Newly diagnosed with low level this evening of 96

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kellykramer

kellykramer

Member Since 2013
Important doing glucose curve male cat diagnosed 11 days ago with a 515 BG .He is on prozinc insulin 3 units 2 times a day. Doing a BG curve to get regulated with the contact of my vet. With the exception of this weekend. UGH when things are changing drastically.
Been 400's in the AM 300 to 200 in the afternoon. last evening 180 now 96. So going low in the evening. BG before his meal I am not sure what to do he just ate so should i check it again after meal? Give him insulin? Or hold off till I can talk with vet in the AM?
His food is mostly wet high protein Friskies canned so low carbs only So is this possibly the contribution to the low levels in the evening? I am scared to take him to low.


Dont want to have him go to low. SO please help.
 
No shot below 150 mg/dL. Edited to add: when your mid-cycle test data shows it is safe.

You need to reduce the amount given for that level of pre-shot. I'd shave off at least 0.25 units and maybe even 0.5 units. You want a dose you can give safely, every 12 hours, and it is possible to adjust the dose based on the preshot test.

It should start wearing off; please keep monitoring, though and post the next test here.
 
So hold off and see what it is in the AM? Or call vet for next step? Thanks so much really I am a basket case he is my baby boy. 14 but still my baby. Will it be higher after he just ate? Still dont want to mess around. Scary
 
It is not dangerously low. We start to get nervous when they reach the 40s. However we generally advise new diabetics not to shoot under 200. Since he is quite a bit lower than that, I think I would skip tonight. This kind of cycle with PZI usually means the dose is a little too high.

If you skip, he will likely be high tomorrow am, as he will have been 24 hours since his last shot. He may also bounce to a higher number. (Bouncing is when their body senses a low number and releases extra glucose). But I would still the reduce the dose tomorrow.
 
He should be OK.

To confirm that, do another test. It may show he is coming up or let you identify if he needs a little help.
 
Any time you get an unusual test, retest.

If its a pre-shot and too low to shoot, wait 30 minutes without feeding to see if it is rising.

When you're concerned the number is continuing to drop, testing in 20-30 minutes will identify if it is still falling.

If the number drops below 50 mg/dL, you start a process of feeding 1-2 teaspoons of higher carb food, wait 30 min, retest, and repeat as long as needed to get 2 rising numbers in a row, and above 100 mg/dL.
 
Level of pre shot? Please explain? Thanks

Glucose curves over the last few days.

9/27
7:45 515 Meal then Insulin
10:45 310 At vets
5:00 334
8:00 395 meal then insulin

9/28
8:45 491 meal then insulin
2:15 134
7:20 184 recheck 225
7:45 Meal then insulin

9/29
8:00 415
11;45 284
4:00 142
7:45 94 Retested 96
Meal NO insulin
eating more now 9 PM
 
You need to reduce the amount given for that level of pre-shot.
Click to expand...

Is this the line you had a question about?

I think what BJ was saying is that when you get a preshot test of 400 like you did today, then 3 units is too much insulin since it resulted in a drop of more than 300 points in BG, and it happened 12 hours after the shot this morning. Usually, Prozinc will last only 12 hours, with a peak effect about 6 hours after the shot. After the peak effect - which is when the BG should be at the low point, you would expect the number to come back up in the next few hours leading up to the PM shot. This dose lasted longer than normal, which can indicate that the dose is too high.

The "dose you're looking for" would be one that allows you to give shot every 12 hours. And when you are first starting out with insulin, we normally don't recommend giving a shot unless the BG is 200 or higher.
 
The food will probably push him up (food raises blood glucose levels. That's why, when you are waiting to see if a number is rising, you don't feed)

Your cycles look like the insulin is starting to work with his body. In some cats, this can take a week or more.

Have you gotten another number?
 
The food probably brought him up, and it was the end of cycle, so coming up makes sense. You could give a much smaller dose now - IF it doesn't mess up your schedule. You'd have to shoot 12 hours from this shot, in the am.
 
How long ago would the "normal" shot time have been?
 
PZI type insulins are pretty flexible.

To tide him over the night until starting over tomorrow, you could do a token 0.5 units to keep it from shooting to high without insulin.
 
8 PM I should have given the shot. At 262 can I give the same amount or skip it till i talk to vet in the AM? I am hoping to lower insulin with a good diet.

I am scared to change the dose? What would I go to I only have 1 2 3 etc. on my syringe.
 
I think you could shoot 1 unit now. Then in the morning, test at your normal shot time and see what you get.

If it's over 300, you can shoot 1 unit again. I'd really suggest not shooting more than 1u until you can get in touch with your vet tomorrow.

Ask him what he thinks about the numbers you got today. And see if he thinks a dose reduction is a good idea? Also ask him what his advice is as far as a "line in the sand" that you would give a smaller dose, or skip the shot entirely?

Today's numbers might make him rethink the dose.
 
Postby BJM » Sun Sep 29, 2013 8:43 pm

No shot below 150 mg/dL.
Click to expand...

Usually, the people who frequent the PZI forum will advise that new members draw a line at 200 rather than 150. Until you have gathered enough data to see what any given dose will do, 200 is a "safer" line in the sand. After you have the data, you might feel comfortable shooting below 200, or even lower than 150.

But only when you feel confident doing that.
 
I'm with Carl.

So glad you were testing today and caught this. Just imagine if you shot 3 units on a 96!

We usually advise new diabetics to start at one unit, test and monitor and then slowly increase. It is much easier to increase slowly than try to guess how much to come down. You might ask your vet if you could start over at one unit?
 
Would I want to feed him any more before the insulin of 1 unit?
Since its been a couple hours almost since he ate.
Should I check BG first?
or in the AM only?
 
Thanks Sue and carl I appreciate this sooooooooooooooooooooo much!
I just checked him again and its 298 So any new ideas with that or stay with the 1 unit?
 
I'd stay with the 1 unit.

"PZI" - Prozinc has only been around for a few years. Back when this board first came to be, there was an insulin, made from cow and pig pancreases and it was referred to as PZI. They are "like" each other, but not exactly the same. PZI is just and acronym for Protamine Zinc Insulin. Prozinc is a brand name. The big difference is that it isn't made from animal parts anymore. It's based on human insulin, altered in a lab to more closely resemble cat insulin.

You can still purchase the "old form" of PZI, which is still cow-based, but it is a compounded product produced in pharmaceutical laboratories.

For all intents and purposes, they work the same way, so we just call them "PZI" for short.
 
Edited prior post - several times I've seen it posted not to shoot PZI/ProZinc at less that 150 mg/dL given to a person who has been testing for a while, but hasn't a lot of data for shooting lower numbers. You need mid-cycle test data to make sure the cat is safe; once you have that, you can be more aggressive if you are monitoring.

When you're starting out, we don't want to risk a hypoglycemic event when it is still unknown via test data, how the cat responds, so we set the no shot limit at 200 mg/dL.
 
Thanks to you also BJM I am very grateful for the knowledge. And I am a sponge and appreciate all I have learned and can learn.
 
He is doing as well as he can. I did talk to vet first thing this AM and with all going on he was glad i did not up the insulin and was happy to START OVER with the 1 unit of insulin. So its all going slow again. But I have faith it will be better then him going to low. :) Thanks again soooooooooooooo much for all the advise and help. It was very great, and I am grateful.

I would like to do all I can to get him OFF insulin or to stay at a low dose till he can hopefully get off.
I am motivated to do the Low carb high protein diet and I am doing it as best I can already, I have not taken the dry C/D Hills prescribed by Vet as Oliver had Urinary issues about 6 yrs ago but Nothing since the switch to C/D. i am not leaving as much available as before and will weed it out slowly. Plus I have another cat (overweight) who eats both also. I am aware about the high carbs in this food, Oliver doesn't eat much of it anyhow he is more into wet food.
So any ideas on this is what i would appreciate.
 
Glad you decided to start low and go slow. The dry food can raise the numbers a lot. Oliver went down 100 points overnight when we switched from dry to wet. Our best resource for transitioning from dry to wet is www.catinfo.org. It's a vet's website and she deals with urinary tract issues and food also.
 
What sort of numbers did you see today?

What is it about the c/d that would have helped with the urinary issues? I'm not familiar with it. Does it have more, or less, of something than regular dry food? I'm thinking maybe there's a canned food out there with the same properties but with fewer carbs? That would address the carb issue too.
 
Hills wet CD has 26.5 % carbs in a can? WOW Just read this on the website you posted. What did you feed your cat to get the 100 points down in the AM ?
I have been feeding him mostly wet Friskies or Fancy fest Fish chicken all pate. I add a little warm water and he loves that.
I just don't know how and when to feed him. He wants to eat several times a day. Been sticking to the every 12 hours and have dry down but going to maybe work this out. ?

Today-
8AM preshot 491 1/2 c of wet food 1 unit of Insulin
12 262
8PM Preshot 462 1/2 c of wet food 1 unit
 
He went down 100 points because we switched overnight from Science Diet dry(one of the highest carb dry food) to Fancy Feast wet. It is different for every cat. Some kitties have a drastic change; some not as much. I would decrease the dry by more and more every day until he is on all wet. I feed my normal weight kitties one can (the small Fancy Feast cans) twice daily so you could add another can.

He dropped almost 50% from preshot to midcycle, so the insulin is working. His numbers are still high. Normally I would suggest raising the dose, but I am a little nervous because you are changing the food at the same time. I'd keep working on the wet food and monitor. If the numbers continue this high, I'd raise by .5 or so.

Because he is running high, I'd check for ketones too.
 
Multiple meals can help if you can manage that. For instance, when Bob was on insulin, I fed him four times a day. At AMPS and around six hours later, then at PMPS and a snack just before I went to bed.

It spreads the BG boost from eating more evenly thru the day/night.
 
I have another cat Zoey (over weight) she eats the dry more then Oliver ever did. He must eat some though I dont always see it. as its downstairs and we have a dog as well Cooper :) that will eat the food if its not downstairs. Dang animals LOL I am a dog groomer and a lot of dogs in and out.
Yes I can so do that Carl that would be perfect for all of us. Do you only feed them wet ? Thanks
Do you guy Still do Cat treats at all? I am sure those are full of Carbs? Mine are in the Habit of bed time treats.
 
Yes, when Bob was diagnosed and I learned the low carb canned was best, I switched both my cats to just canned Fancy Feast classic pates and Friskees pates, overnight. Neither of them had any problem adapting. They'd always liked canned food, but I had used dry because it was cheaper and easier for me. I didn't realize it was bad for them before diabetes happened.

Treats? Yes!!! And there are good low/no carb ones you can use. Pet smart sells some made by Beefeater that are freeze-dried chicken or salmon. Very low carb. Bob's favorite treat was fresh boiled shrimp. Basically zero carbs. He got a treat after every BG test and shot.
 
Hi Kelly and welcome!

Just a quick housekeeping note...would you please go to your first post and take down the 911 now that the emergency is over? Just go to your first post and choose "None" instead of the 911 icon above the Subject line.

If you have a question, but it's not a medical emergency, you can use the ? icon too. It helps us quickly see who has emergencies, who has questions, and who is just letting us know how they're doing.

Thanks and good luck with Oliver! The best things you could do for him is find the FDMB and change him over from high carb foods to low carb. :-D
 
I do think I did the removal of the 911 logo right? Hope its gone.
I also would love to know how to do the spreadsheet? Please
 
No, the 911 is still there. Go to the FIRST post you did and remove it there

Here's How to set up a spreadsheet If you need help with it, let us know.

Also, could you put some information into the Signature box? Your name and your cats name, date of diagnosis, what insulin you're using, which meter you're using, any other health problems are all things we'd like to see, so we don't have to keep asking the same questions.

Just go to the top left side and find "User Control Panel"
Go to "Profile"
Go to "Edit Signature"
Put the info in there and hit "Submit" and you're done!
 
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