New User, Newly diagnosed kitty, couple of questions

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Melissa and P

Melissa and P

Member Since 2014
Hello all, My name is Melissa, and my newly diagnosed sugar baby's name is P. We're both so thankful we've found this fantastic place for the wealth of information on diabetes. I lurked the site for a while to do some research and to figure out what I should be asking my vet. I finally registered today and I'm so glad to join all you wonderful folks!

A little background info:
P is 12-13 years old. We found out last month that he is diabetic, so I started him on wet food exclusively. I've been keeping the carbs at or under 6%. I feed him twice a day.
I just started home testing last night. His numbers were at 323.
The vet wanted to wait until after the holidays to start insulin just in case I had any trouble or thousands of questions. I took P in today and we gave him his first shot of insulin. (He did great! Which makes me feel loads better) ProZinc, two units. I told the vet I was going to home test, which he thought was great, but then he said to just give two units of insulin, no matter what his numbers are! And I know from reading some posts here, that doesn't make any sense! And, it could put my baby in danger! Needless to say, I am not going to follow his protocol. I plan to test 3 times a day. Once with his morning meal, once about 5 1/2 hours after that meal (this is the nadir(?) for ProZinc...I think I read that somewhere here, please correct me if I am wrong!) and lastly at his second meal.

QUESTION: But when exactly do I test? Before the meal? I know I give the insulin after he eats, but I don't know when to test his blood, before he eats, or after?

QUESTION: I have read on here about the "start low, go slow" approach. Is two units too much to start off with? I didn't check his numbers before the insulin shot this morning. (Stupid me thought the vet would) I'm going to test him when I am done here. Is there a protocol for ProZinc on how much to give based on his numbers?

QUESTION: I'm going to make a log book to keep track of his numbers, his weight and what/how well he's eating. Do I need to track anything else? Ketones? I've read I should be checking them too, but haven't done much research on that yet. Also, has anyone made a spreadsheet or chart that I can use as an example on how to make a log book?


Thank you for your time, and any input you have!
 
Welcome Melissa and P! You are way ahead of the game doing your research ahead of time.

We do have a protocol for ProZinc: http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=109077

We do prefer to start at one unit and raise the dose slowly, as home testing numbers indicate. It is just so much safer than getting a low number and trying to decide how much to drop the dose. Congrats on home testing. You should be able to see how low he is going today - try for a test 5-7 hours after the shot. If he happens to be in the 40-50 range, post and ask for help.

The mantra is test, feed and shoot. You test before feeding because food can bring the numbers up. It is good to see that he will be eating well before giving the shot. (Lots of us give the shot while the kitty is eating.)

Your instincts are right on. Of course you wouldn't give 2 units regardless of the number. The protocol gives you some ideas about adjusting the dose.

Keep reading and asking questions. We'd love to help you and P.
 
I just teared up when I read your reply. It's so great to have this support! Thank you so much!


I just did a test for the heck of it and he was at 361.
I'll be testing today at 3:15, which will be 6 hours after the shot he had this morning.

I've read the protocol, and will be following the instructions. This makes more sense to me than what the vet said.
 
Hi Melissa and P. Welcome to FDMB.

You are doing a great job so far with your research and questions. P is very lucky to have you.

QUESTION: But when exactly do I test? Before the meal? I know I give the insulin after he eats, but I don't know when to test his blood, before he eats, or after?
You will test before every meal. The method we recommend is Test, Feed then Shoot.

QUESTION: I have read on here about the "start low, go slow" approach. Is two units too much to start off with? I didn't check his numbers before the insulin shot this morning. (Stupid me thought the vet would) I'm going to test him when I am done here. Is there a protocol for ProZinc on how much to give based on his numbers?


Sue sent you the link to the protocol for ProZinc. It is a good insulin. Start slow means starting at a low dose. Usually we recommend starting at 1 unit. Increases are by 1/4 to 1/2 unit at a time. Go slow means waiting at least one week between dose changes to determine if you need to increase the dose. It takes approximately one week for a cat's body to adjust to the new dose to tell how well he is responding to it.


QUESTION: I'm going to make a log book to keep track of his numbers, his weight and what/how well he's eating. Do I need to track anything else? Ketones? I've read I should be checking them too, but haven't done much research on that yet. Also, has anyone made a spreadsheet or chart that I can use as an example on how to make a log book?

You can use ketone strips to test P's ketones. You can get them at any pharmacy. You can use either your meter's log book or we also have a Google spreadsheet template that you can use to track the BG readings.
 
Thank you guys =]

The spreadsheet looks awesome. I'm just having trouble figuring out what some of it means. I know BG is blood glucose, that's what I was calling P's "numbers". But I don't know what "AMPS" "U" "PMPS" and all the +numbers mean. I'm sorry if it's a stupid question, I tried searching the board, but nothing came up.
 
Hi Melissa & P

I just wanted to welcome you to FDMB. cat_pet_icon

As you are already finding out, this is a wonderful place to be for the help you need to understand P's sugar-dance. :smile:

Most of us here started out with vet-prescribed doses that are way too high. Glad you had the 'now wait a minute' reaction when vet gave you the dosing info. My Rumpleteazer hypo'd in the beginning due to vet dose. Thankfully I had already been lurking around here( like you did), was home testing, and had other members help me through the hypo episode. The protocol we use is very smart and everyone is willing to help each other.

Here is the link to our ProZinc/PZI forum. You might want to check out some of other ProZinc members daily 'condos' (condition reports) and spreadsheets.
http://www.felinediabetes.com/FDMB/viewforum.php?f=24

Keep us posted and keep asking questions. We are here to help you help Bart. :smile:
 
I am so amazed at this site! Everyone is so sweet and caring! I am so thankful to all of you!

I ran across the PZI forum a little today. Some of this is just so overwhelming. I've never really used a forum before so there's a learning curve. And there's just so much great information. I just finished P's profile, and I'm going to try to figure out the spreadsheet soon after I've looked over a couple dozen that people have posted. I've made my own chart for now, until I get the hang of this thang. lol @-)

I tested P at around 6 hours after his shot (2 units) and he was at 304. I'm going to start giving him 1 unit tonight. Or should I start doing .5 units? I have the U40 needles and there isn't a measurement for .5 so I'm a little scared to attempt that small of a dose. But I'm more scared of a hypo, so I'll do what I have to for now.

I just want to say thank you, to all of you that have helped me so far! From the bottom of my heart, thank you. You guys are wonderful. <3 :mrgreen:
 
I think I would do the one unit for a few cycles, getting a midcycle any time you can. If it isn't enough, you can raise it a little bit after a few cycles. The midcycle number is important to see whether he goes low midcycle or stays high; it will show you how the dose is working.

You're absolutely right - this is completely overwhelming at first. The learning curve is very steep, but think of how much you have learned just today. Soon you will be posting on a newbie thread and telling them this is doable.
 
Great, thank you so much for your help. I'm definitely going to keep doing the midcycles even though he hates getting tested. I talk to him and tell him he's going to feel so much better, and that I'm doing it because I love him so much.

I'll be so glad when I can post to a newbie thread. Not just because I will know so much more and feel like I know what I'm doing, but so I can make others feel how you guys have made me feel today.
 
Just an update.

DH is home and I wanted to show him how to test and give a shot. We had a terrible time getting the test done. *sigh* P really, really hates getting tested. BG was 377. I showed DH what to do to give a shot, so he gave it a go, and I think we ended up with a fur shot. We didn't try to give another shot, and we won't until tomorrow morning.

What size lancets do you use for testing? I think the ones I have are too small.
 
You'll get it. And you got a number - that's the important part. Just be sure P gets a treat every time and he'll decide a poke is not so bad. Usually 25-27 gauge lancets work best at first; the 30-31 gauge seem to be too small.

And everyone gives a fur shot - even people who have been doing it for years. You might be surprised how much went in - that's why we say never reshoot.

As Scarlett said "Tomorrow is another day.". Today you helped P tremendously by learning so much about feline diabetes.
 
Wow....Melissa .... seems like you have been here for years not just a day. :-D

P is going to do really well with you as his sugar-mom. He is a handsome dude. cat_pet_icon
 
I'll have to get some new lancets, I have the 31 gauge, I believe. His midcycle test is the easiest because he lounges around at that time, so it's a lot easier. But he knows when my alarm goes off in the morning it's time to eat, so he paces the kitchen while I'm getting his food ready. He's not very fond of being hovered over, especially if both DH and I are doing it, which was the case tonight. We gave treats before and after the test, so I might just start giving after so he'll realize he has to be a good boy for the test to get the treat.

That's a good mantra. Tomorrow is another day. Tomorrow is another day. I can do this. I will do this.

Thank you Misty for the confidence! And I know P appreciates that you appreciate his good looks :lol:

I really don't think I'll ever be able to say this enough. Thank you guys so much. All of this support is amazing. You guys rock!
 
Here are some more ear-testing tips and a document I wrote up for creating a conducive ear-testing environment that might be of help.

And here's a snippet of spreadsheet-specific terminology:
Questions on understanding how to use the spreadsheet get asked a lot, so I thought I'd share a quick run-down of spreadsheet-specific terminology:
  • Fur shot: when the syringe needle pokes through almost like a sewing needle through fabric and it is unknown how much, if any, insulin actually made it inside the cat. Usually detected by wet fur or the smell of insulin (it smells like band-aids or scotch or antiseptic). IT IS ALWAYS ASSUMED THAT THE CAT GOT THE INSULIN AND YOU NEVER GIVE ANOTHER SHOT. It is always better to miss a shot than to give too much insulin.
  • AMS/PMS: morning (AM)/evening (PM) shot
  • AMPS/PMPS: morning pre-shot test/evening pre-shot test (it's assumed the shot is given within 15 minutes or less of this test).
  • +1, +2, +3...: How many hours after a shot, i.e. +1 would be one hour after their last PS (pre-shot) test
  • BG/BS: Blood Glucose or Blood Sugar (numbers). Usually used in relation to testing and dosing and what "level" or "point" the cat is at. Used in a sentence: "Michelangelo's BGs have been high so I've been increasing his dose."
  • AMBG/PMBG: morning/evening Blood Glucose. Used when no shot has been given at the regular shot time.
Click to expand...
 
Welcome! Eddie and I are new here as well. I can't even begin to express how helpful everyone is here.

When we started home testing, a couple tips we found very helpful were 1) making sure the ear was warm enough. We have one of those warm up neck terry cloth thingies that you toss in the microwave to warm. Eddie didn't love having it on his head at first, but it warmed his ear sufficiently. There are a variety of ways to warm the ear, but a warm ear really is key in the beginning. 2) We keep his no-carb treats in a bag inside his test kit, so the whole thing smells delicious. We now have a plastic container that all his supplies go in, and he hears the lid click, and walks over to the testing spot so he can have treats. Eddie loves his testing box. 3) I use the lancet device, since I wasn't quick or steady enough with hand poking with the lancet. Ours comes with a clear tip, so you can actually see where you're aiming. I didn't realize what the clear plastic lid was until I ran across someone else's post mentioning the clear lid, and I was like "ta-da!" Seeing exactly where we were poking helped 1000%. If Eddie is being cranky about it or overly squirmy, I'll let him go and tempt him to come back for a treat a little bit later and try again.

This is all very overwhelming at first, but with testing, and the vast wealth of information available, I'm sure you'll start to feel much more in control of P's condition.

Eddie is a ProZinc kitty as well! It's interesting to look the convos and spreadsheets of other ProZinc kitties. We will be watching yours!

Jen and Eddie
 
Thanks you guys, those are some great tips!

I've started putting the treats in the bag with his testing supplies, that is such a great idea. I put some rice in a sock and warmed it up and but he wasn't too cooperative with me holding it to his ear. I do have other cats, and they hover around because they want treats too, so I'm going to have to start putting them in a different room while I'm testing. I was really scared to attempt using a lancing device, because I'm scared I'll pierce his ear, but I think it would help out a lot. It'll be quicker and I think he'll appreciate that. lol which lancing device do you use?

Btw, he tested at 256 this morning. I'm getting ready to feed him, and give him a shot. (I can't believe the shot is the easy part!) I've got school today, but I'll be working on a SS for him when I get home.

Thank you all, have a great day!
 
While you work on the home testing routine, there are some Secondary Monitoring Tools in my signature link which explain other assessments you may wish to make - ex intake and elimination, weight, behavior, etc.
 
which lancing device do you use?
Click to expand...

I use the one that comes with the Relion Confirm. The blue cover allows you to twist and adjust the needle depth, so if you have it too long and are going through the ear, you can decrease the length of the needle. Here is a picture of it.
lancing_device.jpg
We also noticed that the glucometer's beep at various times was bothering Eddie, so we changed the setting to silent.
 
Melissa...I thought giving the shot was a lot easier than testing also. :smile:

This may sound like a silly technique for ear warming, but if Rumpelteazer's ear feels cold, I just breathe on the back of it...she thinks I am giving 'kisses' and it warms it up. Who knew? :lol: :roll:

I tried using the lancing device but it was too cumbersome for me. EBID----Every Bean Is Different .... I guess. :smile:
Some kitties don't like to hear the click sound near their face so if you notice this and still want to use the device, you might want to click it around him when not testing so he gets used to the sound. Offer treats.

We have all gave our sugar-cats an ear piercing at one time or another....we even have poked our own fingers. :roll: It isn't a big problem...just be sure you apply some neosporin with pain when testing (to ear...not finger :lol: ).

Looking forward to seeing your ss.
 
I think I may try the lancing device. I think part of the reason it's so annoying to him because it takes me so long to poke him manually. And the lancets I have are just too small. I have to milk the hell out of his ear to get a bead of blood. He'll probably not like the sound of the device, but I'll make sure to click it throughout the day when he's around. And I'll definitely try the Neosporin with pain. I'm going to start testing in the same, comfortable spot and just not rush it. I know how important testing is, so I feel like I have to get a number every time I test, but if I just slow down and relax, I think we'll both feel much better about it. I try not to psych myself up, but it really is hard. I'm going to follow KPassa's tips and hopefully I'll be doing better soon!

Now it's time to go see about this spreadsheet... @-)
 
I'm wondering if I should be starting a new thread. I'm new to forums, so I don't know when to start a new thread. Please forgive me if I'm not quite up to par with forum etiquette. :? And please don't hesitate to clue me in if there's something I should change or do differently.

I've been going through a few spreadsheets (mainly Misty and Rumpleteazer's) and I think I've figured out why they're so daunting. You guys test a lot! Or rather, started off testing a lot. And now I'm concerned I'm not testing enough. He just hates it so much. Once I get better supplies (proper lancets/lancing device/Neo with pain) and get better at testing, I'll be more than able to test more. But for now, do you guys think testing 3 times is enough? I'm going to make sure I always do the midcycle test because that one's really important and I do his AMPS and PMPS. What should I do?
 
Three times a day is fine. The midcycle number will warn you if he is going too low or if we might need to adjust the dose upward. Always test before giving a shot. Our lives are all different. Some people can test more than others. Those three times and the occasional curve will work fine.

Re the new thread. As soon as you get a spreadsheet going, you could post on the PZI forum. Everyone there has been on your insulin. It is much smaller than Health so if you have an emergency, post here. If you are posting for dosing advice, the PZI forum is better. Unless it is an emergency dosing question and no one else is posting on your thread here, it is unlikely that anyone using another insulin will give dosing advice on this forum. (the insulins require different approaches)

But if you need feeding or testing advice, this is the place.
 
I swear by the Accu-Chek FastClix lancing pen. It is the most silent, easy-to-use device out of all the ones I've tried (One Touch, ReliOn, Accu-Chek SoftClix, etc...). The hole where the lancet comes out of is off-center, which makes it super easy to poke by feel instead of by sight, although it does take some getting used to. You get 6 lancets already pre-loaded, so no fiddling around with loading lancets and it's easy to swap out the lancets (just turn the switch). I also re-use my lancets, so this makes it even easier (and safer) since I don't have to recap the lancet every time.
 
Thanks for the advice on the lancing pen. I'll look into getting that one since it's quiet and easy to use.

Whewww. I'm glad three tests is fine. And thanks for the info about the forum :smile:
 
Ohhhh you guys. You guys are so good. The lancing pen. Hail to the lancing pen! Testing was so much smoother this morning! I bought the Relion because I couldn't find the Accu-Chek FastClix. AND IT WORKED SO GOOD! Woo! He doesn't really seem to have a problem with clicking noise. And he stayed beside me long enough so I could put pressure on his ear, so hopefully he won't bruise this time.

*whewwwwwwwwwww*
 
Today is starting off great! Easier time testing (still not where we want to be, but we're still noobs) and no fur shot this morning!
 
YAY.....Glad to hear things are working out for you and P. :thumbup

That is one awesome thing about being here....you get suggestions from other members and then you can pick/try/choose whatever works for you. cat_pet_icon
 
Looking good, Melissa. Succesful test (treats all round, we assume :-D )and spreadsheet up. Today's number looks good. (so last night wasn't a fur shot - you really can't ever know how much goes in).

So our no shoot number for a new diabetic is 200, until you have more data to know what he might do. For reference, the general range in which we consider a cat regulated is mid 200s at preshot and lower 100s at nadir. We don't want to see a number 50 or below without some kind of intervention. Regular food first, other shot in 30 minutes. If number is not rising, then gravy off higher carb food and restest. If still going down, honey. A cat in the 30s probably needs to go to the emergency room.

So can you get a midcycle number today? That will tell us how the insulin is working - how low it takes him.
 
Wow Melissa you're doing great. Took me a good month to get it together and I don't think I was up to your level then. P is one lucky kitty ;) welcome to the board.
 
Thanks you guys!

Oh yes, there were definitely treats all around, Sue! Momma even gave herself one! (A slice of pie for breakfast for this Bean) :lol: Thanks for the update on the numbers. I've read about the no-shoot 200 for newbies, but I didn't have any clue about what was considered regulated. I have read up on all the hypo info, printed it out, and stuck it to the fridge, but it never hurts to keep hearing and reading about it. Drill it in.

We're going to get a midcycle here in about 30 minutes.
 
Doesn't tell us much. There are a couple possibilities: He may have been lower earlier. He may continue to fall. More numbers over time will help with the picture of his patterns - early days yet. The important thing is that you are getting tests in and he is in safe numbers. :-D
 
Once we get more used to testing, I'll start testing more so I know more of what's going on when. Early days yet. Thanks Sue :-D
 
It's a marathon, not a sprint. It takes time to become proficient with the testing, plus you are being given a ton of new information to absorb.

Melissa, you are a woman after my own heart, treating yourself to pie for breakfast this morning! ;-) My favorite apron I use when cooking says "Life is Short, Eat Dessert First".
 
Deb & Wink said:
Melissa, you are a woman after my own heart, treating yourself to pie for breakfast this morning! ;-) My favorite apron I use when cooking says "Life is Short, Eat Dessert First".
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I've always considered bagels, donuts, waffles, pancakes, or croissants as the nutritional equivalent of dessert for breakfast. Since I'm not a fan of any of those breakfast staples, I simply consider cakes and pies as a great replacement. :lol: :lol:
 
Deb, you just can't beat a slice of pie and a cup of coffee in the morning. Best. Breakfast. Ever. :-D I need to get me an apron like that. But mine would say "Life is short, eat dessert first...and last." :lol:

Oh wait a minute. KPassa said DONUTS. ilovedonuts. @-) Sweets really do make the best breakfasts!
 
About the fur shots: sometimes, you see it immediately in the current cycle by flat numbers, sometimes you don't see it reflected till the next cycle (insulin can sometimes last longer than 12 hours). Food can also influence the numbers, too. When I accidentally give Mikey fur shots, I'll feed him 0 carb food (Tiki Cat Chicken and Egg) vs. his regular 5% carb food to keep his numbers from spiking too high from carbs. It also seems to help him "recover" quicker from the missed shot. Some cats who have a partially working pancreas might even see slightly lower numbers a couple of hours after eating as their pancreas kicks in and tries to pick up some of the slack.
 
That is such a good idea about the 0 carb food after a fur shot. I can tell he's not as comfortable after I give a fur shot.
 
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