change insulin and syringe size, Desprately need insight!

Hello all,
I was on here recently about Shadow my kitty that is steroid induced diabetic and recently back from the falls. We are having a hard time transitioning from u-100 PZI with .3cc needles to u-40 PZI with .5cc (U-40 needles). I can't figure out what is going on and his numbers are everywhere. Getting very frustrated. I have attached his spreadsheet and insight would be greatly appreciated. My poor kitty feels horrible.
My thoughts are:
Don't shoot under 220, everytime I do he rebounds (I think, or maybe I shoot too little?)
I have been feeding at +4 to give a cushion, but his onset constantly fluctuates.

Can't understand what is going on and I feel like I am doing him a huge disservice by hometesting and using a sliding scale, even if I am not I have alot of guilt surrounding the difficulty with regulation.
Thank you in advance,
Jeanice and Shadow

 

Hi Jeanice, welcome!

In general terms I would stick with a set dose unless you have determined that your cat does better on a sliding scale. If it is working for you, great, I think sliding scales are an excellent resource when they are working. For me, I have found the data a lot harder to interpret for my own cat when I have varied the dose. Sometimes I can hit it right, but usually when I try to use a sliding scale I just get royally confused. For most people, I think it's easier to start out with a set dose, and then if you can see that a scale is needed, you gradually adapt one that works.

I agree the #s are a bit confusing - those 2 nights you got an overly good response, but the rest of the time it looks like the dose is too low. Are you confident the doses are really what you are going for? I'm thinking you are eyeballing them in the U40 syringes, so something like .4 could easily be .5 or .3 really?

If I understood that right, I think you will be a lot happier if you try U100 syringes and the conversion chart that tells you how much of the U40 insulin to measure out in the U100 syringe to shoot the amount you want. That way you can easily dose the U40 insulin in increments of 0.2 (every 1/2 unit on a U100 syringe - you need the ones with 1/2 unit markings - is equivalent to 0.2u of U40 insulin). If you want a 0.1 you still have to eyeball it, but it's much easier than with the U40 syringes. Many of us using the U40 insulin do that, it just makes it a lot easier. For cats doing well on say 1u I don't think it's necessarily worth the trouble to switch, but your cat seems to respond a lot to tiny doses, so it seems like it's really warranted here.

There is information on all that in the sticky at the top of the forum - if you don't see it, or it doesn't make sense, just shout! Then if you do go that route, post what you are going to shoot before the 1st shot with the U100 syringes, so someone can confirm you've got it right. It's easy once you get the hang of it, but I recommend to everyone to post before the 1st shot just in case they have misunderstood something.

In the BG #s, I don't see any signs of rebound, I would probably keep 200 as your noshoot until you have a little more data to feel comfortable on PSs below that. You might want to feed LC closer to +3 to cushion the drop, looks like he may be an early dropper. I wouldn't worry too much about trying to pinpoint onset and stuff. If you just started on ProZinc, that can move around apparently for the first few weeks, as well as the nadir & duration, and all of those can be affected too by any overlap from the previous dose, or if the dose is too high or low.

No need to feel guilty about any of it - it's a process that just takes some time to figure out what works. I would definitely stick with hometesting, I think that is a good thing!!!

 

Thanks,
I went out and got the u-100 .3cc capacity again and feel more comfortable with that actually. I was beginning to think the .25 u wasn't working so I got a 245 PMPS and shot .4 u at it. (1 u in the u-100 with the conversion chart) we will see what the night brings. I will give food around +3 to cushion and test at +4. I have been considering all of these things just needed confirmation I guess. Thank you. Will be on later to post updated version of his spreadsheet. I think that a .4 u is a comfortable spot for him but time will tell.

Jeanice and Shadow

 

You got it!!! Hopefully the new syringes will make your life a lot easier, especially since you are already used to them anyway...