Too little insulin/too much insulin...paging Goldilocks!

The good news is the Peaches feels so much better its like she's rolled back the calendar 3 years and actively plays now. Getting her thyroid under control seems to have made the biggest difference and allowed us to dramatically lower the amount of insulin she was getting.

However, I have a vet appointment coming up soon and this vet (while I am grateful for the thyroid improvement) makes me feel like I am dealing with the great and powerful Oz. Dropping off your baby at the curb and coming to get them at some future time without being able to actively discuss the case while the vet is looking at her makes me nuts. I get the impression this vet doesn't think I know what I'm doing (which can sometimes be true, but the hive mind here helps immensely). I'd take the long-term members of this group over most vets any day.

So, please look at Peaches updated sheet and tell me what you think. It seems like .25 units is not enough (at least over time) and .5 is too much (over time). Is there such a thing as giving 1/3 a unit? I thought folks who used calipers were over the top when I started this journey. It's looking more sensible all the time...

ALSO, is there a number at which you just don't shoot? I've been using my discretion and if she is 110 or under at shot time, I haven't been giving any.

Thanks EVERYONE!!
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And because I know some of you are new tuning into this saga. Peaches was hyperthyroid (much more common), had radiation treatment, which led her to become hypothyroid. The new vet thought it wasn't enough to bother treating and I think that either led to or greatly exacerbated her diabetes diagnosis. Now that she is on thyroxine, we've been able to get her sky high BG numbers down, reduce insulin by a ton, put weight on the skinny thing, and she feels SOOO much better.

 

I cannot give dosing advice but to me? your BEST defense is Peaches spread sheet! Its AMAZING. Your Vet cant argue with the way you are "treating" Peaches. Print it out and hand it over with "sweettpeach"

I'm just glad shes feeling her old self again...hint you MIGHT want to write that at the bottom of the spreadsheet.

You are doing a amazing job and it SHOWS!
jeanne

 

With some vets you'd think it was a professional requirement ...


Mogs
.

 

Wow, look at her spreadsheet! It's looking good!

Are you following a dosing protocol? The are two - SLGS and MPM. My advice depends on which you're using.
Since you're feeding Dr. Elsey's dry, you wouldn't be able to use MPM, only SLGS, and it doesn't look like you're following it since you're not decreasing below 90. I would recommend kicking the dry and sticking with MPM, I think it would really benefit Peaches.

 

Renee, I've seen members here who would crawl over broken glass to see their kitties have a spreadsheet like Peaches'! You have her very well regulated indeed.

She's not a bouncy cat, either.

On fine dose adustments, yes, some of us do 'shave' or 'fatten' doses. That's the main reason why some caregivers use calipers to measure the amount of insulin in the syringe. Another reason why calipers can be helpful is that there can be quite a variation in the position of the printed graduations between syringes; they improve measurement accuracy in general, not just when fine tuning a dose.

Pity that the radioiodine overshot a bit. (My civvie, Lúnasa, is also a glow-in-the-dark kitty!) It's great that the thyroxine supplementation is working: as can be seen with Peaches, wonky thyroid levels can really interfere with good glucose regulation.

I know what you mean about how awful it is , thanks to the covid restrictions, not to be with our little ones during vet consults. I find that the ensuing telephone consultation isn't quite as effective as being able to discuss matters in real time.

That's all the evidence you need to demonstrate that you are obviously doing a lot of things very, very right indeed, Renee! I'm very glad to hear that Peaches is doing so well. Remember, the Wizard of Oz didn't look quite so impressive when the curtain was pulled back!


Mogs
.

 

I agree with Panic. You’re not following SLGS or you’d have had to decrease each time she goes under 90, which would make her almost at 0 insulin now. But the protocol determines at what preshot numbers you won’t shoot, so you have to pick one. We’re you also adjusting by .5 and 1 units not .25? I’m a little confused by the dosage on the ss, sorry...

congrats on all the pretty ss colors!!!

I think something is wacky with your signature btw. You can hyperlink the ss to just a word or two if that helps

 

I also hate the covid19 protocols. All that and the fact your pet seems to stay there WAY longer than ever before or needed really. We’re not there to make them feel pressured into hurrying it up

 

Minnie, thank you for pointing out 90 as an important number. I'd read the ProZinc dosing sheet (which includes SLGS) but not retained that piece of information. I have a question though, does it mean if your cat goes 90 or below at any testing? I have to think so, because I don't think I'd shoot if my cat's pre-shot number was that low.

Also, can you point me to how to edit the link so I can show "Peaches spreadsheet" instead of the whole url? I looked, but I'm not understanding how to change this. Thank you.

 

* In Google, copy the spreadsheet link to your computer clipboard. (Tip: Make sure the spreadsheet sharing permissions are set to allow others to view only, not to edit or comment.)

* Start editing your FDMB signature.

* Click somewhere on the blue link text in your existing signature, then click on the Remove Link icon at the top of the text entry box (paperclip with an X on it) to remove the existing link.

* Delete the existing link text in the signature.

* At the beginning of the first signature line, type: "Peaches' Spreadsheet".

* Click and drag your mouse over the words 'Peaches' Spreadsheet' to highlight them.

* Click on the Add Link icon (paperclip only) at the top of the text entry box.

* Paste the spreadsheet link from the clipboard into the 'Link' field and accept the change. (You should see 'Peaches' Spreadsheet' appear in blue.)

* Save the new signature.

Hope that helps.


Mogs
.

 

Of course you wouldn’t shoot a 90 I agree. Anytime you get a 90 at any point in a cycle, it means your cat earned a reduction of .25. It doesn’t work for increases only decreases. I’m sorry I don’t have the link for the prozync info since Minnie is on Lantus. I’m tagging @Deb & Wink who is our prozync pro. She typically comes on at night

Ale

 

For the best Prozinc information, you should read the Sticky or pinned posts at the top of the insulin specific forum.

For Prozinc users, that means you would go directly to the Prozinc ISG (Insulin Support Group), do not pass go, do not collect $200.

Usually, you want to still post here in the Feline Health forum, until you get more experience and have some good testing data "under your belt".
But you already have that experience.
Less busy over in the Prozinc ISG, for sure.

I think little miss Peaches is trying to get off the insulin. That is what I think.
I would not shoot more than 0.25U with the low mid-cycle numbers that you are getting.
In fact, Peaches has "earned" several dose reductions that you have not taken.
Please, go ahead and take this most recent dose reduction, starting with the next insulin dosing cycle (a cycle is a 12 hour period, from one set of pre-shot tests to the next).

In fact, if you think you can measure a smaller dose, try for 0.1U of Prozinc. Yes, tiny I know. That is why many Prozinc users get some U100 syringes to measure those tiny doses. To measure the dose of U40 insulin in a U100 syringe, multiply the U40 dose by 2.5.

Conversion chart to do that dose difference between the 2 types of syringes is here, in case doing math in your head is not a strong suit. It sure isn't one of mine!
https://www.felinediabetes.com/insulin-conversions.htm

 

Awfully helpful conversion tool, thank you Deb!

 

Thank you Deb. You just reminded me I had some of those syringes from a cat previously sick with IBD. I hope I kept them. I will do more studying of the Prozinc ISG and syringe conversion charts. I hope she is trying to get off insulin and fully support that idea! I'm picking her up from the vet this afternoon after they've looked her over and pray they feel the same. Is there a number at which you are "Mayday! This cat needs insulin!" This question may be addressed in the Prozinc ISG and I'll review it too.

 

Thank you Mogs. Got it.

 

Really, anything above normal cat numbers says a cat needs insulin. That's 60-100 mg/dL, although some cats off insulin have been known to read as low as the 30's and 40's.
Anything above renal threshold, which is around 180 mg/dL, says a cat needs insulin if other factors for the glucose in the urine have been ruled out.