more questions from Michele and Soccer

Hi everyone,

Thanks so much for being such a great resource!

I have a few questions:
1. Re bolus feeding on PZI~ I've been going home at lunch or waking up at night to give Soccer a tablespoon or 2 of canned food. Yesterday (6 hrs post-PZI) his BG was 180-something (before feeding). I was happy with that but still fed him because I still don't know where the nadir is. Last night (7 hrs post-PZI) his BG was 290-something. So, I'm thinking the nadir is at hr 6 or maybe even sooner. So, do you think I need to keep trying to go home (or get up at night) or is PZI "smooth" enough that I don't need to worry too much about a deep nadir?
2. Peaks are now ~300 (immediately pre-PZI). Better than nearly 500 but still not good. I increased the am PZI to 1.2 (from 1 unit) because DH is home today and can watch Soccer. However, DH won't attempt to check BG for me. Assuming clinical signs during the day are fine, and pre-pm-BG is high, should I repeat 1.2 or go back to 1 unit tonight?
3. Soccer flinches when I stick him. Do your cats react? Or, do they eventually get used to it? He does continue to purr but he no longer will come when I call him.
4. Treats? What kind do you guys give?
5. Since DH is so hesitant to try to get a BG, I was thinking of teaching one of my boys how to do it. They are 12 and 14. Have any of you guys taught a tween/teen to get BG for you. I'm not comfortable with them giving insuling for a variety of reasons but there are times (like when they get home from school and I'm still at work) where I can see wanting to know Soccer's BG.

thanks!
Michele

 

How many days since starting insulin.

I would not increase the dose AT ALL until 1 week has passed and you run your first full curve.

I don't think you can speculate as to when the nadir is, just based upon spot checks.
Even then, the nadir can vary from day-to-day. Remember ECID ! Every cat is different.

Dose increases should not be based upon one pre-shot number.

If you panic, see pre-shots raising, and keep increasing the dose...you are setting yourself
up for rebound (Symogi effect)

If less than a week, insulin has probably not settled yet.
Those numbers are really not all that bad for now.

 

Flinching....what gauge needles are you using.

Also...hold the bevel UP (pointed away from cat's body)...this seems to help.

 

using a lancet. free-hand so no "click"

He doesn't seem to notice the insulin shot at all.

 

Michele, you are moving too fast. Treating diabetes requires a ton of patience. Soccer's body needs time to react to the insulin, time to detox so you can tell what the insulin is doing once he's clear of the built up sugars.

The term 'peak' when treating diabetes is the lowest point in the cycle, when the insulin is most active, it's the lowest number, it's confusing, but it means the same thing as 'nadir'. If you are feeding more than 30 minutes before testing you may be seeing a food spike, that's why we encourage 2 and 4 hour spot checks.

As the insulin settles you may well see the nadir dropping on an almost daily basis, this is why you want to wait at least a week, do a full curve and integrate that data with your spot checks and preshots. You really do need all that information before hopping around on a dose.

Looks like Soccer is doing well!

 

Oh, well I went with the hand-poke for a long time, hurting my Smokey, too.

Until I decided I just had to get the lancet device working.

First I used an AccuCheck Softclix--which I really liked the way I could re-set it one-handed.
But I found that even on the deepest setting, I could not always get blood.

Then I got a ReliOn (WalMart brand) lancet device and their FINE ( not ultra-fine ) lancets.
This worked well at the deeper settings.

I found that because of the "fast poke" a lancet device does, Smokey didn't seem to notice.

My vet started my out with 25ga monoject needles to poke, and I found this entirely unsatisfactory...
hurt Smokey WAY TOO MUCH !!!

It does take practice. The hardest part is learning where to aim the lancet device.

And do use the warm rice-sock to warm the ear well before poking. My Smokey loved his
warm rice-sock massage...all over his neck, top of head...EAR !!! Heh..heh...sneaking up
on you !!!

You might need to condition Soccer to the sound of the click, though Smokey didn't care.
Soccer looks so much like my Smokey...Maine Coon ? They are so adaptable.

 

sorry- should have said "peak BG"

I'm having a hard time seeing 1 unit on my syringe. I'm using 1/2 cc U-100 syringes so it needs to be 2.5 units on that. Seeing a "3" on the syringe is waaaaay easier at 5am. So, I'm embarrassed to say that the above reason (in part) contributed to the change to 1.2 units. That, and the BG readings of 300-or-so. But, yes, I realize that changing to quickly, sets us up for rebound. My friend called yesterday to check on Soccer and was surprised that I hadn't started with 3 units BID as he had recommended. I told him that I'm a weenie and left it at that.

 

The markings on 3/10cc syringes will be slightly easier to see...a tiny bit farther apart.

Ask the pharmacist for a syringe magnification device....BD makes one.

Bring your syringes and vial with you to the pharmacy to be sure everything fits together.

 

Great idea! thanks!