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Discussion in 'Feline Health - (Welcome & Main Forum)' started by Lynn & Rupert, Jul 15, 2015.

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  1. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Hello again,

    I am so grateful for this forum, I have so many questions and my vet treats diabetes the old school way. I want to try Elizabeth Hodgkins's method, with hopes of remission for Rupert. My vet let me talk him into prescribing ProZinc insulin, which I could only find online. I was wondering if Dr. Hodgkins's method works if you don't have the PZI bovine insulin? I did find it online in Texas, but not sure my vet will prescribe it and worried about switching insulin yet. I just started Rupert on Prozinc Tuesday, 2 shots twice a day, his BG on Monday was 488, taken at the vets office. I had already started him on wet food only, 2 days before this visit. I am doing ok with the shots, still makes me a little nervous, but haven't done a BG test yet. I bought a monitor and supplies, but too scared to do it yet. :nailbiting: Has anyone else had success with Dr. Hodgkins's method using Prozinc vs PZI bovine insulin? Thank you for any and all help!
     
  2. Cat Ma

    Cat Ma Well-Known Member

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    May 21, 2015
    Hello and welcome to FDMB!

    I am not familiar with ProZinc vs PZI insulins nor Dr. Hodgkin's methods but I can tell you that BG readings at the vet are usually higher especially with a stressed out cat. I freaked out in the beginning about doing BG tests at home but once I read tips in the FDMB forums and viewed videos, it was much easier than I thought. Poking doesn't hurt the cat. A helpful tip is to warm up your cat's ear before poking. I use a damp small washcloth, microwave it briefly, place it in a ziploc bag, test it on my arm to make sure it's not hot, and then place it gently on CJ's ear. A very tiny amount of ointment such as neosporin, polysporin or vaseline, applied with a q-tip, is helpful in getting the blood to bead up.

    You're already on the right track by switching to wet foods. Be sure to stick to carbs under 10%. I gave you a link for the food chart in your other post. The link is also in my signature line below.
     
    Last edited: Jul 15, 2015
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  3. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    I don't know that you will find ll any advocates for Dr. Hodgkin's Tr protocol on this forum. There is another forum that does use it.

    We tend to believe that every cat is different when on ProZinc and so don't subscribe to a standard formula for every cat. And I have seen too many cats hypo while on wet low carb to believe that it is not a possibility. The protocol we put together for ProZinc is in my signature.
     
  4. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    What troubles are you having with testing? Can we help?
     
  5. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    Thank you for your help! Is it possible to have a cat go into remission with the ProZinc protocol?
     
  6. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Absolutely, although of course, our motto is "every cat is different". You might want to go over to the PZI forum and check out some of the recent threads to see how people are doing. Also look at the Remission thread at the top of the page to see how people got their cats into remssion.
     
  7. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Thank you so much for caring and helping! I haven't even tried it yet, very nervous about it, not sure my cat will cooperate and worry I will hurt him. I have watched videos on the procedure, but I am scared! I am doing pretty well with the shots, still nervous a bit, but handling it. Rupert is getting more suspicious though, so even with a special freeze dried meat only treat, it might prove to be more difficult as he starts to feel better. It's only been two days since I started treatment, so still nervous about everything! I have read tons, which sometimes is confusing due to different opinions. Do you adjust your insulin shots according to the BG test levels? My vet was against me testing more than twice a day. He prescribed 1 ml twice a day of ProZinc. I am afraid I am going to do this all wrong and hurt my poor Rupert more! :(
     
  8. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Thanks again, I am tearing up here, I am in this by myself, so this forum is my lifeline right now! I am very grateful for your kindness!
     
  9. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    Thank you again, I am going to put my big girl pants on and test later. Wish me luck!
     
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  10. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    I have read many great tips here and online, but still scared. I just have to do it and hopefully it will get easier. I thought I would try the rice in a sock heated in the mic to warm the ear up, figure that way I wouldn't poke myself either. Thank you for the link on the food, I was only looking at ingredients, not total carbs. Confused about the Friskies pate though, most have rice in them. I will stay away from the Mixed Grill.
     
  11. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    You are doing fine! Just the fact that you are doing some research, are changing the diet and looking into hometesting puts you way ahead of lots of people. Some hear the diagnosis, throw up their hands and put their cats to sleep. Pro
    Zinc is a good insulin and your vet started with a nice low dose. Yes, we think a before shot test is always important, to be sure the number is high enough for the dose you have planned. The other test we use is a mid cycle or nadir test, 5-7 hours after the shot, to see how low the insulin takes him. Then we have an idea of how the dose worked.

    You might start slow with Rupert. Decide where you want to test. Some people have a towel near a sunny window, some people put the cat on the counter, some just put him between their legs. Take Rupert there, give him pats and praises and a loved treat and let him go. The next time, mess with his ears a little bit, praise, treat and go. After he is okay with that, heat his ear. (We liked a rice sack. We filled a thinish sock with raw rice, knotted it and warmed it in your microwave. Hold it up next to his ear, praise, treat and go. Hopefully by the time you are ready to poke him, he'll be comfortable in the spot and eager for his treat.

    For you, I'd suggest looking at Rupert's ear with a flashlight. There's a vein running down the edge of his ear with capillaries running off it to the very edge. It's the capillaries you are aiming for. The heat helps them "plump up". And also, use the meter on yourself (or a willing accomplice) so you are comfortable with the lancet and how the meter works before you try it on Rupert.
     
    Last edited: Jul 15, 2015
  12. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    We all have tricks to help. One of mine is that some cats do better with a 25-27 gauge lancet at first, to make a big enough hole. Most meters come with 30/31 gauge.

    And it doesn't always work the first time. We poked Oliver for a whole weekend before we ever got a drop. It takes practice and after three times, treats and rest for human and kitty.
     
  13. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Thanks for the great advice, I will start with getting him used to me messing with his ears, I have read most of the tips, been up very late on the internet lately! What you suggested about getting him used to me messing with his ears is a great tip, I am going to start now! I haven't found a willing accomplice yet to let me poke them and too much of a weinie to try it on myself yet! lol
     
  14. Cat Ma

    Cat Ma Well-Known Member

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    May 21, 2015
    As Sue and Oliver said, you're ahead of the game and are doing an excellent job.
    You are doing an excellent job! You are ahead of where I was when I was starting out here!

    I was concerned about the rice at first, too. But many people here feed Friskies and their cats do well. CJ gets Friskies Special Diet (being discontinued and hard to find now) and is still in remission so I am not worried about the rice. Another good low carb choice is Wellness Grain Free (marked with a yellow triangle in the upper right hand side of the can).

    Let us know how the home testing goes. It does take practice but it really does get easier! I never thought CJ would be like the relaxed, happy kitties in the videos but she is now. She actually sits on command and waits to be poked! Most give their cats treats afterwards. CJ doesn't get any. She just gets a lot of extra love and attention. You'll find what works best for you and Rupert.
     
    Last edited: Jul 15, 2015
  15. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    See my signature link Glucometer Notes for feline-specific reference ranges for meter reading differently - mg/dL, mmol/L, and AlphaTrak mg/dL. Also see the link Secondary Monitoring Tools, as your cat is more than a glucose number.
    Here is a picture of the sweet spot:

    ear veins.jpg
     
  16. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    I did it! It took a lot of wasted test strips and lances, but I finally had success! I had no luck with his ear, got a little bit of blood, not enough to test and he did not like me messing with his ears (never has), so I tried the foot pad, which seems to be less used, but it worked for me and Rupert didn't seem to mind much. I wiped his foot with alcohol afterwards. I am going to buy the 26 gauge lances, maybe that will help with the blood bead. I haven't given up on the ear testing yet! I had a reading of 287, which I know is high, but he just started injections on Tuesday. His reading was 488 at the vets on Monday. I logged his numbers in a notebook and will try another reading before his last shot tonight. I think I understand that you don't want to adjust the insulin till they have been on it for a week, he gets l ml twice a day of ProZinc. Am I on the right track?
     
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  17. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    I hit the sweet spot (I think), but didn't get enough blood for a reading, will keep trying. A 26 thin lance might work better for me, I have the ultra thin ones now. Thanks again!
     
  18. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    Fantastic! Welcome to the Vampire club!

    Yes, I'd just start gathering data. We suggest not shooting insulin under 200 until you have more numbers
     
    Last edited: Jul 15, 2015
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  19. Cat Ma

    Cat Ma Well-Known Member

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    Wow! Awesome job, CatX4! Poking either the paw or ear is fine. And yes, the values at the vet are usually higher, especially with a stressed cat. I still use the 26 gauge on CJ's ears so I get blood quickly. If you do poke Rupert's ear again, apply a very tiny amount of ointment such as neosporin, polysporin or vaseline with a q-tip. That will help the blood bead up more easily. But if you continue to have success poking his paw, go for it!
     
    Last edited: Jul 15, 2015
  20. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Lol @ Vampire Club! thanks for the laugh, haven't had many since Rupert was diagnosed! *retracting my fangs now* :joyful:
     
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  21. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Thanks, I was feeling guilty for using his paw! :nailbiting: I thought the vaseline/neosporin was for stopping the blood after the prick, so thanks for that info!
     
  22. Cat Ma

    Cat Ma Well-Known Member

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    May 21, 2015
    If poking the ear, best to use a tissue, cotton ball or a cosmetic pad to stop the blood after poking. I use the ointment to bead up the blood; again just a very tiny amount or it ruins the BG reading. Then I apply a tiny dab of neosporin or polysporin afterwards, if there's bleeding, to prevent an infection.

    Nope, the paw poke is great! Whatever works!
     
  23. BJM

    BJM Well-Known Member

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    You can make 2 quick pokes in about the same area to get a bit more blood.
     
  24. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    I was wondering if too much vaseline would affect the reading, so thanks for clearing that up! CJ sounds like a very sweet, good kitty, so glad she is doing so well!
     
  25. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    I did try that, got some blood, squeezed for more, but it smeared on the fur of the ear. *sigh* I will try, try again. I have not given up finding that "sweet spot"! :)
     
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  26. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    A huge thank you to Cat Ma, Sue and Oliver (GA) and BJM! You have all been so helpful today, I feel like maybe I can do this now! This tired vampire is off to her coffin for the night! :kiss:
     
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  27. Cat Ma

    Cat Ma Well-Known Member

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    Yes, you are correct. I get error messages on the meter when I use too much ointment. A very tiny amount is all that is needed.
     
    Last edited: Jul 16, 2015
  28. BJM

    BJM Well-Known Member

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    You can wipe it on, then wipe it off, which will leave a thin film on the fur and skin.
     
  29. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    ProZinc is human insulin compounded with protomine zinc (the PZ in PZI with the I being insulin). Protomine zinc extends the activity of the insulin.
    BCP PZI, compounded in Texas, use bovine insulin compounded with protomine zinc. Bovine insulin is closer to a cat's insulin than human insulin.
    When the bovine insulin is made/extracted from cow pancreas, the human insulin is made by the recombinant-dna process. See:
    https://www.nlm.nih.gov/exhibition/...A/recombinant-dna-technology-alternative.html
     
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  30. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    I am using it now, seems to bead up the blood better, thanks for another great tip!
     
  31. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    Thank you Larry for that info. I had to decide on an insulin at the vets, I mentioned the PZI bovine, which is what I wanted, but he acted like he never heard of it, so I requested ProZinc instead. I later found the place in Texas who sells the PZI. Wish I had known where to get it, before vet visit, I might have been able to convince him. Maybe I can switch to that, of course under the vet's advice and supervision.
     
  32. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    No problem. Other than the cost, they seem to work about the same. The protocol that we put together for ProZinc is in my signature.

    On your other thread, you mentioned starting at one unit. That's a nice safe starting dose. Start gathering some numbers, always before the shot (we suggest new diabetics not shoot under 200 in the beginning) and whenever possible 5-7 hours after the shot. That's when the insulin should take him to his lowest point(the nadir). It will help you see how the insulin is working.

    Can we help you set up a spreadsheet? It's a great color coded tool for you, your vet and us. We can see his history at a glance when you need dosing help. The directions are here:

    http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

    If you need help, just ask. It's a little tricky.
     
  33. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    Rupert was at 458 last night before his 1 unit shot, I tested him before shooting this morning and he was at 156 (his lowest number yet). After reading your protocol, I have not given him a shot yet. I am waiting 20 mins and retesting. I think I understand that newbies shouldn't shot if number is below 200 ?? He did eat a little, which raises his BG, but he didn't eat much. I administer his shot every 12 hours. I try to retest 6 hours after his shot, the nadir, but can't do a test after his last shot at night due to lateness and my work schedule. I have looked at the spreadsheet, it seems complicated, but I haven't studied it much. I am logging his shot times and test numbers in a notebook at least. Thanks for the link and the offer of help, I will probably need it! :bighug:
     
  34. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    May 9, 2015
    Catx4, I think I have your spreadsheet set up, if you will send my your email in a private message, so I can send it to you?
     
  35. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    No, we'd urge you not to shoot under 200 unless you have more data, to know what he might do. Stalling is good. If he doesn't rise until later, post again. There are some possibilities to try.

    It looks like one unit may be too much. Your goal is to have two shootable preshots daily.
     
  36. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Hi, I didn't give him a shot till 2:00 pm, his BG was 314, so gave him 1 unit and checked again at 5:50 (away from home till then or would have checked it earlier) and it was 255. His second shot of the day is scheduled for 11:00 pm, so would you give 1 unit, or less? I am sorry to be such a pest, but my vet was in surgery all day and I wasn't able to ask him any questions. Rupert's BG's so far are usually quite a bit above 200, the 156 BG was the lowest he tested at. I tested him at 10:30 pm last night and he was 458 and at 11:00 pm gave him his 1 unit shot. I am confused on the term preshot, is that just the regular shot or something else? I will keep reading more and hopefully get a handle on things! He was diagnosed last Friday and started injections on Tuesday, so this is all very new to me and poor Rupert. My vet is not exactly on board with me testing him at home. I skipped the test he wanted to conduct at his office, knew Rupert would be too stressed to give an accurate picture. He also wanted me to use Vetsulin , which I read was not a very good insulin. Thanks again for all your help and guidance!
     
  37. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    He was 458 and one unit took him down to 156 12 hours later. Is that right? And then you gave one unit 9 hours ago? I am trying to figure out how long it has been since the last shot and what numbers you have seen since.

    See why we need a spreadsheet. Rhonda set one up for you; be sure to respond to her.

    Pre shot is the test you take twice daily before the shot. We are all in different time zones. It is easier if you tell us time in terms of hours since the last shot. So 3 hours after a shot is +3.
     
  38. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Understanding the spreadsheet/grid:

    The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

    Each day is 1 row. Each column stores different data for the day.

    From left to right, you enter
    the Date in the first column
    the AMPS (morning pre-shot test) in the 2nd column
    the Units given (turquoise column)

    Then, there are 11 columns labeled +1 through +11
    If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
    If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
    and so on.

    Halfway across the page is the column for PMPS (evening pre-shot)
    To the right is another turquoise column for Units given at the evening shot.

    There is second set of columns labeled +1 through +11
    If you snag a before bed test at +3, you enter the test number in the +3 column.

    We separate day and night numbers like that because many cats go lower at night.

    It is merely a grid for storing the info; no math required.
     
  39. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    Yes, that is correct about the 458 and one unit took him down to 156 12 hours later. I gave him one unit 5 hrs ago and I tested him (preshot) him at 6:00 pm eastern and BG was 255. Only the one shot today so far. I did respond to Rhonda, but haven't looked at the spreadsheet yet. Been gone most of the day, work and shopping for supplies. Must say I am loving the new 26 gauge lancets I just bought! Also bought the U100 syringes and Pedialyte. Rupert and I do NOT like testing, but with new lancets, hoping it will get easier and we will test more often. :)
     
  40. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    If it is only 5 hours since his last shot, I would not give the shot now. His nadir ( lowest point) could still be 2 hours from now. You don't want to shoot a number that could be still falling, not rising because it would mean the insulin is still working
     
  41. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    Thank you BJM, tg no math required! I will refer to your post for guidance and know once I get the hang of things, it will be much easier. Just feeling overwhelmed about it all and worried I will do Rupert harm. I have read and read so much in the last week, my head is spinning. Everyone around me is telling me to give up and put him down, but I am trying with limited time and money. Then there is the guilt of thinking I caused this with a high carb dry food diet! I have 3 other rescue cats and they are all on wet, canned low carb food now, hopefully I will prevent this from happening to them. Thank you again for your help and patience.
     
  42. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    Ok, I will retest in 2 hours and go from there. So far I have only given him an injection twice a day at the scheduled 12 hrs intervals, always 1 unit. I have my new U100 syringes, so maybe can do better now. One pharmacy said they didn't sell them and the other would only sell me 10. Sheesh, guess they think I am on drugs or something! I will order them online next time. I just want to thank you, BJM, Sue and Oliver, Rhonda and everyone else who has been so kind to answer my questions. I am sort of a wreck today, too many late nights, too much worrying, too many tears, y'all have been my lifeline, so thank you from the bottom of my heart!
     
  43. Cat Ma

    Cat Ma Well-Known Member

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    May 21, 2015
    I think you can buy the syringes at places like Walmart but you may need a prescription. Poking with the 26 gauge will get blood to come out faster. I still use the 26 gauge even though I could probably use a higher #, thinner lancet. I don't worry about "mauling" CJ's ears or hurting her because I am not. The ears heal quickly and more capillaries form.

    Don't blame yourself about Rupert's diabetes. Wash away the guilt. You did nothing wrong. And don't listen to others who say to put Rupert down. You're still starting out but it is going to get easier. Trust me. Diabetes is very treatable and not the end of this world. It will get better. I felt the same exact way as you did. I wanted to give up. But once I found support here, I knew there was hope, there was a chance.

    That is a great idea about putting the rest of your cats on low carb diets!
     
  44. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    2 hours will still only be halfway through the cycle. That number will just give you an idea of how low one unit may be taking him. Some long time PZI users shoot as early as +10 but I wouldn't if I were you. Only people with lots of data try that. I think you may have to skip tonight. Then you could shoot at your scheduled time tomorrow morning because it would be more than 12 hours since the previous shot. He is likely to be high 17 hours since the previous shot, but it's much safer too high than too low, especially overnight. Does that make sense?

    U100 needles are great, especially for shooting smaller doses. But be sure to use the conversion chart as you are using U100 needles with U40 insulin

    It is overwhelming at first - really steep learning curve. You are doing great! Don't forget to breathe.
     
  45. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    I might have already given up if not for the support here, so again thanks to all of you for taking time to answer my questions and help calm my fears. *tearing up again*
     
  46. Cat Ma

    Cat Ma Well-Known Member

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    May 21, 2015
    There is always someone around 24/7 :) I cried myself when I was starting out and was so overwhelmed. I had no idea what I was doing. But it all falls into place. You're doing far better than you think you are.

    I just noticed you put up a photo of Rupert! He's a very handsome boy!
     
  47. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Jul 15, 2015
    Ok, will test several times tonight and not give a shot. That freaks me out a bit, but good to know too high is better than too low. I will work on getting my spreadsheet set up and breathe! I have looked at the conversion chart and will use it often till I get the hang of it. How wonderful so many good people have tried to make this easier!
     
  48. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Awww, thanks Cat Ma, he is a handsome dude for sure! Not sure what your orange tabby is called, but he/she is gorgeous! I always had a "thing" for orange tabbies! :cat:
     
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  49. BJM

    BJM Well-Known Member

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    Check out my signature link Secondary Monitoring Tools for some additional ways to evaluate how he is doing.
     
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  50. Cat Ma

    Cat Ma Well-Known Member

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    May 21, 2015
    She's called a troublemaker ;)! No, she's really sweet and loyal.
     
    Last edited: Jul 19, 2015
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  51. Lynn & Rupert

    Lynn & Rupert Well-Known Member

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    Will do!
     
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