To wait or not to wait till the weekend...

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Terri&Kit

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Hello everyone.

An update on Kit -
We had our vet appointment today. She didn't check his BS lol. I thought that was hilarious, she just went by what I told her it was before I left the house. Which is probably a good thing because Kit was totally stressed out. Vet said she only had one other patient that home tested. I was a little surprised. She prescribed ProZinc, she said all of her other patients use it except the one that home tests. I didn't really have much of an opinion on which insulin to use and if ProZinc is what she is most familiar with, I figure it's a good place to start.
She seemed fairly nice and educated on FD and despite Kit's temperment, she was really good with him. Vet let me practice giving Kit an injection of saline. She scratched his head and I gave him the injection. As soon as she let go of his head, he turned around and buried his teeth into my wrist. Ouch! I don't think he bit me because of the injection, he didn't even flinch when I stuck him, I just think he was a little over stimulated with the whole situation. He hasn't ate hardly anything all day today, he apparently didn't like our little day out at all!
Also, vet said 1.5 units on the U40 syringe. I haven't checked the conversion or looked at dosage here yet, but just so you know where we stand.
So....now what? Ok so I know I have to give him injections twice a day as close to 12 hours apart as possible. Someone help walk me through it. I get up in the morning, check his BS first, then I give him the shot, then I feed him? How long should I wait to feed him after the shot? Or does that even matter? Is it ok to free feed? I know I should keep checking his bs every 2 hours on the first day of his insulin, so should I wait and start on Saturday? I could take him to work, and start him tomorrow, but he'd be stressed with the new atmosphere, so I'm not sure if that's best. I just want to get started off on the right foot. What do you all think?
 
Sounds like things went fairly well except for the bite. OUch!

ProZinc is a good mild insulin. Here is some information on it: viewtopic.php?f=24&t=32799

We always tested and then gave Oliver his meal. While his face was deep into his meal, we gave him the shot. He didn't seem to mind at all. Then, whenever you can, get some additional tests in - 6 hours after the shot is good since many cats reach their lowest point about that time in the cycle. I would try for just that tomorrow, before each shot and sometime in the cycle around +6. You can wait for the curve (every 2 hours) until he has been on the insulin a while. It takes some cats a while to get used to it.

I don't think you said. What dose did he start on? I hope a nice low dose like one unit twice daily?

We have a PZI forum with people who use or have used your insulin: viewforum.php?f=24 It is usually fairly busy first thing in the morning and at night. It is not as busy as Health, so post here if you have a problem and need help. You can introduce yourself on PZI and look at some of the other threads to see how other cats are doing.
 
Sue and Oliver (GA) said:
Sounds like things went fairly well except for the bite. OUch!

I would try for just that tomorrow, before each shot and sometime in the cycle around +6. You can wait for the curve (every 2 hours) until he has been on the insulin a while. It takes some cats a while to get used to it.

I don't think you said. What dose did he start on? I hope a nice low dose like one unit twice daily?

I will wait a few days to do the curve, then. I'm just kinda scared it'll be his first day on it and I'll be at work. I can come home and check on him at lunch, but I'll be gone for a good 10 hours. That's why I was thinking of taking him to work. I'm probably just over reacting a little bit lol.

Vet said to give him 1.5 units on the U40 syringe, I haven't checked the conversion yet. Getting some dinner then I'll dive in for the info!
 
If you can't be home and are nervous, you could start at one unit. Our motto is start low, go slow. It is easy to increase the dose once you have numbers and see more is needed. But you can't get it out of the cat once it is shot!

Forgot your other question. Yes, you can free feed. In fact, if he will be home alone part of tomorrow, it would be a good idea to leave out some food.

You could take him to work. But if it stresses him out, he could have higher numbers than he would have at home. You could be sure he is doing well if he is with you and that he doesn't go too low.

I understand the anxiety. Those first few days of insulin are pretty nerve wracking!
 
Wow

Turns out the conversion for 1.5 on a U40 is around 3.5 on a U100. That seems like a lot to me. You say start low go slow, so when you say start with 1 unit, I'm assuming you mean 1 unit on the U100? I am planning on getting U100s but the vet gave me some samples to get me through a few days. But 1.5 U40 or 3.5 U100 seems like way way way too much! Especially since he is on a low carb diet right?
 
Are you using BCP PZI in U100 strength or are you using ProZinc U 40?

If ProZinc U40, you can use U40 needles and give a regular one unit. If you use the U100 needles with the U40 insulin, you use the conversion chart. If you are using BCP 100 with U100 needles, you just shoot without conversion.

Does that make any sense?
 
Hi Terri!

I use ProZinc also but I'm not experienced enough to give dosing advice usually. I do believe 1.5 units is too much to start with. Hopefully someone with more experience will comment. You should post over on the PZI board. I totally understand not wanting to give him insulin then leave. It might be a good idea to wait till tomorrow night to give his first shot so you will be with him & can get some testing done. Are you already feeding wet food? I would also suggest you get some karo syrup or honey before you start giving insulin, I'm sure you won't need it but it's good to have around. Also make sure you have plenty of test strips on hand, you don't want to get stuck in the middle of the night running low on those! When Sue referred to 1 unit she meant on a U40 syringe. That's what the vets usually give with ProZinc. Do you have those? If you are using a U100 syringe with 1/2 unit markings 1 unit would be 2.5. Please don't shoot any insulin until you are very sure of how much you are giving. It's easy to get confused when purchasing the U100 syringes. In my area at least the ones with the 1/2 unit markings are very hard to find. If you are near a Wal Mart I have the UPC for the Relion ones with the short needle. Let me know if you need it. Hopefully I have given you some info you can use & haven't confused you! Drop by the PZI board, someone with more experience will help you! :smile:
 
Sue and Oliver (GA) said:
Are you using BCP PZI in U100 strength or are you using ProZinc U 40?

If ProZinc U40, you can use U40 needles and give a regular one unit. If you use the U100 needles with the U40 insulin, you use the conversion chart. If you are using BCP 100 with U100 needles, you just shoot without conversion.

Good question! I was assuming you were using ProZinc in the green box?
 
Terri,
I think the u40 and u100 units are the same thing. Well, what I mean is, if you are using u40 insulin, then you would give 1 or 1.5 units with a u40 syringe. If you are using u100 syringes, then I think the insulin is "u100"? and you'd give the same number of units using that insulin in that syringe. Somebody correct me if I am wrong. I think they are different concentrations of insulin, so 1 unit of either (using the proper syringe) results in the same amount of insulin. Does that make sense?

I use u40 insulin and syringes. I think if you want to use u100 syringes, there's a conversion chart here somewhere that tells you how many units to pull up in the syringe. I've read threads where people talk about it, but I've never tried switching syringes. I believe the reason some people do is because a u100 syringe is easier to accurately administer low doses of insulin, like if you get to the point where your dosing in tenths of a unit instead of whole numbers or half numbers.

I noticed your location is listed as SC. When I read your first post, it almost sounded like we have the same vet - same familarity with DB, same insulin, although she started me and Bob out at 1 unit twice a day instead of 1.5. Are you located anywhere near Beaufort or Ladys Island?

Carl in SC
 
It's ProZinc 40 units per mL in a green box and the sample syringes are U40 also. I understand what you are saying 1U of U40 insulin on a U40 syringe is the same as 1U or U100 insulin on a U100 syringe. Panic mode is passing....

So I'm ok to shoot 1U of my ProZinc 40 units per mL insulin in a U40 syringe drawn to the line that says 1 lol. I get it. It has registered. The concentration of the insulin is different, not just the markings on the syringes.

I have a funny feeling he's coming to work with me tomorrow. I don't think I can shoot him and then leave him. I'm already panicked and I haven't even done it yet!

Carl and Bob, I'm not sure where either of those places are lol. I'm pretty new to SC, I live in Greenville.
 
what was his BG reading when she told you how much to dose him? That'd give a clue as to why 1.5 as a starting dose maybe.
you're about 4 or 5 hours away. Beaufort is in the SE corner of the state, near the Georgia border on the coast. I actually live on Hunting Island, which is further east.
I also was nervous and scared the first few days, so don't feel different. We probably all were. Once you see that it isn't as frightening as it seems it will be, you'll be okay.

Carl
 
Terri&Kit said:
It's ProZinc 40 units per mL in a green box and the sample syringes are U40 also. I understand what you are saying 1U of U40 insulin on a U40 syringe is the same as 1U or U100 insulin on a U100 syringe. Panic mode is passing....

So I'm ok to shoot 1U of my ProZinc 40 units per mL insulin in a U40 syringe drawn to the line that says 1 lol. I get it. It has registered. The concentration of the insulin is different, not just the markings on the syringes.

I have a funny feeling he's coming to work with me tomorrow. I don't think I can shoot him and then leave him. I'm already panicked and I haven't even done it yet!

Great! It took me days to figure that one out! So yes, the 1 unit marking on the U40 syringe is correct.

Don't ever do anything you are uncomfortable with, even if it means taking him to work, or waiting till tomorrow night! I get the panic, I told the vet there was no way I was gonna be able to give my cat a shot every day...then she said twice a day...I thought I was gonna die. :lol:
 
She didn't test him, but I tested him before we walked out the door to go to the vet. His bs was 253. She said that his dose was based on his weight, which seemed kind of weird to me after what I read here.

I'm sure we'll be ok in a few days after we figure this out. I went into the vets pretty confident. I pretty much told her what I was doing and what I wanted and she gave me the insulin and showed me how to do it. I was fine. Now I actually have to do it, I am not so fine lol. I called my mom to give her an update and she said, you'd rather give him shots than keep giving him those pills? I said yes of course because it's about whats best for him not whats easier for me. (He was on glipizide). I'm sure in a month I'll look back and laugh at how I let my insanity get the best of me lol.
 
Wow, 253 is not really that bad. How heavy is he?
Bob weighed 13 or so lbs when diagnosed (he had been as high as 20) and had lost about 5 pounds in a matter of weeks. His BG was over 500 the day he was started on insulin. His initial dose was 1 unit 2x a day, but within a week, it was up to 1 in the am and 2 in the pm. All this was before I'd heard of this board. After reading here, the starting dose was right, but Bob's were increased more rapidly than what is recommended here.
I don't know what to tell you, but I think you may want to consider starting him lower. I'll let other people give you feedback on that. I don't remember what Bob was getting for doses when he started getting numbers in the mid-200's. The really important thing is the 2nd part of "Start low - go slow". You don't want to make big changes in his dosage quickly. If you have put, or are putting your kitty on a low-carb all wet food diet, you'll see that make his BG drop significantly and pretty quickly. His insulin will need to be adjusted according downward, so I think it might make sense to start lower than 1.5. It's hard contridicting your vet's advice, though, especially if you and she have a good relationship. My vet was really willing to listen and go along with the things I wanted to try, and vice-versa.

Carl
 
I agree that is not a very high number. I would start with one unit. You could tell your vet you were nervous and wanted to start conservatively. You can always raise the dose if you get some numbers and need to.
 
His initial test less than 2 weeks ago at the vet was 529. He weighs 15 lbs. It's hard to tell how much of that 529 was because of stress. He was a mess at the vet today, I should have checked him while we were there. He's actually gained a lb in less than 2 weeks even though he isn't really eating much. He has been on a low carb all wet FF diet for about a week. I'm thinking of starting at 1 U, despite what the vet says. Like someone said earlier, you can't take it out of the cat once it's been shot.
 
Terri,
This info is probably in another thread you've posted but...
okay, so he was over 500 two weeks ago. Today he's at 253. You're starting the insulin tomorrow. He's been on low-carb wet for a week.
I guess my question is what has been done to effect that change in BG? Has he been treated by the vet, or kept overnight at the clinic? Is this all due to diet change? Is there another thread that details the past two weeks so you don't have to repeat it all?

Carl
 
OK, I just read that thread so I'm "caught up".
It wasn't clear whether you had or hadn't stopped with the glipizide. If not, that would be lowering his BG as well. The FF wet is going to continue to make a big difference.
I think I'd probably start him no higher than one unit for a few days and see how that works. Unless you see his number drop significantly once you start the insulin. In THAT case, I'd post in the PZI forum right away and ask for dosing advice.

I saw in your other thread that Kit has been "irregular" (constipated) since switching to all wet FF? That apparently is very common. Dry food has lots of fiber I think, and you've removed that from his diet. Just like people, that can cause constipation.
You can try mixing some water in his food which should help. Bob is getting FF classics exclusively, and he's had the same problem. Not to the point where it's caused real problems, but I just notice he's using the box at most once a day, and peeing less often and much lower volumes (but that's a good thing).

Good luck tomorrow, and keep everyone posted!

Carl
 
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