Newbie with a diagnosed diabetic since June

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lovey11

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My cat was put on Prozinc insulin on June 13, 2013. She gets injections every 12 hours. She continued with her high carb diet at first and started with a 2 unit dose twice a day. I went to the vet about twice a week to spot check a few BG times. Her numbers came down but were too high. we then tried 2 1/2 and then 3 units. Anyway, I believe she had a er hypoglemic episode almost 3 weeks ago. She has week hind legs, but this day her gait was unusual and she had trouble walking. I gave pancake syrup went to emergency and then the Bg was in the 400 's when tested at the emergency vet. I went to my vet and another vet disagreed that it was a hypoglemic episode and suggested I give the 3 units. I gave the 3 units and brought her in at 5 hour later for a BG. BG was 70. My vet suggested 2 1/2 units.
After this scare, I bought Alphatrack meter at the vet and have been paw testing. My cat is a good patient but doesn't like the paw prick.

Anway, I gradually changed from high carb wet and dry food to low carb wet. For 11 days, she has had only the low carb wet food. Since I am still learning, I don't always get a reading when I want one. Anyway using my meter I gave my cat 2 units for 4 days. I got a preshot number of 185 one day so I gave 1 1/2 units and did the BG about 6 hours later and it was 200. I fluctated dose between 1 3/4 and 1 1/4 for about 4 days with some testing usually giving 1 1/2 units. I tested at about 7 hour post shot for 5 days and got numbers ranging from 178 to 101.

I ran out of test strips so I gave a 1 3/4 dose for 3 administrations when I did a preshot Bg (30 minute before shot) I got 133. I gave 1 1/4 units and then did the Bg in 4 hours. I got a bG of 53. I gave food and treats and the Bg went up to 87 in 2 hours. When I did the next Bg the number was 294. I panicked and gave 1 unit. The next preshot was 387, I gave 1 1/ 4 units. After speaking with my vet, he said that the 1 3/4 was too much and that 1 1/2 should be given for at least 5 da
ys consistently without testing so much. I gave 1 1/2 units for 3 aministrations, but was nervous so I did a preshot (45 minutes before next shot and got a 139. I fed her and then tested again and I got a reading of 244. Cat was nervous after 2 paw pricks (trying to escape). I gave a token dose of 1/2 unit since it was late and could not call vet.

What do preshot readings in the 100s mean? Is the insuliln lasting two long?

Anyhelp would be much appreciated.
 
Welcome! Sounds like you and your kitty have been ona bit of a roller coaster. You are doing lots of stuff right! Glad you went to wet low carb (what flavors exactly? Have you checked out the food charts and keep the carb level in the 8-10% range?). ProZinc is a good insulin and it seems to be working well. And you are testing, which is vital!

So now to fine tune. One suggestion would be to put together a spreadsheet so you, your vet and we can see trends and patterns. It is color. Oded and makes it so seasy to see what is really happening. Here are the directions


http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

It does sound like your kitty is bouncing around from highs to lows. This often happens because they bounce - when their body detects a lower number than they are used to, it releases extra sugars. Then if they get extra sugar in the form of syrup or higher carb food from their mom, that raises their blood glucose. So the next number is artifically high - raised by their natural glucose and the food. If you shoot a higher dose into that number, it starts the cycle all over again.

The best way to avoid this is to keep track of the lows midcycle to see how a given dose affects their numbers and use that info to make future dosing decisions. The spreadsheet is so helpful for this.

I do disagree with your vet's advice about testing. Yes, it is stressful to know that your cat has dipped low. It is more stressful (and deadly) not to know! We stress testing before each shot to be sure the dose you are planning to give is safe for the number you got, and then midcycle, to see how that dose is working. Your pattern of doing that is spot on.

If you want to post daily and give us your numbers, we'd be glad to help with suggestions. Check out how others have done that. The forum is small and busiest am and pm east coast time, so if you have an emergency, post on Health where it is busier.

We'd love to have you and your Lovey() join the family!
 
Catherine,

If you need help with the SS setup and link to your signature. Just ask. There are people that do that for new members.
 
What do preshot readings in the 100s mean? Is the insuliln lasting two long?
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No, I don't think so. I think they mean your kitty is doing really well. And when you see a preshot like that, it means you can adjust your dose downward next shot.

Because you are using an Alpha Track, if you see a preshot of 150, you don't need to give a shot because 150 is the top of the "normal" range of 80-150. If you see a 190, then you might think of a tiny dose. The way you were doing things at first, adjusting based on the preshots, can work really well. In general, to me, it just looks like the doses have been higher than they need to be. If you test and get a nadir number around 100, that's a good dose on whatever the preshot happened to be that cycle.
 
Thank you very much for all your help. One one day I gave 1. 5 units on a preshot of 185 and then got a reading of 200 7 hours later? The dose the few days before was 2 units. On another day I got a 242 preshot and gave 1.75 then 7 hours later the reading was 127. If I don't use the same unit consistently, can I tell about what to shoot. I probably need more data?
Is the effect of a dose cumulative? More powerful if given consistently?
What do you think?
 
If a kitty does well on a dose for a certain amount of days does that mean it is a good dose?
 
With PZI, the dose is generally in and then gone in 12 hours. Sometimes if the dose is too high, you get a number at the next preshot that is too low to shoot. That is a signal that your dose was too high because yes, the insulin lasted longer than 12 hours, and maybe because the cat went low and is just slowly moving back up. More data will give you these answers.

I would add ALPHATRAK to your signature so people know you are using that meter. Most of the people here use human meters, which run a little higher than yours, and we want to make sure we are giving you safe suggestions.

There are 2 ways to do ProZinc. One is to give the same dose for a couple days, monitoring carefully. You'd lower the dose if you got numbers too low but you wouldn't raise it for a couple cycles. Some cats seem to do well with the consistency and sort of " settle in" with lower overall numbers. Some cats do well with a sort of sliding scale. Once you have enough data, you decide that she did well on X units when she was in the 300s and X units when she was in the 200s. And you shoot that amount at that number. To do that, you need the spreadsheet so you can look back and determine what dose gave her what number. That's why we'd love for you to have a spreadsheet - so we could help you figure out what system might fit her best and if a sliding scale, what that might look like.

It's difficult, but you will be surprised how in control you feel when you see the data on the spreadsheet and figure out her patterns.

This is the best place for you to get specific ProZinc advice, as insulins are different and require different approaches. Health is a good place to post if you need immediate help in an emergency, or need some non insulin advice. But no worries -'you will get support wherever you post!

It might help if you'd look at Simon's spreadsheet for example. Click on SimonsMom last post and then click on the blue link to his spreadsheet. Joyce struggled a little at first to get a good system down, but she is doing great - adjusting the doses based on what preshot and nadir numbers Simon has.
 
thank you. I didn't even realize that I could use a human meter. I bought the alph track from the vet. My numbers are lower than the human meter.
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Why is that? Is it Ok if I continue to use the alph trak meter. I am not sure how to convert the suggestions. I will figure out how to put in on my signae now. Thank you

the information about Prozince has been very helpful. Thanks
 
Vets like alphaTrak. But they are initially expensive and the strips are expensive. As we think in terms of trends and patterns, we only care about specific numbers if they are low and dangerous. So we use the cheaper meters and figure they work fine. Whatever you want to use is fine, as long as we know which one if she dips low.

Here is a huge document about ProZinc. It's a little out of date and is good for putting yourself to sleep at night :mrgreen: but it has great links and information.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=32799
 
hi everyone,

Since my cat's morning preshot was 381 from the low token dose given yesterday because preshot was too low. I gave 1.5 units today. The evening pre-shot was low again at 146. I am going to test again and see if it is rising. I would like to give a reduced if it is rising to close to 200. My cat has been very wiggly so testing has been tough.

I will lower the dosage to 1.25 as soon as I get a normal preshot. what do you guys think? I am using the alphtrak meter and I am using Prozince\. I will add my signature as soon as I can.

Does this sound OK? Let me know what you guys think. I am not very experienced. My cat's numbers seem to be changing
 
I should have reduced the dose since 1.5 units have been giving me low preshot numbers lately, but the preshot was so high that I thought it would be OK.

I will make sure to test nadir on reduced dose.
 
I am not clear on your final dose decision. Yes, waiting for a rising number is exactly the right thing to do as is lowering the dose, as you got that low preshot.
 
Catherine, where are you located - East Coast, West Coast? Just want to know when we should watch for your preshot questions. We have people on both coasts and in the midwest.
 
I am on the east coast. I wasn't able to get a blood sample from paw to do test again. Not enough blood 3 times. My cat was really excited. I gave a little less than a 1/2 unit of insulin.

This is what I did yesterday. I used to get nice nadirs with this dose, but I didn't do as many preshots. the preshots I have were higher than what I am getting now.
 
My usual dose was about 1 1/2 but I am getting very low preshots. I will try 1.25 dose for tomorrow .
 
OK, one thing we need to help you understand is "bounces". A cat has a built in self-defense mechanism that protects its body from low numbers. What happens is that the liver ends up dumping "sugar" that is stored there (glucogon) whenever it senses that the BG is going too low.
Important thing to realize is that the liver's opinion of "too low" doesn't have to mean that it's really dangerously low.

Think of it this way. A diabetic cat, prior to diagnosis, has probably been living with BGs in the 300s or 400s for quite a while. Its systems see that as "normal" after a while. We all know it's not "normal", but the cat doesn't.

So once you start giving insulin, you're attempting to get his BG back to "really normal" numbers. On your meter that would be 80-150. The more time a cat goes into that level, the more his body can heal itself. And his pancreas will start producing insulin again like it's supposed to. And his cells will "relearn" how to turn that glucose into energy. That process can take time.

So you give insulin, which lowers the BGs. And at some point, his system says "oh no, my BG is dropping!!!" Doesn't have to be low, again, the system just perceives that it is too low. So, the liver releases stored sugars, and pow, the BG jumps back up.

When you see a low preshot, and you give your regular dose, the BG is going down. If it goes down far enough to cause the liver to "panic", what happens is what we call a "bounce". Higher numbers a few hours later are what you see, instead of the lower numbers you expect to see. And you think "where did that come from ???"

Some days, that is what it looks like you are seeing.

one day I gave 1. 5 units on a preshot of 185 and then got a reading of 200 7 hours later?
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That looks like a bounce. Sometime between that 185 and 7 hours later, the BG probably went lower, maybe under 100. Liver says "whoa!" and releases sugar. 7 hours later, the number is just as high as you started with. And on the surface, it looks like the insulin didn't do anything or the dose wasn't high enough, right? But the opposite is most likely the reason. It was too much insulin on a BG that low at preshot. It dropped lower, and then bounced back up.

On another day I got a 242 preshot and gave 1.75 then 7 hours later the reading was 127.
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On that day, that dose worked the way you want it to. It cut the BG in half over 7 hours. He might have been just a bit lower an hour or two earlier than the +7 test. But it didn't go low enough to cause his liver to react, so no "bounce" followed.

Does that make any sense?

If I don't use the same unit consistently, can I tell about what to shoot. I probably need more data?
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The more data you have, the easier it is to make dose decisions. That just requires time. It doesn't mean you have to try to test 10 times a day. Over time, you'll have a much better idea of how much a certain dose does. The other piece of the puzzle is "what caused the number I got at preshot time?" There's several answers to that question. Sometimes it is a bounce induced and "inflated" number. Sometimes it's because the prior dose might have been high enough for the insulin to last longer than it would typically last. There isn't a perfect answer, and again, you'll be able to figure out that stuff over time.

Since my cat's morning preshot was 381 from the low token dose given yesterday because preshot was too low. I gave 1.5 units today. The evening pre-shot was low again at 146. I am going to test again and see if it is rising. I would like to give a reduced if it is rising to close to 200.
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Some people would think that the lower number (146) might mean the dose was too high. Some people wouldn't. Or that it didn't matter even if that was the cause. To me, a 146 preshot is perfect and just what you want to see. Especially after a preshot of 381.
But your instincts here are correct. You would wait and verify that the BG is climbing, without giving any food. Once you get to a number you are comfortable shooting, you would shoot, but a lower dose. Because the preshot is lower. Maybe .5u would make sense on a 200 preshot?

What you are after is preshots that are not too high, and a nadir that is not too low. Much easier said than done of course. It does take a lot of data collection, and good instincts about what dose to shoot.

Bottom line. If in doubt, shoot less, or don't shoot at all. And make sure that when you do shoot, the number is rising and not falling.
 
Hello everyone

I would like to get some advice on what dose to give my cat. I am worried about high numbers because I have been getting too low evening preshots to give regular dose.

My cat went too low on August 3 to 53 at +4 on the Alphatrack. I have been giving between 1.5 and 2 for the last several days before this reading.

For the past two days, I have been giving 1.5 what my Vet suggested was a good number based on the readings that I had. I have 5 or 6 midcycle reading and a few preshot readings. My cat has been on an all low cab diet for about 12 days and I transitioned for about 4 days before that.

For the past two days I have been getting a low preshot for the evening with the 1.5 dose so I have to wait and give a reduced dose. I was getting evening preshots for 2 days b at 146 adn 139. Then the Bg is high in the morning. Today it was 300 at +10 1/2. I decided to give a reduced dose of 1.25. I didn't get to check the midcycle, but now I the nighttime preshot is 409. On 2 other occasions when I used thd 1.25 after a midcycle that was a little low I got a high reading in the morning.

Any ideas on what I should dose? I wonder if it possible, I made a mistake with insulin or 1.25 is too low.
 
I'd give the 1.25 a few cycles to see if it works. It's possible that she is taking a while to recover from all the bouncing around. It may not be enough but you can always raise in a couple cycles. It seems
like 1.5 was too much so I'd try the 1.25.

We have this saying: better to high for a day than too low for a minute.
 
Thank you very much for such a quick response. I did give the 1.25 a few minutes with prayers to God. My kitty seems a little quieter than usual but she is mellow to begin with. Can I ask one last question? Do you think I should check this dose at 6 hours to see what it does if my cat is agreeable or should I give it another dose or two?
 
On 2 other occasions when I used thd 1.25 after a midcycle that was a little low I got a high reading in the morning.
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The high preshots following the low mid cycles could have been bounces. Today's 409 could also be a bounce, if today's mid cycle was a low number.
 
Do you think I should check this dose at 6 hours to see what it does if my cat is agreeable or should I give it another dose or two?
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Any mid-cycle test you can get will help you to solve this puzzle.
 
Carl, thanks.

Lovey and I thank you very much. I will test at midcyle and see what I get. I will try 6 hours after shot.
 
Hi Carl and Bob and Sue and Oliver,

Whenever you can, Could you factor this in as well. Thank you

I forgot that I did get a midcycle on Wednesday night shot of only 1/2 due to the preshot reading of 146 that evening. I got 178 at +6 and then I got 300 at 10 1/2 +. So the midcycle wasn't low on Wednesday night.


On Thursday morning, I gave 1.25 and then got 409 as an evening preshot. I then gave 1.25 again. I am going to do the midcycle now.
 
The midcycle for last night's dose of 1.25 units was +6 143. So this midcycle isn't too low. It is a little high unless her low could be a little earlier?
So Bg went from 409 to 143 in 6 hours.
 
On august 1 I got a high preshot of 409 after giving 1.25 due to a +7 of 101 but then I gave 1.75 dose and the Bg at +6 1/2 hours was 127. But 2 days later using the 1.75 dose 3 more times probably on more normal or lower preshots. I didn't take data for a day or two. I ended up with preshot on August 3 of 133 and gave 1.25 and got the 53 at +4.
 
Hi, Good morning

I am new to the board, I will try to set up a spreadsheet over the weekend. I can get a template I believe. On one of my posts, I have directions.
 
If anyone is availabe, can you help me with dosing for this morning?


I just did a +11 and got a 146
at +6 the the number was 143 (5 hours earlier)

I tested again and the BG is at 177. Can I give a reduced dose?

When I gave a 1/2 unit at 146 . In 6 hours the number was 178 and then 300 at 10 1/2


Another time I got a low. I fed by accident and then did the BG it was 244 and gave 1/2 unit . The next morning the BG was 381
 
The nice thing about ProZinc is that you can adjust the dose based on the pre-shot test.

If the pre-shot is lower, you may give a lower dose.
If the pre-shot is higher, you may give a higher dose.

And you figure out how to do that just as you did - by looking at the spreadsheet and seeing how a particular pre-shot range and insulin dose worked previously.

So yes, if you wish to shoot a reduced dose out of concern it may take the glucose too low, go ahead. It'll either work or it won't. And you'll get data to help you revise your decision the next time.

Better too high for a day than too low for a moment.
 
lovey11 said:
The midcycle for last night's dose of 1.25 units was +6 143. So this midcycle isn't too low. It is a little high unless her low could be a little earlier?
So Bg went from 409 to 143 in 6 hours.
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That might not seem really low, but compared to the 409, it is a big difference. And it shows the dose did very well last night.


I think on the 176 this morning, you could have given a reduced dose if you haven't already. Maybe 1/2 unit?
 
This is a great example of how to use the data, and to give a dose a couple cycles, especially in the beginning when you are switching to wet low carb. Looks like 1.25 was a good dose, maybe a smidge high as you got a lower amps. I like Carl's idea of an am dose, unless it is too late and messes up your schedule 12 hours from now. If it is, skip. Expect a high pmps as she will have been 24 hours since the last shot but plan not to shoot too high.
 
Thank you Sue and Bob for your feedback. I did give 1/2 units in the morning.

I would like to find a dose that has similar patterns for morning an evening.

I think my initial dose yesterday may have been a hair more than 1.25. It is a little hard to measure on the needles because I only have markings for 1/2.

Do you think I should do exactly 1.25 or a smidge under 1.25 today or less. Let me know what you would try? I would rather have even similar patterns for morning and evening. It is difficult with the lower preshots and you seem to get higher numbers because reduced dose probably the BG is probably rising faster since it is 12 hours after shot now or maybe bouncing.
 
Hi again,


I noticed people testing for ketones. My vet tested my cat a few weeks ago and it was negative. How do you test at home? How often and when should you test for this?

I can make an appointment with my vet as well.
 
This may be a radical suggestion, so see if others agree before taking my advice.

I would recommend dropping down to 1u, and, barring ps's under 200, try to shoot 1u for 3-5 days before you adjust anything. My experience is that my cat does better the longer I hold a dose--but he appears to be atypical. Everyone seems to be using sliding scales lately, but before you can develop an effective sliding scale, you need a baseline of consistent dosing to see how your cat reacts. My thinking is that a lower (consistent) dose will give you shootable PS twice a day, and will (hopefully) give you kitty a chance to recover from Tigger-itis (bounce syndrome).
 
Thank you Lisa for your input. I want to have more shootable numbers in the evening. It makes sense.
 
I like Lisa's idea. You should be able to tell in a few cycles how the dose will work. This whole thing is really about gathering data - finding out what amount of insulin does what, when. Think of it as that, and a marathon, not a sprint and you should be less stressed. :mrgreen:

Ketones: http://www.felinediabetes.com/ketones.htm. Early on, especially when you are getting some high numbers or when you are lowering the dose, it's very wise to test for ketones daily or every few days. Some cats are very easy and will let you stick a strip in their urine stream. Oliver would never pee with an audience so we had to buy aquarium gravel, put it in a clean box and put him in a room alone with it. He'd christen the box and we'd get a sample that wouldn't be absorbed into litter.
 
Hi, Sue,

I am a little worried about ketones now. Where do you get strips? My cat seemed to be acting better a week ago. does bouncing make the cat feel sick or tired.
 
You buy the same strips humans use to test their urine - at any drugstore.

Bouncing can make them feel crummy but checking for ketones is always a good idea.
 
Yes, you could, if you are able to see it on the syringe easily. Some people would call that a "fat 1u".
 
Carl, thank you. I appreciate all the help from you and others. It is nice how you find the time to help others after working.
 
You're very welcome. I'm just watching a baseball game, with Bob curled up on my foot (both he and my foot are asleep), and luckily I can reach my tablet without disturbing is Highness. ;-)
 
Hello everyone,

I wanted to let you know how lovey did with a dose of a little more than 1 unit. (less than 1.25)


Preshot BG was 368 gave little more than 1

+6 Bg was 178

+11 was 271

Gave little more than 1 this morning

PM preshot was 301

What do you guys think, Try the dose a little more or bump it up slightly.
 
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