Hi guys. So sox was put on his first lot of insulin Saturday 10th November. The vet gave him 1.5u insulin and said we didn't need to home test before shots were given. Sox reacted really quickly to the insulin and was still quiet a low number when the night shot was due. No night shot was given after some good help through the day from other members on here. They also advised to drop his dose the next day as he BG was still lower and because I was going to be at work and couldn't monitor. We have put his dose up to 1u yesterday as he seemed to have settled on the 0.75u. One thing I have noticed is that his morning readings seem to be going higher now than they were pre insulin? Sox gets BG check and half his breakfast at 7am then the other half at 7.30am with his insulin shot. A mid day snack at around 12.30 - 2.30. 7am and 7.30 am again with BG check and shot. And then a pre bed snack between 9.30 and 10.30. My spreadsheet is attached if and one can give me any advice on this? Will these high numbers settle as the sox gets more used to the lower numbers? Thank you
Hi Becki and Sox! Welcome to our forum! I'm very glad to hear that you're home testing. It sounds like Sox is really responding to insulin! Are you using a human meter or a pet meter? Okay first, yes. Sox's numbers should come down as he gets more insulin. It's not that odd that his BG is that high at preshot. My guess is the insulin dose is a little too low, and that's normal. Looks like you've been on 1 unit now for 3 cycles and he's been sticking in somewhat higher numbers, while still getting a good drop, which is great. We usually suggest increasing insulin every 4-6 cycles if the dose isn't getting what you need. I would probably stick with 1 unit for another cycle, get whatever mid cycle tests you can, and if he doesn't drop lower, I might consider upping him to 1.25. Can you do those smaller increases? I know 1.5 was too much the other day, but it actually gave you a really beautiful cycle. Those greens mid cycle were exactly what you want. It just was a bit too low at night, especially so early in the insulin journey! That's what tells me 1.25 might be good. 1 unit is getting you blues and yellows. 1.5 gave you too low a preshot. 1.25 might be just right? Something else to think about is that the insulin needs change over time. You can find that a certain dose is too high at one point and then later, find that the dose is exactly right. As the body adjusts and the pancreas (hopefully!) get some rest and start maybe putting out some insulin again, the insulin needs will change. What kind of food do you feed? That's something else that can affect BG numbers. We usually feed low carb wet food but I'm not sure what you have available. Sorry this took so long to get back to you! We're mostly on the West Coast here, so we're all asleep when you posted earlier. Others will be by later as we start to wake up! Please ask all the questions you want. We've all been new before and it's tough! We'd be more than happy to keep helping you work through dosing. It'll get easier as you go along and Sox looks like he's really done well so far!
Hi @Rachel thank you for getting back to me. I'm currently using a freestyle freedom lite human meter. I work 9 till 5 through the day and can only get day shifts do work round my husband's shift. I can increase doses just depends on husband's shifts or weekends always work for me as I don't work then. Dry food has been taken away and I now feed just wet food with carbs around 7%. Do you think my feeding schedule is ok (few small meals a day) or is 2 meals a day sufficient? That's not a problem I was thinking that alot of people were the other side of the world from me lol Thank you I've had some really good help on my other thread who guided me through my first day of insulin so I'm very greatful for all of you who can offer advice. Thank you
Welcome Becki and Sox! Rachel has given you great advice. Feeding a few small meals over the day is ideal for most kitties. They seem to be happier with that and it can help to stabilize their blood sugar. I agree with Rachel's suggestion to keep the 1 u dose for another cycle or so and then increase to 1.25 u if you don't see lower nadir range numbers.
It depends on the cat, but for most cats the lowest number is somewhere between +4 and +7. And Hi and Welcome!
The nadir time will move around but it generally occurs in the +5 to +7 range with ProZinc. Doing a full curve on a day off can help you pinpoint it but that only works if the kitty is *relatively* predictable. Oops! I see that Djamila just posted and gave a different nadir range ...
My kitty hit nadir at +3 for the longest time, so I tend to skew the range a little bit given my personal experience with an early nadir cat. You're right though Kris, I think +5 to +7 is probably more typical.
Ok thanks every one. I can increase his dose but it would probably be Sunday as I'm in all day then. I could do tomorrow morning and my partner will be there for +5 hours after injection and he would give food before he leaves for work. But then Sox would be on his own for 6hours on his own. Would you advise the change when some ones in all day with him?
Yes, it's best to increase on a day you can monitor, especially in the early days when you're gathering data and learning his responses.
I think it's fine keeping to the 1u in the interim. (Unless you see a low number that warrants a decrease in dose.) Sox 'is' certainly responding to the insulin. But (it seems to me that) the blue numbers, and occasional steeper drops, are causing his body to be a bit reactive. It may be that by Sunday he'll have got a bit more used to dropping into blue numbers, and that would be good prior to increasing the dose. .
Yes hopefully. That's what I'm thinking if he gets used to the drops he might react better to the increase too. If I ever need to look out for a pre test number at night which ment I wouldn't give insulin would that be around the 11.0mmol
Not sure what his lowest number through the day was but back up to 19.5 preshot. He definitely seems to bounce after the lowest point. Let's hope he settles into a lower routine
FYI: Becki has 3 threads running simultaneously: New to this forum and new to cat diabetes New to prozinc first week of giving insulin any advice (UK) this thread I've asked her to continuing to post here so you'll have the information you need to help... all in one place.
Sorry I managed to post the same thresd twice in 2 different places. I did try and delete the one bit don't think I can delete it. Sorry again.
No worries... not a problem! Now that you have a spreadsheet up and home testing it's best to post in a support group with others who are experienced with prozinc. Congratulations for getting everything together so quickly!
Morning guys so after quiet a good curve on his 1u last night do you think from looking at the spreadsheet do you think we will need to do checks through the night tonight?
Good morning Becki! You're intending to increase on Sunday correct? It looks like Sox had a nice curve last night, nothing too low or even approaching that. If it was me, I'd probably try to get a +2 tonight if you can (that's always helpful) and then go to sleep. You deserve some rest! I'm not sure what your routine is, so if +2 isn't possible, as long as Sox doesn't throw you some crazy preshot, don't worry about it too much.
Yes I am looking to increase on Sunday just as were not home during the day today or tomorrow. I normally feed him at 7.30pm so can do the +2 no problem. If at the +2 if he's in or around the blue numbers an I ok just to go to bed... I just worry a little if he drops to low and I'm asleep I won't be there to help. Do you generally advise through the night tests?
Good numbers last night! Here's a very general guide for how to predict what *might* happen: if +2 is higher than PS - probably no big drop to come so go to bed if +2 is about the same as PS - get a +3 and if that's lower maybe give a small low carb snack and if you're worried, set an alarm for a later test if +2 is significantly lower than +2 - give a small low carb snack, test again at +3 and be prepared to continue small snacks and testing because the lower +2 can often be a sign of a bigger than usual drop to come. Make coffee.
@Kris & Teasel so if my numbers at pre shot and +2 hours are like last night would you suggest a later recheck or would it be ok to sleep through as he probably would stay in the blues wouldn't he? Before I go to bed he always gets a small meal of his low carb food.
You had a 209 at +3 last night. That's a biggish drop from PMPS so a +4 as you did was a good idea. The low of 140 was very safe but a great number. So many of these decisions are based on the judgment that comes with experience. Even then, kitties will do unexpected things. It's hard to learn to live with a certain degree of uncertainty but you will. If you have a good hypo kit ready and have read about what to do you'll be fine. You can certainly post on the main forum using the red 911 icon if something happens and no one answers on this forum. Also - dealing with a low BG situation a couple of times will teach you that it's manageable. We all worry about what might happen when we're away at work. That's where a spreadsheet full of data to refer to and make decent predictions helps a lot. An automatic feeder can help so Sox has meals while you're out. They will often want to eat if their BG is low-ish. Keep asking questions. We're here to help and support. We know how scary and confusing it is!
I know I keep getting really high highs and the big drops due to him been so high. Would a change in dose still be a good idea on Sunday or would it be worth sticking with the 1u a little longer to see if his body get used to the lower numbers and brings the highs down that way. Or does it not work like that. It is very scary... I get anxious at the best of times but this makes it worse
I think I'd wait until we have today's data and tomorrow's data to decide about the increase on Sunday. Especially with a newly diagnosed kitty, it's hard to project out very far.
I hear ya. Sox looked like he might have been on a mission last night. Now you have a better idea of what he does at night and you'll hopefully get a good rest tonight!
@MrWorfMen's Mom I'm hoping so. If he's PS and +2 hours is roughly like last night I might be able to do a full night sleep
Right guys PMPS @7.30pm 20.3 now at 9.30pm +2 they are 13.9. He's just had his small pre bed meal of his usual low carb food. Do I need to test again do we think or will we be ok for the night?
I'd get a +3 and if it's similar in range to last night's +3 you're *probably* OK. I say test again at +3 because you have a 100+ point drop from PS. Set an alarm for around +6 if it'll give you peace of mind. This is all part of the pattern learning.
He does seems to be having quiet big drops in BG...I'm thinking it's because his PS bloods are quiet high... Could he still be bouncing? 10.7 +3 hours would you guys test again later or do you think he will be likely to stick in the blues like last night?
Hi. Don’t know when you’ll see this with the time difference, but even though 209 (+3 last night) and 193 (+3 tonight. I’m looking at your US-numbered SS page) are different colors, they are essentially the same number given how a meter can vary. Your PS last night and tonight we’re essentially the same, too, so if it were me, I would probably get a good night’s sleep on the assumption that tonight will continue much the same as last night.
Yes he seemed to my husband got up in the end. He's been off the dry food since found out (end if October) and his low carb wet about 2 weeks.
If you're home tomorrow you could try giving 1.25 u. He's ever so close to giving you some very nice middle cycle dark greens but you want to approach cautiously. Do your syringes have half unit marks? If not, do your best to eyeball that 1.25 u. You could make yourself a reference syringe by drawing up some coloured water to your estimate of 1.25 u and use it as a visual guide for drawing insulin while you're at that dose. Later on, you might want to buy some U100 syringes with half unit marks and use them in conjunction with this conversion chart: http://www.felinediabetes.com/insulin-conversions.htm
I've attached a picture of the syringes. They have whole and half numbers on. When we were giving the 0.75u we just eye balled that one just went in between. I'm just thinking cause his high numbers are going higher now will putting him on a higher unit make them go higher still morning and night pre shot?
It's good to have those half unit marks. Try not to worry about the higher pre shot numbers. We assess a dose by looking at the low numbers mostly. The PSs are often high until a kitty is more settled. Some kitties will continue to be high at the ends of a cycle but if they spend some time in high dark green (ideal) or very low blues (very good) within the cycle we say a dose is good. The pre shot numbers tell us something about the kitty's propensity to rebound from the lows and also whether it's safe to give the planned dose. Much lower PSs *can* be a sign of a dose that's too high.
@Kris & Teasel ok thank you for that. The only reason I worried about the higher numbers is because they were not always that high before we started on insulin. I'll start with the 1.25 unit tomorrow and check every 2 hours for my curve.
So PMPS tonight is 15.9 which is lots lower than what he's been the last few nights where he's been in the range of 18-20. Am I still ok to issue a 1u shot tonight. And do I still stick to the plans of increasing tomorrow to 1.25u any help would be great guys
Okie dokie, was just wondering if the 1u might have been enough of that pre shot number seems to be lower now. Quiet surprised when I saw the 15.9 reading tonight after it had been in the 20s past few nights.
