? AMPS 142 Do I shoot?

Discussion in 'Prozinc / PZI' started by LindsayF, Apr 26, 2019.

  1. LindsayF

    LindsayF Member

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    Apr 20, 2019
    my cat has been on prozinc for 2 doses.... her amps was 142.... I don’t want to give her insulin at 142 but not sure if I’m correct as I am new at this! Help please!
     
  2. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    Mar 15, 2019
    I would not since this is only her 3rd dose.

    It is hard to know though without information such as her dosage and a spreadsheet or other health issues she might have.

    Have you had a chance to read the stickies on Prozinc and on Hypoglycemia?
     
  3. LindsayF

    LindsayF Member

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    Apr 20, 2019
    I have! I’m overwhelmed with info.... I actually fed her a small amount at 3:30am as she was purring and swatting me in the face lol she’s on 1 unit I just started yesterday with insulin and unfortunately don’t have numbers from yesterday.
     
  4. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    Mar 15, 2019
    How many hours before the test was that that she finished eating then? A bit more than 2?

    So the number being that low with food only a few hours ago seems like more a reason to skip or do like .25 instead of the full dose...

    But again, hard to know this early...I don't want to be the one that advises you right into your first scary experience with low numbers lol ;)

    I'm pretty sure the prozinc guidelines are for brand new people to skip when the PS number is that low, but I'm not positive, that's why I was asking if you'd read them...
     
  5. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    I'm just trying to help you figure it out for yourself in case someone more experienced doesn't come along before you feel like you need to make the decision ...lol ;)
     
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  6. LindsayF

    LindsayF Member

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    Apr 20, 2019
    Thank you!!!!! I skipped it! But I am reading up on everything now.... I’m so thankful for this forum and for people like yourself willing to help!
     
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  7. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    Mar 15, 2019
    Np.

    When you get a chance, set up your signature and your spreadsheet, there is a sticky for that somewhere too I think...lol...

    At least do your signature with as much info as you can, and then someone can help you with the spreadsheet if you need help.

    It always helps to give advice when you can see whats going on in living color on the spreadsheet. :D

    Hang in there, it gets easier... kinda... lol jk it does!
     
  8. LindsayF

    LindsayF Member

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    Apr 20, 2019
    I thought I did my signature ‍♀️Haha I’ll figure it out! Looks like since I’m using an alphatrak i shouldn’t shoot under 225! Thanks again have a good day!
     
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  9. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Hi Lindsay, and welcome! While you can shoot under 225, and at some point will need to, you did the right thing to skip this morning. It's too early in the journey to be trying that!

    Here is a link to the spreadsheet and the directions for getting it set up: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

    Given how low the AMPS was on only your third cycle, I'm curious if that dose might be a little too high. As soon as you get any data you have into the spreadsheet, post again and have someone take a peek.

    And ask any questions you have! It is a ton of information all at once and we are all happy to help.
     
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  10. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    How's she doing?
     
  11. LindsayF

    LindsayF Member

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    Apr 20, 2019
    Hi all!! I’m still getting the spreadsheet in my signature but I attached a copy here... I was not able to shoot on Saturday as both me and my husband were gone from 3pm to 12am. Hoping that’s the last time for the foreseeable future! She was high obviously Sunday morning because of no insulin Saturday night. Last night at pmps she was 129 if I remember correctly! So I didn’t dose her again because we are still beginners here! Today she was 386!!! I feel like we are yoyoing from when she’s too low then she shoots up! I don’t know what to do about that?
     

    Attached Files:

  12. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Hi Lindsay and welcome to you and Zoe.

    First of all, it would be really helpful if you could get your signature set up so that some pertinent information is always available to anyone assisting you. Your signature should include your kitty's name, sex, age, date of diagnosis and any other health issues along with what type of insulin you are giving (ProZinc in your case) and the type of glucometer you are using to test Zoe (AT2 in your case). You can also include current diet.
    To set up your signature, hover your mouse over your user name in the upper right corner of the screen. A menu will drop down and you can select "Signature" from the left hand column. This opens up a text box where you can type in the information along with the share URL for Zoe's spreadsheet. When you are done typing, scroll down and click on "Save Changes". If you get stuck just holler.

    I can see that Zoe is definitely bouncing from high to lower BG which is normal in many cases and sometimes you just have to wait it out. In Zoe's case however, as Djamila mentioned, it may be that the dose of insulin is too high and given that you've now had to skip 2 shots it's certainly looking like that is likely the case.

    In order to determine if the dose of insulin is too high or if Zoe's just bouncing, you need to be sure to test before each shot and you need to find out how low the current dose of 1u is taking Zoe's BG. To do that you need to get some mid cycle BG tests during the time when most kitties have peak insulin action which with ProZinc is normally sometime between +4 and +7 post shot during each cycle. Many if not most kitties tend to go lower at night. Obviously we all need our sleep but making it a habit to get a BG test before bed every night will give you an indication of where Zoe is heading and help fill in the picture of how the dose is working for her. If you are working during the week, grabbing a test before leaving for work if time allows or when you arrive home helps. All data helps fill in the pieces to the puzzle and that helps you figure out whether more or less insulin is needed.

    In the meantime, I'd suggest you drop the dose down to 0.75u until you can get some mid cycle tests to determine how low the dose is taking Zoe's BG.
     
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  13. LindsayF

    LindsayF Member

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    Apr 20, 2019
    Thank you!!!! I think I got the signature down just don’t know how to insert the spreadsheet?!
     
  14. LindsayF

    LindsayF Member

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    Apr 20, 2019
    She just tested at 251...
     
  15. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    Mar 15, 2019
    Are you deciding whether or not to shoot at all? Or pondering what dosage?

    There's a lot of room between 0units and 1unit...

    Personally I'd try .25 this time...
     
  16. LindsayF

    LindsayF Member

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    Apr 20, 2019
    I only have u-40 syringes is it okay to eyeball since it’s lower?
     
  17. Rachel

    Rachel Well-Known Member

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    Is it shot time right now?
     
  18. LindsayF

    LindsayF Member

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    Apr 20, 2019
    Yes
     
  19. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    Mar 15, 2019

    Oh yeah, thats what I have and .25 is a pain in the butt lol but yeah just come as close as you can...

    You can do a "fat .25" should be fine because it's still much lower than her regular dose...

    I imagine a lot of people would go with .5 and feel confident it would be fine too, just don't want to push you to give more than you're comfortable with since this is still new/early.
     
  20. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    Are you doing tests during the cycle and just haven't added them to ss yet?

    Cause you really gotta try to get some tests in to know whats going on...
     
  21. LindsayF

    LindsayF Member

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    Apr 20, 2019
    I haven’t but I plan to do that tonight
     
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  22. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Yes, it's fine to eyeball the dose. We all have to do that sometimes. 0.25 is tough to eyeball if you don't have half unit marks, though, I know. Basically you just do the best you can.

    If you can get a test in this cycle, it would be really helpful. Even if you just a test before going to bed (like +2 or +3). Any data is good data at this point and can help us to understand what's going on during the cycle!
     
  23. LindsayF

    LindsayF Member

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    Apr 20, 2019
    Thank you guys so much!!!! I will keep you posted!!!!
     
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  24. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    Mar 15, 2019
    Just note on the SS whatever your best estimation of the dose is... if it *looks* like it's right on the .25 put that, if it's a bit more, put "fat" or "f" and if it feels like a bit less mark it as "skinny" or "s".
     
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  25. LindsayF

    LindsayF Member

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    Apr 20, 2019
    336 at +7? Is it normal to be high mid cycle?
     
  26. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    Mar 15, 2019
    None of this is normal ;)

    But really there is no normal, and no way to know what's normal for Zoe til you get more tests from more cycles and start to see her patterns.

    Shes not that far off pace for hitting previous AMPS's she's had and she did get a lower dose so that number isn't too surprising.

    My guy is changing up his patterns right now and confusing me lol so yeah you gotta give it at least a few cycles with a bunch of testing at various times to start to see her patterns before you'll start to notice what's normal for her.

    Hang in there.
     
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  27. LindsayF

    LindsayF Member

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  28. Djamila

    Djamila Well-Known Member

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    Hi Lindsay-

    First of all, great job getting your signature and spreadsheet set up! And getting that mid-cycle test last night.

    As for your question...there isn't really a normal since every cat is different, but we can say that it isn't exactly good either. Ideally you want PS numbers to be below 220, and the mid-cycle numbers in the dark greens. So that tells you that Zoe didn't get enough insulin last night. Some cats can get into those good numbers pretty quickly, others can take months and months. It depends on their diet, the match between the insulin and the cat (different insulin types work better for different cats), dose, how healthy the pancreas is, and probably lots of other physiological factors. But diet and insulin we can control.

    So let's start with diet. What is Zoe eating for food and for treats? Are there any other pets in the house, and do they eat the same food?
     
  29. LindsayF

    LindsayF Member

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    Apr 20, 2019
    3 other cats! All are now on FF classic pate’s! For treats I’ve been baking them plain chicken and giving them pieces of that!
     
  30. Djamila

    Djamila Well-Known Member

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    Sounds like you've got the diet under control. Great job! That can often be the hardest hurdle. So next is testing. Are you around during the day? Or do you work all day?
     
  31. LindsayF

    LindsayF Member

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    Apr 20, 2019
    I work all day.... I’m only around all day on the weekends :(
     
  32. Djamila

    Djamila Well-Known Member

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    Obviously the more data we have, the better we can help with dosing. However, many of us work full time jobs and understand how hard it can be to get the mid-cycle tests. If you're gone all day, I can share a couple of ways we do that and you can see if any of them might work with your schedule. One is getting an out-the-door test - so you would test/feed/shoot as soon as you wake up in the morning, and then get a test right as you are leaving the house. That works if you can get about two hours in between those. The other end of that is getting an in-the-door test as soon as you get home. So if it's easier to test/feed/shoot right as you leave in the morning, or if you're one of those people that wakes up and is out the door 20 minutes later, then you might shoot right as you leave, and then if you can get home by +10, you can grab a test right as you come in the door, and before the big BG spike that sometimes happens at the end of the cycle. Other test times are right before bed, or right when you wake up - again depending on when you can get furthest into the cycle. The tests between +4 and +7 are usually the most helpful since for most cats, that's when they reach their lowest point. There are cats that fall outside of that (mine hits nadir around +3 in the PM cycle), but for the majority of cats, they nadir somewhere in the middle. But the +2 or +10 tests can still give us hints of what direction Zoe is going.

    And of course if you're ever lucky enough to work from home or work close to home, anytime you can come home at lunch to grab a quick test can be super helpful. There are folks here who are gone the full 12 hours, and they just really commit to testing in the evenings and on the weekends. And there's no need to feel badly about that. You have to work, and there are ways to manage all of this around your work schedule. :bighug:

    It can be hard at first to balance managing feline diabetes and figuring out to take care of yourself and still maintain a life outside the house. It is possible though. If none of those ideas work for your schedule, and you can share a little about how your day goes, we can help you think of some ways to make it work.
     
  33. LindsayF

    LindsayF Member

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    Apr 20, 2019
    Thank you so much!! It’s been an adjustment for sure but I’ll do anything for my little lady!
     
  34. LindsayF

    LindsayF Member

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    Apr 20, 2019
    zoe’s numbers are higher everyday! Tried getting a test last night at +4 and she was not having it :(
     
  35. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    She's probably bouncing. I don't remember what were her numbers at diagnosis?

    Did they give .5 units a chance? Or did they tell you to start at 1unit?
     
  36. LindsayF

    LindsayF Member

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    Apr 20, 2019
    416 at diagnosis. Start at 1 unit.
     
  37. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    Mar 15, 2019
    Was that just one test in the vets office or a curve?

    And did you change the diet at all after that?

    If you can't get more tests during the cycles , personally I'd be thinking bounces are likely and try to lower it to .75 or .5.

    Try to stay calm during the testing process, treat it matter of fact like the vets and vet techs do, my guys always let them do whatever they want lol and I always wondered why... and I realized it's because they just do it, matter of factly , calmly and confidently , cause they sense our anxiety and get anxious too.
     
  38. LindsayF

    LindsayF Member

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    Apr 20, 2019
    Just at the vets! Plus she had uti! Yes changed her diet completely
     
  39. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    Mar 15, 2019
    Ohhhh wow..


    UTI will raise numbers... and diet change will help lower them too...

    I see dx was 4/17, so assuming the UTI is cleared up now?

    If it were me...I would definitely lower to at least .75...and if you really cant get tests during the cycle, maybe even .5...


    If you can give the insulin when you first wake up and then get a test before you leave for work, that can help... and/or get a test as soon as you get home, before you go to bed...etc.
     
  40. LindsayF

    LindsayF Member

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    Apr 20, 2019
    Planning on testing before bed! Yes dx was 4/17.... I assume the uti is cleared up they have her a shot for it.
     
  41. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    I would not recommend lowering the dose given the consistency of your PS numbers. We do need more mid-cycle data to see the impact of the insulin, but the possibility of an infection, plus insufficient insulin, could be setting her up to develop ketones which are quite dangerous. If she were bouncing we would usually see more inconsistency in the PS numbers, but they're pretty steady on the three cycles when you held the dose at 1u.

    A couple of things that might help with getting tests:
    1. Make sure her ear is nice and warm first - this helps the blood flow more easily so you can get a test quicker. One trick is to take a little fabric square, or a baby sock, or part of an old t-shirt -- anything you can pull together to make a little pouch/bag. Fill it with uncooked rice or other hard uncooked grain. Then you microwave it until it's warm to the touch and hold that to her ear, and rub her head -- most cats love the warmth and the head rubs. Then when her ear is warmed you can do the test.
    2. Use a larger lancet - usually a 26 or 28 gauge works best at first. The larger needle size helps get a better drop of blood.
    3. Spread a very thin layer of neosporin or vaseline on her ear - this helps the blood bead up and makes it easier to suck into the test strip.
    4. Always give a treat after a tests - whether it worked or not. That reinforces this as a positive experience. Only give the treat in the testing place though - if she runs away she needs to come back to the testing place for the treat to build that positive association.
    5. For more suggestions on training a kitty to accept testing, you can click on the link that says "profile" in my signature (next to the food list) - it will walk you through the process i used to train my very test-resistant kitty. It can be hard at first, but it's absolutely necessary to keep her safe.
     
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  42. LindsayF

    LindsayF Member

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    Apr 20, 2019
    I’m testing every few hours today I did +4 and +6 and she’s never been out of the 200’s.... she was above 400 at AMPS. My poor girl!
     

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