Poncho diagnosed diabetic 1/15

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Chris I have been lurking and following along. I am new here as well so can't offer much but I just wanted to say you are doing Grrreat!!!
((BIG HUGS)). I hope Poncho gets to feeling better soon.

Its true what BJM says about sleeping in 45 minute increments, It really is easier to wake up because you aren't in the middle of the deepest REM sleep.

And regarding the vets comments about its my way or the highway.... I had a vet tell me that once, and I hit the highway and never looked back.
 
Whenever you get what seems to be a wonky result, re-test.
If you get 2 numbers within 20% of each other, they may be considered the same.

Also, if you fed him around the time of the shot, there is often a food-related glucose spike by +2 hours after the food.
 
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Ok BJM, I'll test again. I'm not sure how to color the squares.....if I'm understanding you right.
Thank you Jmeli. I called the vet on a screw up 2 weeks ago and guess she never forgets/forgives.
Retest BG 364@+3 Did I mess the shot up?
 
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To manually change the color on a square,
Click on the square.
Up at the top, there is a small icon depicting a bucket of paint; click on it and select a color.
That's all there is to it.
 
It is possible he is bouncing some from getting into the hundreds last night.
A bounce happens when the glucose drops suddenly and/or to an unaccustomed level. This triggers compensatory hormones to release stored glucose, which then brings the levels back up. This effect can last for roughly 3 days.
 
BJM said:
It is possible he is bouncing some from getting into the hundreds last night.
A bounce happens when the glucose drops suddenly and/or to an unaccustomed level. This triggers compensatory hormones to release stored glucose, which then brings the levels back up. This effect can last for roughly 3 days.
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So how often should I check BG levels.....every 2 hrs?.....shot time determined by BG level at certain time?
 
At this point, I'm thinking once you're past +6 (about the nadir of ProZinc, when there is one), unless he suddenly drops, he's high enough to shoot again with 0.5 to 0.75 units. You could nap until then, and possibly nap for 3 hours after you shoot, too.

How's the eating and the fluids going?

@Meya14 if you're on, what do you think?
 
I lost track of how you guys were dosing (twice a day, TID, every X hours, at a certain cutoff, etc?), BJM, if you could refresh me, that would be great.

I'm not sure that his higher numbers are due to him being lower yesterday. You are providing more foods, and as his body starts to compensate for some of the stuff going on, he will probably start needing more insulin. This seems to happen. Don't be afraid to give more insulin to keep his numbers down. Goal is under 300 at all times. Better if he can stay near 200 for most of the day.

I don't have a ton of prozinc experience, and for me it's easier to have a consistent dose (rather than sliding a dose) so I can see if patterns develop. I use Lev, so my approach is quite different, and BJM has a better understanding of the nuances of prozinc. My advice, however, is err on the side of a higher dose if you can't decide.

Oh and congrats on the lower ketones. That's a good thing.
 
Meya, thanks for the input.
ProZinc is an in and out insulin that usually nadirs around +5 to +7.
Last night, Poncho hit a nadir of 160 around +8.
Tonight, with a similar pre-shot (he shot early), he's just staying high and flat.
If the numbers do reflect more food with higher carbs, then I'd agree, lets kick up the ProZinc, maybe even to 1 unit.
And while we don't usually do this, I'm thinking as soon as the nadir is past, if the glucose is high enough, shoot to get it down, just scale the dose to the pre-shot level whenever it is.
I know in a hospital, they'd have an IV drip of R going in for more or less continuous glucose control until they got electrolytes, and glucose stabilized. Shooting as soon as its high enough post-probable-nadir makes sense to me in this situation. Think of it as shorter versions of overlap/depot.
 
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Yeah, I agree with the more frequent dosing, cause you can give a smaller dose more frequently, and not send him down too far like what was happening. Instead of watching the numbers for indication of when to dose it's probably easier for him to do every 8 hours, and it will be easier for everyone else to follow what is going on and help with changes. 8 hours should be just past the nadir and would let him see a small rise (ie. safety), correct? What dose to begin with?

Also, if he is dosing this way, maybe someone could add a column to make it a TID spreadsheet?
 
The simplest approach may just be to use a row for each shot and gray out the unused part. That keeps it all in 1 spot and he can label it as shot 1, shot 2, shot 3 on the respective lines.
He may be grabbing some sleep and be back shortly.
I need to crash - will you be around for a bit?

If high carb food is going in, it could be safe to do 1 unit at maybe 250 or higher., but I am guessing.
 
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1 unit TID seems like a big jump? What was the last shot, 0.5U? I think that if he is closely monitoring, trying a cycle or two at 1U and see what happens might be ok, and lower to 0.75TID if he drops below 80ish on his nadir.
 
Chris
When you come back, if you think it will be easier to shoot every 8 hours, just put each shot on 1 line and label the line so folks can follow it.
If you're feeding higher carb foods and/or Poncho is soaring over 300 mg/dL you can increase the dose.

This is a draft of a sliding scale for dosing. Right now, it looks like pre-shot numbers
over 300 could get 1 unit,
250-300 could get 0.75 units.
200-250 could get 0.50 units, and
under 200 could get 0.25 units.
- this is just a draft/estimate. Use your judgement and get feedback from others.

If/when a nadir happens, it may be anywhere between +5 to +8, so that is when you'd most need to monitor and test.
 
That looks great. I have to go pretty soon as well. If I wake up or can't sleep, I'll check in.
 
I dozed off for 30 minutes and woke at midnight, did a BG and was +6 @ 274. I force fed him a few hrs ago a little over 10 ml of Hills ad. He can't deal with it more than that. Got fluids 8pm or so and ketone 2nd test today was @ 40 moderate both times as opposed to high 60 last night (Fri) He has no appetite and is pretty down and out even after a B12 shot. I wish he could tolerate forced feeding better. I'd like to find something more concentrated so feeding/stress is lessened. So when to give next shot? .5 again now @+7 after new reading over 200?
 
Hi Chris. You seem to have me again:).

Now before I give advice I have to say I have zero experience of prozinc and so I am going to have to give you my advice based upon my reading here and my limited experience.

As BJM said above his nadir is somewhere between +5 and +8. So the +6 of 278 might not be is lowest but them again it isn't that low and so we need to catch it as it is rising. Could you test in 30 mins to give us some more data to work with. So a +6.5. Don't feed again until after the test.okay?
 
Ok 30 minutes I think it will be +8 so I'll test and see if it's dropping or rising from last test #. I'm only able to feed him every few hrs due to the stress on him and I think that amount is at least 1/2 a can per day of ad for a 7-8lb cat. I need to kick it up but the stress on him is major. I wish he'd start eating again like before the vet took him off the insulin.
 
Oh sorry, I got confused in my early morning stupor. Go ahead and test him now and then based on the reading we can decide on the dose.
 
This is the food I feed remi when he was very sick. He had been throwing up for weeks and would gag and be sick if I tried to feed him. Yet when I made this up into a syringe he accepted it much more readily. It is like a milk consistency and not much smell or taste. Certainly not a meaty one. Remi loved it. It won't be low carb but from what I have read that it not our main priority at the moment
http://www.vetuk.co.uk/royal-canin-...n-convalescence-support-instant-sachets-p-254
 
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Hmm I don't know. It's so close to the 250 mark. I am thinking go for 0.75 but let me ask @Elizabeth and Bertie to comment. I think she is online.

Peer need to get poncho into good numbers and I just worry that the 0.5 might not kick it enough but as I say not any experience with prozinc.

You have karo/honey don't you and plenty of strips? And able to test?
 
I have some honey and plenty of sticks. My concern is the sharp drops he had during the two curve attempts. Not sure what caused those.
 
Right I don't she her online anymore so it looks like it is up to us to work this out. We have limited data. I think that BJM would point out that the 274 and the 245 are within 20% variance that you find with meters and we are sort of dealing with the same number the last two readings.

Yesterday's shot of 0.5 got us into the mid blues but no lower. If you look at your spreadsheet you will see yesterday's slight dip. If we want lower numbers then I think that we need to increase just a tad and if necessary support with high carb or honey as the others have mentioned.

When he crashed before he was on 1.5. So even if you go to 0.75 that is still only half the dose. Would you be happy with that?
 
Okay let's see what Elizabeth says in a second. If you don't want to give a 0.75 then you could always give a fat 0.5 but we need to get him into better numbers.
 
phlika29 said:
Is 274 and 245 within 20% of each other:confused: My maths is terrible:nailbiting:

Edit-yes just checked and it is:D
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Yep, it is within 20% (you were quicker than I was working that out, Sarah...)
However...
The trend of the last few tests are that the BG is falling.
That last test may have been correct and not just a +/- 20% variance.
 
I know it's important to give Poncho insulin.
But if the numbers are falling (and may be dropping out of a bounce) it's hard to predict the effect of the shot.

Just gonna get coffee...:coffee:
 
Just looked at Poncho's spreadsheet and it looks to me like he bounced from those blues yesterday (hence little response in the cycle after that) and he is now coming out of the bounce.
Have a look at that Sarah, can you see what I mean, or do you see something different?
 
I sort of see what you mean but I don't have much experience of reading spreadsheets and so reading them appears abit of a dark art to me. What about the 0.25 dose yesterday? That must have played a part in the higher numbers in some way though?

So depending on the next test result it sounds like you are going towards the 0.5?

@christoph do we have another test result?
 
It may simply be that the .25 wasn't enough. Or it could be that the same thing would have happened even it it had been .5 (if it was a bounce). We just don't know...

I would certainly advise very cautious dosing indeed if the numbers appear to be dropping.
Let's see what the next test says, and hope for a rising number...
 
I was waiting for a green light and couldn't see new posts and dozed off, woke up at 3 central and went ahead with 0.5, then all the new posts appeared with the latest conversation. I needed to pre shot test I guess.....I'm a bit confused.....and don't know how to enter this on the spread sheet since it's designed for 2 shots per day and this was to be the 1st of 3, right? Going to test him now.....hope I didn't mess up. BG is 258, but was supposed to shoot @ 2am right after the 245 reading so I was an hr late.
 
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No you didn't mess up. Me and @Elizabeth and Bertie are both in the uk so for ease how many hours ago did you give 0.5 and what will the test you do now be? A +1 or +2. Not sure about your spreadsheet. You gave the 0.5 dose around 8 hours after the last one didn't you?

Not sure why the comments didn't show up. Just make sure that you refresh your browser regularly.

Just to also check you are still giving fluids and syringe food aren't you? Did you see the link I gave to the food I have remi when he was very poorly?
 
I'm glad you managed to grab some sleep, Chris.
This whole situation must be exhausting for you.

I'd suggest getting the first test in as soon as you can, just in case Poncho's blood glucose has continued to drop.
 
Almost an hr ago @ +9, when I had intended to give it +8. The test was 20 minutes after the shot. It's my error.....lack of sleep and drifting in and out. I should have gone to my inbox like I just did. Lack of sleep=stupid. I'll see if they carry that food here in US.....thanks. Last fluids were 8 hrs ago. He likes to wrestle with me on that too....frustrating......hate that big needle.
Since the 258 BG was so close to the shot (15 minutes post shot) I entered it on the spread sheet as pre shot test.....make sense? Still have to figure out the 3 shot daily charting. I need a 3 hr window for sleep.
 
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Elizabeth and Bertie said:
I'm glad you managed to grab some sleep, Chris.
This whole situation must be exhausting for you.

I'd suggest getting the first test in as soon as you can, just in case Poncho's blood glucose has continued to drop.
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I think it was going up when I shot. I'll test again in 1 hr.
 
Okay so we have a sort of preshot at 245, a 0.5 unit given at +9 from the last dose and a +20 mins of 268. That sound okay to me.

When did he last eat? I know its tough but you need to keep on with that.
 
Thanks for that recap, Sarah.
That 245 and 268 are sort of the same number, so, no drop or rise at that point.
Doing OK so far.

Chris, how are you holding up?
.
 
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