Strange BG curve at home, watching carefully

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PumaMum

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Puma and I are hanging out today doing our first BG curve at home, and I'm having trouble figuring it out because it's SO much lower from the vet curve. This is a new Relion meter and I also checked against myself and my husband because at first I was worried these numbers weren't real. But our human numbers made sense. So why is it so different?

I just wish I had done one pre breakfast and insulin (PZI 1 unit, our vet wanted us to go up to 2 but we didn't, he had wanted 2 from the start and we're going to be switching vets).

His +5 was only 64, so I gave him a can of FF and he's eaten about 3/4 of it. He's been acting fine - right now he's sitting on the windowsill next to me watching the outside world.

This is making me think that the switch from dry food to FF has worked magic for him. His weight today is 15 lbs, which means he's gained about 8 ounces back since he was diagnosed just 11 days ago. He's eating less than he was at first, now he usually leaves something on the plate.

I'll post later on today as I update the curve. But I'm already thinking that maybe I should hold the PZI this evening, check BG before breakfast tomorrow morning, and if I give insulin tomorrow it will only be 0.5 U of PZI. Unfortunately we'll be out tomorrow beginning around noon, so I'm not sure I want to give insulin at all.
Thanks for your thoughts!
Jane

Puma's SS: https://docs.google.com/spreadsheet/ccc ... VZHZlFiMFE
 
The 64 is a very good +5 BG. The numbers are consistent )this morning BG was lower that previous preshot BGs) with this morning preshot BG.
Very frequently a curve at home is lower than one at vet because vet stress tends to raise BG.
Unless last night and today were abnormal with respect to eating, one unit is too much now. It is not that unusual for insulin needs to decrease with time, especially if one changes diet to one with less carbs.
 
PumaMum said:
Puma and I are hanging out today doing our first BG curve at home, and I'm having trouble figuring it out because it's SO much lower from the vet curve. This is a new Relion meter and I also checked against myself and my husband because at first I was worried these numbers weren't real. But our human numbers made sense. So why is it so different?

I just wish I had done one pre breakfast and insulin (PZI 1 unit, our vet wanted us to go up to 2 but we didn't, he had wanted 2 from the start and we're going to be switching vets).

His +5 was only 64, so I gave him a can of FF and he's eaten about 3/4 of it. He's been acting fine - right now he's sitting on the windowsill next to me watching the outside world.

This is making me think that the switch from dry food to FF has worked magic for him. His weight today is 15 lbs, which means he's gained about 8 ounces back since he was diagnosed just 11 days ago. He's eating less than he was at first, now he usually leaves something on the plate.

I'll post later on today as I update the curve. But I'm already thinking that maybe I should hold the PZI this evening, check BG before breakfast tomorrow morning, and if I give insulin tomorrow it will only be 0.5 U of PZI. Unfortunately we'll be out tomorrow beginning around noon, so I'm not sure I want to give insulin at all.
Thanks for your thoughts!
Jane

Puma's SS: https://docs.google.com/spreadsheet/ccc ... VZHZlFiMFE
Click to expand...

Well, you are seeing how much of a difference it makes to change a cat's diet, and then test BG at home where a cat feels relaxed.

When it comes to giving insulin, it's always safer to err on the low side, so if you are not sure tomorrow, reduce the dose or even skip if you get a really good ps number.
 
That +5 number is very nice to see! And you did the right thing feeding him his normal low-carb food at that point. The food should stop him from going lower and your next test might show a higher number. What would be interesting to see is if his number (after rising from the food) drops again afterwards. If you see that, it will show you that his body is trying to regulate itself and that would be very encouraging. It might make sense to skip tonight, or perhaps give a tiny token dose, but the rest of the numbers you get before then will point you in the right direction.
In your shoes, I'd be very encouraged :smile:
Carl
 
Here are the next two numbers:
+7 94
+9 104

So, I'll check one more at +12 before his evening can of FF. How do I decide whether to give insulin? I am assuming that at most I would give 0.5 U of PZI (instead of the current 1).

And I'll check in the morning before his breakfast. Do I give 0.5 U with breakfast no matter what?

Thanks!
Jane
Puma's SS: https://docs.google.com/spreadsheet/ccc ... iMFE#gid=0
 
Jane,

Do I give 0.5 U with breakfast no matter what?
Click to expand...
You'll never give a shot "no matter what", but yes, I think that given the numbers you are seeing, a dose of .5 would be better than a dose of 1.0, unless you see a really high number in the morning.

As for tonight -
There is a chance that the number will climb in the next three hours. Many times, when a kitty has a lower green number (especially if they haven't seen a normal BG number for a while, they will "bounce". You've probably read that word by now. What happens is that his body will trigger the dumping of "sugars" into his blood stream, because his body thinks that a 60 is too low for comfort. It happens to almost every cat, and it is more or less expected to happen. But when it does happen, you have to pretty much write it off as "okay, I figured that would happen". You don't shoot higher just because the number is higher. Let's see what the next three hours brings. I do think though, that at most, you would be looking at a dose of .5 if you shoot tonight.

Carl
 
Puma's BG is 120 at +12 and he's now eating his evening FF can. It looks as if he's going to leave some of it, he's probably had about 80% of it.

Do I give him 0.5 U or wait for the morning?
 
I think I would skip. You have no data to help you figure out how low he might go at that number and dose. Your other alternative is to chase the number. - keep testing until he is safely in the 200s and 2 hours after the food (because food raises bg levels. You want a "real" number, not a food induced one). The difficulty with this approach is that it will throw your schedule off. Say if you shoot at +14 tonight, your amps will have to be 2 hours later than usual too.

If you skip, in the morning, he will probably be high. BUT this will be because he hasn't had a shot for 24 hours. You need to think of the amps as a "false" number. I would look back to your amps today. The one unit caused him to have a long cycle and an unshootable pmps. So one unit is too high of a dose. I would think about .5 or .75 if you get an amps over 200 in the am with that scenario.

Confusing?
 
Very encouraging that he didn't go high after so long without insulin. I think you will be giving doses smaller than .5 soon. You can do that with U100 needles and a conversion chart. (ProZinc is a u40 insulin so to use another type needle, you have to convert the dose.)

http://www.felinediabetes.com/insulin-conversions.htm

I would continue to watch today - that one unit carried him a long way. He is reacting very well to the insulin very early on.
 
Good morning Jane,

That was a really nice number at AMPS after 24 hours without insulin. I think Sue is right, you may be shooting even less in the near future and using the U100 syringes with the conversion chart is the easiest way to do that. The doses get pretty hard to even see when they get that small.
I'll check in often during the day, and if you have any questions, ask away!

Carl
 
Thank you so much, Sue, and Carl!

His PMPS was 157 tonight. Shall I give him 0.2 U using the conversion chart you provided with the U-100 syringes I just picked up? He's been getting 0.5 U twice a day since the morning of the 15th. I'm assuming I'll lower him to 0.2 U PZI for the next few days...

Puma has been acting his normal self, happy and occasionally feisty. Since his diabetes diagnosis we've brought him upstairs to bed with us at night, it's fun having the greyhound and cat up there together :razz:

I realize that ideally we'd be getting more BG checks, I'm sorry it's just not feasible during the week with my work schedule.
Jane
Puma's SS: https://docs.google.com/spreadsheet/ccc ... iMFE#gid=0
 
Sorry, he got fed after that 157 was drawn. Four crying cats waiting for dinner. I haven't given him any insulin yet. What would you like me to do?
Jane
 
Assume it will mess up the schedule completely to wait two hours till the food won't be impacting the number, retest and shoot then? If so, then I would skip. We just can't be sure it is rising, not falling, and it is a low number to even shoot a tiny dose into.

So, tomorrow, you are likely to get a higher amps (24 hours since the last shot) than you have seen. It isn't a "true" number. Don't react with a higher dose. Go with that .2 you were planning.

Next time, go hide in another room for 20 minutes and let them howl. Then test and give everyone a little snack until you are sure you have a rising shootable number. Hard, but much better than having to skip....
 
Thank you so much!
I'll skip tonight and check tomorrow morning before giving insulin. Knowing this is a great low PMPS, I'll only give 0.2 U PZI in the morning, assuming the AMPS is above 200. If it's less than 200 I won't give anything and will keep checking before meals...
This is an amazingly wonderful resource, tahnk you!
Jane
 
:oops:
OK, I'm feeling really dumb this morning. I pulled out the new syringes and the old syringes only to find that the old syringes my vet gave me are ALREADY U-100 syringes. Then I checked the bottle of insulin again and it says PZI U-100 on the label on the actual bottle, although not on the outer packaging and label. It's formulated by Professional Arts pharmacy and was sold to me by my vet when Puma was diagnosed, so I guess it could indeed be a weaker mixture than normal PZI.

So, Puma has already been getting very little insulin since the 15th. It would be hard to give less unless I practice fur shots :lol:

Time to go get organized to check that all-important AMPS...
Jane
 
Jane,
Do they have orange caps on them? What you have is compounded PZI, apparently a U100 composition, which is rare. It isn't weaker, it is actually stronger than "normal" pzi. Does the vial or box say "bovine" on it anywhere? As long as both the insulin and the syringes say U100, you're ok.
Nice number to wake up to!
Carl
 
Yes, Carl, the old syringes provided by the vet have orange caps, and so do the new ones. The old ones are 3/10 cc and have a maximum of 30 units, the new ones can hold up to 100 units.
Jane
 
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