Newly diagnosed! Updated post 1st blood test! :X

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I don't do dosing input in general, Karen, and also I've no experience with Prozinc so I can't help you with that side of things. I was just giving you some general background info in my previous post. :)


Mogs
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Wren said:
I guess I could set an alarm and test again at nadir at 1:30am?
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Anything you can do to get a good picture of the effect of a dose - particularly the nadir - is always valuable, and especially in the early days. As you build up your body of test data you'll learn more about Micah's response to his insulin and you'll be able to streamline his testing routine - and hopefully get some decent rest along the way! :)


Mogs
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OK....one thing first....the Pre-shot should always be right before the shot....so you want him to have no food for the 2 hours before shot time, then Test/Feed/Shoot, all within about 5-10 minutes

We want the food taken up for 2 hours so the result we get at PS isn't influenced by food..then:

You TEST to make sure he's high enough to get insulin at all (200 is the lowest you should shoot right now unless you have someone watching over you that has experience) If he's below 200, you should "stall" don't feed and post for help.

Next you FEED to make sure he's willing to eat...it's not as important that he eat a big meal like it was with some of the older, harsher insulins, but it is important that he's not sick and not willing to eat at all

Last you SHOOT....and considering your new and don't have a lot of data on Micah, I think starting with 1 unit is probably safer unless you're able to get tests throughout the daytime and at least a "before bed" test at night....it's not going to be necessary to get a mid-cycle at night every night....Just a quick test before you go to bed....Depending on what that test result is, you will learn to know when it's important to set an alarm to get more tests in, and when you can go to bed and sleep without worry

We use Lantus, so I'm not real comfortable giving much in the way of advice, but I'll tag a few others who have more experience with that type of insulin @Sue and Oliver (GA) @BJM @Rachel @Bobbie And Bubba @Robin&BB
 
One unit is usually a good starting point. However, he wasn't horribly high at the vets, so 0.5 units might be an option, too. Once I can see some test numbers in relation to the pre-shot vs mid-cycle, I'll have a better sense of how its working for him.

We never want you to need this - How to Handle A Hypo - however it is a good idea to be prepared, just in case.

And just to make life even more interesting, the nadir can, and does, move around, so testing during that period at different times on different days (or nights!) can be useful. For ProZinc, it is usually between +5 to +7 somewhere; many of the cats here tend toward the earlier part of that interval unless the dose is too high.

If you're concerned about going too low, testing when he is less active, overnight, is actually more likely to catch him if he's going to do that. If you drink a big glass of water, and set an alarm for a multiple of 45 minutes that'll line up with the nadir period, you'll be most likely to catch it if it happens.
(45 minutes is the rough duration of a human sleep cycle and it is easier to wake at the end of one!)
 
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Hi, Karen - Welcome to the "club" that none of us ever wanted to join.:rolleyes: And congratulations on getting up & running on BG testing so quickly, as that's half the battle right there.:D
BJM said:
One unit is usually a good starting point. However, he wasn't horribly high at the vets, so 0.5 units might be an option, too.
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I agree with BJ about this, and Mogs had a good point, too, re: starting low on the insulin dose, and then adjusting upward in small increments (between 0.25-0.5U), based on what you're seeing in the AMPS/PMPS + nadir BG tests. I know we're all looking forward to seeing your spreadsheet tomorrow.:) You'll find having that SS up & running to be a big help: As the blood glucose test results you get accumulate in Micah's SS, that data will make it easy to see how his body is processing the ProZinc.
Wren said:
I did change his diet from mostly Nutro pate to Purina One Smartblends Pate literally the night before I started his insulin. However I think he had one normal poop after starting the food and before the insulin. I was feeding 2 cans a day. Now I'm giving him 3 cans with 1 can split in half as in between treats/snacks.
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The diet change could definitely have caused Micah's digestive upset, but I'd imagine that will settle back down over the next few days ... please keep us posted on the quality of his pooping, ok? (Just for future reference: When introducing any new food to his diet, it's a good idea to transition over a period of several days: i.e., 75% old food/25% new for a couple of days; then 50/50 for a couple of days; then 25% old/75% new for a couple more days; then 100% the new food.)

The other thing that could possibly factor into his tummy troubles is that he's suddenly getting another full can of food per day: that's an increase in daily rations of more than 30%. It helps to think of your diabetic kitty's food as "medicine," too, making sure you're feeding the correct amount to maintain a healthy weight (slender is better for a diabetic cat, but by that I don't mean "bony"). To give you an idea: My cat's is rather large & long for a female - she's about 10.5 lbs., and we maintain that weight on about 2.33 cans of Fancy Feast turkey/giblets per day (3 oz/can). Every cat's metabolism is a little different, of course, so it's not a bad idea - especially when you're first starting with the insulin - to be weighing Micah every day for a while. Here's a handy chart to help you assess his current condition:
body condition chart

It helped me a lot to to put a cat's weight in perspective this way: An extra single pound on a 10-lb. cat is like an extra TEN pounds on a 100-lb. human! I think that sometimes we tend to underestimate how "a little" extra weight can affect how a cat's body processes the insulin. Whether Micah's need is to gain, to lose, or to maintain his current weight is something you'll need to determine; the only caution I have to offer here is that any change you decide is needed (if any) should be done gradually. This is especially true when weight loss is required: It's best that it happens slowly because a kitty losing weight can mean a significant difference in the need for insulin (usually less). Yet one more good reason for keeping close tabs on kitty's blood glucose via in-home testing.;)

I hope some of what I've written here is useful to you, Karen. I'll look forward to seeing how Micah is doing tomorrow morning!:)
 
Yep, I would start at the lower doses I think. When you have a lower dose, you can go up if needed. But this helps us to make sure you don't skip right over the ideal dose and then have to figure out how to backtrack. :)
 
Ok so I'm kind of worried! Just tested him and he was at 45! I am about to make a chart right now... I didn't read this thread before testing him, so I gave him half a can of food. He was acting like he was starving still and gobbled it right up. His shot isn't for 3 hrs but if it's under 200 I'm not going to give it to him. If I've been giving him 2 units based on vet recommendations do I need to change that gradually or just go down to .5 or 1 units next time I gave him a shot? Chart should be up in the next 30 min or so.
 
Chris & China said:
OK....one thing first....the Pre-shot should always be right before the shot....so you want him to have no food for the 2 hours before shot time, then Test/Feed/Shoot, all within about 5-10 minutes

We want the food taken up for 2 hours so the result we get at PS isn't influenced by food..then:

You TEST to make sure he's high enough to get insulin at all (200 is the lowest you should shoot right now unless you have someone watching over you that has experience) If he's below 200, you should "stall" don't feed and post for help.

Next you FEED to make sure he's willing to eat...it's not as important that he eat a big meal like it was with some of the older, harsher insulins, but it is important that he's not sick and not willing to eat at all

Last you SHOOT....and considering your new and don't have a lot of data on Micah, I think starting with 1 unit is probably safer unless you're able to get tests throughout the daytime and at least a "before bed" test at night....it's not going to be necessary to get a mid-cycle at night every night....Just a quick test before you go to bed....Depending on what that test result is, you will learn to know when it's important to set an alarm to get more tests in, and when you can go to bed and sleep without worry

We use Lantus, so I'm not real comfortable giving much in the way of advice, but I'll tag a few others who have more experience with that type of insulin @Sue and Oliver (GA) @BJM @Rachel @Bobbie And Bubba @Robin&BB
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...What do you mean by pre-shot?
 
Wren said:
Ok so I'm kind of worried! Just tested him and he was at 45! I am about to make a chart right now... I didn't read this thread before testing him, so I gave him half a can of food. He was acting like he was starving still and gobbled it right up. His shot isn't for 3 hrs but if it's under 200 I'm not going to give it to him. If I've been giving him 2 units based on vet recommendations do I need to change that gradually or just go down to .5 or 1 units next time I gave him a shot? Chart should be up in the next 30 min or so.
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How long after the insulin was that reading of 45? Sorry I am trying to follow the posts but without a spreadsheet I am a little lost :) If I am following properly it sounds like it is at +9 hours since the shot. Is that correct?

45 on a human meter is a bit lower than we like to see, depending on where in the cycle (time between shots) that number is it could be something you need to try to push up.
 
Wren said:
.What do you mean by pre-shot?
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The Pre-shot test is the test you should always get immediately before feeding/shooting.....It should be at least 2 hours since he's been fed (unless you HAVE to feed due to low numbers) so that when it's time to give insulin, the test isn't influenced by food.

That 45 is too low, so I'm glad you fed him but you need to test him again in 30 minutes to make sure he's come up. We like to always keep some Fancy Feast Gravy Lovers food in the house in case they drop below 50. You pop the top and then "squeeze" the gravy part into another bowl and give a couple of teaspoons of just the gravy. That's where most of the carbs are anyway

I strongly encourage you to drop back down in dose....45 is too low, especially for a newly diagnosed cat ...I'd suggest like the others have said....drop back to 1 unit and go up SLOWLY as needed
 
Ok, it's been 40 min so I'll go retest him now. Yeah I think I will switch to 1 unit since he dropped down so suddenly, thank you. I will work on giving pre-shot tests each time from now on.

On the bright side, he is acting energetic and normal. He did not throw up while I was at work today. (Turns out it was vomit yesterday too because I heard him go to his litter box last night and throw up in it and it looked the same). His poop is small and dark but solid. He is drinking a fraction of the water he would before. He used to drain a pint every 1/2 day. Today there was still plenty of water left.
 
Ok he's back up to 65. If he's not above 200 in about 2.5 hours should I just skip his PM shot? If he is 200+ should I give him 1 unit insulin shot? Is dark green the range that I want on my spreadsheet?
 
Wren said:
On the bright side, he is acting energetic and normal
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It's good to hear he's acting like he's feeling better! I remember when China started acting "normal" again....it's like we're giving shots of water from the Fountain of Youth instead of insulin!

Wren said:
Ok he's back up to 65. If he's not above 200 in about 2.5 hours should I just skip his PM shot? If he is 200+ should I give him 1 unit insulin shot?
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I'd test again in another 30 minutes without feeding him anymore....we want to make sure that now that he's above 50 that he stays there without you having to feed him anymore.

As long as you don't have to feed anymore, I'd test him again at about +11.5 (30 minutes before his normal shot time) to have some time to get some options for tonight.

I'd suggest you start a new thread (this one is getting pretty long) and maybe a subject line like "+11.5 ###...New to ProZinc..need advice for PM"

You could move over to the ProZinc Forum too since your spreadsheet and signature are done. Everyone there knows how to use ProZinc so they have the most experience with using it and can give you the best advice.

It's also fine for you to continue posting here in Health (or both).....sometimes the ProZinc Forum can be a little slow, so it's fine to post here in Health if you want

If you start a new thread (wherever), put the link to this thread into the body of the post so people can quickly go back and see what's been going on with you and Micah

Edited to add...If you start a new thread, you might also want to "tag" some of the people who've replied in this thread with more experience with ProZinc

To "tag" someone you just put the @ sign in and then start typing their name. A drop down menu will come up for you to pick the correct person.....like @Wren
 
Seems like most people who have replied here are more familiar with Lantus. However, I do like the quick responses. I will post a link to the new thread once I make it. :) Thank you all for the advice as I started out on this journey with Micah. He is already getting more relaxed about the tests.
 
Hi, Karen - Sorry, I just now saw this ... Just looked at the SS, and I would be really surprised if you see Micah make it up to anywhere near 200 by PMPS time. But that said, please DO test @ +11.5 & post that with thread title like: PMPS=(insert #), Dose Advice Needed!

Let's see where he's at by then & we'll figure it out from there, ok? How far away are you from that +11.5, in minutes, right now?
 
Robin&BB said:
Hi, Karen - Sorry, I just now saw this ... Just looked at the SS, and I would be really surprised if you see Micah make it up to anywhere near 200 by PMPS time. But that said, please DO test @ +11.5 & post that with thread title like: PMPS=(insert #), Dose Advice Needed!

Let's see where he's at by then & we'll figure it out from there, ok? How far away are you from that +11.5, in minutes, right now?
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+11.5 would be in about 20 minutes

EDIT: Oops calculated that wrong. About 45 minutes from now (EST 6:30 would be +11.5 since 7:00 is the PMtest.) I am going to test him again in 10 minutes for his +11 and then 30 min later for the +11.5... good thing he's getting used to the ear pricks... he's still going to hate me though!
 
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What we want - as Chris explained earlier - is for Micah to be able to get the BG level up to safer range and STAY there. So you will be testing again in 20-30 minutes after he gets a little bump of gravy and food. (Don't feed too much food at once, though - you don't want to fill him up so much that he won't want to eat if you need to keep on steering for a while ...)
 
Robin&BB said:
What we want - as Chris explained earlier - is for Micah to be able to get the BG level up to safer range and STAY there. So you will be testing again in 20-30 minutes after he gets a little bump of gravy and food. (Don't feed too much food at once, though - you don't want to fill him up so much that he won't want to eat if you need to keep on steering for a while ...)
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Ok thanks, I will give him a little bit to eat.
 
The good news is this, Karen: We know that Micah needs significantly LESS insulin than 2 units. One of the things that can happen at the vet visit is "stress hyperglycemia" - some cats really stress out going to see the vet (some cats get really stressed just by riding in a car, like mine does:rolleyes:).
It is not unheard of for a cat to spike a BG# more than 100 pts higher during a vet clinic visit than the cat would at home where he or she is more calm and relaxed. This is why home-testing is such a smart thing to do!;) (And I am SO glad you're doing it.:bighug:)
 
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