BG and Dosage Help

Good morning,

We switched our cat Simon to 1.5 units up from 1 unit about 2 1/2 weeks ago. We did a day of testing this past weekend and are wondering what the next steps would be. He currently eats 4 meals a day, switching between Friskies and Fancy Feast pate and munches on a little bit of young again zero. He got down to 40 on our ReliOn meter when he was on 2 units, which is why we lowered. Here are his numbers from our testing day.

Morning pre shot - 206
+2 - 372
+4 - 162
+6 - 146
+8 - 241
+10 - 385
Evening pre shot - 398

We are struggling getting him regulated. He seems to be starving all the time. Any help would be appreciated.

As a side note, we are also going out of town for several days at the end of the month. We have someone who can come give shots, but they can't stay with him. The vet suggested not giving shots while we are gone.

Thank you!

 

Hi and welcome Jeanette and Simon
Firstly I want to say, I disagree with the vet in stopping the insulin while you are away. You run the risk of Simon developing ketones which can be progress into DKA which is very dangerous. Please don’t stop the insulin.
We can help you decide on a dose which is safe for the pet sitter to give. If you don’t have an autofeeder, I would look at buying one. Your pet sitter could fill it twice a day with the snacks for that cycle which will help keep the BG from dropping.

I have just looked back at your previous post and it looks like you are using Prozinc, is that correct?

We can help you get Simon regulated but we need you to set up a spreadsheet so you can enter the data so we can see how the insulin is affecting his BGs. The link to the SS is in this link, along with how to set up your signature and information about a hypo kit, in case you don’t have one.....very important to have one up and ready because when/if he drops low, you don’t want to have to race around looking for things. Click on this link https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

If you have any trouble setting up the SS, let me know and I will ask @Bandit's Mom to help you.

Until Simon is regulated he will be hungry. This is because the body can’t absorb all the nutrients in the food at the moment. Feeding him during the cycle as well as before the shots will help with the constant hunger.

Here is a link to using Prozinc. Click on this link https://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/

I am not a Prozinc user so I will tag @Deb & Wink
Bron

 

Thank you so much for all this information. It is hard to test Simon by myself, but my husband and I want to start testing more regularly. We did buy the Alphatrak monitor since we have noticed Simon does a lot better and is less stressed out with less blood needing to be drawn. So I will set this up and we will test more.

I disagreed with the vet too about that. He was in the 300s and 400s when we had him on just one unit a few weeks ago, so that seems like a pretty bad idea.

I will read into all these resources with my husband. We will just stay where we are at and then maybe after the weekend, we will post all the numbers we've gathered for more help.

Thank you guys all so much! This is pretty stressful trying to figure all this out!

 

Lot's of resources here to help you out with the testing. If you look in the
Health Links / FAQs about Feline Diabetes forum, There is an index sticky post at the top. Look in there and you will find the link for hometesting tips.

 

Hi Everyone,

I set up the spreadsheet and added it to my signature. I followed the instructions, so I hope everything is correct. I put in the last two curves we have done at home on 1 unit and 1.5 units. We will test over the weekend and add that information to the spreadsheet so you guys can see where we are.

I think I missed some of your questions/comments from before (my toddler is quite a big distraction!). Simon is on ProZinc. We purchased an AlphaTrak meter recently, so these numbers are all based on that, not the human meter. Simon gets less stressed out with the pet meter. We actually recently purchased the automatic feeders to avoid having to get up in the middle of the night to give Simon wet food. So thankfully, both of our cats are already used to the new feeders. I do have a side question...is it ok to leave dry food out? We have young again zero for them currently.

My vet also mentioned that below 10% carbs is great, but lots of vets recommend having only below 2% carbs in the food. Should we be that aggressive?

Thank you so much for all your help!

 

The Young Again Zero should be ok carb-wise.

I personally don't think you need to be so aggressive as to go to 2% food. Actually, the numbers from the curve are pretty good! Id stick with what you're doing, and adjust the dose and not change food. Still need more data before adjusting the dose though.

There is still some info missing from your signature...I believe the post Bron linked above should explain (and see some of ours as examples).

I know you're still getting used to home testing, but wanted to clarify the tests that are beneficial to have:
- AMPS and PMPS, every day. This is critical to knowing if it's safe to shoot.
- Ideally a +2/3-ish for each cycle every day, this helps you know how fast the numbers might be dropping as the insulin kicks in and whether you might need to watch for a potential hypo. Most of us do a "before bed" test about 2 hrs after the PM shot
- +5 to +7 tests when you can, this tells you how low a dose is taking the BG, and this is how we adjust the dose

Right now your current dose looks pretty good. I'd say once you have a few days' worth of consistent testing check back in, we'll probably send you to the ProZinc forum to get situated.

But of course if you have any questions or trouble along the way, let us know!

 

We also like to see a row for every day of the week. Even if you don't have test data, you likely did give Simon his insulin dose. So you should record that on the SS,

I agree with FrostD that the SS BG numbers are looking good for so early on in your diabetes journey.

 

• Hi Jeanette ,this is what you need for your signature
• when you get a chance ,It would be helpful if you can set up your signature so we don't have to ask you the same questions over again. Members will look at this first . Members would have to look up your previous posts to see what insulin you are using
• It appears after each post in gray, look at mine,

• On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
• • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
  • Add any other text, such as
  • Caregiver & kitty's name (optional)
  • DX: Date
  • Name of Insulin
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


tap on your avatar where it says your name ,then hit profile page ,tap on that ,then go up to the very top, upper right hand side and tap on your name ,it will bring down a drop box, tap on signature, the signature will be under settings, tap on the signature then and you can start to add what I posted above, make sure you hit save ,
Welcome to the best place you could ever be and an awesome group of people
You can also add where you live in your profile, not your signature

This is at the bottom of every ones post in gray

 

Oh I see now how your signatures are! Sorry about that. I think I have everything now. He hasn't really had any other health issues other than diabetes. I would like to mention that we have been told in the past to do a teeth cleaning, but we've always been scared to do it since they put them under anesthesia for it.

We will start testing more now that we have the AlphaTrak meter. Before when we were using the human meter, Simon would get so stressed out when we would warm his ear that it would take all my strength to hold him down while my husband did the test, even when we offered lots of pets or freeze dried treats. Now he doesn't seem to mind much when we grab him to test. So I will try and get used to doing it by myself hopefully soon (when my toddler allows!).

You guys have definitely made me feel better about the numbers. When the vet told us to go from 1 unit straight to 1 units and then Simon had hypo symptoms and was at 40, we knew we needed to start testing more and get on here. So thankful for your help!

 

Welcome Jeanette
When you have time, can you also add to the spreadsheet any other test data you have including when he got to 40, and add the hypo symptoms he had at that time in the Remarks section and what you did to help him that day.
Thanks.

 

Hi and thank you!

I just added the additional information I have recorded. I added the day we did our first curve at the vet (only have starting number) and the days we home tested and thought he was hypo. We did skip a dose the day prior to hypo because his numbers were low and we read that was an option. The days we home tested were on our human monitor, which I put in the comments and what we did. I added additional information like you mentioned above. I know we were able to test here and there in between these days, but I do not have that information accurately recorded anywhere. He has been so difficult to test up until the last week or so.

Please let me know if I need to add anything else! Thank you!

 

Great job with doing your signature.
About the teeth cleaning, if your vet said that Simon's teeth really need a teeth cleaning. It is advised to do it. Bad teeth can cause higher BG and infection.
Can also knock a cat out if remission.

I am going to have Tyler's teeth cleaned in the next 3 weeks, he is 12 and I can see he definitely needs one. Of course I will be nervous but I trust my vet. He has never had one

 

Our previous vet suggested it. Since we just moved here recently, we haven't had an actual physical here other than the emergency visit when he got diagnosed. Simon's gums are pretty red. It's something we were considering next month after we get back from our trip. I hope that it would maybe help him, and I really don't want anything bothering him. I hope everything goes well with your fur baby's teeth cleaning!

 

Same to you Jeanette , wishing you and Simon all the best

 

Hi Everyone,

So we've been testing and his numbers have been very up and down. We are a little confused about what is going on. It may just be him trying to figure out his regulation. I am just wondering if maybe it is food related and we are missing something. I have been mixing in some of the Fancy Feast flaked and chunky options (no gravy) to mix it up a little for them, which according to the chart are still low carb like the pates. Would that be causing him to do what just happened where he was at 188 three hours ago, ate lunch (FF flaked tuna) and is now in the 500s? I'm just wanting to make sure it's not something I'm doing.

Also, does the insulin lose its potency after a few months? We still have a bit left, but it is the same bottle we started with in Nov. We ordered a new one hopefully coming this week. We are thinking maybe the insulin isn't working as well since it's been so long.

Thanks so much!

 

Hi Jeanette
Simon is doing what we call bouncing. That happens when the BG drops too low, drops too fast, or drops lower than he has been used to. His body thinks it has to save himself and he dumps stored glucose and regulatory hormones into his body which causes the BG to skyrocket. This is normal and happens a lot in newly diagnosed FD cats. Once a bounce happens there is nothing you can do about it but wait it out. Bounces can last from 1 to 6 cycles. Just be on the lookout for when the BG starts to drop. It can wobble around a bit and go up and down in the higher numbers before it comes down. Sometimes when a cat is coming off the bounce he can come down quite quickly and into low numbers so just be on the look out for that. If you see that happening, you can steer the drop with some food.
Simon is bouncing from the blue numbers at the moment ......his body thinks the high numbers are the normal numbers and he has to get used to the lower numbers. The more he can experience lower numbers the more his body will get used to them.

The food you are feeding sounds OK. Cats often do a bit better when they have a few more carbs than zero or 2 %carbs. A lot feed around 5 or 6% carbs. Feeding regular snacks during the cycle as well as feeding the main meals before you give the insulin is important. Just don’t feed for the 2 hours before preshot as we don’t want the preshot to be food influenced.

Looks like you are doing all the right things. It takes time for the cat to settle down with insulin. It’s a hormone not a medicine. We humans just need to buy patience pants I went through a few pairs!

Do you have a hypo kit with high carb food and honey and spare test strips in case of low numbers? Really important you do have this set up.
Bron

 

Thank you so much for that information! You have made me feel so much better. I saw those numbers the past two days of tests and just felt so terrible for him. He seems to be acting relatively normal though despite being high. We do have everything for the possibility of him going hypo. We saved several cans of his favorite Friskies shreds and filets wet food from before he was diagnosed. He has always been one to be right there ready to eat when the food comes out, and we did not have a problem with him eating the last time he read 40 on our human meter. We do have plenty of test strips and honey and syrup just in case.

I will keep feeding him what we have been giving him. I think they do like the variety, especially my other non diabetic cat who misses all the tasty high carb food.

Thank you all so much for all your help! I just love my little guy so much and want him to be ok. You all are so awesome!

 

Are you testing the urine for ketones? It is always a good idea to do it when the cat is unregulated. You need to buy a bottle of Ketostix from a pharmacy and get a urine sample and then dip the test strip into the urine and read it exactly 15 seconds later against the colours on the side of the bottle. Anything above a trace need vet attention. The colour will go darker with time, That is why 15 seconds is important.
Put the result into the remarks column in the SS please. so we can see it. I would test every few days while he is unregulated and daily if he is unwell, not eating or lethargic.

My Sheba was a bouncer and it used to stress me out until I learnt what was causing it. By feeding snacks during the first half of the cycle, you can help stop fast and big drops from happening. if you can routinely get a +2 and +3 for a while, you will be able to see when the onset of insulin occurs and when Simon starts to drop. When you figure that out, you can give him a snack before the drop to help stop him dropping too quickly. That is called feeding the drop and that can sometimes help stop bouncing. You might find he drops a bit later than +3 so it is trial and error. Just keep testing at different times to gather data and post and ask for advice and opinions

 

When he is in higher numbers also make sure he is getting enough fluids to remain hydrated. Adding some warm water to the food to make it a bit soupy is a good idea if he will tolerate it.

Also if he drops down to 40, (human meter) you need to be giving him some syrup to bring the BG up higher over 50, follow it with some food.
The take action number for the alphatrak meter is 68 so if he drops below that you need to take action to bring him up higher.

 

We will definitely look into testing for ketones. We are not currently doing that.

We did use syrup and then feed the last time it happened, but it is good to know that we did things in the right order to help him. I have also been mixing a little water in his food because they had a little trouble eating it, but I may add a little more now that you mentioned that.

I am going to be diligent about learning to test on my own with him so that I can catch his low numbers that may come up soon. We keep the youbg again zero dry food around so I can put that out. And I also didn't know that 68 was the take action alphatrak number so thank you for that!

We are going to test throughout the evening tonight to see how he is doing. Hopefully I can get the hang of it to test by myself tomorrow. Simon seems pretty tolerant since we have switched to the alphatrak.

Thanks so much!!

 

Good morning everyone,

Wanted to give you a bit of an update. As you can see from our spreadsheet, Simon has been all over the place. I'm sure that is because of what you guys mentioned earlier. We also had a feeling that our insulin wasn't working as well, so we got a new bottle. I think that made a big difference. He was getting so high for a while there that we started giving him 2 units instead of 1.5. Then he got pretty low a couple times on 2 units with the new bottle (one time hypo numbers). The past day and a half he has been low. We did not give him any insulin last night and he remained at decent numbers through this morning. I cut the dose down to 1 unit and just tested him at +2. I'm very nervous about what to give him when we are gone next Tuesday-Saturday. We do have someone coming who can give insulin. Do you guys have any thoughts or suggestions? I know it may benefit from seeing where he is over the next few days also.

Thanks so much!!

 

Hi Jeannette,

Sorry you've not had a reply yet. This should bump your thread up the list.

I'm sorry that I can't help with the Prozinc side of things as I've not used that insulin, other than to say that the 2.0IU dose is likely too high (see the 66 nadir on PM cycle of 16 Feb).

I'm tagging @Deb & Wink to ask her to give you some feedback on your spreadsheet data and hopefully she should be able to give you a few pointers about strategy for the days you're away next week.

Question: Will the person you've got lined up to give insulin be home testing Simon's BG levels (including some mid-cycle checks) or will they just be giving the insulin? (Members replying to your thread will need to know this in order to make sound suggestions on how to manage dosing for that period.)


Mogs
.

 

Hi there!

No problem at all. We've been having a bit of a hard time and just going with what we think has been best right now. I do agree with you that 2 units seems too high. We were giving him that to try and get those really high numbers down.

The person that is coming is just coming twice a day for feeding and giving insulin. She will not be testing. My first thought is to have him on 1 unit twice a day while we are away, which will five days. I'm definitely wondering what we should do. Any help would be great. As I mentioned back a bit in this thread, the vet suggested giving him nothing. I think that would not be wise to do looking at his numbers the past few weeks.

Thank you!

 

Reduce the dose, since your substitute caregiver can not test. We call this a "vacation dose."
Even cutting the dose in half may be wise. So you might want to cut the dose to 0.5U while you are away.

Since you started the new bottle of Prozinc, 2U was and is too high. 1.5U was and is too high. Even the 1U dose may be too high.

He's bouncing.
I'd recommend keeping the dose at no more than 1U for now, and testing as much as you can between now and when you leave.

Please make notes on the SS, in the Remarks column, of what you feed Simon and when.
Try to do a curve, testing every 2 hours from pre-shot to pre-shot if you can.

I think he is dropping low somewhere, and you aren't catching it with a test.

 

@Deb & Wink - Thank you, Deb.


Mogs
.

 

Thanks so much Deb! I really appreciate this. We have just been so confused and worried about some of the high and low numbers we've seen. We were worried about the old bottle and are trying to be careful with the new one. We did give him 1.5 units tonight at 7pm, so we test tonight at +3 and +5 to make sure he isn't too low and will reduce to 1 unit tomorrow morning.

We will run a curve this weekend (most likely on Sunday) so we can see where he is on 1 unit. I will make notes on what he is eating now. He has pretty much turned up his nose to Friskies pate and only wants Fancy Feast pate now.

I will get on this thread and let you guys know when we do the curve. We are leaving on Tuesday.

Thank you so much for all your help!

 

Good evening everyone,

We did a curve today, and I've updated Simon's spreadsheet. I do agree with you that I think he is bouncing. We will continue on 1 unit and do .5 units while we are away. I have noticed the past two days that Simon has been acting a bit more like his old self pre diagnosis, and it makes me feel so much better to see that. We are home one more full day if you think we need to test at a certain time tomorrow or just do the standard pre shots and +2-3 and +5-7. Do you have any other suggestions before we leave?

Thank you so much for everything! You guys are all the best!

 

Oh my! Simon is all over the place with his BG readings. I can't really see any reason why either.

I still think it is going to be safer to reduce the dose while you are away, since your pet sitter can't test.
Just do the standard testing tomorrow.
Looks like Simon is eating the Friskies again I see from your SS notes.
That's good, since so many people are reporting they can't find the FF in their local stores or online.

Leave a signed authorization letter, and your vet contact information with your cat sitter. In case they need to take your cat to the vet. Alert your vet also, and email a copy of the letter to your vet clinic.

Make a note on the SS in the remarks column that you are not there, and someone else is giving the shots.

 

Thanks so much! We have been confused also! We definitely know that 2 units is too high. I'm just hoping things start to get regulated a little soon. We will just continue to test after we get back. He is eating certain friskies now, which is great! I started paying attention more to which ones he was not liking and figured out which ones he still likes. He still loves fancy feast the most though!

We plan on doing a teeth cleaning when we get back that we've been putting off, so maybe that will help.

Thank you for suggesting the authorization letter! We will definitely do that just in case.

Thank you again so much for everything. In the future when we have questions, where would be the best place for us to post?

Thanks!

 

Either here in the Feline Health forum, or over in the Prozinc ISG forum. The ISG for prozinc can be pretty quiet. So if you have an immediate need, and aren't getting a reply, post here in Feline Health. There are more people here usually to help out. Over in the Prozinc, there are only a couple of people, and we can't be signed on to the message board all the time.

Putting the ? prefix on you post also alerts people that you have a question.

Enjoy your time away!

 

Hi Deb,

We are back from our trip, and I was hoping to maybe get some additional help from you. If you think I should post this on the Feline Health forum, I can as well. We went out of town and had the pet sitter give Simon .5 units twice a day while we were gone. She had a family emergency the morning we were coming home (2/27) and missed the shot. Simon was at 298 at +8 hrs that day. I remembered you saying that 1 unit may be too high with the new bottle, so we kept him at .5 for the last few days to see where we are. The first full day back he got down to 160 overnight. The last two days though he has stayed basically in the 300s. I'm not sure what to do now. Should we keep at the .5 and run a curve this weekend after he's been on it for a good amount of time, or should we increase the dose? I also have noticed a trend overall that he drops lower overnight than he does during the day. The only differences are that we give the cats Young Again in the morning as a treat and that my super active toddler is running around during the day. Simon has been acting more normal than he has been the last couple months. He is cleaning himself more now, cuddling and playing wiht our other cat, wants to be around all of us more, and does not seem to be starving all the time. So the lower dose must definitely be helping, I'm just not sure where we need to be.

Any thoughts or suggestions would be greatly appreciated!

Thank you!

 

I think it's time to increase the dose for Simon. How about trying 0.75U for now?

An increase is needed, because Simon's nadirs are still running too high.

A curve this coming weekend would be good.

 

Thanks Deb! We will increase his dose. Would running a curve this weekend be long enough for the dose to kick in or should we wait a bit?

 

Let's see. It's Wednesday, you raised the dose with the PM shot on 3/3/21.
That should be plenty of time to see the increased dose having it's effect.

You might even see results sooner than that.

 

Hi Deb,

I feel like I keep bothering you so much about this. We have been giving Simon .75 for the last several days. His numbers have slowly climbed up since then. We decided not to not do a curve because his numbers were so much higher than they have been. We reached 500 tonight pre shot, which he hasn't been at in weeks. I'm not sure if we have run into a bouncing situation. His numbers were never really too low over the past couple weeks, so I'm not sure if that's what we are looking at here. I'm at a loss with what to do now. I don't know if there is something else we are missing. He was acting back to his normal self when he was on .5 units, but now has become more lethargic since we've gone up. Do you have any thoughts?

Thank you!!

 

Taking a look at Simon's SS, I'm not seeing any where that indicates he is going really low.

I think it's time to increase the dose. Back to 1U would be my recommendation.

 

Thank you! Do you have any idea why his numbers would go up after we increased his dose from .5 to .75?

 

That is really hard to say. But your cat needs as much insulin as he needs. That amount can vary over time.

Is the Young Again Zero carb food still being fed to Simon? There have been reports from some people, with that particular food raising the BG levels.

 

Yes, I need to add that back to the SS. We do feed him that as a snack. He did not have it while we were out of town, and his number at +8 after missing a vacation shot (.5 units) was lower than we had seen in a while. So maybe that is throwing his numbers off. Unfortunately, my other cat loves it! We will have to figure out a way to sneak it in for him. We can try taking it out for Simon though. I know we would be switching two things at the same time, but we can always lower the insulin later if his numbers get low.

Thank you so much again!