Just diagnosed HELP

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Pepe's mom, Nov 10, 2012.

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  1. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    Pepe just got diagnosed yesterday. He is used to eating when he wants and it's driving me nuts! Can he have snacks (he gets freeze dried treats) between meals? He is on 1 unit of Prozinc twice a day. Plus I'm not sure how much to feed him. My vet didn't say. He eats Proplan (small cans) or Fancy Feast. thanks. I'm at the follow him around and make sure he's okay stage.
     
  2. hmjohnston

    hmjohnston Well-Known Member

    Joined:
    Dec 30, 2011
    Greetings Pepe and mom!

    Yes- freeze dried treats are great for snacks- we suggest them as treats for home testing.

    Food- the FF classics are good food- but make sure it is the classics and not the other kinds as those are all too high in carbs- especially the gravy ones. Don't know about the proplan ones.

    https://docs.google.com/spreadsheet/ccc ... hYXc#gid=0 (called Hobo's List)
    http://binkyspage.tripod.com/canfood.html (called binky's list)
    http://www.catinfo.org/docs/Food%20Char ... -22-12.pdf (new list from CatInfo.org)

    The amount- most cats are diagnosed FD after they loose a lot of weight and that is because they cannot get the nutrition of of the food they eat and they are literally starving to death while eating all they can. So, currently, feed all Pepe wants to eat. He will slow down once he gets regulated with the insulin- my cat was 15-18 oz.day and is now down to around 8-10 oz now that she is regulated. Free feeding is okay- freeze the food in ice cube trays and add water to keep it fresher, longer if you are gone all day.

    And we also suggest home testing- you wouldn't shoot yourself or a baby without testing to see what the BG level is- why do the same for your fur baby?
    You need to get a glucometer to test your cat- a human one is fine and reliable to use. It reads different than the pet ones but all you really need is the consistency of the levels day in and day out. You might be able to get a free one- there is a spot just at the top of every page that says home testing kits. Here is a link to what's inside:
    http://felinediabetes.com/FDMB/viewtopi ... 28&t=60261

    If you purchase one here is a list from Consumer Reports:
    http://felinediabetes.com/FDMB/viewtopi ... 28&t=70140

    You need to look at the ones that have the cheapest strips- not the cheapest meter. The meter you will buy once, the strips you will continue to purchase over and over again. A lot of people on the board use the Relion micro/confirm meters from Wal-mart because the strips are the cheapest around- $.36 each and usually easy to get (and you can get the strips even cheaper online through the ADW site). Bayer is another popular one. Be wary of the generic kinds that have the word TRUE in the name- those have been inaccurate in the past for higher #'s or don't go above 299- and another bad one is the Freestyle Light with the butterfly on the strips- both of these have led many pet owners to believe their cats were okay when they were really in trouble. And you can do your own curves at home when you home test- that is cheaper than doing it at the vet. There are several U-tube videos out there to watch that will help show you how to test.

    To keep up with the BG #'s there is a spread sheet (SS) that we link to our signature line. Here is the link to set up:
    http://felinediabetes.com/FDMB/viewtopi ... =6&t=18207

    Good luck !

    Heather
     
  3. squeem3

    squeem3 Well-Known Member

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    Dec 28, 2009
    Heather's links are broken. Here are the correct full links:

    Hobo's Guide to Nutritional Values: https://docs.google.com/spreadsheet/ccc?key=0AmkyagqUb3nudG9sRVhTVnFEWlhaU19ZUXkxTnlhYXc#gid=0
    Binkys canned food charts: http://binkyspage.tripod.com/canfood.html (info several years out of date)
    New food list from Catinfo.org (Sept. 2012): http://www.catinfo.org/docs/Food Chart Public 9-22-12.pdf

    There are also these charts/lists:
    Pet Food Nutritional Values list: https://docs.google.com/leaf?id=0B8...MzhkYTkxOGM4NThk&sort=name&layout=list&num=50
    Dr. Lynne's Wet Food list: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=12846
    List of low carb/gluten free Fancy Feast: http://www.felinediabetes.com/glutenfree.htm


    Hometesting kit info: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=60261

    Consumer Reports info on blood gluocse meters: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=70140

    How to set up a Google spreadsheet to track your cat's blood glucose levels: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

    How to create a profile (mini history of your cat): http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=82802
     
  4. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    Thanks everyone. I am beginning to wonder about my vet after readying here. I had read a little before I went to get Pepe from his glucose test (which she told me nothing about). I asked her about home testing and she said didn't recommend it as cats had to walk on their feet and that is where I would have to draw blood from!
    Pepe didn't loose weight. Maybe a few pounds. He is 12 lbs. 13 years old. I am trying to add a picture of him. All he will eat is stuff with gravy. He refuses and pate. I have been thinking of a raw diet, like Feline Pride (i think that's the name)

    Thanks again for your help and I'm glad I found this site. I'd be going nuts without it!
     

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  5. Lisa and Witn (GA)

    Lisa and Witn (GA) Well-Known Member

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    Dec 28, 2009
    The majority of us hometest using the cat's ears. If you look closely at your cat's ear, you will see a little vein running around the edge of it. When you test, you will poke between the vein and outer edge of the ear. You only need a small drop with most meters. This usually does not bother the cat, just reward him with one of the treats, even if you are not successful in getting blood. Massaging or warming up the ear, helps to get the blood to flow.
     
  6. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    What do I do once I get the numbers? I read about keeping a spreadsheet and that the numbers give indication on if insulin is needed but that's all I understand. thanks
     
  7. squeem3

    squeem3 Well-Known Member

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    Dec 28, 2009
    You can test blood gluocse levels using the ear. Few people here use the paw pad. Here is the hometestingtips and videos: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=287

    A raw diet is great :smile: There are many people here who feed only raw food or a part raw / part canned food diet. Feline's Pride is a good brand but I think it can only be bought through the online web site? There are other good brands of commerical raw food you can buy at independent non chain pet stores/boutiques, such as Nature's Variety and Primal Pet. There are several commerical raw food brands listed near the end of the Catinfo.org food chart.

    Making your own raw food is another option. Lots of people here use the one here: http://www.catinfo.org/?link=makingcatfood The one here is also good: http://www.catnutrition.org/recipes.html

    Gravy foods are yummy but not good for a diabetic cat. The starches used to thicken up the gravy keeps a diabetic cat's blood glucose levels too high. The carb content for many gray foods are over the ideal 10% carb limit for diabetics. I know that the Fancy Feast varieties in gravy are over 18% carbs. You can try putting some stinky tuna juice (from a can of tuna in water) on top of regular pate food or even raw food to make it more yummy.

    Do keep a few cans of gravy foods on hand, though. if your cat ever becomes hypoglycemic, the gravy will raise blood glucose levels and keep it stable. Corn syrup/honey works as well but the effect wears off pretty quickly. Here the hypo reference sheet: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=1122 And the list of supplies to have on hand: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=2354

    For now, just keep track of the numbers :smile: The spreadsheet is a great way to track numbers and patterns and understand how the insulin and dose is working. Most people here have a link to their cat's spreadsheet in their signature. You can take a look at some to get an idea of how people are using it for their cat.

    As a newbie, do not give any insulin if the blood glucose level is under 200 mg/dl. You do not want to risk sending your cat into a hypo a few hours later. Normal non-diabeic levels are roughly 60 to 150 or so.

    I'm not familiar with Prozinc but there are many people here who can help you understand what your cat's numbers mean.
     
  8. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    Do I need to panic that Pepe has thrown up his breakfast? I got him to eat a few bites afterwards. I don't have a meter yet. He ate about 1.5 oz this am (6:45 ish) and gets 1 unit.
     
  9. Helene & Cleo

    Helene & Cleo Member

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    Oct 22, 2012
    Did Pepe eat well last night? If so, I wouldn't be overly concerned, as long as it is a one off. Sometimes cats just puke, for no real reason!

    You say he ate a bit more afterwards - have you offered him any more food since? Just offer small amounts often perhaps, to try and keep up his interest in food.

    As long as he isn't seeming ill otherwise, or showing any other symptoms of being unwell, I'd just keep an eye on him.

    But if Pepe refuses to eat throughout the rest of the day, please do post again and let us know, as that could have more serious implications.

    Good luck!

    H
     
  10. Helene & Cleo

    Helene & Cleo Member

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    Oct 22, 2012
    It would be helpful if you could phone up your vet and ask her for the results of the glucose tests they took. Did they do a one-off test, or keep Pepe in for a whole day to plot a glucose curve after giving him his first dose of insulin?

    Regarding the blood glucose testing - yep, as everybody else has said, we use the ears to test from, not the paws. Have you got hold of a glucose meter yet? As already mentioned by Heather above, Walmart sells a well recommended meter called the ReliOn. The meter itself is very cheap, as are the test strips. Lancets are not expensive either. To start with, you may find it easier to use a slightly thicker lancet, maybe 26G (the higher the number, the thinner the needle). This will make it easier to get enough blood without having to poke more than once.

    Also, don't hesitate to educate your vet about what you are learning; tell her about what your plans are for BG testing, explain how it is done with ear pricks, and hopefully she will support you in this, and work with you.

    H
     
  11. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    Pepe ate more later and is now napping and I'm thinking about a chill pill! :) Pepe stayed all day. The vet said he was 400 and something first thing and then at noon I think was 168. I've ordered a meter through this site. I'm thinking this vet (it's a new hospital I'm going to and she is the second vet I've seen there) doesn't know much about diabetes as she didn't say much. I received a insulin kit and a pamphlet. She mentioned higher protein food but not how much. I am supposed to go back Friday in the evening for another blood test. I did ask about home testing but she said it was easier for them as I'd have to stick his feet. I asked about meters and she said they use a human one. I'm going to call tomorrow and make an appt for the other vet and ask some questions. I'm making a list! thanks everyone
     
  12. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    You do not have to poke his feet. Some members here do, if their cats refuse to let them do the ears. But the vast majority of us poke the ears. Here is how it is done: Video for hometesting

    While you are waiting for your meter kit, get him ready for the process:

    First pick a place where you want to test. Some people use the kitchen counter, a blanket on the floor, between your legs while sitting – whatever works for you. Take the kitty there and give him/her lots of praise while you play with his/her ears. Give a treat and release. Next time, add the rice sack (thin sock filled with raw rice, heated in the microwave until very warm but not hot) or a prescription pill bottle filled with very warm water. Lots of praise, treat and release. Finally add the lancet so he/she will get used to the noise. The hope is that when you finally poke, they will be used to the process and know a treat is coming!
     
  13. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    2 questions -
    How long after Pepe eats do I give the shot?

    How long before the insulin starts doin something? Prozinc 1 unit

    thanks
     
  14. Helene & Cleo

    Helene & Cleo Member

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    Oct 22, 2012
    I don't know much about Prozinc specifically, but generally speaking as long as you are sure your kitty has eaten a good breakfast and hasn't thrown the lot up, you're okay to shoot. I used to feed Cleo shortly after waking up then do her shot about half an hour later, just before I was ready to leave for work. I should have been testing her BG before feeding her, but I have only managed to get into the habit of daily BG testing since a frightening hypo experience, shortly after which we stopped giving Cleo insulin as she is just about sticking to near-normal numbers. Goes to show the massive importance of BG testing - I almost lost Cleo, because we hadn't realised her need for insulin has dropped significantly and were hugely over-dosing her with insulin every day.

    To answer your second question, how long before the insulin has an effect - it will act immediately, easily lowering blood sugar by a couple of hundred mg/dl points within hours. This is again why it is so important to test BG mid-cycle as well as pre-shot, to see how low the BG is dropping.

    Over the first week or two you will begin to get the full picture of how the insulin is effecting your cat. Regular BG readings will really help with discerning whether the dosage is correct, and if you post these readings this will help other forum members to interpret them and possibly assist with any dosage adjustments.

    Please do post your BG results onto a spreadsheet as suggested above - here is the link again for setting up the spreadsheet:

    viewtopic.php?f=6&t=18207

    Best of luck,

    H
     
  15. hmjohnston

    hmjohnston Well-Known Member

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    Dec 30, 2011
    ProZinc is considered a fest acting insulin and will work quickly. As long as she is eating you can shoot after testing. I did wait 30 minutes after her AM/PM PS to shoot her but that was b/c my vet told me to and he wasn't very well informed on anything FD.

    Nadir- or the lowest part of the numbers, for ProZinc is usually around the +6 (six hours after her shot). So that means if you feed and give her shot and around +2 she has a hairball hack that includes food check her BG's to see what the numbers are. The closer to her nadir time- which you will get with data- the less you have to worry about.

    Hope this helps.
     
  16. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    I do not consider ProZInc a fast acting insulin. It peaks at about 6 hours. A fast acting insulin would be N and Caninsulin.

    edited. The time was 46 vice 6 hours
     
  17. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    So I called the vet last night to ask about how much food Pepe should be eating and she says "his usual amount". ??? Of course that was relayed to me so I couldn't ask. He has a checkup thurs and I made it with a different vet so hopefully I will get some straight answers. He seems to be doing okay. My meter was mailed out today so hopefully we can start doing a spreadsheet soon.
     
  18. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    I stole this quote from Carl re how much to feed:

    How much to feed:
    20-30 calories per pound of ideal body weight, per day. That will keep a healthy cat at its ideal weight. The range of calories is dependent upon a few factors, one of which would be level of activity.
     
  19. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    But isn't there an amount of food for the amount of insulin? Or is that what the blood glucose test is for?
     
  20. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    I am not sure I understand your question, but no, you just feed the cat. The blood glucose number tells you the level of glucose in the blood. Then you shoot a dose based on that number. (One example would be if you get 200 as a preshot number. With a new diabetic, you don't want to shoot under 200. So you wait 20 minutes, without feeding - which can raise the number - and retest. ) For most new diabetics, we suggest you start at one unit every 12 hours (if his numbers are above 250+) Once you get some numbers (on that spreadsheet :mrgreen: ) you can see how the insulin is working. If he is staying in a higher range, you can increase the insulin by .5 units. If he is running in lower numbers, you'd reduce.

    One time food is a factor is if people are feeding high carb dry food. That will make the numbers higher than they would be if they were feeding wet, low carb. Sometimes you can play with amounts and time fed if you want to steer the numbers a little, but that would be after you have lots of data. The other time is the restriction on feeding less than 2 hours before testing. Since food increases blood glucose levels by a bit, you withhold food so you can be sure the number is "true" and food related.

    This is a huge document on ProZinc, but it has great links and info. Maybe it will help.

    http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=32799

    This whole sugar dance is a steep learning curve, but you will get more confident the more you learn and do. Just keep breathing and asking questions.
     
  21. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    So Sue, to see if I understand Pepe weighs 12lb so he should have 240 calories a day?
     
  22. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    If twelve pounds is a good weight for him and he is moderately active, then 240 is a good starting place. Fancy Feast Chicken looks to be about 90 calories a can so 2.5 - 3 cans a day seems like a good starting place. Bear in mind, unregulated cats are hungrier than regulated ones. Their bodies are not using the food efficiently. So we say, feed a reasonable amount but if he seems to be starving, it is okay to feed a little more until his numbers settle.

    I fed Oliver 3 cans a day (he was an overweight Maine Coon) until he was regulated and then in remission, I cut back to 2-2.5. He was fairly satisfied and lost some needed weight after regulation. (Oliver came to me as a starved shelter cat and I always thought that influenced his great interest in food. He never met a meal he couldn't devour. :mrgreen: )
     
  23. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    Thanks. I guess he's about right then. He'll eat a can or a 1 1/2 for breakfast and dinner. I'm trying to get him away from the gravy ones but he LOVES those. On the weekends when I'm home he wants to eat more since I'm there.
     
  24. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    Just got my meter today. Thanks Rebecca! I'm taking it with me to our Vet appt. I'll post our results. Thanks everyone.
     
  25. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    Just back from out appointment. His blood sugar (I've enclosed my SS) was 180. I got 179 on my meter when I got home. She said don't do a shot if his BG is 50-80. She also said if his number continue to go down he may just need diet to regulate. Said to leave dry food down during the day. I'm to call in 2 weeks to let her know how he is doing.
     
  26. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

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    Dec 28, 2009
    There is no dry food appropriate for a diabetic cat; even just a little bit can inflate blood glucose values and interfere with regulation. If you need to leave food, freeze the canned portion and leave that out instead. If your cat (like mine) will gnaw at the frozen food, you can get an timed auto feeder online for a reasonable price that will release the canned food when you want.
     
  27. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    That is what I was thinking but she said to check out Purina DM, Science Diet or Royal Canin diabetes dry.
     
  28. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    Oh she also mentioned a fructosamine test. Is that expensive? Should I get it?
     
  29. squeem3

    squeem3 Well-Known Member

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    Dec 28, 2009
    If you are testing blood glucose levels at home, there is no need at all for a fructosamine test. All the fructosamine tests tells you is the average blood glucose level over the past few weeks. If you are testing at home daily, you already know what your cat's levels are.

    Canned food can be left out all day. It might get a little dry but it doesn't bother most cats. You can add extra water to it or freeze the food into chunks to keep the food from drying out too fast. Many people here use a programmable timed feeder so their cats can have small meals of canned food available all day.
     
  30. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

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    Dec 28, 2009
    Unfortunately, all of those are still too high in carbs for a diabetic. The only prescription diet that is suitable is dm canned, but I wouldn't recommend it because its really overpriced...it is nearly identical to purina fancy feast classics.
     
  31. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    Poor Pepe. Last night for my first home test we only had one ear stick. This morning I think it was 4! Nothing would bleed and then I got a gusher! His level was 167. Thanks for all the answers! I left some canned food out with some extra water on in it.
     
  32. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    Speaking from recent experience (only been doing it for 3 weeks now :lol: ), it takes a bit of practice but you'll both soon find your rhythm and the blood testing will become easier and you'll start getting it in the first try or two.

    Make sure you Publish your spreadsheet otherwise we won't be able to access it if you need help. Go to File -> Publish to the web... to do this.
     
  33. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    Can someone tell me if they can get to my spreadsheet? I think I've fixed it to share. thanks
     
  34. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    Yep, it looks good. I would maybe add a mention of what kind of insulin he's on and the amount.
     
  35. squeem3

    squeem3 Well-Known Member

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    Dec 28, 2009
    It's viewable but not the correct URLfor sharing. When you publish your SS, you need to use the URL that is in the box that appears, not the URL from the web browser address bar.

    Your current link is
    Code:
    https://docs.google.com/spreadsheet/ccc?key=0AlX9wCb1Am2idFJqWUcxNWhIUktrS3QtQVcxWVRfYkE#gid=0


    The ccc part indicates that it is not the correctly published URL.

    A correctly published URL has pub in it:
    Code:
    https://docs.google.com/spreadsheet/pub? ......
     
  36. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    How is that?
     
  37. Dyana

    Dyana Well-Known Member

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    Dec 28, 2009
    I see your spreadsheet. Good job.
     
  38. squeem3

    squeem3 Well-Known Member

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  39. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    Okay I think I got Pepe's story attached. thanks
     
  40. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    For the litter box issues, the common recommendation is a litter box for every cat, plus one. So, if you don't already have two boxes, I would get another one.

    Mikey had a similar problem right around the time he was diagnosed and it was one of the reasons I had brought him into the vet in the first place. He'd never had a single accident outside the litter box since the first day I got him and then I started noticing he wouldn't use his litter box twice in a row without it being cleaned. Not only does he have two large LBs and one small one to begin with, he also has unrestricted access to our backyard, yet I was still having to scoop up after him every time he went in order to get him to reuse the litter box. The times I was gone all day or while I was sleeping, he would end up holding his urine for so long that he'd have "accidents." (Since he was also peeing a lot more than normal, all three boxes would be "used up" in as little as an hour.)

    I began researching different types of litter (he was using feline pine, non-clumping at the time) and I went to my local pet store to check out a few of them. While there, I found out from the very well-informed staff that a lot of their customers are owners of diabetic pets (probably because they carry a lot of the raw pet foods). They said that some diabetic cats are bothered by the smell of their own urine (maybe because of the excess sugar in it?) and pointed out two customer-recommended brands for this issue: Dr. Elsey's Cat Attract and Green Tea Leaves litter. I opted for the green tea leaves because I had a previous cat that had respiratory issues from clay litter, but it's up to you. And we haven't had any LB problems since! :D

    If this turns out to be the case with Pepe, I also recommend the Litter Genie because when you have such a sensitive cat, you're still going to have to scoop more often.
     
  41. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    Thanks KPassa, I'll try that. You reminded me of an important point I didn't put in his bio. His previous oweners had him declawed and I wondered if his feet are more sensitive. He is the only cat I've had that never digs in the box. He jumps in, does his thing and jumps out. Sometimes he is still dribbling as he exits! :coffee: It's too early and now that he's eaten and had his shot, we are going back to bed.

    Sharon and Pepe in bed zzzzz
     
  42. Helene & Cleo

    Helene & Cleo Member

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    Oct 22, 2012
    Aw poor Pepe. What is with declawing in the USA? It's just such an unbelievably cruel concept...

    Maybe try and get a 'softer' cat litter - it could be that the litter is irritating his sensitive little toes? Just a thought.

    H
     
  43. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    I don't know Helene. If you don't want claws, don't get a cat! I think it's a very cruel thing to do. They did not let him go outside but I do. He is very good, stays in the yard. I have a cat door. He mostly stays inside but likes to go sit in the front yard. Or he'll lounge in the backyard. I have a fence so he is safe. He did have a faceoff with a stray, I asked him what he planned on doing and told him I'd get him some strap on claws like Wolverine! :lol:
     
  44. Pepe's mom

    Pepe's mom Member

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    Nov 10, 2012
    Re: Question on whether to give insulin

    Should I hold off on Pepe's dose tonight? It was 111 at 5:30 (he's outside at the moment and hasn't eaten dinner). I don't want to make his sugar go too low. It was 114 last night and I did give it to him and it was higher in the morning. He's had a snack around 2, about TBSP or 2 of canned.
     
  45. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    The suggestion for new diabetics is not to shoot under 200. The reason he was higher this morning is likely to be that he went low overnight. (when they go much lower than they are used to, their body can release additional glucose to combat the lower number. It then looks like a higher number to us, but is likely an artificial bounce). You are shooting very aggressively if you are giving one unit in the 100-150 range.

    If he is under 200 at +12, wait 20 minutes without feeding. Retest, both to make sure he is going up, not down, and to be higher than 200. It looks like he could be in the low 100s. If that is the case, I would consider skipping. If you skip, the next number is likely to be in the higher range because he will have been 24 hours without insulin. Even if it is high, I would reduce the dose - maybe down to .5. (assuming he is over 200)

    Your goal is to have two shootable numbers 12 hours apart. If you have to skip because the preshot is too low, it's likely time to reduce the dose.

    PS on your spreadsheet, please put the amount you shot in the U column. U is for units. They helps us figure out his history of doses and numbers. I am assuming you shot one unit last night and one unit this am?
     
  46. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    Yes I'm always doing 1 unit. I asked the vet about the range for not giving insulin and she said 50-80. So that's why I was still giving but watching the numbers. He's already eaten some around 6. About half a 3 oz can. Should I still retest?
     
  47. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    50 -80 are normal non diabetic numbers. I would not give insulin under 200 unless I had a lot of data to give me a clear idea of how my cat would react. With data, some people shoot around 150 but very seldom do they shoot lower than that.

    We consider a cat in remission if they range from 40-120 with the majority of the time in double digits, off insulin. We consider a cat regulated if they are in the 200s at preshot and in double digits midcycle, but not under 40 on insulin. We don't want to see a new diabetic under 40 and advise intervention with food if they drop that low.

    What was his number before you fed? Did you give insulin?

    I know it is hard to get advice that conflicts with your vet, but I think his dosing recommendations are dangerous.
     
  48. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    I haven't given insulin this evening. He ate a little at around 2, I tested at 5:30 ish and it was 111. He ate a tiny bit at a little after 6 and I just retested and its 139. He get's his dose at 6 am and 6 pm. I'm not comfortable with my doctor's advise after my reading here. I will retest him in the am.
     
  49. Hi Pepe's Mom,

    Sue sent me a message and asked if I could drop by...

    I haven't had time to read this whole thread, but I did take a look at your spreadsheet, and at Pepe's profile. Just wanted to make sure of a couple of things...

    You mentioned the vet said free feeding dry food was okay? Just want to make sure he isn't currently eating any dry food.
    And you are feeding low-carb canned food right? Not the stuff with gravy in it?

    The best thing you can do is to try to get some BG tests in between shots. A 1u dose is not a large amount of insulin. But Pepe's numbers, for the most part, are great. Like Sue mentioned, "normal" range for cats is between 40-120 on human glucometer. Even though your vet seems to have drawn a line at 80 for not giving a shot, that's pretty low of a number to give insulin on. What you really need to find out, though, is what that 1u dose is doing for him. And the only way to know that is to find the "low point" (or nadir) of his shot cycle. That usually happens in between 5-7 hours after the shot is given. You don't want that number to go below 40 at all.

    My first impression is that either his dose needs to be lower, or the number where you don't give him a shot needs to be higher.

    Carl

    Edited to Add: I just saw that you didn't give him any insulin. Good! It's been about 2 hours since he ate, and the rise in BG is mostly due to eating. The food is going to boost his BG number. One good thing to try tonight - test him again in about 2 hours, and see if that number is higher, lower, or just about the same. If it's lower, that can mean his pancreas is producing at least some of the insulin he needs, which would be extremely encouraging news. If you can test again in a couple of hours and post the number, that would be good.
     
  50. Hmmmm, just saw your timeline.

    He ate at 2, and he was at 111 about 3 1/2 hours later. And then he ate a bit more and you got a 139. How long after eating?

    What time zone are you in?

    Carl
     
  51. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    Eastern time. Yes he ate a little at 2 ish. He is only eatting canned, some did have gravy as he refused other canned and I'm trying to mix to get him to go gravy-less. I tested him about 5:30 (I have a hard time getting blood so I start early) 111. He ate a little bit at around 6 and I tested him right at 8 and it was 139. I'll test him again at 10p Thanks for the help. I didn't feel comfortable with the numbers as low as the vet said. He is on 1 unit of Prozinc twice a day.
     
  52. My cat Bob was on PZI (a compounded version) which is a little different that Prozinc, but not by much.
    My vet was very aggressive with her dosing advice, but not as aggressive as yours. My instructions were to give him 1u if he was over 100, and "if he's under 100, call me". I even shot on numbers under 100 several times, but less than a 1u dose. And that was before I really understood things and wasn't really an active member of FDMB. I didn't really understand the danger of "low numbers" then.

    This is a recap of the numbers and times, put in a format that will make it easier for anyone reading to understand:

    AMPS 156 (1u)
    +8 ate
    PMBG 111 (ate small amount) (the "PMBG" indicates that you tested at his shot time, but didn't give any insulin. "PMPS" would mean you had given a shot)
    +14 139
    +16 ???

    That "+16" will indicate that it's been 16 hours since his AM shot.

    Carl
     
  53. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    Thanks. I'll post at 10 - when I can get a drop. His ears don't like to bleed! :(
     
  54. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    A little higher. 147. He is eating a little more now. He's probably had half to 3/4 of a 3 oz can.
     
  55. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    How many hours since the shot? Because we are all over the world, we put our numbers into the +# format - like +14 is 14 hours after the shot. Was the 147 14 hours after the shot?

    I can't see you shooting tonight. You could shoot when he gets up to 200, but it would probably throw you off schedule because you would have to shoot 12 hours from that shot time. Would that be possible tomorrow?

    If not, skip tonight. Remember, tomorrow he may be in the 200-300 range because he has been 24 hours since his last shot.. I would still reduce the dose to .5 and try to get some midcycle numbers. With the food change, things are changing with his numbers. It's always easier to start a little lower with the dose and increase as the numbers indicate than try to react to low numbers.
     
  56. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    The 147 is +16 from his 1 unit this am. He ate tonight first about 4 hrs ago and then then a little more after I took the reading. I'll wait till the morning and check him for this morning shot. Thanks everyone for their hand holding! I was worried what to do.
     
  57. I agree with Sue on lowering the dose (assuming you can eyeball .5u? Do you have 1/2 unit marks on your syringes?

    The object is to get a dose that is low enough to allow you to give him a shot into safe numbers every 12 hours, which keeps insulin working more evenly over the course of the day and night.

    And yes, if at all possible, try to get one or two tests in the range of 4 to 8 hours after the morning shot so you can see how the dose affects his numbers during the cycle.

    You're doing great!

    Carl
     
  58. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    This morning was 196. Thats +24 PMBG Is that right? He's had no insulin since yesterday am. I can eyeball .5 if you think I should give him that?
    Also I am off this week so I can try and test his blood every 4 hours. I'm not having to do as many pricks. thanks everyone

    Sharon and Pepe

    Ok, I decided to give him .5U. I wasn't sure when I'd get an answer and didn't want to get us off schedule. I will test again and do the mini curve today. Every 3 hrs and post that.
     
  59. Hi Sharon.
    Glad that you decided to go with .5u this morning.

    Since you gave him the shot that would be called his AMPS reading, and any tests today would be thought of as how many hours past shot time you get them, like if it's every three hours, it would look like

    AMPS 196 (.5u)
    +3
    +6
    etc.

    Carl
     
  60. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    Here we are so far

    AMPS 196 (.5u)
    +3 151
    +6 92

    He ate about 3 oz before his shot. I gave him about half a can after the +6 reading
     
  61. Those are really nice numbers. :smile:
     
  62. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    They are good? I didn't know if I should worry about the 92. Is it okay to do the next 3 hr even though he ate some after the last one? He is getting mad about all the ear pokes. Anywhere else I can poke besides his ears?

    thanks
     
  63. 92 is a perfectly safe number, especially when it happens in the time frame of +6 or so. That's when his BG should be about as low as it is going to go, typically.

    The ears are the best place to get blood from. Some people have tried the paw, but I never did so I'm not quite sure how well that works, or exactly where to get the blood from. You can use either ear, and you can poke anywhere along the edge. My cat always bled better from his left ear, and I'd pick a slightly different spot each test to reduce scarring or tenderness to one area. Neosporin with pain relief after the poke can help.

    When you test him, do you give him some sort of reward? One thing you might try is to just hold him and rub his ears without testing him, and give him a low carb treat of some sort. Just so the experience isn't always stressful for either of you. If you're tense when testing, he'll pick up on that. Most cats eventually warm up to the whole experience, and testing and giving shots becomes really routine and easy. What you want to try to do is make it a positive experience. Treats and extra lovin' can help make that possible.

    Carl
     
  64. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    AMPS 196 (.5u)
    +3 151
    +6 92
    +9 124

    Ate some at +6 maybe 1.5 oz I am guessing no PM shot?
     
  65. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Wait and see.

    Since he just ate, it could bump up high enough to be appropriate to shoot.

    Looking positive, though.
     
  66. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    Wonder if I can teach Pepe to prick his own ear or paw? I forgot how he hates his feet touched so I had to do his poor ear again. I think this was about 3 pokes. Luckily only 1 more tonight! I think his numbers look good. Which my vet had been a little more help.
     
  67. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    A dab of neosporin ointment (not cream) may be applied to the ears a few minutes prior to testing, then wiped off to test. It helps the blood bead up and may reduce the annoyance of being pricked.
     
  68. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    AMPS 196 (.5u)
    +3 151
    +6 92
    +9 124
    PMBG 103

    He is eating again. As I said previouly he ate some at +6, not a lot. I'd say he's had a total of 3 oz (he has a few more bites to take to be 3 since the +6.

    Sharon and Pepe
     
  69. If you hadn't already decided, I would go with "skipping the shot". :smile:

    Carl
     
  70. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    I was thinking that too. Stick with .5 in the morning if it isn't too low? What would you say would be a stick number? Or I guess a not stick. No one is on at 6 am when it's his shot time.

    thanks for all the advise everyone. I am going to try and get different needles from the vet tomorrow so I can do smaller doses. I am guessing I need a perscription to get at the drugstore?
     
  71. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    Not sure what to recommend for dose level so I'll let a more experienced and wiser person answer that question. ;-)

    I just discovered the other day that out here in California, you can buy up to 30 syringes at a time without a prescription. You can either check with your pharmacist or google your state's laws to see if it's the same (although I wouldn't be the least surprised if there was no law; CA seems to have laws for everything that most states never even heard of).
     
  72. Sharon,
    Are you going to be home tomorrow? If so, then I think you could give a .5u dose on a number somewhere above 150. Maybe 170? Every cycle is not going to be the same. But today, he started at 196, and dropped down to 92 on that dose. Had that been a 170, he may have dropped down into the 60s.

    If you can monitor him, I think 170 might be a good "line in the sand". And, you would want to get a test around +4 to see how low he is. If he is below 100 at that point, then you could give him a small meal to slow the dropping numbers down.

    You may see a number higher than recent numbers in the morning, since he will have not had a shot in 24 hours. But after skipping yesterday, he didn't really go "high" by this morning. If you see a number below 150 in the morning, of course skip the shot. But if that happens, it could be time to reduce his dose even lower whenever he does actually need some insulin. We can cross that bridge when we come to it!

    I'm not sure if Virginia requires a prescription for syringes. Every state has different laws for that. Your vet would know. He may not even realize that they come with 1/2 unit marks. You might have to call around to different pharmacies to make sure they have them on hand.

    Carl
     
  73. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    Yes I am off all week. I'll check him in the morning and see where he is. Tomorrow I'll do 4 hr readings. thanks for your help Carl. I'm going to check tomorrow about syringes. Mine is only in 1 unit increments.
     
  74. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    AMPS 206 .5U

    He didn't eat his food I had left down. I'm trying some new low carb food (Instinct) which of course he didn't like so mixed it in with some Friskies. He's eaten some. I'm going to do the 4 hour tests today. Only had to stick him twice this morning. Yeah! :D

    sharon and pepe
     
  75. Really a decent number with no shot last night:)
    The testing usually gets easier after a few tries!
    Carl

    And that +4 reading looks great too.
     
  76. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    Went to see if I could get needles with smaller increments marked. Vet number 3 (I think I've seen all the vets now at this hospital) was more knowledgable. He said they didn't make needles with smaller increments. I told him about my home testing which he said was good. He said it sounds like he may only need .5 a day. Said they have a hard time doing curves in the hospital. Said Pepe may be able to be on just diet but told me nothing about numbers I should be looking for. Gosh you have to pry info out of them! thank Allah for this site and all of you!! :mrgreen: :mrgreen:
     
  77. Denise & Honey

    Denise & Honey Well-Known Member

    Joined:
    Oct 12, 2012
    Just to let you know that I picked up a box of 100 syringes last month at Walmart - no prescription (CA)
    They have .5 unit markings and I don't have any problems with air bubbles etc.. and they're cheaper than all the others :mrgreen:


    Here's a link:
    http://www.relion.com/diabetes/syringes
     
  78. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    I asked about buying them and they said, well they are made for people and they use big doses. What do we pay vets for?? I'll try them today. Thanks Denise!!
     
  79. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    In case no one has mentioned it, the ReliOn syringes from WalMart are for U-100 insulin such as Lantus or Levemir.

    It is possible to use a U-100 syringe with conversion for the insulin concentration of ProZinc, to do smaller doses without quite so much eyeballing.

    1 mL of U-100 = 100 units (Lantus, Levemir) VS 1 mL of U-40 = 40 units (ProZinc)
    Basically, the mark on the U-100 syringe multiplied by 0.4 gives you the dose of a U-40 insulin, since the concentration is 40% lower per mL.

    For the low doses you are using:
    U-100 marking vs U-40 dose
    1 unit mark = .4 units of ProZinc
    .5 unit mark = .2 units of ProZinc
     
  80. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    The NPSS law changed this past New Year's to OTC purchase of up to 30 syringes throughout the state (vs. being set by county previously?), so who knows why they let you, but take advantage of it, by all means! :lol:

    And thanks for the syringe recommendation because I have been struggling with air bubbles every single shot and it's irritating the hell out of me. :evil:
     
  81. Thank you BJ!!!!

    That is VERY IMPORTANT.
    They do make U40 syringes with half unit marks, but it seems they are very hard to find. And you can probably only get them from a vet or vet supplier. Human syringes are made for human insulin (like Lantus and Levemir) which are U100 insulins.
    The easiest way to tell is that the U40 syringe comes with a red cap over the needle and the U100s have an orange cap.

    You CAN use U100 syringes with Prozinc but you MUST use the conversion chart when you do that.

    Carl
     
  82. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    I have been on a wild goose chase. 2 pharmacies thought I was crazy and said they didn't make them that small. Petsmart vet said they don't have them there but order when needed. They didn't offer to do it for me. I think Walmart gave me the wrong size (they are in the car and Pepe is sitting on my lap. A zombie was waiting on me. First he gave me syringes that did 100 units and I think the second box said 50 but I didn't study it till I got home. That site says

    What kinds of markings are on your syringes?

    Our markings range from ½ unit to 2 unit increments, depending on the volume of the syringe. Here is the breakout:
    •1cc - 2 unit increments
    • 1/2cc - 1 unit increments
    •3/10cc - ½ unit increments

    so do I need 3/10 cc? And would I still use 1/2 unit?

    thanks
     
  83. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Yes, the 3/10 cc (aka 3/10 mL - same thing) will allow you to micro dose your cat, following the conversion from the U-100 marking to the U-40 dose.
     
  84. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    UGH yes they gave me 1/2 cc syringes and not 3/10 cc. It's rush hour traffic time so I'll go back in the morning.

    Found this site that might be useful to others. I am going to educate my vet too!

    http://www.diabeticcatcare.com/COK/Insu ... s%2011.htm

    thanks everyone

    Sharon/Pepe
     
  85. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    His AMPS is 183. I am giving him a tiny bit under .5 Hard to tell on this needle. I'm getting the new needles today and I think I'll check in 6 hours to see what's going on. Had to do a lot of poking this morning. Also going to get the ReliOn meter.

    Sharon and Pepe
     
  86. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    Found out you cannot exchange needles. So I had to buy a new box and call the number on the box (walmart did not tell me this, I happened to see it on the box) They are going to send me a return box and get Walmart to give me a box of the right size needles. So I'll have 2 !
    Got my new meter. Going to try it out at the 6 hour mark.
     
  87. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    Re: Just diagnosed HELP - 1 week in almost

    AMPS 183 (.5u) tiny bit under .5
    +6 51

    Ate about 1.5 oz for breakfast. Ate a few bites at the +6 mark. Since I was using my new ReliOn meter I tested again after he ate and got 59

    thoughts?
     
  88. That's a wonderful number for +6. And good that you let him eat. Another check in an hour would be a good idea to make sure he's staying in the 50s or higher.

    Carl
     
  89. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    Oh he'll love me poking him again! :lol: I'll take another reading. Thanks Carl
     
  90. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    Ok he is now at 85. +7 after his shot. If I am looking at this conversion right I am drawing to 1 unit in the U100 syringes? Yes they have an U100 syringes orange cap, 3/10 cc. I haven't given him a dose with them yet.

    thanks Carl
     
  91. Yes, if the intent is to give him .4u of prozinc, you would draw up to 1.0u on the u100 syringe.
    And the +7 number looks great!
    I think he's good until PMPS tonight.
    Carl
     
  92. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    Great. thanks Carl. I am happy Pepe's numbers are good. I feel very lucky.
     
  93. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Looking good!
     
  94. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    Here we are for today

    AMPS 183 (.5u) tiny bit under .5
    +6 51
    +7 85
    PMBG +12 87

    I am ecited about our new low numbers. But then I get worried about the hypo thing. confused_cat
     
  95. If you can get those syringes with the half unit marks, you could lower the dose more easily. If you draw up to the half unit mark, that would equate to .2u, which is half what you gave today.
    You skipped tonight, right? If so, good call.
    Carl
     
  96. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    OMG what a morning. Got a AMPS 23 with ReliOn. Freaked so tried another and got E 7, which I just found out was the test thing moved or got more blood after it started. So I thought I don't know what's wrong with this meter so I better try the accu chek. *&^%$ thing I had to stab him about 4 times to get enough, he's fighting and growling. That got 82.
    He ate a few bites (he ate at 2:30a when I got up) He seems fine. He had his treat after his test. So definitely no shot this morning which I am happy about but that 23 scared me. He's in here with me now looking normal which I have heart failure. ohmygod_smile nailbite_smile
     
  97. Wow, that 23 would have freaked me out too!
    Having not had any insulin for 24 hours though, there's no way it could be right. I'd trust the 87 because it makes more sense:) and so did skipping this morning.
    It could be that pepe will need tiny amounts of insulin at some point in the future. But as long as you keep seeing numbers in the normal range (40-120), I think I would just sit back and smile a lot:)

    Carl
     
  98. Pepe's mom

    Pepe's mom Member

    Joined:
    Nov 10, 2012
    I'm going to do another test in about an hour. He is not liking the food I'm giving. Trying some of the other low carb Fancy Feast and some Tiki. I remembered Fortiflora on their food is supposed to make them eat it, so I've sprinkled some on. He is snoozing at the moment.
    If he needs insulin today I think I'll do the .2 like you recommended on the U100 syringes. And I'll try not to freak!

    Happy Thanksgiving everyone!

    thanks

    Sharon and Pepe
     
  99. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Warming the food or sprinkling a bit of Parmesan cheese on the food also help encourage eating.

    A bit of active play (15-20 minutes) may trigger the hunt-catch-kill-eat-eliminate-groom-sleep behavior cycle.

    When you get an unusual test result, re-testing is a good idea. Make sure your hands are clean and dry whenever you test. Check the expiration date for the test strips. When you are first learning to test, it may be helpful to have set up to do 2 tests one after the other.
     
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