We've made it a week!

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donnahc

donnahc

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Hi kind folks :)
Thanks to your support we've made it a full week thru this.....adventure ...I guess we'll call it.

Asher seems to be doing fine. He's happy and playing and eating well. Both kitties are altogether off the dry food and we are getting the hang of testing. It's still hard in the morning when all he wants to do is eat but we are getting there.

I have a vet appt tomorrow and have to discuss with the vet our no shoot number plus a few other issues like the prescription food.

Back in my "please help 911" thread a few people said 70 as a no shoot number is way too low and I agree. We decided not to shoot at 92 and we cut our 3 units down to 2 when he was 158. Even with testing I still feel like I am flying a bit blind. Hopefully we will get the hang of this.

Today we tested 3 times to see what would happen. Before food and the +6 mid day. Numbers were 158 am, 273 mid day and 250 tonight. Is this a good thing to do until we have more of an idea of what is happening? I also am going to try to find that spread sheet link I saw here somewhere and set that up.

Thanks in advance for any wisdom you all have .

Donna, Tom, Asher the sugar cat, and Alby the kitty brother :)

Asher: diagnosed 1/3/11
3 units PZI 2x daily
7 yrs old, 17 lbs.
 
Way to go! I think you can find the SS link here in the newbie's checklist: viewtopic.php?f=24&t=32799

I think it's a great thing to keep testing AMPS, +6 and PMPS to keep getting an idea of how things are going. It seems strange to me that he went from an AMPS of 158 to a +6 of 273 then back down to 250. Someone with more experience than me can probably interpret that.

Anyway, I think you're making good progress. Keep up the good work!
 
I think that was because since we were under 200 we panicked and gave him 2 units instead of three in the morning.
Thanks for the link. I am getting on that right now while I am going over our notes for the vet.

Donna
 
Good work on getting the home testing going and getting the food changed. :smile:

Please read the PZI Sticky [especially the Newbie Checklist] - it is your friend. :smile:
viewtopic.php?f=24&t=32799
Print it out if you need to refer back to it.

The links to the Spreadsheet setup are in the Newbie Checklist.

Also discussed in the Newbie Checklist are no-shoot numbers and what to do at those times under:
3) Pick your “no-shoot” number.

I think you took good action to at least reduce the dose under 200. We usually tell newbies to set their not shoot at a Pre-shot reading below 200. Thus it is important you test before every shot. There are strategies for dealing with what to do if you reach a "no shoot" number that are linked in the #3 on the list. Sometimes you may want to "wait and test" if you can. Other times reducing the dose or just not shooting is in order.

It is even more important that you are testing [at least] before every shot and have a safe no shoot number set now that you have removed the dry food [and are hopefully on low carb food]. The change can cause the insulin needs to drop dramatically and you may need to adjust your dosing accordingly.

The spreadsheet [and profile] will help us make more specific recommendations for you.

Sometimes here if the cat has not had keytones in the past it will be recommended once the food change is made to drop back to 1u twice per day and re-regulate. But if you are testing and careful you can reduce the dose as needed. If you are using the U40 syringes then you can change the dose in .5u or even try to eyeball .25u increments if you feel necessary. If you are consistently getting below your "no shoot" then you will probably want to reduce your regular dose.
 
Yes Asher is on the science diet m/d "low carb" food. But I want to discuss that with the vet since Blue Buffalo has this Wilderness canned food that is 1% carbs vs the science diet which is around 14%. I just don't want to piss off the vet I am not wanting to take her food suggestion.

So far I am not getting the template to work in google docs but maybe it's because I am on a tablet now and not my regular computer. I'll get that and the profile done as soon as I can get everything workin.

Donna
 
Hi Donna and welcome,

The learning curve on this is steep in the beginning but you are doing great, switching to wet food and testing bg's are the biggies.

For people new to Prozinc the recommended no shoot number is 200, until you have tested enough to know how the insulin is working for Asher. I've NEVER shot Harley's bg under 130. PLEASE don't shoot any insulin into a bg under 200 until you have more data and or come here and post your number and get some guidance.

The spreadsheet link is in the tech forum, there are people who can help you with that. Once you have your ss set up it will be easier for us to see what is going on and help.

Say no thank you to the prescription food and print out Janet & Binky's food chart and pick anything off of it that is under 10% carbs. You can spend the money you save from not buying the prescription food on testing supplies, you'll get more bang for you buck.

If you can't get a lot of test in on one day if you can at least get both PS's and a +4 one day and a +6 another day etc., will start to fill in the picture of Asher's puzzle.

You will get the hang of this in no time. Take a few deep breaths, this will get easier.
 
Hi Donna,

I haven't been following along, but wanted to say welcome!

The curve that you got today could reflect either too little insulin or too much. I'm not sure how you arrived at the 3u dose? If you got there through gradual increases and feel secure that the lower doses were not working then it may be that the 2u was indeed too little. If you got to the 3u fairly fast, like in less than maybe a month, then it's sort of a toss-up to know. Personally I would err on the side of caution, and I wouldn't shoot 3u if you get that kind of PS again. If I were convinced the 2u had been too low I would shoot 2.2u, if I weren't sure, I would try 1.5u and see what happens. I'm sort of pulling those #s out of a hat though as I haven't been following along closely, they are more for general illustrative purposes.

That's awesome that he is playing and feeling good. That's what's most important!!!
 
The vet started Asher on 3 units of PZI 2x daily thevday he was diagnosed. His bg was 650 at diagnosis.

We have given him those 3 units twice daily except when he tested 92 in one evening (we didn't shoot) and this morning when he was 158 we only shot 2 units.

Donna
 
Sam had an AMPS of 158 once, so I waited an hour and retested. His number was up to 220, so I shot 1.8. That was the first day he went into hypo. In retrospect, I wish I had waited another hour and retested another time. To me, shooting 2 units at 158 would be a very scary thing.

Not saying your vet doesn't know what he's talking about, but I've found the advice here on the board so much more valuable than what any vets have told me so far. That goes for food, dosing, testing...pretty much everything across the board. Vets do their best based on what they know, but the people on this board are in the trenches daily. That experience means so much more. Don't worry about upsetting your vet. They work for you. And if your vet isn't willing to work with the proven advice of this board, I'd say consider a new vet.

Sam is down from 2 units to .8 and has gone from 8 pounds (bones showing) to 10 pounds. He's playing, seeking attention, his coat is shiny and soft and his skin is no longer flaky. I credit a great deal of that progress to the help I found here. It took some courage to follow it and not what my vet told me, but I am SO glad I did.

Didn't mean to turn that into such a long post. Sorry. lol
 
Kristen-
Might be because Asher is a big boy. He was 21 lbs at his heaviest but last week at vet he was 17 which is a lot more weight than your kitty. Could his weight be entered into the dosage?

Donna
 
Wow, he is a big boy! Our Scooter is 17 pounds (down from 18, but it's been a slow process - and he could lose another 2 lbs) I'm sure weight must play into it. It makes sense that it would, don't you think? I just don't know enough to say definitively yes or no. Maybe someone else can answer that better.
 
Insulin should not be dosed on weight.

However, there might be something to be said for the amount of food that a cat eats related to their dose but that's more a theoretical discussion. Bottom line though is that, for cats, insulin should not be dosed on weight.

Of course just with humans obesity can be a complicating problem with diabetes so I'm very happy to see you are on top of the weight.

You can buy and feed whatever food you want. You do not need an Rx for the food.

We were just discussing another "hoover" kitty here:
http://felinediabetes.com/FDMB/viewtopi ... 42#p354942
Not sure if any of those ideas can help you.
 
I am in the process of setting up a SS on Asher's numbers. I am going to talk to the vet today about not shooting below a certain bg number. She told me that should be 70 and we all feel that is too low. I am concerned she'll just say give him the 3 units no matter what, unless 70 or under, and I read here of people's cats going hypo on a smaller dose when in the 150 range.

Any suggestions from anyone out there on how I go about giving him the insulin if he starts to get in the 150 range? His dose right now is 3 units which everyone seems to think is a lot. I do notice (like last night when I didn't get the shot in right and lost a little, or the one time his bg was 92 we didn't shoot) the next morning he is up in the 3-400 range again. I don't want him to get organ damage or whatever else bad can happen from his numbers being high, but my BIGGEST fear is him going hypo on us. Especially if we have a job one day and we have to feed, shoot, then leave the house for hours.

This is all so daunting every time I think about the numbers. He's a big guy but the last post seems to think weight isn't an issue when considering dose. I know it's the first week and we r getting our feet wet on doing shots properly and getting a routine down with testing, etc.

I am trying to remember to breathe :)

Thanks,

-donna
 
Oh, the other thing I wanted to mention to you experts is Asher has a bad tooth but the vet said let's get his diabetes under control, then he'll get the dental. (scared about anesthesia too but you know me, everything is scary)

Just wanted to say that in case it has any meaning in the upcoming discussions.

-donna
 
Dental issues can raise bg levels, but I understand wanting to get the insulin regulated before you tackle the teeth.

To avoid getting into a situation where you have to skip the shot or wait and shoot late, because the bg level is too low, you need to lower the dose. (That is also the best way to avoid a hypo - with a safe low dose. ) Your spreadsheet does work; as soon as you get some numbers in it, we can see better what might work best.

PS. The link to your spreadsheet does come up. If you want it to say Asher's SS without all that other stuff, go back to your original spreadsheet, choose publish again and do your link like this: Asher's SS You are just missing the first part [url=

Edited to add: Oliver was 16 pounds at diagnosis. We were overdosed in the beginning at 4 units twice daily :o As soon as we started hometesting and changed to wet, lo carb, the dose came right down and the weight came off.
 
Hi Donna,
I just wanted to say "hi" from another newbie. My Tessie was diagnosed on 11/27 and I found this board on 12/5. I agree wholeheartedly with what someone else said, it takes courage to go against your vet and take the advice offered here, but every single day I am glad I did just that. I am more impressed by the knowledge, experience and support here every day. Plus, I was fortunate enough to have hooked up with a local FDMB member who came to see us and showed me how to test Tessie, and now she stays in daily contact with me. She is my mentor with her 5+ years of experience with diabetes. Another local member called me and also gave me great advice from her experiences. What an amazing support network this is!

Good luck at the vets! Your boy and my girl are very young for diabetics. Tessie is only 4, but weighs 16.8 right now (18 at her heaviest). I think our "kids" have a good chance for remission if we rely on this board, have a cooperative vet, keep collecting data, and stay strong!

Your fellow newbie,
Sandy
 
The teeth issues alone can prevent you from reaching regulation. The infection, pain and inflammation from it can often wreak havoc on BG numbers.
See an incomplete list of things that can cause wonky BG numbers:
viewtopic.php?p=77223#p77223

Until I can see you SS I really can't make any specific recommendations about what to do in the 150 range. There are the general things you can do when your no shoot PS here:
viewtopic.php?f=24&t=32652
[Sue was instrumental in helping me write that post :smile: :smile: ]
 
Drama, there’s always drama...
Didn’t want anyone to think I disappeared. We had a good vet visit yesterday. The vet encouraged us (wow) to do our own curve at home to see what is happening. So today we started that since we are home.

At +4 we got a bg of 54. Yeah, I couldn’t believe what I was reading. (Naturally our vet is off today but we got her partner vet who is good too)

We called the vet immediately and told her there were no signs of hypo at all, but he was pesty for chicken treats which we give him for being a good boy during the ear pricking. He was alert, rubbing us, nothing weird. Anyhow she told us to feed him a little food and test again in an hour. He’s taking a bath/pre snooze now like normal. 1pm we’ll do the next test.

So there’s where we are today. I haven’t had time to work on Asher’s SS yet, got the page up and working, then life took over so I will try asap and will get this curve info up too.

(curve info so far today is 330 bg before we fed him, fed him half can+ chix treats, gave 3 units of PZI, +2 bg was 254, +4 bg was 54, then we called the vet.

The main thing is he looks good and eats and does everything normal. Tom and I don’t look so good tho ;) We’re still in pajamas and trying not to stress too much.

-donna
 
I thought Asher was on 2 units now? Did I miss something? Check that bg number sooner than later. A +4 of 54 seems pretty low to me. Do you have karo syrup or honey on hand in case of a hypo?
 
Yep that karo is right on the table. We will check him again for sure. Trying to let him calm down a bit from the last ear pricking. That makes me feel bad too.
I’ll try to get back here to post as soon as we have a number and call the vet.
-donna
 
Oh sorry, no the vet still wants him on 3 units if possible. She said we should run this curve to see what’s up so we know what to do next and that it wouldn’t be as accurate if they did it since he would be stressed at the vet. I would rather do it myself for sure anyway.
More asap
-d.
 
54 on +4 is low. You want to make sure he doesn't go below 40. I would test again now. You have at least 2 hours until nadir.

If he is in the 40's, put the karo on some food to see if he will eat it. Or you can rub some on his gums (if he will let you.)
 
Is the 66 with any intervention (syrup or high carb food) or just on his own? If on his own, you are probably in good shape. If you used syrup or food, you will want to keep testing.
 
After the 54 reading the vet told us to feed him a little of the wet food (science diet m/d), wait and hour (since he wasn’t showing symptoms) then retest.
We did all of that and the retest was 66 at 1pm.

(+6 for him would be right now, 1:30 pm)

So we will test again.

Thanks again for all your knowledge. It is so appreciated. I had hoped this might go “smoothly” today.

-donna
 
3 units is a lot of insulin.

Are you supposed to shoot 3 units no matter what?

What if your PS was 276, that's only 54 points lower than todays PS of 330 and your +4 is 54, where would that leave your nadir then?
 
Orig the vet told us we have a no shoot number of 70. Us and everyone here thought that was too low. Yesterday vet said for us to run a curve today to get more info.
She still insisted looking at our numbers from all last week that she wants him on 3 units 2x daily.

We were in the middle of that when we got the low number (54) so we called her right away and I posted here right away.

Yesterday she said she’d prefer if we reduced dose than do a no shoot when possible because when we have skipped before he goes back up to 400ish before the next meal.

It’s all so confusing. I am thinking wouldn’t it be better to try him on 2 units for awhile and see what that does? I’m no expert tho, just a worried mom.

Asher seems fine. He just took another bath and is snoozing before we wake him to stick him again :(

-d.
 
Curves are all about getting information. It looks like you are okay and headed back up, but I would get another number in 20 minutes or so, anyway.

It would really help if you would get your numbers into your spreadsheet. We can respond more accurately if we can see what has been happening.
 
will test again and post...i’m a bit maxxed, will try to get numbers up later today when we get thru this...sorry...thanks for all help..
-donna
 
If you want an example of what reducing a dose can do, feel free to use my spreadsheet as an example for your vet. Of course every cat is different, but I'm not the only one here who's had great success with a reduced dose. 3 units is wicked high in my opinion. The bounces you can get from that kind of dose can screw up the other numbers. And I know how confusing this can all be. In all honesty, this got a lot less confusing for me when I started tuning out my vet and listening to the advice I got here.

I can't wait to see what my vet says when Sam goes in for his check up in the next week or so. lol
 
I'm glad that Asher is coming up.

I wouldn't shoot 3 units in a BG less that the 330 you got today or you could be in trouble.

I'll agree that a reduced dose on a lower PS is preferable to a no shoot night which will send him higher for the next PS but without a spreadsheed and some data we just want to help you keep Asher safe. It's better to be high for a day than too low for a moment.

That is why we tell the newly dx to have a no shoot # of 200 so you will have time to test and collect data on Asher. Once you have a clearer picture of his bg's you can lower your no shoot # to 150 and so on. You will get a feel for it as you go along.

There is a steep learning curve to all of this but you have already mastered the hardest part and that is the testing. Way to go.

You're doing great and you are not alone in this.
 
I finally got the spreadsheet up so feel free to have a look. Asher is doing fine now. I gave him food after the first low reading and again after the last reading. Vet said not to but he was hungry and still low so I used my judgement and gave him some food. He is sitting next to me here purring/snoozing.

We are due to test BG again twice before meal time tonight and the vet said she would suggest a dosage for tonight after we call with those numbers, not that I feel that confident to go by it now, but it is a different vet since mine is not in on Tuesdays.

So any suggestions you guys might have is much appreciated.

My vibe too, is that 3 units is too high a dose. I know he was 650 at diagnosis and weighed 17 lbs. but still.

How would it be if we bumped him back to 2u twice a day and see how that goes?

I know we've made a few mistakes or had a no shoot along the way but it seems like his numbers are up and down a lot.
and maybe that is normal for a cat who has only been diagnosed a week ago.

Just confused and trying to do the right thing.

Thanks tons,
-Donna
 
Donna

A couple of things that I'd suggest

1. understand that your vet and this board are likely going to differ on a few things. We are not vets BUT this board has a collective case history that is HUGE and we've learned through experience

2. 3 units is too much to start; what if he really needs only 1 unit? Then you will have missed the dose and be messing around with rebound/overdosing etc and not know what to do

3. I suggested 200 as your cutoff for a reason; you do not have data and you do not know what is safe to shoot. If you are overdosing, his body will protect itself for awhile...and then not

4. Please pick a dose and stick with it. Unless you get a lower than usual preshot, at which point you skip, wait or reduce. Personally? I'd suggest going to 1.5 for a few days and see how things settle.

Going from the 300s to 54 in 4 hours is not a good thing. Plus most cats don't see a nadir on PZI until later than 4 hours so theoretically he could go even lower which is hypo territory.

Jen
 
Good job getting the spreadsheet up - it helps so much to see your numbers all together like that.

You will get differing opinions. The truth is none of us knows exactly what you should do; we can give you our best guess. Then you test and gather the data and everyone will have a clearer picture. My gut says go down by just 1/2 unit to 2.5 or down to 2. You can also consider starting over at one as Jen suggests. Either way, you will have to get those mid cycle numbers in so you can be sure he is not going too low, or staying flat and high.

I am concerned that your vet suggests shooting at some very low numbers. We tend to be more conservative. We avoid a hypo at all costs.
 
Just tested the last time we will test today. The BG was 184. As I promised i would do, I called the vet with the number and said I won't give a full dose tonight, and asked what she thought we should give. She is supposed to call me back. I'll pose the question to you nice folks too...
Thanks,
-d.
 
I still haven't learned all the lingo yet so I have to go look that up but I think by pmps you mean the bg level I get before I feed him tonight...so yes, 184 was the bg when I just tested him. And the vet hasn't called back. The second time they ignored me today.

I will be feeding shortly I hope.

-donna
 
Pmps is the number 12 hours after your morning shot. I would not shoot at 186. I would wait 30 minutes to see if it gets nearer 200. When you have been doing this awhile and have a spreadsheet full of numbers and patterns, you might consider shooting a reduced dose at 186. But for tonight, I'd wait.
 
Sounds like you are doing a great job, and it's so important that you are testing! The lingo seems like a lot, but you will pick it up fast. AMPS and PMPS are morning and evening PreShot. Ideally they are 12 hours apart, but when life intervenes the PreSHot should be within about 15 or 20 minutes of giving insulin, because otherwise you don't know what kind of BG (blood glucose level) you are shooting into. So we say what the PS number is, and then we post the following testing results indicating how many hours after giving insulin (+1 is 1 hour after shot, +2 is 2 hours after shot, etc).

DO ask about anything that is not clear. I remember it took me the longest time to figure out that DH meant dear husband! :lol:
 
Thanks for your suggestions. Amazingly the vet called me back and said I should give the prescribed dose of 3 units!!
I was freaking dumbfounded. Obviously that ain't gonna happen. I protested but the vet tech who called was just the messenger.

The cat is not pesting for his dinner yet since he had more treats today, so I am gonna hold off a bit, retest even tho I hate to prick him again, then do a reduced dose I guess. I hate to not shoot and have him roller coaster yet again and be high tomorrow morning.

I am mad and frustrated but I feel I have to not piss this vet off too much because if I need emergency help, the next nearest vet is a half hour or more away. I live in podunkville.

Am I doing the right thing?

-donna
 
You are absolutely doing the right thing! Shooting 3u at 186 is paramount to playing Russian roulette with your cat's life, IMO. If you can, wait a while longer then retest and post your number. Hang in there. You are NOT alone in this. No one wants you to succeed in this more than the folks here on this board. (And Asher.) :-D
 
It is hard when you get advice from your vet you don't agree with, or that conflicts with advice from this board. And you do need a vet for emergencies. But you don't have to take her advice on dosage. You can get that here, and then in a month or so, go in with your spreadsheet and show her how he is doing. The hard truth is, if a vet hasn't had many diabetics in their practice, they are not going to be up to date, and not necessarily going to be able to give you dosing advice. They tend to say to shoot a dose and come back later. My vet started us on 4 units and left town for Christmas break. We came here and never looked back. But we still use our vet and like her - I just don't think she is an expert in feline diabetes.

So what is your number and what are you thinking? I would not skip - you are right, that will get you back on the roller coaster again. And 3 units is dangerous advice.
 
I agree that 3u's into that low number makes me nervous. You Should be so proud of yourself! It is really difficult working with a vet who isn't very up-to-date with feline diabetes. It can be a constant struggle. Mine is pretty bad, but I don't use her for any dosing advice. I've done my own research and I've found the folks on this board to be invaluable. I change his dose myself. I'm still trying to find his ideal dose, but at least I know I'm comfortable with my way of doing things, and I'm sure that I haven't overshot his ideal dose. My vet started Charlie at 2u's, but after doing lots of research I dropped him back to 1 on my own. Lots of kitties need doses under or around 1u (unfortunately, Charlie isn't one of those!). I always err on the side of caution. I've seen the phrase "better too high for a day than too low for a minute" many times, and I could not agree more!!!
 
Just tested asher's bg and it is now 291. I am gonna feed him now. Tom and I are thinking maybe a dose of 1.5 or 2 units?
I am leaning more towards the 1.5.
Any thoughts?
-Donna
 
I'd shoot the 1.5 - my thinking when it comes to the evening shot is less is more. I'd much rather risk a higher dose of insulin when I'm awake to monitor him. If I'm going to be asleep, I don't want to have to worry, you know? Just the possibility of hypo and I'll be up every hour checking on him.
 
I think 1.5 is fine. Then you will be able to relax tonight. I think it is easier if you consider this time data gathering, not a time to find the perfect dose. You are experimenting, seeing what various doses do with various numbers.
 
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