Sorry about the 911, but it's shot time and I'm not entirely sure what to give. Alex has never been this low and I have no idea why he would be. I'll remove the 911 once I make a decision. I'm a little nervous to give a full 2u shot given how his numbers have been today. I started a new bottle of prozinc a few days ago, so I'm not sure if it's just now really kicking in properly, and I should actually reduce it until I can be sure this is stable? I can set an alarm to wake up in the middle of the night to check his blood, since it's the weekend, but I'm quite nervous and could use some advice right now.
So I got 13.1 and then stalled for 20 minutes and got 13.1 again. I don't really want to stall again, he's already overdue for feeding and didn't finish his food from earlier today, so I'm going to not give a shot tonight. I'm nervous about it because he's been so high for so long, but I don't want to risk it.
Asiina, when you don't get a timely response in the Prozinc forum, post in the Main Health forum also. More eyes to see and help. The Prozinc forum is less populated and not that you would be ignored, far from it, but there just might not be someone available to see right away and help.
I realize I probably should have given a reduced dose, since now it's +4 and he's at 34.8 which is incredibly high. Not giving the shot has given the same sleepless night I would have had if I'd given it, but it's too late to do anything about it now. I gave him fresh water and even forced a little water into him to make sure if any ketones do develop they'll hopefully be flushed out, since he hasn't gone to the bathroom in a bit. I needed to move his shot earlier anyway, so since the schedule is messed up now I'll give it quite a bit earlier and hopefully a few more hours without insulin overnight won't ruin him. It's never been anywhere near that low before so I have nothing to really compare it to to make a judgment call.
Hi Asiina- In general, here are the guidelines for what to do with a lower-than-normal PS: if the PS is lower than normal, but in the mid-blues or higher, stall without feeding for 30 minutes and retest. If BG has risen try the full dose. if in the lower blues, try stalling up to an hour and if rising do the above. If BG isn't rising much, give a reduced dose. How much to reduce is always a conundrum. Maybe try a 2/3 dose. if BG is much lower than normal give token dose - size depends on what the normal dose is. You can be braver with this once you have a lot of data. It's best to avoid skipping if you can but sometimes that's the safest thing to do. In this case, because you had a mid-cycle test, you already knew Alex was rising. And he was over 200, so you most likely could have given the full dose and been fine. Or reduced slightly in the interest of sleep. Regardless, you now have data to show you what happens when Alex skips a dose, so you can use that to guide you next time in your decision making. We always say that all data is good data, and that the only sight we have is hindsight. So next time you can use what you learned this time, try something different, collect more data, repeat.
I'm having a hard time understanding why you'd hold off food to test, as it's always going to be a constant variable since the cat needs food. Would withholding food for purposes of getting a "true number" give you more insight as to how the insulin/pancreas are working? Is that the rationale? My vet gave us the instructions to feed, test within 5-10 min, then shoot. But I see the opposite here. Where can I find empirical/research data regarding this?
Hi Silvia - and welcome! It's usually best to start your own thread when you have a question so that you'll be able to find the information again later, and so it doesn't send someone else's thread off-topic. This thread is old enough that I don't think Asiina will mind though. The only time we suggest withholding food is in the two-hours right before the PS test. The reason for that can be seen on the spreadsheets, particularly of unregulated cats. After a cat eats, during the part of the cycle when the insulin is waning, you'll see what we call a "food spike". The cat eats and the BG goes up. You can see it most easily at the +1 or +2 tests when they are higher than the PS value was (don't look at my SS for that though - my guy has too much overlap between doses these days - but if you find someone else who is new-ish and testing early in the cycle you'll likely spot it). If you feed during that 2-hour PS window, the PS itself could be quite inflated, leading to overdosing the cat with too much insulin. That being said, your vet's directions to feed and then test within a few minutes is just fine too. The food won't have had time to impact the BG at that point, so you would still get a good test. We just say test-feed-shoot so that you can get the shot ready while they're eating. It's just about being efficient with time when caring for a very time-intensive disease. If you prefer to feed-test-shoot, that's just fine as well since your test is so soon after the meal.
