? HELP - ProZinc AMPS BG <200 for second day - Should I skip?

Discussion in 'Feline Health - (Welcome & Main Forum)' started by _Bobbie, Feb 11, 2020 at 10:57 AM.

  1. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    Hello,

    I just did Alex's AMPS and it was 165. I stalled and the next test was 180. Based on the Prozinc guide, I think this means I should skip this dose? What else should I do at this point? Should I test in a few hours? Feed him as usual? Thanks!
     
  2. Amy and Socks

    Amy and Socks Member

    Joined:
    Sep 30, 2019
    Hopefully someone with more experience will come along soon, but since you don't know how low the 1 unit is taking Alex, it's probably best to skip. It would be really helpful if you can get some other midday tests in today and when you do give insulin so we can see how the dose is affecting his levels.
     
    Callie & Patches and _Bobbie like this.
  3. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    Thanks. I have to leave in about 45 minutes, but will be home around 3:30 (about 4 hours after testing) and will test again then.
     
    Amy and Socks likes this.
  4. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    You could stall again for 20 minutes of you have not fed Alex yet.

    ps. Location data in your user Profile would help us to know where you are. Do not put this info in your signature.
     
    _Bobbie likes this.
  5. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    Ok, I will do that. Thanks!
     
  6. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    p.s. Change the title on your thread to get more eyes on your post.

    Include the word HELP, insulin used, BG reading, and briefly what you need help with. Put the ? prefix on your thread also.
    Upper right hand corner of your thread to edit the thread title.
     
    _Bobbie likes this.
  7. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    Just tested again, 20 minutes after second test and it was 169. So 160, 185, 169.
     
  8. Amy and Socks

    Amy and Socks Member

    Joined:
    Sep 30, 2019
    Those readings are all basically "the same". Meters have a 20% variance in reading, so it seems like Alex is staying pretty flat at the moment.
     
    _Bobbie likes this.
  9. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    OK, so I am going to go ahead and give him food since I have to leave shortly. I will test him again when I get home in about 3.5 hours to see how he's doing. No matter what, I should not consider dosing him again until the next cycle, right? I am on an 11am/11pm cycle. Thank you!
     
  10. Amy and Socks

    Amy and Socks Member

    Joined:
    Sep 30, 2019
    Not unless you plan on changing the schedule. If you shoot at say 3pm, then you'd now be on a 3pm/3am cycle.
     
    _Bobbie likes this.
  11. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Skip the shot for this morning. Pick it back up again this evening.

    p.s. Good job on changing your thread post title.
     
    Callie & Patches and _Bobbie like this.
  12. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    I just tested again 4 hours after the last test, and his BG was 187. I am going to ask now, since when it will be late (11pm ET) when I should start next cycle. If his BG at 11pm is still under 200, should I skip a second dose?

    Here is how he has tested so far today:
    11:10am 165
    11:30 am 180
    12:00 pm 169
    4:00pm 187

    Thanks!

    Bobbie and Alex
     
  13. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    If under 200 at PMPS, skip the Prozinc for tonight. Pick it back up in the morning. Not enough test data yet to know how YOUR cat reacts to the insulin. ECID Every Cat is Different.

    AMPS 11:10am 165
    + .25 11:30 am 180
    + 1 12:00 pm 169
    + 5 4:00pm 187

    + hour times are counted from the shot of insulin If no shot of insulin given, then I think you count from when you did your pre-shot test???. So please move the 187 to the +5 column on your spreadsheet (SS). Thanks.
    You might even have to reduce the dose so you can safely give insulin 2 times a day.

    If you have any notes on how much you are feeding your cat Alex, putting that information in the Remarks column on the SS (spreadsheet) can be helpful to those of us looking at the SS. Notes on how good his appetite is and how he is feeling are helpful too. Anything out of the ordinary like a vet visit is good to note also.

    For now, the 200 at pre-shot is your "pause and think" number or your "stall and retest" number. That 200 BG threshold can and will change with time.

    How is the home testing going? Does Alex like getting his "bribes" for the tests? Cooperative or still hates the shots and testing?

    450 BG at the vet on 2/5/20 and now down to the 200's in only a couple of days? Wow!!! Does Alex hate car rides and being at the vet?

    Ear Testing Psychology
     
    Last edited: Feb 12, 2020 at 8:55 PM
    Reason for edit: time
    _Bobbie likes this.
  14. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    Thank you for all this helpful info. I will add comments about his food and other details later tonight. His appetite seems slightly improved, though still not great. He seems a little less active, which has me slightly concerned, and I’m keeping an eye on him. Fortunately I work from home most of the time so can spend a lot of time with him.

    He is such a chill kitty, and has been so good. He flicks his ear a little, but otherwise seems fine. And he definitely appreciates the pieces of roasted chicken he is getting!

    I’ve been wondering about that discrepancy, too. He definitely hates going to the vet! I’m thinking it might be a good idea to get in touch with her this week to mention these numbers if they stay so much lower.
     
  15. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Just be sure you have a good, firm grip on the ear. I forgot a couple of times, Wink twitched his ear, and the blood splattered all over the wall, floor, bathroom cabinets,..........Looked like a crime scene from CSI.

    There is a possibility that "vet stress" spiked the BG levels up way high.

    Checking with your vet and letting him/her know what is going on with Alex is a good idea.

    What else besides the BG reading of 450 was the diabetes diagnosis based on?
     
  16. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    Neuropathy was the main reason I took him in. I initially thought his arthritis was progressing, but then saw some videos of cats with diabetes related neuropathy who walked just like Alex. His appetite had also diminished in the week before his appointment. He has always drank a lot of water and peed frequently, though oddly that week before the appointment he was drinking and peeing less.
     
    Deb & Wink likes this.
  17. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Getting the BG levels under control is the best treatment for diabetic neuropathy.
    Wink had it, really bad, but I got his BG levels back to normal and the neuropathy resolved.

    So nice to see when he started to walk on his paws again, instead of down on his hocks. Jumping skills got so much better too.

    Some notes on the SS in the Remarks column about the diabetic neuropathy would be good. So you can see over time how it improves.
     
  18. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    I did Alex's AMPS and it was 154. Stalled and it was 146. Similar to yesterday, though slightly lower. Thinking I shouldn't shoot again today? Last night his PMPS was 216. However, he may have had a little food in the 2 hour pre-test window since I was out and my husband was supposed to put his food away at 9pm but forgot. I held off on testing for an hour, so I know he at least had an hour of no food, and test was 211, so I gave him 1 unit of ProZinc, maybe I shouldn't have. I tested at +5 and it was 96. Anyone have any thoughts? Thank you!

    Editing to add that I updated the title of the thread. If I should start a new thread, let me know. Thanks!
     
  19. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I think you are going to have to lower that dose.
    But even then your target BG threshold when you are new to home testing is 200 md/dL.

    Can you stall a second time and retest in 20 minutes? If you have not fed Alex the cat yet.

    With Prozinc, you can stall up to 1 hour and still keep on schedule for the next 12 hour dosing cycle.
     
  20. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    Just tested again since it has been 20 min and he was 151. Should I give him a lower dose or skip? I will need to get the U100 needles. I also need to get in touch with my vet and fess up to her that I haven't been following her instructions.

    Also want to say thank you so much, Deb, for all this guidance. I am so grateful. Also, your Wink reminds me of my first kitty, a black and white named Basil. She lived to the ripe old age of 20, and I still miss her every day.
     
  21. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I don't think that BG of 151 is high enough to give the full 1 Unit of insulin.

    Will you be around to monitor this cycle? or do you need to head off to work?
     
  22. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    I am around almost all day. Away for a couple of hours tonight. What do you suggest? Partial dose? Should I test periodically?
     
  23. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    The test data is very slim at the moment, as you have not been giving Alex insulin AND home testing for more than a few days.

    I would suggest you not do more than 0.25U if you are able to measure that in your U40 syringes.
    Did you get the U40 syringes with half-unit markings on the barrel of the syringe?
    I want to send you a picture, so please hold off on the insulin shot for now.

    Monitor at least every 2 hours this morning dosing cycle.

    Prozinc is an in-and-out insulin, so you don't usually see any overlap into the next dosing cycle. No "depot" to account for when changing the dose.

    So your being away this evening has no effect on the close monitoring needed for this AM 12 hour dosing cycle.
     
    _Bobbie likes this.
  24. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    We do not have pictures of U40 syringes with the half unit markings. These pictures are for U100 syringes. The concept is the same for the placement of the plunger, with the "in between" the lines dose measurements.

    What you are looking to do, is place the end of the syringe plunger, the end closest to the needle, in the correct position.

    Pictorial guide using a U-100 syringe marked with half units:

    [​IMG] [​IMG]
    [​IMG]

    Fine dose gradations:
    • 0.5U = exactly half a unit
    • 0.4U = skinny 0.5 touching the line
    • 0.3U = skinny 0.5 with daylight under the line
    • 0.2U = fat zero with daylight over the line
    • 0.1U = fat zero barely touching the line
    There are also some pictures in this next link. It can be hard, very difficult to see the large drops of insulin in this next set of pictures. The drops are on the end of the needle, hanging below the needle tip. Pictures were taken back in 2006, and digital images have improved since then. But we don't have better pictures to show you.

    Fine Dose Pictorial Guide
     
  25. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    Unfortunately I do not have the syringe with the markings. I will have to buy some. I am attaching a photo of the syringes my vet gave me, with the 1 unit dose loaded.
     

    Attached Files:

    Deb & Wink likes this.
  26. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    OK, I took a chance and eyeballed it with the syringe I have, taking the risk since I will be here to monitor him most of the day. I will try to get some U100s tonight.
     
    Deb & Wink likes this.
  27. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Ok Bobbie. As we say here, "The syringe is in your hands." Meaning you are the ultimate decision maker.

    My computer locked up and I had to reboot. Took awhile. Sorry I disappeared on you.

    If you positioned the syringe plunger stopper about halfway or even a bit closer to towards the needle end, that is probably about 0.25U of Prozinc.
     
  28. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Vets don't often consider that insulin doses for our small cats might need adjustments in 0.5U increments. Or even
    smaller 0.25U increments. They rarely stock insulin syringes with the 1/2 unit markings. Vets tend to think of increases and decreases in the insulin dose in whole units.

    Much safer to only adjust the dose in smaller amounts. That way you do not bypass the dose that is right for YOUR cat. ECID Every Cat, Caregiver, Cycle is Different.

    You may need a prescription from your vet for insulin syringes. Drug epidemic has made many states restrict the sale of syringes.
     
  29. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
  30. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    Oh my goodness, Deb, no need to apologize. You have been incredibly helpful and responsive.

    I am finding that stores around here don't seem to carry syringes. I'm emailing my vet now, and will discuss.

    I did print everything out and have my toolbox together. Hoping I don't need it...

    Thank you!
     
  31. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Do you live in the US, Canada, Elsewhere?

    You could put that in your user profile. Not in the signature.
     
    _Bobbie likes this.
  32. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    I'm in the US (Boston). Just added it.
     
  33. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I'm about 35 miles north of there. But with the traffic, it can be anywhere from 1 to 2 hours on the road.

    It's a small world. Oh no,now I have the disney song ear worm running through my head.;)
     
  34. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    Wow! Small world, indeed (and yes, now I have that song stuck in my head too! Boston traffic is definitely not for the faint of heart.

    Alex's +2 (2 hours after AMPS, 1 hour after dosing) was 119. Will test again in a couple of hours.
     
  35. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    Since you are using ProZinc, you can use U100 syringes to mopre easily measure small doses. If you fill a U1oo syringe to the 1/2 unit marking with ProZinc that results in o.2 units of the ProZinc. Here is a conversion table
    http://www.felinediabetes.com/insulin-conversions.htm
     
  36. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    Thank you! I am hoping my vet will write me a prescription for U100 syringes.
     

Share This Page