Stalling: Merlin pmps 285

[Merlin]

Hello. I am new to posting. I have been taking care of my daughter's cat, Merlin since March 4, 2014. I recently found your website and it has helped tremendously. Hopefully Merlin's SS and Profile will be accessible to you as I just recently set this all up. To give you a quick history. Merlin is 16 years old and was diagnosed with diabetes in October 2013. He is on Prozinc and I use AlphTrak 2 although since I am testing him quite a bit, I will be looking for a more economial meter and strips. I recently got him 100% on wet, low carb (Fancy Feast) can cat food. Anyway, my goal for now is to find the correct dose of insulin. I believe I started to high and I know that I probably shouldn't be decreasing or increasing often or very much. Hopefully his spreadsheet will provide enough information for someone to help. Tonight was the first time he got a 285. I made a mistake a few days ago when I gave him 3U when he got a 309 and I believe it made his BG go low in just two hours after AM shot. I am thinking 2U for tonight but then that would mean a .50 decrease. I thought I would see if anyone else had any other thoughts. Thanks in advance. confused_cat

 

[BJM]

Welcome to FDMB!

You've done quite a bit on your own so far - good job!

Whenever you can't be around to monitor, go for safety. It does look like 2 units may be OK; snagging a before bed test will alert you if Merlin starts to dive.

The following may be helpful:

We suggest using an inexpensive human glucometer with pet-specific reference numbers. One many of us use is the WalMart Relion Confirm, or Confirm Micro, which is also sold at American Diabetes Wholesale as as the Arkray USA Glucocard 01 or 01 Mini (same manufacturer - Arkray USA). It uses a tiny blood droplet and the cost is significantly lower for test strips (like $0.36 each).

Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]

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Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)

 

[BJM]

The Cat Info food chart lists numerous canned foods for cats, with a breakdown of the percent of calories from each of protein, fat, and carbohydrates. As obligate carnivores, cats are able to break down both protein and fat and extract the molecules needed to create glucose - in other words, there is no need to feed them carbohydrates, they can make their own. (Cool, huh?)

For regular feeding, go with anything under 10% calories from carbohydrates. Have a few cans of high carb, gravied foods in case there is a need to address low numbers by intervening with high carb gravy.

 

[Rachel]

Hi to extra sweet Merlin! Could you introduce your human to us?

You are doing great with getting low carb food and constant testing!

Since you do have an SS and are testing and all you might want to post on the PZI forum. We are a small friendly group with lots of experience (more than I have!). If you post in the AM and PM with your numbers, we can advise on dose. You are always welcome here on health but PZI is a good place for dosing advice since that's your insulin. Just wanted to give that option!

Let us know what else you need! We are here to help.

 

[BJM]

U-100 insulin has 100 units per mL
U-40 insulin has 40 units per mL

It is possible to use the U-100 syringes with U-40 insulin by correcting for the 40% lower concentration
0.4 * the U-100 syringe mark = U-40 insulin dose.
0.4 * 0.5 = 0.2 U-40
0.4 * 1.0 = 0.4 U-40
0.4 * 1.5 = 0.6 U-40
0.4 * 2.0 = 0.8 U-40
0.4 * 2.5 = 1.0 U-40
0.4 * 3.0 = 1.2 U-40

Can you fix the entries which were recorded incorrectly on the spreadsheet?

 

[Merlin]

Thank you so much for the response and additional information. I gave him 2U tonight and will check his BG in a couple of hours. I think his BG is lowering because of the low carb food. Also, thanks for the attachments. I have already found them and have used them. I would very much appreciate any other suggestions, after reviewing Merlin's spreadsheet. I am very open to suggestions. Is it good to give different doses each time i.e. according to pre-shot BG numbers while focusing on the nadir number? Or is it better to land on a unit with very little fluctuation?

 

[BJM]

Its more a question of does it work for Merlin. If it does, you can do a sliding scale with ProZinc fairly easily, as it does not build up a depot )sustained release effect) the way Lantus and Levemir do.

Keep trak of the responses to various doses at various pre-shot levels. Occasionally, copy a week or two of numbers into another sheet and sort by pre-shot to group them for evaluation of effectiveness.

Always keep above 90 mg/dL when using an AlphaTrak and 50 mg/dL using a human glucometer. If it looks like he is dropping too fast or has dropped below the limit, you can steer the numbers by using 1-2 teaspoon amounts of medium or high carb foods and testing every 20-30 minutes to monitor effectiveness and repeat as needed to continue adjusting him to safe levels.

 

[Merlin]

Thank you all for all the information and advice. I just wanted to close this post and let you know what is going on. I have decided to post on the Prozinc/PZI forum to get help with my doses as Rachel and Gypsy recommended. Oh my, that was such great advice along with all the other information I received on this post. After only a couple of adjustments and lots of monitoring (all in a very short time frame), I am currently giving him .6U and Merlin is flourishing. In just two days, he is doing so good. I love this website and everyone that is here. I am breathing again.