New to pzi

Discussion in 'Prozinc / PZI' started by Tritt3180, Dec 29, 2017.

  1. Tritt3180

    Tritt3180 Member

    Joined:
    Dec 23, 2017
    Everyone has been incredible on this forum!! I would've been lost without all the help, info, encouragement and direction given by people on this site.

    This is how Ringo's been doing with glucose, insulin and eating so far... I have been instructed to give only 1 unit insulin at night, but his numbers have continued to climb at night. Plus, I will be checking him again at 0100 tomorrow morning. So, he got 2 units last night by mistake and I liked the results so I gave him another 2 tonight. Would appreciate your thoughts.

    12/27: 8p: 422L 366R 407L
    1 unit insulin
    12cc recovery

    12/28 2a: 294L ear
    Poop nuggets!
    530a: 282L ear
    2 units insulin
    10cc recovery, couple bites
    kibble
    1230: 157L ear
    1823: 373
    2 units insulin
    12cc recovery; grazing on DM
    kibble
    2100: 1ml Famotidine; antibiotic

    12/29
    0105: 171
    0528: 289
    2 units insulin
    10cc recovery
    0800-1330: 1tsp recovery + 1tsp DM pate
    + 1ml famotidine + DM kibble graze
    1850: 497L ear (after alcohol pad)
    1904: 470R paw (after alcohol pad)
    2 units insulin
    11cc recovery
    Urine (-) for ketones
    2mg Zofran

    **only 1/3 cup kibble has been eaten w/in 28 hours.**
     
  2. Tritt3180

    Tritt3180 Member

    Joined:
    Dec 23, 2017
    Basically... Am I doing things right? Should I not have increased his night dose? The increasing number at night has me most concerned. The vet did not seem to be too worried about it and told me to keep him on 1 unit at night. But tonight was almost 500 on a ReliOn meter. Just scary to me. I can do more of an around the clock check this weekend for 3 days since its a holiday weekend.
     
  3. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Hi there and welcome! :)

    I'm guessing from the meds that are listed that your kitty might have some other health issues in addition to the diabetes?

    First of all, great job getting started with home testing! It would be great if you wouldn't mind setting up a spreadsheet to record your data. The spreadsheet color codes automatically and helps with finding patterns in Ringo's responses. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/ Let us know if you need any help with that part. We usually list times as the number of hours past the shot since we are all in different time zones. So the spreadsheet says +1, +2, +3....etc to show one hour past the shot, two hours past the shot, and so on.

    It doesn't look like 2u is too much insulin, but you don't want to be moving the dose around a lot, especially at first. I would hold that dose, get your data into the spreadsheet, and then we can take a look and see what the next steps might be for dosing.

    As far as jumping up to 500, that's icky, but it's just part of how it goes, especially at the beginning. Kitties will bounce around a lot when they are new to insulin, or when a dose is changed, food is changed, etc. Plus the other meds/health issues can impact it too. Try not to worry about it too much at this point. We want to get rid of those high numbers as soon as safely possible, but for now it's just part of the journey. :bighug:
     
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  4. Tritt3180

    Tritt3180 Member

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    Dec 23, 2017
    Thank you for your response and the link. Yes, Ringo was diagnosed with asthma in October and received 0.5ml of depomedrol. Went back for another shot and baseline blood work. Learned then he is diabetic after a fructosamine test confirmed it on Friday night. He received 1ml of the depo before the lab results were in. Saturday evening he went into DKA, pancreatitis, had a uti and ketones in his urine. After being in the ER all weekend (and an insulin drip at one point), he was transferred to his vet Hosp for one night where they started him on pzi with good results. He came home Wednesday evening, which is when I started my records.
     
    Last edited: Dec 29, 2017
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  5. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Oh wow! you've really been through it this week!!! In that case...do you also have ketone test strips at home? Does he have a feeding tube, syringe feeding, or eating on his own?
     
  6. Tritt3180

    Tritt3180 Member

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    Dec 23, 2017
    I do have ketone strips at home. I checked him today and it was negative. At the ER he was 2+ ketones. To eat, we have to put the food on our finger and let him lick it off. Once he does that, he is more inclined to eat from a plate or napkin. I measure it out before putting it on the plate. It has to be put right in front of him. He only walks over to the kibble to eat a few pieces at a time.

    He is still trying to have a good bowel movement. He's only had a few nuggets of stool so far. I will be calling the vet to ask for something if he cannot have a good bm by Sat night.
     
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  7. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Oh my! You've got a lot going on. It sounds like you're handling things really well! I have nothing additional to add as Djamila gave great info but I wanted to say hi and that we're happy to help if you have more questions!
     
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  8. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi there,

    Just checking in to see how you and Ringo are doing. When you get a chance it would be great to get an update.

    :bighug:


    Mogs
    .
     
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  9. Tritt3180

    Tritt3180 Member

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    Dec 23, 2017
    I'm working on his spreadsheet... Don't have internet other than on my phone. I'll post as soon as I can. He's still all over the place, but his appetite has GREATLY improved, which I'm sure is the culprit. Not a bad problem to have, though. Just need to figure out how to regulate him.
     
  10. Tritt3180

    Tritt3180 Member

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    Dec 23, 2017
    I don't know why I'm having trouble with the spreadsheet, but I didn't have time to contact the appropriate person to ask, so I filled it out and took a screen shot from the file I emailed myself. Here it is with my notes. You may have to enlarge it to read it.

    Tonight I picked up the kibble so he won't be able to eat it through the night and he'll be hungrier in the morning. Is that cruel? I need to get him on a schedule instead of grazing all the time. He has had an antibiotic for 4 days of this past week. Also, I ran out of famotidine, so he's just getting zofran when he appears nauseas.
     

    Attached Files:

  11. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    It seems from your spreadsheet that you’re giving insulin only once a day at night. Is that correct?
     
  12. Tritt3180

    Tritt3180 Member

    Joined:
    Dec 23, 2017
    No. I give it twice a day - morning and night. I check him 6 hours after the night dose only since I'm at work for the 6-hour check post insulin during the day.
     
  13. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Good to know. It would be a good idea to enter his AM pre shot test result as well as the AM dose on your SS so others understand what you’re doing. That’s why I was confused.
     
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  14. Tritt3180

    Tritt3180 Member

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    Dec 23, 2017
    Oh... I thought I did. The PMPS is pre meal, right? Or no? I put them all there since I feed him wet food with each insulin dose given.

    I'll have to reread the instructions again when I get the chance.
     
  15. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Yes, PMPS is “PM pre shot (+meal) test” and AMPS is “AM pre shot (+meal) test.
     
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  16. Tritt3180

    Tritt3180 Member

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    Dec 23, 2017
    Oooooh! I thought the AMPS meant after meal. Thank you for the clarification!
     
  17. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Is this where you're getting stuck? Getting the spreadsheet linked?
     
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  18. Djamila

    Djamila Well-Known Member

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  19. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Whoops! Yeah that could be confusing...please let us know if you have any questions about how to fill out the spreadsheet. We're so used to it here that we tend to forget it's a bit confusing at first. :)
     
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  20. Tritt3180

    Tritt3180 Member

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    Dec 23, 2017
    Thank you!!! I'll work on thing it uploaded later on after work. For now, I adjusted the placement of the numbers. Here is a clearer picture of the chart.
     

    Attached Files:

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  21. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Liking the blues! :)


    Mogs
    .
     
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  22. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Excellent vid. (Bookmarked!) :)


    Mogs
    .
     
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  23. Tritt3180

    Tritt3180 Member

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    Dec 23, 2017
    Thank you everyone! I think a big problem is that I'm trying to do this on my phone, and not an actual computer. Once I can get to a library to upload it I will. Until then, here is another updated screenshot of the chart. I am starting to enjoy it. :)

    Also, I just got a call from the vet. Ringo went in yesterday for a checkup since he was so sick. They did another chem24 with a spec FPL (?). His love numbers are now within normal range, his glucose per the lab was 111, and his spec FPL went from 85 to 44! Blood doesn't lie, and I couldn't be happier for this news. Well... Maybe if he was back to normal, but that's asking quite a bit so soon. He goes back in another 3 weeks to check his fructosamine number.:joyful::bighug::cat:
     

    Attached Files:

  24. Tritt3180

    Tritt3180 Member

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    Dec 23, 2017
    *love numbers = liver numbers
     
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  25. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Wow! Sounds like things are definitely looking up!
     
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  26. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    So pancreatitis is definitely in play. Pure conjecture here but the pancreatic inflammation may have triggered inappetence which then led to the DKA (not enough food + not enough insulin + inflammatory process).

    Ringo, you poor bunny! Pancreatitis and DKA. That's one major double-whammy. (((Ringo)))

    @Tritt3180 - I am so glad to hear that Ringo is making steady progress. What a trooper he is - and what a wonderful mama he has!! :)

    Be sure to keep up the anti-nausea meds until Ringo's well and truly out of the woods. When you titrate the dose down if you see an increase in nausea then step it up again.

    Sending some :bighug::bighug: for you and some scritches for Ringo Kitty Cat. :cat: Will keep an eye out for updates.


    Mogs
    .
     
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  27. Tritt3180

    Tritt3180 Member

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    Dec 23, 2017
    Question... Ringo's supposed to get 2 units in the morning and 2 at night of pzi. His morning glucose today is 134 - the lowest its been at one of these checks since coming home. He was worked up and had to be restrained, also, to check him this morning.

    He is out of zofran and the vet nearest to me ordered it online as they don't carry it. So, I won't have it for another 5-8 days unless his original vet has some they can give to hold him over until then, but I'll have to call when they open to ask. He's not been eating much lately and is visibly nauseas when he does, so good is there when he can tolerate it.

    I'm thinking about holding off the insulin until tonight because I don't want to drop him. I also have an appetite stimulant I can give him, but I don't want to torture him to make him hungry, but can't eat.

    What are your thoughts?
     
  28. Tritt3180

    Tritt3180 Member

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    Dec 23, 2017
    Here's a snapshot of his chart again - NYE - this morning.
     

    Attached Files:

  29. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Without mid-cycle day to show how he’s responding to this dose, I can’t really recommend if it’s safe to shoot or not at that number, so I would have to say skip.

    I’m sorry to hear he still isn’t eating well. Hope he feels better soon!
     
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  30. Tritt3180

    Tritt3180 Member

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    Dec 23, 2017
    Thank you. That's what I was thinking... I just needed to hear it from someone else, I guess. lol And, I have yet to get a mid-day check, I know. Hoping for this weekend.
     
  31. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Zofran (generic is ondansetron - apparently much cheaper) is a human med so maybe your vet could write a prescription for you to take to a human pharmacy.
     
    Last edited: Jan 10, 2018
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  32. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    And also, I hate to nag, but if there is any way you could link your spreadsheet (there is a how-to video in post #17), I can't read the numbers in the screenshots. So far just seeing the colors has been enough, but as you get more mid-cycle tests, the numbers themselves are going to become more important.

    If you're on your phone, it's almost the same process as the video except the first part which goes like this:
    1. open your spreadsheet on your phone
    2. scroll up to the very top and click in the address bar (where it says docs.google.com). hold your finger down for a second and a little menu appears.
    3. choose "select all"
    4. choose "copy"
    5. Then go into the FDMB website and open your signature (directions for this are in the video) and follow the video from there.

    If that doesn't work let me know and I'll see if I can figure out any other ways to do it.

    Oh, and about the mid-day checks - while +4 to +7 are the most helpful, really anything helps. So if you can even get a +2 or +3 before you leave for work or before bed, that can help us get a hint what's happening.
     
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  33. Tritt3180

    Tritt3180 Member

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    Dec 23, 2017
    He vomited and emptied all his food from this morning, so glad I didn't give him insulin. Called the vet and the refill was put into the pharmacist there, so hopefully there won't be an issue filling it.

    Also, I am filling out, and re-saving, a document on my phone for his chart... Not using an excel program. So, I don't have a URL to copy. I'll see if I can download a program today and transfer the info.

    Thank you for your help. Hopefully I find time soon to fix the chart issue.
     
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  34. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    So sorry about the vomiting! My kitty is having a tough round of pancreatitis the past few days too. Sending healing vines to Ringo!
    Sam (my kitty) is a shelter rescue and Ringo is the name they had given him at the shelter because of the defined rings on his tail. He looked like a racoon when he was younger. :)
     
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  35. Tritt3180

    Tritt3180 Member

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    Dec 23, 2017
    Awe... Sorry to hear about your baby, too. Hope he starts to feel better soon as well.

    I downloaded Excel to my phone. Created a blank chart to start and tried to link it to my signature. Not working. :-/ All I get is a blank screen when I click on the link. There is still no URL to copy and past - even from the app... And I tried to post it as a link. I'll keep working on it.

    Feel better, Sam!! :bighug:
     
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  36. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi there,

    Sorry to hear that Ringo's still got nausea issues but very glad to hear that the ondansetron has been helping him to keep eating OK; it's a great med. Fingers and paws crossed that you'll get hold of the Rx for him ASAP.


    Mogs
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  37. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    It might be more straightforward to download the Google Drive app and use the forum spreadsheet template.

    Just in case you've not seen these before:

    FDMB Spreadsheet setup instructions

    Understanding the spreadsheet grid

    If you get stuck we can ask one of the spreadsheet wizzes to help get you going. Shout if you need assistance. :)


    Mogs
    .
     
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