Newbie Here. Lots of Background Info and Questions.

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tylertheragdoll

tylertheragdoll

Member Since 2014
Hi,

I'm new to the forum and have a 11 y/o male ragdoll named Tyler who was diagnosed w/ diabetes 8/29/14 but haven't done as much reading and extensive research as I should have until I found this board.

Got some Fancy Feast Classic Turkey & Giblets today and already he's a very happy camper with the food. Reduced the insulin from 1u to .5u on Prozinc as he was transitioning from 35% carbs to ~7% carbs. I have my own excel spreadsheet that has all the testing records and the glucose curves I've done since his dx and will be xferring that data to the template that's used on this site.

What I've found is that Tyler quickly metabolizes the ProZinc at a predictable 4 hours after a shot (avg. has been 1u BID) w/ a VERY LOW nadir on Alpha Trak...It was low as it was when it was in the 50s and a high 30 at one time (rubbed corn syrup on his gums right away) but I based it on AT's normal range...not the converted values here that most people use. He would get up into the 250s AT at the end of the curve (PMPS). I thought this might be the somlygi (sp) issue but I have no idea now.

In the meantime, here are his latest readings based on the changes I just made.

10/3/14 - 10/4/14: Tyler's overnight glucose curve on the Alpha Trak II:
5:05pm: 128 after his first FF meal
7:59pm: PMPS of 125, only .5u of ProZinc given after reading
10:11pm: 73...
12:03am: 46!!! Only 4 hrs since his .5u of insulin and no signs of hypoglycemia. Gave him 35% carb dry treat.
12:26am: 63
1:01am: 79
1:29am: 94, had FF meal after reading
2:16am: 123 :-D so tired though...
4:12am: 148
8:05am: 127 No insulin shot given. Fed FF immediately after.
10am: 132
12:03pm: 131, Fed FF
2:01p: 129
3:57pm: 123, Fed FF
5:58pm:132
8:03pm: 108

Tyler's Background, Medical History and Context

2010: Bladder Stones
*Surgical removal of large struvite bladder stones, requiring a diet change of mostly dry Hills "prescription" food from dry "premium" food. Dr. Lynne would be shaking her head if she read this.
*After DM - Rx wet food exclusively had him peeing back in the litter box after only a day so I thought this was a very good sign..until I found out that the Rx canned food was 35% CARBS!!!

2011: Asthma
*Before DM - Put him on low dose of Prednisone daily when asthma attacks were occuring, every other day or 2 when it wasn't.
*After DM - Now use the Flovent inhaler w/ the cute, funny yet daunting AeroKat mask every other day and no asthma attacks whatsoever. Hoping the asthma will cease when he transitions to a mix of the Fancy Feast Classic and raw Feline's Pride.

To Do's, Next Steps & Questions
*Populate the standard SS used at this board w/ the BG data/curves I've recorded since Tyler's dx
*Smaller insulin needles - switching from 40u to 100u. What do you like?Thanks for answering!
*Continue using the lancing device that came w/ the AT kit. I read that there are generic lancets that can be used...Does anyone know which ones? What stores carry them? Thanks for answering!
*Potentially get an autofeeder I've read about this one but I'm concerned about the plastic. Anyone come up w/ ways to deal w/ this other than making your own custom ceramics?Thanks for answering!



Updated Shopping List
-ReliOn meter - Walmart ($15)
-Arkray GlucoCard 01 Sensor Test Strips - ADW (250 strips/$70)
-Ketone testing strips - Walmart
-Generic lancets - local store (100/$5)
-ReliOn U-100 syringes - Walmart
-Sharps Clip - Amazon ($6)
-PetSafe5 Autofeeder - Amazon ($40)

I'll probably have a lot more questions as I continue reading more and more...would really like to get Tyler into remission as it seems realistic w/ the further changes that have been made today alone. Thank you for reading all the way to the end of this post!!! :smile:
 
Awww....Tyler is such a cutie, even if he is at the vet's in that picture. ;-)

Remission is always a possibility. We're actually one of the many success stories of FDMB. Jersey was on Lantus for about 2 months before she went into remission; she's now diet-controlled.

I used a ReliOn meter to test. When using a human meter like that, we consider the normal range for a cat to be 50 to about 120. On the AlphaTrak, we consider the normal range to be 68 to roughly 160. If kitty falls below 68 on the AT, that tells us the dose is too big. It sounds like that has happened to you a few times (with nadirs in the 30s, 40s, and 50s). I also see that Tyler was in the normal range on the AT throughout the entire curve.

At this point, based on the numbers you provided for the curve, my recommendation would be to not give any insulin (assuming Tyler isn't sky high at the next shot time) until we can get an experienced Prozinc user to help you. Since I used Lantus, so I don't have any experience with Prozinc dosing. I'm going to try to flag down one of our experienced Prozinc users to see if she can come take a look.

Are you testing for ketones? That's one more item we would recommend putting on your to do list. You can buy ketone test strips at Wal-Mart (or other pharmacies).

My thoughts on some of your questions:
  • - We used both the ReliOn brand U-100 syringes and the Terumos. The Terumos were very sensitive to the touch - e.g., accidentally touch it and insulin comes shooting out. ohmygod_smile For that reason, we ended up not using them. The ReliOns are stiffer and we did find more air bubbles with them than the Terumos.
    - When we purchased the ReliOn meter, it came with a lancing device. When we ran out of lancets, we just bought the ReliOn brand lancets from Wal-Mart. When you pick up the ReliOn meter, take a look around at their supplies. There should be several different brands of lancets you can purchase. (I did read that most lancets will work in most lancing devices. I never mixed up brands, so I don't know if that's actually true.)
    - We bought the PetSafe 5 feeder and used it "as is." I haven't heard of anyone converting it to ceramic, although I'm sure it's possible.
    - We used our regular scale to weigh Jersey, so I can't help you with baby scales. Sorry! :oops:

I know that doesn't answer all of your questions, but I hope it's a start. I'm sure others will be along soon to offer their suggestions.

Give yourself a huge pat on the back! It sounds like you're doing a fantastic job with Tyler. You're getting him on the right food, and home testing is going to help keep Tyler safe. Great job! :-D
 
Welcome! You have done a wonderful job quickly getting up to speed on the steep learning curve of diabetes. And Tyler is responding very well to the insulin and diet change.

Yes, I would think he is bouncing from the very low numbers. But even then, he doesn't bounce terribly high as his preshot numbers remain in good ranges. (some new diabetics will bounce from a green into the 400-500 range)

Getting the U100 ranges looks like the best approach, so you can shoot tiny doses like .2, even .1 if needed. You do need to use the conversion chart, as you will be using a U40 insulin with u100 syringes. Here is the chart:

http://www.felinediabetes.com/insulin-conversions.htm

Depending on his am number, you might try .2 IF you are around to monitor. We suggest new diabetics don't shoot under 200 (on ahuman meter) but wait 20 minutes without feeding and retest, until it is definitely rising (you don't want to shoot a falling number) and over 200. And then you may want to lower the dose a smidge from the previous shot (as it gave you an unshootable preshot). If you skipped last night and he is till under 200, then I'd be very cautious about giving insulin. If he is higher, I'd still be cautious as the dose was too high yesterday. (although we would have suggested you not shoot as low as you did but stalled and waited for the 200 cutoff. If you had shot that dose over 200, he might have been in okay ranges.)

If he were mine, I'd start at low doses(like .2 or maybe .5) if he is in shootable range and then increase slowly, as your testing suggests.
 
Welcome to FDMB,

Your doing great so far, especially with the home testing!

Syringes: For the U-100's I got them at Walgreens, pretty cheap too but dont remember how much and I also did not use a sharps container, I used a sharps clip
http://www.amazon.com/Safe-Clip-Needle- ... sharp+clip

They sell them at walmart for like $4, Im sure they sell them where other diabetic supplies are sold. Lancets: You can keep using the AT lancet pen with generic lancets. I buy the walgreens brand (100 pk for about $5) and they fit fine. I use the relion micro for testing but preferred the lancet pen that came with the AT.
Scale: This is the scale I use
http://www.ebay.com/itm/SPS-75lb-Digita ... 58aaf10b28
It might even be cheaper by another seller on ebay, I was just trying to find the EXACT model I use. All I do is put a small board on it, tare it, and place my cat on it. I set it to hold (lock the weight when measured) so I can see it after I take my cat off, sometimes it can be hard to read with the board and cat on it still lol. Ive had this scale for years and use it for my cats and crafts with great accuracy.

Auto feeder: Before Hidey was diagnosed I was switching to all stainless steel and ceramic but thats impossible to find in an auto feeder. I also have the petsafe 5 and LOVE it! Buying additional bowls for it is not an option. I even emailed the company seeing if they can be purchased from them and they said they did not offer just the bowls so it would be interesting to see if bowls could be made.

Now on to dosage.....Tyler is dropping dangerously low. We advise newbies no shot if 200 and lower. Hopefully somebody with more dosing advice will chime in as well but I would cycle and and give no shot tonight, and start fresh and LOW tomorrow. His number tonight will most likely be high because he'll bounce from dropping so low. It almost seems like a small token dose of 0.5 might be enough but its hard to say without having more data.

Hope this helps a little and we're here to help each other out
 
hiya,

Tyler is gorgeous. Quick reply about lancets, I've found that any lancets fit my alphatrak so I assume that most lancing devices take any lancets. It sounds like he could be going into remission and that the diabetes could be controlled by diet alone. It may not happen straight away. Angel started on Prozinc and had a few times when he went 24 and 48 hours without. Now he is in remission by most standards, you're welcome to take a look at his spreadsheet (which I need to update). He was on a very tight regulation, receiving insulin if he was over 7/just over 125 on an alphatrak, scary. But if Tyler is dropping so low, that could be dangerous.

x
 
Thank you for the words of encouragement and sage advice! It has been a HUGE lifestyle change for both of us. My friends have their own cat health issues so they understand but when it's as specific and as intense as diabetes on top of the additional TLC needed for his other chronic conditions, it can get a bit overwhelming/too detailed w/ lots of unfamiliar concepts.

@Shelly Congratulations on being "OTJ"!!! Oh that is so good to know re: the Terumos. Knowing that insulin can easily come out is very helpful. I will try getting the Relion brand especially since I need them more than I had originally thought and it's something that can be picked up at the local Walmart. Thank you for reminding me about adding the ketone test strips to my shopping list! The PetSafe 5 is the one I am looking at as well. Someone on this site or on the Amazon reviews wrote about how they actually made their own ceramic dishes and I think they placed it in the 2 unit autofeeder (or maybe it was actually the 5?).

@Sue Thank you for the insulin conversion link! I've been trying to find it somewhere during my searches. I skipped his AM dose altogether and have been tracking and recording it every 2 hours as I go. The overnight glucose curve is now turning into a 24 hour curve.

@dirtybirdsoaps WOW - I had NO IDEA that there was anything like the sharps clip. What a fantastic and BETTER alternative, thank you!!! I have absolutely zero counter space so it has quickly turned into Tyler's counter space. This will help so much. Totally on the shopping list! That is so great to hear that the AT lancing device can use generic lancets. I am really getting sick of purchasing all these expensive AT supplies. Gosh even the lancets are so much cheaper buying them generic. I'll take the $5 vs. the $20 ($30 at VetDirectRx) any day. I use them so much that I'm already low on the 100 test strips and lancets I got a few weeks ago!

@SweetAngel I'm so glad to hear that I can easily find any lancet at the local store as I'm just not very good at tracking the supply levels until it's suddenly down to just a few!
 
Yay - I'm glad some Prozinc users were able to stop by and offer some suggestions on dosing, as well as give you some additional info about the questions you had asked.

I know exactly what you mean about others not being able to understand all that we have to deal with when we have diabetic cats. You have definitely found a wonderful place where others understand exactly what you're going through. I truly credit the members here with Jersey's remission. (Thanks for the congrats, by the way!)

Hang in there. I know it's overwhelming right now, but you have a huge chunk of the hard stuff (e.g., learning to home test) out of the way!
Shelly
 
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