Time management of meals and meds

[Rachel]

Hi! Reading over your introduction post, are you saying that the vet did a fructosamine? And it was 250? That's not a very high number really.

So you started right at 4 units?? That's definitely a lot of insulin. We've had very few cats get that high on prozinc, and starting at that dose is definitely high.

 

[Ruby&Baco]

In France, we don't have U40 syringues containing only 0,3 ml.
The smallest ones are those that Lechatblanc has, with 0,5 ml.
We can find syringues containing 0,3 ml, but only U100, for human insulin.

You can use the U100 syringes, I have used them because of the smaller doses I needed to give later on. The U40 ones, especially the once you have are harder to use when you need to give less, for example 2.5 or 2.25U. That makes it hard with the syringes you have now.

 

[Carol & Murphy (GA)]

Jenny - please don't let what Ruby said above confuse you - you can use those syringes but you have to do a conversion - 4 units on a U-100 syringe (orange top) does not equal 4 units on a U-40 syringe (red top) I think we should first make sure that you are giving the right dose on the syringe you are currently using, then you can think about switching

 

[Ruby&Baco]

yes that is for sure a fact, I just wanted to reply that she can use them it's not that with Prozinc you can't use them.

 

[Sharon14]

Jenny, I see in an above post that you got the meter. Any luck testing? As Carol and Ruby said the u40 and u100 syringes are different. You use the u40 for ProZinc and 4 units of insulin is drawn to the 4th line.

 

[BJM]

While you work on you glucose testing, see my signature link Secondary Monitoring Tools for some other assessments you may find helpful in evaluating your cat.

 

[lechatblanc]

I tried to use the glucometer but couldn't get any blood from his ears with the needle. He endured it for a time, but when I switched attention to the pawpad he rebelled. SO I left it and decided to ask the vet today to show me how. To answer some of your questions, he was started on 4 units x twice a day. He was not hospitalised and the original vet discouraged me from getting a glucometer. I am using the U40 syringes and I can easily measure 2 units on them.

On Tuesday morning I found him all floppy and unco-ordinated. So I halved the insulin dose and 24 hours later he was back to 'normal', though still more lethargic than his healthy self. I have kept it at 2 units since.

Well, good news. Wellington's glucose is down to either 155 or 108, depending on which machine to believe. But either way, he was 320 last Thursday, so that is a terrific improvement. He has also lost 500 grams in weight, which is good, but much too fast in my opinion for an 8.7 kg cat. Today we went to two vets, the original one, who was pleased with his progress but cross with me when I told her I had changed the insulin dosage and why, and I showed her the charts I had made. She did actually say I had done the right thing, though I should have phoned her and asked. Since it all happened at 7.30 am and there was no-one to ask, and the cat was lying there all floppy, I took things into my own hands. She wants him to go into the clinic for a full day next week, so they can do a curved chart of levels against time of day.

So then I went to my 2nd opinion vet, whom I know through the Association for Cat Rescue. She immediately said he should never have been on such a high dosage at the start of treatment, and also that he was losing weight too fast. And she agreed with me that a wet diet would be better, and we discussed brands and amounts and I think he will be much happier as his daily diet will be increased and be more to his taste.. Then she showed me how to use the glucometer and it turns out I was given the wrong needles. So I think after the curve is done I will transfer all his treatment to the new vet - she is older and into nutrition, and I feel much more trust.

 

[Carol & Murphy (GA)]

Jenny I am so happy to hear this great report!!
There's still a lot to do with fine tuning the dose and the food - all of us are in this together!!
Prozinc usually has the nadir about 5-7 hours - is that when the blood sugar of 155/108 was taken? We always test our cats before we give them insulin, and in newly diagnosed cats, we don't usually recommend giving them insulin if their blood sugar is 200 or less at the time of testing (12 hours after the last dose) From my experience, blood sugars can be all over the place when the cat is still trying to adjust to the exogenous insulin.
If you start posting on the prozinc forum, we can help you adjust the dose day to day
also, if you do the home testing, there is no need to take Wellington to the vet for the glucose curve - you can do it yourself at home and it will be much more accurate. Due to the stress of the vet office, the glucose can raise much higher than it would at home all you have to do for a curve is test Wellington before the shot, give the insulin, test every 2 hours until the next dose of insulin - and record the results and that's it!!

the prozinc forum is here

 

[lechatblanc]

Thanks Carol&Murphy. Yes the testing was done at about 3pm, 7 hours after breakfast and 5 hours before supper. The lower dosage was at the first vet, and th ehigher one at the second, which I actually thought less stressful for him. But of course we can never know exactly what they react to.

Even though the numbers have gone down, the second vet told me to continue on 2 units per dose for the moment, and to do some interim testing myself until next Tuesday, when she wants to see his charts. So next week he will have both home and vet testing - it may be interesting to see the comparison.

 

[Sue and Oliver (GA)]

It sounds like things are looking better. The second vet sounds like a better one than the first. We would urge you to get a test before each shot - to be sure the dose you are planning to give is safe and the number high enough to shoot (200 is our suggested no shoot number for new diabetics at first). Then get a test in that 5-7 hour range after the shot to see how low the dose takes him. That lets you know how well the dose is working.

If he let you touch his ears, I would concentrate on them. Find a treat he loves. Not sure what you have in France, but my cats love PureBites and Bonito Flakes (both are low carb). Figure out where you want to test him, take him there, give him a tiny treat and warm his ears. This part is vital - to get the blood circulating through the tiny capillaries. There is a vein running down his ear (put a flashlight behind it to see). You want to poke the tiny capillaries running off that vein toward the edge of the ear.

You can use a rice sack (thin sock with raw rice inside, knotted and heated in the microwave until very warm) or a pill bottle filled with very warm water to heat his ear. You want to leave either one for 15-30 seconds at least. Poke the capillary. If you get blood, you can put it on your fingernail and test from there. Give him lots of praise and a few more treats.

 

[squeem3]

Really really old old timer here who wants to see how the OP is doing

How is the home testing going? Were you able to get a test or two done todat? Are you warming the ear first? That often helps as warm blood veins will expand slighlty and blood flows more easily through. You're not aiming directly for the ear vein, just between the vein and the edge of the ear. Here's a picture. Are you using a lancet device to poke the ear? Some lancet devices don't work well. You can freehand the lancet without the device. Do you know what gauge the lancets are? If the lancet is too fine (like 33 gauge), you won't get a big enough prick hole for blood to come out of. 28 gauge is a good size. Testing can be frustrating in the beginning but you soon learn what works for your cat and then it becomes super easy.

I am a moderator on TheCatSite, a worldwide site devoted to cat welfare, and we have a few members in France, as well as myself.

I've never heard of TheCatSite before. Is there a forum there or is it just articles and stuff?

 

[Ferndoc]

Hi Jenny, Another home testing starting tip is about lancet sizes. If you are using the size that came with the meter it is probably a bit small starting out. Ask for alternative site lancets, they are bigger. They will have a Gauge number of 25-28 instead of in the 30s. After a bit of testing the ears will learn to bleed better because more capillaries will develop.