(Relative) Newbies - Sugarbaby Nìco ⬆️ numbers

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Emily Tuomey

Emily Tuomey

Member Since 2020
Nìco seemingly climbs during the day — well, from what my past 4 days of testing shows — despite insulin twice a day. We are new and have not done a curve yet. Probably this week. Initial thoughts on why?

We have an appointment tomorrow morning.

Thanking God at least he’s acting normal, just yielding moderate numbers that climb, climb, climb throughout the day then seem to reset overnight. ‍♀️

If anyone has any experience or words of wisdom please send them out way
— Nìco and his neurotic (incredibly anxious) mama
 
Great job Emily!! Happy to see you over here from the Facebook group!!

Here's some reading for you when you have some time. The ProZinc basics and the ProZinc dosing methods

Good job on getting some testing data! Just FYI...there's nothing entered in the PM "U" cell for 11/7

When you're this early in the sugardance, I know you are terribly worried about Nico but it's really not best to rush things. We all want our cats cured yesterday but the one thing this disease will teach you is patience!

We suggest holding the starting dose for at least 7 days while you're gathering data and then doing a full curve so it's good you're planning to do that soon too. It's looking like Nico is going to need more than 1 unit but it's a little early to go ahead and increase. Saying that, I'm not an expert with ProZinc so take into consideration what others suggest before making a decision.

It's pretty late in the US (where most of our members are) but hopefully you'll get some other opinions tonight
 
Chris & China (GA) said:
Great job Emily!! Happy to see you over here from the Facebook group!!

Here's some reading for you when you have some time. The ProZinc basics and the ProZinc dosing methods

Good job on getting some testing data! Just FYI...there's nothing entered in the PM "U" cell for 11/7

When you're this early in the sugardance, I know you are terribly worried about Nico but it's really not best to rush things. We all want our cats cured yesterday but the one thing this disease will teach you is patience!

We suggest holding the starting dose for at least 7 days while you're gathering data and then doing a full curve so it's good you're planning to do that soon too. It's looking like Nico is going to need more than 1 unit but it's a little early to go ahead and increase. Saying that, I'm not an expert with ProZinc so take into consideration what others suggest before making a decision.

It's pretty late in the US (where most of our members are) but hopefully you'll get some other opinions tonight
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Thank you. I’m mostly concerned because his (human meter tests at home) are yielding HIGH numbers, but his vet keeps calling him “borderline pre-diabetic.” I’m frustrated because the readings I get would certainly not align with those of a borderline, pre kitty.. He just has been so sick, it’s hard to sit idly by and just watch, especially when his vet keeps dragging her feet on treating him; I want to get him onto a maintenence path sooner rather than later, otherwise I fear he will develop worse issues. Maybe that’s silly, idk.
 
Emily Tuomey said:
Maybe that’s silly, idk.
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Not at all silly! I took China's treatment into my own hands once I got her script (but we used Lantus that I ordered from Canada where they don't require a new script every year). She never went back to the vet for her diabetes....just for dentals, check-ups and a nasty URI once.

We won't let you go too much longer. If you could do a curve tomorrow, that may help us feel better about having you increase sooner than 7 days
 
...yea his vet is still under the impression we haven’t given insulin yet (haha!), but I wasn’t just gonna withhold it because I hadn’t been “trained” in person— there’s enough resources for me to follow and I knew all the specifics regarding treatment from his vet, I just went for it. Tomorrow we have our official “training,” but that’s all it is. What should I ask? We won’t be able to do a curve tomorrow, too many appointments/meetings between him and me, but we could the following day for sure. Nico will be thrilled LOL
 
Most worthless appointment EVER. You’re right, I learned more here— and I didn’t have to pay for a consult. UGH. They told me that testing at home is “not useful,” and that I “certainly shouldn’t be testing 3-4x per day!” They also want me to use a pet meter (Alphatrak), and brushed off my concerns about his readings being in the 500s, and being close to topping out a human meter. 2 weeks on 1.0u Prozinc then reassess. I also inquired about his returning, fairly severe weight loss and their only suggestion was vet prescribed, high calorie, “for diabetics” formula wet food. I was given a few samples to try, to see what he likes before ordering — if I decide to order.. Frustrating! Nico is still reading really high today.. 500. My sweet boy, how do I help him; seems like I’m on my own now. What’s next? Helpppppp!!
 
Sounds like you have already been given very good advice. We are glad you joined us. I just wanted to say...

WELCOME TO OUR FAMILY :bighug:

We here look forward to getting to know you and your extra sweet Nico.

jeanne

Ugh typed this out hours ago and forgot to hit send. :(:confused::oops::rolleyes:o_O
 
Deep breaths Em, deep breaths.

You are doing fine. You are simply a concerned cat momma and love your cat. We all worry about our pets health. You've taken the first best steps, to learn more from the wonderful resources you found here.

You are going to hate to do this, but try to always get a "before bed time" test in the PM cycle. (A cycle is a 12 hour dosing period).
Then, if possible, get a test later around the +5 to +7 time frame, to see what the nadir is. It's possible that Nico is dropping low overnight, and you aren't seeing that. It could be why he is so high at pre-shot test time.

We don't agree with your vet, that testing several times a day is not needed. Home testing is one of the best ways to see what is going on with Nico.
Even the AAHA 2018 Guidelines for Managing Diabetes recommends home testing. Less stressful for your pet and for you.
Perhaps share these guidelines with your vet, as they may not be aware of them.

Imagine how you would feel if your blood glucose was so very very high. It's one reason for Nico to be feeling "lethargic" as you note on your SS.
Are you testing for ketones? Lack of appetite and not enough insulin can lead to a toxic buildup of ketones in the blood and then the urine. Really important to do that, when your cats BG levels are so high.

When you get the curve run, post in this thread again. I'll see it and be able to give you some feedback after the curve results.

p.s. Just saw the tag for me to jump in on this thread. I'm not usually able to sign on until later in the evenings. So that is why the late reply from me.
 
Deb & Wink said:
Deep breaths Em, deep breaths.

You are doing fine. You are simply a concerned cat momma and love your cat. We all worry about our pets health. You've taken the first best steps, to learn more from the wonderful resources you found here.

You are going to hate to do this, but try to always get a "before bed time" test in the PM cycle. (A cycle is a 12 hour dosing period).
Then, if possible, get a test later around the +5 to +7 time frame, to see what the nadir is. It's possible that Nico is dropping low overnight, and you aren't seeing that. It could be why he is so high at pre-shot test time.

We don't agree with your vet, that testing several times a day is not needed. Home testing is one of the best ways to see what is going on with Nico.
Even the AAHA 2018 Guidelines for Managing Diabetes recommends home testing. Less stressful for your pet and for you.
Perhaps share these guidelines with your vet, as they may not be aware of them.

Imagine how you would feel if your blood glucose was so very very high. It's one reason for Nico to be feeling "lethargic" as you note on your SS.
Are you testing for ketones? Lack of appetite and not enough insulin can lead to a toxic buildup of ketones in the blood and then the urine. Really important to do that, when your cats BG levels are so high.

When you get the curve run, post in this thread again. I'll see it and be able to give you some feedback after the curve results.

p.s. Just saw the tag for me to jump in on this thread. I'm not usually able to sign on until later in the evenings. So that is why the late reply from me.
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Oh my gosh, no worries at all! We had a big appointment day today so just getting resettled at home ourselves. Tonight Nico will get a PMPS in about a half hour, then dinner, then 1.0u PZI insulin. Might be a longgggg half hour though, poor guy is hungry (his sister is too)! Neither one of them are used to anything but free feeding. I do intend to let them free feed outside of the 2 hr pre-shot tests. I’m frustrated with the vet. She doesn’t want a curve until 2-3 weeks out; I think that’s too long.. I’m caught between wanting him to feel better quickly and being patient as we attempt to get a correct dose/insulin combo for him. They tested for ketones at the vet, which was negative. I got some 10 in 1 urinalysis strips but have had some trouble with them. I could get some different ones, if you have any suggestions? I’m on the west coast, so feel free to respond whenever you have time— I’m working from home because of Covid, so I’m usually around. Thank you for all your kind words— I’ll try to remind myself that it’s a marathon not a sprint. Look forward to taking again soon. -Em & sugarbaby Nico
 
Emily Tuomey said:
She doesn’t want a curve until 2-3 weeks out; I think that’s too long.
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You are right....if you can get a curve in tomorrow, that would be very useful...tomorrow morning would be the 12th dose at 1U....if we don't see any better numbers than he has been getting, I think you could go up to 1.5 (if our ProZinc experts agree with me)

Emily Tuomey said:
I could get some different ones, if you have any suggestions?
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You can get plain Urine ketone test strips (WalMart) instead of the strips that test for everything or you can get Ketostix (may be available at WalMart) or any other human pharmacy that stocks diabetic supplies.

Be sure to get at least one test on the PM cycle 2-3 hours after the shot. If you can set an alarm and get one later, that's even better! A lot of us would drink a big glass of water in the evening so we uhhh "had to" get up....as long as we were up anyway, might as well test the cat!! You actually will get so good at it in time that you won't need to really fully wake up. There were lots of times that the only way I knew I'd tested China overnight was because there was a number on the meter that I didn't remember getting!
 
No updates on the SS since your preshot test for 11/10/20 AM cycle.
But those high black BG numbers are concerning.

Yes, a larger increase than normal, upping the dose by 0.5U would be ok. So the current 1U dose would go up to 1.5U.
We usually only recommend 0.25U increases, but Nico's terribly high BG levels do indicate the need for a larger initial increase.
 
Deb & Wink said:
No updates on the SS since your preshot test for 11/10/20 AM cycle.
But those high black BG numbers are concerning.

Yes, a larger increase than normal, upping the dose by 0.5U would be ok. So the current 1U dose would go up to 1.5U.
We usually only recommend 0.25U increases, but Nico's terribly high BG levels do indicate the need for a larger initial increase.
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you guys are freaking me out. And my vet said not to test as much, so we didn’t do any mids today. Just trying to hold myself together. His vet isn’t concerned about his numbers being high, she still says he’s “prediabetic.” I feel like I’m spinning completely on my own. She’s out of the office now until Friday but maybe I should call and get advice anyway?
 
Emily Tuomey said:
Only test pre-shot so as not to stress him.
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Home testing him isn't stressful for him, especially if he learns he gets a special treat if he sits still and lets you fool with his ears (or paw) long enough to get a blood sample. Now putting him in a crate he hates, driving him to the vet, sitting in a waiting room with other animals (or being handed off to a stranger in the parking lot) and then being poked and prodded by somebody he doesn't know and doesn't really like....That is stressful!

Emily Tuomey said:
Vet said 2-3 weeks at 1u BID.
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That's too long to leave him on a dose that's not working but you are going to have to make the final decision on whether you want to listen to your vet or listen to us. The people here live and breathe nothing but feline diabetes 24/7/365. We have tried pretty much everything out there and have found what seems to work best. We don't pull our advice out of a hat...it's been proven with thousands of other cats and developed into the dosing methods we recommend here.

In the end, you have to do what you feel is best. If you choose to listen to your vet's advice, we'll still be here to help you any way we can.
 
Deb & Wink said:
No updates on the SS since your preshot test for 11/10/20 AM cycle.
But those high black BG numbers are concerning.

Yes, a larger increase than normal, upping the dose by 0.5U would be ok. So the current 1U dose would go up to 1.5U.
We usually only recommend 0.25U increases, but Nico's terribly high BG levels do indicate the need for a larger initial increase.
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Set to increase to 1.5u at 7a. Just tested +3 and was 472 (which isn’t low by any means, but at ~3 days of 580+ I’ll take it!). So question though. If I increase to 1.5u tomorrow, would I still curve or wait a couple days???
 
Emily Tuomey said:
His vet isn’t concerned about his numbers being high, she still says he’s “prediabetic.”
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Pre-diabetic cats are cats whose blood glucose levels are slightly elevated and may be easily controlled with just a diet change. Just like in human pre-diabetics.

Nico's numbers are far from slightly elevated. He needs insulin.

Emily Tuomey said:
If I increase to 1.5u tomorrow, would I still curve or wait a couple days???
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There's really no such thing as too much data. Every test you get fills in a piece to the puzzle that is Nico. If you don't want to do an official curve (testing every 2 hours for 12 hours), it's perfectly acceptable to get tests in at different points in the cycle. Maybe one day get a +3, +6, +9...another cycle get a +2, +5, +8. Another time get a +4 and +7, etc. etc. The more tests you can get in, the more you're going to learn about how Nico is responding to the insulin.
 
Chris & China (GA) said:
Now putting him in a crate he hates, driving him to the vet, sitting in a waiting room with other animals (or being handed off to a stranger in the parking lot) and then being poked and prodded by somebody he doesn't know and doesn't really like....That is stressful!
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^^Agree!! Especially now that I’m getting good at it!

Chris & China (GA) said:
That's too long to leave him on a dose that's not working.
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^^Agree to this too.. because clearly it’s not doing anything at all, really. Maybe just the slightest. It’d make me feel better to just get him outta the woods and back into the 300s where he started at. So I don’t feel like I’m holding my breath all day every day (and not sleeping because I check on him constantly)... what a happy day that’d be! Not remission, but just to be able to breathe would be nice. <<fingers (and toes) crossed>>
 
Chris & China (GA) said:
Pre-diabetic cats are cats whose blood glucose levels are slightly elevated and may be easily controlled with just a diet change. Just like in human pre-diabetics.

Nico's numbers are far from slightly elevated. He needs insulin.
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See idk why she’d say that but it’s all she keeps saying. “Pre-diabetic” and “borderline.” My readings aren’t nearly consistent with that— I feel like we are on different planets!! It’s making me crazy!

Chris & China (GA) said:
There's really no such thing as too much data. Every test you get fills in a piece to the puzzle that is Nico. If you don't want to do an official curve (testing every 2 hours for 12 hours), it's perfectly acceptable to get tests in at different points in the cycle. Maybe one day get a +3, +6, +9...another cycle get a +2, +5, +8. Another time get a +4 and +7, etc. etc. The more tests you can get in, the more you're going to learn about how Nico is responding to the insulin.
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I’ll do what I can. Certainly more than I did today, but won’t be every 2 hrs. Will be interested to see what a dose increase does for him!
 
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You are doing great Emily! Remember to breathe. Deep breath, hold, release, deep breath, hold, release, ...................... It helps to relieve some of the stress, to
concentrate on your breathing.

I'm glad that Chris already said it about a cat in the 300's and higher NOT being pre-diabetic. Perhaps your vet was basing that on some sort of blood test at the vet clinic? Since you paid for all those tests, the clinic should send you the results. They can easily attach them to an email. There is even a separate tab on the SS where you can enter lab results. A glucose level is often included in standard bloodwork, so you should have that value to refer back to. Let us know what it was please.

Rockstar Nico! I like that idea!
 
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Deb & Wink said:
I'm glad that Chris already said it about a cat in the 300's and higher NOT being pre-diabetic. Perhaps your vet was basing that on some sort of blood test at the vet clinic? Since you paid for all those tests, the clinic should send you the results. They can easily attach them to an email. There is even a separate tab on the SS where you can enter lab results. A glucose level is often included in standard bloodwork, so you should have that value to refer back to. Let us know what it was please.

Rockstar Nico! I like that idea!
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He really has been a rockstar through all of this— everyone he comes in contact with comments on how lovey he is and always in good spirits despite being in a really terrible state of health. He’s my boy. :cat: I’ll call tomorrow and see if I can get a copy of his bloodwork. He’s had at least two routine panels as well as two sets of fructosamine and urinalysis. The vet definitely keeps saying he’s “borderline” or “pre-diabetic,” which baffles me seeing his numbers with my own eyes. A consistent 550-HI on a human meter is NOT in any way NOT a full blown diabetic, like at all. I’ll see what they’re able to send me and attach once I have them. Have some of my own health stuff to attend to tomorrow, but I’ll be in and out. What intervals should I test him tomorrow?
 
Back to too high to read— 600+ “HI” :( I knew it wasn’t gonna be good, you could see it in his eyes a couple hours ago. My sweet boy. Shot 1.5u tonight so hopefully he makes a good upswing before bedtime. :oops: Hard to see him like this...
 
Emily Tuomey said:
Headed back up. 494. Scared for PMPS. Should I continue +3, +6, +9 throughout the night? Would that be helpful? I feel kind of lost as to what kind of poke schedule would be most beneficial right now. Any advice??? :nailbiting:
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No biggie. Well give it a few days at 1.5 then try 2. I didn't see progress with my cat until I hit 3 units. They need what they need.... He'll get there.
 
404 early, early this morning — 4a (+9), then by 7a (AMPS) was back to 600+HI :( I just feel so bad for him when he feels that unwell, usually it’s pretty visible in his eyes... had 1.5u at ~7a after breakfast. So far so good. He’s come by for snuggles, which is a telltale that he’s feeling better. I enjoy them too :smuggrin: Plan on taking a +4 and +7 or 8 today. Wish us luck!
 

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Emily Tuomey said:
404 early, early this morning — 4a (+9), then by 7a (AMPS) was back to 600+HI :( I just feel so bad for him when he feels that unwell, usually it’s pretty visible in his eyes... had 1.5u at ~7a after breakfast. So far so good. He’s come by for snuggles, which is a telltale that he’s feeling better. I enjoy them too :smuggrin: Plan on taking a +4 and +7 or 8 today. Wish us luck!
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GOOD LUCK!
 
Deb & Wink said:
Seconding Janet's thoughts on increasing the dose a bit faster than normal.
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Tomorrow morning is good? Tonight 1.5u? I’m back to being worried... maybe I should keep a closer eye and/or test more often tonight/tomorrow? But maybe that’s only helpful for my own peace of mind... Just want him to be okay, which I know I can’t rush. Please, please continue to advise!!
 
Emily Tuomey said:
Tomorrow morning is good? Tonight 1.5u? I’m back to being worried... maybe I should keep a closer eye and/or test more often tonight/tomorrow? But maybe that’s only helpful for my own peace of mind... Just want him to be okay, which I know I can’t rush. Please, please continue to advise!!
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Honestly id be surprised if he's not at 4 or more before you see results. My vote is for 2 tonight.
 
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