Two months in: PMPS-339 +4 89 +5 69 +5.5 96 +6 76 +6.5 91 +7 70

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AndreaJEP

AndreaJEP

Member Since 2022
I feel like I have a ton of questions and all the information is kind of overwhelming right now, so I'm going to try to keep this organized, but I don't know if I'll succeed.

My kitty, Scully
  • Female, spayed
  • Age 13
  • Weight has been yo-yoing for years, and have tried to control it using her vet's advice, but nothing seems to work. I hope wet food will. Last night, she weighed in at 14.2 pounds, which is one of the highest weights she has been at.
  • Dx'ed late September 2022, after going to the vet for a suspected UTI and finding sugar in her urine. Her BGs around that time and when I first started home testing were in the 300-500 range.
  • ProZinc insulin, 4 units twice daily (up from an initial dose of 2 units twice daily)
  • Current food is prescription DM dry food, which I've found out is not good for her despite what the vet said.
  • Very compliant with insulin injections - no issues there.
  • BG testing so far has been fairly difficult.
  • Spent one overnight in the animal ER a few weeks after starting insulin due to diarrhea, vomiting, and lack of appetite. This occurred a couple of days after Scully's usual vet did a glucose curve in the clinic and raised her dose from 2 units to 3 units twice daily. The ER docs thought she was having rebound highs from too much insulin. Her own vet and a substitute vet at our usual clinic thought her insulin still wasn't high enough. Her usual vet ordered me a meter at that time and had me do a glucose curve at home, which seemed to confirm that Scully's dose wasn't high enough, and had me raise it to the current 4 unit twice daily dose.
  • Scully's vet advised me to do the occasional glucose curve, and gave no other instructions as far as testing her BG.

My own background
I have been type 1 diabetic myself for almost 10 years. I was on Lantus once daily plus meal-time rapid-acting insulin for several years, then switched to pump + CGM.


The current problem (?)
I was researching how to switch Scully over to wet food given that she is already on insulin, found this forum in the process, and discovered that you all test your cat's glucose at least twice per day, before each injection.

I have had a lot of difficulty testing Scully's blood sugar. She's fussy about being handled even under the best of circumstances. She will tolerate one prick from the lancing device, which would be fine...except that more often than not, I get no blood out at all, even when I warm her ear first and put some vaseline on. I actually have more luck lower on the ear than guides online suggest, but even so, I'm more likely to come up dry than to actually get a drop of blood. Her paws are a no-go as she does not allow anyone to touch them without having a second (or third) person to restrain her.

I've tried pricking with just the lancet, and will never do that again. It didn't work, and having had to poke myself that way before, I know it hurts far worse than using the lancing device. I have ordered a lancing device with a clear tip to see if that helps.

When I found this forum a few days ago, I decided to take the advice and check her BG before her PM injection, and it was only 143, so I skipped the dose. The next day, I was unable to get blood from Scully's ear until around noon, and since I am now unwilling to dose her without seeing her BG reading, that means she missed her morning dose as well. The noon reading was 224.

Since then, every pre-shot reading has been in the mid-200s to low 300s. With that 143 she had, I thought maybe she was going into remission, but maybe not. Maybe it was a fluke. I believe I managed to catch her nadir around 9 hours a few weeks ago, and at that time, it was 127. I understand I need to test more often, but I need help figuring out how to actually get blood out of her reliably.

I also understand that to switch her to wet food, I need to be able to test her BG frequently, but...well, see above.

I did read the page with the big spreadsheet of wet cat foods and their macronutrient contents, plus the advice on switching a diabetic cat to wet food, but all that seemed to do was stress that lower carbohydrate intake means less insulin is needed immediately which...yeah, I've known that for a decade now. But I need to know how much to reduce the insulin before I give her a meal of wet food, not just dose her as usual and keep testing to hope I catch the low! Was that information there and I just missed it?

I've read recently that CGMs are available for cats. Maybe I should talk to the vet about getting one for the food transition? Scully really hates the vet's office and gets very stressed out every time we go, but maybe it's worthwhile?


Choosing a wet food
I got some Tiki Cat After Dark variety pack and have given her just a taste of a few flavors to see what she will like, but unfortunately, so far she only seems interested in licking up the liquid, and doesn't really eat much of the shredded meat. But most of the high-protein, moderate fat, under 10% carb foods seem to be the shredded kind. I've looked at the pates too, but they seem to be mostly higher in fat.

Plus, the feeding guidelines seem kind of insane. For instance, Tiki Cat says something like 3 cans per 7 pounds of body weight, which means 6 cans a day for Scully. That's half the box! That can't be right??



I hope this wasn't too disorganized to read, but I feel like I have both too much information and not enough, and I need someone to set me straight. Please. I'll take any ideas or advice you might have. I'm a bit too stressed out to sleep right now, anyway.
 
AndreaJEP said:
I've read recently that CGMs are available for cats. Maybe I should talk to the vet about getting one for the food transition? Scully really hates the vet's office and gets very stressed out every time we go, but maybe it's worthwhile?
Click to expand...

The Freesytle Libre is being used in a lot of cats now but it's far from perfect. Hardly any of them last the full 14 days...they shut down earlier, probably because a cat's body moves in a lot more ways than the upper arm of a human. Also, some cats get them off...we've had one get it off within an hour of placement (and it can't be re-applied so you have to buy a new one and start over). Some people have had good luck using a baby onesie or t-shirt to cover the sensor.

That being said, it is helpful in getting regular readings (as long as it's working) but it doesn't completely take the place of regular testing. It's notoriously bad at lower numbers so it's important to re-check those (it usually says it's lower than it actually is on a regular meter). Also, occasionally it will produce an icon that looks like a magnifying glass next to a blood drop. That's its way of telling you that it's not sure about the reading it just gave you so you need to re-test.

I would talk to your vet about giving it a try though! Taking some of the stress off of you can be helpful since if you're stressed and nervous, your cat feels it and thinks there's a reason she should be stressed and nervous too and you're not going to get much cooperation that way. Try singing a silly song. It forces you to use a different part of your brain so you're not sending out those scared and nervous vibes. "You are my sunshine" is a favorite here!

AndreaJEP said:
I understand I need to test more often, but I need help figuring out how to actually get blood out of her reliably.
Click to expand...

As you poke more and more, new capillaries will grow into the area to "heal the injury" so it WILL get easier to get that precious drop. If poking further down works better for you, then try to concentrate most of the pokes in that area. The "sweet spot" picture you see is just a suggestion. Anyplace you can get blood from is fine.

AndreaJEP said:
Last night, she weighed in at 14.2 pounds, which is one of the highest weights she has been at.
Click to expand...

The trick to weight loss in cats is the same as humans....less calories in, more exercise to burn them. There's a formula to start with that's [13.6 x IDEAL weight in pounds] +70. Start there, weigh every 4-5 days and adjust as needed. You don't want her losing too fast so shoot for 2-3% per month. Find some way to get her moving, even if you have to walk behind her and "chase" her to keep her from laying around all day. If you can get her moving to the point where she's starting to pant, she's burning good calories. Does she like laser toys? With my China, the only thing that worked for her was a wand toy called "Da Bird". She'd chase that thing when nothing else worked. We had one person who used tiny amounts of chicken that she'd toss down the stairs...her cat would go down the stairs to get it and then have to come back up them to get another tiny bite. Another person attached a piece of string to her shoe so as she worked around the house, her cat chased after her to catch the string. Creativity is important!

The amount of calories per can is on the label (in teeny tiny print somewhere near the ingredients). It will be listed like 1300k/cals per kg, 90k/cals per can.

AndreaJEP said:
I've looked at the pates too, but they seem to be mostly higher in fat.
Click to expand...

Cats are very efficient at using fat so there's no huge reason you need to restrict it. Most of us feed our own cats Fancy Feast Classics, Friskies pates or 9-Lives ground.

AndreaJEP said:
Plus, the feeding guidelines seem kind of insane.
Click to expand...

You're right...they're insane. They're more interested in selling more food. Go by the formula above when determining how many calories your cat actually needs per day, check the label for the number of k/cals per can and do the math.

AndreaJEP said:
I did read the page with the big spreadsheet of wet cat foods and their macronutrient contents, plus the advice on switching a diabetic cat to wet food, but all that seemed to do was stress that lower carbohydrate intake means less insulin is needed
Click to expand...

The switch from the high carb kibble to the low carb canned should be done slowly. By testing (with the CGM or a meter), you'll see how the diet change is effecting your cat and can learn when to reduce the dose. 4U is a high dose for most cats (although they need what they need) so if you're really concerned, maybe drop back to 3.5 while you're doing the diet change and depending on the numbers you get, you'll know when to decrease more (or increase....some cats are just higher dose than others)

AndreaJEP said:
Since then, every pre-shot reading has been in the mid-200s to low 300s. With that 143 she had, I thought maybe she was going into remission, but maybe not.
Click to expand...

Those aren't horribly high numbers. We've had cats in the 700's before. Unlike humans, cats tolerate high BG numbers much better than we do.

Sorry for answering so out of order but was answering the ones that I felt were the most important first. Keep asking questions! The people here are very generous with their time.
 
Chris & China (GA) said:
Sorry for answering so out of order but was answering the ones that I felt were the most important first. Keep asking questions! The people here are very generous with their time.
Click to expand...
Thank you! I'll have to reread this tomorrow to process everything you've said (I have to be up for work again in 5 hours -_-), but I really appreciate the response and it has made me feel a bit better already.

I managed to check Scully's glucose again half an hour ago (about 3.5 hours after her shot) and it was at 184. She was really not happy with me, but she's very forgiving, luckily. Hopefully I'll be able to get another reading when I wake up.
 
I've added some values to Scully's spreadsheet. Not many, I know, but I am trying to get more. I found a tip to gently rub the warm rice pack against the ear instead of holding it, and tried it for the +3.5 last night. It seemed to help, though her ear wasn't super cold to begin with like it is sometimes.

What I'm understanding right now is this:

Using the formula [13.6 x IDEAL weight in pounds] +70, using maybe 11 pounds as her ideal weight for now (I don't know what it should be, tbh), she should get roughly 220 calories per day. If I went with the Fancy Feast classic chicken pate (for example), then at 99 calories per can, she would need 2.2 cans per day.

However, since she is on insulin, I'm still confused about how to do the switch without risking her going low and just hoping I catch it, especially since I work and can't be home to monitor her every day. I know the suggestion was to lower the dose by half a unit, but as I replace more of her dry food with wet, I would need to continue lowering her insulin dose ahead of time. Should I do a glucose curve on a day I will be home and see what happens before I do anything else?
 
AndreaJEP said:
I feel like I have a ton of questions and all the information is kind of overwhelming right now, so I'm going to try to keep this organized, but I don't know if I'll succeed.

My kitty, Scully
  • Female, spayed
  • Age 13
  • Weight has been yo-yoing for years, and have tried to control it using her vet's advice, but nothing seems to work. I hope wet food will. Last night, she weighed in at 14.2 pounds, which is one of the highest weights she has been at.
  • Dx'ed late September 2022, after going to the vet for a suspected UTI and finding sugar in her urine. Her BGs around that time and when I first started home testing were in the 300-500 range.
  • ProZinc insulin, 4 units twice daily (up from an initial dose of 2 units twice daily)
  • Current food is prescription DM dry food, which I've found out is not good for her despite what the vet said.
  • Very compliant with insulin injections - no issues there.
  • BG testing so far has been fairly difficult.
  • Spent one overnight in the animal ER a few weeks after starting insulin due to diarrhea, vomiting, and lack of appetite. This occurred a couple of days after Scully's usual vet did a glucose curve in the clinic and raised her dose from 2 units to 3 units twice daily. The ER docs thought she was having rebound highs from too much insulin. Her own vet and a substitute vet at our usual clinic thought her insulin still wasn't high enough. Her usual vet ordered me a meter at that time and had me do a glucose curve at home, which seemed to confirm that Scully's dose wasn't high enough, and had me raise it to the current 4 unit twice daily dose.
  • Scully's vet advised me to do the occasional glucose curve, and gave no other instructions as far as testing her BG.

My own background
I have been type 1 diabetic myself for almost 10 years. I was on Lantus once daily plus meal-time rapid-acting insulin for several years, then switched to pump + CGM.


The current problem (?)
I was researching how to switch Scully over to wet food given that she is already on insulin, found this forum in the process, and discovered that you all test your cat's glucose at least twice per day, before each injection.

I have had a lot of difficulty testing Scully's blood sugar. She's fussy about being handled even under the best of circumstances. She will tolerate one prick from the lancing device, which would be fine...except that more often than not, I get no blood out at all, even when I warm her ear first and put some vaseline on. I actually have more luck lower on the ear than guides online suggest, but even so, I'm more likely to come up dry than to actually get a drop of blood. Her paws are a no-go as she does not allow anyone to touch them without having a second (or third) person to restrain her.

I've tried pricking with just the lancet, and will never do that again. It didn't work, and having had to poke myself that way before, I know it hurts far worse than using the lancing device. I have ordered a lancing device with a clear tip to see if that helps.

When I found this forum a few days ago, I decided to take the advice and check her BG before her PM injection, and it was only 143, so I skipped the dose. The next day, I was unable to get blood from Scully's ear until around noon, and since I am now unwilling to dose her without seeing her BG reading, that means she missed her morning dose as well. The noon reading was 224.

Since then, every pre-shot reading has been in the mid-200s to low 300s. With that 143 she had, I thought maybe she was going into remission, but maybe not. Maybe it was a fluke. I believe I managed to catch her nadir around 9 hours a few weeks ago, and at that time, it was 127. I understand I need to test more often, but I need help figuring out how to actually get blood out of her reliably.

I also understand that to switch her to wet food, I need to be able to test her BG frequently, but...well, see above.

I did read the page with the big spreadsheet of wet cat foods and their macronutrient contents, plus the advice on switching a diabetic cat to wet food, but all that seemed to do was stress that lower carbohydrate intake means less insulin is needed immediately which...yeah, I've known that for a decade now. But I need to know how much to reduce the insulin before I give her a meal of wet food, not just dose her as usual and keep testing to hope I catch the low! Was that information there and I just missed it?

I've read recently that CGMs are available for cats. Maybe I should talk to the vet about getting one for the food transition? Scully really hates the vet's office and gets very stressed out every time we go, but maybe it's worthwhile?


Choosing a wet food
I got some Tiki Cat After Dark variety pack and have given her just a taste of a few flavors to see what she will like, but unfortunately, so far she only seems interested in licking up the liquid, and doesn't really eat much of the shredded meat. But most of the high-protein, moderate fat, under 10% carb foods seem to be the shredded kind. I've looked at the pates too, but they seem to be mostly higher in fat.

Plus, the feeding guidelines seem kind of insane. For instance, Tiki Cat says something like 3 cans per 7 pounds of body weight, which means 6 cans a day for Scully. That's half the box! That can't be right??



I hope this wasn't too disorganized to read, but I feel like I have both too much information and not enough, and I need someone to set me straight. Please. I'll take any ideas or advice you might have. I'm a bit too stressed out to sleep right now, anyway.
Click to expand...
@Chris & China (GA)

@FrostD Let's see if Melissa has any more advice, she is a prozinc user
 
AndreaJEP said:
I've added some values to Scully's spreadsheet. Not many, I know, but I am trying to get more. I found a tip to gently rub the warm rice pack against the ear instead of holding it, and tried it for the +3.5 last night. It seemed to help, though her ear wasn't super cold to begin with like it is sometimes.

What I'm understanding right now is this:

Using the formula [13.6 x IDEAL weight in pounds] +70, using maybe 11 pounds as her ideal weight for now (I don't know what it should be, tbh), she should get roughly 220 calories per day. If I went with the Fancy Feast classic chicken pate (for example), then at 99 calories per can, she would need 2.2 cans per day.

However, since she is on insulin, I'm still confused about how to do the switch without risking her going low and just hoping I catch it, especially since I work and can't be home to monitor her every day. I know the suggestion was to lower the dose by half a unit, but as I replace more of her dry food with wet, I would need to continue lowering her insulin dose ahead of time. Should I do a glucose curve on a day I will be home and see what happens before I do anything else?
Click to expand...
@Chris & China (GA)
 
Thank you!

I just tried to get her PMPS and had 4 pokes without enough blood for the meter :banghead: Her ear was warm so I skipped the sock, but maybe I shouldn't have skipped it. She's pretty annoyed with me right now, so I'm going to let her calm down for 10 or 15 minutes and then try again, with the sock this time.
 
Bron and Sheba (GA) said:
Don’t give up. Keep trying. You will get there!
What size lancets are you using?
Click to expand...
Thank you for the encouragement. I'm not sure what size the lancets are. They came with the AlphaTrak kit, but none of the documentation, nor the packaging, says what size they are. A google search suggests they are 28 gauge, which I understand is on the thicker side?
 
Red & Rover (GA) said:
Try a deeper depth with the lancet device. A cat's ears are not as sensitive as a human finger. Their ears can take a beating during a cat fight.
And yes, lancet size can make a huge difference.
Click to expand...
I can try, but I'm already at depth 3.:arghh: Sometimes that gives me no blood (like tonight), whereas other times, it seems to go all the way through her ear. I keep reading about cats' ears not being that sensitive, but the way she yowls sometimes, it's just hard to believe.

I will keep trying periodically. At some point soon, if I do get a shootable reading, it will be late enough that I will probably have to skip her morning dose, but we'll see.
 
AndreaJEP said:
I can try, but I'm already at depth 3.:arghh: Sometimes that gives me no blood (like tonight), whereas other times, it seems to go all the way through her ear. I keep reading about cats' ears not being that sensitive, but the way she yowls sometimes, it's just hard to believe.

I will keep trying periodically. At some point soon, if I do get a shootable reading, it will be late enough that I will probably have to skip her morning dose, but we'll see.
Click to expand...
Take a deep breath & breathe. If you are stressed out your kitty will sense it & be stressed out as well, 28 gage should work. Have you tried just using the lancet without the device? Alot of us do that & seems to work be alot easier. It gets easier I promise. :bighug:
 
I was hopeless in the beginning. 28 gauge is OK. So is size 26.
Try milking the ear towards the tip, before you prick it and again after to get blood into the area. Are you giving a treat each time you try?
A lucky few can have success from the beginning but most of us fail off and on before it works.
I always used the device but others just use the lancet…whatever works for you.
It is great you are doing the hometesting as it is the single biggest thing you can do to keep Scully safe.
 
Chrispooky12 said:
Take a deep breath & breathe. If you are stressed out your kitty will sense it & be stressed out as well, 28 gage should work. Have you tried just using the lancet without the device? Alot of us do that & seems to work be alot easier. It gets easier I promise. :bighug:
Click to expand...
Thank you as well for the encouragement.:bighug: I finally just got a reading using depth 4, and it was 338. I wonder how much of that is stress from all those failed pokes.:banghead: She's hiding from me under the bed, so as soon as she emerges, I'll give her the shot. That part usually goes smoothly, at least.

I tried once poking with just the lancet and I found that much harder, though partially due to having had to prick my own finger that way before, and knowing it hurts a lot more than using a lancing device.
 
Bron and Sheba (GA) said:
I was hopeless in the beginning. 28 gauge is OK. So is size 26.
Try milking the ear towards the tip, before you prick it and again after to get blood into the area. Are you giving a treat each time you try?
A lucky few can have success from the beginning but most of us fail off and on before it works.
I always used the device but others just use the lancet…whatever works for you.
It is great you are doing the hometesting as it is the single biggest thing you can do to keep Scully safe.
Click to expand...
I do give a treat each time. I got these Blue Buffalo ones, which I hope are ok.

I'm glad I'm not the only one having trouble. I kept seeing tutorials on YouTube and elsewhere insisting that most cats tolerate BG testing just fine, so it was frustrating that Scully and I are having so much truoble.
 
Bron and Sheba (GA) said:
WELL DONE!!
How far out of schedule are you with the shot?
Will you be able to stay with this schedule as you go back 15 minutes each cycle to get to the previous schedule?
Click to expand...
We are two hours late now. Unfortunately, I have to go to work in the morning well before this new schedule would allow me to give a shot, assuming her number tomorrow morning is in the blue like it was this morning.
 
Great job getting a test. Rover's ears needed the depth 4 setting. I think a larger lancet will help too (the lower the number, the larger the lancet).

If you don't get enough blood the first time, try squeezing around the drop a bit to get more blood. You may want to scrap what blood you do get onto a clean fingernail in case Scully takes off on you.

Eventually Scully will associate tests with treats.
 
(sorry for the brevity, I've got a newborn and trying to hit the main points as quickly as I can)

Welcome!

Agree with Chris's suggestion to reduce to 3.5U. Based on the numbers you do have at certain times, I think 4U is too much. Right now you want nadir around 90.

Focus on the testing first, then the diet. There can be very drastic results from diet alone - my own cat dropped from 2U in the 300s down to 0.1-0.25U in the normal BG range within the span of about a week. Had I not been testing I probably would have killed him.

Realistically we only need about 3-4 tests per day. The two fasting preshots (fast for 2 hours just for consistency in the data point), then a midcycle test 4-6 hours after the shot. Ideally day and night, but we can usually "fill in the blanks" pretty well. Getting those tests now will tell us whether the current dose is still too high; then as you start the diet change it will help you stay ahead of any necessary reductions.

The Libre would be great if you can get it. It has some known drawbacks - cats don't always keep it on, they die well before 2 weeks, and they tend to read artificially low in lower numbers - but in your situation it's a good tool to have.

Just keep at it :bighug: You're doing all the right things, it just honestly sucks a bit the first week or two until you both get used to it.
 
AndreaJEP said:
do give a treat each time. I got these Blue Buffalo ones, which I hope are ok.
Click to expand...
I’m not sure they are ok. I don’t live in the US so I’ll ask someone who does @Diane Tyler's Mom


AndreaJEP said:
I'm glad I'm not the only one having trouble. I kept seeing tutorials on YouTube and elsewhere insisting that most cats tolerate BG testing just fine, so it was frustrating that Scully and I are having so much truoble.
Click to expand...
Most cats will tolerate it but in the beginning both the caregiver and the cat has to get used to it first.
I used to give Sheba a treat as I was doing the test so she had he head in the plate as I tested and she didn’t notice nearly as much.
And you should have a box of chocolates for yourself as treats after you test!
 
AndreaJEP said:
We are two hours late now. Unfortunately, I have to go to work in the morning well before this new schedule would allow me to give a shot, assuming her number tomorrow morning is in the blue like it was this morning.
Click to expand...
I’ll tag @FrostD again about the morning …I’m not a Prozinc user…to ask her about the morning shot as you are going to be only at +10 when you want to give the dose. And insulin is given 12 hours apart.
 
Thank you all so much for the advice and encouragement given! :bighug: I will see what kind of mood Scully is in before I go to bed later, and if she has calmed down, I will try to get another reading. I will call her vet tomorrow to ask about the CGM as well.
 
AndreaJEP said:
I'd need to give it 10 hours after, provided I get a shootable BG from her in the morning. I just have to leave for work pretty soon after that, so I can't wait longer than 10 hours.
Click to expand...
Ok. The main consideration when shooting early is twofold - (1) the BG itself may be lower than usual, but not always and (2) typically the rise into shot time isn't as steep, so the insulin has a little less work to do and the cat may drop a little lower than usual.

This is specifically for tomorrow only with shooting early -

In the 200s I would give roughly a half dose, so around 1-1.5U (lower 200s I'd do the 1U).

300s+ I would do the 3-3.5U we suggested.

Below 200 the best I can say is skip. More than likely a token dose of around 0.5U would be ok above 150 but we just don't have the data for me to say that comfortably.

Note for anyone lurking - again this is specifically for Scully - factoring in current dose of 4U is likely too high, testing limitations, and shooting early.
 
AndreaJEP said:
Scully really hates the vet's office and gets very stressed out every time we go, but maybe it's worthwhile?
Click to expand...

I remembered something else I meant to add....If Scully gets super stressed and you need to take him in (like to have the Libre attached), you might ask your vet to give you some Gabapentin. You usually give it the night before and again an hour or 2 before you leave. It really helps most cats tolerate the car ride and the poking and prodding by a person they don't like much anyway.
 
I googled what you are giving as treats ,they seem to be OK
Product Description
Product Description
Cats of all ages can’t resist BLUE Wilderness soft, meaty treats made with more of the protein they were born to love. These tender morsels of real meat feature two favorite feline flavors in one tasty treat, like chicken and salmon or chicken and duck. So cater to your cat’s natural cravings with these scrumptious, grain-free treats.

From the Manufacturer
BLUE Wilderness cat treats are: 100% grain-free, Made with real chicken and salmon. Free from chicken, poultry by-product meals, artificial flavors and preservatives
 
FrostD said:
Ok. The main consideration when shooting early is twofold - (1) the BG itself may be lower than usual, but not always and (2) typically the rise into shot time isn't as steep, so the insulin has a little less work to do and the cat may drop a little lower than usual.

This is specifically for tomorrow only with shooting early -

In the 200s I would give roughly a half dose, so around 1-1.5U (lower 200s I'd do the 1U).

300s+ I would do the 3-3.5U we suggested.

Below 200 the best I can say is skip. More than likely a token dose of around 0.5U would be ok above 150 but we just don't have the data for me to say that comfortably.

Note for anyone lurking - again this is specifically for Scully - factoring in current dose of 4U is likely too high, testing limitations, and shooting early.
Click to expand...
Thank you!! I will do this. I am setting my alarm earlier than usual to give me extra time. Hopefully tomorrow morning will be like this morning was, though. She was warm and cozy from being in bed with me, and it was surprisingly easy to get a reading.


@Chris & China (GA) I do give her gabapentin before vet visits, but it doesn't seem to help much. :(


@Diane Tyler's Mom Thank you for the treat information! I'm glad the ones I chose seem ok, but I will look into the ones you suggested as well.
 
AndreaJEP said:
I do give a treat each time. I got these Blue Buffalo ones, which I hope are ok.
Click to expand...
Diane Tyler's Mom said:
I googled what you are giving as treats ,they seem to be OK
Product Description
Product Description
Cats of all ages can’t resist BLUE Wilderness soft, meaty treats made with more of the protein they were born to love. These tender morsels of real meat feature two favorite feline flavors in one tasty treat, like chicken and salmon or chicken and duck. So cater to your cat’s natural cravings with these scrumptious, grain-free treats.

From the Manufacturer
BLUE Wilderness cat treats are: 100% grain-free, Made with real chicken and salmon. Free from chicken, poultry by-product meals, artificial flavors and preservatives
Click to expand...

From the website (https://bluebuffalo.com/cat-treats/wilderness/grain-free-chicken-salmon/), it looks like they have potatoes so they are unlikely to be low carb.

Ingredients
Deboned Chicken
Deboned Salmon
Potatoes
Vegetable Glycerin
Gelatin
Natural Flavor
Salt
preserved with Phosphoric Acid
Sorbic Acid
Citric Acid and Mixed Tocopherols
Oil of Rosemary

Most grain-free food and treats have fruits or vegetables instead of grain.
 
Bron and Sheba (GA) said:
If you do give her insulin in the morning I would make sure she has some food to eat while you are at work.
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She tends to eat her meals spread out over several hours regardless, so she wouldn't be left without :)

@Bandit's Mom Thank you for the information. I will look for a freeze dried treat at Petco today.

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Her reading this morning was only 106, so no shot for her. I wasn't sure how to record this on the spreadsheet, so I put it for both AMPS and +10 from the previous day, along with a note.
 
I managed to get her PMPS reading within a reasonable timeframe, so she got her 3.5 unit shot without it being late like yesterday.

It still took at least 5 or 6 pokes to get blood for the meter. Her ear did bleed for several of the pokes, but despite putting Vaseline on first, the blood kept soaking into her fur, so I couldn't collect it :banghead: I tried the nail trick, but it still didn't seem to be enough for the meter. The reading this morning was so easy by comparison. I got it on the first poke, and she barely stopped purring in order to express her displeasure with me.

I got some of the Fancy Feast pates and I had a thought: if her AMPS reading tomorrow is unshootable again, it might be a good idea to set out a decent portion of one of the pates (in addition to some of her normal food), to see if she'll eat the pate? I'm thinking if she does fill up somewhat on the pate, then she'll eat less of the dry food, and I can see what that does to her blood sugar. Obviously I would NOT do this experiment if she gets her morning insulin, only if I have to skip the shot.

What do you think? Good idea? Terrible idea?
 
My initial thought is that changes a few too many variables at once - the main reason is that the dry food effects BG in odd ways, the effects tend to carry over a few cycles. So it would make it a little more difficult to tell whether the 3.5U is good; I'd rather first settle on a good dose with the dry food, then start changing food.

But as we always say - you hold the syringe (and the food bowl!). There's no harm in doing it if she doesn't get insulin, just "muddies the data waters" so to speak.
 
FrostD said:
My initial thought is that changes a few too many variables at once - the main reason is that the dry food effects BG in odd ways, the effects tend to carry over a few cycles. So it would make it a little more difficult to tell whether the 3.5U is good; I'd rather first settle on a good dose with the dry food, then start changing food.

But as we always say - you hold the syringe (and the food bowl!). There's no harm in doing it if she doesn't get insulin, just "muddies the data waters" so to speak.
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Thanks. I was thinking it would be a less risky way to get her to try (and hopefully like!) some pate, but I can see how that would make the data messy right now. Maybe it's better to wait until I can get some mid-morning or early afternoon readings from her on the weekend, plus hopefully some more overnights, and then reconsider. I'm also hoping to hear back from the vet tomorrow about getting her on the Freestyle for a bit.

I do still need to have her taste them before I'm ready to switch so that I have time to find something she likes, but I can just give her a small taste, and let my other cat eat the rest of each can.
 
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AndreaJEP said:
Now she's at 69. Not symptomatic, but I gave her a can of Fancy Feast Gravy Lovers and she's eating that now.
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Which one did you feed
Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs
 
Well done getting those tests in.
Scully is still quite safe. I see you gave her a can of Gravy Lovers. For future reference, a teaspoon or two of the high carb food is all that is needed to bring the BG up higher. I would test again in 30 mins after the 69 to see how she is going. And post the result please.
I am not a Prozinc user (I doubt any of them are awake at the moment), but I would reduce the dose to 3.25u at the am dose seeing you dropped under 90.
I will tag @FrostD and she will pop in sometime when she wakes up to guide you on the dose.
 
AndreaJEP said:
Thanks. Hope I did it right this time.
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Perfect, when are you going to test her again, Bron suggested to test 30 minutes after you fed the gravy lovers, and don't forget to reduce tomorrow mornings dose to 3.25 units. Anytime she drops under 90 you reduce by 0.25 units

If her BG number in the AM is shootable number can you get some tests in during the AM cycle so we can see how she's doing? or do you work?
 
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Have you read the 2 dosing methods for prozinc ,since you do feed some kibble you need to follow the SLGS method.
Being new I would suggest you follow it anyway
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
 
Diane Tyler's Mom said:
Perfect, when are you going to test her again, Bron suggested to test 30 minutes after you fed the gravy lovers, and don't forget to reduce tomorrow mornings dose to 3.25 units. Anytime she drops under 90 you reduce by 0.25 units
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Just got the result a couple minutes ago: 96

Would I need to test again, do you think? Or is the upward trend a good enough sign?
 
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