Two days of excitment

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I will give you guys the short and sweet of this two day ordeal to summarize where we are and pick your brains for advice. I have gotten immediate advice on these events on both the welcome page under old cat, new issues and then a 911 post on the feline health main page. One of my assistants in the last crisis suggested sharing here with the other pro-zinc users for perhaps more relevant advice but I have been getting awesome help so far!!

Oreo is 13 and had been boarded for about a week while we were on vacation. I had not ordered enough canned Royal Canin and the vet got dry. (He insists it's ok-basically I ignore him and feed canned.) It isn't until this week that I have really started investigating foods. I just can't keep up with the ordering. I need something easier to get to! 4 days after he came home he had crash on the 1unit he'd been getting since mid-march. You can see the numbers on the chart, the crash was about 4 hours post-shot. I gave him 1 tsp of karo and an hour later he was good. Last night we reduced 1U dose to .6U. This morning we went back to 1U after his predose levels were 189. Then yesterday repeated it's self. I was trying to monitor every 2 hours and he got enough of me and hid. When I found him he was at 35. I only gave him 3/4 tsp of karo this time and then I got him to eat a little food. When last tested his sugar was up to 119.

Our vet thinks we should drop to .5U for at least the next two shots and test and see where everything stands. Any other suggestions?
 
I would first be careful shooting under 200. If he is close (like the 189) make sure he is sure rising before you shoot. Wait 20 minutes and retest, without feeding. If he is still going down, don't shoot until he starts to rise. You don't want to add more insulin if the previous shot is still working.

I like .5. I am guessing if you'd stuck with that today, he would have stayed in okay numbers. ( my thinking is that he did okay on the .6, giving you a low but probably shootable pre shot, so that or .5 is a safe dose for now)

For reference, a pre shot in the lower 200s is a great place for him to be, especially with the food change. A nadir in the 50+ range is also good. If .5 gets you there, good. If he drops too low, then reduce again. If, after a day or two he is running higher, then add a smidge. It is always better to increase slowly rather than try to figure out how much to reduce (although if he continues to drop, you have to deal with it)

Hope that helps. BTW, this is a great problem to have. He seems to be responding well to the insulin and food
 
I agree with Sue. I think .5 is probably a good dose for now. It can always be adjusted after all!

What wonderful news to hear how well he is responding! I know it's been a bit stressful and scary, but it is great that his numbers are coming down. :)
 
Good Morning campers, this morning Oreo's BG is at 140. He hasn't eaten yet is seems annoyed by the fact that I made him come in and it isn't what he asked for. ;) I have not given him his shot. Where do we go from here? What are you guys feeding? After analysis of our current food, only the fish meets our needs and he doesn't need fish only. I really don't want to make my own food. I am 7.5 months pregnant and it seems a lot to take on at the moment. @BJM
 
140 is quite a way from 200. I think I would test once more and if he is still low, skip the shot for now. He is likely to be higher for the pm shot, but I would stick with .5 - maybe a little less as .5 didn't give you a shoo table morning number. Can you give him less with your needles? One way is to draw up .5 and let a drop or two out.

Looks like he wants to go off insulin - great news!

I feed Friskies pates. They are in the 5-7% range. I would introduce one different flavor at a time so you don't get any tummy upsets. You're absolutely right - feeding fish only is not good. Once or twice a week is fine.
 
I just retested after he finally ate and his sugar is up to 201. I can easily measure out smaller doses with our needles so I think I will do at little less than the .5. New question, suggestion on how to report this on his spreadsheet? I listed this morning's values at the AMPS but it will not be. Now the 201 will be, what will be less confusing for everyone offering help. THANKS!
 
Have you considered using the U-100 syringes? They are quite helpful for shooting small doses of ProZinc - as low as 0.2 may be measure. You use a conversion chart with them to adjust for the concentration difference (short version, 1/2 unit mark on a U-100 syringe = 0.2 units of U-40 insulin).
Per Cat Info, you can add 1o unce plain meat or poultry to 5 ounces of canned food, mix well and portion out to boost the protein content and reduce the fat and carbohydrate content. Might be an option for mixing up his food a little bit at a time.
I'm feeding my cats Friskies pates - mainly Turkey and Giblet, sometimes Poultry Platter, and very occasionally the beef pate or liver and chicken. They come in the 13 ounce cans which is easier when feeding so many, though I have been getting cases of the 5.5 ounce cans, as they seem slightly better in quality.
 
@BJM We have the U-100 needles. I am really happy with his numbers today!! Now to think about this evening...if his numbers don't come way up before his next shot, I guess I wait. His eating has been better today also. I need to get some meat back on his bones. He looks terrible! I can't believe the vet didn't notice while he was there. I am thinking about getting some chicken thighs and see if I can get him to eat those but to be honest, I hate to rock the boat too much.
 
It can help with the weight gain to do frequent moderate feedings so he doesn't get too full, nor have too big of a food spike at once.
I wouldn't do just plain meat. You might try a kitten food as it will have a touch more protein, plus fat for growth and development. Fancy Feast Turkey and Giblets is one
 
Oreo dissappeared last night and did not get a shot. He did get his morning shot at .5U. Today's numbers have been in the low to mid 200s but fairly consistent. They are not bouncing but he doesn't feel great. He hasn't eaten much all day. He has started to eat now. We are trying to determine what to do about this evening's shoot. Suggestions?
 
I think I would stick with .5 another cycle and see if you get a lower overall cycle. His pre shots are pretty nice and it's hard to tell whether there was any downward movement before or after your mid cycle test.

If he continues with flat cycles in that 200 range, maybe increase a smidge.

Any idea why he isn't feeling well? Any infection or even constipation/upset stomach can keep the levels higher.
 
I don't know what is up with him. He is moving from one favorite sleeping spot to another and has done his normal disappearances but he seems off. We have interrupted his routine with summer not to mention vacation. I teach so he could just be annoyed that he is sharing the house with at least 2 humans and 2 uncrated dogs but it seems a little more than that. He is super skinny from the vet still. I have been poking him with needles a bunch of times each day...maybe its just stressful. We are running low on test strips today so we were a little stingy with them because we thought they might come in today. I am going to get freestyle lites tomorrow...but he did come get a couple of snuggles.
 
Oreo seems happier today. I have gotten several good snuggles and he is eating well. I didn't get a amps reading due to a lack of strips but I went to the store and got the Freestyle lite strips. We have now been on our low carb food for 6 days and on 0.5 units steady for 3 full injections so around 36 hours. Oreo's BG this evening was 177 so I am not going to shoot tonight. Where do we go from here? Do I just keep preshoot testing and stay at 0.5 for several days? I will test in the morning preshoot to see what happens over night. What is the recommendation for how long you keep the status quo before changing things. My biggest concern is that his doses are not evenly spaced so I know there must be higher BG somewhere in the 24 hours. It just seems best to control the spikes. Thank you guys for all your help!!
 
For us, it worked best not to be in a hurry to change the dose everytime the numbers dropped a little. I would've given the .05 at 177 as long as kitty eats. The more evenly you give the insulin, the better. It'll give you a much clearer picture of what's happening.
 
I think you have two choices - either do the stall thing each time you get a pre shot under 200 ( wait 20 minutes without feeding to be sure the number is rising, not falling and nearer 200) and shoot a smidge below .5. My thought is that your pre shots are not super low. You could shoot a number lower than 200 if you can monitor (and are sure about the rising thing). Or reduce the dose and see if it gives you two shoo table pre shots in the 200 range. That might mean dosing a skinny .4 with your U1oos. (To do a skinny dose, pull up .4 and let out a drop)

Just to check. If you are using U100 needles, are you using U100 BCP PZI or are you using the conversion chart?
 
I am using the U100 needles and the conversion chart for the U40 PZI. I was going to retest tonight before bed for the final call. I am just a bit of a planner and my hubby is doing this along with me so we are trying to sort it all out so there are no frantic decisions. Of course, biology always has it's own plans about timing. ;) I certainly don't want to do the all night monitoring if I can help it but monitoring during the day is normally not hard for us. As I mentioned earlier he has been munching all day today so I think that the 177 wasn't long after a little snack. I am going to let him free eat as much as I can because he is so thin! We did get him the Friskies kitten food today; maybe that will help his weight a bit.
 
Hi Oreo,

You are very brave I probably would not shoot at all if the numbers were 162. 1 u for 189 seems a little excessive. My cat's bg is about 396 in the am and the maximum I ever shoot is 1.25u. What number are you aiming for?
 
@Alexandria M we haven't shot 1U in while. We are actually not shooting regularly at the moment becuase his sugar is lower; the signature is a little old above. We are currently .2U and I his sugar is holding in low to mid 100s. I don't like this becuase I can't always do two shots a day so there is some inconsistency but I don't have the ability to smaller doses. So we do .2 and test and see. He seems to be slowly managing better on his own so I am just helping a little here and there. Originally our vet said he would be happy with 200 but that was before he realized I would home test and manage. I really haven't thought about a true goal other than in the normal range so for now I am pretty happy.
 
@Alexandria M we haven't shot 1U in while. We are actually not shooting regularly at the moment becuase his sugar is lower; the signature is a little old above. We are currently .2U and I his sugar is holding in low to mid 100s. I don't like this becuase I can't always do two shots a day so there is some inconsistency but I don't have the ability to smaller doses. So we do .2 and test and see. He seems to be slowly managing better on his own so I am just helping a little here and there. Originally our vet said he would be happy with 200 but that was before he realized I would home test and manage. I really haven't thought about a true goal other than in the normal range so for now I am pretty happy.
What brand and size of the syringes are you using? I am using Canninsulin U-40 and I am not very happy with them, I find them not sharp enough I have a hard time getting it through the skin at times.
 
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