? Need to adjust insulin dosage

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Camille and Oliver, Jan 10, 2020.

  1. Camille and Oliver

    Camille and Oliver New Member

    Joined:
    Jan 8, 2020
    Hi all, my cat Oliver was diagnosed 6 days ago and started on 3 units of ProZinc two times a day. The first couple of days his symptoms seemed to be improving, then on day three he seemed to start to decline again. At that point I knew I had to start home testing. I did a couple spot checks and he was okay whereas yesterday morning I gave him his regular insulin dose without pre checking his sugar levels and I believe he went hypo all day. He was hiding in the basement, glassy eyes, very sleepy.... (I was at work and heard this second hand from my spouse at the end of the day) so I obviously checked his sugars before giving his evening dose of insulin and he was only 4.4 (80 md/gl) so I did not give his shot and called the vet immediately. They said test in the morning and call. This morning he tested 16.2 (286 md/gl) so I called the vet to see how they wanted me to proceed as far as dosing goes. I was told since I tested with a human glucometer it was not accurate and to continue on at the prescribed dose (3 units) 2 times a day. I said absolutely not, if he is going hypo off of the current dosing I feel it is too high. I asked what the number for no shoot should be and the veterinarian herself told me 6 (128 md/gl) I am NOT going to administer 3 units of insulin if he is at that kind of pre shot level.

    I have contacted a new veterinary office and scheduled an appt. They advised I cut the dosage in 1/2 and do a glucose curve on Sunday, and come in on Monday with the results and go from there.

    What do you all recommend I should do? What does it mean if he is dropping that low from current dosage- too high? Possibly remission already? I'm so angry with my currentveterinarian. If I did what they advised I would have probably sent my boy into severe hypo last night.

    One thing I have learned - ALWAYS pre test!!

    I also posted this in the ProZinc forum page.

    Camille
     
  2. Juls and Billy

    Juls and Billy Member

    Joined:
    Dec 28, 2019
    Newbie here. More experienced members will come in and give you specific advice. I just wanted to tell you that you are awesome for taking such good care of Oliver. In my opinion, your new vet seems much more on top of things and should be a great help to you. You are ahead of the game now that you are testing his blood at home. If I had not been home testing and simply following my vet's initial advice, I would have given my Billy 2 units when he pre-shot BGL was only 52.

    Now, to help the experienced members help you, you should check out this post: How you can help us help you. It's a great way to make the most of the experienced sugar cat parents on this message board. The sooner you can start making Oliver a Spreadsheet, for example, the better advice you will get. It really helped me and my Billy.

    Keeping you and Oliver in my happy thoughts!
     
  3. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Juls is right that reading that link she gave you would help us to help you better. Only takes a minute or 2 to add the info to your signature.

    Here is another very useful document on using Prozinc. Give it a good read and then ask more questions.
    BEGINNER’S GUIDE TO PROZINC/ PZI INSULIN FOR DIABETIC CATS
     
  4. Camille and Oliver

    Camille and Oliver New Member

    Joined:
    Jan 8, 2020
    hi, thanks for the responses. I have updated my signature and added the spreadsheet. Any advice is greatly appreciated.
     
    Juls and Billy likes this.
  5. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Good job on getting some info into your signature and getting that spreadsheet set up. I just bet my civie (non-diabetic) cat that you are from Canada. If I'm right, she gets a low carb pure meat treat (Tiki Cat Succulent chicken)! If I'm wrong, she gets a treat too (Bonita or tuna flakes). Win/win all around.

    Would you add a couple of other pieces of information to your signature for us? Country if you are not in the USA. Your first name and cat's first name. Oliver's age. Time zone. We are all over the world, mostly in the US and Canada and the UK. But Spain, Argentina, Mexico, Australia, New Zealand and other places too.

    You should take your meter with you to the vet's office and test the same drop of blood. Before some of the pharmaceutical companies saw a market back around 2006, even vets used human glucometers. They do not read as close to laboratory values, but they are close enough to monitor your cat at home via BG (blood glucose) testing. Good for you at getting started with home testing already and pushing back at the vet on the dose. Strips for pet specific meters are very pricey. Test strips cost is a bit more reasonable for some human glucometers, which is why so many of us use those.

    I can't tell you how many people come here with a starting dose of insulin that looks really, really high. Plus the vet has basically said "Your cat is diabetic, here are insulin and syringes, feed this food I sell, and come back in 2 weeks." With no more training than that, not available in case of emergency, and what signs to look for if the dose is high.
     
  6. Camille and Oliver

    Camille and Oliver New Member

    Joined:
    Jan 8, 2020
    Thank you. Yes, I am indeed from the West Coast of Canada. Looks like she gets a Tiki Cat Succulent Chicken treat :) I updated my signature line to add the suggested information as well.
     
  7. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    As you can see here, since this message board was started in the US, all our documents refer to US measurements, using a human meter. Pet meters didn't exist when this message board started years ago. US still uses the outdated mg/dl where as the rest of the world uses mmol/L. Some of the documents have been/ will be updated to reflect both human and pet meter readings.

    Conversion is done automatically by a formula behind the scenes to populate the US tab on the SS, so if you live elsewhere, you enter the info in the World tab and us backwards folks in the USA can look at the US spreadsheet tab. (or multiply in our head by 18).
     
  8. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Hi @Camille and Oliver. One last thing for now. Would you please only post here in this thread in the Feline Health forum for now? I didn't realize you posted in the PZI forum also. That is why you got almost the same info from me twice.
     
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  9. Camille and Oliver

    Camille and Oliver New Member

    Joined:
    Jan 8, 2020
    Yes, I LOVE the spreadsheet! It is going to be so handy. I had just been recording all test results on a piece of paper until this point.
     
  10. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    A couple of pointers. You will want to get test information during the cycle -- not at pre-shot times only. The pre-shot information lets you know if it's safe to give your kitty a shot. The data later in the cycle tells you how low the dose is bringing his numbers down. You want to get spot check during both the AM and PM cycles. It's particularly important to get a test before you turn in for the night. That "before bed" test let's you sleep better knowing your cat is in safe numbers.

    There is also a tab on the spreadsheet for labs. It's very handy. I always have my vet email me my cat's lab results so I can see changes at a glance.
     
  11. Camille and Oliver

    Camille and Oliver New Member

    Joined:
    Jan 8, 2020
    Thank you. I will request the vet email me the lab results and will update those numbers as well.

    How many times a day do you typically spot check? +6 when he would be at his lowest point (typically) or more? My cat is what we shall call fiesty. The shots have been easy to administer as I do it while he is eating and distracted. Whereas the blood glucose tests are difficult and is a two man job. I obviously want to test as often as I need to as I want to provide him with the best outcome for this as quickly as possible. Do you have any suggestions on making the glucose testing an easier process for me to enable me to test more frequently?

    Thanks so much.

    Camille
     
  12. Juls and Billy

    Juls and Billy Member

    Joined:
    Dec 28, 2019
    Newbie here, so take with a grain of salt. Every cat is different, and I'm sure more experienced members will chime in with ways to make BGL testing time easier. What's worked with my Billy Is having low carb treats or food at hand, and giving him at least a nibble after every test. It took a few days, but now Billy is pretty chill about the testing. He purrs when he gets food, now he purrs when he sees me grab the testing kit, because he know he's getting a treat. Lately, we've been using plain cooked chicken breast as a testing treat (which has the Billy seal of approval) but even a little bit of his favorite flavor wet food does the trick.
     
  13. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Of course. Bribes. Any plain meat treat, fresh meat or freeze dried.

    2 documents for you.
    1. Hometesting Links and Tips - includes numerous links, instructions, pictures, & videos
    2. Ear Testing Psychology
    Both of these can be found in the Health Links/Faqs forum. It's a sticky at the top of the page.

    Look in the Index over there to see a lot more helpful articles. INDEX: Health Links/FAQs
     
  14. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Camille --

    Every caregiver is different when it comes to testing just like every cat is different (ECID) with regard to how accepting they are about testing. I had a pretty easy to test cat and I was a testaholic. (If you look at Gabby's SS you'll see what I mean.) I like data! I would likely suggest testing a bit before nadir. If you see that numbers are dropping, it gives you more advance notice with respect to intervening.

    @Juls and Billy is correct. One of the things that will help is if you give Oliver a treat each and every time you poke for a test. If he's treat motivated, it will help build the association between testing and a reward. Try to keep a routine -- test in the same spot as best you can in the beginning. Also, your kitty gets a treat regardless of whether the test is successful.

    Treats can be cooked chicken or any freeze dried protein. My guy like freeze dried chicken but there are any number of options you can choose from. You want the treats to be low carb (vs something like Temptations). Some cats prefer being brushed or other activities that enjoy as a treat.
     
  15. Camille and Oliver

    Camille and Oliver New Member

    Joined:
    Jan 8, 2020
    I am doing a curve today and testing every 2 hours after adjusting his insulin dosage a couple of times since the hypo scare a few days ago. Its weird, it is in the shape of a frown face rather than a smiley face. I am so confused. I need to do more night testing as when I woke this morning which was 10 hours post shot he was 9.5, so I need to ensure I see where is he dropping to over night. Besides 2 hours before his shot this morning being a blue, he is typically in the yellows/pinks. Should I not have decreased his dosage by so much?
     

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