Testing for curve tomorrow and need advice?

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Djamila

Djamila

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Samir started on ProZinc this week. The vet said to do a curve on him on Day 5 (tomorrow), but I'm not entirely sure how to do that. He said test every two hours. That seems clear enough, but as I've been reading around this site a little, I'm seeing things about feeding all day, withholding food, only giving AM/PM food. I'm wondering if there is a recommended way to deal with feeding while doing the curve.

I usually put food out in the morning and again in the evening, he eats most of his food at those times, but comes back and grazes a bit during the day and night. Should he just eat like normal?

Anything else I should know? He HATES getting his BG tested, so it should be a fun day for us both :-(
 
Welcome!

So, first thing in the am. Do a test, then feed and shoot. (You want the pre shot tests not to be influenced by food, which often raises the number. You want a "true" number to base your dose on.). Then, two hours later, another test, etc. through the day. In the evening, withhold food for 2 hours before your pre shot test.

With ProZinc, you are looking for a smile curve, around the same range in the am/pm, dipping lower in the middle. Regulated cats are in the mid 200s at preshot and in double digits at their lowest point (called the nadir 5-7 hours after the shot). So you are looking for those kinds of numbers first; then you fine tune the dose. The protocol we put together for ProZinc is in my signature in blue.

You are doing everything right! Good insulin, low starting dose. Stella and Chewy's is a good low carb food. I would suggest you might find a substitute for the Hills as a treat. It is pretty high carb and just a few bites can raise levels. PureBites are a freeze dried treat that is kind crunchy and might interest Samir.

What is difficult about the testing? If he is sensitive, you can get the Neosporin with Pain relief (gel) and put a tiny smear on his ear before poking. Do you always offer a treat? That is the secret to this thing; they learn to associate the poke with a treat they love. If he ever moves away, you can get the drop on your fingernail and test from there.

Good luck on your curve! This forum is friendly but small and busiest in the am/pm hours. If you ever have an emergency, be sure to post here and on Health to get me more eyes.
 
@Sue and Oliver (GA) Thanks so much for your quick response! I'll go edit my signature as I have already stopped with the Hills. The vet said it was fine for diabetic cats as it's listed as low carbs, but his highest numbers are always the days when he's had some of that. Even a little seemed to increase his numbers. For treats he now has freeze dried chicken and (once or twice a week) freeze dried salmon.

The difficulty with testing was twofold: first, his ears just didn't bleed much, so it was taking a couple of pokes to get a big enough sample. That was remedied by getting a thicker size of lancet, and by me just getting better at hitting a good spot (and "milking it" quickly). I've also started testing in his paws if he's laying down, and that seems to bother him less. The second (and bigger) problem is that he doesn't like human contact. He was feral and was going to be put down, but I offered to try and socialize him. He adjusted to life here and I adore him, but he really doesn't like being held, and if I try to do it without holding him he just runs away. He is starting to settle into the routine, but still growls when I do the stick. And yes, he definitely gets treats! That's the only thing that's keeping him from flat out refusing to let me do it. At the beginning he would jump away, but keep coming back because he saw the treats. Now he's stopped jumping, so progress is being made. Today he let me test him without even getting up from his nap!

Thankfully the insulin shots aren't a problem at all. He doesn't even seem to feel them. I have some practice with giving shots to humans, so I'm pretty quick at grabbing some skin and shooting before he can really get too upset.

I'm so thankful for everyone on this site! I've learned so much here and am feeling more hopeful about making this work. Thank you!
 
@Sue and Oliver (GA) One more question: His shot times right now are at 6:30am/pm. How much can I vary that? I need to leave my house this evening at 5:45pm. Can I give him his shot then, or do I need to skip if I can't give it at the right time? Unfortunately I live alone, so there isn't anyone else to help when my schedule changes. Is there a thread that addresses things like that?
 
I think I would be tempted to skip. It is so early in this sugar dance and we have so little data for him. Normally 30 minutes early is not a big deal, but I am assuming you'll be gone for awhile? Skipping is not usually a good practice and he is likely to be high in the am, as it will have been 24 hours since his last shot. But I wouldn't raise the dose in the am; he is starting to get good numbers on one unit.
 
I'll only be gone for about 2 1/2 hours. So I'm thinking I'd be home before he's likely to drop (if that were to happen). That usually takes a few hours, right?
 
I'm okay skipping if that's the best decision. I'm just excited that he got a low number today and want to keep the momentum :-)
 
Oh, if you think you can be home in 2.5 hours after your shot, then if you are comfortable, you can shoot 30 minutes earlier. I would as soon as you get home, test to see where he is at. Typically, at +2 or +3, you can tell if you are going to have an active cycle, i.e. lower numbers at nadir.

Are you going to start getting AMPS and PMPS before giving your insulin shot? Looks like some are missing and I wouldn't want you to shoot blindly. With Prozinc it is very important to know your AM & PM number as well as your nadir (mid-cycle) because with Prozinc, you can adjust accordingly.
 
@Merlin (and anyone else who reads this): The AM/PM test is about to change (in 5 minutes to be exact). My vet said that I didn't need to test before shooting since I had enough data at those times and the dose was going to be low. I asked in the main forum and was told that was bad advice, so I'm going to start testing before I shoot. Also, I'm going back to work on Monday, so I won't be able to do the mid-cycle tests anyway. I figure if his number is in his normal high range, I'll shoot early and make sure I'm back by +2. If his number is even a little questionable, I'll skip tonight and get back on track tomorrow. Does that sound good?
 
Sounds like a great decision. Glad everyone told you how important testing is before the shot.
 
173!!! Definitely not shooting. Thanks for the advice! I'm excited about the lower numbers. I know it's only one day, but every day he's lower is time for healing, right? Hopefully they are a good sign.
 
His numbers are looking good! Often the wet low carb food and a little insulin makes a huge difference.

So tomorrow, he will likely be high as he will have been 24 hours since his last shot. But, I would reduce a smidge. Your goal is to have two shootable numbers a day. Maybe pull up one unit and let out a drop or two. If he is below 200 tomorrow, stall for 20 minutes without feeding and retest. You want him rising and over 200.
 
Woo hoo! Get to sleep good tonight too! If you have to stall tomorrow, also don't feed while you are testing or stalling. That way, your test is not influenced by food. Aren't you glad that you are testing before shooting?
 
Definitely not below 200 this morning. 293. One of his worst numbers ever (at home). And he bit me when I tried to give him his shot. He generally didn't look like he was feeling well when we got up this morning, so hopefully the insulin will help him feel better as the day wears on. Just about time for the +2 test. Right after this one I'm headed to the store to get some neosporin. Hopefully that will make the tests a little less painful for him. Especially given the number of pokes he's going to have today!
 
He's already down to 144 at the +2, so that's a huge improvement over this morning. Plus, he held still and didn't fuss about doing the test. I mean, he pulled his ear as back and flat as he possibly could, but he didn't run away, bite, or growl, so I'd call that a win ;-) Going from 293 to 144 is a pretty big drop, isn't it? I wonder if one of the tests is off? Both of them had nice blood drops and filled the test strip completely, but not too much. I guess we'll see when I get the next one...
 
293 is not a bad number when you consider that he has been without insulin for 24 hours. In fact, it is a great number! I am glad you are getting a curve today to see how low the dose takes him.

Be sure to get some favorite treats when you are Out!
 
Good timing! I am just about to run out the door, and a treat stop is indeed on the list. He really loves these things called Bonito Flakes. They are very thin ribbons of fish. I'm going to use them today since it's going to be such a tough day for him, but I know in general fish isn't best for them. Do you think it's okay a couple of days/week or is even that too much? He goes crazy for these things.
 
Hooray! Thanks! I'm also glad to hear 293 isn't too bad. It feels terrible since his all time high is 310, and that was in the vet's office!
 
I see a green in your future. :D That is quite a drop for +2...glad you are checking him throughout the day.
 
No green here. :-( He's at 174 at +4. It wasn't a completely full drop though. However, he took his treat and ran under the bed, so I can't retest right now. I think I'll try again at +5 instead of waiting until +6. Is it possible that his nadir is super early? I guess time will tell...
 
Hmmm. Maybe he will surf around the blues today which is not a bad thing. Good info though.
 
Well, if it's a smile, it's a pretty lopsided smile ;). He's up to 235. Is it every okay to shoot early? When it seems pretty clear that he's been rising is it better to shoot early and try to bring it down, or just wait and stick to the schedule? Or is that something that comes later after his patterns are better established? And by the way, I cannot tell you all how grateful I am for this forum!
 
No, you don't want to shoot early. It is really a very nice cycle so early in this sugar dance. He got some blues and didn't bounce up high. I think it looks good. Even if your evening number would bounce up in a higher range, I would hold the dose.

This isn't an easy fix and you can't rush it. It is a process - someone said a marathon, not a sprint. His body has to learn how to use the food and the insulin effectively. You are doing great and so is he.
 
This is really good information and Sam did very well today. Great job in doing your first curve! All excellent data.
 
Next question (and hopefully the last for tonight): I'm supposed to do his PM shot at 6:30, but he isn't eating. I just did his pre-shoot BG and he's at 256. Is it okay to just shoot, or do I need to wait until he comes and eats food? I gave him a treat with the test, and he's usually a grazer, so he doesn't always come running at dinner time. I did pull his food at 4:30 to give him two hours before his PMPS.
 
Yes, it should be okay to shoot. On Health, I suggested giving him some food on your finger - it would be nice to have something in his tummy.
 
Thank you! I woke him up from his nap (surprised the BG test wasn't enough to get him moving!) and just set him down in front of his dinner. He ate a little and I gave him his shot. And then of course another treat. He's going to get so spoiled! He's going to start thinking treats are part of his regular food!
 
So glad we're done with the curve! THANK YOU so much for your support all day today. It is tremendously comforting to know that there are so many compassionate experts out there who can help us get through all of this and adjust to this new way of living. Sending so much love to you all!
 
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