Dosing help for Piper

Hi Everyone,
I posted another thread on the main forum and they suggested I come over here. I just want to thank you all for reading and sharing your amazing advice all of these years. My 16 1/2 year old cat, Piper, has been diabetic for 6 1/2 years. She has been on 2u of Prozinc twice a day for the entire time. We started with one and stuck with two units. I never had the nerve to home test her until this week. Believe me I know now how dangerous that was for her, and I feel terrible. She threw up three times last week and stopped meowing, so I forced myself to do it! She was back to normal when I started testing Thursday night. I started a spreadsheet, and you can see she went dangerously low yesterday. She was acting completely normal, so now I feel like I have been keeping her that low for the last 6 years. I feel very strange skipping her shot tonight as I have only missed a couple ever. The 120 number tonight really scares me after yesterday. I will continue to update my spreadsheet whenever I can get a test in. She eats 1 can of FF Classic Beef in the morning and then again at night. Any suggestions or thoughts on how I should move forward would be greatly appreciated. Thank you so much for reading this, and I look forward to hearing from you.
Braden

 

Wow! Well first, welcome to our little forum! First off, we are a small but friendly group. If you ever have an emergency, please post here and on Health to be sure you get eyes on it.

Don't beat yourself up over not testing before now. Most vets don't suggest it or explain why it might be necessary, so how would you know? You can't change the past...the point is NOW you know how important it is and you are doing it. You can rest comfortably knowing that you are doing what you need to keep her safe.

Are you using a human meter or a pet meter?

Looking at her SS, skipping was definitely the right call! Plus now you can get some rest tonight knowing she's safe.

If she is over 200 in the morning, I think I'd reduce the dose. Maybe 1 unit? Looks like that dose may have worked well for you the other night. Will you be around to monitor tomorrow too?

 

Hi Rachel!
Thank you for responding so quickly! It really is nice to be able to "talk" with other diabetic furbaby lovers. Piper is a bit of a miracle in that she has survived my ignorance all these years.
I'm glad you think it was a good idea to skip. I feel like she has just been recently diagnosed all over again. All of this information is so overwhelming, and I want to to the right thing.
I got a human meter from Walmart. The cheap Relion brand. My brain is going crazy thinking it could be faulty. Ha! I am probably going to get another one tomorrow.
I will do 1u in the am if she is over 200. It is just so surprising that after all these years she would need less insulin. Is that even possible? I can monitor her closely for the first 3 hours after her shot. I'm having a party after that, and she will be impossible to test until it's over. She hates people and will be hiding the whole time. I work from home, so I am available all day most days.
Thank you again for your help. I truly appreciate it!
Braden

 

Nice Braden! Looking really good and skipping that 120 was a great choice! I'm glad you came over to this part of the forum!

 

Surprising enough, yes. Cats can take years on the same dose and suddenly break through and start to drop. Not common, but has happened. And yes, don't blame yourself - congratulate yourself on starting testing! How could you possibly know that home testing was even possible if your vet doesn't. You can be his trial cat testing, show him how well it works and save lots of future patients of his. One thing I will say for your vet is that he didn't have you blindly raise the dose to high levels.

Great job skipping the dose. We generally tell new diabetics not to shoot under 200, but to stall. Wait 20 minutes without feeding and retest. You want to make sure the number is rising, not falling and nearer 200. The one unit at 243 was a little too high as it gave you an unshootable pmps. The ideal is two shootable preshots twice daily. If you read this before shooting today, I'd try a little less than one if she is 200 or just over. She could be high because she will have been 24 hours since a shot, but I'd stay in the 1-1.5 range even if she is high.

We put together a protocol for ProZinc. It is in my signature in blue.

 

She definitely earned a reduction. Past is past. Can't worry about things you can't control. I think holding at 1 unit as long as the numbers are safe is a good suggestion. Keep in mind her numbers may be a bit inflated for a few days after the low hypo.

Well done for home testing! You are keeping her safe!

 

Ps, home testing isn't as bad as you thought, is it?

 

Y'all are incredible! Thank you so much for your insight! I am just kicking myself for not joining sooner. I did stall last night and retest. It started at 124 and the second test was 120. This morning she was at 243. I just gave 1u. I am concerned now, because she is drinking a lot of water and peeing more than usual. I really don't want her to get a UTI. She is prone to them. I will definitely test her again here in a little bit.
Janet, definitely not as bad as I thought, but I did stick her 5 times today and made myself bleed. Ha!

 

I like the dose for this morning. Getting a few numbers today (especially in 5-7 hour range) will help fill out your picture.

PS. The ReliOn should work fine. It is the most popular meter on this forum - mostly because it is accurate and the strips are cheapest.

 

Haha. Put a cotton pad behind the ear so you aren't testing yourself.

 

Thank you! I will test at +2 and hopefully +5. I am having people over and she will be hiding, but I am going to make it work!
It just feels so weird lowering her dose when she was acting normal. And now she is drinking so much water. So frustrating. Thank you for the heads up on the meter!

 

Haha! It was when I was getting the lancet out of the pen. I am not a morning person.

 

She is at 200 at +2. I am assuming that is good. She is very hungry and still peeing a lot.

 

Sorry about the hunger and excessive pee, but 200 is good! She'll get there.

 

Thank you Sharon! It looks like she hasn't peed since this morning. So that's good. I just tested at +6, and she has stayed at 198. I can't get to a computer to update the spread sheet, but I will tonight. Thank you for your help!

 

I just did her PMPS and she is up to 250. Do y'all think I should up her dosage, or just leave her at 1u for tonight? She has been VERY hungry and thirsty today. Thank you!

 

I'd hold the dose at one unit - your pmps is close to amps. We suggest holding a dose for three cycles before increasing. Unless the numbers are really high or low.

 

Thank you so much!! Okay, will do! Is it good that the two numbers are close? Also, three cycles means her next shot too? I'm sorry for so many questions. Thank you for taking the time to answer me.

 

Yes, three cycles is a day, night and another day. Regulation is generally considered to be mid 200s at pre shot and low 100s or double digits at nadir (but above 50). That's the first goal. Then you work to lower the ranges.

If he is still in yellows and higher blues, you could raise the dose to 1.25 on a cycle you can monitor.

Someone answered my questions. I am just paying it forward.

 

Okay, great! I will stick with this plan. I am just floored that I have been overdosing my kitty for 6 years. So sad. Thank you again. Hopefully one day I will be able to do the same.

 

You will. We've all been where you are now. You'll be surprised at how fast all this makes sense!

 

Thank you Rachel! We are at 233 AMPS this morning. I am wanting to give her more insulin this morning, but I will wait. She is still peeing so much and very hungry!

 

You can shoot at 233, if you want. Maybe a little less than one unit if you won't be around to test.

 

Thank you Sue! I did. I gave her 1u. I am just worried that it is not enough because of the excess peeing. Could that be from the shot I had to skip night before last? Cutting her dose in half has me freaking out a little.

 

The excessive peeing should calm down as she becomes regulated.

 

Thank you Rachel! Hopefully it will! She just hasn't peed like this since she was diagnosed 6 years ago. It just has me on edge.

 

She was at 228 PMPS. I am thinking I want to increase to 1.25 tomorrow. I don't want to tonight while I am asleep. Do y'all think it is a good plan?

 

Can you b around to monitor? I think it'd be fine IF you can...just to be sure all stays well.

 

Thank you Rachel! I had a surprising AMPS. It was 151. I don't want to skip again. Should I go less than 1u. I will be home today to monitor her. Thank you!!

 

I think that'd be okay - as long as you can test. Especially around 5-7.

 

Thank you Sue! Will do!!

 

Well, she was definitely high all day. I think am going to go back up to the full 1u tonight. I ordered an auto feeder today. Should be here tomorrow. Random question, does anyone know how long it takes for half a can of food to unfreeze. More specifically what time should I put it in the feeder? Thank you in advance!

 

Not unusual after a low pre shot, but not a terribly high cycle. I still wouldn't shoot any higher on that range pre shot.

 

You wouldn't shoot any higher than .75? I am sorry for not understanding.

 

I think one unit on your 236 is fine. I am thinking about your amps. I am reluctant to advise people to shoot under 180. Sometimes people do, but usually with only a few drops on a number like 150. I know you didn't give a big drop after shooting the 150, but I think it could have been a flat cycle after a low one. I wouldn't shoot more than 0.75 on a number that low. But, as always she is your cat and you hold the syringe.

 

Oh wow! Okay, next time I won't shoot that low. Thank you for working this out with me. What is a flat cycle? I am just worried about the constant hunger and peeing. It's just so strange to have her doing that all over again. Could I have been just been taking her super low all these years and destroying her body?

 

A flat cycle is when the numbers are pretty much in the same range for the cycle, with no highs or lows. Sometimes we see it when there was a low cycle or number the cycle before.

No, I wouldn't worry about what came before. You are doing a great job now!mIf you are worried about peeing more than she used to, you might get her checked out with the vet, just to make sure there isn't an infection - especially if she is prone to UTIs.

 

Okay, makes sense! Thank you! Ya, she is do forblood work anyway. I was going to take her up there in a couple of weeks after we had some consistent numbers. She hates it there. Always makes a vet tech bleed.

 

If Piper is prone to UTI's, you may want to try D mannose, it's really helped Colin.
https://www.amazon.com/gp/product/B000HCMK90/ref=ox_sc_sfl_title_4?ie=UTF8&psc=1&smid=A367YBEX25WJNQ

 

That's awesome! Thank you Sharon. I'll order some today. Should I give it everyday?
Piper is at 182 this morning. I am going to keep her at the 1u, and monitor this afternoon.

 

Piper looked pretty good and even today. Thinking about keeping her at the 1u tonight. Do y'all think it is a good plan?

 

Sounds good. Can you get a before bed test, just to make sure she doesn't surprise us?

 

Ya, I definitely can! +2, or +3? I will be up for a while. Her auto feeder was supposed to be here today, but it never arrived. Hopefully tomorrow. As always, thank you for your insight!

 

Any data you get is fine.

 

Okay, great!

 

Hi there! Congrats on home testing. You will see how helpful it is for regulating Piper. So very glad that you started to post to get some feedback.

 

yu67

Hi Bobbie and Bubba! Thank you so much! This has definitely been a huge learning curve in the last week! I feel like an idiot for not doing it sooner. It's hard, but we are working it out. Thank you for your words of encouragement!

 

Don't beat yourself up. You are testing now and he will help you.

 

I give Colin 1/8 tsp /day. I have no real method, I give it everyday when I suspect he may be starting a UTI, or his numbers spike a little more than normal, but I stop after a couple weeks. I think it's fine to give it everyday though.

 

Thank you. Trying not to.

 

I hear that! I definitely feel her out. Thank you so much. Hopefully this will help her!

 

This kitty is bizarro. We had the best day together we have had in years. She laid on me today for an hour. She hasn't done that in 6 years probably. We had a low morning, I gave her a smaller dosage and now she is at 284. Any thoughts? What should I give tonight?
Also, I am feeding her more than I used to. She is eating at 9:00, 3:00, and 9:00. She used to only eat at 9:00. Amazon has lost her auto feeder, so I haven't started feeding her through the night yet.

 

Maybe one unit tonight?

 

Thank you Sue. That's what I did. It was my highest number yet. Has me freaked out.

 

Low morning again. 136@amps. I would rather not skip today, bc I can be home. Tomorrow I have to work. any thoughts?

 

Stall with your feeding and retest in 20 minutes.. Twice if it takes that long. I'd like to see 180 at least, and then a tiny dose.

 

congrats on the home testing. I've got the Walmart relion micro and I love it. I also bought a confirm later on to have as a backup, just in case. they both take the same test strips.

 

Dang! I already gave her food. I haven't given any insulin yet. What should I do now? Thank you for getting back to me!

 

You'd have to wait 2 hours to be sure the number is not food influenced. What is your schedule like today and tomorrow? Could you shoot later today and then gradually get back?

Next time, stall. Wait 20 minutes without feeding. (Food raises bg levels. You want a true number, not one food influenced) Retest to be sure the number is rising, not falling, and nearer your target number.

BTW, that was a great number!

 

I'm so mad at myself for not stalling! I know I should have waited. She had just been screaming for food for 4 hours. Ugh! I'm going to be here all day today, but not at all tomorrow. I have to work until 1:00 am tomorrow. Maybe just a very small dose? The 284 was just so high last night. Is it possible that she might not need insulin at all?

 

No worries. You are early to this sugar dance and she is in excellent numbers with a tiny dose. By the way, 284 is not terribly high. 400-500 is high! For reference, we generally consider a cat regulated if they are in the mid 200s at pre shot and in low 100s or double digits(but not below 50) at nadir. So she is already in regulated ranges.

She certainly looks like she will not need much insulin to push her into normal ranges (40-120 with no insulin onboard) It may take you awhile with very careful dosing and monitoring to get her there, but she is already on her way. The most important thing now, IMHO, would be to get her into normal ranges without risking a hypo. With such low numbers, you need to be very careful about dosing.

BTW, you might feed her about 3 hours before amps so she is not starving when you wake up. An automatic pet feeder is great for this. You can set it to close 2 hours before the test.

 

Amazing. Thank you so much for your insight. I'm going to wait and test her again 2 hours after her meal, and then possibly give a small dosage. It'll be better to have her at this time anyway with my work schedule this fall. I ordered the auto feeder three days ago, but amazon has lost the package. Ugh! It would definitely be a miracle to have her off insulin. The more I read on here the more I think I could have just been keeping her unregulated all these years. She initially went to the vet for a UTI and they just spot checked her there. She never had a curve, only fructosimine tests. She is psychotic at the vet. I'm sorry to be vulgar, but she poops herself there. She was always 250 with those tests. I probably have been just taking her super low and she has just been bouncing back. She is a miracle kitty for surviving this.

 

Thank you Misterbeesmom! I will definitely pick up a second as a spare. Smart. This has definitely been a HUGE wake up call. If only I had done it sooner...

 

Just remember that the dose following will need to be in the +12 hour range, and sure rising, not falling. Giving a dose after skipping a pre shot is called giving a CSD in our colorful shorthand. (A chicken $&@%# Dose). So a smaller dose than usual.

 

Haha! I like a CSD. So this mornings shot needs to be smaller or tonight's (12 hours later)?

 

it took me a long time to work up the courage to home test too. don't disparage yourself.

 

Thank you. Trying not to.

 

If you give a dose at +14, (even a small one) you'd need to wait until she is high enough again to shoot. That is unlikely to be at your regular pmps. Not sure if your schedule would work with that. You could test around +12 see where she is, but it is likely to closer to +14 tonight. Then that throws off your dose tomorrow.

Where is she now? You might just wait and you could shoot early tonight (after +10 or so) if she is sure high enough.

Shooting early or late messes up your schedule.

 

She was at 246. I gave her .75. I can have her at this time. It's better for my fall schedule anyways. The only time I can't be home is on Saturdays from noon to 1 am. This will give me better control anyway. My boyfriend normally gives her shot Saturday nights, and there is no possible way he could test her. So I'm assuming don't change anything (if her levels are fine), if I can keep her at this new schedule?

 

OK. Just so I sure understand. Her new schedule with her new amps is at this time; she had a 246 and you shot .75. Twelve hours from now you can test again for pmps. Do I have it?

 

Ya, exactly!

 

So piper went up again at her new shot time to 236. Should I keep her at .75 or move back up to 1? She also bit me. She was very mad she had to wait for food. Ha!

 

One unit gave you the unshootable pre shots. I'd give 0.75 a few cycles. I know 236!seems high to you, but it really isn't. It's a very good number for a new diabetic. I think she will go OTJ(anti jinx). It will just take finessing to get her there. And maybe some grey hairs on your part....

 

Hey Sue! OMG!! You just made me cry a little. I did give .75 last night. Hopefully we have a good number this morning! I went ahead and fed her 3 hours before her shot today (she bit me last night). I'm hoping that doesn't mess with her numbers too much. Do u have any tips or tricks on how to get her OTJ? I know I should switch to the u100 syringes for more accuracy. Do you know which ones to buy? Thank you so much for your help!! This is incredible!!

 

Hi y'all! Quick question. Piper has been staying awake pretty much all day. She sleeps maybe 3-4 hours while I am awake. Who knows what she does while I am asleep. I am assuming she is doing this because I am not overdosing her anymore and she is feeling better. I am feeding her more. 4 times throughout the day and night. Do y'all think that's the case, and could being awake that much effect her numbers? Thank you!!

 

I'd say that she is awake more because she feels better. She probably sleeps a lot at night too. I don't know if that could affect her numbers...seems unlikely, but maybe someone else will have some ideas?

 

Someone once said that activity lowers bg numbers. It was a time when the cat was in hypo ranges and they asked if excercise was a good idea. And they were told no, because it would further reduce the levels. I think that is the only connection I ever heard?

 

Thanks y'all! Hopefully it is because she's feeling better! She is a totally different cat. Running around jumping up and down off my desk. All of this change is very confusing for us both. Ha! I am not wanting to wake her up to test her. Hopefully she settle down into her new schedule soon. Thank you for your thoughts.

 

Hey! I just took a look at Piper's spreadsheet and i'm really liking those numbers!
Great job!

 

Thank you!! I just left the vets office. I was trying to get different syringes. They just told me by not using the alphatrack meter, her numbers were pointless. Ugh. You're comment is really really appreciated right now. Thank you!!

 

Pff don't listen to your vet! What a PITA, come on why would it be pointless? Well you know what, we all here support you and we do find them valuable!
What kind of syringes were you looking for? You can buy a lot of them online, you don't need to get them from the vets office, better not buy them there because it's really expensive there!

 

Seriously! I am in agreement. It was the vet tech. She just said that a human meter wasn't at all accurate, and I shouldn't change Piper's dosage without talking to them. I was looking for u100s, so I could just be more accurate. All of the numbers on the syringes have me so confused. Do you know which ones I should get? Thank you so much!

 

Jeez they really need to STFU! Well you know what you should do, don't tell them that you changed it... And just nod and smile.. That's it! You pay them, so they should not treat you like you're doing them a favor, it should be the other way around! Stupid vets, we do need them for other stuff, but when it comes to diabetes.... Men oh men!

See the picture I just made from my box I still have (you never know if you will ever need them) those are the perfect ones with the correct marks.
0.30mm (30G) x 8mm
You should be able to find it on Amazon I think!

 

Oh btw, you do know that you need to use the convert table if you are going to use U100 right? Because 1U in a U40 isn't the same amount in the U100

 

Thank you so much! That's exactly what I wanted to tell that woman. She just made me question whether or not I was doing the right thing, and if I am testing her right. And with Piper not sleeping, it just has me on edge. Ugh!!
Thank you so much for sending me a pic of your box! I did find the same one on amazon, but it was $70. Yikes! Hopefully I'll be able to find them cheaper. I just did a test at +4 and she was high. So I might not be switching doses anytime soon. Granted, I gave her insulin 45 min late because I was at the vet. I'm sorry for rambling. Just a blah day!

 

Wow $70 is extreme!
They are not that expensive, so maybe you can find it elsewere online. @Bobbie And Bubba @Sue and Oliver (GA) can you help with a cheaper deal online for those U100 syringes? I can't believe they aren't available for a lower price.... I bought mine for €15/€20 that's around $30 (+/-) so.

No need to say sorry, are you crazy? You're in your right to say something about this!

 

You can try buying U100 syringes at a human pharmacy or at a place like Walmart in their pharmacy section. I pay $25 CAD for a box of 100 syringes at my vet's or at a human pharmacy. If you're in the USA they're probably even cheaper.

 

Considering she got her insulin late, and was only 6 points higher than yesterday's amps, she looks fine.

Sounds like a bad day at the vet. We do know that human meters read differently than pet meters, but we make allowances for that. And when you consider the real dangers of not testing, using any kind of meter is an improvement. As others have said, U100 needles are the same one humans use and readily available. Print out the conversion chart and have it handy:
http://www.felinediabetes.com/insulin-conversions.htm

Maybe time for a relaxing drink of choice, some chocolate, a snuggle with Piper and repeating to yourself. "I have learned an amazing amount of important information in the last few weeks, and I am doing a great job with my kitty"

We think so!

 

Do you have Walmarts in your area? I get Relion syringes from Walmart, U100 a box of 100 syringes for 13 bucks. Here is a photo of the box of the ones I use.

 

Wow!! Y'all are absolutely incredible. Can I just say THANK YOU!! It is a rare person indeed to be so kind and helpful to a complete stranger. Just so you know, you are changing lives. Thank you for the info on the syringes. I will go to Walmart and get them tomorrow. I am going with the theory, "If you build it, it will come." Thank you again for everything! Hopefully I will have good things to post tomorrow.

 

You are so welcome. That is what we are here for. We are all just paying it forward as we were where you were when we started this journey.

ETA : Please print out the conversion chart that Sue linked for you to use as ProZinc is a U40 insulin and if your want to micro dose and use the U100 syringes you will need that conversation chart.

 

Hopefully one day I will be able to do the same! I will definitely print it out and study it before I attempt a smaller dose. I have learned more math and science in the last week than I did in college. Ha!! I will probably have a few questions though.

 

Ahhhh vets. They love to think they know everything. As Sue said you are doing an amazing job with Piper!

 

When I was using the conversion chart I hung it inside a kitchen cabinet and referred to it every time I shot, (two and three times) LOL It wasn't something I could commit to memory.

 

Thank you Rachel! We had a much better day today! She is peeing less, numbers are slightly better, and she finally went to sleep! She slept for 6 solid hours today. It's been like living with a newborn. Ha!

 

Ha! I will definitely be doing that! I'll probably just stick it on my fridge.

 

Well, Piper jumped up pretty high tonight. She was 291 at her PMPS. Should I raise her dosage to 1u? Thank you in advance!

 

I think Sue and the other experts have gone to bed and I'm not comfortable giving anyone dosing advice.

I will say that 291 isn't all that high relatively speaking, and personally I'm a chicken when it comes to raising doses unless I can monitor

Your ss numbers look awesome, by the way! Obviously you're doing great!

 

Thank you!! Ya, I'm a chicken too. I know I would sleep right through it. I kept her at .75 tonight. It was just so strange to have such a low day today and then that. Who knows, maybe it was just one weird number.

 

Very strange. Piper was 188 at her AMPS, after the 291 last night. Should I change her dosage, or stick with the .75? She has also had 6 bowel movements in the last 36 hours. That is a lot! They are mostly normal, solid. A few small ones are slightly squishy. I am feeding her an entire can more a day (3 FF Classics a day). Am I feeding her too much?