99 PMPS stalling

Discussion in 'Prozinc / PZI' started by JOJI and Kit, Mar 16, 2020.

  1. JOJI and Kit

    JOJI and Kit Well-Known Member

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    http://www.felinediabetes.com/FDMB/...rs-kit-is-a-bouncy-kitty.226581/#post-2543442


    Deb says our thread was too long, so alas, a new one.

    @Deb & Wink So, on your suggestion we were trying to stick to one food to see if it would help us regulate Kit. It was a spot on idea, but Kit's digestive system decided that it really does not like Weruva Paw Lickin' Chicken.
    Sad, because she did like it and now we have yet another stash of canned food to add to the others that have been kicked to the curb.

    We've never seen a reaction in her like that before, so we pulled her off it and her stools came back to normal.
    But now we think it's time to increase her insulin since she's been riding high for over a week. We did inch up starting yesterday to a fat 1.5, but really think a 1.75 is warranted.

    If you're around, would love your input!
     
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  2. Deb & Wink

    Deb & Wink Well-Known Member

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    Agreed. The 1.5U dose is simply not enough to bring Kit's BG levels down into the blue range at mid-cycle.

    From the protocol for SLGS and Prozinc:
    "If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit"

    Wish you had thought to take a BG test last night at +4, when you said she was "super hungry." Might have shown you why she was so hungry. Next time she's still telling you she is hungry, grab a BG test first, then feed her.

    p.s. Are you 2 ok? Both Jo and JW? Just checking up on folks, during this covid-19 panic.
     
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  3. JOJI and Kit

    JOJI and Kit Well-Known Member

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    Hi Deb,

    Thanks for the reply. New info came in today. Our vet called with results of Kit's urinalysis from last week. So even though she's
    not showing any outward signs of a UTI, they did find bacteria and we need to do an antibiotic again. The convenia is "convenient" but the more I read about it the less I'm sure it's the safest route. (thank you catinfo.org!) We are also thinking that if she has had this underlying infection that her BG numbers have likely been impacted.

    Now we are deciding whether to go the Convenia route or oral antibiotic, and whether or not we should hold off on any insulin dose changes.
    Do you have any thoughts on any of this?

    PS thanks for asking about our wellbeing. Yes, it is quite the moment in time. Surreal. We're doing okay and trying to stay smart and make sure everyone around us - family, friends and community are doing the same. Anxiety? Yes! (it definitely puts feline diabetes in perspective!!) How about you??? How are you? Thanks for being here and being our Kit lifeline.:kiss: (JW just alerted me that I had mistakenly given you a stick out the tongue emoji instead of a kiss!) all better now
     
    Last edited: Mar 16, 2020
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  4. Deb & Wink

    Deb & Wink Well-Known Member

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    If going the oral antibiotic route, try to get one without any added sugars. UTI's can be more stubborn in a diabetic cat, because the excess sugars spilling into the urine provide a "nutrient rich" environment for bacteria. "Oh yummy! Sugar, lots of sugar! Just what I need to grow and have ten zillion generations of descendants."

    Also, the bacteria can be a bit resistance to any antibiotic since Kit has already been on an antibiotic and that did not kill them off. So you need to have a C&S (culture and sensitivity) to identify the main bacteria and then find an antibiotic to fight those specific bacteria, like a Ninja would. "Hey karate chopped that one, kicked that one to the curb, headbutting another one, only a few more to take out." Kit may also need to be on an antibiotic longer than the standard 10 days, because of that glucose rich urine environment.
    I love all the different emojis! Doesn't matter to me which one you use. ;) My fave, in honor of my sugardude Wink.

    Surreal is the perfect word to use for this situation.

    p.s. I'm fine. Staying home, no big deal for me since I'm retired. Kitchen stocked with food, plenty of cat food, treats and litter. Doing a bit of cooking to have things ready to heat and serve just in case I get sick. I've always enjoyed solitude, and the perennial gardens are starting to green up, so I'll get to go outside and play if it stops raining.
     
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  5. Deb & Wink

    Deb & Wink Well-Known Member

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    How is Kit doing?
    Are Jo and JW ok too?

    I see from Kit's SS that she is still running in really high BG levels. I think it's time to increase to 2U.
     
  6. JOJI and Kit

    JOJI and Kit Well-Known Member

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    Hi Deb, So were considering this as well, but she just had a Convenia injection this past week for a UTI. I think I read somewhere that underlying infections can cause elevated BGs. I can't find where I read this, of course....Do you have any insight into this? And given this, do you still think we should increase? Thanks! J and J
     
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  7. Deb & Wink

    Deb & Wink Well-Known Member

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    Yes, underlying infections can cause elevated BG's.

    But Kit is still not getting BG readings below the middle yellow range. At least, not that you have caught with a BG test.

    You don't want insulin resistance to develop. So yes, I do think you need to increase the dose.
     
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  8. JOJI and Kit

    JOJI and Kit Well-Known Member

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    Okay, thanks Deb. And thanks for keeping an eye on us. :bighug:
     
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  9. JOJI and Kit

    JOJI and Kit Well-Known Member

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    arghhhh, every time we go up in dose, something like this happens
    159 PMPS
    so we are stalling 20min
    @Deb & Wink
     
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  10. Deb & Wink

    Deb & Wink Well-Known Member

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    150 is a shootable pre-shot with Prozinc. Monitor though. A +2 is good. To tell you which direction she is headed. You need to learn to shoot those low numbers sometime.

    New protocol has 150 as the new threshold for giving Prozinc insulin. Kit is a steep diver, so get out those medium carb foods for her, just in case.
     
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  11. JOJI and Kit

    JOJI and Kit Well-Known Member

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    Dec 19, 2019
    so shootable for the 2U with a 150?
    or with a reduced dose?
     
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  12. JOJI and Kit

    JOJI and Kit Well-Known Member

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    148 after the stall
     
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  13. JOJI and Kit

    JOJI and Kit Well-Known Member

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    @Deb & Wink still dropping 148 after stalling 20mins
     
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  14. Deb & Wink

    Deb & Wink Well-Known Member

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    Ok, that 148 and 159 are within meter variance. Less than 7% difference. Well within meter variance which is 15-20%.

    Here's the thing. If I tell you to go ahead and shoot, our convention is that the person that tells you to do that stays up with you. I can't do that. Too exhausted. I kept thinking today was Monday.

    Can you stall for another 20 minutes? Retest?
     
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  15. JOJI and Kit

    JOJI and Kit Well-Known Member

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    yes, we are currently doing the next stall and will retest in about 12 min
     
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  16. Deb & Wink

    Deb & Wink Well-Known Member

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    I'll be here. Second dinner is due for my kitty Dancer. Only stepping away for 2 minutes.
     
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  17. JOJI and Kit

    JOJI and Kit Well-Known Member

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    168 after the final stall.
    so reduce the does by half? i.e. from 2U to 1U?
     
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  18. Deb & Wink

    Deb & Wink Well-Known Member

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    Yes, I'd give Kit a reduced dose if she were my cat. And test this PM cycle.
     
  19. JOJI and Kit

    JOJI and Kit Well-Known Member

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    Dec 19, 2019
    so is 1U the reduction you'd give Kit if she were yours?
     
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  20. Deb & Wink

    Deb & Wink Well-Known Member

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    Sorry, yes 1U. And I'd stay up to monitor and get that +2, and I'd stay up and/or set an alarm to wake me at +6.

    p.s. you can tell I'm tired. Forgot to say how much insulin for Kit.
     
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  21. JOJI and Kit

    JOJI and Kit Well-Known Member

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    great, thanks for the clarification.

    yes, no problem.

    also, how does this change, if at all, the dosing for the morning? assuming we get thru this evening cycle in a non-emergent way?
     
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  22. Deb & Wink

    Deb & Wink Well-Known Member

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    With a reduce dose like that, half the normal amount of insulin, expect a high BG in the morning.

    If so, then the full 2 U dose again. This reduced shot tonight was a "safety dose".
    You probably would have been ok to give Kit the full 2U dose tonight. But being a champion diver, the reduced dose was safer, so you could get some sleep tonight.
     
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  23. JOJI and Kit

    JOJI and Kit Well-Known Member

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    ok, that made me at least smile bc it conjures the image of her on the high board at the pool. i'm sure there's a kitty gif of that someplace on the web .... but it'll have to be a search for another time.

    :bighug:thank you so much for being here. especially during these crazy, exhausting times. :bighug:

    kit is asking what she can possibly do to thank you enough.:kiss:
     
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  24. Deb & Wink

    Deb & Wink Well-Known Member

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    Help the next person. Emotional support is so needful for everyone. Pick one member and give them some help. Someone here in the Prozinc forum would be just fine.

    Getting ready poolside.
    upload_2020-3-22_19-50-55.jpeg
     
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  25. Deb & Wink

    Deb & Wink Well-Known Member

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    This kitty asking "Is that water wet?"
    upload_2020-3-22_19-52-22.jpeg
     
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  26. JOJI and Kit

    JOJI and Kit Well-Known Member

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    indeed it is. we will. thank you.
     
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  27. Deb & Wink

    Deb & Wink Well-Known Member

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    I tagged you in someone else's post. Go visiting. Pat (Patrick) and Brady are new. Only been here on the message board a few days.
     
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  28. Deb & Wink

    Deb & Wink Well-Known Member

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    Hi J & J.

    Kit has a very nice surf in the lower to mid-blue range today, 3/27/20 AM cycle. Nice and safe. She could even have gone down to the greens and have been safe, but then the bounce would have probably be higher tonight.
    I see you fed her at +4 and +5. That probably helped her stay in those nice blues.
     
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  29. JOJI and Kit

    JOJI and Kit Well-Known Member

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    is that what you call "feeding the curve" ?

    we usually feed her up to 3 times before +4 (main meal plus 1 or 2 smaller ones).
    but today at the +5 she was acting hungry so we "topped her up" a bit.

    and have been meaning to follow up on what you said earlier in the thread about learning to shoot low numbers sometimes.

    does the learning mean to shoot and feed the curve? or something different?

    trying to anticipate what might be waiting for us at the PM pre-shot
    +8 at 170
    ^jw
     
    Last edited: Mar 27, 2020
    Reason for edit: new info
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  30. Deb & Wink

    Deb & Wink Well-Known Member

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    Yes, that is "feeding the curve." Feeding the curve, the curve being the BG tests plotted on a graph, the curve being like a smile shape, or maybe a steeper V shape some times.

    If you can feed, and keep the dives from being too steep, you can stop some of the bouncing, or maybe I should say, keep the bounces from being so severe.

    It means shooting a low pre-shot BG number, lower than you have shot before, and monitoring the BG numbers and feeding when needed to keep the numbers from dropping too low.

    If you never learn to shoot lower BG pre-shots, the BG levels will stay too high.
    If you never learn to shoot lower BG pre-shots, and instead always skip the insulin dose, the BG's will simply bounce back up later in the cycle. Maybe within a couple of hours.
    If you do learn to shoot lower BG pre-shots, and know how to stall and look for a rising BG number before you shoot, you keep Kit more on track, and give her insulin to process her food.
    If you do learn to shoot lower BG pre-shots, and even after stalling, the number is still a bit low, but you give a reduced dose of insulin, say around half the normal dose, you keep Kit more on track and she has some insulin to process the food that she eats.
    If you learn to shoot lower BG pre-shots, and feed the curve, you can level out the bouncing and the bounces will clear faster.

    You've got enough test data, you monitor, so you should be able to shoot pre-shots of 150 now, giving Kit the full dose. It will be scary. The numbers may drop into the greens. As long as you can "feed the curve" and know when to give Kit a bit of food, either her low carb Tiki Cat, some medium carb or when to pull out the big guns and start to give her syrup/honey and some high carb food, she'll be ok because you know what you need to do to keep her safe from a hypo.
     
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  31. JOJI and Kit

    JOJI and Kit Well-Known Member

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    ok

    yep:nailbiting:

    thank you.:bighug:

    ^jw
     
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  32. JOJI and Kit

    JOJI and Kit Well-Known Member

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    ok @Deb & Wink
    here we go
    PMPS 187 .... full dose ....
     
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  33. Deb & Wink

    Deb & Wink Well-Known Member

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    OK.

    p.s. Starting to run a slight fever. Could be the flu. Not sure how I'll feel in the next few days.
     
  34. JOJI and Kit

    JOJI and Kit Well-Known Member

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    oh baby, thinking good thoughts for you. :kiss::kiss::kiss::kiss:
     
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  35. Deb & Wink

    Deb & Wink Well-Known Member

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    Please post in Feline Health, if no response here in the Prozinc ISG.
     
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  36. JOJI and Kit

    JOJI and Kit Well-Known Member

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    thinking ahead to today's PM dose.
    kit was 92 at AM+5. after that, we fed a small amount
    92 is greater than 90 :)
    but alphatrak2 has a meter variance which is 15-20%.
    so, not sure how to interpret that 92 wrt dose reduction, or not.
    at AM+6 she is 107. after that, we fed a small amount.

    thoughts?
     
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  37. Deb & Wink

    Deb & Wink Well-Known Member

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    You could consider the 92 to be close enough to the 90 to do a dose reduction.
    Maybe only to a skinny dose. but you could try a 1.75U dose. I could go either way.

    Kit is bouncing, up to those reds at pre-shot, from the lower numbers the day before. Yuck!
     
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  38. JOJI and Kit

    JOJI and Kit Well-Known Member

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    hope you are feeling a little better today, deb

    cool. those were the options we were thinking.
    we did a skinny 2 last night bc lowest pre-shot we'd ever done.

    i not sure there's been a time was kit was *not* bouncing :(
     
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  39. Deb & Wink

    Deb & Wink Well-Known Member

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    Me neither!
     
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  40. JOJI and Kit

    JOJI and Kit Well-Known Member

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    weird day for BG's but we are above our 150 number with a
    166 PMPS
    s2U here we come.
    all ready for monitoring this evening.
    here we go ....
    ^jw
     
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  41. Deb & Wink

    Deb & Wink Well-Known Member

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    Good luck.
     
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  42. JOJI and Kit

    JOJI and Kit Well-Known Member

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    06apr2020
    99 PMPS
    stalling
     
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  43. Deb & Wink

    Deb & Wink Well-Known Member

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    OK, looks like Kit bounced really high yesterday, into the blacks and is clearing the bounce today, and aiming for a dose reduction.
     
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  44. JOJI and Kit

    JOJI and Kit Well-Known Member

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    110
    another stall
     
  45. JOJI and Kit

    JOJI and Kit Well-Known Member

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    so that 99 would qualify her for a dose reduction if we make it to 150 tonight?
     
  46. JOJI and Kit

    JOJI and Kit Well-Known Member

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    @Deb & Wink
    what do you think if her next (final) stall bg is something like 135 or greater but not 150. still no dose?
    or something like 50% at f1U ?
     
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  47. Deb & Wink

    Deb & Wink Well-Known Member

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    Not technically, but I think Kit is aiming for one.

    With those blacks yesterday (blacks = bouncing), I think she is clearing the bounce tonight. If you shot the full S2U dose, or even a reduction of 1.75U, I think you could be up for quite some time tonight, monitoring.

    Are you able to stay up and monitor, if she dives low tonight?

    Technically, you want the BG <90 for a reduction, but with an Alphatrak, and her not rising much so far, I'd go for a reduced dose tonight. Maybe 1U or a fat 1U or 1.25U. Something in that range.
     
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  48. Deb & Wink

    Deb & Wink Well-Known Member

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    I don't think you want to skip the dose entirely. Then she'll bounce even harder.
     
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  49. JOJI and Kit

    JOJI and Kit Well-Known Member

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    106
    so we'll do fat 1U
    unless you think 1.25U is the better move
     
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  50. Deb & Wink

    Deb & Wink Well-Known Member

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    Nope, number is not rising much at all, so stick with the lower dose of f 1U.
    With that low, you are going to have to stay up and monitor. Please get a +2 and then proceed from there.
     
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  51. JOJI and Kit

    JOJI and Kit Well-Known Member

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    ok. 1U

    yes, will do.

    so for the morning then 1.75U ? or ?
     
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  52. Deb & Wink

    Deb & Wink Well-Known Member

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    1.75U if Kit is high enough.
    If not, then do the stall again and a reduced dose if she is not rising much.

    I have to make a run to the store in the wee hours of the morning, to try and pick up a few "essentials" so won't be around.
     
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  53. JOJI and Kit

    JOJI and Kit Well-Known Member

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    so
    if in the morning 150 or higher,
    then 1.75U

    else

    if lower than 150 and we need to stall like tonight and she again remains flat along the stall values around the 90-100 range.
    1U

    correct?

    i hope it's for groceries or similar and this means you're feeling better :kiss:
     
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  54. Deb & Wink

    Deb & Wink Well-Known Member

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    Yes, what you said on the dosing.

    Yes, a few groceries and toilet paper if I can find it.
     
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  55. JOJI and Kit

    JOJI and Kit Well-Known Member

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    Let us know. We found ^^^^^^^ and would love to send you some if you can't find any.
    Thank you for your support!
     
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  56. Deb & Wink

    Deb & Wink Well-Known Member

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    Scored the toilet paper! I'm all set for a while, thanks.
     
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