Completely flat curve (low 100s) after LC wet food change???

Haha no I understand. It's helps to break up the bleakness that this diagnosis can cause you know? I like staying positive. 94 @ +9

 

You mean +9 right?
No change. She hasn’t risen as much as I thought she might. I think another test in an hour if you can.
She’s quite safe. I just don’t want her dropping back.

 

Oops, yes! I corrected it. And okay I'll give it a try. Update at +10

 

When I had PJ parties I always went to sleep inbetween all tests even the 1/2 hourly ones otherwise I wouldn’t have survived. I was always able to fall asleep and wake up with an alarm.

 

Holy cow, Kyo! What are you up to, little girl?! And Bron, you are a rock

It sure has been a challenging 48 hours for you, Lauren, but things are trending in a great direction!

Depending on what happens, it may be worth going to the pharmacy and seeing if you can get some U100 syringes. You would have to use a conversion chart (it’s very easy) since ProZinc is a U40 insulin, but using U100s allows for tiny doses accurately measured. I did a quick google search, and evidently in Texas it is at the pharmacist’s discretion whether or not to sell syringes OTC, so not sure how that would go. (Basically, they would have to be convinced you are a concerned cat owner and not an IV drug user.)

 

That’s a really good idea @Jenna Josie but make sure you use the conversion chart to get the correct dose.

 

111 @ +10, oh man it's been a long couple of hours. I honestly don't think she's going to rise up to 150, her shot would be due 2 hours from now. I think you're right @Jenna Josie I might have to go pick up some u-100s. I was thinking I could also get some from the vet but they know my ProZinc should be used with u-40s so idk how willing they would be to give me those. Ill have to check with my pharmacist, maybe if I show them my detailed spreadsheet I've been compiling lol. And yes, Bron has been with us for 2 consecutive nights trying to figure this out, makes me get all teary-eyed because I could not have done this without you the lack of sleep is making me emotional lol. Well we are back in the blues so I'm going to give her a break to sleep for 2 hours (me too) before she gets her AMPS test and breakfast. And I'll go according to your dosing advice Bron like you said unless Djamila says otherwise.

 

Dont get a whole box of U100 syringes because I don’t think this little girl will be on insulin for much longer. She’s on a mission.
You’ve done another great job and must be exhausted!
I’ll look in tomorrow to see what Miss Kyo has in store for us!
I’m heading to bed too.

 

Oh Lauren! You poor thing! And @Bron and Sheba, you're amazing! Thank you so much for being around and helping out over here! We've been rather short handed, and I really appreciate your pitching in. Plus, you're doing a great job with prozinc dosing advice! I agree that if she is under 150, skip, and over 150, try a 0.25u dose (if you can test).

I'm so sorry you missed another night's sleep. Just keep reminding yourself that this is temporary. She'll either go OTJ, or settle down into a dose soon. These really volatile periods are usually fairly short lived.

 

144 AMPS, pretty close to shoot but still under. No shoot?

 

The fact that her numbers are heading in that direction are so encouraging and keeping the sleepless nights worth it.

 

Ugh. It's so hard to say when they're close like that. You're still under three months since diagnosis (cats are much more sensitive at that point), and her ears have got to be tired of being poked at this point. I think I would skip. If she ends up pink again like she did the other day, then we'll know not to skip again next time.

 

Stalled for 20 min and tested again @ 149, right on the edge.

 

Ugh man I know! It seems like either way I go she might drop on me. I agree with you and I think I'll skip for now and see how she reacts. I know shes hungry so no more stalling.

 

Argh. 216 @ +4. Her body really doesn't like the skipped doses it seems.

 

She’s likely to be high for her PMPS. Do you plan to go with a reduced dose regardless? We think about doses based on the nadir, but since with no shot this morning, previous nadirs should be considered instead.

 

Yeah, I was thinking I do the .25u and she how she responds to that for a couple of cycles without skipping (unless she reads green for PS later on). The last time I skipped and she was in the pink for PMPS and I gave 1.25u that seemed to be too much. And then .5u seemed to be a lot yesterday night, even though she was fine at .75u in the morning... Do you guys ever do a higher morning dose and a low night dose routinely?

 

Wow she actually stayed in the 200s, 284 AMPS. That's a good sign that she didn't rise to the pinks like last time right?

 

I gave Sam different AM/PM doses for a little while. Just slightly different - 0.4 AM and 0.3 PM if I remember correctly (too lazy to check the spreadsheet ). In hindsight, I don't really think it was necessary and may have actually contributed to the problem though.

 

Wow, good to know! You experienced members are something else with all the wealth of knowledge you have. My parents ask me all the time about what's going on with kyo and I forget how many hours I've spent online and/or on this board and still don't have the answers to everything. I'll be back with a +3 update, since that seems to be when she starts her drop.

 

This sounds like a good plan. Hopefully she will be able to clear this high BG (from the no shot this morning) relatively quickly, and you'll be able to get a good idea of how she is doing with the .25 dose. It can take a few cycles for a kitty to "settle in" to a dose . . . something you've not had a lot of experience with, what with the way she's been running down the dosing scale!

 

Watching with interest.

 

Everyone gets to be experienced eventually with at least some parts of it all!!!! And remember, there was a point in your life you did not know how to give a cat insulin and probably did not think you’d be able to! (I know I didn’t.)

I was popping by and glad to see such dramatic improvements so soon!!!!! <3

 

Aw thanks Alice! Yeah it's crazy how fast you go from overwhelmed to information hungry lol. Kyo just read 72 @ +3! I'm going to be monitoring her levels closely as she tends to drop between +3 and +6, will definitely get a +4 test and then go from there.

 

Ok Miss Kyo, remember what your Auntie Bron said,......no more swimming with the sharks in the deep end of the lagoon. Stay near the edge where your mamabean can watch you.

 

Haha yes! Stay on beach front property please it's a nice view.

 

88 @ +4

 

Surfing nicely. I’d give her a teaspoon of normal low carb food to help her get up on her surfboard and surf safely and test again +5.5. Does that sound ok?

 

Sounds good!

 

127 @ +5.5! We did it! Wooo!

 

I can see Kyo is listening to her Auntie Bron. Good girl
I think you can go to bed. I’d leave out a bit of low carb food for her to snack on during the night. Is she a grazer or will she eat it all now ?

 

She is an eater man, she would eat most of what I give her. but since my sleep is so messed up right now I'll be up to give her some more through out the night. I need to invest in one of those times feeders I think. How much should I give her? 1/4th of a 3 oz can?

 

Yes a timed feeder is great. I had one for Sheba and used it every day because she was one who would eat it all at once.
Kyo only needs a small snack. I wouldn’t give her any at the moment if you are going to get up later.
But you must look after yourself otherwise you will just get exhausted. Hopefully she will settle down and let you sleep. Did I read somewhere that you were on holidays at the moment?

 

Is a small snack like a table spoon of LC wet? If so i'll just place it down before I go to bed. And yes! I'm on summer break from college at the moment (kinda, I still have summer classes). But thats why I've been able to stay awake for whenever she deems necessary, good timing because I've got a lot of free time at the moment!

 

Yes very good timing. Lucky Kyo. Yes a tablespoon of wet is a good sized snack. It looks like 0.25 units might be a good dose for her...... unless she surprises us again!
I hope you can get a decent sleep Lauren. See you tomorrow

 

Yes! I'm so happy we found a consistent dose for her! I wanted to jump with joy when she tested okay earlier! Great work everyone!! I will enjoy my victory sleep tonight! Goodnight

 

Hooray for 0.25u! That was a lovely cycle. Also looks like Kyo might be inclined to be an early nadir cat. Sam does that at night too - his nadir is somewhere around +2-+4 in the evening. Makes it easy on my sleep! If Kyo keeps this up, you might actually be able to sleep too one of these nights!

 

I picked up the u-100 syringes today and took a look at the conversion chart. Since Kyo is getting .25u of u-40 insulin that means that I draw up to the .6 mark on a u-100 syringe. I'm going to insert a picture of where I believe that is just for clarification but I'm 95% sure I'm correct. The green line is where I should draw up to, another eyeball but much less of an eyeball than on the u-40 syringes!

 

She read kind of high this morning and I'm pretty sure that's because I wasn't getting that accurate of a dose from the u-40 syringe, I think I might have given her less than .25, not sure. But now I've reduced that room for error!

 

Looks about right to me. Micro dosing is hard, no matter which syringe you use, but the u100s really do make it better.

 

I got my package from DCIN today! They sent me a ReliOn Micro, she said it requires less blood. Is there any level variance between two human meters? Or should I be good to go with using the Micro to test for my PMPS?

 

They are the same brand and so should be essentially the same. I switched from Relion to CVS brands a while back, and I took about 10 "side by side" tests to see if there was a difference. There may have been a bit (IIRC, the CVS tended to run about 5% lower), but given that meters are allowed to have 20% variance (which is just ridiculous, imo!!), it really wasn't worth thinking about. It might make you feel better to do a side-by-side with the same blood drop, though, so why not? Just keep in mind the ordinary variance when they come up different numbers, lol.

 

Perfect! Thanks Jenna and Djamila!

 

Wow, I just looked at the size of the needle, only 6mm it's so short! Kyo is a short haired cat, but our last needles were 12mm in length! I worry that I won't be able to penetrate his skin! Anyone else have problems with this?

 

This is a very moment for me... Why didn't I think to check that lol

 

Ours our 8mm, and I love them so short: there's very little risk of accidentally piercing the muscle. I'm sure that after a couple of injections, you'll get used to them and they will be just fine.

 

31g was much less smoother to get into her skin for some reason...I had to push harder and I could tell she didn't like it very much. We have a vet visit tomorrow at +3 after our AM shot (1 pm), so I might ask them if they have different ones available even though I know it will be expensive upfront..

 

Honestly, I wonder if that 2mm will make a difference. After some research it seems like most u-100 syringes are pretty short as well! I just want to make sure that its being administered correctly really. I'll give it a couple more tries before I try the 8mm ones.

 

Sorry, that’s what I meant to say: that I think you’ll come to like the 6mm ones just as I’ve come to like the 8mm ones, which — like your switch — are about half the length of the ones we used to use. And I agree that 2 more mm would likely make little difference!

 

Good morning everyone, Kyo throwing me for another loop today reading 101 AMPS, I'm going to stall 20 and try again. I will be at the vet around +3 but I didn't plan on having them check her BG levels, it was just a check up for her recurring ear infections. What do you think, kind of low to shoot or stick with trying to get 3 cycles of .25u insulin?

 

She read 111 after a stall and so I know she is rising and since her body doesn't like the skips I'm going to go ahead and give her the .25 dose. I'll be around to monitor her and check back in later.

 

Was a good call not to skip! I think I'm getting the hang of her cycles finally! 172 @+2

 

Really great decision this morning! And perfect way to think through it!

I love the 6mm needles. And Sam has very thick fur. Give it a couple of tries, I think you'll adjust. Oh, and as for pushing harder, make sure you have the bevel facing the right direction. That helps it to slide in.

 

Hey @Djamila ! Thanks I was happy about that decision too, that is until my vet visit that I just came back from. I posted my question in the main health forum though because it was more about meters than the insulin

 

I responded out there.

 

Thank you so much. You are the best!

 

Miss Kyo is looking good.

 

Thanks for the check up Bron! I've been thinking about the snacking during the night like you said to kind of keep her from going too low while I'm asleep. What I'm experimenting with tonight is that instead of giving her 1 and a half cans at her feeding time all at once (usually takes her 2 to 3 hours to finish it all), I'll give her the 1 can at usual feeding time, and right before my bed time, +4 for her, I'll put down the rest of her meal (the half can) so that I'm not going over her calorie limit but she is still able to get in some food over the course of her nadir. What do you think about this plan?

 

That sounds like a great plan. Are you doing that during the day too? That's a plan I would use every night..it's better for her pancreas to have her food spread out over the 24 hours.
I have 2 cats now (neither is a diabetic) but I still feed them 4 times a day.....breakfast, lunch, dinner and just before I go to bed. And I feed them a raw diet and I make sure they never get any high carb food.

 

This is the first night I'm trying it, but I was thinking I would start doing that for her breakfast as well! Her weight check in at the vet was 13.5 from the 13lbs last time so I need to try to be better about her calorie intake and I thought this would be a good solution with how everyone says the small feedings through out the day work best! Eventually I would like to scale her food down more since she's getting over the recommended calorie count , I just didn't want to add that variable in at this time. Trying to get her regulated and then begin reducing the diet little by little according to Dr. Lisa's formula.

 

Lauren, how is she doing with staying inside? Is she settling in, or still crying a lot?

 

Hey @Djamila ! We just hit test time and she just read a 96, so a green for the first time during an AMPS. I'm going to stall (she's hungry pretty hungry right now though) and test again in 20 min and see if she's rising. If not, how much can I reduce the dose from .25?? That's such a small dose to measure out already and I know she doesn't like to skip so I'm kind of scratching my head trying to figure out exactly how low she wants me to go on the dose today lol

 

Yay we are rising! She got back into the blue after a stall so I went ahead and fed and will be shooting the .25. Curious as to why she was so low at this time though, it's a first.

 

Well alright, so Kyo just threw me her first line green during the morning round. I checked her at +3 since she was just a little lower than usual this morning and she read 43 she was even eating her low carb wet food before I tested her! Gave her a tsp of high carb gravy lovers and 1 drop of Karo. Update in 20 min.

 

Oops, was so tired forgot to update. Read 72 @ +3.5, fed 1/6 of her 1/2 can LC wet food for lunch in case I needed her to eat more. Tested again at +4 read 97. Put down the rest of the 1/2 can for her to graze. All is well.

 

Hey @Bron and Sheba , I've got a question for you! Kyo has been doing good with her readings, besides this morning where we had that lime green hiccup (still trying to figure out what that was, maybe I should have reduced dose?). Anyway, I know that she usually reads low at night, which is why I started breaking up her meal a bit. So my question is, if I'm feeding her the 1/2 can of FF @ +4 (which she ate all of) and she read a green 77 before feeding, do I need to stay up to test her more?

 

Yes Kyo earned a reduction in dose. Make sure you reduce it tomorrow.
Yes you will definitely need to keep testing tonight as she could easily drop very low again this cycle. You could give her a teaspoon of medium carb food now if you have any, just to stop her dropping too much. You already have earned a reduction so have nothing to prove. I'd test again in 1 hour. I'll watch for your post.

 

I suppose my last reduction would be to a drop now (.1u) right? Is that because she's starting to read greens and low blues for her Pre shoot testing?

 

Also okay! Update 1 hour from now or from last test? +5 would be right now for me since I already got a +4 reading

 

From last test

 

Okay just got the result. She tested 90 @ +5 but that could be food influenced since she just finished her 1/2 can of LC wet after +4 testing

 

The reductions are because of the nadirs not the Preshots.
Yes go down to 0.1 units. And you will stay on that until she earns a reduction down to a drop.
I can see a remission in her future

 

Yes probably. Did you feed anything else apart from the 1/2 can LC?
Don’t feed again and we’ll see what she is in an hour. Is that ok?

 

No I haven't given her anything else since you told me to test and I saw your post right at +5 time! So I'll update at +6.

Oh so the order is .1u and then reduction to a drop. How the heck do you dose the drop? I've been trying to use the search feature for that info but I wasn't able to find anything

 

Don’t reduce to a drop until the next reduction. I know how to get a drop for Lantus insulin but not sure if it is the same for Prozinc when using a 100u syringe. @Djamila will tell you

 

Gotcha! I'm eager for information but I definitely don't want to rush reducing her down if she doesn't call for it yet because I don't want to stress her body out. Thanks for the great advice as always!!

 

Because you are using the U 100 syringes for the Prozinc with the conversion chart you will probably be able to go down further before a drop. @Djamila will be able to guide you with this.

 

105 @ +6!

 

How long is it since you last fed her food?

 

It's been 2 hours since she had her 1/2 can of FF liver and chicken

 

Ok than she should be ok now. I’d give her a good tablespoon of low carb food now and then go to bed. Try and get some sleep.
You are a good mamabean to Kyo.

 

Yay sleep!! Yeah I'm really starting to feel the lack of sleep creep up on my body. Kyo been trying to do a diabetes speed run on me these past couple of days it seems! But I don't mind because she's putting in some hard work in healing! thanks for everything Bron, goodnight.

 

It is always a pleasure to help you Lauren. I am so happy to see Kyo racing towards remission. You must post some more photos of her.

 

Ah work! I always miss all the fun!

Usually on prozinc we reduce to 0.1u (which isn't really 0.1u, that's just what we call it), then to a Drop, and then nothing. The 0.1u dose is basically less than 0.25u, but more than zero. Wherever you decide to put the plunger to do that, just be consistent from cycle to cycle. For Drop, you take the syringe and push the plunger in as firmly as you can and hold it there. Then insert the needle into the vial, invert the vial, and release the pressure on the plunger. It will suck in one drop. Then you inject that into Kyo. It will feel like you've injected absolutely nothing at all, but you'll usually see an insulin response in the numbers. I found it helpful to play around with a syringe and some water so that I could verify for myself that there really would be a drop in there, and that it really would come out/be injected.

 

Alrighty! We did our first ".1"u today! She read 95 AMPS. I'll get in a +3 or +4 and see how she likes it

 

And @Bron and Sheba haha, I'll definitely have to pay the cat tax on the photos! I'll search for a couple of good ones I know I've got saved on my computer somewhere

 

75 @ +4, gave her lunch of 1/2 can FF after I tested the +4

 

Kyo read 148 @ (PM) +4 after doing really well today highest she's been in 5 days. Going to see how she handles her .1 for the morning. For now I guess her numbers mean I can get some sleep tonight at least

 

Sweet dreams

 

Kyo read 284 for her AMPS this morning. Is this an indicator that I should go back to the .25 for our next couple cycles? I'm going to give .1 this morning and test again at +4

 

I’m just popping in again and want to say I am thrilled to see Kyo’s progress so soon! You are doing a great job.

 

Thanks Cassandra! I hope Alice is recovering well from her surgery! Poor baby, I remember when Kyo came back from getting spayed we had a miserable 3 days of recovery until she finally started to come back to life. Sending some healing your way

 

Update on Kyo: 95 @ +4

 

Thanks! She’s improving! Her tumor removal was what I think looked the worst. But all of it has been worth it because her numbers are much better. It’s always good to see some progress after our sleepless nights and worry!

 

I hate to have you go back to 0.25u when that resulted in a lime green so recently. Based on how you're drawing the dose, do you think there's anything in between 0.1 and 0.25?

 

Yes actually! I can eyeball a little more! I'll try that for tonight. Should I denote it as .15 in my notes since it's more than the .10 I'm drawing but less than .25?

 

That sounds good. As long as you know how much it is, that's the important thing.

This always makes me shake my head though when I think about how the manufacturer and vets do all dose changes in full units. And here we are, yet again, finding that one single drop can make a difference in a cat being too high or too low.

 

I know! It seems as we get to the very low doses it becomes such a delicate process. Thanks for the input though! Hopefully I can get her back into the good greens

 

Also @Djamila , I was looking at other peoples charts when they've made a reduction this low and their numbers seems to be similar to Kyo's. Do you think I'm being to hasty with wanting to up the dose again? Should I give her system more time to adjust to this ".1" dose I'm doing?

 

She doesn't seem to require much time to adjust to doses, and isn't all that bouncy, so if it was my cat, I'd probably give a little bump in the dose too. She isn't needing much insulin, but she also isn't looking like she's in any hurry to get off the insulin either. When you've skipped doses, or in this case, gone too low in dose, she responds by going back up in numbers, which we want to avoid. That being said, she could prove me wrong, so if your mama-sense says to hold at 0.1u for a couple more cycles, you could try it and see what happens.