Need immediate advice

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Backyardtarpon, May 12, 2013.

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  1. Backyardtarpon

    Backyardtarpon Member

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    Apr 3, 2013
    My Jezzi, 15 year old calico, diagnosed march 22, 2013 has been tested at the vets office because he told me I couldn't test at home, that the food I was feeding her was great...NOT! So I finally got the nerve to home test. I am using the Bayer Contour USB.
    FIRST TEST TODAY PRE-food @ 4:00pm. 288
    Test right before injection (post-food) 7:30pm. 73
    Thinking I had done something wrong, but not sure, I gave her 3 units (instead of 6 like vet prescribed)
    Just tested her now, 2.5 hours post insulin and it was 42!
    Panicking now!
    She is acting ok, no seizures, she did throw up, but that's not particularly new. Sometimes she eats too fast.

    So now, beside staying up all night and putting pinholes in my poor cats ear, I don't know what to do. Should I be freaking out? Should I race her to ER vet? What do I do?

    I am SO mad at this vet. Why would he tell me to give 6 units 2X daily without knowing her BG? Why would someone do that, seems a tad irresponsible if you ask me.

    If anyone can tell me what to do, please....
    I may as well put the coffee on, it's going to be a long night!
     
  2. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    First, take a deep breath. Do you have some higher carb wet food - like some with gravy? If so, give her a little and test again in 15 minutes. If no high carb, put a little syrup into the regular carb food. You want to feed him only a few spoonfuls so he will eat if you need him to later.
     
  3. What kind of insulin is it?

    Plan on testing again in 15 minutes. And what kind of food do you have on hand? Do you have karo or honey?
     
  4. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    ProZinc, Carl.
     
  5. Thanks, Sue.

    At what point did she throw up (how many hours after she ate)?
     
  6. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    It's PZI.

    Please follow sue and Carl's advice. They are very experienced. Please keep checking here and updating and posting her status for us when you do a test etc.
     
  7. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    I gave her just a few drops of kero, going to test in 10. I do not have any other food on hand but the dry Iams.

    I am beginning to question if I can do this, the poor thing wants to run as soon as she sees me.
    Going to test, will return with results...
     
  8. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    You might have to wrap her up in a towel to test. You will have to test for at least the next four hours to keep her safe. If it becomes too difficult, you can consider the ER. It will be expensive but they can take over.
     
  9. You CAN do this! And right now, she's depending on you.

    Are you home alone, or is someone there that could make a quick trip to get some gravy-style high carb wet food?

    And not to scare you, but is there a local emergency vet you can call and talk to?

    Let's see what this number looks like.
     
  10. Barb & Mr. Frog

    Barb & Mr. Frog Member

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    Apr 4, 2013
    Don't forget to breathe, and keep calm... She will pick up your nervousness. Remember, you are her parent, you are guiding her on the path to a better life, for her own good! She will thank you for it later once she realizes that little poke is as bad as it gets.

    I've seen people mention some people food options for bringing bg up a bit, maybe try some cream cheese, or yogurt? I'm sure there are other things too, but I can't think atm.
    I really hope she's ok! {{{H U G S}}}
     
  11. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    Ok, seems the kero is working a little, it's at 69, should I give more syrup or retest in 15? Should I do this throughout the night? She feels pretty warm, should I be really worried?

    Thank you so much!
     
  12. Warm is okay.

    What you want to look for is any sign that she's "out of it", like walking like she's drunk or huge pupils.

    Give a few drops of karo, but we need to try to get some food in her. Dry food works more slowly to raise the BG. Can you put a little in a dish, put some warm water on it to soften it up and add a drop or two of karo to the mix. We might be able to use that a teaspoon at a time.

    Do you have any vanilla ice cream in the freezer by chance?
     
  13. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    69 is better. You can't relax until at least 6 hours after the shot. It's going to be testing every 15 minutes, giving her little spoonfuls of syrup mixed with food and hoping that the numbers continue to climb or at least say the same.

    Symptoms to watch for - disorientation, acting like she can't see, yowling, sleeping and not being able to rouse her easily.
     
  14. Backyardtarpon

    Backyardtarpon Member

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    Apr 3, 2013
    I may have ice cream, I'm guessing the 69 isn't good enough, heck, I'll find something that she'll eat, she's very picky.
    Is it not good to give more kero?

    Her pupils are big, but they always get big when she's mad, and she is mad!
     
  15. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    The numbers in the cycle continue to go down for 5-7 hours after the shot so you can't relax until after that time frame. And then you need three rising numbers.
     
  16. 69 is good, but we want to see 100 or more, because the insulin usually doesn't "peak" until about 5-7 hours after the shot. In this case, high BG is better than dropping lower, and you sure don't want a number lower than the 40s. At that point, our advice is going to be "take her to the ER and bring bottle of karo with you for the ride".
     
  17. Backyardtarpon

    Backyardtarpon Member

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    Apr 3, 2013
    I have the only cat that won't eat ice cream. I tried frozen, and melted, no good. I have her another few drops of kero. Will retest in 5, if she lets me next to her.

    Should I test every 15 for the next 5-7 hours? I don't mind if that's what I have to do, just not sure.
    Also, even if I get her above 100, keep testing if it's inside that 5-7 window, right?
     
  18. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    If you have any plain meat, poultry, or tuna fish, you can mix small amounts of that with the Karo to add a bit of protein. The Karo will bring up the glucose short term, the meat/poultry start work on stabilizing.

    Gravy is nothing more than flour and water mixed together with a little heat to help it soak up. No flour? Bread can be mushed up with a little water, too.

    Might want a pot of coffee/tea/cococa to help you stay up.
     
  19. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    If you have an oral syringe (no needle), you can give 0.5 to 1.0 mL of karo or melted ice cream as needed every 15-20 min.
     
  20. Did you see what I posted earlier about mixing dry with water and karo?

     
  21. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    If you crush the dry first, it'll soak up faster.
    Warming it slightly will hasten that too.
     
  22. No, you won't need to poke her ear every 15 minutes. That will be adjusted based on the numbers you get. If she gets over 100, and we can get some food into her tummy, you won't need to test that often or for 5-7 hours.
     
  23. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    I've got chicken, and can make gravy.
    I have a syring with no needle (for just such an occasion).
    I just made her a mix of some dry food and FF appetizer. Not touching it.

    Funny thing is she's sitting here watching me freak out like I'm the one that's sick. She's acting like nothing is wrong, literally!

    I just ran her BG and it back to 45
     
  24. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    You may have to offer pea-sized amounts on a finger, or actually put it in her mouth to get her to eat.

    Will she eat any of it separately, so you don't have to force all of it?
     
  25. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    Maybe put some syrup on her gums first. Then cut up the chicken in shreds. See if she will eat that. Or tuna? What else does she like?
     
  26. Backyardtarpon

    Backyardtarpon Member

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    Apr 3, 2013
    I'm giving her two of her favorite, FF appetizers and dry food, she sniffs it and lays down, but not acting like she doesn't feel good, she's leaving that to me!

    I've got her confined to a bedroom since she's not happy with me right now and my house is a series on islands. She could have me doing laps all night.

    I keep thinking to myself, what if I had given her the full 6 units?
    How many other nights has it been like this that I didn't know about because of this vet?
    I'm back to the quilt phase!

    Trying chicken now
     
  27. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    The syrup is vital too. You can rub a teaspoon on her gums or cheeks so she will lick it off. Then see what you can get her to eat in terms of protein.
     
  28. Yes, what Sue said. If she'll eat chicken, that's great. But chicken is pretty much zero carbs and what we want right now is carbs to raise her BG back up.
     
  29. Backyardtarpon

    Backyardtarpon Member

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    Apr 3, 2013
    Not much, when I say she is picky, that's an understatement. I've got dry food soaking in warm water, cut up chicken on another dish, all while giving her small amounts of kero.

    I have to mention, that you people have to be the most amazing group I've ever met. To be this attentive to someone you've never met, even if it's just for my cats welfare, just amazes me, and I am truly touched.

    Thank you

    Will test again in 10
     
  30. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    At 69, she may not be hungry enough to eat. Give her a break for 5 minutes and try again.

    Maybe a bit of play with a toy will perk her appetite for you. Sometimes "toss a kibble" gets some hunt/catch/kill/eat behavior going.
     
  31. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Just paying it forward.

    Folks did this for me with Spitzer.
     
  32. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    Sometimes feeding by hand helps - have her lick off your fingers. (you can "unspoil" her tomorrow)

    Bj, she's in the 40s again.
     
  33. Yeah, try not to "go there"...it'll drive you crazy and raise your blood pressure.

    How can I say this kindly? Your vet prescribing a starting dose of 6u was insane. The AAHA guidelines recommend no more than 1u to start unless your kitty is really heavy. Not sure what she weighed at diagnosis, but she'd have to weigh 50 pounds or so for that dose to make sense. Thank God you dropped it at least as far down as 3u. But I'm thinking that going forward, 1u makes sense until you have hometested enough to collect the data that shows a higher dose makes sense.

    Basically, a starting dose of 6u put your kitty's life at risk, whether your vet wants to accept that or not.


    Oh, and it's just not for your cat's welfare. It's for your welfare and sanity too. :D The day you joined the board, you became a part of the "family". The long-lost sister we never knew we had, so to speak. You're stuck with us now :lol:

    Pretty much every one of us was in your shoes on the first day we found this amazing place.
     
  34. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Sorry - that slipped by me. But it still may be true that she doesn't feel hungry enough to eat.

    Tactics that can help:

    Hand feeding

    warming food so its stinkier

    sprinkling parmesan or any cheese over it

    With the Karo, rub it on the gums rather than squirting it in, so it isn't inhaled instead of swallowed.
     
  35. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Leah,

    I am going to have to drop off. Bob is our night owl and says he can stay on with you. Hope Bj can too.

    Will keep you and Jezzi in my thoughts. Just keep following their advice. And if they say it's time for the ER, go.
     
  36. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    My boys like butter (I mix the syrup into it when softened) or small shortbread pieces or small pieces of white cake.
     
  37. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    Thank you, and I mean that from the bottom of my heart and the end of Jezzi's tail.

    The only reason we discovered diabetes was on a routine office visit in January, she weighed 14.8 lbs, in march she had dropped to 10.4. Thinking he knew what he was talking about, I didn't question it. It just didn't soak in. And I'm the type person who googles everything, but I didn't this time. I don't even know why. I was so caught up in the how's and why I didn't question the how comes.

    She actually ate some chicken, after she saw me eat some, monkey see monkey do! Not much, a tablespoon or so. Getting ready to retest.

    Thank you Sue
     
  38. Yeah, the standard weight based formula for dosing is .25u per KG of lean body weight.... So that works out to 1.18 units. At the most, 1.25 would have been okay, but since syringes are marked in no smaller than 1 or .5u marks, the logical dose would have been 1u twice a day.

    There are occasions where a higher dose may make some sense, but that usually only happens if there is something else going on besides just the simple diabetes. I sure would like to be able to understand where "six units" makes any sort of sense.

    The initial diagnosis is overwhelming to the caregiver. I didn't even know diabetes could happen to a cat, so the first few days was pretty much just a haze to me. Don't feel unique in being overwhelmed by it all.
     
  39. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    A tablespoon of chicken is good.
    Keep going with the Karo on the gums; it absorbs faster.
     
  40. I just remember something from when I first started reading your adventure tonight.
    Did she get 6u this morning?
     
  41. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    Well, she's at 52.

    Please, I understand this is a Monday night and people have to get up for work. You all have been so patient and helpful, and you've given me the knowldge to deal with this tonight. There's no reason we all need to lose sleep tonight.
    I went online and got the phone number of the animal ER, so I can call them if she doesn't improve over time. I'm going to keep testing her, and if I don't see improvement within a few hours, I'll be taking a ride.

    I've gotten her to eat small hits, I'll keep working on that, and I'll post an update in the morning. Besides, I'll need you all to keep me from blasting that vet! Which I'll be finding a new one first thing.

    Thank you all so much. I can't tell you how much this means to me, without you I don't know what I would have done. Now I know what to do and what to watch for. Go to bed, get some rest. I'll be here in the morning to let you know how it went.

    Thank you, see this is a good excuse to stay up and read more posts on here, lol!
     
  42. Backyardtarpon

    Backyardtarpon Member

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    Apr 3, 2013
    Yes, she's been getting 6 since day one! Why? That's what vet put her on
     
  43. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
  44. Mary & Simba

    Mary & Simba Member

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    Dec 19, 2012
    Please keep posting numbers since you will be online anyway. Some of us are up all night with our own sugarcats and will be here keeping an eye out.

    Are you using a U40(half the syringe is full) or U100 syringe (tiny little markings)? 6 units on a U40 would have a very long carryover. You might have been getting some overlap from shot to shot.

    How much does your cat weigh?
     
  45. Because I was going to try to explain what I think went on today.

    You tested at 4:00 and got a 288. And then she ate, right?
    And 3.5 hours later, you said you got a 73 (and thankfully only shot 3u).

    What I think is that the six unit dose from this morning might still not have worn off. Either that, or her pancreas was doing the job nature intended.

    At 3.5 hours after eating dry food, the BG should NOT have been lower, especially not 200 points lower. Even if she barfed up some of that food, some of it would have been digested, and all the carbs in it should have raised her BG and she should have been in the 350 or higher range. Not down to the 70s.

    So either the morning dose was still pushing the BG down, or the pancreas was. Being that much lower before you gave tonight's shot defies logic.

    If it is actually her pancrease that is trying to do the job on her own, then that's even greater evidence that a dose even as high as 3u is too much.

    When did you say you were seeing the new vet?


    And don't worry about others losing sleep, really. Today was my "Friday". I'm off the next two days so I won't be setting the alarm to wake up tomorrow. It's about 12:30 here, but for me, this is still early. ;-)
    You will find that when something like this happens, and people jump in to help, "we" aren't going to bed until you do. It is just the way it works around here. We also have members in pretty much every time zone around the globe, so there is usually somebody online no matter what the hour.
     
  46. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    I'll be up for at least another hour or two (west coast), so don't worry. You have eyes all over the world helping you at all hours. UK will be up soon, as well. :lol: I haven't interjected yet because everyone else is already doing a great job helping you but I just wanted you to know I'm here to jump in if need be.

    :thumbup I want to frame this somewhere. :lol:
     
  47. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    The suspense is killing me, what triggered you asking if she had 6 this morning. I only lowered it tonight because I had been reading through a bunch of posts and since she was at 73 got scared by giving her the whole dose. Hind sight I guess I should have waiting to hear from someone before dosing.

    I just read your reply, her first test today 430 was 288. Then, she ate, but not dry, the fancy feast appetizer. At 730 I tested her she came up 73 at which point I decided to only give her 3 units. Before the last hour she hadn't had dry since mid-afternoon.
    U100

    I'll keep updating.
    She is acting better right now then is has in days. She's playing ( mostly biting me), taking a bath, and eating a few crunches here and there. Will continue testing and updating.

    Do you think her numbers would be so low if I hadn't given her the 6 this morning? Can you sue a vet for malpractice?
     
  48. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Yes, you can sue.There is likely a veterinary licensure board where you can report the vet's incompetence, too.

    My signature link has Vet Interview Topics.

    In the future, please do not give insulin below 200 mg/dL until and unless you have data that show it would be safe to do.
     
  49. Mary & Simba

    Mary & Simba Member

    Joined:
    Dec 19, 2012
    Okay so I didn't read it wrong, you tested her at 4:30pm but didn't give her a shot until 730PM? So she was still in the midst of her morning shot when you took the 4:30 test?
     
  50. Backyardtarpon

    Backyardtarpon Member

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    Apr 3, 2013
    What a fantastic group of people that I'm proud to say I lost sleep with!

    I will be calling right at 9 am to get new appointment. I have no doubt that after they hear my story they will tell me to come right in.

    I'm in Florida, this too is early for me, but I guess the drama has gone straight to my head. I've been watching her and she's has been calming me down. She took out a little revenge on my hand, guess she figured if I was going to keep making her bleed she would return the favor.
     
  51. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    She's stayed above 40, which is good. Non-diabetics normal range is from 40-120 or so, so the goal of the night is to keep her safe.

    One thing you've learned about insulin tonight is that once you put it back in, you can't take it back out. That's why most of us were shocked by the starting dose. We prefer more conservative initial doses to see how the kitty reacts. Some cats can drop very far on very small doses.

    You're doing a great job so far and the fact that you knew 6u was too much and shot 3u is fantastic! Perhaps it would have been better posting here first before shooting, but how we're you to know what amazing people this board has until you experience it for the first time (unfortunately because of tonight's low numbers). So don't beat yourself up for it. Jezzie is doing fine and we're all here to help you keep her that way. One day soon, you'll be paying it forward like the rest if us. ;-)
     
  52. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Well ... you can test yourself to see if the stress has raised your glucose.

    (ducks)
     
  53. Regardless, if was FF then it wasn't high carb, but there's still no good reason (except for insulin) that her BG would be 200 points lower at 7:30. The BG doesn't drop on it's own unless a cat goes hours and hours with no food at all. Either her pancreas produced insulin on her own, or the dose from this morning was still working well beyond the 12 hour point where it is usually all used up and gone from the system.

    A high dose of insulin can work two ways. It can push the numbers really far down in the normal 5-7 hours after a shot (this is how it normally works), or it can push the numbers down well beyond that 5-7 hour time frame. (that happens, but not too often).

    Unfortunately, it's impossible to know for sure. If you knew what her BG was before giving that 6u dose this morning, that would help in trying to figure it out, but there's no way to know that for sure. The bright side is that now that you have your meter, you'll know what she reads before a shot, and you can check her anytime you want to see where she's at. And you'll be able to see what any dose does whenever you want to know what it's doing. Now you know why one of the first questions a new member gets asked is "are you home testing?" ;-)

    I don't know if you can sue for malpractice but if I could ask your vet three questions, they would be:
    1 - how do you determine an appropriate starting dose for a diabetic cat?
    2 - how many cats are you currently treating and how many have you treated for diabetes using this specific insulin?
    3 - how many of your patients have gone into remission?

    Bonus question:
    "What is the best diet for a diabetic cat?"

    I have a feeling I wouldn't like any of their answers...

    LOL, next time that happens, grab the meter and test your own BG.
     
  54. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    It was the first time I had done a home test and thought I'd get a range a few hours before dinner and evening dose. I actually questioned whether or not to dose her, but not knowing any better reduced by half. You can rest assured I will never do this again! So any BG number below 200 and she doesn't get her shot? Is it skipped all together? Postponed ?

    Say her BG is 180 an hour before she's due, do I just not inject? How do I handle that and how do I decide what to do in each situation?

    If her pancreas is making her own sugar, so soon after being diagnosed, is it possible it was just a temporary thing or is that wishful thinking?

    She's at 59 and holding...
     
  55. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Its test, feed, and shoot, within about 10-15 minutes of time.

    You can stall 15-20 minutes without feeding and retest to see if the glucose number is rising before you shoot if the number is below your no shot level.
     
  56. In a case like that, what you can do is stall. Don't give insulin yet, but don't feed her either. You wait an hour or so and see if the BG rises above 200 on its own. If it does, then you can give her food and insulin right afterwards.

    To be clear, the pancreas is producing insulin, which is used to allow her cell walls in her whole body to absorb the glucose (sugar) out of her blood and into her cells, which is then used as energy to fuel her body. Sometimes with diabetes, it isn't that her pancreas completely stops working. It just doesn't work quite right. It either doesn't produce enough insulin on its own, or for whatever reason, her body can't use it right, and it doesn't get absorbed out of her bloodstream. And yes, diabetes can be a short term deal. My cat only needed insulin for 10 weeks. Some cats heal faster than that. Sometimes just a change to a low carb wet food diet does the trick. Some cats never heal completely, and others can do so after much longer than 10 weeks or 10 months. But it's never an "impossible" like it is for dogs or people.

    That's good. This is 5.5 hours after the shot, right? Has she eaten lately or been given more karo?
     
  57. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    When this first came to light, I asked about diet and told him when jezzi was getting and the part that still amazes me is that he said " I couldn't give her better food then what I'm already feeding her"! He doesn't have a clue, does he?

    It's not my glucose I'm worried about! My blood boils thinking about that quack! He shouldn't be treating pets for fleas never mind diabetes! But I guess my own ignorance is partly to blame. I should have done my homework.
     
  58. Mary & Simba

    Mary & Simba Member

    Joined:
    Dec 19, 2012
    Here is the U40 to U100 syringe conversion chart:

    http://www.felinediabetes.com/insulin-c ... rinter.htm

    If you are using a U100, then you were giving 2.4 units of PZI. If you dosed 3u on a U100, you actually gave 1.2u of PZI.

    What was the original BG number that provoked the vet to go with such a high dose? I once gave my cat a 2u shot of PZI (5u on U100) for a 700 BG and it carried over almost 17hrs. So you have probably been getting some overlap. The nice thing about higher shots is they sometimes drag out and take longer to get the job done. The 1.2 is much smaller and will work faster, so you saw some quicker results.

    After tonight your cat might be more sensitive to insulin, so depending on your BG, I would wait at least 12 to 24 hrs before giving a shot, and test to see what's happening, especially to see how food is affecting her BG. You can probably expect a big bounce number, but don't let that worry you into giving a higher shot, it's just smoke and mirrors, and needs time to clear away before you see her actual BG. You might want to cut the shot down considerably, or see your new vet first before dosing.
     
  59. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    We ssume a level of basic knowledge from professionals and the willingness to continue education and brush up.And we are sometimes mistaken in our trust.
     
  60. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    She's been nibbling on dry food and chicken, she's in there now munching on crunchies, I can hear her and I'm 2 rooms away. I had to take a break from the floor, besides she's been giving me weird looks for a few hours now.

    I can see she's thinking "what on earth are you doing and why do you keep sticking that sharp thing in my ear".

    At least I'm armed with what to ask a new vet, and more importantly, what answers to look for. This would make a great ad for Angie's List! Matter of fact, that's on my To Do list for tomorrow...

    Hey, thanks for explaining things to where I could understand it all. It helps. You have the patients of a Saint!
     
  61. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    please clarify:
    Are you using ProZinc (a U-40 insulin) or PZI (usually a U-100 insulin).
    Are doses given as actual units or as converted markings on a U-100 syringe?
     
  62. I also have a couple of questions on the U40 or U100 issue.


    Are you using Prozinc, or is it compounded bovine PZI?

    If compounded PZI, does the vial say U40, or U100 on it?

    What color are the caps on your syringes?
     
  63. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    Oh you can bet I'll be seeing a new vet before noon. I'm not playing this game. Vets here are actually very good, obviously with a few exceptions. There's a lady vet in the next town that caters to cats. My other cat was seeing here for a blocked UT. He passed right before X-mas 2011 at the age of 16.

    You have me confused about marking vs units vs u100-u40.

    I was told, by the vet, that the "6" mark on the syring was 6 units. Is that not correct?
     
  64. What color are the caps, red, or orange?
     
  65. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    The caps are orange.
    The insulin bottle is brown and says Protamine Zinc Insulin.
    I was told to go to Walgreens and get u100 and to fill to the 6 mark for a total of 6 units twice daily.

    The bottle says 100units
     
  66. Does the bottle say U40 or U100 on it?
     
  67. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    U100

    What does this mean?
     
  68. Whew, okay it's all good.

    U40 and U100 insulins are two different concentrations of insulin.

    The U number on the insulin and on the syringes is supposed to match. Yours do, so it's all good. That means you really have been giving 6 units twice a day. THAT isn't good, as you now have found out. But at least the two products are made to work with each other.
     
  69. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    U-100 has 100 units of insulin per 1 mL
    U-40 has 40 units of insulin per mL.
    They use U-matching syringes, unless you do the math to use U-100 syringes to measure U-40 insulin - its 40% of what the U-100 syringe marking.
     
  70. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    So, if I am to understand this correctly, I am NOT giving her 6 units but 2.5? And since I thought I dropped it to 3, I actually only gave her 1.3? And if that's the case, I wonder why he told me it was 6 UNITS.

    Also, if it was just 1.3 u, then why did her number drop so drastically?
     
  71. Mary & Simba

    Mary & Simba Member

    Joined:
    Dec 19, 2012
    Sorry about that, I saw Sue's post that it was ProZinc, that's what made me ask about the U100. It's as Carl said, you are giving 6 units.
     
  72. No, sorry for all of the confusion. You are not giving 2.5u. You are giving 6 units. If your bottle said U40, but you used U100 needles, THEN it would convert to only 2.5u.

    But since the bottle says "U100" and the syringes with the orange caps are also U100, then you are really shooting 6 units of insulin. Forget about all the conversion confusion. Your vet gave you the right needle prescription for the insulin that he gave you.

    It is very odd to see a vet give U100 concentration PZI insulin though. Not something we seen often.
     
  73. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    I'm so confused, lol.


    Seriously I understand, she has been getting 6 units, right? I can understand how someone could be really confused by all this. I mean I've just been going by what Dr,Quack told me. The only true knowledge has come from people like yourself, who's cared enough to completely explain it all. But you had me worried there for a minute. I was starting to wonder if I messed up.

    Took another test and she's at 79, good to hear
     
  74. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    It's not common? Is it stronger than others? Is it old school? Is there something better that I should look at with the new vet?

    I just want to go in tomorrow to the new vet and at least act like I know what I'm talking about.
     
  75. Leah,
    Just to try to lessen the confusion.

    There is "PROZINC" insulin. It is made from human insulin, and it is genetically altered to be more like "cat insulin". It is called a recombant human insulin.

    Then there is "PZI". It is derived from cow pancreatic cells. It is then turned into a powder, mixed with other junk, and is sold as "Compounded PZI". The reason they use cows is because their insulin closely matches that of a cat.

    Today, PROZINC is more common, and what is usually prescribed by vets.

    Compouned PZI is less common, but it used to be the only Protamine Zinc Insulin available before PROZINC was invented about 5 years ago.

    Here on FDMB, the forum for PZI users was titled "PZI", and that's where users of PZI ended up posting, because everyone used the same stuff.
    When PROZINC became popular, because it works the same way as PZI for the most part, users of PROZINC just posted in PZI, and everyone understood that while they weren't exactly the same, they worked the same, and everyone is good with that.

    Over the years, as more people use PROZINC and fewer use PZI, it became standard for everyone here to refer to PROZINC and PZI like they were the same thing.

    I used Compouned PZI with Bob (although mine was U40 concentration and not U100). Compounded PZI can come in U40, U50 or U100 strength. So because I used PZI, I have always considered it "different" than PROZINC, which is why I always try to find out if it's PROZINC or compounded PZI, just because to me they are two different things.


    Now that we all know exactly what you are using, and that you are also using the proper syringes for that specific strenth PZI, there shouldn't be any more confusion. ;-)
     
  76. No, it's not common. It isn't "stronger" really. It has a higher concentration, but as far as total dose... the way the needles are marked between the two concentrations is just different. But six units of U100 is the same as six units of U40 as long as the correct needles are being used.

    You could ask your vet about PROZINC and tell him you are currently using U100 compounded bovine PZI. He'll probably suggest switching to PROZINC, and he will precribe the proper U40 syringes too if he wants you to switch.
     
  77. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    Thank goodness, I was getting really confused thinking I had done something really wrong, again, thank you for clarifying it all.

    No worries, no need to be sorry for anything. I'm just glad I've got people like yourself that can confuse me at 2am! lolol!

    Kidding, she has decided its time to play with her box. I save big boxes for her and I guess she thinks she can dig through them, she's making a racket though, going to wake up my husband.
     
  78. Oh, forgot to say...

    the 79 is nice to see!

    You are now beyond what should be the danger zone. By now, the effect of the insulin should be tapering off. That would be a "typical" cycle over the 12 hours.

    It usually kicks in 2-3 hours after the shot, reaches it's peak 5-7 hours after the shot, and wears off by the 12 hour mark.

    I think if you test in another 30-60 minutes, and she has come up a little bit more, then you should be able to leave out some food for her and catch some zzzzzs.

    Nice that she seems oblivious about all of this and just wants to play in a box. Bob is a big box lover too!
     
  79. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    SHE'S AT 120!!!!
     
  80. That's really nice to see!

    Now, don't be surprised if you test her in the morning and you see a higher number. A lot of the time, when a cat drops that low, their bodies will instinctively react - in "self preservation" mode, and what ends up happening is that their liver releases "sugar" into their blood to save itself from going hypoglycemic. That is what we call "bouncing". The numbers bounce way up. It's common, and it eventually "goes away". Many people see the high number and think "she needs more insulin", but that's not the case.

    If you see a number over 200 in the morning, before breakfast, you can shoot 1 unit, but not more than that, no matter how high the number happens to be.

    Then call the new vet and see how soon they can see you.
     
  81. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    Carl, Mary, and BJ, thank you for being there in my hours of need. I won't forget this.

    I'll stay up another hour or so, test her again, and God willing be able to get some sleep before I test her PRE-breakfast (6am).

    I can't thank you all enough for the help, Jezzi thanks you too and if you were here I'm sure she'd bite you too!

    Get some rest, I'll post updates tomorrow.

    Thanks so much,
    Leah & Jezzi
     
  82. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    Test before breakfast, if above 200 give 1 unit no matter how high and call new vet. It's in stone.

    Thank you so much!
     
  83. Leah (and Jezzi),

    You are both very welcome. It was nice to "meet" you both!

    There's a bright side to this, Leah. It was a "trial by fire" but having seen this so early in this "dance", you now know what to do if you see a low number like this again. And you can always post here for help, with any questions, or just when you need to vent.

    And not sure if you have any children, but you do have a "fur kid", so I'd like to close by wishing you a Happy Mother's Day!

    Carl (and Bob)
     
  84. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Nice job managing Jezzi's curve!
    Welcome to the board, Leah! :mrgreen:
     
  85. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    Thank you Carl, Jezzi is my kid, and acts every bit of a 2 year old most of the time.

    I'll be around...a lot. A have a lot to pay forward! So glad to have found such a welcoming new family!
     
  86. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    And BTW, I wouldn't have minded reading about all this instead of jumping right into the fire. My only help is that I hope other new people read this in its entirety and doesn't make the same mistake.

    Heck, after tonight I feel like a pro! lol
     
  87. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    Yay for the nice rise! I've got another hour I'll be up myself with my kitty (+5/88).

    And I bet testing her has become much easier, too. :lol: ;-)
     
  88. Simon'sMommy

    Simon'sMommy Well-Known Member

    Joined:
    May 10, 2013
    This blew my mind. I am so happy your kitty is ok. I went to bed worried about your baby. When I woke up, I checked and saw all of the exchange and I am so happy to see that they are out of danger. What an amazing group you all are. I am so happy that I googled and found you. Peace of mind with a diabetic kitty can't be underestimated!

    Again, so happy your kitty is well!
     
  89. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    Great news all, tested her BG this morning and its 255! 1 units given, then breakfast.

    Climbing back in bed to catch a few more zzzz.

    2 hors from now I'll contact a vet vet,
     
  90. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    How lovely to read all the way through this thread and see that you did fine and Jezzi is doing well. Definitely a trial by fire. You can pay the help forward by posting your experience on other newbie threads - that your vet said to give 6 units and your cat hypoed the first day. So often the initial dose is too high. One of the many reasons we like to start low and go slow.

    I would get a test at +3 or so and again at nadir (+6) to see how she is reacting to the insulin this morning. Her dose should have been okay but all bets are off after a hypo and we want to be cautious.
     
  91. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Good job Leah! Y' made it through the night :smile: (sounds like a song title, doesn't it?)
     
  92. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    We have a few primers (see below) but the issue is that newbies dont know their way around the board to find them and tend to panic and post first before having found these. There is a ton of info we have to pass on and if we give too much at once they tend to get overwhelmed.

    http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887
    http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=46003
    http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

    Maybe we need to greet each newbie with New to the board? When you have time and are feeling a bit less panicked... but as soon as you can, please carefully read through all this https://docs.google.com/document/d/1Rd6sMfsrNB41yQVEqpyjlHrJsDIbGEhbRIWR4QAwu3c/pub
     
  93. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    My appologizes Wendy, I should have read the post you have listed, but when your new to feline diabetes things get overwhelming fast. There is a lot of information all over this website, and know matter how much you read, it's never enough.

    When a situation like last night occures, you don't always have the time to read through scores of web pages to find the correct information pertaining to your current emergency. Which is why I posted under the forum Main Forum.

    I feel bad keeping other members up so late helping me through my hour of need, but I would do it again if I felt doing so would save my Jezzi's life. I've been a member here for less than a week, I've been reading through posts before that maybe a little over a week. Could I have handled this differently, absolutely, but I didn't know any better (I do now).

    I appologize for posting in the wrong forum, or for not reading the correct material to be able to handle this on my own. But as I stated, being new I didn't have the time last night between answering replies to my post and doing BG tests every 15-20 minutes. When I'm in panic mode, I didnt have my wits about me to search through pages of posts to read the right one to get me through last night.

    The people here are absolutely increditable! You are a bunch of the most caring and generous people I've met. And I'm glad to say I am a part of it.

    As soon as I get Jezzi in to a vet, I will make the time to read through the links you have provided so that an issue like last night doesn't happen again.

    To everyone that sat up with me last night, please know you will forever hold a place in my heart for helping to keep my Jezzi alive. To me, that is the single most precious gift someone can offer.

    I look forward to becoming a valuable member of this forum and maybe one of these days, I can help someone through a similar situation by sharing my story.

    Thank you again.
     
  94. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Leah,
    Sorry but I have to chuckle a little...You havent done anything different than A BUNCH of us have done.
    You posted just fine. Wendy is one of the BEST here. You had the best of the best helping you last night. There are a HOST of others following along silently.

    We are family...WELCOME

    jeanne
     
  95. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    You handled this situation last night exactly as we want members to. You yelled for help with that 911 icon.

    We will always sit up with you during a hypo situation. Always. If a person can't commit to that, they will go find someone who can. That is just the way we do things around here. You did not keep anyone up that was not willing to stay up. No apologies needed. If you need our help again, you can yell for help with that 911 icon. That is what it is for. Health emergencies.

    You didn't post in the wrong forum. And no way did you even know some of this reading material was even available. Think of the links that Wendy gave you as information for the future. The next lessons in this crash course, advanced graduate level,in dealing with feline diabetes.

    There is no way for you to learn all this info in a couple of weeks. Some people are eager for more info right off the bat and others want little bits. We try not to overwhelm people with information because if they get overwhelmed, scared and leave, that doesn't help them or their cat.

    By the way. You did a fantastic job last night. Three cheers hip-hip hooray! hip-hip hooray! hip-hip hooray!

    :RAHCAT :RAHCAT :RAHCAT​

    Yes, as Jeanne, Troubles mom said, you are part of the family as soon as you join and start posting. We'll try to be helpful and not drive you crazy or be too annoying like my Uncle Ed is with me. We are good family members to have around! ;-)
     
  96. Hope + (((Baby)))GA

    Hope + (((Baby)))GA Well-Known Member

    Joined:
    Dec 28, 2009
    You would be surprised......

    if you knew how many were watching out for you but were not posting :D When a post like yours shows up we all click on it, then we see who has responded already, then we keep reading but do not post because there truly is nothing to add to advice already given. Then we make sure the responders are staying up with you or going to bed and if they are going to bed, then usually all involved or just reading will make sure someone else will take over. There are many of us that literally have stayed up all night, especially if we on the East coast are helping someone on the West coast that is 3 hrs. behind us.

    You did fantastic last night and Jezzi is fine but so very hard to learn via trial by fire. Welcome to FDMB. No one is ever without at least one person to help them.
     
  97. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    Ok, so it's been a long time since I've gotten this emotional over a situation. Call it gratitude, or pure appreciation, or lack of sleep from a stressful emergency, heck, I don't care if you call it menopause! But being welcomed into a community such as FDMB with such caring individuals in of itself is overwhelming.

    If I could hug each and every one of you, I would ten fold!

    So, I finall have an appointment for Jezzi at 11:30 tomorrow. After explaining the whole situation, in its entirety, to every vets office in a 30 mile radius. It's amazing how some vets treat diabetes. The one I chose, believes in a low carb diet (depending on cats individual tastes), home testing is good for ballpark numbers, and NEVER should she have been given any insulin last night with a reading of 73. I believe they like ProZinc.

    So there we have it. I have 24 hours of "use my judgement" before seeing new vet. I'm going to test her at 1pm, her last BG was 327 at 9:41 am. That's about 2 1/2 hours after a 1unit shot. I'm going to get her some FF cans and give that a whirl. Maybe mix some of the FF appetizer in with the FF canded to ween her off slowly. Dry food is gone.

    I'm beginning to sound like a broken record here, but you ALL are an amazing group of people. Thank you for such a warm welcome, you're stuck with me now!
     
  98. Hillary & Maui (GA)

    Hillary & Maui (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Where in Florida are you located? We have several members in Florida and some may be nearby who can suggest a good vet for you to try.

    You don't need help testing! ;-) As you now appear to be a pro at it.

    You are not the first person who has come here with an emergency hypo and sadly you won't be the last. And one day, you too will read someone's cry for help and be there to help them out. It's what we all do, help in our own way. It's what this board is about.

    The reason your cat kept looking at you like you were crazy, is really simple, being in normal BG range, she actually felt good and couldn't understand why you panicked.

    Congrats on finding our group and congrats on successfully handling this emergency.

    When you have time to rest and regroup, re-read this thread, so you can pick up on the links and other suggestions that were offered last night that you may have missed.

    Also, when you go to the store, pick up a few cans of Fancy Feast Gravy Lovers - in whatever flavor she likes and put them in a safe place, just in case you ever need to use it again. You can use it instead of dry food and along with karo (or ice cream). It's a great high carb cat food option just for this purpose.
     
  99. Backyardtarpon

    Backyardtarpon Member

    Joined:
    Apr 3, 2013
    I'm getting to be good at this ear prick thing. She hardly even looked at me,(that or she's just so pissed off she doesn't want to look at me!) lol.

    BG 274 ! And that's with 1 UNIT

    I'm so happy!
     
  100. Barb & Mr. Frog

    Barb & Mr. Frog Member

    Joined:
    Apr 4, 2013
    This really made me smile, because, word for word, it is EXACTLY how I feel too :lol:
     
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