Advice on a dosage please!!

Hello Everyone,
I finally took my cat Bibo to the vet this morning, and the vet put him on PZI 1 unit twice a day, his bg was 297 at the clinic, so the vet gave him his first unit of PZI. Six hours later I checked Bibo's bg and it was 130 (which I was so happy) having had 300s for the last 2 weeks. I will be checking his bg in the evening before I give MY FIRST shot, and I'm quite nervous. My question is if his bg is in the range of 150 and 250, should I still give him 1unit? Please help me figure this out because, I'm so new, and so afraid of getting my Bibo hypo. And BTW, thank you for suggesting me to ask the vet to give 1unit, because he wanted to start with 2units. Thank God we didn't do that, he's already 130. Thank you all so much!!

 

The usual advice is to not shoot unless the cat is over 200 when you are new to insulin and not sure how he will react. If he is close to 200, you can wait 30 minutes and test again to see if he is over 200. If you are really worried how he might react on your first night on insulin, you could give 1/2 unit if he is at 200 but not that far above.

The 130 is a nice nadir number, 6 hours after insulin. He may be high enough to shoot by the time you need to decide.

If I were you - and if he is hovering around 200: The thing is it won't be dangerous if he is high overnight for one night. But if he really is reacting to the insulin and he gets too much, you can't get it out after you shoot. A potential hypo situation is really complicated by your just learning how to hometest. Sometimes, this early in the sugar dance, it is better to be safe than sorry.

 

yes - 130 is a lovely number this early in the process.

you may be very lucky and have your kitty become "Diet Controlled" or go into remission after a few weeks of treatment with insulin to let his pancreas rest.

 

Thank you so much for replying to my post. I just tested him before giving him his evening dose, and it was 148, so I'm not giving him any insulin, but I fed him, and I'll be checking early morning. I am so amazed what 1 unit PZI could do to my cat! As you all know, his bg since I started testing him two and a half weeks ago, has been in the 300s and suddenly today with 1 unit, it dropped. I really hope, his pancreas will start working normally again, and I am so glad you all encouraged me to get rid of the Glipizide!!!! Sorry, that I'm posting several times a day, but this support system is allowing me understand and better help my little boy. Cheers.

 

you're using prozinc, right?
how bout reducing your dose to 0.75u and seeing how that works out? your goal initially is to be able to shoot twice a day, so it's better to find a dose that will allow you to do that, rather than risking higher numbers from a skipped shot.
next time you get a number you feel is too low to shoot, i suggest waiting 15 minutes and testing again to see if you now have a shootable number. keep doing that til you get a number you will shoot. otherwise, you could shoot a partial dose so your cat doesn't miss getting insulin. if you're shooting a number lower than expected, it helps to test again an hour or two later, then 3 to 4 hours after that, to see how your cat is doing.
really great first day on prozinc!

 

Good Morning Everyone,
Like I said on last night's post, Bibo's bg was 148, so I didn't give him an insulin, and Iwoke up at 5, and checked his bg and it was 458 and I was terrified that the numbers could jump so high, so I gave him 1.25u and I know it's low, but we're still so new and experimenting. Please help me understand why the bg would be low for 13 hours and then rises that high. I wanna test him again in few hours, and I realize I can't give him more insulin, before 6 hours intervals.

 

I have not used Prozinc, only PZI IDEXX, so I am only going to say not to panic on one high bg. It is all a learning curve right now and one high is better than one low. Do not increase insulin based on one test.........hometesting is going to be a major help to you. What I usually do when doing an increase or with any new diabetic I adopted through the years was test, at least an hour or two, before their normal test time. Say you had tested him about 2 hrs, before his shot time and you had gotten a 110. Then you tested and got a 148 at his normal test time. That would have told you that he has bottomed out and is on his way back up. You also could have given him half of a unit last night, something, to keep him from going high on you. Not sure what you mean about not giving him insulin before 6 hrs, interval?

Just ride today out with the dose you gave, do some spot checks, and see what he is tonight.

 

It is normal to get a high number after you skip a shot. (Not shooting at 148 was a good decision. But it makes today a new day.) His body went 12 hours without insulin. It would be very surprising if he wasn't high this morning. You cannot give more insulin until 12 hours after the shot - not 6. As Chris said, the goal is to find a dose that will maintain him in nice low numbers throughout the cycle.

So, you start again. Get some numbers today. Since you shot more insulin than yesterday, you will need to get more numbers - just in case he goes low. Keep track of the bg levels you get and come on for advice before the evening shot. If you get a number under 40 during the day, come on and ask for advice. Print this out: viewtopic.php?f=28&t=15887 It is info for a hypo. It isn't that likely, but he is very new to insulin and you just don't know how he will react. You want to be prepared.

You may want to go on the PZI forum and get some advice on how the insulin works: viewforum.php?f=24 That forum is not as busy as this one but they all use your insulin.

This is complicated and hard to understand at first. We are here to help you and you will be fine. It is a steep learning curve. I would urge you to read the FAQ's and other info on the site. Keep asking questions.

 

Hello again,
I'm having such a hard time testing Bibo, he's biting me, struggling so hard to get free, and I'm not being able to get enough blood, since he doesn't sit still. I am getting so frustrated, because I wanna know what's going on with his bg, especially that it was quite high this morning 458. I'm just gonna let him relax for few hours and perhaps try again. Giving the shot was so easy and I realize now that the testing is the hardest part. Please send Bibo your positive vibes, so he could let me test him!! Thanks again.

 

Hi Taline,

If you are really struggling but need to get bg levels (which you do) you can try the burrito. We put a towel on the couch next to the arm. Then sat Oliver on the towel and wrapped him up until only his head was showing. We could press him lightly against the arm and he couldn't get away. Another method mimics the way a mother cat holds her kittens by the nape of the neck: http://www.felinecrf.org/giving_sub-qs_ ... _peg_trick

Be sure to reward him with each test, successful or not, with a treat. For now, a break for both of you is fine. But I sure hope you can get the +6 number.

 

Re: Advice on a dosage please!! +3 57

Hi Taline,

Did you read my post over in PZI. You're +3 of 57 is a good non diabetic bg, it's good that you fed him, but you need to keep testing him every 20 minutes or so to make sure he doesn't go too much lower.

PZI usually nadirs anywhere from +4 to +7.

Do you have any Karo Syrup or Honey handy? just in case he does go too low? You would rub it on his gums, the sugar will bring up his bg.

Please keep us posted on how you two are doing.

Robin

 

Yes I read your post. e got up again and ate a little more, and I tried to test him again, he ran away under the bed. I'm gonna try to get him out of there and try as soon as he allows me. It's been 5.5 hours since I gave him the 1.25u. I have honey, so the minute I see his #s lower than 55 perhaps, I'll rub the honey on his gum. Do you think 55 is an alarming # to do so? Thanks a million.

 

Hi Taline,

55 is not an alarming number, I was concerned because it is early in his cycle and he could go lower.

Have you been able to test him yet? The burrito method might work or I've heard that if you put clothes pins on his scruff, shoulders, etc. like when their momma carried them around, they go kind of limp and it would be easier to test.

You're doing great.

 

I'm gonna do it Robin. I'm waiting for my sister to come any minute so we can handle him together. Thank you for being there for us.

 

I may have mis read your post. 55 is a normal non diabetic cat number. It is not a hypo #. but at +3 it is possible that he might go lower.

I just wanted you to be aware and to keep testing to see where he is at.

It's great that he is eating.

 

You are doing great, Taline. When your sister comes, you might have her wrap him up in a towel and you handle the poking. If he moves away after you get a droplet, put it on your fingernail. You can test it there.

You really are okay unless you see a number 40 or lower. Then you can try some higher carb food (with gravy) to get it up. The honey is sort of an emergency thing - if he continues to drop and food won't bring him up.

 

I just did the test +6.5 and the bg is 76. so fed him a little bit again so he doesn't hate me doing the test. He's yelling and crying so hard, I don't know why? Am I hurting him, I wonder? But anyway, I guess the # is good, I can relax a bit.

 

Glad you got a test. That is a nice number. I would just plan to get another test in about an hour or so, since he surfed yesterday - staying in the same range for several hours.

You can put Neosporin with pain reliever on his ear after testing. It really shouldn't hurt that much. Just may be that he doesn't like you doing stuff to him on your terms. Be real generous with the after treats.

He is responding very well to the PZI. You both are doing great!

 

Hi Sue,
When you say, he surfed yesterday, what do you mean with that term? I don't quite understand yet some of the new vocabulary used here, besides I'm a foreigner too, so I can miss some of the expressions perhaps. I hate to test him again in hour, because, he's hating me even with the treats I'm giving him, he's hussing me. I will do it as soon as I see the opportunity . And let me ask you this: Do I change the topic tomorrow in order for you guys to read and reply? or I can just go on on this page? Thanks again.

 

Surfing is when they stay at about the same number for several hours. He was in the 130's - 140's for 6 hours or so yesterday, right? I am thinking from about +6 to +12 (6 hours after insulin to 12 hours after insulin). Oliver on PZI went down for 6 hours, then started back up - usually arriving at about the same hour he had started with 12 hours earlier. It means Bibo is getting a long duration from the PZI and it may mean that you will need to get creative with your dose. The PZI forum folks can get you some good ideas.

I think you said you had a spreadsheet right? It would be great if you could attach it so people could see what happened yesterday and today when giving advice. This explains how to attach it to your signature: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=16

Here is an explanation of some of the crazy terms we use: http://www.felinediabetes.com/dictionar ... y-fdmb.htm

 

Sue, I did attach my spreadsheet, and I wonder if you're not being able to see it from your end? Please let me know, perhaps, I've done something wrong.

 

It could be that he is fussing so much because he dislikes being restrained (most cats do). After you have done a few tests and he gets the idea that they aren't something to run away from, you may be able to loosen up on the restraint. But getting tests is very important right now. He'll forgive you quickly for restraining him, particularly if you give him a treat each time you try to test (whether successful or not).

Testing does not hurt. Some cats are very dramatic about it, but it really doesn't hurt! (Have you ever seen a kitty act like he was being murdered when his claws were getting clipped? Same idea.)

It usually works best to have one thread (series of messages) for each day. So tomorrow morning, start a new topic.

 

Taline, I can see your spreadsheet fine, good job setting that up!

I'm glad that Bilbo came up from the 57 to 76. It looks like the food helped bring him up a little. You're doing great!! Like others said, the testing is important so if you can get another test with your sister's help, that would be helpful. Give treats right after testing, he will start to look forward to the tests after a while.

You will definitely need to reduce that dose tonight.

 

The spreadsheet is there. Great. Sorry I missed it.

Wondering if you understand now what happened with the doses. The 1 unit was probably a smidgen too high and made your evening preshot number too low to safely give him more insulin. (After a week or so, when you have more numbers and can see how he does with the insulin, you would be giving insulin at that number, probably a reduced dose. But not on day 1) When he went the 12 hours without insulin, you got a high number in the morning. He has been in nice low numbers today. Be sure to come on this forum (or the PZI forum if there are people there. You can tell by going to the bottom of the page and seeing who is online at the moment.) a hour or so before your shot today and get some ideas on how much to give.

 

Sue, how would I be able to ask them? Just by posting or there is another system that you can privately write? I see at the bottom,the list of the people on line. Thanks Sue for guiding me, I'm taking so much of all of your times, hopefully one day I'll be able to help a new diabetic parent. :smile:

 

Absolutely you will. All the people who post are paying it forward, helping someone because they received such wonderful help themselves. You can help now by replying to a brand new person's post when you see it. Just tell them your story. It is good for them to hear that vets don't always know best - like your vet wanting to start you at 2 units - because it is hard to take advice over the internet instead of your vet's advice.

To post on the PZI forum, just go over there: viewforum.php?f=24 Choose New Topic and put something in the subject line about dosage help. The only complication is that there are fewer people on that forum than on this one, Health. If you don't get an answer as fast as you need one, come back over here and start a new topic.

It is easy for me to be on the forum today. I am working on other things on my computer and just check in every so often. Glad to help.

 

I just tested him after 8 hours and it measured 123. He ate 1hour and half ago. More tests coming soon.

 

Great number for +8. And it is good that he is heading up. He is doing very well on PZI.

 

Very glad he's coming up. Nice numbers today.

I had to leave for a little bit but didn't want to go until there was someone else here with you. Thank you Sue and Oliver.

Sue is right, there is not much traffic in PZI these days. So if there isn't anyone in PZI and you need a quick response Health is the place to post.

You're doing a great job.

 

Hi Sue, I agree your doing great.
And for the time being it would be a good idea to post on health and on pzi.
Until you find some steady help on pzi (and it looks like you've got Robin looking in on you)
It's good to be 'known' on health too.
It's good to be 'known' in general and it forms a continuing story for peeps to follow with your kitty so be a regular poster.
I'll be looking in on you in pzi
lori and tom

 

Taline, just a quick reminder that you don't want to feed Bilbo after +10 (within 2 hours of the next shot). You want your preshot test to be a true test, not inflated by a food spike. Bilbo's numbers look great, he's coming up nicely. Keep up the good work!

 

Hi Laurie,
So I won't feed him from +8 to 12hrs until I test him, and if his #s are below 200 on the 12th hour, can I feed him and wait another 2 or hours to test to see if he needs a shot?

 

You can feed him between now and +10 if he wants to eat. After +10, don't feed him until you test him at +12. If he is below 200 at +12, wait 15-30 minutes (don't feed) then test again. If he's still below 200, wait another 15-30 minutes, test again. Try not to feed him before you give the shot, but if you have to hold off for a couple of hours on the shot, you may have to feed him. That's why I would offer him a snack before +10, probably now is about right.

Don't worry, when you test at +12, just post the results here. I know there are a few of us here watching and will be here to offer advice based on his number then.

You are going to want to shoot a lower dose anyway, but you want his number over 200 before you shoot any dose...at least I would, if he were my kitty. He doesn't need much insulin, and with so little data I would want him over 200 before I would give any insulin in this particular case.

 

it's perfectly fine to post on health for pzi advice, or for any insulin. it's also fine to post on the specific insulin forum AND the health forum, or just the insulin forum. some of us don't post on the insulin support forums so we wouldn't see you there. just do what feels right to you. after hours or if the insulin forum is pretty quiet it helps to post on health to get faster assistance.

the number was probably high because (1) 1u dose was too high and bibo bounced up (self-protective mechanism to keep him from going too low), and (2) shot was missed and bibo ran out of insulin to help keep numbers down. that's why it helps to use a shot that allows for 2 shots a day at the beginning (some cats nearing remission only need 1 shot but we don't see that yet for bibo). most cats use the insulin up by 12-13 hours after a shot, so their numbers rise then. that's why i recommended continuing to test until you got a shootable number, or just shooting a partial dose so he at least has some insulin on board. i wouldn't recommend even a partial shot at this point if he's only in the low 100s but 140s could have merited a little insulin.

recommend you shoot 0.75u at least 2 or 3 more times unless bibo goes too low again, in which case you'll want to reduce further. remember, don't worry because of one reading. if you overreact and shoot too much they bounce and it gets tougher to figure out the proper dose.

don't worry too much. all of us were new at one time, too. most of us learned that diabetes management is a marathon, not a sprint. in a short time you'll be amazed at how easy this becomes for you. (((HUGS)))

 

Hi just want to say welcome.... :mrgreen: You are doing a great job..Just wondering when you do your test do you warm his ear a bit first makes the blood easier to get.. Sending Angels and glowing healing green light to help you and Bibo Good luck with your next shot You have come to the right place for a cat with Diabetes.....Also one more think before each test Breath...your doing great....Kath

 

as I was reading other posts from the health forum, I noticed that a lot people use 100U syringes on PZI as oppose to 40U. On my 40U syringes, there are no halfs or quarters, so I will be just guessing! The vet told me to use that particulat one. Should I go and buy the 100U syringes? When I hear people saying converting, isn't it the same numerical numbers on 100U, except that it has more fractions?

 

No they are not the same.

You probably will want to switch because U100 syringes are easier to measure smaller doses with but there is a conversion chart you will need to use, we'll find it for you.

But for now it's ok to eyeball it, when the plunger is half way between 0 & 1 unit that would be 1/5 (.5) unit. half way between the 1/2 (.5) and 1 unit that would be .75 unit.

Does that make sense. You can get a syringe and practice with it to see where the .5 & .75 are before you actually have to give the shot.

 

Yes, many people use u100 syringes with u40 insulin, because it is easier to measure small dosage adjustments. You do need to use the conversion chart because 1u of u40 insulin would be measured as 2.5u in a u100 syringe. The info you need is in the link below, including a link to the conversion chart. Make sure you understand how to use the syringes correctly, and if you have any doubts or questions, be sure to post and ask for clarification. http://felinediabetes.com/FDMB/viewtopi ... 979#p17673

 

Thank you guys!! I think I should stay with what I have for few days, until I get more confident overall. I'll be checking Bibo 12th hour bg in 20 min.

 

I just tested him and it was 149 on the +12 so I'm gonna wait another hour and test him again. The only thing I feel bad that I'm not gonna feed him for another hour or two. He's so used to eat small portions every few hours. It's ok though.

 

yay!!! :mrgreen: what a great +12!!! i'm betting you have a kittie who's going to become diet controlled!!!!! yippee. dancing_cat dancing_cat dancing_cat cat_pet_icon
btw, did your kitty recieve a steroid shot in the last year?

 

Ok, that sounds like a good plan.

 

Not that I know of Lori. He was hopitalized 6 months ago for an ingrown nail, and had to stay a day at the vet, and Bibo got so stressed out, he had a sudden anemia induced by stress which required the vet to give him a blood transfusion. I don't know if he was given any steroids though.

 

Feline diabetes has a very steep learning curve in the beginning and you are catching on much faster than I did.

Good job!

 

if you can find out it might help you. a large percent of kitties that recieve steroid shot end up getting diabetes within the year. my cat did. more often than not this is a transient diabetes. i mean he will always be diabetic in terms of food, but no insulin dependant. USUALLY. :mrgreen:

 

Bibo is sleeping under the bed, and I tried to lure him with toys and food to come out, he doesn't want to. He seems depressed. Is that normal for a cat to feel that way in the beginning when he's tired of being poked so many times, and he was so upset? I just wanna test him one more time. I wanna give him .50u even if he didn't let me test him tonight, because it was 149, 2 hours ago. What do you think?

 

I would give him the 0.5u, but please try to get a test when you get him out to shoot. I'm sure he's tired of being poked and pestered! But it is for his safety.

 

sorry disagree...it's nightime, you may be asleep that is not a # to shoot and if anything token dose would be .2 or .3

 

only the most experienced amoung us who thouroughly know our cat's routine would shoot .5 into an unknown # possibly 149.

 

unless you wanna stay up and test throughout the night ;-)

 

Lori, she was advised (not by me BTW) that in the same situation as last night (148 ps #) that she could cut the dose in half (0.5u) so that Bibo would have some insulin on board. That's where the 0.5u came from.

Of course she could give less, she could give none. Naturally, we would all prefer to see a ps#.

 

the only reason i suggested less is the red may have been a bounce, and sure she may have a ligit high or another bounce but with so little data and it not being a daytime shot i err on the side of micro dose. that's all, nothing personal

 

I just tested him and it was 191, so I gave him a .50u but I felt a little wet area on the fur, so probably didn't do a good job. i am so nervous, haven't rested my mind for a minute all day.

 

I just tested him and it was 191 so I gave him .50u so I can feed him, but his fur around the neck felt little wet, could be I couldn't shoot him right. So stressed, what a first day!

 

A fur shot, it happens! Don't worry about it, and whenever that happens, don't give a second shot.

Do you have any chocolate in the house? You've earned a reward, doing a great job on a very stressful day!!

 

Thank you Laurie, I feel so overwhelmed that I couldn't even eat much today. I hope this is gonna change because I can't do this everyday. Sorry for being so negative, despite what you guys did for me all day long.Don't get me wrong. I am deeply so grateful!!!

 

I know it's very stressful, and overwhelming in the beginning. You are doing exactly what you need to, reading and asking questions and trying to get your kitty used to the whole testing/shooting routine. It's a very steep learning curve! You're doing really great, having to deal with low numbers in the beginning, and you knew to feed him right away....that's awesome! It will get easier, I promise! You are not being negative, don't be so hard on yourself, you've had a rough first day!!

You will want to test him again tonight, +3 would be good if you can stay up. If not, can you set your alarm for +3 or +4?

 

Its okay hon, breathe, it gets easier, its just a learning curve and well today has been scary and stressful. Remember fur shots happen, and better too high for a day than a minute too low. Also unfortunately from what you have written about Bilbo's charming personality he probably hasn't been the easiest patience either, but you've done great. As newbies I don't think anyone here wasn't scared, stressed out and questioning if we could do this day in and day out. But you are in the best place to be when the scary stuff happens. Never think because a lot of different folks aren't posting that there aren't hundreds of eyes on the post. They may just not have anything to add at the moment.

Mel & Muse (GA)

 

Muse is right Breath and you are doing Kath

 

We have all had a fur shot. No big deal. Think of these last two days as data gathering. They call this a sugar dance - but it is a slow dance. It takes a while to get all the parts working well. You have the food and the hometesting down and are working hard on the dosage. It will all come together.

Give each of you a treat and breathe......And don't worry if you have a higher number in the morning. If not much insulin got in, the number may be like today. And maybe more went in than you think. And maybe it was best not to give much insulin, and what he got was the perfect amount.

Whatever. You can start over again tomorrow. No worries. He is within safe numbers and will be fine. Both of you have a restful, snuggly night. We will be here to help in the morning.

 

i would have felt fine shooting a partial dose on a 149. but don't give insulin without testing first. even the most experienced of us are occasionally surprised by a very low preshot number or by a cat who suddenly drops at the end of the cycle. don't want to shoot a dropping number. again, if you shoot a number lower than expected, test an hour or two afterward to make sure he's ok. if you think he's dropping too fast, give him a bite or two of food.

everything's new to your cat, too, plus he's dealing with diabetes. doesn't feel good to have high blood sugar or swings in blood sugar. so he might be protesting in general rather than specifically about the poking. just do what you can to make this a very happy experience for him. i used to warm up a rice sock and use it to massage cleo's head and neck/shoulders and then warm the ears with it. so it wasn't just about treating the diabetes. a lot of praise and a nice treat or two will do wonders in getting him looking forward to test time.

most important thing: even if you don't feel confident, fake it! it'll reassure him.