New to this forum and new to cat diabetes

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Well that's lower than I expected and makes me concerned about giving any insulin tonight. Since we don't have much data, I think I'd skip the shot tonight and tomorrow I'd reduce down to 1u. And you can back the time of tomorrow morning's shot to whenever you choose. This may result in higher numbers tomorrow but better to be safe than sorry. With today's nadir being so close to the warning level, I just wouldn't chance shooting tonight. And bonus, you get to sleep soundly!
 
MrWorfMen's Mom said:
Well that's lower than I expected and makes me concerned about giving any insulin tonight. Since we don't have much data, I think I'd skip the shot tonight and tomorrow I'd reduce down to 1u. And you can back the time of tomorrow morning's shot to whenever you choose. This may result in higher numbers tomorrow but better to be safe than sorry. With today's nadir being so close to the warning level, I just wouldn't chance shooting tonight. And bonus, you get to sleep soundly!
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I totally agree with all of the above...
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Ok thank you guys I was a little bit concerned of giving it myself tonight when I say the 9.1 reading.
I'll try and wake up in the morning at 7 lol test and feed then shoot at 7.30.
You think just give 1u in the morning unless he's still lower than 11?
Does it hurt if I miss a shot tonight in the overall picture.
And would you monitor every couple of hours tomorrow to see how he reacts?
Maybe worth me giving these results to the vets already do you think cause the vet nurse was saying it would take a while to get into his system?

Oh and what does nadir means sorry?
 
Becki and sox said:
You think just give 1u in the morning unless he's still lower than 11?
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In principle, yes. ...But, if he's close to 11, I do wonder whether to shave a bit off that one unit.... Are you going to be around to test tomorrow, Becki?
Becki and sox said:
Does it hurt if I miss a shot tonight in the overall picture.
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A missed shot here and there shouldn't be a problem in an otherwise healthy cat. And sometimes skipping a shot is just the safest option...
 
Becki and sox said:
You think just give 1u in the morning unless he's still lower than 11?
Does it hurt if I miss a shot tonight in the overall picture.
And would you monitor every couple of hours tomorrow to see how he reacts?
Maybe worth me giving these results to the vets already do you think cause the vet nurse was saying it would take a while to get into his system?

Oh and what does nadir means sorry
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Missing a shot isn't something you want to do often BUT safety trumps shots as long as there are no other medical concerns involved like a history of DKA. BG may be a bit higher tomorrow but then Sox surprised us all today and may do so tomorrow too!
I'd definitely monitor him tomorrow as you did today to see how he reacts to the 1unit dose. That way, you'll get some data to make dosing decisions for when you are not around to monitor all day.
Insulin is a hormone not a medicine that takes time to "get into his system". You probably should show the vet the results but I don't think there is any rush to do so.
Nadir refers to the lowest BG point in the 12 hour cycle. Dosing decisions should be made based on both pre-shot which tells you if it is safe to give insulin and then mid cycle tests which tell you how low a particular dose is taking the BG. The two readings are important so even if the pre-shot is safe, you wouldn't give a full dose of insulin if the dose drops the BG so much that it would put kitty into dangerously low numbers. Sox went down almost 12mmol today, so even at a pre-shot of 12 for example, I wouldn't give 1.5u right now.
 
Elizabeth and Bertie said:
Are you going to be around to test tomorrow, Becki?
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Yes I'll be in all day tomorrow so can keep check on him.

Ok so if he's 11.0 or over do the 1u if he is under 11.0 should I still do 1u or do less.

I just think if we would have done what the vets said and not tested and just shot him tonight we could have made him poorly.

I've attached a photo of needle.
Thank you SO much for the help today.
 

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Becki, I am hesitant to say give 1u if he is around 11 tomorrow morning. I like Eliz's suggestion of reducing a bit. I suggest 0.75u if he is between 11 and 15mmol. You'd have to eyeball that dose half way between the 0.5 and 1u markings on the syringe. If he is over 15mmol, then I think 1u should be fine. Monitoring is key given you are still trying to find the right safe dose that doesn't push his BG down too far so you can safely shoot twice daily without having to skip shots too often. Glad to be able to help!:bighug:
 
If the UK is like here, the amount of training vets get on diabetes is really quite minimal and it covers all different species. Unless a vet specializes or just happens to have a lot of experience with diabetic cats, they don't necessarily stay up to date on treatment recommendations. Diabetes is a very hands on situation so educating pet parents should be paramount however vets seem to overlook this and feel it's a medical issue so they should take the reigns. Many don't recommend home testing for a variety of reasons some of which are just plain ridiculous like "your cat will hate you" to "your cat can't go hypo on that low a dose" or they've had bad experiences when they have encouraged people to home test. My vet had a client who refused to give her diabetic cat shots never mind test the cat! Vet was devastated! Being a vet isn't easy and they can't be experts in all things. The important part of the relationship is whether they will work with you as a partner rather than a dictator when it comes to dealing with our diabetic cats.

This forum is a remarkable community and we are just trying to pay it forward for all we have learned and received from the community. Everyone here either is living or has lived the experience and that hands on experience is invaluable.

As for cats only needing one shot daily......it's happened with long acting insulin but it is very rare. I haven't seen any in my time on this board. Cats have a fast metabolism so it's more common for insulin to not last long enough through a cycle than it is for it to last through a 24 hour period. :)
 
Morning all
MrWorfMen's Mom said:
Being a vet isn't easy and they can't be experts in all things.
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Yeah definitely I believe that and conditions are always changing due to new every day factors.

I've tested BG this morning at 7.10am 14.8 so I will give the 0.75u at 7.40am. would have been earlier but sox wasn't been cooperative this morning lol

If when I speak to the vets will they be not happy with me for not doing night shot and changing dose?
 
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Becki and sox said:
I've tested BG this morning at 7.10am 14.8 so I will give the 0.75u
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That .75 looks like a good bet to me. It is far safer to start lower and work up from there, and especially given Sox's response to insulin yesterday.

Becki and sox said:
If when I speak to the vets will they be not happy with me for not doing night shot and changing dose?
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Quite a few of us have had that conversation.... ;)
Given that your cat's blood glucose looked like dropping quite low the first time he was given insulin, I think reducing the dose 'should' be seen as entirely reasonable.

However, one of vets' concerns does seem to be that if people are hometesting, they will start to take control of the situation in ways that aren't healthy for the cat (as Linda mentioned above.) My own vet wasn't thrilled initially. So I found myself just 'not' telling him stuff...and doing a lot of 'nodding and smiling'... It was an ethical dilemma for me, because I value honesty, but it was safest for my cat.... Further down the line my vet conceded I was doing really well, and that he'd never had a diabetic cat live so long after diagnosis....
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It depends so much on the individual vet and how you approach a conversation with him/her. Some vets are lovely and open-minded, will respect responsible owners and their efforts to learn more about a complex disease, and work with them on a treatment plan, putting any professional pride to one side in the best interests of the cat. Others are affronted at the thought that a mere layperson can think they know better than a trained "expert". So you have to tread softly at first and get to know the vet and what sort of person he/she is. Ask questions, ask "what about if...?" and "what would you expect to happen if...?" and respond with your own thoughts so you engage in a conversation rather than develop a "teacher and pupil" type of relationship. A healthy working relationship of mutual respect with your vet is worth its weight in gold. You may disregard some of their advice/suggestions, but you never know when you might need them in an emergency so it's always best to keep them on side.

I currently have a lovely vet and it takes away a lot of the worry of visiting the surgery.
 
Yes definitely. I was told to email the results across after next weekend after doing my curve . Been as I will have this information after today is it worth contacting vets tomorrow with this weekends results and telling them I dropped the dose as he seemed to be dropping quick.
OR just leave it for the week and then just give them all the data I have gathered when they wanted it?

Sox also seems a little brighter today after injection where as yesterday he seemed quiet sleepy (he always sleeps alot bit just seemed more so) could that have been due to the amount of insulin?

3 hours post insulin 11.2
 
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Becki and sox said:
Been as I will have this information after today is it worth contacting vets tomorrow with this weekends results and telling them I dropped the dose as he seemed to be dropping quick.
OR just leave it for the week and then just give them all the data I have gathered when they wanted it?
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If it were me I'd leave it for the week, as by then there will be more data (based on experience) of how the insulin is working in Sox's body.

Becki and sox said:
3 hours post insulin 11.2
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OK. ...Don't be disappointed that it hasn't dropped more. It is entirely possible that Sox's body released some counter-regulatory hormones in response to that low number yesterday. And the purpose of counter-regulatory hormones is to cause temporary insulin resistance. It may settle out in the next cycle.
Of course, it's also entirely possible that the .75 isn't sufficient. But it's too soon to tell. 'Waiting and seeing what happens' can be a big part of dealing with feline diabetes...
 
I too would hold off and just accumulate data this week and present it to the vet next week as was planned. Otherwise it may seem a bit confrontational.... like "look what happened". :)
 
Yes that sounds like a good idea.
I've just done his 6 hour post insulin BG 8.7
Would you suggest testing again at 7 hours just to see if it goes lower?
 
You could and it would be useful info to see just how well the 0.75u dose is working for him. You're getting the hang of this...it's like a puzzle you are piecing together! :)
 
Thanks @MrWorfMen's Mom Right will do :woot: was just reading up on prozinc and it says it can peak up untill 10hours if I've read right.
Is the main aim of it all to keep his BG in the green area for majority of the day?
 
BG at 7 hours 11.6 so starting to go back up now.
For tonight's shot should I stay at 0.75 seen as I'm back to work tomorrow or would you say from looking at the results I could possibly do 1u?
 
Eventually green numbers are the goal but until you get to know how Sox reacts to insulin, it's best to work at dosing slowly and methodically. This is a marathon not a sprint and intentionally dosing to reach green numbers this soon could be dangerous. Sox and you and doing great and you've already made a lot of progress toward healthier BG for Sox.

Every cat is different so while the nadir usually occurs around mid cycle, there are cats who will nadir later. Sox does not appear to be one of those kitties at this point but nadir can move and sometimes the dose can influence the nadir timing. The data you collected yesterday and today's data will be helpful in learning just when Sox usually hits his lowest BG.

Sox could be bouncing a bit today so right now I'm thinking it might be best to stick with the 0.75u for a few cycles before increasing. It's best to stick with consistent dosing rather than changing it for each shot right now so you get a good picture of how each dose is working for him. He may level off again before PMPS.
 
MrWorfMen's Mom said:
I'm thinking it might be best to stick with the 0.75u for a few cycles before increasing.
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That sounds perfect to me. I'm happy giving the 0.75 to be fair while I'm out of the house and not with him.
My partner finishes work Monday and Tuesday at 2 so although it will be past the half way mark he can take a reading when he gets in to check how he is.
 
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9hrs post insulin 16.8 so he has gone back higher. Wether that's due to the dose not been enough or him bouncing as you called it... Maybe tomorrow might get a better idea as it's settled into him abit more

Will I be ok to do the shot at 7.30 instead of 7.40 tonight?
 
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You can shoot 15 minutes earlier or later without any noticeable effect. With ProZinc you can, when more familiar with Sox' reactions to insulin, shoot up to 1 hour early, but best to not shift times by more than 30 minutes if at all possible as shots pushed too close together can behave like dose increases. A few minutes here and there as you want to do is nothing to be concerned about.:)
 
That's fine just want to move him to half 7 as i go out to work at quarter to 8.

We should be ok to do the 0.75 in the morning and then be left on his own till half 2 shouldn't he... From today's results.

How many days do you think I should keep the 0.75 till as I'll be at work now from Monday to Friday.
 
You indicated you are feeding Sox twice daily with his shots. Once thing you could do is to spread out his food allowance a little more to keep a more steady supply available. Some folks here feed their cats 4 times a day, others 6 by taking the daily food allowance and dividing it between the number of feedings with a little heftier meal given with the shots and the remainder divided up for snacks in between.

Right now I see no issue giving the 0.75u and not testing again until 2:30 but it is always a good idea to leave a little snack out for kitty to eat if they feel the need. Many folks use automated feeders but I used to just freeze some wet food in an ice cube tray and leave out a cube or two depending on size, before I left so it would melt gradually and be edible a little later on in the cycle as a snack.

We try not to hold doses for too long if they are not adequately lowering BG but that has to be balanced with caregiver monitoring ability. Right now, I'd suggest you give the 0.75u another day or two, to see how Sox is doing and then if needed, you could increase on a night shot when you could monitor for a few hours to see how he does with it.
 
MrWorfMen's Mom said:
Once thing you could do is to spread out his food allowance a little more to keep a more steady supply available.
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The only problem I have with that is when I put food out Sox will just eat what ever is there he never leaves any lol.
And having 3 other cats they always steal each others food.
I could possibly get my hubby to start feeding a little before he starts his 2oclock shift or after he has finished his 2oclock shift... That could work maybe.
 
I know all too well the conundrum of multiple kitties in the household. My extra sweet kitty still likes to pilfer one of her brother's food and he walks away from his bowl when he sees her heading his way. As a result, I no doubt erred on the side of leaving too much food down but I then I was lucky because my diabetic doesn't like cold food...room temp or warmer for her and she was a one flavour kitty so I usually put a flavour she didn't like down along with one they would all eat and hoped the amount they all got worked out. All you can do is experiment a bit and see if you can devise a plan for your crew. There are microchip activated feeders that would alleviate the problem but they get expensive when you need more than one.
 
Do you think it's better then for them to have a little nibble during the day? The vet nurse just recommend to still stick to a morning and night feed?

If I left anything down sox would eat it all no matter of the taste lol :woot:

Normally I feed a little extra food before bed so if I give insulin tonight at half 7 he will be ok for a little food at 10 won't he?
 
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It is now generally accepted that feeding several small meals per day is easier on the pancreas than feeding twice a day and we want to give the pancreas a chance to heal and hopefully get back to doing it's job without the need for insulin injections. In the past, the belief was that kitty should be fed twice daily with their insulin shots. The problem with that is that diabetic cats can't utilize the food they take in efficiently. That's why they are always hungry, eat a lot and still lose weight. By feeding them multiple meals it keeps that continuous hunger at bay and keeps kitty's food stress down. Until they are regulated and if they have lost weight, there is no reason not to up their food intake a bit to keep them well nourished.
 
Okie dokie. I'll get Brad to give him a little before or after his shifts in the week. A
And a little extra before bed will be ok?
 
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Perfect. It Wouldn't be set times would either be 1pm or 2.30pm depending on what shift pattern he has. Would that still work?
HAHA yes but they all stay down stairs while we sleep upstairs anyways :D
 
No problem with snack being at different times. We all have other things on our schedules other than kitties and if you leave food out for them they'll eat when they choose to anyway. All you need do is figure out what works for you and Brad. As long as you are both clear on who is doing what and especially who is giving shots. There have been instances where more than one person has been responsible for shots and double doses have been given inadvertently.:nailbiting:
 
MrWorfMen's Mom said:
As long as you are both clear on who is doing what and especially who is giving shots.
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That's going to be me for now then once I'm confident I will teach Brad.
MrWorfMen's Mom said:
There have been instances where more than one person has been responsible for shots and double doses have been given inadvertently.
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Oh dear that's not good. I suppose it can easily happen can't it.

18.2 pre shot check now
 
Fingers crossed just hoping he behaves for his jab now lol

Is it ok to feed him and then inject while he's eating. Might be easier whiles he's distracted or does it have to be half hour later?
 
Some suggest feeding and making sure the food stays down especially with faster acting insulins but as long as you know he is eating and he's not a scarf and barf cat, you are fine to inject while he has his face stuffed in his bowl. When you won't be home during the day, you could give him half his meal wait a few minutes and then give him the rest and inject with the last half of his meal just to be sure he has food in his tummy while you are out.
 
MrWorfMen's Mom said:
When you won't be home during the day, you could give him half his meal wait a few minutes and then give him the rest and inject with the last half of his meal j
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That's a good idea. So if I was to do that in the morning I could at 7am test and feed half food then at 7.30am feed the other half of his food and inject?
 
Just looking at Brad's rota if the 0.75 isn't enough Brad's off on Wednesday so could do a 1u shot on the morning then he's at home to check him through the day.
 
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Right bed time now just tested and BG 14.2 given a few spoons of food so should be good for the night do we think?

By the way sorry for all the posts :rolleyes:
 
Sox should be just fine. No problem with the posts. I remember all the questions I had when I was new at this! This can be totally overwhelming and confusing so the more you ask the more in control you will be. :)
 
Absolutely.... which is why we suggested you lower the dose given the numbers you got at the 1.5u dose. Those first green numbers are both a thing of beauty and fear especially when you can't be home with them to monitor constantly. Another good reason for home testing so you get to know how kitty is reacting and can make decisions based on the data you've collected when questions about whether to shoot or not, whether to give a full or reduced dose, increase or decrease the dose etc. crop up. This isn't a one size fits all medical condition...it's very much hands on.

Sleep well tonight. I have to run....I have Special Olympic curling tonight so I best go start piling on my warm clothes! Any questions in the morning, just post. There are usually folks here from the UK or Europe and possibly Australia or NZ when you're doing your morning routine but if you don't get a response and are questioning shooting for any reason, just skip. Sox will get back on track soon enough. :D
 
He may have been a little lower a bit earlier, still in a bit of a bounce or he may need a bit more juice. Stay the course till Wednesday. By then any bouncing should be cleared and you'll know if a little increase is in order.
 
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