? AMPS 57/58

Little Bit is at 57/58 for AMPS! I checked twice to make sure the first wasn’t a fluke. I know he shouldn’t get insulin, but does he need other intervention??

 

Gave a small spoonful 15% carb + some regular low carb

 

Hi Olivia,

I've not used Prozinc but my understanding is that sometimes a dose can last longer than 12 hours, so even after skipping I'd suggest keeping a close eye on BG levels for the next few hours. If numbers are in the 50s or above, it should be OK to give LB low carb food to keep his numbers up. Has he had his brekkie yet?

Tagging @JanetNJ to ask her to pop over when she's online. As you know, Janet's an experienced Prozinc user and should be able to give you more specific advice.


Mogs
.

 

No ma’am, I did not let him eat his full breakfast yet. Should I go ahead and give it to him? He’s ravenous.

 

@Deb & Wink @Panic @JanetNJ

 

If you aren't planning on shooting this morning, then I'd definitely feed breakfast. The only reason not to would be if you were stalling in hopes of getting a higher (non-food-influenced) number to shoot. I'd maybe keep him from completely gorging himself on LC food, just in case he drops soon and you need him to eat a bit of higher-carb.

I'm not a Prozinc person, wish I could help more.

 

Thank you! That’s exactly what I needed to know—feeding him the rest of his breakfast now. Will check him again in two hours unless that’s too long to wait?

 

I'd check sooner than 2hrs, you don't know if he's on the way up or down.

I'm a little confused, on the spreadsheet there's no dose entered for last night. Does that mean he's now 24hrs after his last shot????

 

Sorry! I gave him 3.25 U last night. Will update now.

 

I will also add last night’s shot was given at ~+12.75, so a little late.

 

Aha.... Did you move this morning's "shot" time so it's 12hrs after that, or were you testing at +11.25? Just trying to figure out how the heck he pulled this morning's numbers out of the hat!

While not a prozinc person, I'm pretty sure that the next shot, LB has earned a reduction of 0.25?

 

Yes ma’am, this would’ve fallen within a one-hour range of his shot last night, so +11.25 is pretty accurate. He just NEVER goes this low! Especially this far out from his last dose. I agree, I think I will decrease his dose by .25 next time. On MPM, I believe it is supposed to be below 50, but I don’t think it would hurt to err on the side of caution.

 

Ah, yes, I see the MPM on your spreadsheet, sorry, I was thinking of the SLGS method. Looking at your spreadsheet, it looks like maybe you've had a change in your schedule that has decreased your testing frequency? If that's going to be the case going forward, I'd probably be pretty cautious on dosing, too-- the MPM, like TR, assumes more than just pre-shot testing, so it's hard to do it safely with that.

 

No, I am here with him most every day as I am working from home at the moment. His little ears get so bruised, I have not been testing as much since I’m here to keep an eye on him. I do everything to avoid the bruises, but for some reason, they keep occurring. I use a warm rice sock and 28 gauge lancets. His ear has gotten to where it bleeds better and I hold it with a cotton round when finished, but bruises are still forming.

 

You're applying pressure for several seconds after each poke? I've found that's the only way to stop bruising, although sometimes if you accidentally hit a vein there's really no way to keep it from happening. Poor LB.

 

Anyway, without some between-shots tests, I wouldn't follow the more aggressive methods like TR or MPM. Until you can go back to more frequent testing and be able to assess the nadir most days, you really can't adjust doses according to those methods, and it'd be safer to shift back to SLGS for a while.

 

129 now

 

Thank you. We will do that. I hope I’m not hitting the vein! poor baby is such a good sport. He has a vet appointment Thursday and I don’t want them to think I’m not taking care of him!

 

If his ears look sore you can put a thin layer of Neosporin Ointment with pain relief
on them. Just DON'T buy the Cream.

 

I do! It doesn’t seem to help much with the bruising, though. He hates it but I keep putting it on there lol.

 

Can you take a pic of the bruising and post it so we can see if we have any other tips? And I’m sure you are, but just double checking you’re aiming for the sweet spot right?

 

Yes, the Prozinc MPM method does use a BG of <50 mg/dL for a dose reduction. But you don't have to follow that exact BG number if you can't test as much. You could make that dose reduction point at 60 if you wanted to. Or even 70. Sometimes, it takes a while to get all the way down to <50 mg/dL to "earn" those dose reductions.

Remember, the guidelines are just that. Guidelines. So you can make adjustments that make more sense to you and your situation.

It usually takes more than a few seconds to stop the blood flowing. If you hit a vein, you'd know it, because the blood would well up much faster than if you only poked in the "sweet spot".

Try a bit of ice on the ear, after you poke. Just like preventing swelling and bruising on us humans, ice can help minimize bruising with our cats also.
Alternate ears.
Choose a slightly different spot on the ear for your pokes. You can poke the lancet just about anywhere outside that marginal ear vein. See the previous post, #21, for the diagram of the "sweet spot".
Remember to angle the lancet if freehanding. The lancet is beveled, so you want the bevel pointing up when you freehand.
Lancing device gets used flat against the ear, and also needs something firmer to poke against.
If using the lancing device, try adjusting the depth, so the lancet doesn't poke as deep.
Try smaller gauge lancets, 30 or 31 gauge if you are finding it easier to get blood from Little Bit now. You might not need the larger poking size of the 26-28 gauge lancets.
Change out your lancets at least once a day. They do get dull and hurt more.

 

Thank you, Deb. I will try ice! I change lancets for each poke. I’ve always lanced with the beveled (pointy? Hope I don’t have that backwards) edge down—just like when I give an injection. Is it opposite for lancing the ear?

 

I also think I will try to reduce by .25 and see what happens. I was thinking he needed an increase and then he gives me this curveball!

 

Yes, bevel side should be facing up, away from the ear. So the slimest part of the lancet enters the ear.

Little Bit may need that slight dose reduction. Try it for a while.

 

Well perhaps that’s what I’ve been doing incorrectly all along. Thank you for giving me that info! And we will decrease for his dose this evening and keep an eye on how that affects his numbers in the near future.

 

One other thought, if you are squeezing the ear, to get the blood drop to form that could be causing bruising. Plus, if you try to squeeze out the blood, you are likely to get lymph fluid mixed in, and that can lead to inaccurate BG readings. It's harder, but letting the blood drop form naturally works better. At least it works better when I poke myself.

 

Thank you! I do squeeze sometimes :/

 

289 PMPS not too bad considering he didn’t have an AM dose.