RX or dose Help needed!

Since you fed him some food, the pre-shot test is higher than it might normally be.

Your options are:

1. to wait 2 hours after feeding him ANYTHING, retest and give the shot. Next shot time would need to be adjusted to compensate.
2. Give a reduced dose, a "token" dose of 10 to 25% of the normal dose.
10% of 2U is 0.2U
25% of 2U is 0.5U.
3. skip the shot.

The risk with skipping the shot is that ketones can form and they can be dangerous.

Some cats do better on slightly higher carb foods. Tom may be one of them.
The Tiki Cat foods are mostly 0-2% carbs if I remember correctly. The After Dark line are not on the food chart, so can't be sure.
The Friskies pates are in the 5-6% carb range.

There is no danger of hypo if you have not given Tom insulin for the PM cycle. So no reason to feed high carb kibble to bring his numbers up.
 
So I’ll test him at 8pm (He was 148) & 9pm. If he is going up finally then I am comfortable doing a token shot but he will have to be way up. Otherwise I will skip until 6am.
I’m not worried about hypo. I’m just now hopeful his pancreas has some life left in it.
But what dose should I do for his morning shot? Hold at 2 units as long as he is over say...300 like normal?
Or back down a little?
 
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New members on the message board, with newly diagnosed diabetic cats, are told to use 200 as the minimum pre-shot BG level when they start posting in the Feline Health forum.

But Tom has been on insulin since November 2019. Your SS says that Tom started insulin on 11/19/2019.

So I'm kind of confused and not sure why you have set 300 as your decision point BG threshold. (Also sometimes called the shoot/no shoot number). A pre-shot BG of 300 is the suggested level for people using a really fast acting insulin, like NPH or Vetsulin/Caninsulin.

A BG level of 200 (or close to it) or higher should be fine for giving Tom his full dose of insulin.
You want Tom's BG levels to go down into those lower blue ( <150) and higher green (60-99) BG ranges. It's only a drop below 50 mg/dL where you need to be concerned with hypo and become more proactive with feeding and testing. Or a drop early in the cycle, when you have shot the insulin.

Whenever you are in doubt as to your next step, the Prozinc dosing protocols give you good guidelines to follow.
Sticky PROZINC DOSING METHODS

Not only does his pancreas have some life left in it, but the different food, the Friskies pate seems to be helping Tom too!

p.s. If you go back and edit a previous reply, we don't see that change. If you need to change something, it's better to post a new reply. When looking at a thread that I've already seen, it takes me to the "first unread reply", not backwards if you make a change.
 
Since we can't be here 24/7, having a backup plan is useful. It's why I pointed you to the Prozinc Dosing Methods document. There is also the option to post in the Feline Health (Welcome&Main) forum, if no answer here in the Prozinc forum.

It's a holiday weekend, and there will not be as many people on the message board as usual. No big gatherings, but many people are celebrating with small family get-togethers.
 
So I didn’t shoot. 9pm was only a bit higher.
He didnt start Insulin until Christmas. He was diagnosed in November but I tried diet change first.
Technically he has been on insulin since Dec 27 but since it wasn’t enough, in my mind, he is a new to insulin cat.
He has been on both Friskies and Fancy feast before today for extended periods of time, I only gave him the Tiki in the last month. The food never had any impact on his numbers before so I dont think it’s the food. I think it’s the insulin dose.
I'm worried about shooting a 200 because he went from 400 to 138 today and it lasted longer than 12 hours. I don’t mind if that happens daily, twice a day, but he was still dropping at dinner and after dinner so that concerns me.
Keep in mind I have only seen high numbers for months and this is a radical change my mind needs time to process.
Ex.) If it drops him 300 points (400 to 100) and he is only 200 then that sounds like a bad plan... ????
So if the 2 units is too much I don’t want a hypo and kill him.
 
So oddly today there was no crazy numbers, just the usual. He got pretty much the same food plus 4 oz. Tiki after dark on top. so I increased him to 2.25 units tonight.
 
so I got an 86 this morning preshot. Yikes. So no shot now.
This is making me a little nauseous. I dont know how low he got overnight or if maybe he is still dropping like two days ago. Ugh.
 
So 6:00 86
Then 7:30 93
Then 9:13 was 151 so I gave him his shot but not 2.25 but a smidge over 2 so a “fat” 2 I think it’s called at 9:15Am. So I know to change his Pm shot time. I guess I’ll try holding him at a “fat” 2 for a few days and see how he does. I’m wondering if I should have held him at 2 units longer and not increased him so soon. Maybe his body needed more time to adjust to the 2 units? I need to do a Full curve at some point.
1. can you tell me why twice now the ProZinc has not “worn off” by the next shot?
2. I’m trying to understand that and understand how it is still safe to shoot when his preshot numbers are lower than what I am accustomed to.
 
Mesacakes said:
So 6:00 86
Then 7:30 93
Then 9:13 was 151 so I gave him his shot but not 2.25 but a smidge over 2 so a “fat” 2 I think it’s called at 9:15Am. So I know to change his Pm shot time. I guess I’ll try holding him at a “fat” 2 for a few days and see how he does. I’m wondering if I should have held him at 2 units longer and not increased him so soon. Maybe his body needed more time to adjust to the 2 units? I need to do a Full curve at some point.
1. can you tell me why twice now the ProZinc has not “worn off” by the next shot?
2. I’m trying to understand that and understand how it is still safe to shoot when his preshot numbers are lower than what I am accustomed to.
Click to expand...
Prozinc usually lasts 10 - 14 hours. Looks like you are getting a longer duration. :)
 
Mesacakes said:
1. can you tell me why twice now the ProZinc has not “worn off” by the next shot?
Click to expand...
  1. The duration of the insulin and the nadir time can vary from cycle to cycle. The nadir doesn't always stay static.
  2. You could have mixed the insulin vial more or less those times.
  3. Insulin syringe barrels have the marks on them stamped inconsistently. What may look like being drawn to the same dose line, could be a different dose.
  4. Different activity levels in your cat can vary and influence the BG levels. Play more, sleep less or vice versa.
  5. Your cat could have eaten less food. That often keeps the BG numbers lower.
  6. Slight variations from batch to batch, or within the same batch of commercial cat food occur.
  7. Stressed out cat can have variations in the BG levels. Maybe there was a strange kitty in the area, or a squirrel near the window.
  8. Cats being more active at night, can burn up more glucose, causing a bounce to occur the next cycle if they dropped lower than their body is used to
There are too many possibilities to name them all. Above is a small sample I came up with in a couple of minutes.
 
Well now I feel like I’m back to not giving enough.
This is so frustrating.
Here I thought I was doing pretty good, and two days later he is running high again. So maybe it is inconsistent marks on the syringe? Really not sure at this point. Ugh. I’m sticking with the 2.25 for a few days and we will see what happens.
 
Mesacakes said:
Here I thought I was doing pretty good, and two days later he is running high again. So maybe it is inconsistent marks on the syringe?
Click to expand...
Have you made yourself a reference syringe? Drawing up a colored liquid in a used syringe, and then comparing the dose of insulin you do draw up to that reference syringe?

Do you overdraw the dose slightly, then remove the syringe from the insulin vial, and use that "twisting motion" to squeeze out the excess insulin into a paper towel or tissue?

Calipers can also be used, if you are questioning the amount of the dose you are drawing up.
This thread has the information you would need to use calipers >>>>>>>>> Dosing with Calipers
 
No but the reference syringe is a good idea. Thanks.
I also need to eyeball compare the lines of a few dozen syringed to see if I can see variations.
I don’t overdraw much. Usually only if I see an air bubble or if I just overdraw accidentally.
I did buy calipers I can use those ...
 
I never did use calipers myself, even though I have a set.
That link I gave you lists the caliper readings for several different brands of syringes.
I think most of the caliper readings were done for U100 syringes.

It IS POSSIBLE to use U100 syringes with a U40 concentration (strength) insulin.
2.5 times the U40 insulin dose is what you would draw up in the U100 syringe.

The printable conversion chart for U40 to U100 is here. >>>>>>> https://www.felinediabetes.com/insulin-conversions.htm

Or bookmark it on your device (pc, laptop, phone, tablet).
 
So Tom just was 61 at +4 because I gave him his full dose this morning at 260. He hadn’t ate all his Tiki, which is normal, but did eat all the Sheba. After I tested him he did go eat some Tiki and Proplan on his own. Then I gave him some Fromm kibble (10 pieces) and 6 Greenies treat pieces. So will retest in a bit and see how he is doing. He is happy as a clam now grooming post-feast.
 
Mesacakes said:
So up to 90 at +7...
So why did this happen? Ugh
Click to expand...
If we knew why, we could probably win the Nobel Prize in medicine.

Whatever the reason, those lows earned Tom a 0.25U dose reduction.

I expect that Tom will be higher at PMPS, from the extra carbs in the kibble and Greenies.
You might want to have some MC and HC foods in your hypo toolkit. Those can work wonders to bring up the BG levels from a low BG test.
 
Oops well I gave him the normal 2.5 as he was up to 391...But I left food out while I was gone before shot time So might be high if he ate anything. I’ll check him at +3 and maybe overnight...
I did actually buy some medium and high carb foods recently but since he was eating his regular food so well after I tested him I didn’t know if I should use it. Hence the kibbles and treats... just in case.
 
Just some information for next time Tom throws you a low BG level.

So the regular low carb foods are fine, a teaspoon or so to try and bring the BG numbers up, then you retest in about 20 minutes. Lather, rinse and repeat as we say, until the BG levels are back to a safer number.

Some additional tests for Tom will be good in this PM cycle. Hopefully his regular dose doesn't drop him too low. With the high carb dry food, the Fromm kibble and the greenies, those stick around in the system sometimes for days and can keep the BG's higher for a bit. But they take longer to digest initially than wet food, which is why we suggest you reach for the LC wet food first, then the MC wet, then the HC wet food. Last resort is some simple sugar like corn syrup or honey.

So the kibble and treats were left out because you had to leave?
Have you tried feeding Tom the MC and HC foods, to see if he even likes them?
If you are worried about his BG levels, and have to step out for a while, carb him up with the MC and/ or the HC food. The wet foods don't stick around in a cat's digestive system for days, so are a better choice than the dry foods.

Better too high for a cycle, than too low.

Would you start a new thread please? The mods get upset when a thread runs to more than 50 replies.
Link this old thread into the new one, if you would. Thanks.
 
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