? Unsure about next dose -- 2nd week on ProZinc, nadir at +10??

[applecove]

DBD's Spreadsheet


My newly diagnosed guy started out on 1 unit twice a day of ProZinc last week. His numbers were still bad this week when I took him back in, so his vet upped the dose to 2 units twice a day. I was still getting preshot readings in the 400s and 500s, so I spent today testing the poor guy every hour since his morning shot. His lowest number today was 373 at +10, which is weird, right?

He's due to get his next shot very soon. Right now as a matter of fact. Do you think it's still safe to give him 2 units?? I feel stupid asking, because as you can see from his ss, his numbers are still pretty bad. I just have a fear of him going too low.

 

[Djamila]

Hi there! That 373 isn't really that weird. These meters are allowed a certain amount of variability in their readings, so all of those numbers are pretty close.

No need to worry about the 2u right now. Go ahead with the dose. I do understand the worry. When I first started down this journey I was sure every time I left the house my kitty was going to fall over in a hypoglycemic coma. You're doing just fine. Please ask as many questions as you have! We'd love to help you get your fur baby into some better numbers!

 

[applecove]

Thank you so much for your help, I feel safe giving him his dose now.
There's soooo much to learn. Comas and ketones. Scary stuff. He's a dry food eater only and refuses to switch. Every time I give him his shot (which he hates) and test his ear (which he tolerates), I tell him this could've all been avoided if he'd learned to like the wet stuff.

 

[Jenna Josie]

Hi there! How wonderful that DBD already tolerates testing (and that you’re testing!). Most people find that the harder one. Have you tried giving the shot while he’s eating? We give Josie hers while her face is in the bowl, and 9/10 she doesn’t even notice ... when she does notice, it’s been caretaker error on our part; e.g. maybe pulling too hard on her skin/fur. We don’t do that so much now that we use the “roll” technique vs the “tent” technique we started with back when she was scrawny and had lots more loose skin to mess around with. We found it on the “Shooting Tips and Techniques” sticky on the Lantus forum. Maybe that would be helpful?

 

[Rachel]

There is some scary stuff to learn about with FD. Comas and low numbers are frightening, but the good news is that since you're testing, it's less likely to happen. And if it does, you can catch it and we can talk you through it. We've had plenty of members here hit some low numbers and there is usually SOMEONE around to hold your hand/walk you through what to do/remind you to make coffee and eat some chocolate. If you do hit a low number, post on the Main forum as well as here with that red 911 and you'll get eyes pretty fast...and we won't hesitate to tell you to go to a vet if we think it's needed. I can tell you I've seen plenty of hypos or near hypos on here and hardly ever have they needed a vet...only if a double shot was given accidentally or something like that usually. Have you got a hypo kit prepared? That made me feel better because I knew I was ready. Had high carb food, karo syrup, extra test strips (change those out every so often), coffee grounds (I wasn't kidding about the coffee!), a bar of chocolate (nope, wasn't joking about that either...you'll deserve it!), and the hypo instructions printed out + the number and name of the closest emergency vet and my vet. That way, you're ready and you won't be rushing around looking for stuff if you need it. I will say it again though...it's RARE that it's bad. 50 is the take action number but that's not even really hypo...that's just where we start doing something to make sure it doesn't BECOME one. And we'll help you if one hits...or someone on Main will.

Ketones. Yeah, they're scary. And honestly, they scare me more than hypos. I've never seen a cat on here die from a hypo but I have from DKA. And it's heartbreaking. But they too CAN be dealt with! The earlier you catch them the better, so make sure you're testing. You can use urine strips for humans...ask at the pharmacy and they can point you to them. Sounds hard, but catching urine isn't too tough...we have several tricks if you need. The recipe for DKA (diabetic ketoacidosis) is not eating + not enough insulin + some sort of infection. It can happen at lower numbers or when those things aren't present, but you're most likely to see it then and in higher numbers. So test for ketones when you can, but don't worry about them unless he starts acting off and refuses food. Then you want to test ASAP or just take him in if you can't get a test. We've seen PLENTY of kitties recover from DKA and go on to live long lives and be healthy. We've also seen PLENTY of kitties (including mine!) who never got ketones...yes it can happen, but if it does, we can help you (and we really won't hesitate to recommend a vet for that one) and we can help you prevent it by more aggressive dosing in the future. It's more likely that it won't happen without some sort of cause, and if you're testing you don't have to worry because you'll catch it fast and the recovery will be that much easier. One thing about the ketone test strips...check them at EXACTLY the time listed on the bottle (I think 15 sec). They get darker over time so you'll panic if you wait and check it later.

Okay, that was longer than I intended, but I wanted to give you a rundown of both things you mentioned so hopefully you wouldn't be as scared of them...I find knowledge to be power. Both those conditions CAN be dealt with, sometimes at home, sometimes at a vet, and we can help you prevent/recover from them if they do happen. And you might never deal with either one....but if you do we can and WILL help you.

Please ask everything you want to. No dumb questions here, and we get the fears very much! I hope my novel here helped some and didn't scare you. Let me know if we can clarify any further and be secure that you are NOT alone.

 

[applecove]

Hi there! How wonderful that DBD already tolerates testing (and that you’re testing!). Most people find that the harder one. Have you tried giving the shot while he’s eating? We give Josie hers while her face is in the bowl, and 9/10 she doesn’t even notice ... when she does notice, it’s been caretaker error on our part; e.g. maybe pulling too hard on her skin/fur. We don’t do that so much now that we use the “roll” technique vs the “tent” technique we started with back when she was scrawny and had lots more loose skin to mess around with. We found it on the “Shooting Tips and Techniques” sticky on the Lantus forum. Maybe that would be helpful?

I was surprised too! I thought for sure he'd give me a hard time. It's so not like him to NOT give me a hard time. I finally figured out a couple days ago to give him a treat to distract him while giving him the shot. He scarfs it up so quickly, though, that sometimes he finishes before I've got the needle in. That's when he gets irritated, because he doesn't want to be messed with. Which is why I was shocked that he doesn't care that I'm pricking his ears.

I've never heard of the roll technique. Maybe he wouldn't mind it as much. Thank you for telling me about it.

 

[applecove]

There is some scary stuff to learn about with FD. Comas and low numbers are frightening, but the good news is that since you're testing, it's less likely to happen. And if it does, you can catch it and we can talk you through it. We've had plenty of members here hit some low numbers and there is usually SOMEONE around to hold your hand/walk you through what to do/remind you to make coffee and eat some chocolate. If you do hit a low number, post on the Main forum as well as here with that red 911 and you'll get eyes pretty fast...and we won't hesitate to tell you to go to a vet if we think it's needed. I can tell you I've seen plenty of hypos or near hypos on here and hardly ever have they needed a vet...only if a double shot was given accidentally or something like that usually. Have you got a hypo kit prepared? That made me feel better because I knew I was ready. Had high carb food, karo syrup, extra test strips (change those out every so often), coffee grounds (I wasn't kidding about the coffee!), a bar of chocolate (nope, wasn't joking about that either...you'll deserve it!), and the hypo instructions printed out + the number and name of the closest emergency vet and my vet. That way, you're ready and you won't be rushing around looking for stuff if you need it. I will say it again though...it's RARE that it's bad. 50 is the take action number but that's not even really hypo...that's just where we start doing something to make sure it doesn't BECOME one. And we'll help you if one hits...or someone on Main will.

Ketones. Yeah, they're scary. And honestly, they scare me more than hypos. I've never seen a cat on here die from a hypo but I have from DKA. And it's heartbreaking. But they too CAN be dealt with! The earlier you catch them the better, so make sure you're testing. You can use urine strips for humans...ask at the pharmacy and they can point you to them. Sounds hard, but catching urine isn't too tough...we have several tricks if you need. The recipe for DKA (diabetic ketoacidosis) is not eating + not enough insulin + some sort of infection. It can happen at lower numbers or when those things aren't present, but you're most likely to see it then and in higher numbers. So test for ketones when you can, but don't worry about them unless he starts acting off and refuses food. Then you want to test ASAP or just take him in if you can't get a test. We've seen PLENTY of kitties recover from DKA and go on to live long lives and be healthy. We've also seen PLENTY of kitties (including mine!) who never got ketones...yes it can happen, but if it does, we can help you (and we really won't hesitate to recommend a vet for that one) and we can help you prevent it by more aggressive dosing in the future. It's more likely that it won't happen without some sort of cause, and if you're testing you don't have to worry because you'll catch it fast and the recovery will be that much easier. One thing about the ketone test strips...check them at EXACTLY the time listed on the bottle (I think 15 sec). They get darker over time so you'll panic if you wait and check it later.

Okay, that was longer than I intended, but I wanted to give you a rundown of both things you mentioned so hopefully you wouldn't be as scared of them...I find knowledge to be power. Both those conditions CAN be dealt with, sometimes at home, sometimes at a vet, and we can help you prevent/recover from them if they do happen. And you might never deal with either one....but if you do we can and WILL help you.

Please ask everything you want to. No dumb questions here, and we get the fears very much! I hope my novel here helped some and didn't scare you. Let me know if we can clarify any further and be secure that you are NOT alone.

Your post was perfect. Not too long. Lots of helpful info and reminders. Speaking of which, thank you for reminding me that I still haven't gotten everything for the hypo kit. I definitely have the Karo syrup. I was afraid to give him that first shot of insulin without having Karo nearby. I was paranoid he was going to immediately go low and wanted to be prepared. ha

I thought hypo was the worst I might have to deal with until I found out about ketones. Once again, thank you for the reminder that I need to get some ketone test strips...and extra glucose test strips...and I still haven't printed out the hypo instructions. So much to do. I'm so behind.