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New here and Concerned about the numbers.....

Discussion in 'Feline Health - (The Main Forum)' started by Goose, Oct 3, 2019.

  1. Goose

    Goose New Member

    Joined:
    Oct 2, 2019
    Hi all,

    New to this site and feline diabetes. My cats name is Do daa and he is 11.5 years old, 14.5 lbs. and has recently been seen by the Vets and diagnosed with diabetes.

    (Yikes this is a long post!)

    He is a diehard dry food only cat for his whole life and I know that's a problem in the long run. He has currently been weened off the original dry food Friskes Seafood Sensations and is currently on Dr. Elseys Clean Protein Chicken.
    He is supposed to be eating just a little less than a full cup (.90) at (450-470 cals) a day. We have broken it down to 1/3, 1/3 and 1/3. He is also a diehard Grazer and does not eat a lot at any one given time. 10-20% of a 1/3 of a cup. Transitioning him to wet food, if possible, will take time. This is a stressful time for all involved.

    He has yet to eat the full 1 cup requirement per 24hrs. but seems to be progressing towards that goal a little each day. Dr. Elseys is 59% protein vs. FSS at 30% and it's taking him longer to digest? His bowel movements are normal so far. There it no unusual walking.

    He is on Prozinc with the dosage at 2 units in the morning, and 2 at night, a total of 4 units per day. He has only been on Prozinc since mid day last Friday Sept. 27th. 2019.

    I'm using the Relion Prime meter with u40 syringes. Test strips are current.

    We are very new to all of this. A couple of times this past week, he has been high "HI" on the meter which means 600+.

    The vets are closed on the weekends and on Wednesdays (issues on these days of course) and we've had to wing it logically a couple of times.

    I'll give the numbers for the days so far: (TEST/FOOD/INSULIN is the procedure)
    9/27: The day he was taken to the Vet
    He had his first shot around 1230pm
    1048pm 511

    Was not told to leave food for him overnight and then... crashed in AM.

    9/28: 934am 35 - tested again - 46 no insulin given (very lethargic) Did not know about Karo Syrup at this time or didn't hear from Vet. Information overload.
    952am 51 tested again 57 then ate food

    1134am 118
    133pm 366
    535pm 427
    931pm 504 insulin given
    Food left overnight

    9/29: 922am "HI" per meter 600+
    937am insulin given
    1147am 413
    604pm 559
    937pm 375
    951pm insulin given
    1133pm 278
    food left overnight

    9/30: 849am 112 food but no insulin given
    954am 107 (Called Vets because of these numbers - down after food?? Went to Vets, left him there all day, they tested our meter against their "pet" meter, apparently ours is less accurate at the lower end of the numbers 20-30 points - according to them. Picked him up at 530pm, big stress on Do Daa all day, no eating no peeing. Not helpful.)
    846pm 460
    902pm insulin given
    food left overnight

    10/1: 850am 373
    901am insulin given
    851pm 68 no insulin given
    10:06pm Checked again 79 - no insulin given

    food left overnight

    10/2: 854am "HI" per meter 600+
    859am insulin given
    1050am 592
    255pm ( 6hrs after does) 502
    842pm 157 no insulin given
    food left overnight

    10/3: 837am 573
    849am Insulin given
    846pm 180 no insulin given

    *(The food left overnight has been 1/3 of a cup or slightly less)

    All the blood work tests were done including a urine tests all of which came back normal except for the high
    glucose. Which started us on this journey.

    I am confused by these results. Is Something Wrong?
    Many of these days he has only received 2 units in the course of the day.
    If it's below 200 we do Not give him insulin. A couple of times it's been really high in the AM and really low in the PM.
     
  2. Margie and Jackson

    Margie and Jackson Member

    Joined:
    Apr 26, 2019
    Yikes. I hope you get responses from people familiar with Prozinc and more experienced in general, but that seems like too much insulin. You could also try the Prozinc forum for folks who use that insulin.

    You might read in the stickies about the somogyi effect, in case you want to bring that up to your vet. This is when too much insulin can cause high blood glucose.

    Good luck, and I’m sure you’ll get a more experienced response soon.
     
  3. Panic

    Panic Member

    Joined:
    Apr 10, 2019
    Hi Goose! I agree, 2 units is definitely too much for him. You don't want him going lower than 90 on a human meter when he's on ProZinc. The high numbers you're seeing are bounces, it's his body's way of protecting himself from dropping too low. The body dumps excess glucose to protect itself and thus we get those really high 500-600s. He definitely needs a reduction ASAP. I'm not experienced enough to give a suggestion of how much though.
     
    Nan & Amber likes this.
  4. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Welcome, and well done with the testing!

    I do not use ProZinc, so I can't advise on dose, but it does look like the 2U might be too much for him.

    One thing you could do to help people evaluate the data you have is to put it in spreadsheet form. We have a common format we use on this forum (click links in most of our signatures to see examples). Instructions here:

    FDMB SPREADSHEET INSTRUCTIONS

    Let us know if you have any problems setting it up and putting a link in your signature.


    What you are probably seeing is a phenomenon called "bouncing", which Elizabeth explained very well. The thing that makes it extra-tricky to figure out is that the bounces can last a while-- up to three days! This is one reason we like to see the BG data on a spreadsheet-- sometimes you have to be able to look at patterns over several days before you can see what is going on, and the spreadsheet gives a nice visual shorthand.
     
  5. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    I agree with @Nan & Amber The dose is too high and Do daa is trying to compensate for that.

    Tagging @MrWorfMen's Mom for you. She knows more about prozinc than I do.

    In the meantime, please read about what to do in case of a hypo. The information can be found here.
    Symptoms of & how to treat HYPOGLYCEMIA - what to do if your kitty experiences hypoglycemia
    Jojo's Hypo Tool box - be prepared, what to have on hand in case of an emergency

    It is good to print them out and have them on hand.

    The only time you need to pick up food is 2 hours before shot time so that the shot test is not food influenced. Until you start shooting a lower dose, I would leave food available at all times.
     
  6. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Hi and welcome to you and Do Daa! So glad you are home testing and caught those lows and not given insulin at low pre-shots. The starting dose of 2 units is roughly double what a normal starting dose is. The problem is that our kitties are notorious for being stressed at the vet and that leads to elevated BG. That elevated BG often leads to the vet prescribing a higher dose of insulin than is needed and it only becomes apparent once kitty is back home in their own environment.

    The other thing that may have caused some of the low numbers is the change of diet. The difference in the carbs in Friskies dry food vs the Dr. Elsey's is substantial and has likely brought about a lowering of BG. While a kibble diet is not optimal, the Dr. Elseys is an acceptable low carb option. I know only too well how difficult it can be to get some cats to transition to a wet diet. I fought with my girl for quite a while through our journey. Just keep trying.

    Does Do Daa have any history of ketones or DKA (Diabetic Ketoacidosis)? If not, I would suggest you reduced the insulin dose to 1u twice daily as long as pre-shot is 200 or higher and mid cycles tests are not dropping below 90. I'd hold the dose for a period of at least 5 days to start and then re-evaluate.

    It would help us help you if you would set up a spreadsheet and keep it updated with your test results. We are very data oriented here and the spreadsheet will give you a great way to track progress in a very visual way and keep information readily available so you don't need to type out a list of readings to get help. If you need any assistance getting the spreadsheet set up, just holler. We can set it up for you.
     
  7. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    Hi Goose and welcome to you and Do Daa. You have come to the right place for information and support to help Do Daa get his BG (blood sugar) regulated and feeling a lot better.

    Please create a signature so that we can see Do Daa's information right away when you post.
    Setting up your signature (light grey text under a post). Here's how:
    click on your name in the upper right corner of this page
    click on "signature" in the menu that drops down
    type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what he eats/any other meds or health issues he has. You can add your name, and a geographic location (sometimes the country/time zone matters) Be sure to SAVE when you are finished.

    Nan gave you the link to the spreadsheet, and here is another link that explains how to understand the spreadsheet:
    http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

    When you set up the signature and then the spreadsheet, it's very helpful to put the spreadsheet link (eg. Do Daa SS) at the very end of Do Daa's info, even make it bold so it stands out.
    The instructions tell you how to create a text link (the URL spreadsheet links can be very long and take up a lot of room and signature space is limited).
    Much easier to find, just in case you have a bit of an urgent event or question and the spreadsheet data needs to be consulted.

    Will Do Daa eat canned food at all? If he is willing, and you decide to transition him to a low carb wet diet, here is a Food Chart from www.catinfo.org by Dr. Lisa Pierson DVM. Dr Pierson recommends " start with protein minimum of 40, fat maximum of 50, carb max of 10, and for cats with kidney issues....phos less than 300."

    Many members feed Fancy Feast Classics, Friskies pates or 9 Lives varieties, because they are available and affordable. If you worry about him having food when you are at work or during the night, many of us use a timed feeder so that compartments can be set to open at certain times, and food will be available. Many of the feeders have little ice packs that fit under the dishes so that wet food stays cool and can be used in warmer environments.
     
  8. Goose

    Goose New Member

    Joined:
    Oct 2, 2019
    Thank you all for your replies! I've yet to test him, but will be soon.

    How do I start a private conversation?
     
  9. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    You click on the person's avatar, then click "start a conversation"
     
  10. Goose

    Goose New Member

    Joined:
    Oct 2, 2019
    Again, thank you all for your assistance. I will be going through this thread in the coming days.

    Do Daa's BG tonight was 337 and he was given a 1U dose. We're going to re-test at 1130pm to see what 1U is doing with BG at 337.

    Tested at 1130pm - BG at 205. Not sure what it will be in the AM.
     
    Last edited: Oct 4, 2019
    MrWorfMen's Mom likes this.
  11. Goose

    Goose New Member

    Joined:
    Oct 2, 2019
    We had been giving Do daa 1U at night and 2U during the day (only 2 days tho) after a brief conversation with the vet because of the up/down/bouncing- but that doesn't seem to have helped much. Having the dosage different in AM and PM doesn't seem to be helping. This is indeed frustrating.

    I have the last couple of days numbers but today he was high all day.
    840am 558
    857am 2U insulin given
    1140am He ate some wet food for the first time in a long time
    3pm 516 - because of the wet food?
    843pm "HI" 600+
    9PM 2U insulin given ( we felt it necessary to give 2U tonight because of the numbers...)

    I haven't looked at the spreadsheet information yet. Someone mentioned that they could assist with that I believe if needed.
     
  12. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    It takes time to get anything close to regulation....be patient! It was a good 5-6 months before I started to see anything that resembled a pattern with China.

    ProZinc can be dosed based on the Pre-shot test, but we've found it usually works best when you give the same dose both AM and PM …...and it's important to test in between the shots too so you know how low the dose is taking him.

    I'd suggest dropping back to 1.5U and holding that dose for several days. Let's see how he's doing then. 2U dropped him too low, so it's best to drop him back a little until you get more tests in.

    I'd be happy to set you up with our spreadsheet. Just click on my name and choose "start conversation" to send me a private message so I can get some information
     
  13. Goose

    Goose New Member

    Joined:
    Oct 2, 2019
    Hi Chris & China,

    Your suggestion is to give him 1.5U during the day and 1.5U at night? Does the constant changing of the dosage help or hurt?

    2U was given today because he was high in the morning, and really high at night. I haven't noticed 2U bringing him down too far... like going from 500 back to 300. It's seeming like 100 points is about it. But without the spreadsheet, I'm guessing it's hard to see a bigger picture.

    As mentioned above, he was high all day 840am 558 - 2U insulin given - 1140am ate some wet food - 3pm 516 - 843pm 600+ - 2U insulin given. Given this info. how would dropping him to 1.5U twice a day help him?

    Does hunger play a role in increasing BG? We gave him 2U at 9pm and tested him again (no food for 2hrs) at 1130pm and the meter still says "HI" 600+.
     
    Last edited: Oct 6, 2019
  14. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    The fact that 2U dropped him to very low numbers on 9/28 is the reason I suggested a lower dose. It's always better to start lower and gradually go up.

    Yes, 1.5 both AM and PM.....Usually we suggest giving the same dose for both shots at first anyway. With ProZinc, you can give different amounts, but we've seen better results with a consistent dose. If it doesn't end up working well for Goose, we can always try a sliding scale dosing later.

    Until his numbers are lower, he'll want to eat more than normal, but the only time it's really important that he not eat is for the 2 hours immediately before Pre-shot tests so you get a number that's not influenced by food. In between shots, you can feed multiple mini-meals which are easier on the pancreas than 2 big meals per day.
     
  15. Goose

    Goose New Member

    Joined:
    Oct 2, 2019
    Chris,
    These numbers were today/tonight 10/8:
    850am 560
    902am 2u given
    309pm 208
    850pm 535
    858pm 2u given

    Your suggestion is nearly the same as @MrWorfMen's Mom.

    Common consensus is that starting Tomorrow AM/PM I'll start giving ( Do Daa ) 1U of insulin No Matter His High Numbers. Suggestions for how long this should go on before I see any results? What exactly am I looking for? A 100, 200 base point drop constantly? Or?
     
  16. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    @Goose ….we're very data driven here so we need to get you a spreadsheet for you to put your numbers into.

    I'd be happy to help you with it. Just send me a private message so I can get some information from you. Click on my name and choose "Start Conversation"

    We also need you to fill out your "Signature" so people can quickly see which insulin you're using and get a little background. You'll see our signatures under each of our comments. Things we like to see are:

    Your name/Cat's name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health issues or medications? and a general location.

    We want to see a nadir around 90 with Pre-shots around 200 but that will take time to achieve. For now, I'd just stick with the 1U dose (if that's where you've decided to start) and hold it for at least 3 days and then let's see where you're at.
     
    Last edited: Oct 8, 2019
  17. Goose

    Goose New Member

    Joined:
    Oct 2, 2019
    Chris, etc,

    I started Do Daa on 1U yesterday morning.

    847am 356
    904am IU given
    3pm 560
    843pm "HI" 600+
    852pm 1U given

    Today:
    842am "HI" 600+
    852am 1U given
    303pm "HI" 600+
    900pm "hi" 600+

    I'll included tonight's readings later, which will be the end of day two at 1U.

    As of right now, and can't see 1U helping him at all. Is this how it's suppose to be? Because it seems he's constantly Really high. I don't want to do damage.
     
    Last edited: Oct 10, 2019
    Reason for edit: added info
  18. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    High numbers do take time to do damage...it's the low ones that kill quickly but yes he may need more insulin. I think I originally suggested 1.5

    We really need to see his numbers on our spreadsheet though. Without the spreadsheet, you're really tying one hand behind our backs.

    Are you testing for ketones? You can get urine ketone test strips at any human pharmacy. Here are some Urine Testing Tips
     
  19. Goose

    Goose New Member

    Joined:
    Oct 2, 2019
    Yes, you did originally say to start at 1.5U. I figured that 1U was as low as I would go as not to overshoot a correct dose for him.

    I have been speaking with MrWorfMen's Mom about the Spreadsheet. She has indeed agreed to help me with that. She has been Very helpful.

    I have yet to do the SS because I have a clear dislike for Google, however I think we may have found a work around for the phone number exposure - a requirement for a gmail account apparently. I appreciate my privacy and am always online with a VPN.

    I have not been testing for ketones. He had a complete blood panel and urine test not 2 weeks ago, everything was fine except the high BG.

    I just gave him 1.5U tonight. I'll continue with this dose and hopefully we''ll see some improvement.
     

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