No shot in AM, low PMPS

[Pippin's Team]

Hello again. My first post is here. I wanted to give an update on Pippin and also ask about dosing.

I took him to the vet on Monday so she could do a glucose curve (I still wasn't feeling very confident about my home testing skills at that point) but he wouldn't eat anything there, so they couldn't give him insulin. The vet advised that I do a curve at home. I also showed her the numbers I had gotten to that point and she was a little concerned about the low ones and advised putting out frozen food or getting a feeder so that he could eat at the nadir.

I was actually planning to do the curve today, but I couldn't give him his insulin shot this morning. Last night he was low (186 mg/dl) at the PMPS. I waited half an hour, per these instructions, and tested again. He was at 208 so I gave him his food and a little less than 1.5 units. Probably should have just dropped it to 1u. At 2:40 am he tested at 57. He wasn't eating very much of the thawed frozen wet food, so I gave a some milk, which he lapped up. Is not being interested in food (or some food) a hypo symptom? He seemed fine otherwise.

At AMPS he was at 97, so I skipped that shot. Tested 78 at 1:40pm today. Still wasn't eating a lot, so I opened a fresh can and he seemed to like that better -- he ate about 1/2 can of Wellness. Just tested him at 8pm and he was at 151. Obviously, I don't want to shoot unless he's above 200 and probably shoot a smaller amount. But I'm curious, since he didn't get a shot this morning, does that mean his pancreas is starting to produce insulin again? Should I reduce his regular dosage to 1u or less?

Update: Just called the vet and they said not to give insulin tonight and call them with his reading in the AM.

Thanks again, I really appreciate all the help we've gotten here.

 

[Sue and Oliver (GA)]

We are big fans of shooting low to start, increasing as the testing indicates. So much easier than shooting higher, getting lower numbers and trying to lower the dose enough.

If he were mine, I think I would go down to one unit, get those preshot and nadir numbers. After a few days, evaluate. It is hard to tell how much the numbers are influenced by the insulin or the food. (definitely not eating enough can mean lower than usual numbers)

Hope you find something he likes and get him on track to eating a good amount daily.

 

[Carl & Polly & Bob (GA)]

Hi Jamie,

This is Prozinc, correct? First off, Pippin's numbers are looking terrific!
You did the right thing every time you've skipped the shot.

But I'm curious, since he didn't get a shot this morning, does that mean his pancreas is starting to produce insulin again?

To me, yes, it would appear that his pancreas is doing at least part of its job, and that is very encouraging to see. One thing you can try on these cycles where you skip the shot....go ahead and feed him, and then take his BG an hour later. It should have increased some from eating. Then test him again 60-90 minutes later. If you see a drop in his BG, then that would most likely be due to the pancreas putting out insulin on its own.

If you see a shootable number, I think it would make sense to drop the dose. If he needs insulin, then you want to be able to give him two shots a day to keep insulin in his system as many hours as possible. Keeping his numbers down, but in safe ranges, helps give his body time to heal. I'd suggest going as low as .5u even. If you can test like I described when he doesn't get a shot, that will help. IF you do need to give a shot, make sure to test about 3 hours after the shot if possible so you can see what the smaller dose is doing. As you get numbers, post them here if you have any concerns or questions. You can also post in the PZI forum where everyone is familiar with your insulin. The PZI forum tends to be most busy in the early morning and early evening.

You're doing a great job, and Pippin is looking awesome,
Carl

 

[Pippin's Team]

If he were mine, I think I would go down to one unit, get those preshot and nadir numbers. After a few days, evaluate. It is hard to tell how much the numbers are influenced by the insulin or the food. (definitely not eating enough can mean lower than usual numbers)

Thank you, I agree and will do that. Intellectually I understand that it makes sense to start with a low dose, but I guess I have still hesitated to not follow exactly what the vet says.

Hope you find something he likes and get him on track to eating a good amount daily.

He seemed to really like the Wellness Chicken, but he's not scarfing it down as much as at first. I'll try to find some other types to try tomorrow. I'm not exactly sure what amount he should be eating, but he still could stand to gain some weight. He's been eating a can to can and a half a day until now.

One thing you can try on these cycles where you skip the shot....go ahead and feed him, and then take his BG an hour later. It should have increased some from eating. Then test him again 60-90 minutes later.

That is a great idea. I won't be able to get his +6 numbers for the next two days because of my work schedule, but I should be able to do that if I skip a shot and get the +3 if I need to give him insulin. I'm planning to get a glucose curve on Sunday if possible.

Thank you, Sue and Carl! Your advice is incredibly encouraging and helpful.

 

[max&emmasmommie]

Hi. Welcome to FDMB. It is so wonderful that you are willing to help this cat even though you aren't planning to keep him. I kinda wish you would. There aren't many people who will help a diabetic cat. Pippin looks like he might (might) be one of those cats who can go into remission quickly. It happens sometimes. The change in food alone can make a difference. Then, the human just has to test once a week or so to make sure the cat stays in remission. Let's hope so! Maybe his fur-ever home won't have to deal with diabetes!

I noticed that no one answered your question about Chinese herbs. My vet prescribed some for my cat's Chronic Renal Failure: solidago (goldenrod) -- a pill and Rehmannia 8 -- a tincture. I've been testing out whether they were interfering with his BG. No answer yet; I've just been omitting them lately. I am going to start adding one at a time back into our regimen soon. The Rehmannia might be in an alcohol solution. I have to find out. I think the vet's office makes it. You should ask about that if your vet prescribes R8 for your cat.

Good luck with everything!

 

[Pippin's Team]

Hi Dale,
Thanks for your welcome and good wishes. I wish that I could keep him... We have two cats and are about to move but you never know. I am getting pretty attached to him! Yeah, I am hoping that he'll be able to go into remission, even if it takes a while. We think my grandmother was giving him a mix of canned food and dry food and then he started getting dry food only after her death, which probably tipped him over the edge. So no more dry food!

Oh, thank you for the info on Chinese herbs. I haven't asked that vet to take a look at him yet -- seemed like it might be too many variables at the moment. Adding one at a time definitely sounds like a good idea.

Thank you!
Jamie

 

[max&emmasmommie]

You are welcome. I'm am sorry to hear that your grandmother died. I'm sure that is hard for you, and it is a wonderful legacy that you are going to extra effort for her cat. Have a good weekend.