Will someone take a look at my SS, please?

Hello again,
Closing in on week two of ProZinc after a 3-year remission (we used Lantus the first time, but vet no longer prescribes it due to cost). After blood work at vet, it was determined that he may have pancreatitis and was given two injections of antibiotics three days apart.

Sadly, I had to go out of town just days after we started on insulin again but a vet tech graciously agreed to replace my normal housesitter. I asked her to test pre-shot (even though my vet told me not to test for the first week at all - she told me she thought it was "potentially too damaging to the relationship", but later the vet tech explained to me that the first week, the body is still adjusting to the insulin and the tests won't be an accurate reflection of what's going on....I'm still confused and skeptical). Anyway, she lost the paper she wrote the results on but said she remembered the low as 199 and high of 306.

Now that I'm home, I'm getting far higher numbers. After a BG curve Wednesday (vet instructed every 3, not 2 hours) she doubled his dose from 1U to 2U. Yesterday at +5.5 he tested 48! Then 53 ten minutes and lil' Karo and food later. More Karo and he was back to 176 and fortunately no hypo signs during any of it.

And then we're back in the 400s. Does that indicate something is still going on with some kind of inflammation/infection (either pancreas or something else)? Or is this just going to take more time? This is just different from the first round, so I'd love thoughts.

Thanks for reading this long post.

 

It looks like he is still bouncing from those greens. It can take several days for his body to readjust. A bounce is when his body perceives a level lower than it is used to and releases extra glucose. That raises the numbers and creates what we call a bounce into higher numbers. The greens earned him a reduction so I am glad you went down in dose.

I'd suggest you give him a few cycles at one unit, see what his lowest points(nadir) are and then you'll know if you need to decrease or increase. When we increase, we tend to do it by .25 units at a time, unless the kitty is in very high numbers. Then we consider a 0.5 increase.

If you get any other numbers in the 50 range, the dose needs to be reduced again. And we'd suggest not shooting under 200 in the beginning.

We put together a protocol for ProZinc which is in my signature in blue.

 

Thank you, Sue. I have read the ProZinc protocol. And I questioned the vet's suggestion to go up by an entire unit. She said it was too hard to accurately give .5 or .25 adjustments with the syringes we have. I trusted my vet, but was cautious enough to not up the dose on the PM shot the day she told me to, bc I was worried about monitoring him in the middle of the night. I purposely stayed home yesterday so I could test in the middle of the cycle and I'm glad I did. I will be testing him today again at +6. The vet instructed me to call if it was under 100.

What are your thoughts on the 400s after I returned when my housesitter said the highest number she saw was 306?

 

Not sure about the 400 - could have been another bounce? The cycle on 7/6 was pretty good. Slow drop with the pmps lower than amps. At that point increasing by 0.25 might have gotten you in just a little lower range.

The hardest thing to do is to let the insulin have time to work, to let his body adjust to it. Ideally start at a low dose like 1 unit, hold 3/5 cycles and if the numbers are on the high side, increase by 0.25. Then give it time and adjust again.

Your vet may not agree but lots of people here use U100 needles and the conversion chart.

http://www.felinediabetes.com/insulin-conversions.htm

With U100 needles, you can dose 0.2, 0.4 even 0.1 with greater accuracy.

 

Appreciate that link to the conversion chart. Of course, I just donated my U100 needles from last time, but that's okay.
And thank you for taking the time to look at the spreadsheet and offer your thoughts. I'm finding diabetes much harder to deal with overall this time. We just haven't found our groove yet with testing, injections, this new vet, etc. Thanks for easing my struggle a tiny bit.

 

Dang it! I'm as confused as ever. I just got a 301 on his +6 check (well, technically +6.5). He did squirm and meow at injection time this morning (usually doesn't make a peep). Could I have not got it under the skin, but in the muscle? What results would you expect to see if you didn't get the injection right? It definitely wasn't a fur shot as I always feel the spot to check for liquid...though with such a small does (1U) and his long hair maybe I could miss it. But his +4 number was in the range I'd expect....shouldn't +6 be on the lower side too? Or are we just seeing readjustment/reaction from yesterday's dose of 2U?

HELP!!! Please.

 

Yes, I think you are still seeing the bounce's effect. The other thing to remember is that it is just one number, just one cycle. We are looking for patterns and trends, over time. Think of these early days as data gathering. You're getting numbers so you can figure out how he works with the insulin.

And don't forget to breathe!

 

Patience is what you're saying. I will try to hear it.