Yosh is at 134 preshot

Discussion in 'Prozinc / PZI' started by Stressedcatmom, Apr 12, 2017.

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  1. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Hi everyone, again, unfortunately

    Yoshi is at 152 30 min before his eve preshot reading. He's eating now. Any advice as to whether I give him the full two units in a half hour? Or test again before the shot? But I just gave him food cuz I think he needed it. Should I stall?
     
  2. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I tested him early cuz his neuropathy was worse when I got home
     
  3. Stressedcatmom

    Stressedcatmom Well-Known Member

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  4. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    When you have a lower than usual PS reading, you would want to stall. This means wait 20 minutes without feeding and take another reading. I don't see any AMPS for him today.
     
  5. Stressedcatmom

    Stressedcatmom Well-Known Member

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    He ate half a can of fancy feast in a matter of seconds.
     
  6. Kris & Teasel

    Kris & Teasel Well-Known Member

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    The stalling technique involves not feeding so you can see if the BG is rising high enough on its own. He's already eating so that won't work. You can give him a much reduced dose instead of skipping insulin, say 1 u. When you have a minute could you update your SS?
     
  7. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I didn't am preshot. I was low on lancets and his ear is so poked and it's so obvious cuz he's so light. I feel bad. I'm trying
     
  8. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Yes I will
     
  9. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Omg I shouldn't have fed but he's so hungry!
     
  10. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    How long will you be able to monitor tonight? Are you firmly holding his ear for a few seconds after testing and putting a little neosporin on his ears?
     
  11. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Yes and singing and praying to the Gods and everyone else
     
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  12. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Those pre shot tests are the most important so you don't accidentally give too much insulin for the BG level. Why not stock up on several boxes of lancets. No need to buy the AlphaTrak version. Try other brands in your AT trigger device or use them freehand.
     
  13. Stressedcatmom

    Stressedcatmom Well-Known Member

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    It's updated. I'm really bad w am testing. I just don't want to hurt him.
     
  14. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Amazon is delivering 100 tomo
     
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  15. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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  16. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I feel like I can't test for two hours cuz I fed him 20 min ago. I'm just wondering about the insulin shot he's supposed to get in 25 min
     
  17. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Testing again in 10
     
  18. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I have to remind myself that every time. Thanks. I just see the dots on his ear and I feel really bad
     
  19. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I suggested 1 u in my post above. That's half of what he's been getting so it should be OK.
     
  20. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    It's ok, was your first time. Now you know what to do next time :). Don't need to test again, his number will be food influenced. Will you be able to get another test tonight?
     
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  21. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Yes just tell me when. And give his shot at 1 u that seems so low he's usually 2
     
  22. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I think I maybe did the right thing by feeding him. He's now way more chill now and less neuropathy now that he has food in his belly. I don't know anymore, but I'm not giving up
     
  23. Kris & Teasel

    Kris & Teasel Well-Known Member

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    The goal is to get some insulin into him but at a safe dose. A pre shot of 152 is far too low to give a full dose on.
     
  24. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Ok. So testing again preshot will be futile cuz my dumb ass gave him some food? Probably. Ugh.
     
  25. Stressedcatmom

    Stressedcatmom Well-Known Member

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    He was wonky when I got home I couldn't help it
     
  26. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Save his ear. A test now won't give any useful info. Don't be too hard on yourself. You haven't been at this long, there's a lot to learn and it can be very confusing at first. It gets easier over time and your confidence will grow. The most important steps are to set up a testing routine to keep him safe, log all data in your spreadsheet and post here whenever you have a question. :)
     
  27. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I can't thank all of you enough. I think I'll give 2 temptations and 1.5? Or is everyone saying 1? That's low for him. 2 has been good thus far
     
  28. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    No more than 1U. At least test again in +2.
    2U has only worked when he's over 200. Giving him full dose on 152 may put him in dangerous territory.
     
  29. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Ok scares me but I trust you guys.
     
  30. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I don't like dangerous territory. Thank you.
     
  31. Rachel

    Rachel Well-Known Member

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    1 unit should be more than fine. That's half his dose and with food in him, you know he'll have that to stop from dropping too fast. Then getting a test as the food starts to wear off will tell you if he's dropping fast or gently...prozinc is an in and out insulin so you can change the dose when needed and not worry that there will still be insulin from previous shots.
     
  32. JanetNJ

    JanetNJ Well-Known Member

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  33. JanetNJ

    JanetNJ Well-Known Member

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    1 unit. Because I'm too tired to stay up to help with hypos. Lmao! Really though that's a low preshot.... Don't risk a 1.5. See how he does at 1 since he's never been this low. You are really doing great with him.
     
  34. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Thank you. I gave a tiny bit over 1 u and he's eating and playing and being his normal self. Neuropathy is even better
     
  35. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I even put 3 temptations in the mix so we could all sleep well tonight. He's ok. No more food or insulin. I'll test in am for sure.

    Love you guys. Thanks so much
     
  36. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    What about tonight's next test? Especially, with a tiny bit over the 1.0U. Please make sure he's ok before you go to bed. :cat:
     
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  37. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I will but he just ate so I have to wait till 1030 my time
     
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  38. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I know he feels better already but I'll test in two hours. This is not a 911 but more of a maintenance freak out.
     
  39. Stressedcatmom

    Stressedcatmom Well-Known Member

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    He's a big boy btw. Like by nature not just food. He seems really happy now that he's fed
     
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  40. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Thank you
     
  41. Rachel

    Rachel Well-Known Member

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    Did you manager another test?
     
  42. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I fell asleep, of course. I'm doing his amps in 10 min. I'll post.
     
  43. Stressedcatmom

    Stressedcatmom Well-Known Member

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    He's at 142. Should I feed him? Ideas on shot? Ugh this is good I think but nerve wracking
     
  44. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I posted in the main forum as well
     
  45. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Stall 20 minutes without feeding and retest. Post here when get the result. You can repeat this for up to an hour of stalling if you have the time to spare. You might be looking at another 50% dose reduction or a no shot depending on the stall numbers. Great news, but nerve-wracking!
     
  46. JanetNJ

    JanetNJ Well-Known Member

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    wow great preshot! Those in between numbers do make it hard to decide what to shoot though, eh? I agree with kris... stall wihtout feeding and lets see if the numbers are going up or not.
     
  47. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Omg you guys I just fed him ugh
     
  48. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I kinda want to cry. I have to go to wk in an hour
     
  49. JanetNJ

    JanetNJ Well-Known Member

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    haha i did the same thing the first time cc had a preshot under 200... I fed her then came on here and they said don't feed her yet... and I was like , um, too late. lol well I would say jut give a little token dose of like .25 or you can skip.
     
  50. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I think I'm going to go with 1 u and his food in the timer. I'd rather have him high than low while I'm at wk?
     
  51. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Ok I'll do the .25 but my needle thing only has 1u marks
     
  52. JanetNJ

    JanetNJ Well-Known Member

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    how long ago did you feed her? If it was less than 10 min ago you can grab a quick test and just see what it is.
     
  53. Kris & Teasel

    Kris & Teasel Well-Known Member

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    The safest thing is to give no insulin this AM because you won't be home to monitor. You should post here tonight for advice before feeding him if you're unsure, although he'll likely be high enough if he has no insulin this AM.

    The routine when confronted by a low pre shot is:
    1. stall without food for 20 minutes then retest
    2. repeat the stalling for up to an hour without feeding, retesting after each 20 minute increment
    3. post here for advice until you've learned how to handle these situations on your own.
     
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  54. JanetNJ

    JanetNJ Well-Known Member

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    can you do less than 1? I wouldn't do more than .25 honestly.
     
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  55. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Probably 12 minutes ago
     
  56. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Eyeball just over the zero line. A tiny bit of insulin like this should be OK.
     
  57. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Thank you. This stalling business is new to me
     
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  58. JanetNJ

    JanetNJ Well-Known Member

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    it's a GOOD problem to have... means there's improvement. I have a feeling it won't be long before we are counting the days to being off the juice. :)
     
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  59. JanetNJ

    JanetNJ Well-Known Member

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    Next time you need needles, buy ones with half unit marks on them... makes eyeballing fraction doses much easier.
     
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  60. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Omg that would be such a blessing!
     
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  61. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I think the vet gave me these. She's such a peach :/
     
  62. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Just an FYI I gave him .5. Thank you again. Fingers crossed. He's been dieting and that may be helping? He's at about 2.5 cans a day
     
  63. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I emailed my vet about all this and this is what she said:

    I am really sorry for the stress and confusion. I did receive your question about the B12, but not the other questions (or I missed them in the note); I believe Colleen was planning to call you back this afternoon since I was out of the office earlier this week. There isn’t a lot of firm research behind using B12 for neuropathy, but it certainly wouldn’t be harmful. The injectable is cheap - $24.60 for a large bottle (will last a year at least). You would start out with once weekly dosing.


    If Yoshi is at 150 or less, do not give insulin. A curve on Friday is fine. If you start at 7:30, go until at least 2:30 in the afternoon. The insulin levels are likely to decrease after the morning dose, and at some point in the afternoon you will likely see them increase again as the insulin starts to wear off – this is normal and expected, although flat lines can happen too. You can stop the curve if you see the increase starting to happen earlier than 2:30pm.


    Diabetes is a long-term management disease for cats, so unless you see numbers below 150, do not feel like you need to make rapid changes in dosing. Variable doses based on blood sugar readings are not necessary for all cats. We will decide on whether or not to reduce the dose based on the curve; typically we reduce by 0.5 to 1 unit per dose. Based on the spreadsheet, I think we will decrease Yoshi’s dose to 1 unit twice daily, since it seems like he is making progress.

    I responded with:

    Thank you for your response. Yes, I'd like the B12. Can I pick it up on Friday? Do I inject it like I do the insulin? Or do you think a pill form is better? I asked Colleen about the curve, but not about the insulin. He didn't drop really low until last night and this am.

    So in essence, if he's at say 152 or 155, I am supposed to give him the full 2 units? This seems like a lot. He was in the 150's last night and I gave him 1 unit and he was at 140 something this am.

    Whenever you get a chance.

    Thought some of you would find this interesting, in case you wanted some afternoon reading...
     
  64. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    If you need to look at some stalling, take a look a my SS ;).
     
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  65. Stressedcatmom

    Stressedcatmom Well-Known Member

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    He's at 156 pmps
     
  66. Stressedcatmom

    Stressedcatmom Well-Known Member

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  67. Frank's Mom

    Frank's Mom Member

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    Wow...I'd be SO NERVOUS to shoot at that number. I'm sure someone with experience will be on here soon to help. Remember though that we ultimately want those lower numbers, so even if it's stressful, you're going in the right direction!
     
  68. Rachel

    Rachel Well-Known Member

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    Have you shot yet? Checking out your SS now.
     
  69. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I gave him .5 when he was at 152 and he was at 143 the next am
     
  70. Stressedcatmom

    Stressedcatmom Well-Known Member

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    No. Waiting
     
  71. Rachel

    Rachel Well-Known Member

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    Have you fed him already? If not, it's been about 20 min...I'd get another test to see if he's coming up.
     
  72. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I fed him after the test
     
  73. Frank's Mom

    Frank's Mom Member

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    I'd probably try for a .25 or so. But I'm still new at this too and amy pretty conservative most of the time.
     
  74. Rachel

    Rachel Well-Known Member

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    Hmmm...okay. Well are you able to monitor tonight? I honestly wouldn't give very much considering how he was already low this morning and got such a tiny amount of insulin...and ended up still low tonight! You could give a token dose...like draw up to just above the zero line like Kris suggested this morning and monitor...get some tests in to see what happened.

    Or you can skip. It's not ideal to skip a dose, but it makes me nervous that he's that low and at this point you don't have much data. If you don't feel able to stay up and monitor, this may be the best option.
     
  75. JanetNJ

    JanetNJ Well-Known Member

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    Only if you are going to test. "Normal" is 68-150 so it's basically a normal number. I would do 0.25 or a very skinny 0.5. And try to catch a test at +5 or 6.
     
  76. Rachel

    Rachel Well-Known Member

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    In the future, if you get a number like that, stall for about 20 minutes WITHOUT FEEDING and test again. Then you can see if he's going up at all or not....that's good to do both because he might get to a higher preshot that you can shoot, and it will also help you see that he is going up...not down which helps you decide about shooting or not.
     
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  77. Stressedcatmom

    Stressedcatmom Well-Known Member

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    He's at 150 amps. Today may not be the best day to curve. Vet said don't shoot if he's at 150
     
  78. Frank's Mom

    Frank's Mom Member

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    It's probably still not a bad idea to get some random pretests in there, just to see where he's at throughout the day. It would give you an idea of how a lower dose on low PSs would affect him. For example, if in 4 hours he's up to 400, then you know you could have probably safely given him .25U or so to keep it from going up. (It does take a bit for the insulin to kick in, thus the "curve" shape, so a high number at +4 to +8 would indicate that it was ok to give a smaller dose.) I hope that makes sense, how I explained it.
    And for the first time since diagnosis I joined the NS club today! It's a good feeling!!!
     
  79. Kris & Teasel

    Kris & Teasel Well-Known Member

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    He's right on the no shot margin. Are you at home today to monitor? If you are you could do a "mini curve" by testing at +3, +6 and +9 after giving 0.25 u again. It would give you a better idea of how he's doing because he might be on his way to remission. You need a lot more data though.
     
  80. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Congrats! I'm actually completely confused. I was going to curve today but not shire if I should even shoot w this #
     
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  81. Frank's Mom

    Frank's Mom Member

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    @Stressedcatmom Do you have any idea how long Yoshi has had diabetes? I know you were just diagnosed, but had you seen signs of it for a while? The quicker you catch their diabetes the better the chance is that they go into remission, so maybe you caught it super early and he's already on his way to being OTJ.
     
  82. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I'm home. I don't know what to do. The vet said to curve every two hours till 2:30 my time
     
  83. Frank's Mom

    Frank's Mom Member

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    That's a tough one. I'm at much higher dose than you are, so I would still give SOMETHING for a shot. But you're dosing what I'd give as an adjusted shot. I think Kris recommended a .25 IF you'd be home to test throughout the day, and that's probably what I'd do, too. You said you were going to do a curve today, so that tells me that you'll probably be around to monitor Yoshi, so you should be ok to do a small .25 and see what happens.
     
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  84. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Then go ahead with the vet's schedule. You need data on how Yoshi is responding and with the 150 being right on the cut off margin I think it's worth doing that partial curve.
     
  85. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I think I understand now
     
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  86. Stressedcatmom

    Stressedcatmom Well-Known Member

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    The vet also told me to keep giving two units if he was above 150. I was like "what?!" Then she said you can do 1 u if he's 150-200, if it makes you more comfortable....
     
  87. Rachel

    Rachel Well-Known Member

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    Yep, you have to temper what the vet tells you with your own wisdom. :)
     
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  88. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Going to give the .25. I hope the curve will still help even if he's at a way lower dose. He is def not a fan of all this ear pricking. I just hope we figure something out.

    Rachel told me to test again 20 min after when this happens so I'm debating that. I just don't want any pokes that aren't vital
     
  89. Stressedcatmom

    Stressedcatmom Well-Known Member

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    It seems so. I don't get it. Aren't they vets? Why are all of you smarter than them? rachel do you agree with the .25?
     
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  90. Frank's Mom

    Frank's Mom Member

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    I'll be honest and say the only reason I understand as much of this as I do is because I'm a science major, and years of biology and anatomy and physiology are finally paying off for something. (I use all my science knowledge to treat my cat's diabetes, as I work in accounting. Lol.)
     
  91. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Rachel was suggesting the stall and retest technique to see if Yoshi's BG was coming up on its own. You have a different plan now:
    1. feed his usual low carb wet food then give 0.25 u
    2. test again in 2 hours as per your vet's curve instructions
    3. fit in his mid day meal so it's 2 hours before one of your curve tests
    4. be prepared to abort the curve if one of the BGs is too low (68 or lower on the AlphaTrak meter) by giving a higher carb small snack
    5. only do #4 if necessary
    6. update your SS as you go so we can follow.
    Most vets have little training in treating feline diabetes so they follow some very general set of instructions or go at it as though they're treating dogs. People here live and breathe FD 24/7 and have amassed a huge amount of experience and knowledge about what works and what doesn't.
     
    Last edited: Apr 14, 2017
  92. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Oh Jesus I just fed thin them was going to shoot. You said insulin first. Was that a typo? I hope?
     
  93. Kris & Teasel

    Kris & Teasel Well-Known Member

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    We also understand the anguish of going against your vet's instructions, especially if he/she is otherwise a great vet. I've been there.
     
  94. Kris & Teasel

    Kris & Teasel Well-Known Member

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    So sorry - my error!! Yes, feed then shoot! :banghead: Thank heavens you took me to task. I've edited that post.
     
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  95. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Oh thank goodness
     
  96. Djamila

    Djamila Well-Known Member

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    It's still early, right? (at least in my time zone)
     
  97. Stressedcatmom

    Stressedcatmom Well-Known Member

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    Thank you for this. I will follow your instructions. Do you think this curve will even show anything with such low insulin? I'm eyeballing the .25 and it looks so small
     
  98. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I don't know how long he's had it. He has neuropathy so he either had a bad hypo when I wasn't home once or he's had it for a while. No clue. He's always been a big eater which got him into this mess. But he was drinking water like a maniac I would say for about the past two months
     
  99. Stressedcatmom

    Stressedcatmom Well-Known Member

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    I go to a cat vet. They only treat cats. Which is part of the reason I'm so frustrated with them. I think I'm going to switch once this settles.
     
  100. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That's why you need to do a curve. However, insulin is a very powerful hormone and can have an effect even when the tiniest dose is given.

    If you like your cat vet for everything else and they either:
    • will work with you as a hands on owner OR
    • you can agree to disagree without them going ballistic
    then there's really no need to change. We can help you here with Yoshi's FD.
     
    Yong & Maury GA likes this.
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