New here. I have a few questions!

Discussion in 'Prozinc / PZI' started by mattm1124, Dec 29, 2017.

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  1. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Hello everyone!

    My cat Oreo was just diagnosed with diabetes on 12/16/17 with a reading of 427. She is about 9 years old, not sure on exact age because we took her in as a stray 2 years ago and the vet at that point thought she was around 7. I have been reading through the forums but just wanted to post my specific questions here so they were easy to find. First took her to the vet when she started drinking a lot more and of course urinating more. Since she has been on ProZinc, she has been drinking less and urinating less.

    The vet gave us ProZinc and we give Oreo 2.2 units every 12 hours. Once around 5 AM while she's eating and then again around 5 PM while she's eating. The shots have been pretty on time so far. I have a few questions which I'll list below, but please give me any other useful information I may be missing.

    1. I want to know if we are feeding Oreo enough and if we should change to more wet food. I've read wet is overall better. The vet gave us the food but wondering if there are better options. Right now we are feeding her 1/4 cup dry food in the morning, at 5PM we feed her wet food (the can is 5.5 oz and we feed her 2 spoonfuls which is 1/5 of the can each night so about 1-1.5 oz), and then we feed her 1/8 cup of dry food over night or she'll bother us. The wet food is PURINA - Pro Plan Veterinary Diets DM and the dry food I believe is the same kind, just dry. I'll have to call the vet and find out. I threw the package away after putting the food into a container not thinking. Also, with the wet food it's stored in the cupboard but after it's open, we keep it in the fridge until it's gone.

    2. We are supposed to take Oreo back for an insulin curve but I have been reading about the benefits of home monitoring. Would it be a bad idea to at least have the vet do the initial curve?

    3. I saw in another thread most people use the Bayer Elite Glucose Meter. When I clicked the link, that one wasn't listed there but I found it on Ebay. Are their other good meters?

    4. What should Oreo's glucose readings be? What is normal?

    Thank you all in advance and I have attached a few pics of Oreo, as well as the can of wet food we now use.
     

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  2. Vader723

    Vader723 Member

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    Dec 12, 2017
    Hello, and welcome! Some of your questions, I do not have enough experience/knowledge to address, but I can speak to the meter. Many of the members use the ReliOn meter from Wal-Mart. The strips are reasonable, it’s an accurate meter, and it uses a small sample size.
    Regarding the food, prescription diets are often more expensive and much higher in carbs than a diabetic cat should have. The pate versions of both Fancy Feast or Friskies are fed by a pretty large majority of the people here with great success. If you haven’t yet looked at it, Dr Lisa has a link to a food comparison chart on the main health forum. I have it bookmarked, and anytime I am looking for a new food as a treat or just a change, I always reference this.

    I will defer to other members to advise on recommended calorie needs of cats, as I do not have the specifics available right now.

    Oreo is a cutie!
     
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  3. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Hi and Welcome! Sounds like you're already doing a great job of getting started! And those pictures are absolutely adorable!!!

    Okay, here are some responses to your questions and a whole bunch of other info. I hope I don't overwhelm you....one step at a time...

    1. Has Orea lost weight? Is she at a healthy weight? Underweight? Overweight? Calorie needs really depend on the cat. Most cats lose weight prior to diagnosis and need lots of food at the beginning because while they aren't getting/making enough insulin, the can't use the nutrients well. But it really does depend on if she needs to gain or lose right now. In general we say to feed them as much as they want at the beginning - unless she is heavy. The wet DM is 10% carbs which is the max recommended for a diabetic cat - lower is better. The DM dry is 18% carbs - way too high for a diabetic cat. If you can, I would recommend getting her off of the dry as soon as you can - but not before you are monitoring BG at home. Changing food can lead to changing BG rather quickly - so you want to make sure you are testing BG at home to keep her safe. There is a food list in my signature that can help you find foods that are appropriate for Oreo. Most of us stay around 0-6% carbs, but anything below 10% is okay.

    2. It doesn't hurt to have the vet do the curve - except to your wallet. The biggest problem is that the results aren't that helpful. Most cats are stressed at the vet which means their blood glucose (BG) numbers are higher than they would be at home. Then the vet uses those higher-than-normal numbers to tell you how much insulin to give - which is then too much insulin once you get home. So while you certainly can have the vet do the curve, you'll need to be very careful about how you decide to use the information the vet gives you.

    3. At this point, most folks are using the ReliOn meters from WalMart because the strips are so cheap. I used the store brand meter from my local pharmacy for a long time, and when that died, I went to this one: https://www.adwdiabetes.com/product...ose-test-strips-lancets-and-free-presto-meter because I like online ordering and don't have a WalMart near me.

    4. Normal BG for a cat using a human meter is 50-120, with most cats running between 50-80

    Now on to a few other things.

    5. Get a spreadsheet set up as soon as you can so you can keep track of the BG numbers you get. The spreadsheet color codes automatically and helps with finding patterns in Oreo's responses. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/ Let us know if you need any help with that part.

    6. Start your signature with all of the key info: cat's name, age, weight, date of diagnosis, food, insulin type, meter type, any other health issues, anything you want us to know so we don't keep asking the same questions over and over (we have terrible memories :))

    7. When you start testing, you'll want to test before every shot, and mid-cycle tests whenever you can. The mid-cycle tests are really helpful so you can judge if the dose is working, too much, or too little. Nadir on Prozinc is usually somewhere around +4 to +7 hours after the shot is given, but every cat is different - mine has typically hit nadir around +3, I've seen a kitty here who usually hit around +9. And of course the nadir can move from day to day based on activity, food, stress, etc., although most cats will have a "typical" time at least.

    8. Ketones - one more thing to buy while you're at WalMart - ketone test strips are around $15 - you stick it under your kitty's bum when he/she is peeing and catch a drop, then see if it changes colors. Ketones can develop quickly and are deadly if not caught right away. If your kitty won't let you in the room when using the litter box, we have some tricks we can teach you to get these tests done. Usually once/week is enough or if symptoms pop up.


    Okay, that's probably more than enough for now. Please let us know what questions you have as this can be a bit overwhelming in the early days. I promise it gets easier. It will be as routine as brushing your teeth in no time, but the first couple of weeks are tough. We've all been there. We are here to help.
     
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  4. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Umm...just noticed you already have a signature set up. Sorry about that...:oops::)
     
  5. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    Hello! Djamila gave great info so I have nothing more to add, but wanted to say hi and your pictures are adorable! Please let us know if you have more questions for us...we'd be happy to help!
     
  6. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    Thank you so much for the answers and help! I tried to respond to each question within your question Djamila but it wouldn't let me post that way for some reason. When I tried to quote your post it said it contained spam like content or inappropriate elements.

    1. Oreo has lost weight overall. At one point she was around 13 lbs about 2 years ago and we realized she had to lose some weight so we changed her diet and made sure she was playing a lot more. She seemed to be losing weight prior to the diabetes diagnoses. She is now 10 lbs and we think that is a healthy weight. 10 lbs is a good weight correct? As for the food, this may be a dumb question, but how do you figure out Protein, fat, carbs based on the food label? For example, the wet DM on the label says crude protein is 12.5%, crude fat is 4%, fiber is 1%. I'm guessing some math is involved but I'm just not sure how to figure that out. Grocery stores don't seem to have a great selection for foods high in protein but low in carbs. Where do most people buy from? At Walmart though, I found the Meow Mix - Tender favorites Tuna and shrimp and based on your chart it appears to be a good one to use. Is that correct? I have a lot of the DM cans left, do you think it's ok to finish them and then switch or would you recommend going to a lower carb wet food right away also? I also heard in the past that fish type foods weren't always good to serve and chicken/turkey was better?

    2. This makes a lot of sense. I don't want to stress her out any more than she needs to be but doing all this testing seems overwhelming at first. But I want to do what's in her best interest obviously.

    3. At Walmart today, I picked up a ReliOn Prime GC meter, 50 test strips, and lancing device. I am still a little nercous about doing this at home but let me make sure I have this correct. I first use the lancer to prick her ear and then use the meter to test? I don't think she'll sit still and let us lance her ear. She's good with shots because while she's eating we give it to her. Is there not a device that I just stick to her ear and it automatically pricks, instead of a single needle I have to use? Maybe it's really easy but obviously never having done it, it seems hard. Also, I read that I need to call the number and have them send me the control solution to make sure the meter is accurate. Should I wait to test anything until I get the solution. Also, should I wait to start testing when I can be home for the whole day?

    5. Once I start testing, I will definitely get this set up!

    8. I picked up the ketones testing strips also and she should let me test this without any issues.
     
  7. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    Thank you so much!
     
  8. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    I appreciate that and the help!
     
  9. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Hi! Let me see if can get some of your questions answered:

    1. Here's a link to the Food Chart we use. It has a ton of different brands of food on there and you can find all the info on nutrition that you should need. If a brand isn't on there, you'd have to contact the company to find out that info. Most of us get our food from either a pet store (PetSmart, PetCo, etc) or from an online source like chewy.com. I used to order from chewy before I started making food.

    As for what to feed, I wouldn't switch from the DM until you start home testing and feel comfortable with it. They can drop BG dramatically overnight with new food so you want to be sure you are okay testing first. Then you might want to introduce the new food slowly....mixing it into the old food. That'll help reduce any tummy upset. However, once you've got them on new food I'd just return the DM you have left. Tell them your cat stopped eating it if you want...a lot of cats won't eat it long term.

    Fish is okay, but not too often. Many feed it once a week or so. It can have high levels of mercury and some cats will get hooked on fish and refuse to eat anything else. I don't feed any to my cats due to other issues that fish can make worse.

    3. Yes! Use the lancet to prick her ear and then put the blood drop on the strip that you inserted into the meter. You might want to try it on yourself once or twice to get the hang of it...and don't worry about the pain. It hurts US in the fingertip but really, it doesn't hurt the cats as much. We have tons of nerve endings in our fingers but they don't have that many in their ears. Might want to youtube a few videos first too...that helps you to really see what to do. You can use the lancet device if you want...where you put it against her ear and press a button and it pricks but most of us find it doesnt work well and the noise can scare the cats. I found it easier to use the lancet myself and freehand it. Whatever works for you is fine!

    I never used control solution with my relion. I didn't know they had it. I think it should be fine...anyone else know about that?

    I'd start testing right now! Why wait? It'll help you get used to it before trying to do a whole day curve. :)
     
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  10. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    Thank you for the information Rachel! Actually, when the vet gave us the new food, we did just switch all at once, not knowing we should do it gradually. Luckily Oreo seemed fine with it.

    I'm still not quite understanding where the numbers on that chart are coming from though. On the Chart, the DM Savory Selects has a content of 49 Protein, 40 Fat, and 10 Carbs. I'm assuming those are percentages. When I look at the can though, how do you get the 49,40,10 on the chart from the can that says: Protein (min) 12.5%, Fat (min) 4%, Fiber (max) 1%, Moisture (max) 77%, Taurine (min) 0.05%.

    Would you be able to send me a few links to appropriate wet foods from Petco, Petsmart, or even Chewy that would be great for Oreo to be eating? I feel like when I look at the chart and then search for the food, I can't find the specific one.

    I'll probably watch a few more videos and then give the meter a try!

    Thanks again.
     
  11. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I can tell you that ProPlan DM Savory Selects is about 10% carbs as fed and the ProPlan DM pate is about 6% carbs as fed. I asked to see the product info sheet when I was at my vet's quite a while ago.
     
    Last edited: Dec 30, 2017
  12. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Here is a link for understanding the spreadsheet. You might also find it helpful to click on a few or ours (in our signatures) to see how they look. You don't have to test as often as some of us do, so don't be scared off!

    http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

    And here is a link with some pictures and videos to show you how to test:
    http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

    We have loads and loads of tips and tricks for overcoming the struggles in the beginning, so give it a try and let us know what worked and what didn't for you and we can help you problem solve. It doesn't always go perfectly the first time, so don't let it stress you out. We're here to help! :bighug:
     
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  13. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Oh, and about the food calculations - you can't figure it out from the labels. The labels have minimum and maximum values for different things, so it might have a max of 48% protein, but it might also only have 20% - the companies won't put the real values on the label - which means you can't know for sure. The numbers in the food chart were gained by writing to the companies and getting the actual values. Many companies will tell you - but only if you ask for it. Some companies won't - and they are not included in the list for that reason.

    Most folks around here just feed Fancy Feast Classic pate styles, or Friskies pates. They are low carb, inexpensive, and easy to find in just about any grocery store. As you can see from the list, there are lots of other good choices as well - those are just the most convenient.
     
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  14. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Dr. P painstakingly over the course of months contacted each company to get the "as fed" values. There are apps that claim to do the calculations but none of them are accurate.

    I have a video in my signature showing how I test my cat CC. It's not as hard as you would think. The whole thing takes all of 30 seconds each time. Giving your cat a favorite low can treat that she only gets for a test will quickly make her grow to tolerate and even look forward to the tests. As you can see she's purring in the video. The first two weeks she wasn't nearly as happy about it. Lol
     
  15. Vader723

    Vader723 Member

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    Dec 12, 2017
    Agree with @JanetNJ about the food. Dr. Lisa put in a ton of time and research into putting together her chart. There are a few brands that weren’t helpful or that she feels are outright unhealthy for cats, and if you look at her pdf version she will note these by the name of the brand. The carbs column is indeed percentages, and you want to stay at less than 10%. Most of the time pate versions of food are within this range, but not always, so you may want to reference the chart until you become familiar with the brands and flavors that meet not just the carb threshold but also the approval of your feline overlord :) You can pick up cans of Fancy Feast or Friskies pate at Walmart, Target, or pretty much any grocery store.
     
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  16. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    Thank you so much for the information! We tried to test Oreo today but her ear wouldn't bleed. We used the lancet device after rubbing her ear for a bit.

    We are going to try again later. We currently don't have rice to put in a sock which I've seen suggested. Can we try a microwavable heating pad to warm her ear up? Also, if the lancet device doesn't work, I guess we'll try freehand with the needle.

     
  17. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    I wanted to thank everyone else for the responses as well. It has been a big help!
     
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  18. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    I'd you are using a 31 gauge lancet that might be the problem. Get some 26-28 gauge lancets. Don't be afraid to poke all the way through.
     
  19. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Is it on the cold side where you are? Sometimes in colder weather you need to warm the ear up a bit longer.


    Mogs
    .
     
  20. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    You mentioned not having rice -- you can also use uncooked popcorn or flaxseed if you happen to have either of those. You only heat it for somewhere around 20 seconds for most microwaves, so the popcorn won't start popping ;)
     
  21. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Another option is an empty pill bottle...you can fill it with warm water from the sink.

    And if the popcorn DOES start popping...just means you have a nice snack for after, right????
     
  22. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    Ok, We just tested Oreo for the first time with the ReliON Prime meter from Walmart. We had struggles to get blood in the past couple days as you know, but today we warmed up a sock of rice and it worked.

    We fed her at 5 PM and also gave her 2.2 units of ProZinc Insulin. We then tested her BG at 6:45 PM and her reading was 103.

    With this being a "human" meter is the 103 a good test? What are the ranges I should be looking for again? Oreo has not had an insulin curve yet since she was just recently diagnosed but now that we had a successful test, we hope to do the curve this weekend when we can be home all day.

    I know we'll have to get a spreadsheet started also.

    Thanks for any advice and if the 103 is a good start.

     
  23. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    Thank you for this. We were using 30 gauge and didn't realize so we bought the 28 gauges this past weekend!

     
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  24. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Whew! That 103 is a nice number but it's a bit low for only 1.75 hours after her shot. ProZinc usually reaches its peak action (where BG will be lowest) around 5 to 7 hours after the injection. I think you'll have to practice some more testing this evening. I suggest testing again at the 3 hour mark and posting the result here. It's possible that the 2.2 u dose is a bit too high.
     
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  25. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    First of all, congratulations on getting the test!!! So glad to hear that warming and using the 28's helped.

    Now for the bad news - I agree with Kris - that is a bit low for so early in the cycle and it makes me a little nervous about where Oreo might be heading tonight. If she gets below 50, you'll want to take some action to keep her safe as that is getting into hypo territory.

    So 103 is a great number, but with 2.2u, there is some risk with that number at less than two hours into a 12 hour cycle. Hopefully she'll float along and stay above 50, but please do try to get in another test tonight.
     
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  26. Critter Mom

    Critter Mom Well-Known Member

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    Normal reference range for cat BG as measured on a human meter is 50-120mg/dL.

    Good catch on that 103 so early in the cycle! :)


    Mogs
    .
     
  27. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    Ok, we just tested her again 3 hours past her insulin shot (2.2 units) and she is at 48. We have been giving her 2.2 U since December 19th at 5 AM after she eats and 5 PM after she eats. From the symptoms we've look up of Hypoglycemia she has not shown any of them since we have been giving her the 2.2 U. This is obviously the first time we've been able to test though. She will also play if we take out the laser pointer. What do you all suggest with the numbers given tonight and her not showing any signs of HYPO since December 19th? Do we lower the units given, snack, etc?

    Thanks!

     
  28. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Yes, lower the units, and yes, give a snack.:) Since she's only at +3, she is quite likely to go lower still, which means you'll need to be careful with the snack - yuou don't want her to fill up and refuse to eat later. What foods do you have at home? Let's see what carb levels you have to work with and we can try to help figure out the best way to manage the next little bit. Also, how long until your bedtime?
     
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  29. Djamila

    Djamila Well-Known Member

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    PS - most cats are still fine at 48, so no need to panic - we just want to intervene at this point so she doesn't drop much lower. The lowest point on Prozinc is usually around +5-+7, so the insulin might still be pushing her down for a couple of more hours.
     
  30. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    Thank you so much for the information and help! We actually give her an 1/8 cup of dry food (Purina DM) at 9 PM (4 hours post shot) every night or else she will bother us all night. I'm guessing that's what helps with the BG going up some each night and allow her not to go into hypo. So instead of 2.2 units tomorrow morning do you think we give only 2? We will also try and test her BG before the shot tomorrow morning. What's a good number to aim for tomorrow morning pre-shot?

    Oreo usually heads off to bed after she eats her snack but I'm up for awhile after that. I can try and test her again tonight but how long after she eats at 9 PM would be good to test?

    PS. I'm setting up my chart on Google sheets now but when I put in the +1, +2, etc the + disappears unless I put it like .+1. How did you get yours to only show the + and number?

     
  31. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Okay, so you have DM dry and wet? Go ahead and give her a tablespoon of the dry. I'll respond to the rest in a minute, but want her to get some carbs and not wait for me to finish typing :)
     
  32. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    you aren't using the template we have?
     
  33. Djamila

    Djamila Well-Known Member

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    So let's see if I have this right....(my memory gets fuzzy sometimes ;))

    You have been giving her 2.2u for a couple of weeks now, but tonight is the first home test? I would recommend dropping the next shot down to 1u and start testing before each shot. There are two possible reasons for the low number tonight. The most likely reason is that she's getting too much insulin. The other possibility is that she is still eating high carb food, and that can cause erratic numbers.

    However, based on what you said about needing to feed her at night or she drives you crazy, that can be an indication of low numbers, so my guess is that she's on too high of a dose.

    Oh geez! And I meant to say to give her some wet food. Ah typing! Please go ahead and give her a tablespoon of wet food too. It absorbs a bit faster.
     
  34. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    In regards to the spreadsheet? I am, and it looks the same as the one's I've seen on here. I'm just trying to get the +1, +2 on the sheet. Every time the plus before the number disappears though. I know that's not a big thing but it bothers me!

     
  35. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    After you've given her the snack, wait about a half hour and test again. Hopefully she'll be holding steady or rising a bit by then.

    Also, do you happen to have any of those soft treats? Like Temptations or similar? Those are super high carb.
     
  36. Djamila

    Djamila Well-Known Member

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  37. mattm1124

    mattm1124 Member

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    You are correct. Honestly though, before she had diabetes, she would bother us at night if she didn't eat so that's pretty normal for her. Once she eats the 9 PM snack, she's fine until morning. This didn't just start when she was diagnosed. Also, we've tried to feed her only wet food, but she doesn't like it. The times we have tried, she seems out of it and it takes her a long time to eat. She only seems ok when we feed her dry food but then wet for dinner. I know from reading wet is a lot better, but she won't seem to only eat wet food.

    UPDATE: She just finished her snack which was dry and she's now playing with her ball as usual and seems fine like always. Obviously I want her to feel the best she can.

     
  38. Djamila

    Djamila Well-Known Member

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    Most kitties don't show symptoms until they get really low. All of this testing and snacking is just in service of keeping her away from the dangerous lows.

    That makes sense that the nighttime snack is just her habit. I like a bedtime snack too :D.

    Have you tried Young Again Zero Carb? It can be ordered online and lots of folks around here use it if they can't get their cats off of kibble. It's lower in digestible carbs than any other kibble, so for most cats it doesn't mess with their BG as much. It's expensive, but most cats only eat about 1/4c per day (and less if it's just fed as a snack) so apparently a bag lasts a long time.
     
  39. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    Thanks, I'll definitely look into that food. She ate at 9 so I'm planning on testing her in about 8 minutes or so.

    I doubt this will happen but I want to be prepared. Say we test her tomorrow morning at 5 AM and her BG is within normal range 50-120. What should we do then?

     
  40. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    If she is under 200, don't give her any insulin. As you collect more data you can give her insulin at lower numbers, but at this point I would error on the side of caution. Her liver is going to need a little time to recover from this.

    More likely though, she'll be high tomorrow. Usually after a low number they'll bounce a bit (go up higher). Even if she's high tomorrow though, I would still recommend reducing the dose. She went low early in the cycle, so she needs a big reduction.
     
  41. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    Once again, thank you for the help. We just tested her again, 30 mins after her snack and her BG was 53. She climbed a little from the 48.

    We will test in the morning and sounds good on reducing her insulin down from 2.2. Did you say how many units you recommend giving her tomorrow? I know that would overall depend on her BG but probably won't have time to post her number and then get a response that early and before heading to work.

    Thanks.

     
  42. Djamila

    Djamila Well-Known Member

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    That's a long 8 minutes. ;):p

    Any news?
     
  43. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Oops. we cross posted. Before you sign off....how many hours post-injection are you now? She is still really too low to leave her alone yet.

    She is going to need you to keep giving her more snacks and another test to make sure she doesn't drop still.
     
  44. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Djamila recommended a dose of 1 unit in post #33 above. I agree with that.
     
  45. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Are you at +5 right now? Do you have any other cats? If you leave out food will she graze or inhale it all? If I'm right that it's +5 and you need to go to sleep, I think at this point you could just leave her a good helping of the DM Savory and go to bed. That's high enough in carbs that she could steer herself if she needs to. Although if she tries to wake you up, pay attention - cats are known to wake up their human when they get too low. Clever little critters. :cat:
     
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  46. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Thanks. I thought it was 1 but then I couldn't find the post and thought maybe I made it up!

     
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  47. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    We are at +5 right now. Oreo is the only cat we have and typically if we leave any food out she inhales it.

    She's actually really good after she eats her 9 PM snack. She does start to wake us up around 4:45 - 5AM which is when we feed her anyways. We will keep an eye on her though for sure and if she trys to get us up earlier this in the morning, we'll know why.

    Thanks again for all the help tonight everyone!

     
    Last edited: Jan 9, 2018
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  48. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Try putting an apostrophe before the plus sign.


    Mogs
    .
     
  49. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Good morning! So we just tested Oreo and she was at 95 BG AMPS. We obviously didn't give her a shot. We're going to test her again in a couple hours before we leave for work.

    I'm hoping that number is correct and we don't have a faulty meter or something.

     
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  50. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Thanks, got it! I used the template link instead of trying to make my own.

     
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  51. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Wow, that 95 is great! And good decision to skip the shot!!! Can’t wait to see where she is tonight!
     
  52. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    We're slowly learning! We checked her BG at 7 AM (2 hours after feeding her) and her reading was 109.

    Now on the chart I'm making, do I still enter the 109 at the +2 mark even though I didn't give a shot? I did put zero for the units though and also in the remarks I added that I didn't give a shot in AM. I didn't know if the chart and plus numbers were only for after a shot is given.

    Also, so we're prepared for later. After testing her BG before dinner at 5 PM if she is under what number should we still not give a shot? No matter what her number should we still only give 1 Unit or if it's really high do we give the recommended dose of 2.2?

    Just want to be prepared for when we test so we give her the right amount of units based on the numbers.

    Thanks!

     
  53. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Wonderful number after no shot last night! :)
     
  54. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    No matter how high her BG is tonight, still only give one unit. If she is below 150, don't give anything. If she's between 150-200, could you eyeball 0.5u?

    The spreadsheet can be used regardless of if you gave a shot or not, so go ahead and fill in the numbers you just got. Here is a video for how to link it to your signature so we can all see it too:


    And then also make sure you click the blue "share" button in the top right corner of the spreadsheet so we can see it, and then choose "anyone with the link can view" You don't want to let us be able to edit!
     
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  55. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    What a beautiful number!
     
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  56. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Ya we should be able to eyeball 0.5u.

    Ok, I think I linked my spreadsheet correctly now in my signature. Our plan is to do the glucose curve this Saturday.

     
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  57. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I can see your SS now. :)
     
  58. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Nice job! Perfect!
     
  59. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Good evening everyone! So we just tested Oreo's BG and it was only 113. It went from 109 at 7AM to only 113 at 5 PM.

    Based on these results what do you all think? I know we need to keep testing her but so far so good. We plan to test her again in 2 hours at 7 PM or is that too long to wait? In a cat without diabetes, how high should we expect to see BG go up after she eats and we test again?

    Maybe her numbers have been good because she's been too low for awhile and now without the insulin, her body is out of whack a little bit?

    Thanks!
     
    Last edited: Jan 10, 2018
  60. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Just tested again +2 and she is now at 174. We didn't give her a shot at 5 PM after eating because she was only at 113.
     
  61. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    At this point I would hold off until the normal shot time in the morning. Is she still eating the dry food? If so, that may have triggered the spike. If not, then it might just be one of those things. How many more hours before bed for you?

    ETA: shoot, sorry. I have the memory of a gnat. Just last night we were talking about the dry food. :rolleyes:
     
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  62. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    We fed her the dry food at 5 AM as usual and she remained low. Every night at 5 PM, she gets her wet food.

    So in the morning when we test, I'm assuming it'll be on the high side. You still recommend giving her 1 unit instead of the 2.2? What about 1.5u or is that not a good number to try.

    We give her that snack around 9 PM so should we test before that snack or after?


     
  63. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    I would absolutely positively not give her more than 1 unit. :) She dove early in the cycle, and stayed low for an entire extra cycle after that 2.2u. I don't want to scare you, but that was a little dangerous last night. You took good care of her, but let's not play that close to the edge anymore! ;)

    It's going to be a little process to figure out what she needs. One unit is likely not the right dose either, but I think it's the next step in figuring out what is the right dose since we really don't know if she needs more than one unit or less than one unit. It's just going to take some time and data to sort out.

    It takes about 20 minutes for food to impact the BG number, so you can either test her before the snack, or immediately after - whichever works best for you. I would just aim to get the test in before the snack has had time to register.
     
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  64. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    I'd just give her the 1 unit in the morning if she's high enough. I know that her number may be higher, but it's sort of artificially high from no shots today...and since 2.2 brought her so low, I think sticking to 1 for a few cycles would work. It might take a few cycles to bring her down into good numbers, but it would do so more gently than pumping the insulin back up and causing possibly another super low and another couple days of no shots followed by a higher number followed by too much insulin etc...

    I see I cross posted with Djamila and she gave you perfect advice as always! :)
     
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  65. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Agreed. You're basically starting over at the typical new diabetic's ProZinc dose of 1 u twice a day, pre shot test numbers permitting. From there, you'll have to log a couple of cycles worth of BG data to see what the next dosing step should be. There's been a lot of change the last couple of days - too high a dose, no insulin, etc. Some stability is needed now.
     
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  66. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Thank you all, that makes a lot of sense. We'll go with the 1 unit and then log the results of course!

    We were also planning to take her back to the vet as they requested this Monday to do the glucose curve. I let them know we have started home testing and they would still like to see Oreo to do their own curve and they said they would also test her with our home meter and then discuss the results.

    Do any of you see any real harm with us doing that, besides it costing us money.
     
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  67. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Cost aside, the curve numbers are likely to be vet stress inflated. They might then recommend a dose increase when it's not needed. That's why we're proponents of doing curves at home.
     
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  68. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    Ok, so we just checked Oreo's BG level (+4) and surprisingly it was only 109. That is down from 174 just 2 hours ago. I know we've only been testing for 2 days, but does this indicate anything with her number back down in a good range on her own without any insulin?

     
  69. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Ya that's what we were thinking also but just wanted to double check. The vet always sounds so convincing and I think they typically have the pets best interest in mind but the added stress they go through is never good.

     
  70. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    It can mean that her pancreas is doing what it should. It's a good sign! :)
     
  71. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    If Oreo drops down like that with no insulin on board it is a clear indicator that the pancreas is producing some insulin. :)


    Mogs
    .
     
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  72. Critter Mom

    Critter Mom Well-Known Member

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  73. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Haha ok that's what I thought but making sure! I know also with diabetes the pancreas creates some insulin, but just not enough. Let's hope Oreo's numbers stay low...but not too low!

     
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  74. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Good morning. So I think we may have made a mistake this morning. When my girlfriend got up, she checked Oreo's BG and it was at 130 and she gave her 1u of Prozinc. She had thought she was supposed to give her the 1u no matter. When I got up, I told her I was pretty sure that if we test her AMPS or PMPS and she was at 150 or below we don't give any shot.

    Am I correct going forward that if she is ever at 150 or below AMPS or PMPS we don't give a shot? Only if she is above 150 do we give the 1u now?

    Then again, if 50-120 is normal range if her BG is at 130 at 5AM after not eating for 8 hours that is high right? I would think a cat without diabetes in the AM would have a lower BG than 130.

    Thanks

    EDIT: Tested her BG +1 and she was at 133. Tested her before we left for work.
     
    Last edited: Jan 11, 2018
  75. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Yes, that's correct. That's actually lower than the 200 usually recommended for newly diagnosed cats. The shootable PS number can come down once the owner has enough data to be able to predict the kitty's responses fairly well (cats are notoriously independent, though!). That 150 is as low as you'd want right now. That 130 is a squeaker but you'll probably be OK.

    In the early days of insulin treatment the goal is to find the dose range that keeps the BGs at decent levels. It's best to give the same dose AM and PM at the start, PS number permitting of course. Changing the dose frequently in response to the PS numbers can be done once you're tinkering with what appears to be a good dose - fine tuning in other words. Oreo is responding well and giving you good blues but they're still high-ish off and on. He might need some time at very small doses (fractions of 1 u) to get his numbers settled consistently in the normal range.
     
  76. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Did you leave food out for her today? Onset for Prozinc isn't usually until +2 so I am a little concerned about the impact of that dose at a 130. Any chance someone can check on her in a couple of hours?
     
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  77. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Thank you for the information. All of that makes sense. Just to be clear though, for now, at times she tests over 150, we should still be trying the 1 unit correct? Then just stick with 1 unit morning and night for awhile if the numbers are above 150.

     
  78. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    We did not leave food out for her. We just put down her bowl and she typically eats it that sitting. She did have a little left though today before we left. Unfortunately no one can check on her today. We won't get home till around 7 PM.

     
  79. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    The answer is ... it depends. It depends on whether she's had an NS the cycle or cycles before, it depends on what the BG data shows about her response to the dose, etc. For example, if she has one or more NSs in recent cycles at a dose of 1 u BID and then gives you a 150 PS, we'd recommend trying a reduced dose. If the PS is 150 and recent history is a set of cycles where that 1 u dose gives a good nadir value in the dark greens with no incidents of NS, we'd recommend staying at the 1 u dose. Make sense? So much of this is judgments made on BG data on the SS in the cycles immediately surrounding the one in question.
     
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  80. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    If she's your only cat a timed feeder could be very helpful to allow more meals while you're away.
     
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  81. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Sorry it's been awhile, my grandma had to have surgery so we've been in and out. Quick question, the spreadsheet I am using that I copied from the template. Do those numbers and colors at the top correlate with both a human meter used for pets and also the AlphaTrak2 meter, or are those numbers just to be used with either the human or pet meter. If so, which one?

    So on January 15th, we decided to take her in to the vet for a glucose curve because we also wanted to see how much lower our numbers were on the human meter. The human meter turns out to be about 30 lower each time. We also then decided to get the AlphaTrak2 meter so we would be more accurate with her numbers. We just got it in yesterday and we tested today. The human meter is still around 30 lower.

    The vet suggested based on her curve that we only give 2 units each time and if after every 2 weeks, if her numbers are still good we should lower her insulin by 10% each time so it's a gradual change.

    Just wanted to get everyone's thoughts on that. Obviously we are getting better with this information but it's definitely a lot of new information at first!

    Thanks,

    Matt

     
  82. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Oh and if normal BG on a cat using a human meter is 50-120, is normal on the AlphaTrak2 around 80-150?
     
  83. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Hi Matt! It's great to see the data you've collected! Your spreadsheet is for a human meter, but the only difference is that on an AlphaTrak, hypoglycemia starts at 68, and on a human meter it starts at 50. The rest of the ranges are the same.

    Normal BG on the AT2 is 68-150.

    I disagree with your vet on dosing however. Whenever you get a lime green number (under 50 on human, under 68 on AT2), you need to lower the dose. Also, cats run lower at night, so you really need to get some tests during the PM cycle just like you did on 1/09 and 1/13. Both of those cycles show that Oreo is getting too much insulin right now, which puts her in danger of having a significant hypoglycemic event.

    I'm glad to see you lowered to 2u, but please keep monitoring before every shot and at a mid-cycle time or two whenever you can. And remember - 68 = reduce the dose. Please don't wait for a set amount of time to do that.
     
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  84. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Matt,

    Sorry to hear your grandma had to have an op. I wish her a speedy recovery.

    Great job on the BG monitoring. Oreo is doing so well! :cat:

    I, too, am very glad to see you reduced the dose after that 37 (really was on the low side, that one! :nailbiting:).

    Did you give any honey/karo/food after that 37 reading, Matt? If yes, it will be helpful to you to make a brief note of what you did to bring numbers back up in the spreadsheet remarks for that night, just in case you need to refer back to it at some point.

    Vet advice is OK on the gradual reductions (reducing by 0.25IU is the general FDMB guideline) BUT ... (and it's a very big 'but') ... as Djamila advises above as soon as you see a cycle where BG goes below 68mg/dL on an Alphatrak you need to intervene with food/karo/honey as appropriate (see links below) and keep testing, intervening with more food/syrup as necessary until BG levels come up and stay up without any need for further intervention with food/honey/karo. You then reduce the dose on the very next cycle.

    In fairness to your vet, perhaps there are other clients with diabetic felines who aren't home testing, in which case all the vet can do is give general guidelines.

    Ain't that the truth! :rolleyes:

    To refresh your memory about procedure when you get a low BG test result:

    How to treat Hypos

    And here is info on the recommended supplies you need to keep a stash of:

    Hypo Tool Kit


    ** SAFETY NOTE - Spreadsheet Colour Coding **

    It looks like your spreadsheet is based on the human meter FDMB spreadsheet template. Now that you're using an Alphatrak meter it's important to keep this in mind because you won't be able to rely on the colour coding to alert you that you need to take action to get BG levels into safe numbers because the cell background colour won't change to lime green if you enter a BG result between 50 and 68.


    Mogs
    .
     
  85. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Well, Oreo's numbers were great in the morning with the 2 units but then at 5 PM we tested her and she was at 170 PMPS. We gave her the 2 units and +2 she went to 204. Then at plus 4 she dropped dramatically to 34. We tested again right away to make sure the BG test wasn't wrong and she was at 33. We immediately fed her an 1/8 cup kibble and put a little syrup on it. She then improved to 35 BG at +5 and then at +5.5-6 she went up to 74.

    My question is this. Her numbers stay well in the morning for 12 hours with the 2 units given. Then at the PMPS she was at 170 so we gave her the 2 units. She was at 204 at +2 but then dropped to 34 at +4. I'm guessing that dramatic of a drop isn't normal but what makes her drop that drastically in the evening compared to morning/afternoon? I know we shouldn't be changing doses from morning to night but 2 seemsto be ok in the morning.

    Anyways, this morning AMPS she was at 191 so we only gave her the 1 unit. +2 she was at 122. We'll test again shortly before heading out to visit my grandma in the hospital. Now when we test tonight am I right to assume that if she is at 150 or lower we shouldn't give any shot and if she's above that just give the 1 unit? Obviously we see 2 units is too much at night but it seems ok in the morning which is confusing.

    Thanks for any advice!

     
  86. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Thank you so much for the information, it came in handy for sure last night as you'll see from my above post. The last time she went low we just gave her the food we always do at 9PM. Last night though, we had to give her syrup. We realize 2 units is way too much at night but seems ok in the morning. We will try 1 unit from now on as suggested earlier.

    Even looking at Oreo's chart, on 1/10/18 the time we didn't give her a shot at night her BG dropped on its own from 174 at +2 to 109 at +4. I guess we just get confused on when to give her the 1 unit at night and when not to.

    Thanks.

     
  87. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Hi Matt - The higher cycles in the morning are most likely her body's response to the low numbers at night. Her liver pumps out stored glucose to try to keep her safe when she drops like that. Then it takes a while to cycle that glucose dump back out again. So it looks like the 2u is actually too high for both cycles, and the numbers that have made it look like it's okay are actually inflated.

    I would suggest for both cycles that you try 1u at the most, and as you said, only if she's over 150.
     
  88. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Ok, so going forward then when we test AMPS and PMPS only if she is above 150 we will give the 1 unit. Say we test for 2 straight days and her AMPS and PMPS are below 150 we give nothing but then on the 3rd day if she is above 150 in the AM we give 1 unit but then PMPS if she is below 150 we do nothing?

    I guess the inconsistency with dosing/not dosing scares us a little but it makes sense to g0 with what the numbers say. I didn't know if it was harmful to one day give shots but the next nothing. When we do give again isn't that like a shock to the system if she hasn't had any for days?

     
  89. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    What time zone are you in, and what are your shot times? I'm wondering if we can try to work through this dose by dose for a few days.

    The thing is that we don't really know how much insulin she needs right now. We know 2u is too much. But beyond that, we don't really know if she needs 0.5u, 1u, 1.5u, or something in between. So it's going to be some trial and error for a few days to try a dose, wait, see what happens, and try something else. If your shot times land when folks are around, having a few different minds working together might be best as you try to get this sorted out.
     
  90. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    We are in the U.S. (Eastern Standard Time). Right now here it is 12:10 PM.

    We give Oreo her shots at 5 AM and 5 PM. We also feed her at those times. We also give her dry kibble at 9 PM as a snack.

     
  91. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Oh that's right! Geez, my memory lately...:oops:

    Being on the left coast, I'm either asleep or at work during your shot times, but hopefully some of our more easterly folks can keep an eye out for you. And of course I'm happy to help after the fact. :) Not as good as real-time dosing advice though.
     
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  92. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    It's ok haha...I'm sure you're posting on a lot of other people's posts helping them out too and it's easy to forget little details!

    So Oreo's PMPS was 191 so we gave her 1 unit as instructed. Her +2 was 183 and +4 was 95. That is a much better number at +4 than it has been!

     
  93. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    That's a great cycle! Way to go, Oreo! (and of course Matt and mama-bean!)
     
  94. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Thanks! We're just glad she didn't drop down too low, it's a huge relief!

    This morning AMPS she was at 138 so we didn't give a shot. We probably could have since her numbers seem to stay higher during the day but aired on the side of caution and we'll see where she is at 5PM.

    In the future if she is around 138 in the morning do you think we should be good giving her 1 unit anyways? Based on the prior numbers we got on her chart, it looks like it would be ok.

     
  95. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I think that was wise. My suggestion is that you play it safe for a while as you accumulate more BG data on your SS. The 1 u dose seems OK for now and not shooting unless she's over, say, 150 might be the way to go at this point. The shootable PS number can come down if your increased data base supports that. You've recently switched to a pet meter that will read higher than your previous human meter so you really have to pay attention to those recent lows. They're way under the "take action" number of 68 for a pet meter. Another thing - you're using the human version of the SS which has automatic colour coding that will show lime green only when BG is below 50. That lime green would pop up with a 68 if a pet meter is being used. I suggest you manually colour code any number under 68 with lime green using the paint can icon on the tool bar so we see those immediately when we scan your SS.
     
    Last edited: Jan 22, 2018
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  96. mattm1124

    mattm1124 Member

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    Dec 27, 2017
    Got it, makes sense! I will definitely color code on my own in lime green if she ever drops below 68 again (which I hope is never!). As of now, her chart looks correct. The lower numbers not in lime green was with the human meter. The recent lows below 68 using the pet meter are already in lime green on their own since they were below 50 anyways.

    Is there a template spreadsheet out there I could use for pet meters or does everyone just use the human spreadsheet template?

     
  97. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    There is a pet meter version. The resident techie @Marje and Gracie can fix your SS for you. :)
     
  98. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Thanks, Kris, for tagging me.

    We do have a SS for pet meters or I can convert the one you are currently using so you can’t keep the same one. Just send me a private message by clicking on “Marje and Gracie” to the left and then “start a conversation”.
     
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  99. mattm1124

    mattm1124 Member

    Joined:
    Dec 27, 2017
    Hope everyone's night or day is going well so far!

    Had a few questions for everyone. We've been giving Oreo 1 unit of Insulin the past couple of days and her numbers are a little higher than they've been. Based on the numbers do we stick with 1 unit still in the morning and evening or maybe raise it some in the morning since she usually doesn't get to low then? Or do we just stick with the 1 unit for now since it has only been a couple days and we don't want to keep changing it right now?

    Thanks

     
  100. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    The 1 u dose has given you nice dark greens recently as well as an AMPS yesterday that was too low to shoot. I wouldn't increase right now.
     
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