Newbie needs assistance with BG readings please.

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Scruffy

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Hello, thanks for taking the time to check this out. Here is a link to a post I started recently about some issues we have had. Post started as me looking for advice on Scruffy urinating outside the litterbox and went from there. I have included it if anyone feels the need to look through it.

viewtopic.php?f=28&t=28293

I have since switched him to some low carb soft food and he was returning some low BG readings consistently, the very next day. He has probably been diabetic since August sometime (thats when we started to note increased urine in boxes). He was heavy at around 16#'s. He was put on a weight management dry food around July and we switched all of our cats to timed feedings. Scruffy was loosing weight fast (too fast, unknown to us at the time) and showing other signs of diabetes (again unknown to us at the time).

He was diagnosed on Sept. 7th. He started insulin (long story) Sept. 15th. We have been home testing since 9/21. His dose went from 3 to 4 units on 9/21. As far as we know he was never over about 450. Since 9/21-9/27 he was around mid 300's. He then climbed up to low 400's and vet increased his dose from 4 to 5 units of ProZinc. He has been on 5 units since 9/28. He has been getting two shots each day.

After the 5 unit dose increase he started to drop but it was not constant. He would still spike into the mid 300's, but his overall average was coming down. His average from 10/11 - 10/21 was 170. Keep in mind all the above readings were taken once a day with a few being two times a day 6 to 7 hours after his insulin. Thats what the vet directed me to do.

That brings us up to a few days ago when I started his SS which is linked in my sig.

Due to the consistent low readings (under 50) I consulted with vet yesterday who advised no insulin lastnight. He was still low as you can see, so he was given Karo and dry DM food to bring his numbers up. It worked, however, his numbers went to nearly 300. He has since come back down, I did give him a 2 unit dose (as directed by vet, if AMPS readings were above 200).

I submitted a detailed log and a link to my SS to the vet a bit ago. I will wait for a response but wanted to see what advice anyone had from here.

Its very fustrating due to no knowing exactly how accurate my meter is. I am using a OneTouch Ultra fyi. Strips are coded right, and are new. Unit has been tested with solution several times. Unit was even compared to Vets monitor, one time it was 50 points low (vets read around 440, mine 387), another time ours both gave a reading of 446. The consistent low readings on my SS from yesterday were with a low battery (unknown to me at the time), new battery was put in this am before the 270 reading. However, the manuel does state unit will give correct reading until it just will not work anymore. So I would have to assume readings were correct.

As for behavior, Scruffy is always hungry and eats his food like a starved dog. His water intake and urine has both decreased. Even during the low low readings yesterday he has remained otherwise normal in his appearance/behavior. On his weight, he went from the 16# mentioned above down to 11.5#'s. Since insulin and DM dry food he climbed back up to about 15# now. We are very strict on what he eats but he does scam food from the other dishes from time to time if we get distracted. I was told NOT to starve him while we are trying to stabilze him, so I have been giving him small snacks inbetween his main feedings/injections.

Thank you for any input advice you can offer.
 
The excessive appetite is probably due to the wild swings in BG numbers. More data always helps with advice, but from what it looks like to me - 5 units looks to be way too much for your kitty. As long as the numbers stay up above 60, I'd stay with the 2 units for a few days and see how things even out (you may have higher numbers for a cycle or two due to the low numbers seen yesterday). As you already know now, it is very important to test at each preshot time with prozinc, and at a minimum once during the middle of the cycle. Great job on avoid a possible hypo situation yesterday!!
 
Thanks, we are keeping a close eye for now. For today his +5 is 151 and +7 is 76. Update is sent to Vet waiting to hear back. I am guessing he is a bit to low for being +7 but we will see if he continues to fall. I will re-check at +8 and see what we have.
 
Make sure you feed a small amount of low carb food with that 76. We don't want him dropping any more from there! Depending on what he does today, you might need to lower the dose slightly for tonight. Keep us posted!
 
Thanks, I am still thinking in terms of low BG=more dose, need to get that out of my head. I was thinking the same thing, thanks for confirming the food. He and his one brother are stalking me now anyway so they are hungry. Going to go with a 1oz snack of the low carb soft. I also want to avoid going to low again and then needing the Karo and higher carb dry DM food. Giving him that can't be any good for his system either.
 
Spoke with the Vet and she is pleased. She explained that hopefully the insulin is starting to wear off and his numbers will climb. I will be taking a +9 shortly and a +11 at 4pm. If not, then it would look like a change in dose and or maybe insulin is in order. I am almost out anyway. This is starting to make more sense now. Thanks!
 
With that 47 you definitely want to feed some more food. I would test again in an hour to make sure he doesn't go lower. If he does manage to get above 200 by shot time then I personally would recommend going down to 1.5 units. If he is still low then you can postpone the shot until he is above 200 or you can skip the shot tonight and start again tomorrow. If you do wait to shoot until he is above 200 then you must be able to shoot at or around 12 hours after the shot tomorrow. I hope this all makes since!
 
With the 47 Vet advised I feed him his normal meal now. So I did at 2:30pm (instead of 6pm), gave him 3oz of low carb soft food. I will recheck at 3:30 and call them back. I work third shift and come home for lunch, wife works first. So we are pretty flexable most of the time. I just need to show her how to do the bg and we will be all set. If he starts to climb and stays there over night I would agree with you on the dose.

Yes, it is starting to make sense to me now. It was never fully explained to me at the vets. The one I have been working with is great. If it wasn't for this site I never even would of heard of a BG curve. Other doc was just having me test 6 hrs PS and thats it.

Now I have to try and get some sleep. Getting up every hour 45 to test does not get you much rest @-)
 
Way to go Scruffy.. with the posting and being on the BG readings! have you considered isolating him and making sure he is able to eat wet low carb anytime he wants? You can add a bit of water to wet food and put in ice cube trays. Others have done it..maybe someone else will chime in and give advice. I feed as much and as often as possible.. Khan lost 6.5# so he really needs it. Whatever I do I'm being consistent as much as possible with the feeding so his BG can be regulated on that type of food with that type of schedule. Unless your cat is obese- I guess I wouldn't worry about over feeding low carb wet food.. if he is hungry feed it, document it so you know if the BG number become strange. I think of it this way (maybe its wrong I don't know).. if Khan's BG numbers drop too low he will have food to eat to help him- even the low carb can help vs nothing in his system.

Way to go..
 
Actually yes, he is over weight. Thats what startedt his whole thing back in July. He lost weight when we took them off the self feeder. He lost too much though, somewhere in there he became diabetic. He went from 16#, down to 11.5#. He should honestly probably be about 11# or so. Since he has been treated for DB, his weight has climbed back up to 15#, even with the restricted feeding. He needs to loose weight, not right now, but I don't want him to gain any more either.

The way he eats now, I truely believe he would just keep eating until whatever amount I put down is gone. I have caught him eating the other cats throw up!
 
This is what helped me so I'll pass it on to you..

Insulin is the key for the cat's body to take in the nutrition..without it the cat's body literally starves...so the cat keeps eating and eating yet loses wt and lean body muscle mass-- so it is why it is important the cat eats. Certian insulins do not work very well unless there is food in the tummy-- food that has already began to process. Humulin N works that way.. I use to try and wait 15-30mins after Khan began eating before I gave the shot because once the food starts to process the body needs the insulin to open the doors up for the nutrition to be used from that food. if you give an insulin like Humulin N without food being processed you will think you need to keep giving more and more to get the numbers down.. doesn't work that way. insulin and food work together for Humulin N. I am very happy with the Lantus..sure wish you could switch to it.. just look at how much more regulate Khan is just in the 2 wks he has been on it vs a long time on Humulin N? I can tell he is feeling better as well by how he is grooming himself, coming out more, purring. fur looks better. As for being fat well the is secondary to addressing the inconsistent BG readings. Poor kitty has been on a rollercoaster ride.. it will make the kitty feel icky.. so happy others are watching and advising since I'm a newbie too- just passing along information.
 
Just to clarify - this kitty is on Prozinc, and it does not act like Humalin N and should not be shot/dosed like humalin N. You shoot prozinc just like lantus: Test > Feed > Shoot all within like 15 min.
 
Just took a look at the SS - looks like he is on his way up! I'd guess that within 2 hours or so you guys may have a shootable number. dancing_cat
 
All I know is what I was told when we started him. I was told to feed right before the injection. So we have been feeding, when he is nearly done eathing we inject. Should I be waiting 5min after he eats?
 
There is no need to wait for him to finish eating before injecting. Prozinc acts much more gently than Humalin N. Humalin N can hit like a rock if kitty didn't eat their entire meal, but you don't have as much of a worry with Prozinc. Most prozinc/pzi users inject the insulin while the kitty is eating since they are otherwise distracted!
 
Good to know thanks. As an update his BG was at 88 13hrs PS. Spoke with Vet. We are going to check him a few times tonight and early AM around 4. She predicts he may be a bit hight again but we are going to go with 1 unit if over 200 BG at 6AM. If under then no shot, and monitor close. Wish us luck. Expecially the wife, it will be her fist time trying to get a BG around 9PM tonight.
 
Great, I appreciate it!

So far so good. Wife was able to get BG reading after about 6 attempts. He was 80 at 9:00PM, 3 hrs after his small snack. Just to be cautious I had her give him another small wet snack. I just checked him at 12:20am, again 3 hrs after his small snack and got reading of 104! I will first be able to check again about 4:15AM, so 4 hours after this last one. I will edit this post with those numbers and his 6am numbers.

Ok, 4:30 BG reading is 101. So thats no insulin for 23 hours and no food for 7hrs and he has stayed nearly the same for his last two readings!

Wife will attempt a reading again at 6AM before morning feeding, I will recheck at 8AM and go from there.
 
He sure is wanting to hang on to those lower numbers! Oscar did a very similar thing to me twice while on prozinc. (See his spreadsheet around 4/24) One thing that I have seen when this happens time and time again is the kitty parent runs down the dosing ladder because of the numbers and when everything settles, the cat is back to higher numbers. Prozinc does not technically have a "shed" like lantus, but there is *something* that builds up in the system. Can't tell you how it works, I just know that I have seen it with a few cats on prozinc. So try not to take big dose reductions all at once, just in case. Since your kitty is doing this going from 5u to 2u, you may be ok though! Prozinc can give big changes with small dose adjustments, so a 0.5u dose adjustment is actually a pretty decent decrease I believe. Of course, if in the end you feel more comfortable with 1u then go with it! :-D cat_pet_icon
 
Well his +2 was just taken and it was 98. And at this point its just +2 from feeding this am, no shot. I should be able to get him every two to see if he is going to drop below this 70-80 mark or not that he seems to like recently. If he starts to climb by this evening then we can dose him tonight. The doc predicted he would be high again this am like yesterday, 241 PS.

Edit* Just took his +6 from his am feeding (no insulin) and he is at 85. Going to give him a usual noon snack and check in a few hours. I don't want to get to excited just yet but this is very promising!
 
Very interesting here! The prozinc would definitely be out of his system by now, so I'd say this is good ole pancreas action. Just keep monitoring because if the numbers will rise, it will often do it very quickly and all of a sudden. It is looking more and more like if you get a shootable number, that 1u might be a better way to go.

edit to add: there is no insulin in his system now, so you don't really have to worry about hypo here anymore :-D
 
Just got a low number (65), please take a look and see what you think. I am not over worried but it is lower than most over the last two days. I plan to retest in 1 hour and see where he is going. As noted on SS he did have a snack of canned tuna, different than his usual of Cowboy Cookout lately. The tuna has zero carbs where the CC has 5% I believe. Would this make that much of a difference?
 
65 Is a great number, especially with no insulin! A lot of times the numbers go down just after eating - this is because food triggers the pancreas. Just as a reference for you - my otj kitty Yoda frequently gives me numbers as low as 39 now that he is off insulin. Some kitties are just naturally a little lower than others.
 
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