911. After 4 cycles down to 3.5/63 +10 hours.

Leroy was started on ProZinc on Friday. I have a human meter I've been testing him with it reads in mmol. His initial reading before a can of food was 19.4.

Yesterday (Saturday) before meal was 19.8.
+ 2 hours 16.5
+ 10 hours 20.4
I was unable to get a reading at 12 hour mark as he was getting fed up with all the poking.

Today he was 16 mmol before meal
+4 hrs. 10.7
+ 10 hrs . 3.5

The vet prescribed 3 units every 12 hours.. and didn't tell me to test. I've been told by a few on here the 3 units is very high to start off with. He has also had a diet change to wet food only.

I'm not sure if he should be given his next dosage since his BG is so low right now. Please help.

 

That 3 units is way too high as a starting dose! Please test at shot time, and if it is less than 11, do not give a shot. If it is over 11, please do not give more than 1 unit. 1 unit is the appropriate starting dose.

 

Thank you! I will test again at 12 hours and let you know the outcome.

 

By the way, it is so good that you are testing. Most likely, your cat would have become hypoglycemic this evening, and it could have been very dangerous for him and very scary for you.

The testing will get easier. It is really important that you always test before giving a shot to make sure it is safe to give the planned dose. When you are first starting, to be safe, it is recommended that you skip the shot if the result is under 11. It is normally recommended that you stall for 20 mins without feeding then test again to see if the glucose has risen enough to proceed with the shot. You can stall without feeding an additional time if needed. At that point, if he is still too low, do not give the shot. As you gather more testing data, you will get more familiar with how Leroy responds to the insulin, and you will be able to give shots on lower numbers... you can always get help here as you go along, too. Testing during the cycle is how you know the impact of the insulin. With ProZinc, it normally peaks somewhere between +4 and +8. When Mia was on it, it was usually at +6. You can gradually gather testing data at various times during the cycle to help you determine when Leroy's lowest point usually is.

 

We are now at the 12 hour mark and it has only gone up to 5.8. I will skip this dose and test again in the morning. You mentioned 1 unit but he seemed to be doing well with 3 units. Should I stick with 1 or try 1.5? I've noticed a huge improvement over the past couple of days. He doesn't seem as thirsty and has stopped peeing on the floor.

I'm so glad I decided to test him even though the Vet said it wasn't necessary. It has definately saved me and Leroy a trip to the emergency animal hospital.

Thank You!

 

I have another question.
Do I wait the full 12 hours before giving him another shot or give the shot if it shoots back up before then?

 

I would definitely go with 1 unit. After you have been on 1 unit a couple of days, if he needs more insulin, you can increase the dose. It is best to increase in increments of .25 units; otherwise, it is easy to go past the appropriate dose.

Wait until the next scheduled shot time unless you are wanting to change your shot time. This would give you an opportunity to do that. Whenever you give the next shot, that will then become your new shot time - every 12 hours from then.

 

Did you try stalling without feeding then test again?

 

It would be very helpful (to you and us) if you could set up one of the spreadsheets we all use to track test results and doses given.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

 

I've downloaded the spreadsheet but haven't had time to fill it out yet. I've been tracking everything in a notebook. I have tomorrow off work. Hopefully I can figure it out then.

 

He was already eating by the time I saw your message about stalling.

 

That's okay. He will probably be a bit high in the morning from the missed shot, but do not let that worry you. It is better to be safe than sorry!

 

So glad FBM was here to help you out! Sorry the rest of us weren't around...been a busy few days. But you were definitely in good hands!

 

How is Leroy this morning?

 

I tested him before his meal this morning and he was at 18.2. I gave him 1 unit of ProZinc as suggested and will test several times throughout the day.
Thank you again for all the help.

 

That is really not 'horrible' considering he did not have a shot last night! I see you figured out the spreadsheet.

You are welcome!

 

+2 hrs
BG has gone up to 19.4. I'm hoping I didn't give him a fur shot.

 

Hi Lorie. Could it be that he just ate, and so the number going up is due to a food spike? Our kitty usually goes up at +2 but then starts coming down by +4.

 

Onset may occur later than +2 - in other words, the insulin may not have even started to do anything yet. It is not uncommon for the BG to rise some before it starts to drop. If Leroy has eaten that could raise his BG a little. Also, that number is not that different from the AMPS. If you take into consideration the meter variance, he has pretty much stayed the same.

Are you planning to do a curve today (testing every 2 hours)?

 

Yes, I'm trying to do a curve today. Leroy is being very patient with me. lol.
His BG hasn't dropped significantly, but it is lower +4 18.1 mmol.

I've been having an issue with getting enough blood to test. It seems to take 10 or more jabs before I get enough to test. I've been using the lancing device that came with the meter on it's deepest setting. I have tried with just the pin but it usually goes right through and bleeds way too much.

I think I've watched almost all the videos on testing. His poor ears are so RED. I'm worried when I take him back to the Vets she will yell at me for testing so much.

 

It is possible that Leroy went pretty low yesterday. You got the 63 at AM +10, but odds are that he was already rising by that late in the cycle. Even if he did not go any lower than that, it was lower than his body is used to. So, it is possible that this has triggered a 'bounce'. When that occurs, their BG goes pretty high then can stay fairly flat for awhile. Sometimes, it takes a couple/few cycles for a bounce to fully clear. You have to just wait it out.. let it work itself out. Once it clears you will be able to see the true impact of the 1unit dose. (So, don't be tempted to crank up the dose prematurely. It is usually a good idea to hold a dose 3 or 4 cycles before determining whether to change it.)

Are you warming up the ear before you poke? It really helps. Some people put rice in a sock and microwave it and use that. I wet the corner of a washcloth/rag with hot water, wring out the excess, and hold that to Mia's ear for a few seconds. Then, after I get the blood drop, I use it to apply light pressure and clean up the area. I do not use the lancet device. I free-hand it. I suggest trying that again. It removes another item you have to juggle, and those are usually bulky and make a click that can startle the cat. If you happen to go all the way through, it is okay. Maybe use a lighter hand if you keep doing that repeatedly. Be sure you are poking between the edge of the ear and the vein - not directly on the vein. It just takes a quick little poke right at the edge of the ear. You can put something on his ear afterwords to sooth it. Plain Vaseline would work.

 

By the way.. if you are testing at home, why do you have to take him back to the vet??

 

I tested again but missed +6. He was 13.9 +7 so at least I know that I got the shot into him this morning. I freehanded it and got it on the first jab. Not in the vein.. but close to the edge. It gave a good size drop and he didn't flinch. Easy Peasy. It can only get easier right?

The vet wants me to bring him back in a few weeks because she wants a follow up to see how he is adjusting to the ProZinc. She said it may have to be adjusted at that time. I'm glad I'm a little OCD and tested him myself otherwise things would have went horribly wrong. The other reason she wants to see him is because when they took his blood and Urine initially, the urine was spilled and they need a new sample. I will bring Leroys spreadsheet with me. And I will continue with the 1 unit for a few days to see how he reacts.

 

I'm very glad you dropped his dose to 1 u. This user's guide for ProZinc has a lot of great info in it:
http://www.felinediabetes.com/FDMB/...prozinc-pzi-insulin-for-diabetic-cats.164995/

 

I've read the users guide a few times and definitely learned a lot. I've also had more success with the testing. Using a sock with rice and Vaseline sure does make a difference. Should I continue with the 1 unit or wait a bit longer before I increase it? I'm not sure what the optimal numbers I'm looking for should be.

 

Continue the 1u another few cycles. Increase to 1.25 u if you don’t see blue. You’ll have to eyeball that dose and it’s easier if your syringes have half unit marks.