Coco 12/19 no AMPS, 90 @ +2 - quick nadir?

Discussion in 'Prozinc / PZI' started by CocoDB, Dec 19, 2022.

  1. CocoDB

    CocoDB New Member

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    Nov 24, 2022
    Hello all,

    I am halfway through my second ever BG curve. Our (mine and Coco's) first one was on Thursday. She was not very happy about it at all and consistently had readings above 300. So I spoke to vet and upped dose by 0.5 int units and said I would do another curve today.

    Today Coco has been very compliant because she has worked out she gets a freeze-dried chicken treat after. At Coco's first reading at +2 hours (she was sleeping) I got a reading of 90! Never seen one so low, although I realise that this isn't panic alarm time yet. +4 the reading was 126 and at +6 we're at 162.

    This is all very new to me, and I realise that ECID, but is this very soon to be having a blood glucose nadir of the curve? I have tried to read stuff online and on the website but finding it very overwhelming!

    I'm currently unable to do pre-shot readings because she gets very agitated at food time, but actually as today has been going so well maybe I will try later.
     
    Suzanne & Darcy likes this.
  2. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Just real fast and I have to go but we will come back later for more. Please be sure to get a preshot test BEFORE giving insulin every time. Those are the AMPS and PMPS columns on the spreadsheet. You need to know if BG is even at a level where it is safe to give insulin. Good job getting those tests!
    Oh, and I would definitely caution you about doing increases in half unit increments. Some cats are very sensitive to changes. On this ProZinc forum (yesterday) we just had a cat drop from a preshot BG of 200 to 55 with just an increase of .25 units. Every cat is different, but it’s necessary to be cautious with increases. You are testing though so you are in control and will be able to intervene with high carb food and karo syrup( if necessary). if BG drops too low. Hopefully you have your hypo kit set up with these items.
     
  3. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Okay… I see your note about preshot tests, but they are super important. Just give lots of treats at test time (perhaps you already are.)
     
  4. CocoDB

    CocoDB New Member

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    Nov 24, 2022
    Thanks so much for your reply. We're still very new to testing and I can't get Coco to sit still before meal times for anything, let alone blood tests! But I think now that we've done tests a few times (with treats) we might be in a better place for a preshot test later. She seems in very good spirits today, but I realise it's not a great sign to dip low so early.
     
  5. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Some cats do dip by +2. I’ve seen it quite a bit here recently. The problem is that we don’t know wjere she started at preshot time. So we don’t know if it was a dramatic dip or not. The good news is that it’s a safe number and that you are testing and so can keep her safe. I wonder if you give her a couple of treats right before the test, test quickly and give a few more — if that would work? With some cats it won’t work because it’s like they get even more frantic because they want more of the treats and are looking for them…. So they won’t hold still anyway! Hopefully she will get used to the routine and will know that if she just sits still for a bit that she gets treats.
     
  6. CocoDB

    CocoDB New Member

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    Nov 24, 2022
    Have had a horrible evening. As we got closer to feed time Coco got more agitated.

    +10 had to be done a three times as I was getting error messages, the eventual reading was 364.

    I coaxed her over for a PMPS shot with a piece of freeze dried chicken. She was very wriggly and I ended up lanceting her ear in the wrong place! There was blood everywhere and she shakes her head anyway whenever i touch her ear. I couldn't stem the bleeding and I thought she was going to bleed out. I was so scared. I eventually managed to - one arm holding her (and her ear) - get some gauze and stop the bleeding after almost 10 minutes. She was wailing the whole time.

    Not that it matters but the reading was 479 (hardly any surprise)

    One minute later she had completely calmed down and was begging for her food. She ate and had her shot about 90 minutes ago, now she's fast asleep.

    I however am feeling wrecked! I have just completely lost my confidence. I don't want to go through that ever again, but I know I have to monitor regularly. Every YouTube video I have watched has a cat calmly accepting a lancet. Coco will squeal, shake her ear or try and use her paw to get me off her.

    Sorry for the rant but I feel so disheartened after tonight. :blackeye:
     
    apollonia-artemisia likes this.
  7. apollonia-artemisia

    apollonia-artemisia Member

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    Nov 11, 2022
    Every youtube video has a cat being calm because they have been trained and are now used to it! Cats are very particular and make their discomfort known, and she doesn't fully know that you're doing this to keep her safe. Cadmium (my cat) also gets especially wiggly when it's his mealtime and I'm trying to get his pre shot tests. It's something that takes practice and lots and lots of positive association, and those things take time. You might have gotten the vein and it can be sore for a while, but she should be just fine!

    If its any consolation, I have given Cadmium a few accidental "piercings" with the lancets, as in they went completely through! It did make me sad when it happened, but he recovered from it okay.
     
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  8. CocoDB

    CocoDB New Member

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    Nov 24, 2022
    Yes, I have def gone through a few times too! Is it meant to just be a prick? Their ears are so thin, I felt like it was unavoidable. Maybe this is part of the problem...
     
  9. apollonia-artemisia

    apollonia-artemisia Member

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    Nov 11, 2022
    It is just supposed to be whatever draws enough blood to get a reading, without going through the ear if at all possible. Sometimes the cat jumps or moves right when they feel the lancet touch, and accidents happen. What gauge lancet are you using if I may ask?
     
  10. CocoDB

    CocoDB New Member

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    Nov 24, 2022
    28G. That was the lancets that came with the reader.
     
  11. Linda and Newman

    Linda and Newman Member

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    Jan 29, 2010
    Not sure where you do the testing. Try to use somewhere in the apt./house that is not associated with feeding. My cat jumps up onto my desk for his tests.

    Get her to come to that spot and give her a treat for coming. No test, just a treat and some petting. I did this and it only took a few times until Newman was often jumping onto the desk ahead of test time.

    In the beginning, Newman was growling at me as I attempted to poke his ear. It will get easier for both of you.
     
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  12. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Oh, I am so sorry that this happened! It does happen. I definitely would not minimize your experience tonight, but I will say that it does get better — and this will not be the norm. You are not alone! I can’t tell you how many times people on this Board have described their early testing experiences as looking like a “crime scene.” Sometimes this happens occasionally at other times even after you are more experienced! Cats can keep you on your toes.
     
  13. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Oh gosh, I gave Darcy “pierced ears” on many occasions — even sometimes after we were “experienced.” It healed up. It os good to pinch the ear between your fingers for a few seconds after if your kitty is a bleeder. You probably just nicked the vein instead of going outside of it. It definitely happens. You are not alone! Please don’t be hard on yourself! It’s not your fault. Remember how I said I cried for the first week. It probably was more like the first two weeks at least. I said things like… I am never going to be able to do this! And … I guess he will probably die of a hypo because I will never be able to test him! Stupid negative stuff, I admit! But that’s me! I was very emotional at the time because I thought this diabetic thing was going to be so easy (all I have to do is give insulin, right? And he will get better!). Anyway, I am just sending many hugs your way!
     
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  14. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Easier said than done, but try to go in with the lancet at a 45 degree angle at the ear. I also started out with a slightly larger lancet and worked my way down to the 30 gauge ultra thin Relion lancets.
     
    CocoDB likes this.
  15. Chrispooky12

    Chrispooky12 Well-Known Member

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    Oct 11, 2021
    I've hit my boys vein a few times, lots of blood & clean up, but like you said she was fine a minute after it happened, Panzer was as well. You might think your hurting them & hitting the vein may hurt a little bit but they bounce back quickly. You just have to try & stay calm, your kitty will pick up on you stressing, I know it's easier said than done but I promise you it gets easier.
     
  16. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    I am thinking about you and Coco tonight! I’m sending warm thoughts your way!
     
  17. CocoDB

    CocoDB New Member

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    Nov 24, 2022
    Hi everyone,
    Sorry for not updating yesterday, the typical busy rush before Christmas and just spreading myself a bit thin.
    Firstly I just want to say thank you for all the support on here both on Monday, but also coming back to some more supportive messages on Tuesday means the world.
    I spoke to the vet yesterday and she was concerned by the dip, so we're lowering the dose to 1.75 (although the syringe only has 0.5 units so it's a bit of guesswork!). I read online that a quick dip could indicate too high a dose and that the stress later in the day was her body trying to get her blood sugar up which might explain the carnage for the later ear pricks!! But 1.5 wasn't lowering her blood sugar at all last week... We'll see how 1.75 does.
    Coco has been in a really good mood the past couple of days, she has been coming and waking me up purring which she hasn't done since her a couple months before her diabetes diagnosis (although in hindsight she was clearly suffering from that then). Although not as settled as she was before DB.
    Secondly, thank you so much for the specific tips. I'm not going to do a blood curve until next week now, but I am associating a new space in the flat with a treat and will start bringing the glucose meter to give it a positive association. Good to know about the angle too with the lancet, I have been a bit stabby! Hopefully I will hone my craft soon and Coco will become regulated and even happier in 2023.
    Thanks so much again,
    D
     
  18. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    I am happy about the decrease in dose. I prefer the increases in only .25 units (unless the nadirs are 300 or greater or ketones are present and there’s a history of DKA.) Paws crossed here for you and Coco.
     
  19. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Oh and it’s soooo good to hear about Coco’s behavior returning to more normal. She must be feeling better! That makes me happy!
     
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