New Member - 2/22

Hi - I have been doing a lot of reading on the forum trying to get a basic understanding of what I have taken on. Sammy is 12 years old and was diagnosed with diabetes on 2/11. He is on ProZinc (1 unit twice daily) and I administered his first shot that evening. We went cold turkey from dry SD Urinary food to canned. The first three or four days were hard but I managed to get him to eat probably 50% of what the vet was wanting him to consume in a day. About day 5 his appetite improved dramatically and we are now pretty much past any trouble getting him to eat. Mainly feeding him twice a day, but as our schedule allows we feed him other times as well. At diagnosis, Sammy weighed 10.3 pounds which was down significantly from his 14 pounds in the summer. I can’t attribute all of the weight loss to diabetes as there were other changes to his lifestyle which could have played a part over the past six months. I just got a test kit (AlphaTrak 2) and have spent the day doing a curve. I haven’t started a spreadsheet yet but will try to do so tomorrow. I know that the curve test info will be better responded to in the proper forum but as these are the first glucose tests I have given I will include them here. We are on a late schedule so I haven’t completed an entire cycle yet but the “curve” is definitely off from what it should be.

Before shot - 217
+2 - 64
+4 - 70
+6 - 155
+8 - 242

I see much knowledge and many helpful people here. Thank you to everyone involved for the tremendous resource.

 

Hi

That's a very steep drop already at + 2. A too early nadir which should normally be between +5 - +7.

You've done a fine home testing bg curve job there. Congrats!

 

Hi Robbin and Sammy and welcome to the forum.
Great you are testing the BG levels and have swapped over to canned food.
Is the canned food low carb?
Here is a link to low carb food. Choose 10%or under, most of us feed around 5% carbs
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

As you are using the Alphatrak meter, Sammy has earned a reduction in dose down to to 0 75 units. Please make sure you take the reduction as Sammy is dropping too low. Anything under 68 on the Alphatrak needs some high carb food to bring the numbers up.


Here is another link to information
http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Feeding two or three smaller snacks during the cycles is best as well as a meal before the shots. A timed autofeeder is a great asset to have.
Always test before every shot and try and get at least one test in during the cycles.
A before bed test every night is recommended to see that Sammy is going to be safe. If the BG is lower than the preshot, set the alarm and test a couple of hours later.
Ask lots of questions
Have you read the Prozinc info. Please read carefully and ask questions if you don't understand.
http://www.felinediabetes.com/FDMB/...-the-prozinc-basics-please-start-here.164995/

http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.165103/

 

I’ve been feeding Royal Canin Glycobalance one meal a day since he started eating it. He wouldn’t even taste the first can I opened for him the day of diagnosis but likes it now. I have been feeding him Fancy Feast Fish and Shrimp Flaked and also Rachael Ray Nutrish. Looks like the Nutrish needs to be replaced with something else as the carbs are higher than I thought they were. I purposely withheld snacks today as I wanted this first curve to more accurately reflect the effects of the ProZinc. I think I have read all of the links posted but will go back and doublecheck. Last test was quite high.

+10 - 383

 

Even if the Preshot is high (he might be bouncing) you need to take the reduction in dose.
There is no need to withhold food on curve day (just withhold the food 2 hours before the Preshot BG so it isn’t food influenced.

 

Hi Robbin and Sammy boy and welcome to the correct forum for posting. (I redirected her here from the Prozinc ISG - Insulin Support Group)

Did you take the dose reduction that Bron suggested? It's very important to Sammy that you do that.

 

I agree with Bron and Deb about the dose reduction. The thing is, dosing is based on the low mid-cycle BGLs, not the pre-shot numbers. Based on the BGL readings in your first post, it looks like Sammy is having some bounce. He's dropping over 50% and into the green from pre-shot BGL to lowest BGL. That signals a dose reduction.

A simplified explanation of bounce: A cat's body gets used to those high sugar levels. When the levels drop, even into a good range, the cat's body can overcompensate. "The sugar is crashing!" the liver shouts. "Release all the sugar!" Then the liver and pancreas release stored sugar, pumping up the BGL. But if you dose based on those pumped up levels by keeping the dose the same or even raising it, you run the risk of the mid-cycle readings dropping too low, which can lead to a dangerous hypo event. Dose based on the mid-cycle, and the bounce should clear in a few days.

 

I reduced the dosage a little. The syringes I have are U40 and only marked in whole units so I can’t be very accurate. What is recommended for this - U100 with half unit markings? Thanks for the explanation.

 

They have U-40 syringes with half unit markings, you can get them from ADW Diabetes on their website

 

Some pictures for you. These pictures show U100 syringes with 1/2 unit markings, but the concept is the same if using U40 syringes.
Pictorial guide using a U-100 syringe marked with half units:




You are looking for plunger placement when you are measuring those doses in between the lines. Unfortunately, insulin syringes are not made with 0.25U (1/4 U increment) marks on the syringe barrel.
Make sure you are getting all the air bubbles out of the syringe with the "finger flick" technique.

Yes, U40 insulins can be used with U100 insulin syringes. We have a conversion chart.
You'd still want to get syringes with 1/2 unit markings on the barrel.

More info in this sticky on fine dosing. It was written with Lantus in mind, but again the concepts cross over for the different insulins.
Sticky Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing

 

Fine dose gradations:

• 0.5U = exactly half a unit
• 0.4U = skinny 0.5 touching the line
• 0.3U = skinny 0.5 with daylight under the line
• 0.2U = fat zero with daylight over the line
• 0.1U = fat zero barely touching the line

 

Thanks - it seems like I can be more accurate with the U-100 with 1/2 unit markings. I don’t have a problem doing conversions. I’m guessing that I want a 3/10 cc syringe. What is the best needle length?

Hope not to confuse with all of the questions, but I just tested him at 181 for preshot. I know that is a little low. I can wait another 30 minutes or so and still be in my 1 hour window.

 

Getting an SS (spreadsheet) up and running would really help us help you better.

Directions for doing that are here.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

While you do that, I'll work on gathering more information for you.

 

Some info in your signature would be really helpful too.
Takes about 60 seconds.

Complete your profile. This is where you can put your location if you wish. Please do not put in personal information such as work schedules as it is a security risk.

Make sure your signature is up-to-date.

• On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
  • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
  • Add any other text, such as
  • Caregiver & kitty's name (optional)
  • Name of insulin
  • DX: date
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

 

Yes, 3/10 cc volume syringe, U100, 1/2 unit markings on the syringe barrel. Needle length is a personal choice.
BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings.

Conversion chart for using U100 insulin syringes with a U40 insulin are here.
http://www.felinediabetes.com/insulin-conversions.htm

Basically, you can measure insulin doses as small as 0.2 unit increments if you are using U100 syringes with Prozinc. The conversion from U40 to U100 is multiplying by 2.5.

You record the amount of U40 insulin on the standardized, color coded spreadsheet. Not the amount of insulin measured in the U100 insulin syringe. Takes a bit of getting used to, that bit of "mental gymnastics."

 

Thanks for your help. I got the signature done and will try to get his spreadsheet going later this evening.

 

Excellent on the Signature! Thank you.

The spreadsheet setup instructions are very detailed. Directions include doing the setup from a pc, tablet, or smartphone. It's a standardized, color coded format, with a template that you copy. No need to "reinvent the wheel".

Since you are using the Alphatrak to test (pet meter) select the appropriate template for the pet meter.

 

Forgot to respond on the BG pre-test. 181

Did you happen to stall, no food fed, and retest in 20 Minutes?
You can stall for up to 1 hour with Prozinc, and still keep to your regular schedule for the next 12 hour dosing cycle.

For new members, using Prozinc, we suggest you do not give insulin if the Pre-shot test is <200. Since you are using a pet meter, you may want to keep that a bit higher at first. 225 or so.

As you gather more data, that pre-shot "threshold" BG can be lowered. Right now, I only know of the one BG test, for this test cycle. That 181 so not much to base a dose on.

Did you go ahead and feed and shoot already. Or are you still waiting?

What is the dose of insulin right now? The 0.75U dose that Bron suggested? or as close to that as you can 'guesstimate' with your current syringes?

 

I decided to shoot 1/2 unit and will test around +3, monitoring him through the afternoon. Normal dose has been 1 unit and reduced it to .75 last night.

 

OK.

 

Hi Robbin, I simply wanted to make you aware of this.

All the "Sticky" or pinned posts in the Prozinc forum have been updated and there are a couple of new ones.

Highly recommend that everyone using Prozinc or helping those using Prozinc read them thoroughly.

I'll be doing that myself. Been expecting this for some time. Came about a week before I thought it would.
Thanks Marje, and Robert, and especially Djamila for the Modified Prozinc Method. You folks are FANTASTIC!

 

Thanks for letting me know about the sticky update. I reread all of them.

Sammy’s spreadsheet is now online and in my signature. I’m still waiting on delivery of the u-100 syringes. I think I may have them on Saturday. Based on his recent BG tests I am planning on going back up to a skinny 1U with the am shot tomorrow. I will be around to test a few times through the afternoon.