tuna's numbers are really weird today

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Katsallday

Katsallday

Member Since 2021
last night i had to push 0.25u instead of 0.75 because his pmps was 166. today his numbers are:

amps:418 (0.75u) +1 419 +2 370 +4 278 +6 225 +7 193 +9 173 +10 156

is that weird to you too??
 
Katsallday said:
last night i had to push 0.25u instead of 0.75 because his pmps was 166. today his numbers are:

amps:418 (0.75u) +1 419 +2 370 +4 278 +6 225 +7 193 +9 173 +10 156

is that weird to you too??
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No. He was bouncing this morning from the run is lovely blue and green numbers yesterday. Looks like he is coming back down off the bounce. It is possible he could continue to drop a bit more.
 
Bron and Sheba (GA) said:
No. He was bouncing this morning from the run is lovely blue and green numbers yesterday. Looks like he is coming back down off the bounce. It is possible he could continue to drop a bit more.
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Is it normal to have these low preshots? I think he will be barely in the 200's again for his pmps in an hour
 
Katsallday said:
Is it normal to have these low preshots? I think he will be barely in the 200's again for his pmps in an hour
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Yes, perfectly normal. He’s making progress. He’s not doing anything lots of other diabetic cats are doing.
If he continues to have a lower than normal preshot, you may have to lower the dose for both the am and pm shots a bit or maybe shoot a lower preshot.
Dont forget he is a work in progress and we are trying to find the best dose for him.
I’ll tag @ panic to see if she has any other ideas as I am not a Prozinc user.
If he’s still low at PMPS stall, dont feed and test again in 20 mins and post. I’ll watch out for you.
 
Bron and Sheba (GA) said:
Yes, perfectly normal. He’s making progress. He’s not doing anything lots of other diabetic cats are doing.
If he continues to have a lower than normal preshot, you may have to lower the dose for both the am and pm shots a bit or maybe shoot a lower preshot.
Dont forget he is a work in progress and we are trying to find the best dose for him.
I’ll tag @ panic to see if she has any other ideas as I am not a Prozinc user.
If he’s still low at PMPS stall, dont feed and test again in 20 mins and post. I’ll watch out for you.
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Thank you so much for everything
 
Bron and Sheba (GA) said:
Yes, perfectly normal. He’s making progress. He’s not doing anything lots of other diabetic cats are doing.
If he continues to have a lower than normal preshot, you may have to lower the dose for both the am and pm shots a bit or maybe shoot a lower preshot.
Dont forget he is a work in progress and we are trying to find the best dose for him.
I’ll tag @ panic to see if she has any other ideas as I am not a Prozinc user.
If he’s still low at PMPS stall, dont feed and test again in 20 mins and post. I’ll watch out for you.
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First stall is started. His pmps is 162 right now.
 
Katsallday said:
First stall is started. His pmps is 162 right now.
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My fiance thinks that tuna doesn't even have diabetes now because of these low pre-shot numbers. I think he thinks that Tuna is bouncing around so much because he doesn't even need this insulin. His mother was a vet tech and his father is currently a vet in Texas (we live in FL)

His mom is thinking that they didn't do the proper testing to get an accurate diagnosis of diabetes but I feel like a fructosamine test is hard to mess up right? But even if this was pancreatitis or a dental thing if his blood sugar is high he needs insulin. I think no one was prepared for how challenging finding regulation is or how much his numbers can swing around. I got this diagnosis on a fluke, I took him to the vet for what I thought was a penis infection. my original vet said that he was a non-symptomatic diabetic. My second opinion vet said she wasn't convinced it was diabetes and then she did a fructosamine test and then said she wants to start him at 4 units. I think these low pre-shot numbers and all the stalling that we do is really throwing my fiance and his veterinarian family for a loop of what they expected of a diabetic cat.
 
The fructosamine test is usually pretty accurate as it gives the last 2 weeks average of the BG.
I think with a preshot of 177 you need to either skip or a token dose.
What was the actual preshot in the end last night.
 
Bron and Sheba (GA) said:
The fructosamine test is usually pretty accurate as it gives the last 2 weeks average of the BG.
I think with a preshot of 177 you need to either skip or a token dose.
What was the actual preshot in the end last night.
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By the second stall he read at 194 but he is not there yet tonight :/ what is a token dose?
 
25% of 0.75 is 0.18u
So I think maybe give 0.1 unit tonight would be the easiest option for you.
Here is a photo of a syringe showing 0.1 units. It’s the middle syringe. Do you think you could draw that up?
The other option is to skip the dose.
****note these are U100 syringes below

upload_2021-5-30_16-43-17.jpeg



**** From tomorrow morning I think the best thing moving forward would be for you to reduce the overall dose to 0.5 units and see if that gives you a preshot you can shoot each time. So that means giving 0.5 units each dose am and pm...does that make sense?.
 

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Yes that makes sense, I'll start shooting that after tonight. His BG is definitely rising but we are 50 minutes past feeding time. I'd like to shoot something but I have u40 syringes that aren't even half unit marked. I think my fiance is leaning towards a NS tonight and starting up the 0.5 tomorrow
 
T would
Katsallday said:
Yes that makes sense, I'll start shooting that after tonight. His BG is definitely rising but we are 50 minutes past feeding time. I'd like to shoot something but I have u40 syringes that aren't even half unit marked. I think my fiance is leaning towards a NS tonight and starting up the 0.5 tomorrow
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That would be fine as long as there are no ketones in the picture.
Then you could choose the best time to start tomorrow morning
 
Bron and Sheba (GA) said:
T would

That would be fine as long as there are no ketones in the picture.
Then you could choose the best time to start tomorrow morning
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I actually caught him peeing today and did a ketone strip test and got another negative! My fiance wants to find a third opinion now. The original vet took tuna's blood work directly after he ate because I get him in the carrier using food and he didn't perform a fructosamine. The second vet took the fructosamine test after tuna was on 4u then 2u of vetsulin. He results were not a blank slate and that vetsulin really messed up tuna. Of course I'm happy to redo the testing and get a good look at his dental and also do a complete urinalysis as well but I'm scared I'm going to have to do that with him off insulin
 
Katsallday said:
I actually caught him peeing today and did a ketone strip test and got another negative! My fiance wants to find a third opinion now. The original vet took tuna's blood work directly after he ate because I get him in the carrier using food and he didn't perform a fructosamine. The second vet took the fructosamine test after tuna was on 4u then 2u of vetsulin. He results were not a blank slate and that vetsulin really messed up tuna. Of course I'm happy to redo the testing and get a good look at his dental and also do a complete urinalysis as well but I'm scared I'm going to have to do that with him off insulin
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That is good the ketone test was negative.

Taking a BG test after a cat has eaten won’t necessarily have the BG high, especially if the cat is not a diabetic. Most diabetic cats get a food bump after food of around 50 points.
I had blood tests done on one of my cats the other day. He is not a diabetic and I had just fed him his meal an hour beforehand and his BG was 94.
If Tuna had just eaten, the food probably hadn’t had a chance to get into his system, so may not have made any difference to the test.
Also vets take fructosamone tests all the time while cats are on insulin.....that is how most of them monitor feline diabetes, so that test would have been valid that Tuna had while on vetsulin..
It is only because we home test that fructosamine tests are not necessary.

I’m not sure why your fiancé is wanting to get another opinion. Is it because he doesn’t believe he is a diabetic? It is wonderful, however, he cares so much for Tuna.

Just by looking at Tuna’s SS I can see his BGs are not a normal cats BG. A non diabetic cats BGs would all be green with maybe the odd low blue....50-120
If you got another fructosamine test done now it would just be the average of what the last two weeks of home testing you have been doing. The only difference would be that you would not get the highs and the lows......just an average.....which can be misleading.

If he had been started on the appropriate dose, you would not have had the dramas you had.
He is actually doing really well for a newly diagnosed cat. He is responding really well to the small dose of insulin......many cats don’t see any greens for months!

It is up to you if you want to have him seen by another vet, but be careful you don’t get stuffed around again.
Please don’t stop the insulin though because that is not a safe thing to do to a diabetic cat.

If he has issues with his teeth, that can raise the BGs and stop regulation.
 
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I'm glad to hear you say don't stop the insulin. I wish we had a better first experience with the first vet to make this diagnosis a bit easier. But thank you for your informative comments. We will probably be lowering his dose to .5u and than monitor his progress.
 
Katsallday said:
I'm glad to hear you say don't stop the insulin. I wish we had a better first experience with the first vet to make this diagnosis a bit easier. But thank you for your informative comments. We will probably be lowering his dose to .5u and than monitor his progress.
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Hang in there. It gets easier. You are both doing a great job and Tuna is making progress, even though you probably don’t think so!
 
I agree with the .5u dose. If we don't see nadirs reaching below 150 consistently over the next few days then I'd bump back up to .75u

Personally I think another opinion would be a waste of time (and money). Tuna's spreadsheet is not an unusual sight alongside all the others on FDMB. Here at least we have decades of real-world FD experience at our fingertips. I'll take first hand experience over a generalized degree any day. :p
 
I found it very helpful, Katrina, when I started out to look at the spreadsheets of others here on the forum to manage your expectations and to see what a cat in remission looks like. Take a look at Diane's Tyler who went OTJ (off the juice) 4 months ago. Tyler's spreadsheet is what you want to show your husband of what a cat who is no longer diabetic looks like. My Ruby is about to go off insulin (anti-jinx!) after having numbers below 100 most of the time. When Ruby started her sugar dance her spreadsheet looked a lot like Tuna's, but with some patience and attention and following the advice of the great people here, you will have the right tools to get him to stop bouncing and perhaps into remission. He's definitely not there yet, so I wouldn't get the advice of another vet. Human diabetes does not work the same way as feline diabetes. I have seen others here who have human medical expertise who make the mistake of conflating/equating the two and kitties wind up being in prolonged states of hyperglycemia needing more and more insulin.

Hang in there. We're here for you. :bighug::bighug::bighug:
 
Panic said:
I agree with the .5u dose. If we don't see nadirs reaching below 150 consistently over the next few days then I'd bump back up to .75u

Personally I think another opinion would be a waste of time (and money). Tuna's spreadsheet is not an unusual sight alongside all the others on FDMB. Here at least we have decades of real-world FD experience at our fingertips. I'll take first hand experience over a generalized degree any day. :p
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Bron and Sheba (GA) said:
Hang in there. It gets easier. You are both doing a great job and Tuna is making progress, even though you probably don’t think so!
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Welp I'm looking at increasingly lower numbers once again as I get closer to his PMPS. Even on 0.5u, even after a NS last night he's not going to hit a preshot of 200. What am I doing wrong? He's dropping low so late, making insulin decisions so hard :arghh: he's at 147 +9 and still dropping
 
He's breaking the bounce right now. When you're at PMPS I would tag Bron for advice. You safely shot 0.25U around 160 and he didn't go too low, it may be ok to shoot 0.5U around there as well (but only if he's flat or rising). If hes still dropping that's a different story.

Still withhold food 2 hours before PMPS, we especially do not want him to be food influenced when breaking a bounce.
 
FrostD said:
He's breaking the bounce right now. When you're at PMPS I would tag Bron for advice. You safely shot 0.25U around 160 and he didn't go too low, it may be ok to shoot 0.5U around there as well (but only if he's flat or rising). If hes still dropping that's a different story.

Still withhold food 2 hours before PMPS, we especially do not want him to be food influenced when breaking a bounce.
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He only gets a little snack right at 6 hours between shots, and it's only a piece of dried salmon. I just wish I could predict what's going to happen next Tuna is keeping me on my toes
 
I would give a couple of snacks routinely during the first half of all cycles. Not just a piece of dried salmon but a tablespoon of low carb food each time.
He’s doing fine. Let’s see where he is at PMPS
if he’s under 200, stall, don’t feed and test again in 20 minutes.
Can you tell me how long til your PMPS so I can watch out for you please ?
 
Bron and Sheba (GA) said:
I would give a couple of snacks routinely during the first half of all cycles. Not just a piece of dried salmon but a tablespoon of low carb food each time.
He’s doing fine. Let’s see where he is at PMPS
if he’s under 200, stall, don’t feed and test again in 20 minutes.
Can you tell me how long til your PMPS so I can watch out for you please ?
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Pmps is in 2 hours and 10 minutes
 
Bron and Sheba (GA) said:
I would just feed him and skip the dose. I’d check again in an hour to see he’s on the way back up.
If the preshot is high enough in the morning I would stay with 0.5 U and give him a couple of snacks during the cycle
How does that sound?
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Sounds like a plan! It's so weird for the past 3 nights I've had to stall! I've been looking through a lot of people's spreadsheets on here and I haven't really found a lot of people stalling like this
 
Katsallday said:
Sounds like a plan! It's so weird for the past 3 nights I've had to stall! I've been looking through a lot of people's spreadsheets on here and I haven't really found a lot of people stalling like this
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It’s not uncommon at all. I see a lot because I am on line during a lot of the Preshot times.
Don’t be alarmed by it. He’s bouncing which is why he is in high then low numbers. That’s common too especially in newly diagnosed cats. Insulin is a hormone so cats systems need to get used to it. Some do it faster than others. Tuna hasn’t read the rule book yet.
My Sheba was a bouncer and a diver and she never read the rule book.!
 
Bron and Sheba (GA) said:
It’s not uncommon at all. I see a lot because I am on line during a lot of the Preshot times.
Don’t be alarmed by it. He’s bouncing which is why he is in high then low numbers. That’s common too especially in newly diagnosed cats. Insulin is a hormone so cats systems need to get used to it. Some do it faster than others. Tuna hasn’t read the rule book yet.
My Sheba was a bouncer and a diver and she never read the rule book.!
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Would you say this is a hindrance to remission? Having to skip so many shots?
 
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