New Member help with dose

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AbyResq

AbyResq

Member Since 2016
I introduced myself in the new member section last week. I'm back with some numbers and I need help. I'm using a human meter, grain free fancy feast and ProZinc. I loaded my spreadsheet to my signature.

I'm looking for some advice on dosing Tuck properly. I'm more concerned about going too low than I am about the highs. I've had some oops's along the way with fur shots which explain some of the highs. Initially it didn't seem like 1 unit was enough so my vet said try 2, I tried 1 1/2 instead. 1 1/2 seemed like he was getting too low for my comfort midday. I'm now back at 1 unit and it still seems like he's dipping a bit close to hypo at +6. Thoughts?

Tonight's PMPS was 189 and I decided not to give him insulin. I'm not sure if that's right or if I should give him .5 units instead of 1 unit. He had an AMPS of 199 earlier this week and I gave him a slightly lower dose of insulin and ended up feeding and testing him the entire afternoon to avoid a low.
 
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I haven't posted in the ProZinc forum. He's been eating an entire can of Fancy Feast at each meal. I only gave him 1/2 of a can. I was going to retest him at +1 and feed him the other half of a can. If he's 250+ I was thinking of giving him 1/2 unit. Anything below that I thought I'd skip for tonight to see what happens.
 
The problem with doing that is that there's no way to know how much of that +1 is going to be "food influenced" though

Generally, if you have a Pre-shot you're not sure about shooting, you should stall, don't feed, and post for help. Test again in about 20-30 minutes to see if the numbers are going up on their own....that way you can be reasonably sure that the last shot is wearing off and it's safe to give another

In the ProZinc forum, they've developed a Protocol for ProZinc that's a good place to start! I'd start posting over there so the people who use ProZinc will get to know you and your kitty so they'll start to watch out for you

The ProZinc forum may not be the busiest though, so it's always OK to post here in Health too, but it's good to have more "experts" watching out for you too
 
You posted while I was with him. He was 280 and I gave him the other 1/2 a can of Fancy Feat and 1/2 unit of insulin. And believe me I will be watching him and testing. I keep hoping this general downward trend is a sign he might be one of the lucky ones who gets to go off insulin - I know all newbies hope for this :)
 
I think I might just reduce the dose overall. Chris gave you the protocol we put together. We consider a nadir in the 50s to be a sign the dose needs to be reduce. Since he is new to insulin and has had a diet change, it is likely his numbers and dose will gradually drop.

Chris gave you the info on stalling - a good plan if you get a number under 200.

I think I would reduce the dose to 0.75 and monitor carefully to see if the dose needs to be further reduced.

Btw, this is great news and great progress!
 
Thanks. I think I need to get some U100 syringes. I'm assuming I have to get them from the vet or need a prescription, is that right?

This guy still needs a dental. He has some resorptive lesions. If his dose goes down to .75 or .5 then I am hopeful that after the dental he may go into remission.
 
Chris & China said:
Depends on where you live on whether you need a script or not

All these are U100 that have half unit markings are available from ADW online:
UtiCare
Monoject
Carepoint
Sure Comfort

They're also available at WalMart if you have one near you..Their Relion Brand 3/10ml, 3o or 31 gauge, 8mm insulin syringes all come with half unit markings and are only $12.58 for a box of 100
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@Chris & China i went to two Walmart stores today in N.C. and they didnt carry the 1/2 markings on relion 100u 31 gauge or on the BD brand syringes. They looked at me like I had two heads lol. I wonder if i can order them on line...
 
These are the ones you want at WalMart...take this picture in with you. Most of the pharmacists (and techs) don't know that they DO have insulin syringes with half unit markings! We hear that a LOT around here!! (and you can get 30 or 31 gauge needles)
relion syringes.png
 
@Chris , I had to sound like a complete idiot but are the 3/10cc for the Lantus 100U? My vet told me to make sure the box says 100U insulin verses 40U but I don't see 100U on the Relion box above. Thank you for your patience with me as this is all new and I want to make sure I am getting the right syringes for Lantus 100U:cat:
 
Last night 4 hours after I gave him the second half of his dinner and 1/2 unit he was 319. This morning he was 118 so I didn't give him a shot. I will see where he is at +6.
 
Good plan! It looks like he may not want to be on Insulin. (Anti jinx). If he would rise to 200 at least 2 hours after feeding (food raises levels - you want a "true" number not influenced by food) you might give him a little insulin- maybe eyeball 0.25 and then monitor. That will throw you off schedule tonight, but it is something you can do with ProZinc.

If you wait until +6 and dose a little, just be aware you will be looking to dose again 12 hours after that shot.
 
I wasn't planning to give him anything at +6 even if he's high. I'm curious to see where he naturally falls at this point.

I'm not going to give him anything a +2 either. In the event that this pattern continues and I want to give him a little insulin at +2 tomorrow, would I also need to offer some food?
 
AbyResq said:
I wasn't planning to give him anything at +6 even if he's high. I'm curious to see where he naturally falls at this point.

I'm not going to give him anything a +2 either. In the event that this pattern continues and I want to give him a little insulin at +2 tomorrow, would I also need to offer some food?
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Not giving insulin today and seeing how he does would be fine. I was trying to give you some options but probably was confusing.

We would rather the pattern not continue, though. MIt'd be easier on both of you if you could give 2 shots 12 hours apart. That's why I'd reduce the dose next time you shoot and see if you get 2 shootable preshot numbers, even if you are only giving a tiny amount of insulin. (We have ways to just give a drop or two)

But, if you have to stall, try 30 minutes without feeding first to see if he rises enough to shoot. If he is still low, feed him and wait 2 hours for the food to be digested. Then test and see if he is high enough to shoot.(as long as you can deal with the schedule change) You can give food then if you want. You might give half his meal at the regular time and then half 2 hours later after you stalled.

Just to be clear, it is normally test, feed and shoot. You test before food. Many people give the shot while the cat's deep into his breakfast.

Hope that wasn't more confusing. Usually you have time to get a regular routine down before you have to switch things up. He is in a hurry, which is great!
 
Thanks, not confusing :) Test, feed, shoot was my method. This new downward trend has had me a little stumped. I was figuring on giving him a 1/2 unit tonight as long as he is in the shootable range. i.e. anything over 200 I was planning to give 1/2 unit even if he's pretty high (which I hope he's not). Almost time for the +6 check.
 
That is fantastic!

Sometimes kitties just need a little insulin and a change in diet to get their pancreas working again. Looks like he might be one of the lucky ones!
 
He was too low to shoot again last night and this morning. I haven't given him any insulin since the reduced dose on Wednesday night. It does appear that he's going into remission :D.

Should I just keep testing to monitor and skipping insulin like I did yesterday and this morning? Or would I be better off retesting at 2 hours and offering a small dose if his meals are still spiking him higher than a normal cat?

He came out of a very stressful home, eating cheap dry grain laden food. Even though his blood work and urinalysis looked clear of an infection we gave him a shot of Convenia for dental issues. It really is looking like the improved diet and calmer environment may be all he needed. I'm betting the antibiotics also helped with an infection that wasn't clear in his labs. He'd been left untreated long enough that he'd lost the muscle mass on his spine so I really wasn't expecting this result!
 
Ooh! Purdy blues and greens. :) C'mon, Tuck! I'm so glad he has you caring for him now, Kristen.

I've not used Prozinc but I'm tagging @Sue and Oliver (GA) because she'll be able to give you good advice.

How often are you feeding Tuck at the moment?

Any news about a forever home yet?


Mogs
.
 
What lovely, lovely news! If he were mine, I would continue to monitor, maybe morning and evening so if he sneaks up above 200, you could give him a drop. Generally we say a cat is in remission if they are between 40-120 without insulin for 2 weeks. It is possible he will just continue to drop or he may go into the 200s at some point and need a little boost of insulin.

To give a drop, put water in a syringe and pull up the smallest amount you are confident measuring - maybe 0.5. Let the insulin out, drop by drop, counting. Once you know how many drops are in 0.5 units, you can pull up 0.5 units of insulin and let out drops, save the number of drops you want to give. (I am thinking one or two drops if he is over 200). I would be sure you can monitor the cycle.

We think it may help to give small frequent meals during this time to help support the pancreas healing.

Looks like you may have "fixed" him! Amazing what a good diet and some love and caring and a little insulin will do. If he is eventually adopted, be sure to tell them no high carb food ever. Once a diabetic, always a diabetic.
 
Thank you, thank you, thank you. I was wondering when I saw people giving a "drop" how they achieved that.

I haven't tried too hard to find him a new home yet, @Critter Mom. He still needs a dental and we will do that through my rescue group. We like sending them off in the best shape possible. He also was surrendered with his sister who is getting spayed on Monday and having a mammary lump removed. Hoping she's also lucky and doesn't have cancer but the odds aren't in her favor. As I said, they came out of a bad situation but luckily they are now getting some much needed care.
 
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