Day 3 Nala...baseline 198

Good morning everyone. So its day 3 since joining and we are now on day 2 of at home testing. I had skipped Nalas injection last night bc she was just under the threshold of 200, checked at the one and two hour mark as you will be able to see on her spreadsheet. Numbers went up a hair, then back down so we called it a night. Several of us were interested in seeing what her baseline would be this morning...198! Thats good right?? Im gonna stick with blue is good =) Im going to do the same as I did last night, skip her injection, test at 1 and 2 hours and then every 2 hours after to get a full curve thru the day. If there is an thing I am missing or doing wrong please let me know.

 

morning I can't advise to dosing but I can't open your SS - you may need to change the sharing settings to "anyone with link". Those that do give advice will want to see the numbers in the SS

 

Ok, I think I figured that part out...did it work? Can you open the SS now? (Thanks so much for letting me know it wasn't working

 

Good morning, Tiffany!

Yep. We can see your SS now. Here's link to yesterday's thread for continuity.

I don't have the experience to be able to give you any dosing advice. I'll tag @JanetNJ and @Shelley & Jess -- they're ProZinc folks..

Enid

 

Yes! Ss is working. So I see you are in the high 100's. You gave no shots the last three cycles? Normal on a human meter is 50-120, so I think he needs a little insulin support. Can you do 1 u over 150 and see what happens.

You took other readings that were in the 200's that I don't see on here. Can you add the earlier readings and doses?

 

Hi Janet. So her normal dose is 2 units as prescribed by the vet. So I should do half of that now and then do another BG in how long?

 

I wouldn't do 2 units when it's under 200 without more data. ProZinc usually peeks 5-7 hours after the shot, so I might check at 3-4 hours after the shot just to make sure she isn't heading too low.

 

1 unit is the recommended starting dose. I think starting at 2 might be a little bit much unless testing tells you otherwise. We usually suggest raising doses by no more than 0.25-0.5 units at a time.

 

Ok, so here is what Im going to do. I was going to do a BG check here in about 15 mins anyway. Ill add that to her SS, and if its still staying around this mark I will give her 1 unit then check her 3 hours past that. I am sorry Janet that I am just now seeing your other question about her 200+ readings. I will go in and add them to the SS, these were readings taken by the vet the day of her scheduled curve. She was also started on canned food (by my insisting) by the vet that day as well. The day before that and the whole month prior she was on script dry. Ive had her on primarily canned since getting her from the vet and she has nibbled some kibble here and there but is beginning to show no interest in it which I am happy about.

 

I see. Ok so going to the wet food will have an impact on the numbers too. Plus the numbers are usually higher at the vet because they are stressed. Good job changing the food. I have got to say these are awesome numbers for a newly diagnosed cat. I'm willing to bet it won't be long before she's in remission.

 

147...suggestions? Shoot or not to shoot??

 

OK, it's official: Nala is reading these posts!

I don't think I'd give insulin now-- you're 2hrs past your usual shot time anyway, right?

 

LOL, right! I think she's tired of being poked, sweet girl is such a trooper though and I think I finally found the sweet spot at the tip of her ear. It barely took a prick to bleed and she didn't flinch this time.

As of right now we are 3 hours past. Ill start checking her every 2 hours from this point then. Im fully on board with what @JanetNJ said earlier. I am aiming for remission. Hopefully all this is a good sign that we are in the early enough stages to where she can be regulated with diet like the specialist thought initially. I haven't felt this encouraged since the day of the diagnosis. I am SO HAPPY I found you guys. Its amazing where research can lead you, as I just stumbled across this group trying to educate myself on the best food.

 

You are already past time, right? Skip

 

Yeah definitly skip or it will mess up your timing later.

 

12:30 check rendered a 129. She had her lunch right after.

 

Well, would you look at that!

 

We totally need love buttons like what's on Facebook...lol! I am totally near tears happy dancing right now. I am praying hard it stays the course.

 

Help! 2:30 check and we jumped up to a 216! Should I wait 30 mins and check again? Or give her an injection now...which would move her next possible injection to the early am right?? She did snack about 30 mins ago.

 

Holy cats Im kinda freaking out right now. Im thinking it was her food. All her awesome numbers were on the fancy feast, then I let her finish off her can of Merricks from dinner last night (whither numbers were borderline then).

 

Which the numbers....

 

Don't shoot now, she's fine....

Is the Merrick's higher carb?

 

ok, whew. It was the beyond she ate thru out the day, not fancy feast. Im looking at the print out I have now. The Merricks Grannys Pot Pie is the flavor and the list says its 6 carbs. The beyond flavor was only 2 carbs.

 

Hmm, well, it's not the carbs in the food causing that little rise, it's probably just her. But she's really not very high at all-- nothing to worry about.

It does mean that she'll likely be getting a shot tonight (unless she pulls another switcheroo!). I do think that 1U probably makes more sense than 2U given her numbers today, but see what others say.

 

Ok, will do. I check her again at 4:30. Im pulling the Merrick just incase tonight and when she eats again it will be the Beyond. Just incase. And if I see a pattern it may be she needs really really low carb food.

 

You do know that’s not really a high number, right? Don’t shoot until it’s her normal shot time. No need to test again until then.

 

Heading back down...4:30 test was 186

 

Im still learning, so no not really sure exactly what is high right now and what is not. Especially when reading that "we don't usually shoot under a 200, but do if its over". I absolutely appreciate everyones patience as I learn and go through this process, but that's just what it is..a learning process. Everyone was a first timer at one time or another. And then I was concerned over how high it went in a short amount of time, so I may have panicked a little.

 

Don't worry, all of your reactions are perfectly normal! We have all been there in the beginning, believe me

The thing about cats is, they can tolerate much higher BG values for much longer than, say, humans. It's not at all uncommon, especially for newly-diagnosed cats, to see numbers in the 400's, 500's, even higher. I don't even want to think what that would feel like for a human , but with cats, most of the time the damage only comes with numbers like that over long periods.

Normal BG range is roughly 50-120, so the numbers up in the 200's you've seen are definitely diabetic. On the higher end there, they're likely over the renal threshold (varies among cats), where the glucose spills over into the urine, but, again, that's really more of a concern over the long term.

In general we're much more concerned on the lower end. Unlike high numbers, low numbers can be instantly dangerous, even fatal. So the recommendations and advice about shooting are conservative on that end. The 200 cutoff for shooting isn't because the numbers over 200 are dangerous and need insulin, it's because it may not be safe to shoot numbers under 200. As Janet said up above, after you get some data and see how Nala reacts to insulin, you can start to relax that rule and shoot lower numbers, we just don't like to see it done in the very beginning while you're still getting used to everything.

I'm sorry we don't always explain all these things in detail. There's just soooooo much to learn in the beginning, I maybe err on the side of being too brief because I don't want to bury new people in the details, but sometimes that makes things even more mysterious .

Anyway, back to Nala! Even though she climbed back up for a bit, she's spending an awful lot of time in blue numbers for a cat who has skipped several shots !!! She really is looking very good, I'd say .

 

My cat didn't even have a number under 300 for the first 2 months... so I'd say your cat is doing great. hahaha

 

So it looks to me like the 2U dose is too high for Nala. Especially since she dropped to that low blue BG of 129 at +4.

I think you should reduce the dose, to 1U max.
With the food change, you are likely to need to drop the dose pretty rapidly.

p.s. I'm not usually on until later in the evening, east coast time. We are getting slammed with a big snow storm tonight into tomorrow.

 

Thanks for checking in, Deb-- stay safe with the storm! Looks like it's going to stomp all over the northeast...

 

@Tiffany Smith, I see 186 in last night's pre-shot number-- did you shoot? How is Nala doing?

 

Good morning, No, I didn't. I did the same as the night before and skipped the dose. I just did her AMPS and it was 204. Putting together everything everyone has talked to me about, would my thought process be correct in one of the two things....(1) Do I go ahead and feed her and give her half a dose, 1u, of her Prozinc, or (2) Do I wait 30 mins, check again, and see where we are there?(it did get a little stressful checking her this morning bc I did it by myself instead of waking one of my kids to help and from what I understand stress can raise BG I just don't know how fast)

 

Thanks so much for coming on Deb, Im east coast too (South Carolina so our times on will be compatible) but we aren't staring down the barrel of that storm. Please stay safe. As far as dosage, I am fully convinced that 2u is too much as well.

 

Lol, thanks...I am def one of those who over thinks things for sure. Which causes me to probably ask the same question 10 different ways so I know that I fully understand the answer..lol. Thanks for all your help so so far, Im so thankful for all who have been keeping watch over us. I have learned more in the past 3 days than I have in the past month from my vet. I know she means well, but Nala isn't her only patient so perhaps she is just looking to keep things as streamline for her as she can. But I want remission, and I will do whatever it takes to get her there

 

Are you going to be around to test today? If so, I think you could try the 1U to see how she does. It seems like she's going to need some insulin, at least for a little while . Now that you're testing, you'll be able to get a much clearer idea of what a particular dose does for her, and keep her safe while administering insulin.

 

Yep, Ill be around all day. So its injection time anyway, so Ill BG one more time to just cover the first reading and prep a 1u dose. Then test at the 2 hour mark maybe?? How long would you wait to test again?

 

Could you color your last reading?
Consider your spreadsheet as something that has to be filled out, every single column. And spread it out when you can. For example do a +3, +6 and a +10 one day. Next day a +2, +5 and +8. It doesn't take long to figure out when its most important to test. If you're up peeing at night, grab a test. I test mostly out of curiosity I can't help myself!

 

Done and gotcha on the spreading out the testing. Think Ill spread it out a little further today, the 3+. I know her little ear has to be sore from our curve yesterday. I can't get her right ear to give me anything and I feel bad poking her over and over trying. So its always the left. My husband gets up at 4:30 am for work. I may just start throwing in a test every now and then when he gets up. She is not so compliant right now with testing or shots, so I always need a second set of hands...as I confirmed with myself this morning when I tried a test on my own...lol

 

Aaaw poor ears! Did you try warming it up a bit? Milking it before you poke?

 

I doI massage it, warm it before, and put the Neosporin with the pain reliever on it afterwards and a little pressure to make sure it stops bleeding.

 

3 hour check after 1u of insulin and we have gone from a 193 to an 87. Is this too much too quick? Should I do another check sooner than another 3 hours? She's eating now. And a food question...should I have her food bowl out to where she can graze her canned thru out the day or try to stick to a schedule for now?

 

Witch dosing protocol are you following?
I'll do another check in an hour, if she seems odd in any way do a test sooner.
+3 is to soon for her to reach nadir.
You can't test too much, if you feel worried, take a test.

 

Im not quite sure about dosing protocol and the differences in those yet. So here is a run down of what the vet wants me to do..2 units every 12 hours. It was suggested here that that was a very high dose so anything over 150 I should try the 1 unit dose. Today was the first day doing that. I will def test again in an hour and she is in my eyesight now. I have made the kitchen table my desk/workspace so I can be in the main part of the house with her. She just ate really good (canned), no change in behavior.

 

See: PROZINC DOSING METHODS

The usual recommendation is to start with the "start low, go slow" (SLGS) method. According to that, Nala has earned a 0.25U reduction by going under 90! Just like Deb predicted she would, she's starting to zip down the dosing ladder already.

I second the recommendation to test again next hour. She's just starting the part of the cycle where the insulin will be active, so you want to keep a close eye on her. I'd also make sure you have all your carb-y supplies (gravy foods, honey/syrup/karo) at the ready, in case she dips below 50. The low-carb snack now is good, it should help slow her down a bit.

First green! Whoo hoo!

 

Adding: a good-sized snack under her belt is a good thing right now, as I said above, but one thing to keep in mind is that, if she starts to go low later on, you're going to want to keep her willing to eat whatever carb-loaded snacks you are using to bring her up again. So, the snack now is good, but don't let her over-stuff herself, just in case.

 

Ok, now I'm a little confused...lol..whats new..haha..so should I have done a little more than a 1 unit shot being she was started out on 2u?

 

Oh, sorry! I meant, "a 0.25U reduction, down to 0.75U." On Prozinc, when a reduction is earned like this, you always take it from that day's dose.

The 1.0U was correct this morning, but now Nala is telling you nope, still too much, so whenever you give the next shot, it'll have to be lower.

 

Gotcha! Thanks!

 

One hour later and we are headed in the right direction at a 103

 

And back down to 82. She at and Ill check her agin at the next hour mark which will be 3:30 here

 

She's looking very good today. Keeping you on your toes!

 

I a

I agree. 0.75.

 

Yes, very much so!

 

Ok, we are 2 hours away from her 8:30 check and what would be her 2nd shot. Just so I can go ahead and get in my mind what we might do, based on her SS for today what do you guys think we are looking at doing? I know it will based on her numbers at 8:30, but if shes still looking like this I won't shoot her right? Wouldn't that make her blood sugar go down more? @JanetNJ @Nan & Amber (GA)

 

Well, again, not a Prozinc person, but if it were me I'd stick to the 200 cutoff (or, I guess, something like 190 since you successfully shot a 193 this morning, starting to sneak the cutoff down a tiny bit). I don't think I'd be comfortable moving the cutoff down much more than that with how she dazzled us all today with her green surfing , but let's see what the Prozinc folks have to say, there may be other options.

 

Personally, if Nala were my cat, I would not give her any more than 0.5U.
On a pre-shot of 190 or above.

With the food change, I think the BG levels are dropping too quickly on the 1U dose.
Even the 0.75U dose may be too much for Nala.
So that is why I'm suggesting an even smaller 0.5U dose IF HER BG levels are high enough at pre-shot.

If it happens that the 0.5U dose was too little, you can always increase the dose again. But give that small 0.5U dose at least 6 cycles (cycle = 12 hours) to see what impact it's having on her BG numbers.

Again, decrease the dose by another 0.25U whenever Nala goes < 90 mg/dL.

 

Im sorry, I keep forgetting that part But value your thoughts just the same.

 

No problem, I really wish I could help more with the details! So glad Deb is here with those specific recommendations. I like the idea of dropping all the way down to 0.5U and still using the 190 cutoff.

Deb, I hope you are not snowed in where you are!

 

@Nan & Amber (GA) please don't sell yourself short on your knowledge level. You do great with so much advice, and that is invaluable. I value you too Nan.

My plow guys plowed my LONG driveway twice today.
I shoveled way too much snow though, as we got a good 1 foot of the frozen white stuff. My shoveling guy bailed on me, so had to do the work myself. Snow was higher than the bottom of the storm doors this morning, with drifting and blowing snow. We got almost as much snow in 1 day, than we got during last winter.

Took some pictures of my backyard yesterday and today. Too tired to download them from the camera and post them though.
Hot chocolate with plenty of mini-marshmallows really hit the spot, after being outside shoveling for a couple of hours.

 

@Deb & Wink , am I understanding right then that when I do her PMPS that unless its 190 or above, I will not give her a shot? And if it is 190 or above, try a 0.5u?

Im jealous of the snow. I love snow!! My mom used to live in Northern Maine before moving back down here to South Carolina and we would always go visit in the winter just so we could get the real snow. It just been a gloomy cold and rainy day. Im tired of all the brown and yuck.

 

She was a 113, so Im going to leave that alone and check her again in 2 hours before I go to bed. Im not going to shoot her now..does that sound like a good plan? @JanetNJ, @Deb & Wink , @Nan & Amber (GA)

 

Yes, that's the plan.

Oops, you just posted with the number-- well, that settles it! Yes, skip tonight, test once more just to see what she's doing.

 

Awesome!! Happy dance!!

 

Awesome

 

Yes, you have that correct.

Skipping was the right decision last night.

 

Good morning @Deb & Wink. I was wondering if you could take a look at Nalas SS. Her pr shot this morning was a 170, I have planned on skipping this mornings shot as well based on your suggestion. Am I still following this idea correctly? No insulin under 190 correct?

 

Deb won't be online until late tonight.
But I'm reading it same as you, so no insulin if she's under 190.

 

Thanks! I appreciate you checking that for me @SashaV

 

SashaV gave you the correct info, on both skipping the dose if Nala is <190 and when I am usually on the message board.

Nala is doing pretty good, for a cat that hasn't had insulin in 4 cycles.

We'd like to see her going lower than the blues she is getting, into the dark green BG range you see on the SS.
For now though, let's see if Nala can stay in those blues without insulin. And maybe drop lower into the greens.

She might only need a very tiny amount, like 0.1 Unit (1 drop).
So you could try practicing drawing up some colored liquid with a used syringe, and "squeezing" out the drops of liquid, to practice that tiny dose.

You want to try to make the drops the same size, and when you have the final drop on the tip of the syringe, pull back on the plunger to "suck" that last drop into the syringe.

 

Ok, sounds like a plan. And Im pretty happy with today. She started out like she was going to be a little high, but dropped. Its like her body is wanting to heal and I think the food change is doing wonders. Makes me wish I had of known better in the beginning. But we are getting there, and I also have 4 other kitties making the transition to canned as well so we don't run into this problem with them in the future. Hope you have a good night, everyone else who checks in too, hope you all have a good night and are staying warm.

 

Tip for practising measurement of drop doses:

When trying the drop counting, I smeared a small sheet of regular printer paper with Vaseline and wiped off the excess to create a moisture barrier. Then I would practice getting the drops the same size using water in the syringe. The oil barrier helps the droplets to bead up and it's easier to compare sizes that way. Also, twisting the plunger like you'd do with a corkscrew makes it easier to s-q-u-e-e-z-e out little droplets. The Vaseline-smeared paper can also be wiped off and used again. Adding a little food colourant to the water in the syringe might help you judge drop size better too.


Mogs
.

 

Wishing you a warm, safe, and peaceful night too, Tiffany. Glad to see how well things are going for Nala.


Mogs
.

 

Good morning! I was reading over how you practiced your drop dosage and that is going to be really helpful, thank you. Now when I move this over to insulin, what I am taking from this is that when I get the water droplets the size I want them, I need to practice drawing them and seeing exactly where the plunger is, bc the insulin will only be in the needle and not down into the syringe itself correct?

 

Good morning everyone. Ok, so new situation. Nalas AMPS this morning was a 196. However, I went to bed half asleep last night and accidentally left her access to food out. I have no idea when or how much she ate. Do I need to wait another hour and test again with no food? Or is it time to shoot?

 

Doesn't hurt to wait... But I really think she does need a little insulin support. Id like to see her numbers in the greens

 

Ok, thanks!

 

But I do think in general you've been skipping when she could use a little (0.1-0.25) insulin. Let's get those mid cycle numbers into the greens.

 

@JanetNJ, Im right there with you in that thinking after watching her SS this week. She does need a little.

Im supposed to be checking in with the vet today to give her an update on Nala. Im just going to email her and send her a copy of the SS and explain what Ive been doing for her. Her prognosis after this week is that Nalas symptoms would be about the same and that I would be giving her 2U in the am and up to 3U in the pm. That was if I followed what she said about canned am and pm feedings and graze dry thru the day, being fully transitioned to canned by the end of last week. I of course have gone in my own direction. But I really feel like I could have killed my cat this week if I had of stayed the course of 2u am and pm with the complete food change. I just don't know how to feel about that...mad, confused, both...ugh.

 

So Ive been re-reading all the info on the Prozinc forum so I can try to figure out the dosing before coming back here to bug you guys with questions..lol. I have the U-40 needles, so should I get my husband to stop by Walmart and pickup some u-100's? I feel confident I can get .5u dose (half a unit) on the u-40, but anything smaller than that I feel like I really need those extra lines.

 

You certainly could do that.

 

Ugh so our Walmart is out of stock. I have been practicing with the drops like @Deb & Wink and @Critter Mom told me about. Im getting pretty confident with that, each time I draw a drop off the paper the syringe shows the top of the plunger right in line with the bottom of the first red line, still touching it. Ill probably start this dosage with her tomorrow depending on her starting numbers.

 

Good morning everyone. I hope everyone is safe and warm and their day is starting off well. Sunny and cold here.

Nala update, I have decided to start Nala on the .1U (drop) for anything above 150. After watching her for almost a week on no inulin it just doesn't seem like she's going to break into that healing point on her own, and she's consistently staying below the 190 range not allowing for any insulin therapy if I keep waiting for the 190 to hit, silver lining to that though is I would def say the food change is doing wonders! With no inulin and her old diet we were looking at the high 3 and 400's

This morning her AMPS was 168, so shot her with her first .1 dose. I will check her every 2 hours today to see how she does, updating her SS with each time so you guys can watch right along.

Any thoughts, concerns, constructive criticism, suggestions all welcome =)

 

Only one for now. Would you please start a new thread? We like to keep threads to 50 posts or less, and this one is now up to 85 replies.

Smaller threads help the message board run better, all that software behind the scenes that we can't see, doesn't run as well when the threads get too long.

p.s. Nala seems to do ok on the 1 drop of insulin.

 

Absolutely, will start a new thread first thing tomorrow. I was wondering when I needed too..lol