To Shoot or Not To Shoot??

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Doug N Libby

Doug N Libby

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Sorry to ask so many questions - We are at Day 4-1/2 of Hershey being on ProZinc 1u.
His insulin was due :45 ago - PMPS 130, so Doug tested again, to be sure. It was 138.
We waited :20 min and it was 150.
:25 later and it's 171.
Clearly it's rising, but it's still not high enough to give the shot. So, do we just wait for it to get to 200, testing every :30 or do we go ahead and feed knowing the food will raise the BG? Do we skip this dose and try again at 2:30am? nailbite_smile

Thanks!!!!

Libby (and Hershey, too!)
 
What great numbers and "problem" to have! :smile:

If you can be home to keep an eye on him and to test, you could stick with the 1u.

If you can't be home, I always panic the most when I can't be there, perhaps .5 or .75u.

While Hershey's numbers are low, they are clearly rising even if a little bit. I tend to be conservative when unsure, so I'd tend to go with the .5u.

And good on you for waiting and retesting, and good boy Hershey! Be sure to have lovings and treats all around! :-D
 
Our syringes are full unit - U40, so would you just eyeball .5u? It just seems cruel to keep him from eating while we watch his numbers rise...but, this being so new for him and us, I'd rather err on the side of caution.

Libby
 
I totally understand! Poopy gets very angry with me when I poke and no food! :lol:

I eyeball the dose (I use u40 syringes and normally shoot 1.4u).

If you are planning on giving Hershey his shot, go ahead and let him eat. :smile:
 
Thar syncs with.my advice; shoot a reduced dose. Just estimate the .5 for now. Might consider changing syringes soon. Congrats on the low ps & great job handling Hershey's curveball!
 
Are there different u40 syringes, ones with smaller graduations? I've read of people giving .2u, etc and I'll just tell you that my 'maturing' eyes can't tell .2 from .6 when the 2-1/2" syringe is graduated in full units only.

Thanks, again, y'all!!
 
I responded earlier in your last post that I think the 1 unit dose is a little too high.

So I think it's time to switch to the U100 syringes and print out the conversion chart so you can start going with more accurate smaller doses.

You may have already shot .5u which is fine but without having any data on shooting lower numbers I probably would have waited until he was closer to 200 FWIW.
 
All u40 syringes have full unit markings. When I first started to up Poopy's dose, I eyeballed very carefully and counted how many rubber syringe rings there were from my starting point to the next same spot a unit later (I counted 5 rubber syringe ring widths, so that's .2 units each for me). I marked a syringe with those lines and use it to compare with the syringes I shoot with.

My eyes are also old. I had to do this without my glasses, it's such close work. I've also ordered the u100 syringes to give my eyes a break (and to be more accurate on how much I'm giving Poopy). I should get them soon. :smile:

While I may really be shooting, say, 1.3 or 1.5u with my 1.4u marking, it's consistent since I use the same tool (the marked syringe) as a guide.
 
We waited 25 minutes and it was (166), so it actually came down a few points. We haven't given him a shot, yet, I know he wants to eat - although, he isn't screaming at me, YET!

Rob - I was just reading your post about the 1u maybe being a little high. That's one of the reasons I was asking about syringes with different graduations. Our vet told us we were "on [our] own" with this, except for her ordering the insulin and syringes.

Now, he's starting to gag, bringing back what looks to be bile -so, it's time for us to decide something so he can eat. It's been :15, so one last check...
 
I thought the 1 unit was too high on the higher numbers, that's why it makes me nervous to shoot a reduced dose on a much lower number, we don't have any data on it. Not that it won't work.
 
If it was me I would skip the shot. Without alot of data and seeing how much 1 unit brought him down - from 300's to 50's I would be to nervous even doing a low dose. That is only my thought and I don't have a ton of experience :smile:

Good Luck
Sharon
 
Hi Libby and Doug,
First off, never apologize for asking lots of questions!
I just looked at the SS, and it looks like you had an exciting day. That was a huge drop from AMPS to nadir on 1u this morning. What is encouraging is that you didn't see an immediate "bounce" from that low number. The PMPS is still nice and low. The reaction to those low numbers may come later, but so far, so good.

I probably am too late to advise on what to do next....
But I would shoot a small dose, if any at all. .5 at the most.
Edit - ignore that and see my advice later in the post.

It looks like you might be having to deal with tiny doses going forward, so like others have said, see if you can get some u100 syringes with 1/2 unit markings, and print out the conversion chart. Put it on the fridge for quick reference when you are filling the syringes.

It looks to me like the insulin is working very well, and so is the diet. It might not be a very long "dance" if this keeps up.

Go ahead and feed him. And on the dose, I'd go (you'll have to eyeball it), even less than 1/2 unit. In fact, I'd probably skip the shot tonight. 1u brought him down almost 350 points today. You only have about 100 points of leeway with that 166. Of course, insulin works differently every cycle to some extent, and there isn't a ratio, nothing is proportional exactly. But a dose of .25 units may be fine, any more than that and it'll probably make you worry all night long.
 
With u100 needles you can easily shoot in increments of .2u, using the conversion chat here. You may be able to get them without a prescription at any pharmacy, depending.on.your state laws. Make sure you.get ones with half unit markings. Can estimate .1u.beween the marks. If you.do.switch, make sure to report the u40 dose, not the converted one.

If you're worried about waiting longer or shootimg a reduced dose, skipping entirely is an option. Jusr expect a.high ps in the morning and don't increase to compensate.
 
Sorry I cut the last post off so abruptly, but Hershey was READY for FOOOOOD! :smile:

What an exciting/scary afternoon! You have no idea how much I appreciate y'all coming to our aid!!

We tested him one more time and it was back to 175. We hesitantly went with .5u - that was before I got your posts about the possibility of skipping it. (SO much to learn!) So, yes, I'll worry much of the night, but I was worrying the last almost two hours.

And, thanks for the information about syringes. I'll look up the conversion chart and I'll call Rite Aid and see if we can buy them OTC.

Is there anything special I need to do/be on the lookout for with Hershey? And, we usually test him at +6, should we do it earlier or wait until then?

THANKS!!!

Libby
 
You're probably okay to wait until +6, but if you're worried (or paranoid like me) you might check at +4 to make sure he's not dropping too fast.
 
My eyes have trouble seeing regardless of syringe type, so I often use some sort of clip on magnifier. I got mine at See It Bigger You may find it helpful to get one to try.
 
I would definately get an earlier test in maybe +2, +4 & +6, just to stay on top of things.

The link to the conversion chart is in Lisa's post (bookw0rm).

Sorry, I'm not trying to scare you, but I havn't been keeping up with our new members for the last week and don't know what information you have been given and what you havn't.

Is your hypo kit stocked? If one day he throws you a scary low number, that is not the time to go looking for Janet & Binky's food chart and trying to figure out how many carbs are in which food.
Do you have any medium and high carb food around? something with gravy? If not I would get some now and have it on hand, I write the carb % on top of the can with a sharpie so it is easy to see at a glance. I for one went into panic mode when I got a scarry low number and if I had not been prepared I would have freaked out even more.
 
Thanks, guys, I've been watching the clock and am thinking we'll for sure test somewhere between +2 - +4. I hate to put him through the extra pokes, but it'd make me feel better. Wow - at this rate we'll need to order more supplies soon - not a cheap undertaking, huh?

Teresa - My eye doctor says 'maturing' - sounds kinder/gentler than old eyes. ;-)
Thanks, BJ, I think I'll check out that site
Thanks for the link, Lisa, I'll be printing that out tonight, too
Carl - Thanks for the encouragement and for explaining things so simply. Sometimes it's overwhelming trying to process all that I'm reading.
Thanks, Rob, I appreciate hearing the good and the bad, so hopefully we can have the information we need if/when a crisis arises. We went shopping last night and bought an extra bottle of Karo syrup just for the kit and 2 cans of Friskies Prime Filets with salmon & beef in sauce. I checked the list and it was the highest carb food our Food Lion carried.

Hershey played with the pompom a few minutes and has been mostly sleeping since then; he's not very vocal, either. I'll be glad when it's time to test him.

Thanks, again, and please let me know if you think of anything else we should know or might need to be looking for.

Libby (who is hoping to figure out how to make a profile for Hershey...)
 
You never know!
sometimes even if you have a low preshot, if you cut the dose in half
you wont see much movement.....OR
you could have a lot of movement
I would just keep an eye on him....+4 would be great (and 6 if you can!) :mrgreen:
 
+6 of 246 - what is that?? Now, I'm ALLLLL confused! Hard for a girl with no rhythm to dance to this beat...

I was thinking maybe we could skip the next shot and get him back to the 2:30 times, but then the +6, so who knows???

Thanks, everybody!

Libby
 
It is not uncommon for numbers to be higher after having low numbers. It's referred to as a bounce. Most say to not change the dose due to a bounce as it should clear on it's own.
 
Thanks, Teresa - but does not change the dose mean the regular 1u or again like the .5u we gave earlier?

We need to get him back closer to the 2:30's so, we're thinking of moving the next one up ~ :45 and the next one ~:45 that would get us back to 2:30. Does that sound reasonable?

Thanks -

Libby
 
Moving shot times around is fine. I've done it a couple of times now. I just kept a bit closer of an eye on Poopy when I did it.

As far as dose, even without the low number today, folks were looking at your numbers and thinking you could drop back a bit. Might be a good time to test those....um...mature eyes out and go for .75u.

What I meant about not changing the dose...usually when we see higher numbers we're tempted to up the dose. Not a good idea since it's a bounce. :smile:

I'm sure others will chime in, :-D
 
Prozinc is flexible so you can move the shot forward and backward as needed, some general guidelines: I wouldn't shoot any earlier than +10 so you are sure you are past nadir and make sure he is rising. An early shot can work like a dose increase so adjust the dose down by .1 or so per hour.

When they get a lower bg then they are used to or they get a steep drop (yesterday's drop was about 85%, that is very steep) their bodies think they are in danger of hypo and their livers dump sugar to protect itself so their bg's spike. We say don't shoot a bounce because it will clear by itself.

Since 1 unit seems to be a little too high I think I would try to eyeball a dose between .5u and .75u and see how much drop you get from that and adjust from there.

You are doing great.
 
Tried, but couldn't eyeball to .75, so Hershey got .5. I'm concerned with him hanging out in the 400's. How long before the rebound is no longer in play and we know his numbers are more reflective of what's going on with him?

Also, trying to figure the quickest way to get syringes. It's looking like we may have to order them, I SURE don't foresee the vet selling them to us. I know if/when she sees these 400's she's going to go into the 'I told you so' mode - so I'd really like to get them down before she sees the SS.

Thanks, again, and I hope y'all are enjoying a day as beautiful as the one we're having!

Libby
 
Doug N Libby said:
...Also, trying to figure the quickest way to get syringes....
Click to expand...
Unless your state requires a prescription for syringes, pop over to WalMart and pick up a box of these insulin syringes:
3/10 cc
5/16" needle length
half unit markings
30 or 31 gauge
U-100 (use the conversion chart - the math is every unit = 0.4 units of a U-40 insulin, because the insulin concentration is 40% rather than 100%)
 
How long does it take a bounce to clear? It really depends on the cat, and the diet, and the insulin, and.....there' s no hard and fast rule. :roll:

Sometimes it can clear up in a day, sometimes a few days.
 
That doesn't look like a bounce to me. I think your dose is just under 1 unit.

If you want them I can send you an almost full box of U100 syringes with the half unit markings from Walmart. Just send me a PM of where to send them.
 
Trying to process -

So, Rob, you're thinking this is no longer a bounce but that even with the eyeball of ~.5 it's still too much? I've been concerned with him staying in the 400's and of course, want to help him get those numbers down as soon as possible.

It's funny, it seems when his numbers are elevated, he actually acts like he feels better. He has played some today and tonight briefly wrestled with Oreo and chased him down the hall once. Could it be because his numbers have been elevated for so long that his body thinks that's normal?? (scratches head)

Thanks, Guys. It means a lot knowing y'all are keeping a check on us!

Libby
 
No I don't think this is a bounce. And no I don't think that .5 unit is too much.

I think your good dose is just under 1 unit. Like .75u on a U40 syringe or .8 on a U100 syringe. Seriously, I lost my sugar cat last Saturday, if you want the syringes I will send them to you, otherwise I will send them to Rebecca for her new member kit stash.

He acts normal when his numbers are high because he has gotten used to them. You want to get him used to the lower numbers again BUT without the steep drops. You want to ease him into the better numbers.
 
I see what you're saying. And, I'd appreciate the syringes, I sent you a pm earlier.

Oh, Robin - I am so so sorry you lost your sugar cat. I lost one to feline leukemia several years ago; I can imagine the pain you're feeling. I pray time eases your pain and you are able to enjoy those happy memories of your sweet cat.

Libby
 
Doug eyeballed .75 as best he could. Tried Teresa's 'counting rings' method - our stopper has only 3 rings. We'll see how Hershey does.

Thanks a bunch!!

Libby
 
How I counted rings:

I used the one ring at the top, closest to the needle (my plunger has multiple rings too). I used the 1u mark as my starting point. With the ring just at the back side of the 1u mark, as if I was going to shoot 1u, I marked the other side of the ring between the 1 and 2u mark. I pulled the plunger back to where my new mark was my starting point and marked the other side of the ring, and so on. (I used a fine sharpie). When I reached the 2u mark (in the same spot I would have been at the 1u mark when I started), I had made 4 marks, equally spaced apart. (Note: my last mark behind the ring was on the line of the 2u mark, but - for me - the unit mark is with the plunger ring lined up right at the end of the mark.) It may not be exact but since I use it as my guide it's consistent. :smile:

I'm hoping to get my u100 syringes soon (just got an email they mailed them Tuesday).
 
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