Newly diagnosed, looking for help

I was scared that eyeballing was bad, In my mind I thought that if I couldn't accurately measure it that it would be a bad thing so I went back and forth about it for as long as I could. 😣😫😣
 
Honestly, in a newly diagnosed cat with very little data and very few mid-cycle tests to know the nadirs. I would not recommend shooting 1 unit, especially with no knowledge of his nadirs.
 
espinogena said:
I was scared that eyeballing was bad, In my mind I thought that if I couldn't accurately measure it that it would be a bad thing so I went back and forth about it for as long as I could. 😣😫😣
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It’s okay. You should try to get some tests tonight during the cycle though. will you be awake in two hours so that you can get a +2 test?
 
Suzanne & Darcy said:
Honestly, in a newly diagnosed cat with very little data and very few cycle tests to know the nature I would not recommend shooting 1 unit, especially with no knowledge of his nadirs.
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But you're the one who told me to give him 1 unit though so now I'm extremely confused... It feels like what I'm supposed to be doing is changing constantly and I just don't want to do the wrong thing...
 
If his +2 number is quite a bit lower than the PMPS number – – let’s say he has gone into the green numbers — I would be sure to give him some food (which you should do at +2 anyway) and to set an alarm to test him again in an hour or two — depending upon how low the number is.
 
espinogena said:
But you're the one who told me to give him 1 unit though so now I'm extremely confused... It feels like what I'm supposed to be doing is changing constantly and I just don't want to do the wrong thing...
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Yes. Your vet wanted you to start with 2 units and I initially did recommend cutting that to 1 unit right off the bat. This was based off of the high numbers you mentioned before you started testing. As soon as I saw the blue numbers you were getting with your home testing, and particularly today where he stayed in blue even after you skipped the shot, I recommended cutting the dose to .5 units. This is what we do when we start to accumulate data on the spreadsheet; we can make adjustments that are in line with the BG numbers. I mentioned this afternoon about reducing the dose to .5 units if he had a blue PMPS. The reason I did this this afternoon is because I wanted to make sure you knew what to do if I wasn’t available at your evening shot time.

If Manten were my kitty, I would reduce his dose to .5 units going forward. Then I would hold this dose for 7 days (unless he dropped below 90 where he would earn a reduction down to .25 units.). After 7 days on the.5 unit dose, we would reassess the dose and see if his nadirs are in the desired range or it he should increase to .75 units.
 
Ok I'm going to have to get different syringes then because my main issue is that eyeballing insulin felt like a bad thing to do so I was just worried that if I didn't have the correct way to measure it I shouldn't guess..
I'll test him every 2 hours to see how he is, I just figured since he was in the 120s before last night and was ok with 1 unit, that at least for right now since I couldn't measure .5 right that it would be best. I just never imagined eyeballing insulin would be allowed
 
I’m sorry if it’s been confusing. And in the post above I meant to say — that in a cat who is staying in the 100s (the blue numbers) like Manten has been, I would not recommend shooting one unit just yet until more information is on the spreadsheet about how low he is going. Sorry I phrased that wrong.
 
espinogena said:
Ok I'm going to have to get different syringes then because my main issue is that eyeballing insulin felt like a bad thing to do so I was just worried that if I didn't have the correct way to measure it I shouldn't guess..
I'll test him every 2 hours to see how he is, I just figured since he was in the 120s before last night and was ok with 1 unit, that at least for right now since I couldn't measure .5 right that it would be best. I just never imagined eyeballing insulin would be allowed
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It’s OK. Do not be hard on yourself. You were trying to make the right decision and I can understand how not having the half unit markings on the syringes really makes it very difficult. I totally get that! You haven’t done anything wrong, but you really will want to have the U-40 syringes with the half unit markings because when we make dose adjustments, they are usually done in .25 unit increments. So there are doses that you have to eyeball even if you have half unit marks on your syringes. If you are shooting a .25 unit dose, you have to eyeball between the zero line and the half unit mark. If you are shooting .75 units, you have to eyeball between the half unit mark and the 1 unit mark. I can show you pictures later. This is very common practice doing this, but it might help to have some photos.
 
Well now that I know that I do feel better. At the vet they had us practice with saline on syringes with half unit markings but sent us home with full unit line ones and i didnt even realize it until now. If he's below 90 why would he still get insulin? I'm just wondering how will I know when to reduce or when to skip a shot.
 
Normal cat blood glucose is between about 50-120 (human meter) with most of the time in green (below 100.) For newly-diagnosed cats, we usually recommend following the start low go slow dosing method (SLGS). After about a month of data is collected on the spreadsheet, we can see if it would be in the cat’s best interest to follow the Modified ProZinc Method (MPM.) I won’t go into a long explanation of that right now. For the time being, when following the SLGS protocol, a reduction in dose is earned when the kitty drops to 89 or less. That would not be the case with the MPM method, which allows the cat to spend more time in the normal green numbers. Don’t worry about that at this time.

I hope that makes sense. Right now, Manten’s BG hasn’t really been that high, so we may need to do some custom dosing. He may be keeping us on our toes.

His lower BG is probably a result of the lower carb food (which is fantastic and means he needs less insulin.)

Did anyone tell you to not shake the vial of ProZinc? To mix the ProZinc you just gently roll the vial on a flat surface such as a table or countertop. That’s important so that the insulin is not damaged. I am trying to think of things that the vets often do not tell you.
 
Oh no. I just realized I have to get up in 4 hours. I’m going to bed.

If Manten should drop below 50, which I am not saying he will do tonight…. post for assistance on the Feline Health Forum where there should be someone to assist you overnight.
 
Good morning. Well done last night taking care of Manten! You did just the right thing to feed a little food with each test. It doesn’t need to be a lot of food, but you did it just right!

I see that he went to 78 — so actually a very beautiful cycle. 78 is a great and healthy number for him to be in. Of course (because we are currently following SLGS protocol for Manten) it also means that he earned a reduction in dose of .25 units — down to .75 units as his new dose going forward. Until you get the syringes with the half unit markings, will you feel comfortable drawing an approximate .75 unit dose? You can definitely try to eyeball between an imaginary half unit mark and the 1 unit mark. I don’t want you to stress about it though so if you want to just give .5 units (which you already will have to eyeball anyway) you can do that. It’s your call.
 
I haven't gotten back to the computer yet but I tested him again 2 hours after that and he was 148 but that was because I let him have 2.5oz of kitten food because I was anxious that he would continue dropping too low past that since he was dropping about 15 points an hour. I didn't want him to get below 50 like you mentioned but it definitely shot back up.

I was just having a panic attack for hours and that's why I'm still not asleep. He is absolutely sick of me testing him at this point, he hissed at me very loudly like he usually does without gabapentin even though he had it as usual.

I don't know what the right dose is for him at this point but I feel like .5 would be easier to approximate if it is still good enough to give him. My boyfriend is much less experienced with handling animals and medical things than I am so I definitely want to make sure he can correctly handle his mornings with Manten like he has been.
 
It’s going to be okay. And a 78 at +4 in this case was okay. A little of his regular low carb food would have been okay. Are there a lot of carbs in that kitten food? I do understand how stressful that must have been for you if he was really getting grumpy with you. It’s really upsetting too! It hurts our hearts too — for them to be mad at us.

Let’s just take things back a notch to .5 units for now. I think he will do reasonably well on that dose. As for testing today, of course you will want to get the preshot test, but just plan to get only one mid-cycle test somewhere around +5 or +6. This will give both you and Manten a break. Do you think you can do that?
 
Amazon sells these U-40 syringes with half unit markings.
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How do you dispose of your sharps without the sharps container one? Do you just get plastic storage bins or something?
 
Wow I had no idea they made these, I really appreciate that advice. I'm going to get this one that cuts the needle hub and can fit lancets so I can get them all in there to start. My diabetic friend just throws them in the trash, and the american diabetic association says most people do but its very bad to. That stinks so I want to be as good as I can with this
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