he does require insulin, I can do a curve and get more info. Is the rule not to shoot below 150 or is it 200? I haven't found a concrete answer. Should I try only giving him half a unit instead of .8 if he is above 150? Anyone know? Lol

 

[jt and trouble (GA)]

I cannot give dosing advice but it looks to me like you are doing a very good job.
Hang on for more replies.

 

[Panic]

Is the rule not to shoot below 150 or is it 200? I haven't found a concrete answer.

The rule changes depending on how much data you have. We recommend most people skip the shot below 200 if they don't have much data, then gradually lower that limit to 150, and then even lower later. We basically want to see the data to know when it's a good idea to keep giving insulin or skipping. It also depends on whether you are going to be home to monitor - you might prefer to skip if you can't stay and the pre-shot is lower than usual.

Your spreadsheet looks very good for a new diabetic and a lot of skipped shots! I wonder if Jack will go into remission soon.
Not sure if this has been mentioned already but since your signature says you only get one snack between meals - we encourage caregivers to offer food throughout the day and night.

 

[Lauren Smith]

The rule changes depending on how much data you have. We recommend most people skip the shot below 200 if they don't have much data, then gradually lower that limit to 150, and then even lower later. We basically want to see the data to know when it's a good idea to keep giving insulin or skipping. It also depends on whether you are going to be home to monitor - you might prefer to skip if you can't stay and the pre-shot is lower than usual.

Your spreadsheet looks very good for a new diabetic and a lot of skipped shots! I wonder if Jack will go into remission soon.
Not sure if this has been mentioned already but since your signature says you only get one snack between meals - we encourage caregivers to offer food throughout the day and night.

Thank you! That makes sense! And I feed him whenever he is up and about - he used to be more of a grazer when he was on kibble, but since the diet change after diagnosis he only seems hungry about twice a day but sometimes more. But if he is hungry, he can eat.

 

[Red & Rover (GA)]

Since Jack had DKA, it is important that he get some insulin to stave off a second round of DKA.

I see that @Chris & China (GA) recommended starting at 0.5 units twice a day. Would you feel comfortable with this dose for a couple of days to see what it does? Sometimes, especially when new, it is less scary to go up the dosing scale rather than down.

 

[Lauren Smith]

Since Jack had DKA, it is important that he get some insulin to stave off a second round of DKA.

I see that @Chris & China (GA) recommended starting at 0.5 units twice a day. Would you feel comfortable with this dose for a couple of days to see what it does? Sometimes, especially when new, it is less scary to go up the dosing scale rather than down.

That's my question, to simplify: Is it safe to administer insulin of any dose when the BG reading is less than 150? Say he is in the 120s or even less, then should I still give him half a dose and see if it gets him lower without a hypo? Or am I correct to be skipping when he's in the low 100s? I got my spreadsheet link up, but maybe I should start a new thread to simplify my concerns. I'm still new to this forum and how threads and comments work, lol.

 

[Red & Rover (GA)]

You don't have to start a new thread.
If you go up to the top of of this thread, in the right hand top corner you will see "Thread Tools." Click on the blue "Edit Title."

This will take you to

Click on the question mark. Then change the title of your thread to something like "New member. Post DKA cat. Need help with dosing. Low numbers" so that anyone glancing at the thread titles can immediately see what is needed and help if they can.

 

[Lauren Smith]

You don't have to start a new thread.
If you go up to the top of of this thread, in the right hand top corner you will see "Thread Tools." Click on the blue "Edit Title."

This will take you to

Click on the question mark. Then change the title of your thread to something like "New member. Post DKA cat. Need help with dosing. Low numbers" so that anyone glancing at the thread titles can immediately see what is needed and help if they can.

 

[Lauren Smith]

Thank you very much!! I edited it, so hopefully people will read all of my comments and make sense of it, but I think I know what to do now based on the comments I've gotten. I'll give him half a unit if he's just over 150, 1 unit if closer to 200 or slightly above, and hopefully I'm correct not to give him any if he is 120 or less, which is what's been happening.

 

[Red & Rover (GA)]

Dosing is based on how low a dose takes a cat and not on the preshot number. So if the numbers are high enough to shoot, do not give 1 unit. I have a feeling that that is too high.

Let's see what the Prozinc users have to say.

 

[Red & Rover (GA)]

Can you put "post-DKA" in the thread title? DKA is a game-changer in regards to advice.

 

[Lauren Smith]

Can you put "post-DKA" in the thread title? DKA is a game-changer in regards to advice.[/QUinOTE]
I'll do that next time I need advice for sure! He's still hanging out in the 107-121 zone without insulin and eating/acting great! I just keep checking glucose and it's not really changing! If he gets above 150, I'll give a half unit, and if closer to 200 or above, I'll give 1 u and do a curve. Then, I'll have enough data to post in the ProZinc group, which may be more informative.