BG Going Up Again - Could Use Some Advice

Discussion in 'Prozinc / PZI' started by Greg and Goma & Friends, Jan 10, 2018.

  1. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Yesterday the bg numbers moved back into red and now I am back seeing black again. Goma also regurgitated food from earlier this morning. What can I be doing now? She drank some water, but I do not see urine in the litter box. She appeared fine in all respects yesterday except for the numbers. Yesterday I had given her more boiled chicken as I had reduced thinking she may be having an allergic reaction to it. She has been scratching herself to the point around her neck is open wounds. She previously had this, but they were healing. Now back to square one. She is eating now and will hopefully keep it down.

    UPDATE - She did just urinate after I repeatedly took her to the litter box. Could not get a ketone strip there quick enough. Tested last week and she was clear. Today was the day I was to do the weekly test.

    Perhaps I am just overreacting to everything now.

    2nd UPDATE - Vomited Again....

    3rd UPDATE - Vet opens in approximately 50 minutes - heading there....
     
    Last edited: Jan 10, 2018
  2. Kris & Teasel

    Kris & Teasel Well-Known Member

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    She might be allergic to chicken. It's also possible that it has upset her stomach. Let us know what the vet says.
     
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  3. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Still home but getting ready. What is the rule for insulin at times like this and what could be causing the higher bg level now?
     
  4. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Has she kept any food down at all? If not you'll have to reduce her dose. How much to reduce is always a hard decision. If she's dehydrated from vomiting and her BG numbers are elevated I would not skip insulin because there's a risk of ketones developing.
     
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  5. Djamila

    Djamila Well-Known Member

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    It's still about four hours before her next shot, right? That gives her some time to settle down before you try to feed her again. If she can keep food down by then, I would give her the regular shot. She is running high this week and as Kris said, that puts her at risk for ketones if she doesn't get insulin. You can try feeding her some plain chicken or turkey, or even some meat-only baby food (just make sure it doesn't have any onion or anything else in it - just meat). If you do try to feed her in a bit, I would suggest very small amounts (1/2 T to 1 T), wait 20-30 minutes, and little more, wait, a little more.... and don't worry about the two hour no-food before the shot thing. You already know she's high enough to get her shot, so it's more important to make sure she will eat and keep it down than to worry about that guideline right now.

    Let us know what the vet says, and we'll all be sending healing vines to little Goma!
     
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  6. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    At the Vet now. About 1 hour from shot time. They could not get any urine for ketones test. Blood has been drawn and waiting for results. She definitely has more strength than the last time they saw her.
     
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  7. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Thanks to you and Kris for being there. I have only this group to turn to for support
     
  8. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    White blood cell count way too high so there is an infection somewhere. They are still getting more results but they will be giving her antibiotics at a minimum
     
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  9. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Looks like I may miss regular dose time.
     
  10. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    I don’t believe so. She has vomited a total of two times. About 5 am and again after my first post after giving her a small amount of food
     
    Last edited: Jan 10, 2018
  11. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That could be why her BG is higher recently.
     
  12. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You can give her dose late by up to an hour with no negative effects. You could likely stretch that boundary right now because it's important that she doesn't miss a dose. Post for advice once you're back home.
     
  13. Djamila

    Djamila Well-Known Member

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    Prozinc has about an hour of grace time. If you need to shoot later than that, we can help you figure out how to get back on schedule. So no worries if you are late getting home.

    I'm so sorry to hear she has an infection! Hopefully the antibiotics will help quickly!
     
  14. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    You all keep educating me
     
  15. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    I hope you all will be around in another hour or so
     
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  16. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, I'll be here.
     
  17. Critter Mom

    Critter Mom Well-Known Member

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    According to my reading, this is not at all uncommon in kitties with food allergies.

    Be sure to let us know which tests they have run.

    BTW, remind me; do you have urine ketone test strips at home?


    Mogs
    .
     
  18. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Yes I have strips at home and began testing last week. Today was my scheduled test day but the current situation precluded it.

    All blood tests are done now. They show her liver is not well. They will start once a day subcutaneous injections with liver medication and antibiotics. We did this before but stopped when they closed for 5 days and she was doing fine on the medication they gave me.
     
  19. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Have they given you specifics? Was there any mention of hepatic lipidosis?
     
  20. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    No specifics just high number. I have now asked. They had some food here so I have fed her two tablespoons to see if she will keep it down. BG level was 401. Not the food I would normally give but if she vomits at least I am at the Vet
     
  21. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    They say not hepatic lipidosis at this point
     
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  22. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That's a relief. Will they give you any meds for the vomiting? She needs to eat even if you have to syringe some pureed food into her.
     
  23. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    They gave medication for vomiting in a subcutaneous injection. The two tablespoons of food have stayed down so far. She is acting quite well now. 100ml fluids with liver med, vitamin c and b12, calcium and potassium.
     
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  24. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Was in the injectable med for vomiting called Cerenia?
     
  25. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    They say no. Primperan.
     
  26. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I had to Google that. It's drug name is metoclopramide. I've read about other members using it. Is it a long-lasting med?
     
  27. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Yes that is the one. 12 hour med so I asked for the pill form for tonight.

    She is still holding the food down I gave her here. I am headed home now to give insulin and will post prior for any additional advice
     
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  28. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'm glad you have that med to take home.
     
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  29. Critter Mom

    Critter Mom Well-Known Member

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    Metoclopramide is more helpful for speeding up gastric emptying and normalising gut motility. It can be effective when nausea is caused by constipation - but only because it helps solve the constipation problem. The resolution of the constipation is what reduces the nausea, not any direct anti-nausea benefit from metoclopramide: cats are thought to have very few of the receptors it targets for nausea control. Also because of its side effect profile metoclopramide should only be given for a very short period of time (talking days max here).

    Ondansetron and Cerenia are specific anti-nausea treatments that work well in cats.


    Mogs
    .
     
  30. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Okay - All - I am now home with Goma. She has just eaten about 1/2 can of ff pate. Acting very normal - Just to be sure, I did a bg reading. At the vet it was 401 - Here just now it is 274 - Now - My question is, I am 1 hour past dose time - her level is lower than it has been in the past two days - What should I be looking at in regards to insulin dosage and injection given all that has transpired? Oh and where should I put these readings in the ss?

    I really can't say thank you enough to everyone -
     
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  31. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Being one hour past her normal dose time isn't a problem. No schedule adjustment needed. That 274 is lovely! Put it on your SS in the pre shot test box. I'd encourage you to give her the full 2.5 u dose and get a test at +2 to see where she's headed. You might have a very nice cycle if you're lucky. I doubt very much that she'll dive low and by that I mean 50 or below at nadir. If you see a dark green above 50 in the +5 to +7 time range don't panic! It's what you want. I'm mentioning this because it's my bed time now (eastern Canada) and I won't be around to see your test results.

    Sound like a plan?
     
  32. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Okay - Than tonight I can go at 1 hour earlier? Or 1/2 hour earlier to get back to the 11:00 am./pm. area by tomorrow. Now 12:12 (noon) here.
     
  33. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Your current dose is going to be an hour late, right? You can do the next dose at your normal time so there ends up being 11 hours instead of 12 between this late dose and the next one at the normal time. ProZinc allows this type of occasional schedule change.
     
  34. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Got it - Have a good night -
     
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  35. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Tomorrow I will ask about a different med for the vomiting if she continues to do so. I obviously need to do more research on my own. This Vet is not used to clients asking what the name of a drug is that they are prescribing.[/QUOTE]
     
  36. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    [/QUOTE]
    Not sure if anyone is here at this time. I received, as usual, excellent advice from @Kris & Teasel, @Critter Mom, and @Djamila this morning. I am at a +2.50 reading of 91 and while I understand this is okay the full effect of the dose has not taken hold so I think it will probably be going further down so I am concerned it will be below the 50. I have already provided a bit higher calorie food to hopefully steer this abit but not sure if this was the right thing to do so early on.
     
  37. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    I wasn't a Prozinc user, but steering with food is an excellent idea. The longer you can keep the numbers in high greens and low blues (on an AlphaTrak), the better.
     
  38. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Thanks for the response. Hope I have not acted too quickly however. The idea was given to me from @FurBabiesMama and @Djamila in a different thread but hope I can use it correctly.
     
  39. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    You will be able to tell with the next test. Surfing the curve involves feeding using the lowest carb food that will do the trick. This knowledge will come with experience. Document what you fed this time so that you know what does or doesn't work next time.

    Off to bed. Holler for help if numbers drop dangerously low (under 68 on AlphaTrak).
     
  40. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Okay - Thank you - Have a good night
     
  41. donnalea

    donnalea Member

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    Looks like you did everything right. Your a great pet parent,
     
  42. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Not sure if anyone is here at this time. I received, as usual, excellent advice from @Kris & Teasel, @Critter Mom, and @Djamila this morning. I am at a +2.50 reading of 91 and while I understand this is okay the full effect of the dose has not taken hold so I think it will probably be going further down so I am concerned it will be below the 50. I have already provided a bit higher calorie food to hopefully steer this abit but not sure if this was the right thing to do so early on.[/QUOTE]



    Whew! This is much lower than I thought she’d get so soon after a pre shot in the high yellows. Perfect example of a cat’s unpredictability. I also mentioned the take action number as 50 when it’s 68 on an AlphaTrak. I’m very sorry I made that mistake.

    If you could update your SS with any extra test numbers you have since your post that would be very helpful. I’m having a little insomnia right now and decided to check FDMB. When I saw your post I was very concerned. We try hard to give good advice but I certainly misjudged this. I’m very sorry.

    How is Goma doing right now? Please let me know ASAP.
     
  43. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I see you’ve just added a BG of 81 at +4.75. Are you giving her small snacks of higher carb food intermittently to keep her “surfing” as we call it? That means her BG stays in a narrow range for several hours. So far so good but you still have a few hours of monitoring ahead. Her SS shows some late-ish nadir times. I suggest you make notes on your SS about what carb level of food you gave her in what amount at what time. It can be a valuable reference.
     
  44. Kris & Teasel

    Kris & Teasel Well-Known Member

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    It seems you’re not online right now. I hope you can steer Goma’s numbers successfully through this surprise incident. Again, I apologize for getting this so wrong. I know it took you quite a while to trust advice that was very different from your vet’s and I hope my mistake hasn’t ruined that.

    Signing off now. Will check first thing when I get up. Post a 911 in the main health forum if you need advice in the hours ahead.
     
  45. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Whew! This is much lower than I thought she’d get so soon after a pre shot in the high yellows. Perfect example of a cat’s unpredictability. I also mentioned the take action number as 50 when it’s 68 on an AlphaTrak. I’m very sorry I made that mistake.

    If you could update your SS with any extra test numbers you have since your post that would be very helpful. I’m having a little insomnia right now and decided to check FDMB. When I saw your post I was very concerned. We try hard to give good advice but I certainly misjudged this. I’m very sorry.

    How is Goma doing right now? Please let me know ASAP.[/QUOTE]
    Sorry for the delay in response, I am feeding and caring for a multitude of other cats in addition to monitoring Goma. She appears to be resting comfortably at present. I will be performing another test in a few minutes and will post. I see you posted again after this so this will be the response to both. I have been documenting what I am feeding her at these low readings. I gave her 1/2 can of FRW at the 91 reading (+2) in hopes it would slow down the slide. At +4.25 I gave her ff and a tablespoon of FRW when I saw the number was 81. I will test now and place the number in the ss. I will also comment on the spreadsheet what I fed her.
     
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  46. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    I am trying to give small high calorie food. I am concerned though. I will make the notes as you suggested when this is over and I have more time. I am keeping track of the food I am giving but not sure of the carb level. Will sort it out when this is over. I sincerely appreciate your help and additional guidance which is, as always, welcome. Get some rest...
     
    Last edited: Jan 11, 2018
  47. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Thank you for the thoughtful comment. I'm doing the best I can with what I have. Desire is not lacking, but the old brain factory is a bit lacking at times.
     
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  48. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    There is absolutely nothing to apologize for. It never entered my head there were any mistakes made so please let us not go down that road. I continue to hold you in the highest regards and respect and commend you for being so helpful to me and everyone else. We are all lucky to have members such as you.

    In regards to trusting the vet - I can read instructions and guidelines provided with medications (ProZinc) - my trust went out the window when he wanted to dose once a day and feed her small morsels. That is why I turned to you all and Goma is, all in all doing quite well. She has already gained nearly 2 lbs and I hope once I get these glucose levels stabilized her energy level will return.

    You and the others have warned me there would be rough seas at times. This was just one of the storms. She had a rough day and there were multiple things going on in that tiny feline body that I will never begin to grasp. But I can sure try...

    I will be asking for dosage advice for this evenings injection. I am completely lost at this point in time in regards to which way to go. I understand it will depend on bg numbers, but at what number do I lower, raise, hold off, etc. Still got a long learning curve going here.

    Kindest Regards to you. And again, thanks for being there.
     
    Last edited: Jan 11, 2018
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  49. Rachel

    Rachel Well-Known Member

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    Looks like you surfed in greens...With luck Goma will stay there for a bit and then gently come back up. Are you at the midway point of your cycle still? How's she feeling today?
     
  50. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Been a tedious day but she has handled it well. A bit on the quiet side, but a good appetite which has helped and thank goodness she kept everything down. I am now at +8 and will be doing a test in the next 15 minutes or so. Keeping my fingers crossed for a smooth transition...
     
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  51. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    I really appreciate this information. I obviously have a lot of homework to do. I have guides for human medications, do you or anyone else know of a good guide for animals (cats in particular)? I need to obtain it if it is out there. Currently, I think if she has stopped regurgitating they will stop giving the medication for it. And, thus far - no regurgitating since this morning - Thank Goodness.
     
  52. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I’m very relieved you got Goma through this safely! Be prepared for some mighty bouncing. Please post when it’s time for her next dose and we can help figure it out. I’m still surprised at how her numbers came down so much after the vet intervention yesterday. Could be coincidence ...

    Thank you for your kind words. I felt bad that you ended up in this situation because I advised the full dose last shot.
     
  53. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Since this thread has gotten rather lengthy and the evening dose will be off topic I will start a new thread in this forum requesting dosage advice for this evening. I will not be giving this until 11:30 pm (approximately 2 hours from now) so I plan on taking the bg and entering into the spreadsheet at approximately 11:00pm my time (1 1/2 hours from now). Will then post the new thread. Hope you can be around to assist.
     
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  54. Rachel

    Rachel Well-Known Member

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    I’m at work but I’ll try to pop in just in case no one else can be around!
     
  55. Djamila

    Djamila Well-Known Member

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    Wow you had a dramatic day! You did an absolutely perfect job of feeding that curve! Well done!

    Cats who have been up in the really high numbers often seem to feel quiet, even lethargic, when they first hit the lower numbers. It's okay, it just takes their bodies a good long while to start to adjust to the lower BG. Did you notice any of that? Or did she seem to handle it okay?

    Just like the last time she had a green, she will likely be quite high and flat for the next few cycles. There are two options for your next dose, and I'm afraid either one of them is going to be a bit of a guess. You could hold the dose at 2.5u and wait for the next low-ish PS to reduce the dose to 2.25. The reason for that is because usually after a low there are high flats and she doesn't necessarily need a reduction yet. The other option is to reduce to 2.25 now. I don't think 2.25u is really enough for Goma right now, however, you're going into your PM cycle and you need to sleep, so if that feels safer, and so you won't need to keep waking up to check on her, then go that route.

    If she gives you a lower PS right now (yellow to mid-pink), I would go with the reduced dose (2.25). If she gives you a high PS (high pink to black), I would probably hold the 2.5u dose. Again though, we know that the 2.5u dose can sometime bring her a strong response, so it's really up to you and what will make you comfortable tonight. You certainly have the skills now to manage whatever she does, but sleep is important!
     
  56. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Great advice from Djamila. I do think the 2.5 u dose is the one that gives you some good BG lowering action but it can be stressful to monitor and "feed the curve". You did a very good job at it last cycle. The hope is that exposure to these lower numbers will help Goma respond better to insulin and feel better too. Unfortunately, a dosing breakthrough like this is a necessary step even though it can be hard on the care giver.
     
  57. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Not sure I really have the skills yet, beginners luck is more like it...I appreciate the information in regards to the next dose. I do need some sleep - However it is much more important to me that she receives what is best for her. I would like to minimize the bounce if at all possible.

    She was very quiet all day and yes, to the point of being lethargic. However, she ate when I presented food then just laid back. She just now got up for the first time and used the litter box and then ran back to her spot under my desk. So I guess she is ok. Doing her cat thing... Will post number in a half hour or so in ss and a new thread in about an hour to confirm which way to go with her benefit in mind.

    Thanks so much for taking the time to provide such detailed info.
     
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  58. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    I appreciate that offer - Please do not interrupt your work and get into any trouble on our account. -
     
  59. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Okay - We'll see where we stand in about 20 minutes or so - I'll then post in new thread requesting advice -

    Thanks again.
     
  60. FurBabiesMama

    FurBabiesMama Well-Known Member

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  61. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Thank you. My hope and wish is it will be good enough.
     
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