Regulation Help

Discussion in 'Prozinc / PZI' started by rachrp, Jan 4, 2013.

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  1. rachrp

    rachrp Member

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    Shoot, I'm not sure. I ordered them off here through the Med Vet website or whatever it's called. They were U100 1/2cc 29g. If they don't have the half unit markings, are they still usable?
     
  2. rachrp

    rachrp Member

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    Jan 4, 2013
    Here's exactly what I bought...
    EasyTouch Insulin Syringe U-100, 1/2 cc, 29 ga. x 1/2", 100/Box
     
  3. kse

    kse Well-Known Member

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    Yes, I agree that I think he will need an increase regardless, but it might be interesting to see how he does today. My Chewy (who was in a shelter) was eating only dry and once I started the wet his numbers slowly came down. Hopefully, once you have Diablo off of the dry and get a good dose, his numbers will come down and his pancreas will decide to start back working. It is not unusual for this to happen-- ditching the dry food is the first step!

    Yes, how did I get so lucky?!!! I just refer to my residence as Diabetic Alley!
     
  4. kse

    kse Well-Known Member

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    One good thing about using the U100s is you can buy them from most pharmacies. You must buy the U40s from a vet or an online vet source and they control the price! Not to mention, I normally got low on syringes on the weekends when the vet was closed.

    The U40s were about .50 each....ouch!
     
  5. kse

    kse Well-Known Member

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    I just saw your post about the syringes...... like I said, I never used the U100s- but, any of the U100s are okay and usable with the conversion chart. The ones with the 1/2 unit marks are just easier to see for small increases-- they have more lines!
     
  6. rachrp

    rachrp Member

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    Believe it or not, the U40s I get from my vet are $20 more than what I found on the Medi-Vet site. Ridiculous. Glad I found somewhere else to get them if I need them. A little money saving in this whole process is nice. Anyone know what the U100s are at Walmart?
     
  7. Rob & Harley (GA)

    Rob & Harley (GA) Well-Known Member

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    The U100 syringes at Walmart are about $12, $13 for a box of 100.

    I tried looking up the syringes you ordered but they don't show a picture of the syringe itself so I can't tell if they have the half unit markings or not. Probably not. You could call them and ask, and if they don't have them then you can refuse the shipment and get a refund.

    I'll try to find the info for the Walmart syringes.
     
  8. Rob & Harley (GA)

    Rob & Harley (GA) Well-Known Member

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    Here is what I wrote to someone else about a year ago. I doubt anything has changed.

    "I use the Walmart Relion syringes, 3/10ml Doses up to 30 units,29 guage, long needle (you can get a higher guage in the short needle), UPC/Barcode 6 81131 31167 0. Before leaving the store with them open the box and make sure they have the half unit marks."
     
  9. rachrp

    rachrp Member

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    Great! Thanks for the info!
     
  10. rachrp

    rachrp Member

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    I posted this to the health forum, but wanted to post here too...

    My kitty was lowered from 4u to 1u AND switched to wet food completely just within the last couple days. He has been eating great and acting normally. I've only been able to test him once for ketones because he is so sneaky about going to the bathroom. He was negative the first day we switched everything. He just threw up (small amount, all bile) but is otherwise acting normally. Is it possibly ketones? Just food change? How can I better ensure I get him tested? I'm really starting to worry and freak myself out.
     
  11. kse

    kse Well-Known Member

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    Chances are that throwing up would not be the first sign of ketones! While Ketones are bad, the fear is the cat going into DKA. When Kitty went into DKA her BG was above 500, she ate very little, and became listless (I was not testing for ketones, or I would have caught it-- You Are!). As long as Diablo is eating, playing, drinking etc..... I would not assume Ketones. BUT, you are exactly correct in your desire to get a test as soon as possible.

    There is a blood monitor that checks for ketones.

    You can line the litter pan with saran wrap and put aquarium gravel in it for litter-- it will not take much. Then we he goes the urine will not be absorb and you should be able to collect a clean sample for testing.

    You are on top of this--- don't fret!

    Also, it is not uncommon for a diabetic kitty to have trace ketones.

    Get a Test!

    What was his amps today?
     
  12. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    What Kim said. :D We could never get a sample without using aquarium gravel in a clean box and leaving him alone in a room with it for awhile.
     
  13. rachrp

    rachrp Member

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    He is at 258... just tested. Also, since I've been giving him three meals a day, he more so grazes or free eats. Should I go back to two meals? And I've been adding water to his food to make sure he's getting enough. He normally drinks out of the bathroom faucet (the only way he'll drink any water), but he hasn't been in there the last few days. Is this okay since I've been adding extra to the food? He's going to the bathroom normally, so I'm assuming he's getting plenty of fluids.
     
  14. rachrp

    rachrp Member

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    Should I start doing 1.25u instead of 1?
     
  15. kse

    kse Well-Known Member

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    You will get different opinions about the feeding--- here is mine! If he is unregulated, he will be extremely hungry and it is good to let him eat whatever and whenever he wants. That being said, he will be extremely hard to regulate eating all day. Once regulated, I found it easier to control the BG by eating "normal" meals and taking the food up. It has to with the timing of the food and the onset of the insulin and his nadir. One additional thing to consider is--- if a diabetic cat recieving insulin, starts to go to low (hypo), if food is out they will naturally eat to raise the blood sugar. So, many people leave some food out, especially if leaving the cat alone to protect against a hypo situation.

    I like the amps this morning of 258. I wonder what his nadir was? I can't pull up the SS (work firewalls!)

    When considering an increase or dose, it is probably more important to know the nadir (lowest BG) than the preshot. Ultimately, the lowest number is the goal, but also the biggest concern.

    SO-- I have not answered anything!!!! So, I will summarize..... I would feed two meals a day, test at +4 to see where the cycle is at and headed, and I would not increase yet! You have a great AMPS this morning. Once you establish where his nadir is and how his cycles are running you can add additional snacks or feedings. It just will be hard to know what the insulin is doing if he is free feeding--- because everytime he eats, he "probably" is getting an increase in his BG and you are not getting true readings of what effect the insulin is having.
     
  16. kse

    kse Well-Known Member

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    One additional thought---- He might not be drinking from the faucet as much, due to the elimination of the dry food. The dry food can make them have increased thirst.
     
  17. rachrp

    rachrp Member

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    Yesterday his lowest reading was 278, and that was him PMPS. He started at 335 yesterday and went down, up, down. I'm assuming this is probably because of the free feeding. So I'll start picking his food up when he seems to be done and see if that affects his numbers.
     
  18. kse

    kse Well-Known Member

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    Yes, I would assume the fairly flat cycle that was down and up was from the free feeding.

    If might be that 1 unit is enough to keep him flat, but just not drive his BG down--- you are doing great! Get a ketone test!

    Don't with hold any food from him, if he is hungry feed him and don't worry about the numbers. I would just "encourage" him to eat "meals" if possible!
     
  19. rachrp

    rachrp Member

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    Okay, thanks! Is it okay to take what he doesn't eat from this morning, stash it in the fridge, and put it back out when he acts hungry? Is that what you mean by "meals"? Just don't leave it out, but give food when he needs it.
     
  20. kse

    kse Well-Known Member

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    My opinion..... perfect scenario is that he eats two meals a day...in the morning before insulin and at night before insulin. BUT, the reality is- Don't withhold food from a diabetic that is unregulated. So, yes, I would take it up after he eats and put it in the fridge and then feed him when he acts hungry or midcycle. It would be good to test, feed, give insulin and then test again (+3 +4 range) and see what impact the insulin is having before feeding him again. If he continually eats throughout the cycle, you will not get a true picture of the insulin's onset and impact.
     
  21. rachrp

    rachrp Member

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    Okay, got it. I've put his food away for now and will test at +3 probably and see where he's at.

    Getting there.... slowly but surely. :YMSIGH:
     
  22. kse

    kse Well-Known Member

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    You are doing GREAT!
     
  23. Rob & Harley (GA)

    Rob & Harley (GA) Well-Known Member

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    I agree, you're doing great!!

    I love his AMPS, he's coming down nicely, a bit slowely but still coming down.

    I'll also agree that you need to find his nadir (lowest point) in the cycle. Usually +4, +6, +8, somewhere in there. But since he is still clearing the carbs and probably some rebound out of his system you wont see a true curve yet. But I think in the next day or two you will.

    FWIW I always free fed, because with multiple cats and a full time job away from home I had to choose my battles and food wasn't one of them and I was able to get him regulated anyway.

    Ketone testing, I have a Smart Litter Box that a former member gave to me after she lost her kitty, that you can have, I've included a link to their website so you can see what it is and how it works. I never used it because again with multiple cats I wouldn't know who used it and also the collection cup is very small so it is better suited for a one cat household. Basically it comes with non absorbant material as litter so the urine flows down into a cup in the bottom that you can pull out and test the urine that way.

    http://www.smartcatbox.com/
     
  24. rachrp

    rachrp Member

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    Thank you so much for the offer, Robin. I will check out the link.

    Today I had to test a little before +6, about a half hour earlier. How do I indicate this on my spreadsheet?
     
  25. You can put it in either the +5 or +6 spot and just put a comment in the comments column.

    Carl
     
  26. kse

    kse Well-Known Member

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    Love the BLUE!!!!!! Once again, you are doing Great!
     
  27. Rob & Harley (GA)

    Rob & Harley (GA) Well-Known Member

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    What a purrdy blue.
     
  28. Rob & Harley (GA)

    Rob & Harley (GA) Well-Known Member

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    Beautiful PMPS 236, he's still coming down. I wouldn't think about raising the dose until he levels off and stops coming down on his own. He's getting close, today is the first more normal smile curve that he's had.

    Great job testing!
     
  29. rachrp

    rachrp Member

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    Thanks! I was really happy with his results yesterday. AND my husband was able to get a ketone test after I went to bed last night. Negative! Needless to say, I slept very comfortably after he woke me up and told me :D

    By the way, what's the LOWEST I want to see his midcycle numbers?? From what I've read through on the website, no lower than 100? If he gets that low, do I reduce is dosage?
     
  30. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Lovely! 100s at nadir are fine - anything over 50 is fine. When he is in the 40s and 50s at nadir, it is time to watch closely and be ready to move the numbers higher with regular food first, the higher carb food if necessary (always have some gravy food around for this)

    We consider a cat regulated if he is in the low 200s at preshot and in double digits at nadir (but above 40)

    A cat in remission runs from 40-120 (0ff insulin) with the majority of the time spent in double digits.

    Could you start a new thread? This one is getting really long.
     
  31. kse

    kse Well-Known Member

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    Good Morning! The numbers look great, even the 333 this morning is not bad.

    Like Sue said, anything above 50 is very safe for a nadir. A non diabetic cat's bg, normally runs below 120 at all times. If you can determine when his nadir is, you can test at that time and see how low he is going on the dose-- realizing that every cycle is different. Without the nadir numbers, it is hard to interpet the preshots numbers. For Months, I did not check mid cycle, I just checked at preshots. I never knew if Kitty had high preshots from not enough insulin or from a low cycle- that scared her liver, causing it to dump "sugar" and protect itself. '

    One thing that I started to post last night, when I saw that you were have a cycle in the mid 100s was this.....You want to have a "No Shoot number". We generally do not recommend that you give insulin on a BG lower than 200. Once you have more data, you might chose to lower that number. But, if you check at your preshot (12 hours) and you get a number lower than 200, I would encourage you to wait and retest. It is also important not to feed until you retest, as the food will artificially inflate the "true" bg.

    Prozinc is a 12 hour insulin and once it is gone, it is gone. So, sometimes you will get a sharp rise in the BG even when waiting 30 mins. I just wanted to share that in the event you get a low preshot reading.

    You are doing Great! I am expecting Diablo's numbers to continue to slowly come down. I checked out Chewy's SS last night, and it took a few weeks off of dry food to see his numbers really come down. Slow and steady wins the race!

    Good Luck!
     
  32. Rob & Harley (GA)

    Rob & Harley (GA) Well-Known Member

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    Is it possible to get some before bed tests?

    I'm just wondering if this AMPS is a little bounce from him going lower than he's used to last night. Last nights PMPS is the lowest # you've shot into since you starting testing.
     
  33. rachrp

    rachrp Member

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    I can definitely get some before bed tests. I was wondering about that too. The last two nights I did leave food out for him, but his number yesterday morning was good, so I'm not sure that has anything to do with it.
    I'll do some testing tonight after he eats and gets his shot.

    Also, I'll start a new thread :)
    Is there any way to delete threads?
     
  34. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    You don't want to delete this one. You might want to review it at some point. Just go to the PZI forum, choose New Topic and start another thread. Some members (Like Bookworm) start a new thread every couple of days with new numbers and new questions.
     
  35. Rob & Harley (GA)

    Rob & Harley (GA) Well-Known Member

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    I agree with Sue, you wouldn't want to delete this thread. Not only can you go back and review it but it has alot of good information in it that new members might benefit by reading it.

    BTW, Diablo is having a great day so far. Love those blues!
     
  36. Zamrich

    Zamrich New Member

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    Jan 11, 2013
    Hi All

    I have a regulation question and cant seem to work out how to start a new topic so thought i would post here and see if i get any anwsers.

    My cat was diagnosed with diabetes in Oct last year. Noticed weak hind legs and took him to vet who tested for diabetes.

    We started him on insulin immediately (Actraphane) starting at 1 unit twice a day and building up to 3 unit twice a day.

    We also got him onto diabetic food (both Hills and Royal Canin).

    We only did random glucose tests and when we found him coming down to below 4 (76) we decreased the dose to 2 units twice a day.

    When i did his glucose curve we were shocked to find his glucose going down to as low as 2.2 (41.8).

    We stopped giving insulin immediately and have been monitoring his glucose levels each day.

    His glucose now varies between 4.6 (87.4) and 9 (171).

    My question is, am i doing the right thing stopping the insulin? Also, is it normal to get low readings first thing in the morning after he has eaten (as low as 4.6)?

    Any help would be appreciated. Thanks Rich.
     
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