Too much insulin? Possible bounce?

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Fluffy Face

Fluffy Face

Member Since 2016
This is one of those times I feel like I should stick with my own gut feeling. I started Serena on insulin Sunday (finally getting the hang of testing, thanks to everyone who offered advice!). I don't have her levels from that day and yesterday since I'm at work right now, but here's what I've done and am now stressing a little about...

Yesterday morning her level was in the 200's. Gave her 1 unit (ProZinc). Came home that evening, 12-13 hours after that shot, and her level was 412. My boyfriend's vet gave him some guidelines to go by which he was recommending to me:

<200-- no insulin
200-300 1 unit
>300 2 units

So, yesterday evening I gave her 2 units. All seemed well (I slept of course but she cuddles pretty frequently with me through the night), but then this morning her reading was 390. I was expecting a lower number, and had gotten blood from 2 different prick sites, so I tested again, and got the 570's. That's a huge variance...but I tested the strips and they are fine. That kind of variance really concerns me when it comes to glucose meters, but that's a whole other post that's already been done I'm sure.

So, I gave her 2 units this morning. Now, I've been reading about "bouncing", and I'm worried she could be sinking to really low numbers while I'm here at work. I'm feeling I really should have stuck to the 1 unit as prescribed...

Thoughts?

I know the spreadsheet helps, and I'll get one going soon.
 
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Prozinc tends to "peak" around +5 or +6 hours after injecting. It would be useful if you could get a preshot number and if possible a couple of tests in between. Or if you are able to do a curve...testing every 2 hours between shots, that will give a clearer picture of how well she is reacting to the insulin. You need a good amount of data to be able to tell if the dose is too high, too low or if she is bouncing.


ETA And yes the spreadsheet is most useful :)
 
Maybe try 1 1/2 units if relatively high. However, it is hard to give advice without know more BGs that you already provided here.
If you need help setting up a spreadsheet there are caretakers here who can help. I do not use the Google SS myself.

Also, what are you feeding and is she eating two daily and eating the same amount each time?
Also does she have a name?
 
Her name is Serena. I definitely would like to do some inbetween dose tests, but that will have to wait until the weekend unless I do it in the middle of the night...might just do that.

I am feeding her Fancy Feast Classic, one 3oz can twice a day, giving the insulin while she eats. She eats the whole can. Only treats I give are the freeze-dried chicken from PureBites.
 
Either one is possible. If she is dropping low midcycle, she might be bouncing back up for preshot. If she is flat through the cycle, she may need more insulin. If you can't get any midcycle tests during the day, you might set the alarm for around +6 and get a number at night
.
 
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What meter are you using...human or pet? This could also have an impact on your no shoot number. Is your vet basing that 200 no shoot number on a lab reading, pet meter reading or does the vet use a human meter. The no shoot number we usually recommend until some data is available is based on readings using a human meter. With a pet meter, the no shoot number should be higher because pet meters read higher.
 
I have a pet meter, the AlphaTrak. Pricier strips, I know, but it's the one my boyfriend got and he found strips cheaper on Ebay. Figure it's easier if we use the same brand stuff (his cat was recently diagnosed as well). It's his vet that recommended those numbers. I assume she knows what meter he's been using.
 
As a pet meter user myself, I would suggest a no shoot number, when there is little or no data, at about 300 on a pet meter.
 
When cats are first diagnosed they have been used to high numbers for some time and even dropping into a normal range glucose level can cause hypo symptoms - this was my experience with Cappuccino, so its best to be cautious with dosing to begin with and try not to change the dose (unless you have a no shoot number in which case don't shoot) until you have had a chance to do a curve to see how the cat responds to insulin and how low they drop. Better to let them run a little high for a while than to risk them going too low. Usually a curve can be done about a week after starting insulin, or a bit sooner if you have a free day. Cats can tolerate high glucose levels much better than humans can.
 
JanetNJ said:
Do you mean 200? Because 300 on any meter is really high.
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Nope. I mean 300. I've been dual testing with both a human and pet meter on the same drop of blood, for over a year and in my comparisons, readings in the 190-205 range on a human meter average out to about 300 on a pet meter. Obviously this is just an estimate because there is no conversion formula. 300 on a pet meter is high but not a horribly high number.
 
Thanks Alexi. I sure hope she's doing OK. Wish I could run home to check on her...I'm sure I'm just being a worry wart though.

MrWorfMen's, thank you, I'll communicate your recommendation to my boyfriend and he can pass that along to his vet, get her thoughts since we use the same meter.
 
Fluffy Face said:
Wish I could run home to check on her...I'm sure I'm just being a worry wart though.
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I had exactly the same to start with and still do some days when her numbers are a bit 'off', I used to leave a little bit of food out when I was away from home just in case, now she doesn't have any as she is on a strict feeding regime, but all I find on return home is a hungry cat!
 
I'm not sure how much information your boyfriend's vet gave him but a normal BG for a cat on a pet meter which is calibrated to mimic animal lab values, would be 72-175 (as per IDEXX labs). You will often see 68 used as a warning number for the possibility of a hypo event here. 68 and 72 are close enough to be considered the same reading. Knowing the range you should be aiming for and having data to see how low any given dose of insulin takes a cat during a cycle, makes it easier to figure out when to give insulin and how much to give. With more data and a bit of time, you will get a good feel for how Serena reacts and be able to make judgement calls accordingly.
 
I was told the no shoot for the AlphaTrack was 200. I have been going with that. I will shoot when it's a little bit lower with a smaller dose. If I am going to be gone for a while, I will give less then half her dose. So far, this has worked for Callie. But you need to remember that every cat is different and it takes time to see how your cat responds to insulin. If your not sure, it always a good idea to call your vet.
 
Just to be clear, I was not suggesting that insulin should be withheld for any reading under 300 on a pet meter.
If however there is no prior data or very little data on how the cat reacts to insulin, then I think a reading of 300, which would be roughly the equivalent of the suggested no shot number of 200 on a human meter, would be appropriate. This is simply my personal opinion based on a considerable amount of dual testing.
Once one has data and knows how their cat is reacting to the insulin, shooting at lower readings can be done safely.
 
Alright, got my diary here...she was 87 when I got home last night! Scary...but she was behaving 100% normal. Hope she didn't have any problems during the day...

Sorry, don't know why the image isn't uploading upright :(

The note regarding this morning's shot - it seemed that I either didn't get the full 1 unit into her or none. I felt a little bit of wet on her fur. Since I couldn't tell if she had gotten any at all, I administered 1/2 a unit.
 

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You definitely did the right thing withholding the shot last night. The other thing you can do is stall without feeding and then re-rest to see if the BG is rising on it's own although with that low a pre-shot, it may have taken awhile to get to a shootable number.

A word of warning for the future...... If you think you have done a fur shot, (and all of us have experienced this at one time or another) do not give any more insulin. You never know how much might have actually been injected so injecting more could result in an overdose. By giving the extra half unit this morning, it's possible Serena got more than one unit but not the full 1.5u. With her pre-shot number today, she should be fine but that pre-shot number might just be a bit of a bounce from the low number last night. It's better to let kitty stay a little high for a cycle than giving too much insulin.
 
Thanks for the warning, I will take heed! I was relieved to come home to her acting normal. I'll be moving forward with the ONE unit 2x/day until I have a better feel for her levels.
 
Wow, thank you! The 8/1 numbers were 246 AM and 412 PM. Not sure how we'd want to put in the 2 different readings from 8/2 AM. Average them maybe? I'd love to get a copy to start tracking with and put it in my signature... :)
 
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