Uh oh! I'm new to FMDB and my buddy tested low BG

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BanditsMom

BanditsMom

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Hi Everyone,
Thank you in advance for any help you can provide.
My buddy, Bandit, was diagnosed with diabetes on Friday afternoon. He was prescribed 3 units of prozinc insulin with a U-40 syringe every 12 hours. The syringes say 3/10 ml at one end. I have been reading up on diabetes in felines and decided that I should test his BG at home and begin a chart for the vet. I tested him for the first time tonight before feeding him and his number was 75mg. This was his 3rd dose of insulin. I fed him and gave him the insulin at 7:30 pm. I tested him at 11:40 pm and his numer was 46mg. I immediately fed him some more food and after reading a little bit more have deciced to test him again after I am finished posting. Looks like I'm going to be up for most of the night.
My vet is out until after the holiday. I think I should lower the dose. Any advice you all can give me is very much appreciated.
Thank You,
BanditsMom
 
Hi Banditsmon! It's good to have started the home testing. I am not experienced with Prozic & cannot give you advice on the dose. I think it is important to keep Buddy safe this evening. What did you feed Buddy after the test of 46? Do you have enough test strips & high carb for the night?
 
Hi, welcome to FDMB! I don't know much about ProZinc either, but great catch on the 46? do you know what % carb the food you gave him is? It usually takes about 20 minutes for food to start showing up in the BG. A higher carb food will bring him up faster or a drop of honey or karo syrup will bring BG up even faster, but will wear off fairly quickly.

I'll see if anyone is around in the ProZinc forum.
 
Hi,
Thanks you so much! After posting, I found a very similar experience with prozinc. I am so glad I decided to home test. Bandit seems fime, however, I just tested him again at 1:10 am and it was 39. I just fed him a little bit of the dry food we had (purina for urinary tract health), a drizzle of maple syrup, a little luke warm water... He didn't eat it all. I offered him plain dry food and he didn't want any more. To answer your question, when I fed Bandit after getting the reading of 46, I gave him half a can of wet food. Iams, salmon pate.
I am going to test him again in a little bit. I only have 7 more strips. I bought a kit with 10 at cvs. His BG was 480 at the vets, but I could hear him meowing like crazy and he's a very quiet cat. He barely ever says a word. I wonder if the vet gave him a dose too high because he was stressed.... or he's bouncing? Ughhhh!
I'm definitely going to lower the dose tomorrow and test before feeding and may even wait to give him it.
Looking forward to all feedback and thank you so much!
Samantha
BanditsMom
 
Also not familiar with Pro Zinc, but another new member started at 3 units and had a really low number last night...on her first night.

For now, you need to get the numbers up, so keep testing every 30 minutes and let us know how you're doing! The syrup takes them up fast, but also wears off quickly, and dry (although high in carbs) takes too long to get into their system.

You're going to want to keep testing/feeding until you're into the 70's, and then for about 2 hours after to make sure the numbers stay up.

When you can get out to go shopping, besides getting more test strips, look for Fancy Feast Gravy Lovers. The gravy is high carb, and we use it a lot to help bring those low numbers up.

Any time you get a number under 50 (on a human glucometer, 80 if you're using an AlphaTrak), feed a couple teaspoons of HC (or low carb with a couple drops of honey, syrup or Karo) and keep testing. You don't want to feed a lot, because you may need kitty to keep wanting to eat for quite some time!

Might want to put on a pot of coffee too ~O) ~O)

We're all here to help, but you're probably going to get a lot of information thrown at you very quickly. Try not to be overwhelmed. It will start to make sense after awhile, and we've all been where you are! The learning curve is steep, but soon you'll be a pro and helping another new member through it!
 
Hi Samantha, pls refer to the sticky on the top of this Health forum. http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887
It is important to boost up the bg of Buddy with high carb food or syrup, honey, sugary. The Iams pâté you fed is not a high carb for boosting bg. Usually its the canned with gravy are hc. You can mix in maple syrup with Iams if he's willing to eat it.
The testing you did is

PMPS @7:30. 75
PM +4. 46
PM + 6 39
 
Ed. to Add: Dry food will take too long to boost the BG up. If Bandit won't eat get a little syrup on your finger and rub it on his gums. It will get absorbed into his system quickly. A reading in the 30s needs to be brought up quickly.

Can you tell us generally where you are? You are using times and we don't know what time zone you are in. I'm on the west coast and Helen is in Hong Kong. To avoid time confusions and calculations we tend to tell time by + hours after an injection. So if you shot at about 7:30, 11:40 would be about +4.

Right now you need to keep testing and if the BG isn't rising, keep feeding about every half hour. If Bandit drops any further give some Karo! Once you get a steadily rising reading you can check back in an hour w/out feeding to see if the BG is staying up. Another test and if the same or rising you can take a break.
Usually any BG under 50 for a newly dx cat would mean a reduction at the next injection.

I can't find anyone in the Pzi forum so I don't know what the reduction would be. Try to get another test about an hour before the morning shot and post right away to get advice. Use the question mark in the subject and put in "dose advice" in the subject line of the first post, that will change it on the list. Be sure to post a reply too as that will bump you up to the top of the list.
 
BanditsMom said:
Hi,
His BG was 480 at the vets, but I could hear him meowing like crazy and he's a very quiet cat. He barely ever says a word. I wonder if the vet gave him a dose too high because he was stressed.... or he's bouncing? Ughhhh!
BanditsMom
Click to expand...

Vet stress can often raise a cat's BG ove 100 points/ That's why most of us home test and do our own curves.
 
His BG was 480 at the vets
Click to expand...

Stress from being at the vet may raise the glucose nearly 100-200 mg/dL. If you've recently tried to go with the lower carb wet foods, that can also bring the number down another 100 mg/dL

You'll definitely want to reduce the dose. We suggest no newly diagnosed cats get insulin if their pre-shot number is below 200. If you test, and get under 200, don't feed, and post and ask for dose advice. Once you've got more data on how Bandit reacts to insulin and food, that "No shot" number can come down but it's too soon for that right now.

Go slowly and transition Bandit off the dry. Pretty much all dry foods are high carb, so you'll want to try to get him eating less than 10% carbs. Here's a great list that shows pretty much any food you can buy and the carb percentages (column C) Dr. Pierson's Food List
 
Thank you, thank you, thank you!
I will be testing him in another little bit.... Bandit loves to eat, so it should be no problem getting more food in him and adding syrup. I have 2 different cat foods to choose from until the stores open back up. I'm going to check which has the highest carbs.
Also, thank you for helping me describe the tests.
 
BanditsMom said:
... He was prescribed 3 units of prozinc insulin with a U-40 syringe every 12 hours. The syringes say 3/10 ml at one end....
Click to expand...

Just checking here - did the 3/10 mL syringe have a red cap or an orange cap?
Were half units marked or only whole units?

Red caps are definitely U-40 syringes; orange caps are U-100 syringes.
 
Okay, we're getting somewhere here.
PMPS 7:30. 75
PM + 4. 46
PM+ 6. 39
PM +7. 73
I guess the maple syrup on the dry food helped. He didn't eat the whole thing so I put the bowl on the floor and he is eating it again now. I will check him again in a little bit. I realize now that I shouldn't have given him any insulin this evening at his dinner time. So glad for the information, support and advice I've found here.
Thank you again
 
Yes, Bandit will be off of dry food. I started feeding him wet food not knowing that it was so different in carbs. He loves it. The dry food is the only HC food I have until the stores open up again.
The syringes have a red cap and are U-40. They do not show .5.
Thanks
 
OK...now that we're in the 70s, don't feed any more, but continue testing for about 2 hours AFTER his last "meal" (or syrup,honey,Karo)

You're going to want to keep testing (no food) at least that 2 hours to make sure he doesn't dive down again..if he does start to go down, go ahead and give a teaspoon of low carb wet (if you have it) with a drop or 2 of syrup added. Don't fill him up! Just a little...and then you'd have to start testing/feeding every 30 minutes again until he's above 70.

At some point, his nadir will pass, so the numbers would start to come up on their own, but until you get a 70 or above (and no food within the last 2 hours), the night's not over :cry:
 
Thank you.
PMPS 7:30. 75 
PM + 4. 46
PM+ 6. 39
PM +7. 73
PM + 9. 67
Feeding him a bit of syrup and tablespoon of wet food and damp dry food. I will test him again in a little while. I messed up this time and had to retry it. My hand hit the little bit of blood so there wasn't enough to get a reading and so I had to use start all over again. That's why I missed +8... Seems like it doesn't work on his left ear (back towards me) as well. I was trying to give his other ear a bit of relief. :sad:
Hopefully next read will be above 70.
 
Just wanted to check in and see how things are going. Were you able to get a +10 yet?
 
Thank you! Just finished taking it.
...
PM +10. 135

I'm guessing that's a spike from the dry food kicking in and the maple syrup.
I will take a +11 in a bit. How exhausting! Thank you all for your help.
No more insulin without testing. I had asked my vet about tight regulation and expressed my interest in home testing and diet change. They just wanted me to start at the recommended dose and check in after a week. I'm so glad that I went on my own and tested myself. I might have lost my Bandit buddy way too soon if I kept this up for a week.
 
He's also probably on the upswing of his cycle. If you feel up to it, get the +11 but I think you'll be good at this point. ;-)
 
Okay, he's purring and rolling around on the floor. He gave me the look that says, "I feel so much better". I'm going to wait until after I get a couple of hours of sleep to test him and possibly feed him again. I'm thinking I will start giving him insulin again when he's above 200 BG (like I read here). I will start at 1 or if I can find the right syringes at cvs, I will give him .5 and work up if necessary.
Thank you all so much.
I will add his picture after I get some sleep. He's the most beautiful Snowshoe Siamese. He's 10 y.o. I think. He's come so far since I adopted him. He is a big fluffy love bug now when he used to hide under the bed all day long. I can't stand seeing his lovely personality shadowed by this diabetes blood sugar hurdle.
 
I'm glad some of the Lantus folks were able to lend a hand. You might want to print out or bookmark this post on dealing with low numbers. It was written with Lantus in mind but it's useful for any insulin.

I've sent a note to an experienced Prozinc user who can offer some help with dose.
 
Hi Samantha,
Sienne sent me a message and asked if I could drop by.

I think your plan to wait until the BG is over 200, and reducing to 1 unit is a good place to start. 3u is a higher than normal starting dose.

The bigger issue last night, outside of dosage, was the 75 on the meter when he got the shot. Last night could have been worse, but you were able to keep the numbers from going too low with what you did. Glad you posted and that people were here to help.:-)

Had I seen this before you gave the shot last night, my advice would have been exactly what you came up with as a plan for this morning - "Wait, without feeding, until the number rose above 200. Then feed Bandit, and reduce to 1u.". Then try to test about 3-4 hours later to see how much the number drops.

Your vet isn't aware you decided to home test, right? Because if he had been, I'm guessing (hoping) he would have drawn a line in the sand and said "no shot under this number" whether it was 200, or 150 or whatever. I feel certain he would not have advised a shot with a BG on 75 though.

You were running low on strips last night, right? When you go to CVS, make sure to stock up on them:-) I have heard that U40 syringes are made with 1/2 unit marks, but I think they are very hard to find so don't be surprised if CVS doesn't have them in stock. Usually you can't find U40s at a pharmacy because they are "pet insulin" syringes. I think an online source like Drs Foster & Smith might sell them. I always got mine from the vet directly, but they only had whole unit marks.
 
Hi Everyone,
Thanks again for all your help.
Hi Carl & Bob
Thanks for the input.
I realized when I started getting really low numbers that I probably shouldn't have given Bandit the insulin at feeding when his BG was 75. However, the vet had told me that between 70 and 120 was fairly normal, so I really just thought that the insulin was working. It was actually his 3rd shot since he was diagnosed. At the vet, I inquired about home testing, tight regulation, and diet change. I also expressed my desire to begin the process as soon as possible. The vet tech told me that after a week of the insulin shots at 3 u, we'd test again and go from there and that they'd help me learn home testing then. I didn't really feel comfortable with that because it's a holiday weekend and the vet will not be back until Tues., Bandit didn't seem to be showing too much improvement, and I wanted to know as much as I could about it, so I went to cvs and got a starter kit... thus began my very long night of battling low blood sugar.
Here's the info from last night:
PMPS 7:30. 75
PM + 4. 46
PM+ 6. 39
PM +7. 73
PM + 9. 67
PM +10. 135
PM +12. 150

Anyway, I just checked his BG again.
I am starting a new chart??? or do I add the hours again. I know the info is out there, I just woke up and am practically brain dead after the all nighter I pulled.

PMPS 11:45. 176 ..... or ... PM+17. 176

I decided to go ahead a feed him a little bit because he is just so hungry and I am exhausted and out of supplies. Also, his poor little ears... I really am a butcher. :sad: He only ate 1/2 of what I put down which was 3/4 of a can of wet LC food.
Unfortunately there's a flash flood warning here and a huge thunderstorm. I have no more test strips. I am going to hold off on the insulin for now. My husband should be home soon, so I will try to go out to get some more supplies and have my hubbie keep an eye on Bandit while I am out...

Thank you all so much!
 
If you didn't give any insulin this morning, it'd be +16 176

7:30pm-7:30am=12 hours, plus 4 hours = 16

Each time you shoot, the cycle starts over, but if you don't give any insulin, you just keep counting from the last shot

The next big hurdle will be setting up a spreadsheet. We do have members who can help you if you can't figure it out (I'm not one of them though...I just barely got my own working :lol: ) Getting the spreadsheet up will give you an easy way to track Bandit's numbers, how he reacts to insulin and food. It will also let us help advise you since we'd be able to see your numbers too! Here are the instructions on that: Setting up a spreadsheet

And after you've had a cup of coffee (or 5), I think you'll enjoy this. It's not only funny, it's true!! A Message from your cat

Just keep asking those questions...we'll do all we can to help make things easier on you!

Edited to add...Where are you? I'm in mid-Missouri and we're getting our first rain in quite awhile...but of course ours is coming all at once, so flood watches/warnings abound here too
 
Carl & Bob said:
You were running low on strips last night, right? When you go to CVS, make sure to stock up on them:-) I have heard that U40 syringes are made with 1/2 unit marks, but I think they are very hard to find so don't be surprised if CVS doesn't have them in stock. Usually you can't find U40s at a pharmacy because they are "pet insulin" syringes. I think an online source like Drs Foster & Smith might sell them. I always got mine from the vet directly, but they only had whole unit marks.
Click to expand...

I'm glad to see that Bandit has come up and can't wait to see his pic! :-D

On the syringes: I doubt that CVS will have U40 syringes let alone U40 syringes w/ half unit markings, as Carl said U40 insulin is animal only and pharmacies seldom carry them. Even U100 syringes w/ half unit markings are hard to find, Walmart is the only place I have heard of that carries them regularly. You can use U40 insulin in U100 syringes using this conversion chart. The lines on the U100 syringes will be further apart and easier to see. Even so I use a magnifying visor to see those tiny little lines!

On the meter and strips: What did you get at CVS? If it was one with "True" in the name many of us have found that they can give off readings at lower BG levels. Most of the major brands have really expensive strips (especially in retail stores), strips are where they make their money, not on the meter itself. I like the Target house brand of Up & Up meter, strips are $20/50 strips there and you can get them much cheaper online about $13. Online look for WaveSense Presto strips (they make the meter and license Target to put their own name on it.) (Hmmmmm, never looked for half unit syringes at Target.)

Walmart also has a house brand meter, the Relion Confirm or Relion Confirm Micro is what many here use. I think the strips are about the same price as the Up & Up, not sure about online prices. The Up & Up and the Relion meters got Top Pick reviews from Consumer Reports. It depends on what's most convenient for you.
 
Hi Samantha and extra sweet kitty Bandit! Welcome to the FDMB. Guess Bandit decided you needed to learn to home test right now! :shock: Talk about a trial by fire! :o :shock: :o We never like to see those, but we are so happy you found us and we were able to help you out.

You did fantastic last night, managing those low numbers!

I'm Deb and that tuxie to the right is my sugardude Wink. I'm one of those people that Chris mentioned that helps people to set up their SS (spreadsheet). When you are ready, send me a PM. You need to have a google account set up first. Let me know if you want help.

Where do you live? country, state/province, city/town would be nice to know.
 
The Relion Prime (WalMart) strips are $9 for 50...the Relion Confirm/Micro are about $18 for 50 (these take the tiniest drop to get an accurate test)

Each of the meters themselves is about $15. Ann is totally right...the meters are cheap..it's the strips that kill the budget!!

While you're out shopping, don't forget to get some Fancy Feast Gravy Lovers...you should always have a few cans in the house in case of those low numbers.

Look for "alternate site testing" lancets too. They're usually 28 or 29 gauge lancets. The ones that come in the kits are usually 31..and are too tiny for new people to have much luck with. Once you get poking down, and the ears "learn to bleed", you can go back to the 31 gauge, but you'll probably have much better luck with the 28 or 29 gauge for now

A little Neosporin with Pain Relief oinment (not cream) will also help those ears heal.

My brain's not fully engaged yet either, so I'm adding things as I think of them...LOL

Edited to add...making mental note that Deb is one to holler at for spreadsheet help :lol: (Thanks Deb)
 
Unfortunately there's a flash flood warning here and a huge thunderstorm. I have no more test strips. I am going to hold off on the insulin for now. My husband should be home soon, so I will try to go out to get some more supplies and have my hubbie keep an eye on Bandit while I am out...
Click to expand...

I agree with holding off on the insulin if you're out of strips for sure. Hopefully the storm and floods will miss your area.
 
Hi again Samantha! I keep thinking to add this and then forget to do it! Now that the "emergency" is over, if you'd go back to your first post, you can remove the 911. You can choose "none" from the available icons above the subject line.

We always want you to use the 911 if you need advice quickly.(and low numbers is definitely one of those times!!) We watch for them! After the "emergency" is over, you should go ahead and remove it

That first post is the only one that shows up when we "scan" the message board, so any edits to the subject line that you want us to notice always need to be done from your first post (from that day anyway). As you get more used to the board, you'll start new subjects as you need to, and can always add the 911 (for emergencies) or the ? icon for general questions to help get our attention :smile:
 
To start insulin again or not. If so, how much?

Hi Everyone.
I filled out the spread sheet, the best I could. I hope I did it right. Thank you all so much for helping.
https://docs.google.com/spreadsheet/ccc ... sp=sharing

I went and got new test strips at cvs and different lancets. They only had 26 gauge or 30, 31, 33.... I bought the 30. I find if I have the right amount of pressure on the other side of the ear, I get it right. Bandit's being so patient with it, so we'll just have to make it work. I couldn't find the fancy feast "gravy lover's", so I bought a few that had gravy in the name. I will buy the right one's at the pet store later. These are just to have just in case... I also bought him some ointment + painkiller. They did not have U-40 syringes.

So, here's my next dilemma: Now that the storm warning is over, and I have test strips, should I give him insulin? If so, how much? His BG hasn't gone over 200, but I haven't been able to test as much as I'd like. I added the exact times and everything I have fed him in the notes of my spread sheet.
Thanks Again.
Bandit says thank you as well!

P.s. thanks, I will remove the 911
 
Good job on getting the spreadsheet set up, but you're making it harder on yourself than you need to (and harder to notice the "trends" we all look for)

Go back and only put each date on only one line...so you'd have just 2 days...8/31 and 9/1

At the times you have decided to shoot insulin, those are what we call "Pre-shot times"....those numbers go into the columns marked AMPS and PMPS (AM pre-shot and PM pre-shot) Since you did NOT shoot, you'd just type in "no shot" (or NS) except for the AMPS & PMPS on 8/31 of 3 units

Each cycle starts at AMPS or PMPS...so if you decide your schedule is going to be 7am/7pm, each test after that would be a + number...so at 9am, it'd be in the same line, but in the +2 column. +5 would be 12noon, +9 would be 4pm, etc. Then at 7pm, you'd do your pre-shot test, put that number in the PMPS column (same day) and the clock starts over again...so 10pm would be +3, 2am +7, etc.

Here's China's spreadsheet. Hopefully you can see what I'm talking about a little better. China's Spreadsheet

Over in the "remarks" section, you can add anything you want to that you think is important...like what you fed, when you fed it, anything usual that happened that day, etc....it will expand as big as you need it to

As for dosage, since you haven't given any insulin, decide what would be a good time that you can routinely test/shoot every 12 hours apart. (take into consideration your schedule....and when you'll want to be awake to test during the PM cycle) I used to do my test/shoots at 11/11 so I didn't have to get up early and because I had a lot of early doctor appointments...that got old fast when I couldn't test/shoot again until 11pm and then wanted to get a +3 or mid-cycle test during that cycle...5am wasn't much better than getting up early in the morning...LOL)

Once you know when you want to do your pre-shot tests/shots, wait until you get a reading of at least 200. Don't feed, and post and ask for help. Since he's newly diagnosed, we usually say don't shoot under 200 without help (if you get something close, you might go ahead and give .5 unit, but I'd post and have someone available to help you just in case...and have your high carb food, plenty of test strips and a strong pot of coffee)

I guess we have to start somewhere. A dose of .5 is a pretty safe start
 
Good job!! Now you'll be able to easily start to see the "trends" we all look for!

Yes, make sure to take care of yourself too! (I'm always hearing this too..the members here really do care not only about our cats, but our families too)

We tend to get wrapped up in this disease, especially at first. You don't want to get HIM healthier and put yourself in a sickbed!
 
Good job on the SS. The only suggestion I would make, is to put the NS or No shot in the dose column. That is the one labeled U.

Yes, please get yourself some dinner. It can be so easy to get wrapped up in caring for your newly diagnosed cat, that you forget to take care of yourself and other responsibilities.
 
Hi All,
I just wanted to thank you again.
I decided to try giving Bandit insulin this morning. I was feeling pretty confident that I would be able to treat any low BG without help, especially since I gave him only .5 U as opposed to 3 U. So far, his BG seems steady around 180. Here are the results:
AMPS 201
+3 184
+5 180
+7 167

If it stays this fairly stable this way throughout the day on .5 U, I have a feeling that I should move it up to 1 U starting tomorrow. I will be testing every 2 hours.
Any thoughts / advice?
Thanks so much. All of the information here is so valuable. I have spent much of my free time reading this forum. I hope one day that I am able to pay it forward. I'm sure Bandit would love you all up to show his gratitude if he could.
Best,
Samantha
 
Hopefully someone will be along soon to answer your question on dose but meanwhile you might want to check out our board that is dedicated to PZI users - its fairly active and you will get the PZI members eyes on your sheet as often as you are willing to post and ask questions! http://www.felinediabetes.com/FDMB/viewforum.php?f=24

I like to suggest that people go over to their insulin specific support group and check it out. Read the Stickies at the top of the Topics section. Read a few condos posted by other members. Get a feel for how the forum works. See if you think it would be a good fit for you. But you are always welcome to post here in the Feline Health forum for as long as you want.

Wendy
 
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