Roller coaster readings

[Consorte_bella]

Hi everyone. Nigel is a recently diagnosed diabetic who started insulin about a month ago. My husband and I haven't been able to get his levels stable yet and I think it may be because of 2 things:
1. He is still constantly hungry, so it is hard to establish a consistent food schedule
2. We were trying to adjust his doses before we got a strong cycle established. Now I think he is bouncing

Take a look at his spreadsheet. You will see that his pm reading is usually lower than am. If you have any suggestions on things for us to do, please let me know.

I also posted about Nigel on the main Health board (but that was mostly our issue with getting blood). You can view it here- viewtopic.php?f=28&t=92638&p=1003361#p1003361

 

[Grayson & Lu]

Hi Stephanie -

I can appreciate where you're at. Grayson has been known as "my little turnip" - not interested in giving up much blood! I now use an Accu Chek Aviva, but have likewise used a Relion Confirm which uses less blood than the Relion Ultima I initially used. That challenge was very overwhelming for me, so perhaps you can get a Confirm. I also test on the top (furry side) of his ear currently. Sometimes it takes more than one poke to get blood.

The eating - if you're around - can be doled out in small frequent servings. I FINALLY bought an auto feeder (Petsafe 5) with 5 little trays that rotate on a prescribed schedule you set. That way I can give 1/3 can Fancy Feast every hour or so... it helps tremendously. I printed out Petco's on line ad for $49 and took it to our local Petsmart and they matched it ($15 savings).

Food really impacted G's numbers, so I've logged food intake in my SS for about a year. The appetite is often connected to the out-of-whack blood sugar.

You seem to be dosing on the preshot. With ProZinc, you can do that, but it seems that holding a dose for at least 3-5 days is the best way for them to adjust to it. I would think you could do 1 or 1.5u consistently and see if Nigel's numbers don't balance out. For some cats, the bounces can come from changing the dose like you're doing.

Hope this helps. Please ask questions - we've all been there!

Lu-Ann

 

[Sue and Oliver (GA)]

Glad to see you and Nigel on PZI, Stephanie. It is a much smaller forum than Health but everyone here has experience with your insulin. It is busiest at night and in the am. If you have an emergency, post on Health where you are likely to have more eyes.

Nice low pmps! If you get a blue at the end of the cycle, it is usually a sign to reduce. In this case you had reduced, so it is hard to know whether you need a further reduction or if the low pmps was due to the 2 units a cycle ago. Skipping was the right choice but it does complicate things. This am you will probably have a higher number (24 hours w/o insulin) but don't give a big dose. If he is higher this am, stick with the usual and give it a cycle to balance out.

So I'm with Lou - lower the dose a bit and get a curve this weekend? It will really help to know when his nadir is and generally how long it takes him to come back up. Those numbers can guide you going forward. And I would experiment with food. Do small frequent feedings help smooth the numbers out? Does feeding overnight change the picture?

How much are you feeding? Is Nigel overweight? Unregulated diabetics are literally starving as their bodies are not processing food well, so you can offer more food. You can also add some warm water to it and make a gravy. It'll seem like more food to him and he will have to spend more time eating it.

 

[BJM]

...He is still constantly hungry, so it is hard to establish a consistent food schedule..1

Diabetics are hungry because they can't use all the food due to the lack of insulin. You might be able to feed about 50% more, spread out across the day, possibly with a bit of water added to give it more volume, to help him feel less hungry.

You can freeze a half to two thirds of it and put out both at shot time. He'll be able to nibble on the frozen as it thaws. And it will be fine sitting out all day. I feed 14 civvies and I put out food in the morning and at night; no one has gotten sick on it, all are doing well. Do keep it away from the refrigerator exhaust - it will fan the smell around!

Another option is an electronic pet feeder. You might budget to buy a PetSafe 5 to spread out his feeding. This model has been used by many of the FDMB folks.

 

[Consorte_bella]

Food really impacted G's numbers, so I've logged food intake in my SS for about a year.

Great idea. I've been kind of doing that here and there, but I am going to add a line under the testing line to show when we feed him

You seem to be dosing on the preshot. With ProZinc, you can do that, but it seems that holding a dose for at least 3-5 days is the best way for them to adjust to it. I would think you could do 1 or 1.5u consistently and see if Nigel's numbers don't balance out. For some cats, the bounces can come from changing the dose like you're doing.

I had a feeling that was it. If you look at his latest tests, he was even lower for pmps today. We've been trying to keep his doses at 1.5, but that might even be too high. Also, we did give him 1.5 last night about an hour after the pmps test when he was in the 200s.

This brings up a new question- if we do wait on giving him a dose until after his normal shot time, do we test him/give a shot at the normal time in the am or change the am time to 12 hours after the shot? We gave him his am shot at his normal time, which was 11 hrs after the previous pm shot, not 12. I am wondering if that is why his numbers were so low tonight.

 

[Sue and Oliver (GA)]

It could be, but the only way to know is to take two tests a few minutes apart, with no food. You can shoot at +11 if you have to, but you want to be sure he is rising, not falling.

In general it's best to have shots 12 hours apart, if you can. If you shoot early, it's considered a dose increase. If late, a dose decrease. So it's easy to lose track of where you are if you shoot early or late.

 

[Grayson & Lu]

So to add to what Sue said, some people, due to scheduling, have to shoot at 11 and 13 hrs. They may adjust their dosing a bit to keep the long term averages, if that makes sense. So if you're shooting 1.5 or so, and say you should shoot at noon/midnight. If you have to shoot at noon and 11p, at noon you might shoot a "skinny" 1.5 (for the 11 hr cycle); and at midnight a "fat" 1.5 for the 13 hr cycle. Because ProZinc is in & out in one cycle, it gives you a little bit of that flexibility. But if at all possible, it's best to stick with the 12/12 schedule. If that means shooting at 7 am/pm, or noon/midnight, or 3 am/pm. Doug & Libby (now posting on Lantus TR) used to shoot Hershey at 3 am/pm, as Doug got home from work at 2 or 3 am so he was awake. Libby could monitor him during the day and shoot in the afternoon.

It's whatever works best for you & your kitty! Grayson used to get shot at 6:30; now we're on a 10 pm schedule, as his current insulin works different than ProZinc, and the onset and nadir are much later.