Newbie Needs help establishing testing/feeding/dose schedule

Status
Not open for further replies.
Tigger's Friend

Tigger's Friend

Very Active Member
Hi, I'm having a hard time trying to figure out how I'm going to do Tigger's testing, feeding & shooting around the existing schedule he & our 6 other cats are used to-

We live on a ranch, & have 7 tame ferals that need to come inside or into enclosures before dusk because of coyotes, bobcat, etc.

We usually get up around 6:45 - 7AM & go to bed around 9:30 - 10PM (I need alot of sleep :oops:)

Morning: Normally we feed all cats around 7:30 AM.
Could I test Tigger @ 7AM, & if all's good, feed him at 7:30 & shoot. Does that give me enough time if he's below 200?
7:30 works well because all the cats are used to it, plus I'm medicating 2 other cats then. If Tigger's glucose is below 200, I could hold off & re-test up till 8AM or ??????

Afternoon: Normally we start getting the cats in around 5PM, & feed at 5:30 (earlier in the Winter).
Tigger needs to get his big meal & insulin at 7:30, though, based on the Morning schedule. Unfortunately he's used to the 5:30 routine & all other cats are eating then.
Can I test Tigger at 5:00, & if he's above 200, give him a snack with the others, then re-test at 7:00 for his big meal & insulin at 7:30?
Not sure what I'd do if he's below 200, tho'. Am I giving myself enough time for lower glucose levels with this schedule?
Would a 5:30 snack mess up a 7:00 test for his 7:30 insulin?

Lastly, the indoor cats all get fed a small snack at 9:30-10PM when they go to bed. I can test before that, too.

Does this schedule sound like it will work? If not, does anyone have any suggestions for the parts that don't?

Thanks alot, everyone - this has been really perplexing for me.
 
Re: Newbie Needs help establishing testing/feeding/dose sche

Easy part first...
The PM snack is not at all a problem. In fact, it can give you some confidence that he won't drop as low at night if you are giving them a snack a couple of hours after the shot. And just before that snack is a good time to test anyway. It would be at +2 or thereabouts. If you see a surprisingly low number at that time, it would indicate a cycle that is likely to drop "lower than normal", sort of like a "head's up" that you may be in for some late night testing. A snack at that time should ward off a big drop before nadir time.

As to your other questions, it seems the big issue is "what if he's lower than 200 at shot time"? It will largely depend on how comfortable you eventually feel about shooting at a number below 200. We always suggest that newer members not shoot under that line in the sand. But it doesn't mean you can't ever do it. That's where your data becomes your best friend.

With a good set of numbers that show you how far his BG is likely to drop on any given dose, you might find you have some "wiggle room" on that 200 line. One option is to just give a slightly reduced dose on time. Another is to stall, hope the number comes up to 200, and then feed and shoot. But the obstacle sounds like you can't stall for long, or it throws all the cats off schedule, and that can be nerve-wracking with a bunch of loud voices telling you "it's way past time to eat!!!"

I think your plan as you laid it out can work. It may mean you need to skip an occasional shot if you see a 140 at shot time and it only goes up to 160 when feeding becomes unavoidable. But I think that the times that will happen to you are going to be few and far between. Definitely the exception, and not the rule. And I also think that once it happens, you might be at the point where shooting a 175 is something you are comfortable with doing.

Lets see what other think?

edit to add - I think the 5:30 PM snack before the 7 PM test is okay, as long as it isn't a whole meal's worth of food. It shouldn't make his numbers go sky high.
 
Re: Newbie Needs help establishing testing/feeding/dose sche

Glad you joined us, Suzanne. It's a small but friendly group busiest in the am/pm and on weekends. If you ever have an emergency, post on Health where you'll have more eyes.

I think your schedule looks good. Staying two hours away from food for a preshot test is the important issue and you have that covered.

Have you started testing yet? It's a good idea to get that routine down before you get the insulin. How about a spreadsheet? Do you need help with that.
 
Re: Newbie Needs help establishing testing/feeding/dose sche

Thanks Carl & Sue,

Good input, it makes sense. I'm relieved you both think our existing schedule could work. That's a big load off. I'll have to address the lower than 200 issue when it comes, & will post on the Board. With the GLipizide, Tigger's numbers have stayed mostly in the 220 - 280 range, with a few higher & lower numbers

I have a spreadsheet, Tigger's Glipizide SS (attached), but it's for the glipizide (oral) that Tigger's currently on. We haven't received the ProZinc yet!

I'm also concerned that Tigger's test numbers are due to the influence of the glipizide, which is lowering his glucose. I don't know what his un-medicated numbers are. Given that, do you think it would be better to start at 1/2 unit instead of the 1 unit my vet recommended?

This is a DUMB question: My vet didn't show me what the U-40 syringes look like - are they marked by units so a first-time shooter won't make mistakes????

Again, I apologize for all my questions - for whatever reason, this disease - the threat of hypo - has me terrified & doubting my ability, especially knowing once I give the insulin, its a 12 hour ride nailbite_smile . I understand there are things I can do if Tigger gets into trouble, but the nearest vet is 35 minutes away, & the ER 40. Tigger's health is really important to me, but we've spent alot of money so far, at a bad time. I guess there's never a good time, really!
 
Re: Newbie Needs help establishing testing/feeding/dose sche

The only dumb questions are the ones you don't ask. :mrgreen:

You want, and they make half unit syringes for U40 insulin. I think I would start with .5 since his numbers haven't been bad on the Glizide. The first couple of cycles are always a little scary until you see how he is doing with the insulin. That's why it's good to be confident about the testing so you can test a lot if you need to.

So I'd plan to shoot and then be around to monitor after that first shot. Get a test around 2 hours after the shot to see where he is headed. If he has dropped a bit, then maybe +4 and +6. If he is in the same range as the preshot, +6 should be fine. After that first day, if he is staying in safe numbers, just a midcycle number during the day or night will tell you how he is doing. Any other numbers are great too. After a few days, a complete curve (every 2 hours) will give you good info about increasing or decreasing the dose.

If you want, post here daily with his numbers and you'll get input on how we think they look. After a while, you'll get a feel for what dose is needed for which number.

Generally we consider a cat regulated if they are in the 200s for preshot and in the low 100s or double digits at midcycle (nadir). We don't want them under 40 without intervention with food or possibly syrup. We suggest no shot under 200 but to do the wait, no food, retest thing.
 
Re: Newbie Needs help establishing testing/feeding/dose sche

Hi, just keeping up w/ you. Yes the U40 syringes are marked in units. Did you order them from Costco w/ the insulin? Since U40 is pet insulin many pharmacies don't carry them. If not there is a conversion chart to use U40 insulin in a U100 syringe. Some use the U100 syringes as the markings are further apart and easier to read. They are easier to get and way cheaper too. U40s always have a red cap and the U100 are orange.

If you need them I have extra U100 and a bunch of lancets too. We could meet for coffee. Let me know.

Ann
 
Re: Newbie Needs help establishing testing/feeding/dose sche

What a nice offer! U100s are great for small doses. Do be sure you use the conversion chart since you would be using U100 needles with U40 insulin.
 
Re: Newbie Needs help establishing testing/feeding/dose sche

The easiest way to tell if the syringes are right -
U40 syringes have red caps over the needle. U100s have orange caps.

Don't let insulin or injections freak you out. You'll be giving a hormone, not a "drug", and it is something that is normally "in" your cat anyway. You won't be adding any type of foreign substance. You're just helping her pancreas until it heals and can produce insulin by itself. Think the other thing that will surprise you is how tiny an amount 1u or .5u is in a syringe.
 
Re: Newbie Needs help establishing testing/feeding/dose sche

Hi and welcome to the group!

Like Sue said, there are no dumb questions. Besides, that's why we hang around here so much. :lol:

I'm with Sue and think you should start with .5 unit, that way you can see how the cycle goes and can make adjustments from there.

What a nice offer from Ann & Tess.
 
Re: Newbie Needs help establishing testing/feeding/dose sche

I have a spreadsheet, Tigger's Glipizide SS (attached), but it's for the glipizide (oral) that Tigger's currently on. We haven't received the ProZinc yet!
Click to expand...

Keep using that same spreadsheet. Put some text across the middle columns that say you have switched to using the Prozinc.
 
Re: Newbie Needs help establishing testing/feeding/dose sche

Wow, thanks, everyone, lots of great information.

I think I'll order U-40 half-unit syringes for now - don't want to screw up a conversion in my jumpy state.

Until then, I just 'guestimate' .5 unit, right? Syringes should arrive today, so maybe mine are marked. I ordered from Costco, but they weren't sure how long it would take or the cost, so I also ordered from American Diabetes Wholesale ($21/100 incl. shpg). Prozinc at Costco is about $125 w/ tax.

I prefer the .5 dose - it would lessen potentials for hypoglycemia - that's my only fear around insulin. We can always increase the dose, like you say, after a day or so, once we have some curves. Hopefully the vet agrees. Do you ever go against your vet's advice when dosing? I do feel much more comfortable with the .5 unit to start.

I also like keeping all the data on one SS - I can see easily what improvements are made when.

Anne - once we're regulated here I'd love to purchase your extra syringes! Thanks for the offer. I'll also check out your vet asap once Tigger's regulated. I like the new vet, but she's only in the office Mon & Tues, & every other weekend - I didn't realize that, & communication's difficult or with a different vet not used to Tigger. The Prozinc's in at Costco, but I still don't have a vet response re. changing over from glipizide to Prozinc & any detox time. I won't start dosing until I know that. So we may have to wait some more. But I'd love to have coffee - maybe in a week or so, once Tigger's regulated. I'll be ready for a break!

Plus Tigger's developed a wet cough that's not going away - not terrible, but several times a day since the dental & diagnosis 5/15. Had hoped it was a hairball. :sad:

You all have been amazing - it's like finding an oasis - with knowledge! I don't think I can ever thank you enough.
 
Re: Newbie Needs help establishing testing/feeding/dose sche

I think that is exactly what you tell your vet. It was his first insulin shot and you were nervous and you wanted to start lower and increase if necessary? Nobody can argue with that.

We do have some history when changing from Lantus and Levemir to ProZinc. With that switch, the prevailing wisdom seems to be wait a few cycles so the shed can deplete. I am not aware of a PZI user switching from Glipizide to insulin so I don't know what would be best. It would seem like stopping the Glip for a cycle would be enough, the starting the PZI. You could test during the off cycle and if and when he is rising and clearly above 200, start the insulin.
 
Re: Newbie Needs help establishing testing/feeding/dose sche

How often do you dose on glipizide? May want to wait one day, instead of one cycle. Glip works differently than insulin, so it's probably safer to err onthe cautious side.
 
Re: Newbie Needs help establishing testing/feeding/dose sche

A number of things may cause a wet cough, including pneumonia and congestive heart failure. It would be a really good idea to have the vet check him out.
 
Re: Newbie Needs help establishing testing/feeding/dose sche

I heard from the vet's office - glipizide is short acting, dosed q. 12 hours, so its ok to start the insulin at the end of 12 hours, when I would've been dosing the glipizide.

So, that means we start Prozinc Saturday AM, 1/2 unit. (oh, my syringes weren't marked in half-units, will have to call & order different) nailbite_smile

Re. Tigger's cough, his heartr sounds good, but he'll need an x-ray next week. It's intermittant - sometimes none, once or twice a day - & started when he got his dental 3 weeks ago.

Am still hoping the diabetes from his dental infection & 1 steroid shot will be transient. The shot was given 4/18, & the vet said at the time it would last 2-3 months, so its conceivable his high glucose is still influenced by the steroid.

Thanks, everyone!
 
Status
Not open for further replies.
Back
Top