911 BLOOD SUGAR IS 91 TONIGHT - DOES HE STILL NEED A SHOT BEFORE BED?

My 11 -year old cat, Kuma, has been on 4 units of insulin morning, 3 units evening for the last month. His last check a month ago, he had been testing at about 330 blood sugar, 5 hours after his shot. That vet then raised him from 3 units morning/3 units evening, to 4 units morning/3 units evening. He seemed more lively and has been acting like he felt very good the last month, but I noticed about the last 4 days he would want to sleep shortly after his morning shot. I finally home tested his blood this morning to make sure things were OK, but his blood was only 51. I fed him a lot after that, and he was feeling good today. I thought I'd better test him now before I give him his evening shot (9:15 P.M.), and he tested at 91. I don't know if I should even give him his shot before bed now. Can someone let me know what to do tonight? I can call the vet in morning, but not sure whether to give him his shot now before bed.

 

What kind of insulin are you using?

And with a BG of 91, there's no way I'd shoot 3U of any kind of insulin without seeing a spreadsheet and knowing how your cat has responded to both food and insulin in the past.

It would really help if you'd start using our spreadsheet and keep track of what kind of numbers Kuma is getting when you test so that when you need advice, we have something to look at to see how he's been doing. Here are Instructions on setting up the spreadsheet when you have a few minutes

 

REPLY: Thank you for responding. I am using ProZinc. I have a spread sheet for Kuma. How do I show it to you?

 

I wouldn't give my cat insulin with a 91, especially 3 units.

 

Here is the link to instructions to set up the spreadsheet that most use. If you have something else, I'm not sure how to share it.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

Is the spreadsheet you have the same one we use? If it is, just copy the URL from the address line and paste it here

It would be helpful if you'd fill out the signature box too (like we have under all our comments)...then we don't have to keep asking the same questions. Just click on your name at the top right and choose "Signature"...a new box pops up where you can put info like name/cats name, date of diagnosis, type of insulin, type of meter, any other health issues, etc.....and the link to your spreadsheet would go there too

 

Chris & Debby - who posted above - are so right: Please do not shoot any insulin with a BG # that low. (I am a ProZinc user.) Just skip the dose tonight.
Usual routine is: Test BG, feed, then shoot if BG# is at 200 or more. While some of us shoot at somewhat lower #s, we never attempt that without lots of data (meaning a good BG #s history in a spreadsheet), careful BG monitoring, and knowledge of our cat's unique patterns throughout a 12-hour cycle.

 

REPLY: Here is Kuma's spreadsheet: https://docs.google.com/spreadsheets/d/1IuL1NsBPUOT1beuA15CjtPhI23DR-o8t1XiR-Jj6LZk/edit?pli=1#gid=0
I always test his blood sugar in the afternoon , so I have simply put his readings on the right hand side of the spread sheet (although this may not be how it should have been done) - please also note the one very high reading of 600 which I don't believe I got his shot into him properly that day, so that reading is probably not relevant. But you can see his numbers there on the right hand side. I have been giving him his Prozinc insulin shot at 9:30 in the morning, and at 9:30 in the evening.

 

You need to change the permission on your spreadsheet to "anyone with the link"....go to the top right where it says "Share" and click....a new box will pop up and along the bottom right you'll see "Advanced"....click there and choose "anyone with the link" and then save it

More info to come

 

CHRIS AND CHINA: Thank you for explaining how to share the link to Kuma's spread sheet. I have now clicked to share it with "anyone".

 

With ANY insulin, you want to get a test in before each shot ALWAYS...it's the only way to know if they're high enough to shoot at all...then on the AM dose, if you can get a test in somewhere between +5 and +7 (5 to 7 hours after the morning shot) it will help to see how well Kuma is responding.

On the PM cycle, you want to get the Pre-shot, and then at least a "before bed" test. Most cats go lower at night so it's important to get that test in

Dosing with ProZinc is based on how low it takes them as well as where they start out at before shooting

Generally, until you've got lots of data on your cat and really know how he's doing, you don't shoot insulin if he's under 200, so I'd plan on skipping tonight's shot completely

If you'll post here daily, there are lots of people here who use ProZinc and can help teach you how best to use it both safely and effectively to get the best possible results on your dear Kuma.

There is also a ProZinc Forum where you can start posting when you are ready (but of course you can continue posting here in Health if you want to). They have developed a protocol for ProZinc to help guide you too

 

I am so thankful for all the wonderful people on this site. I might have killed Kuma tonight if I'd have given him his usual 3 units of insulin at 9:30 PM. I want to thank everyone.

 

Can see your spreadsheet now...good job!

No, I would NOT shoot tonight and I think it's entirely possible that you are already shooting a lot more than you should be. Without more testing, there's no way to know, but my first thought is that your vet doesn't know what he's doing (there's no nice way to say that)

It's not necessarily that he's a "bad vet"...it's just that vets don't have the time to keep up to date on the latest treatments for every disease in every type of animal they see. Even in school, they only get 5 hours of class time devoted to diabetes at all...and that's for both dogs and cats!!

The people here on this board are your best friends and can really help you with Kuma. They have years of real life experience to share with you and I pray that you'll take advantage of this knowledge to help you along the way

 

This board really is a lifesaver.

Glad you checked in and that Kuma is well.

 

REPLY: Would Kuma be starting to get over his diabetes, like some cats do? Would there be any other explanation for why, a month ago, his blood sugar was in the mid-300 range (in afternoons), while he was on about the same dose of insulin he is getting now? Why would it have changed so drastically (only 52 early afternoon today, and 91 now tonight at 9:30)? His history was several bouts of pancreatitis last fall and this spring. Kuma was 22 lbs. at that time, so was overweight. His blood sugar was high during his pancreatic attacks (300+), and the vet thought that maybe his high blood sugar was due to his pancreatitis attacks, but when the attacks would subside, his blood sugar was still high. That is when the vet said he had diabetes, and I then started insulin shots twice a day this last May. Could his pancreas have simply been inflamed from the attacks and his blood sugar is now regulating itself with the passage of time - could that be what is going on?

 

Pain from pancreatitis can raise the BG so that may have had something to do with it, but without seeing a lot more tests, it's impossible to say if Kuma might be heading for remission

Yes, some cats do go into remission, but what we do here is gradually reduce their dose until they're on just a drop (as long as they continue to stay in normal numbers) before going off completely. We don't want to "rush" their remission....we want a good strong remission, not a fast one!

As I said above, I think your vet probably doesn't really know what he's doing. If Kuma were mine, I'd probably start over at maybe 2 units (IF he's over 200 at Pre-shot tests) and then get at least one mid-cycle test in on that AM cycle (if at all possible) and then a PMPS (PM pre-shot) test and a "before bed" test. Post on the ProZinc forum daily and let the people who are experienced with your insulin guide you. I promise they won't steer you wrong and our number one rule here is to keep your kitty safe!

What's most important is finding out how LOW the dose is taking him. It's totally possible that he's been going too low already, and you just haven't been testing enough to know about it.

When they go too low they can "bounce". Bounces are when the liver releases stored sugar and hormones to bring the blood glucose back up quickly. It's kind of a leftover "survival mechanism" from when our cats were wild...if their blood glucose dropped too low, the liver would release those sugars and hormones to bring them back up...so hopefully they'd be strong enough to hunt again and survive.

Same thing can happen if they just go lower than their body has gotten used to being at. By the time we get a diagnosis of diabetes, most of our kitties have been diabetic for quite some time and their body has gradually gotten used to living at much higher numbers...then we start giving insulin which brings it down to normal numbers (or even a little lower) and the liver causes another bounce.

Keep asking questions too! The people here are very generous with their time and really just want to help you and your "extra sweet" Kuma

 

I just don't know how to thank you. I finally figured out how to post Kuma's picture now, also, so you can see him. Gentle, sweet, boy. I did not give him his evening shot tonight, thank goodness - all because of your amazing help. I will test his blood before I give him a shot in morning also, and if it's below 200, I definitely will not give it to him. I am calling the vet to straighten things out. When I called him earlier today (3 1/2 hours after his morning shot) to tell him I was concerned due to Kuma's blood sugar being only 51, he didn't say a word to me about possibly skipping his evening shot. All he said was to not let it go below 20 or he'll "get goofy". If I had given Kuma his evening shot at the blood sugar levels he was at today, I might have awoke to tragedy tomorrow morning. What a relief it is to know there is REAL advice here from all these wonderful people.

 

Update on Kuma: His blood sugar tested low again this morning (65) pre-shot! So I did not give him his usual 4 units morning ProZinc shot - no shot at all. I was amazed, as he had NOT had his usual evening shot last night of 3 units of ProZinc due to a low pre-shot reading (91). So, he is at 65 this morning after having no shot at all for 24 hours. I am now feeling guilty, in hind site, as I had not been testing him for about the past month, as he had been acting like he felt so good. The vet had bumped up his ProZinc to 4 units morning/3 units evening about a month ago due to high blood sugar readings (mid-300's), and I simply thought we were finally at the right dose, as he acted so good the past month after that bump up. So, I was amazed at the readings yesterday afternoon (after his 4 units morning shot) of 52 mid-afternoon and 91 pre-shot in evening. I am not sure what has happened - if his body was going into remission during the shots over the past month, without my knowing it, and it was luck that I caught it. This really shows the need for regular blood testing, even if you think they are acting really normal.

 

Yes, this is a good reminder to ALL of us; thank you for sharing this. And I'm so very happy about Kuma Cat's #s. Please don't beat yourself up; it's so obvious to everyone here that you're a loving, deeply caring kitty "parent!"