First time

Hello all, my kitty was diagnosed a week ago and I just received my prozinc today and was told to give 3 units twice a day, starting tonight. Her sugar is running around 400 in the mornings and dropping to around 160 in the evenings. Just nervous that 3 units may be a bit much to start her out on. Any input appreciated. Thanks!

 

Hi Kristin, and welcome! Are you home testing, or was the 400 from the vet's office?

 

In case you don't see this until right before shot time: yes, 3 units is too much. We recommend starting at one unit, so please please don't give your kitty 3 units tonight - especially if you aren't monitoring her blood glucose at home.

 

I am home monitoring! The first couple days I was told to do it every two hours to get her curve and after that just morning and night. I also think 3 units is too much, I was thinking of starting with 1 and going from there.

 

Hooray! Would you be willing to put your data into our handy-dandy color-coded spreadsheet? It's already set up, you just need a google account (gmail) and link it to your signature. Then we can see what's going on, find patterns, and help with suggestions without having to ask you to repeat everything all the time.

I think starting at one unit is the best way to go. If her numbers are way too high on that dose, we can help you increase it fairly quickly, but in a way that won't make your kitty feel all crummy.

Here are directions for the spreadsheet and setting up your signature. If you have any trouble with either of those, or just fine it overwhelming please let us know. We have a couple of people around here who can help!

Spreadsheet

Signature

 

ok not sure if i did it right but i tried.

 

Your spreadsheet is there to see. You should add the insulin dose in the " U" column for AM and PM.

 

I havent given her any insulin yet. Im worried that 3 units is too much to start. Her first dose will be this evening .

 

Listen to your gut. You can always raise slowly as needed to find the right dose. I would start with 1

 

First dose given, I took everyones advice and started with 1, thank you so much!

 

Great job on the shot tonight! And also getting your spreadsheet set up so quickly! You have so much data already!

So to clarify - on everything up until today, the numbers were without insulin? Would you mind entering NS (no shot) in the numbers that were without insulin?

Also, what food are you giving her? And what is your feeding schedule? And your kitty's name?

We have a lot of questions at the beginning, but I promise the interrogation eases up as we get to know you!

 

So glad you started with 1 unit! I'm interested to see what numbers you get on this.!

 

My kitties name is Lola!! She is almost 11 years old and super spoiled! We got her from a rescue when she 4 and we are so glad we did! I will update my sheet in the morning and enter where no shot was given. We feed her at 5:30am and 5:30pm, at those times she gets pro plan wet food. I did some research into low carb foods like I was told and then had to find something she would eat. She also gets a small amount of merricks limited ingredient dry food, sometimes she is super picky. So she got her shot with 1 unit at 5:30pm eastern time her bg was 337 and 2 hours later it is 114!! So glad I didn't give her the 3 units!! I will check it one more time before bedtime to see where she is! Thanks!!

 

Oh dear. And thank goodness you didn't give the vet recommended dose! Kristin, you might want to stay logged in this evening. That is a 50% drop in two hours, and prozinc doesn't usually kick in until right around 2 hours. You may be headed for an interesting evening. I would suggest that you test again in one hour. It's possible with a drop that far and that fast that she may get a little too low tonight. Did your vet talk to you about hypoglycemia?

 

Are you using an AlphaTrak (or other pet meter), or are you using a human meter?

 

I am using a pet meter, and he didn't say anything about hypoglycemia, what do I do??? Now I'm scared!!

 

Please don't be scared. First of all, she may stay in perfectly safe numbers. And second of all, we know plenty of tricks to keep Lola safe no matter what. No need to panic. I'll post more directions in a second, just want to reassure you first.

 

On a pet meter, our "take action" number is 68. She's still safe at 68, but that's the point at which we start "fixing" the low number to bring it back up again.

 

ok how do I do that?

 

Prozinc hits nadir (the lowest point in the cycle) somewhere between 5-7 hours after the shot is given. That's why I want you to keep an eye on things for a couple of hours still.

You have her on low carb food which is great day to day, but do you happen to have any of higher carb food still in the cupboard? If so, what kind do you have? And do you have any honey/karo syrup/pancake syrup? Again, this is just a precaution just in case.

 

I have cans of friskies and reg purina dry food for my other kitties, I also have honey and pancake syrup

 

And one more time: please don't be scared. We tend to take a better-safe-than-sorry approach around here and I just want you to be ready. Odds really are that she's going to be just fine.

 

This whole process scares me just a tad.

 

Perfect. So now just take a deep breath and find something to occupy yourself for an hour until the next test. I'm working on super boring work stuff all evening, so I'll be around tonight. And I'm sure there will be other folks around later as well.

 

It's actually been an hour since I did it, so here goes nothing. Will let you know in a minute

 

Ok I says 425 now, that can't be right

 

Lol...well, it could be that the 114 was an error. Or I suppose the 425 could be an error....hard to know. As you collect more and more data, you'll be able to tell right away when a reading is most likely an error. Right now there just isn't enough data to be sure.

At 425, we certainly don't have to worry about a hypo! You could either retest now, or wait an hour and test again at that point. How long until you are planning to go to sleep?

 

Well usually a half hour ago lol but I can stay up another hour. I also tested twice just now and got 425 and 480.

 

Is it possible for it to go up some before it comes down?

 

Okay, sounds like the higher numbers are right then. Which means you can put the syrup away and have a good night's sleep!

Yes, it's not uncommon for the numbers to rise for a couple of hours after a shot, and then to start to go down later in the cycle. It's also pretty common in the early days of figuring out the dose to have an upside down cycle - that means that the numbers go up during the cycle instead of down. As the dose gets worked out, the cycle will start to look more like a smile - higher during the pre-shot times, and lower in the middle.

Go ahead and enter the tests that you got tonight on the spreadsheet, and then hug Lola and get some sleep I promise it isn't always this stressful!

 

Thank you so much! My vet has not been very helpful at all! Guess we will see what happens with the morning dose. Can't wait to get this all worked out and have a healthy kitty.

 

Vets do their best, it's just that most of them don't have a lot of experience or training in feline diabetes.

If you get a pre-shot number in the morning below 200, do NOT give any insulin. Over 200 you can give the one unit. Do you work during the day, or are you home?

 

And really great job managing all of this! It's stressful at first, but it will about as exciting as brushing your teeth in no time!

 

I am actually not working right now so I'm home usually all day. I can't wait for this to get boring!!

 

And just incase for tomorrow if her number ever drops to or below 68 what should I do?

 

This will take you to the links about hypos:

http://www.felinediabetes.com/FDMB/threads/hypo-links-be-prepared-just-in-case.48385/

They will scare you a little bit, so you might want to have a glass of wine with it.

Mostly you just post here and in the Feline Health (Main Forum) and people will gather around and start giving you directions. Do read the links though and put together a little kit (especially info on a nearby 24 hour emergency clinic) so you're ready if you ever need to be.

 

Yeah that's a little scary, I'm not sure where the closet clinic is, we live out in the country so not many places around us.

 

Sounds like you had your first wonky test strip. And welcome! Djamila gave you tons of info! Glad you decided to start wuth 1.0U too.
Feel free to ask us any questions =)

 

Where is the best place to test at? I usually use the outer edge of her ear but my husband insists on her paw pad, whenever we use her paw pad we get a lower reading.

 

Hey Kristin! Most people test on the outer edge of the ear. They don't have many nerve endings there, so it tends to not hurt (they just feel pressure).

The paw pad is fine too, but it's strange that you get different numbers. I am wondering if your husband gets enough blood? Could you guys try it out once where you test both at one time so you can see the difference? I know, that wouldn't be much fun but might help you see what's going on!

 

Do bear in mind that two samples taken at the same time can still give different readings, but the difference should be negligible unless there's something weird with the meter or strips.

Also just here to Nth the support for not starting her at 3u, especially when she hasn't been on insulin before. It would've been so easy to miss a good dose that way. If she needs more, increasing doesn't really take that long. Like you, I'm able to test very often too since I'm home a lot, and that definitely helps to speed the process along where necessary and get a clearer picture.

 

You had a great intro to what FDMB does best! You'll get Lola on track.

 

Kristin, great job getting your spreadsheet set up!

About the meter: many of us use inexpensive human glucometers because the test strips are much cheaper (18-25 cents) than the alphatrak strips (closer to $1) since we test a fair amount. Then use the AT2 just for doing curves for the vet, or checking low numbers. The AT2 is a great meter, and you can definitely keep using it, but if the price becomes more than you'd like to spend on the test strips, it's okay to switch to a human meter.

 

I am going to have to switch for sure, which human meter is best or does it matter? I am also thinking my husband doesn't get enough blood from her paw pad (this is his baby and he swears I'm hurting her lol). I also totally understand the logic about slowly getting her to the dose she needs but my vet made it sound like if I didn't get her levels down asap I was going to lose her

 

Many people in the US buy a ReliOn meter from Walmart (their store brand). There are a couple of models that take as tiny a drop of blood as the AlphaTrak. As far as ear testing goes, warming the ear in advance helps a lot and they bleed more easily over time from the growth of new capillaries.

Cats can tolerate elevated BG better than dogs and humans. Slow, careful dose increases are safest and guarantee that you won't skip over the good dose. That's why we recommend increases of 0.25 units at a time.

I see the picture of your lovely kitty when I click on your name but it's not showing in your avatar space. Not sure why.

 

I have really slow internet where I live so maybe it will show up sooner or later lol I am beyond thankful I found this space and have so many people helping me to get my kitty straight!

 

Hm, the avatar shows for me in both places. She's very pretty!

The ears definitely do learn to bleed over time. It was a struggle with Freya at first and her ears had to be super warm, but now her ears can even be a bit cool to the touch and plenty comes out with a little squeeze. It's kind of amazing, hahah. It'll get easier!

 

She shows up in the avatar space now.

 

Any of the Relion meters work and the strips are cheap. I believe the Prime has the cheapest strips, but the Micro and Confirm use the smallest blood sample (@Yong can correct that when she gets here since I don't actually use that meter). I use the meter from my local pharmacy. CVS (the pharmacy at Target stores) has a good meter as well. My meter takes a 0.5 blood sample which is on the larger size, but Sam's ears bleed like crazy so it's no big deal here.

I can see the Avatar now too. I think it just took a minute to load into the system here.

Try to get a test somewhere around +5 to +7 today. Kris is right about the increases of 0.25u at a time, and you can increase every three to six cycles (a cycle is 12 hours - so 6 cycles is like 3 days). That gives time for Chloe's body to adjust to a dose before moving on. If the adjustments are too big or too frequent it can cause bouncing (when the numbers go too high super quickly, or become unpredictable). You'll learn more about bounces quickly around here. They are just part of the process, but we do what we can to minimize them.

So I would recommend that you give the one unit tonight as well, and then tomorrow morning (assuming you keep getting the numbers we've seen so far), you can increase to 1.25u. You will likely end up at least at the 3 units your vet recommended, but it's gentler on Lola if you baby step it up there instead of starting there all at once.

If you do end up with a blue or green number at the mid-cycle test today, we might revise that plan though!

Lola has such a pretty face! How could you not spoil her?!?!

 

I'm actually going out now to get a human meter, and thanks! I think she's adorable but I'm also biased lol will someone be able to tell me how to read the human meter versus the at2? And how to adjust my chart?

 

There isn't a direct conversion between human and pet meters, but most of our Stickies are written based on human meters, and we can definitely help you start to make sense of it all.

As far as the spreadsheet - I know a couple of people have switched over, so they may have a better idea than this....but I am thinking it might be easier to just download the spreadsheet for the human meter, and then cut and paste your current data into that spreadsheet, then add a note across the top of the AT2 data that says it was with that meter, and then another bar indicating the beginning of the human meter. If you look at my spreadsheet around 3/13/17, there is a row I inserted to indicate a big food change that we made -- so maybe something like that?

Then update the link in your signature to the new spreadsheet.

Does that even make any sense? I feel like I didn't explain it very well.

 

Oh, and the best part is that human meters give lower numbers than the AT2, so you'll quickly feel better about the numbers you're seeing

 

So her +2 number was 213 and her +6 number is 404, I did get a human meter and will try and figure out how to switch the data over

 

I see 213 at +4 on your SS.

 

You are right it was +4 I'm sorry!!

 

So the 404 was +6? That can mean that she has had an early nadir today - it can move around.

 

Ok I believe I got the spreedsheet updated and I will start with the new meter in the morning just to make it easier to document on the new sheet. I know that Djamila told me that my take action number for the pet meter was 68, what will it be on the human meter?

 

It's 50 on a human meter because those read lower than the pet meter.

 

ok one more question for now, how do I change the name of the link to my spreadsheet? lol

 

Not very techie but I think it goes like this:

1. copy your SS URL
2. open your signature
3. in the text box, type in the name you want for your SS and highlight it
4. click on the paperclip icon at the top of the text box
5. paste your SS URL into the dark blue bar that appears and click "save".

 

Hello!
Yes the ReliOn Prime uses 0.6µl with cheaper test strips. Confirm/Micro only use 0.3µl which is what AT2 is listed as but I feel like AT2 takes a little less even .

Can you add some more information to your Signature too? To include at least the following:

• Name / age
  
• Dx date (diagnosis)
• Insulin
• Any other health issues
  
• Meter
• Diet
• Time Zone and or general location

Is my understanding correct, that last night was her first insulin shot? Just looking at those AM cycles from 22/23 May

 

Oops. I didn't even have general location on mine! I'll add it now...

 

It's ok, it's just taken me like 4 months to remember you are west coast

 

Ok signature updated!! Last night was her first insulin shot. The low numbers on the 22/23 I believe are from where my husband was testing and he likes to use her paw, I dont think he gets enough blood and it throws low numbers that way. I could be wrong but thats my guess because they are never that low any other time.

 

Ok, her +2 number was 329 and I am going to do it at +4.......should I still go up with the morning dose by .25??

 

Yes, I think you can try 1.25 u tomorrow morning.

 

Yep, me too. You got a nice drop from AMPS to +4 today!

 

Thank you guys! I had to do a +3 instead of a +4 because she has settled in to sleep with the husband lol that reading was 313. So I will try 1.25 in the morning!

 

Ditto!

 

HI Kristin! Welcome to the board and the land of Prozinc. Glad to see you're getting a good handle on things, and the super experts are helping as they always do!
I need to get my location in my signature, too!!! Oops!
What prompted the vet visit to get the diabetes diagnosis for you?

 

Hi! Lola has anal gland issues and the poor thing had a flare up last week so we took her in right away! They said her levels were elevated (580 I believe) and that some of it could be due to stress, since cats blood sugar rises when their stressed but they felt it was a little too high and suggested I home test to find out. They were right, so now I am just trying to get her where she needs to be!! Everyone here has been great!!

 

I can't help but think Starfish issues again . To fill Kristin in, another member who just got her kitty OTJ (off the juice) had similar issue and referred to anal glands as starfish

 

I just wondered if the was a DKA (diabetic ketone acidosis) that made the vet so super anxious to get tons under control and to kind of freak you out. You had some decent PMPS without insulin...hoping you get it under cinema with a low dose.

 

Also, stress, illness, infection, and a vet visit areally all things that can raise BG, so maybe when Lola starts feeling better the BG will decrease at least some on its own. (Which is why it's so important to home monitor, so great job with that!)

 

I agree Lola was totally stressed out, so bad in fact that she didn't do any of her normal "stuff" for 3 days!! But I am happy to say this is the first morning I got a reading below 400! 316 woohoo!! So I may just stick with the 1 unit and see what happens. Good idea or bad idea?

 

I've read anal gland problems often stem from poop issues.... The analysis glands are natural expressed with a good poop. Does your cat have problems with constipation or diarrhea?

 

Today is the first test with a human meter? That would explain the lower number.... Human meters run lower.

 

It's probably due to the switch to human meter. I do think that the 1 unit was fine this morning, but I'd go to 1.25 tonight if she's in similar numbers. That could be nice too since you can monitor and have all weekend to see how this dose works for her!

 

Yes, the human meter gives lower numbers, which is kind of nice for our feelings about this whole process. It looks like you're good to move forward with the increase to 1.25u tonight. Nice job getting the spreadsheet figured out, by the way.

 

I agree. You can try 1.25 u tonight. I hope Lola is less stressed today.

 

Thanks everyone! Lola is starting to finally get back to herself! I am going to do the 1.25 u in the morning because it's harder for me to monitor her at night than during the day. I would rather be safe than sorry

 

Always better safe than sorry!

 

Ok did 1.25 u this morning! I updated her sheet with the latest numbers

 

Hurray for you! I like that yellow at +2.

 

More yellows for Ms. Lola . Maybe she will sneak a blue at nadir (anti-jinx)

 

Keep it up, Lola!

 

I wasn't able to monitor as much as I would have liked due to basement renovations but she seems to be getting closer to where she needs to be! No red numbers for 2 days now!! It really is the small things in life that excite me

 

You're getting some nice predictable responses from Lola. The dose will have to come up a little to shift the whole curve down but that doesn't need to be rushed. I can't imagine you starting at the initially recommended 3 units!

 

It scares me to think what would have happened if I had started at 3u !! I'm also thankful I found this group to help me get her where she needs to be! I also can't wait to see blue numbers!

 

Lola is gorgeous!

 

Thank you!! I love Chloe's eyes!! So cute!

 

Almost in the blue this morning!!

 

Come on Lola! Give your momma a blue today!

 

Oh so close...keep going Lola! Just a little lower!

 

Come on Lola...you can do this!

 

We have blue!!! Yay!!

 

Yeah !!

 

Well this morning she was in the blue before her morning dose, was I right in skipping that dose since she was in the blue?

 

Good call. She was just on the margin and we generally say no shot under 200. As you accumulate more data you'll be able to revise that number downward a bit. Let your experience and comfort level be your guide.

 

It is better to be safe than sorry, especially since this is all relatively new for Lola. In the future though, if you get a number like that, you can try stalling for 20 minutes without feeding, and retest. Most of the time, the number will have risen high enough that you can give the shot. While sometimes a shot has to be skipped for the safety of the kitty, it's usually better if you can avoid skipping so that they don't run high for a cycle. The stalling technique usually works for kitties in higher numbers. You can stall for up to an hour past the normal shot time, and then you have to decide to either skip, shoot a reduced dose, or shoot the full dose. You'd only want to try the full dose if she was close to the 200 mark and you are going to be around to monitor (get extra BG tests).