Dosing help

Discussion in 'Prozinc / PZI' started by Mhpfed, Sep 16, 2020 at 8:14 AM.

  1. Mhpfed

    Mhpfed Member

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    I mentioned in my new member post that Furril had a glucose level of 38 2 nights ago and we brought him to the ER. The vet never discussed checking glucose before each injection but I will do it from now on. I've updated his spreadsheet-although it's a bit messy because until yesterday I'd only been doing glucose curves so I added those to it as well.

    Basically I'm really scared about sending him into hypoglycemia again and with his glucose at 198 how much insulin should I give him today? He was on 3 units for a few days which was clearly too high. Should I give him 2 this AM?
     
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  2. Mhpfed

    Mhpfed Member

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    @Panic looking for help for what dose to give this AM
     
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  3. Panic

    Panic Well-Known Member

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    Can you stall feeding 20 min?
     
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  4. Mhpfed

    Mhpfed Member

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  5. Panic

    Panic Well-Known Member

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    Okay let me know what reading you get.

    I might suggest cutting the 3u in half but let's see where he's at in 20...he might just need a token dose this morning. Tagging @Deb & Wink for dosing advice when she's on later tonight.
     
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  6. Shelley & Jess

    Shelley & Jess Member

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    Was just gonna post the same thing. Did you feed anything after that reading of 198 an hour ago?
     
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  7. Panic

    Panic Well-Known Member

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    I'm at work atm so I'm going to set a timer on my phone to check on you guys okay?
     
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  8. Mhpfed

    Mhpfed Member

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    he's at 245 now-no haven't fed him anything since last night

    Also we cut him back to 2 units per the vet after the hypo
     
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  9. Panic

    Panic Well-Known Member

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    Okay he's on the way up so if you can monitor today I'd try 1.5u

    If you've skipped any shots like yesterday please put "skipped" in the dosage section on your spreadsheet. Also for today put 198, 245 (+12.20) in the AMPS cell and manually color it blue.
     
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  10. Panic

    Panic Well-Known Member

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    Do you have a hypo kit for backup? Gravy food and karo syrup?
     
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  11. Mhpfed

    Mhpfed Member

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    thank you so much! Spreadsheet is updated and yes, I do have karo syrup on hand.

    I'm working from home but do have to go into the office a bit today from 1-7. It's a 4 minute walk from home so I can keep checking on him. How often should I check on him and just monitoring for sx or actually doing readings?
     
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  12. Panic

    Panic Well-Known Member

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    Get a +2 (2 hours after insulin) if you can, that will tell us what he'll be doing today. You do feed small snacks of food throughout the day, yes? He'll need some at +2.
     
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  13. Shelley & Jess

    Shelley & Jess Member

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    Readings please! Agree with Elizabeth, we want to see that +2 if possible.
     
  14. Mhpfed

    Mhpfed Member

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    ok-just did reading he's at 98
     
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  15. Panic

    Panic Well-Known Member

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    Okay give him some food and check him in an hour please!
     
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  16. Shelley & Jess

    Shelley & Jess Member

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    I'd feed and test again in 30 minutes - that's a hefty drop for a +2 - over 50% drop.
     
  17. Panic

    Panic Well-Known Member

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    Yeah I was just thinking about that - do you have some medium carb?
     
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  18. Mhpfed

    Mhpfed Member

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    no I don't have any. What would be some examples? I can go get some
     
  19. Panic

    Panic Well-Known Member

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    Most gravy lovers from Fancy Feast will be medium-high carb. The more I think about it the more I'd like to stunt that drop early.
     
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  20. Mhpfed

    Mhpfed Member

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    just gave him some med-carb food. should i test sugar again since it's been 30 mins since last one or wait til food kicks in?
     
  21. Shelley & Jess

    Shelley & Jess Member

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  22. Mhpfed

    Mhpfed Member

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    he's at 107
     
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  23. Shelley & Jess

    Shelley & Jess Member

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    That's basically the same as the 98 with meter variance. Grab another test in 30 minutes please.
     
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  24. Mhpfed

    Mhpfed Member

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    at 126 now

    also where would I put these last 2 numbers on the spread sheet?
     
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  25. Panic

    Panic Well-Known Member

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    Put it in with the same hour, for example if it was

    +2 98
    +2.20 107
    +2.40 127

    You'd put them all in the +2 cell, like so

    98, 107 (+2.20), 127 (+2.40)

    And then color the cell green.
     
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  26. Shelley & Jess

    Shelley & Jess Member

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    Some notes in the remarks column - when and what you fed is helpful too.

    (and urghhhhh - got stuck in refresh/reload limbo & couldn't get back on)
     
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  27. Panic

    Panic Well-Known Member

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    How's he doing? Any more tests in?
     
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  28. Mhpfed

    Mhpfed Member

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    So just tested again and he's 98. Gave him a bit more food.
     
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  29. Shelley & Jess

    Shelley & Jess Member

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    Where are we in the cycle?
     
  30. Mhpfed

    Mhpfed Member

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    Just tested again and he is still at 98. I'm assuming no insulin tonight?

    Thank you for all your help!
     
  31. Panic

    Panic Well-Known Member

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    Probably - could you update your spreadsheet for us? I'm hoping Deb will have time to peek here and give dosing advice going forward.
     
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  32. Mhpfed

    Mhpfed Member

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    I updated his spreadsheet with numbers. If he ends up needed it he's not due for next injection until 10pm
     
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  33. Deb & Wink

    Deb & Wink Well-Known Member

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    I think you are going to need to skip the insulin again tonight, if Furrill's BG level is not >150 mg/dL.

    I know it's a pain to do this, but could you please add a row for each day?
    I realize you don't have test data for all those days, but it helps my mind process the SS (spreadsheet) information better if there is a row for each day.
    Plus, Furrill was probably getting insulin back in August and early September, and it's good to know what dose he was on.

    Did you change the food recently?
    Would you please tell us what you are feeding Furril? Be very specific if you would please.

    I think the 1.5U dose is too high. But if could let us know about the food, that would be great. Thanks.

    p.s. Waving to you from the North Shore of Massachusetts.
     
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  34. Deb & Wink

    Deb & Wink Well-Known Member

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    Never mind on the food, I found your other thread. See that you changed from Fancy Feast and Friskies to Walmart's Special Kitty wet food. Is that correct?

    Which flavors/kinds of the Fancy Feast/Friskies was Furril eating before?
     
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  35. JL and Chip

    JL and Chip Member

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    @Panic I’m just following along quietly and don’t want to distract ... but are we really at the granularity of tenths of an hour (6 minutes) these days? For example, +2.20 is 2 hours and 12 minutes after the last shot, and +2.40 is 2 hrs and 24 minutes. I’ve always just rounded to the quarter hour as in every 15 minutes (+2.25, +2.5, +2.75) but if that’s no longer the standard, I’d like to make sure I’m keeping up to date since I haven’t been around as much recently...
     
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  36. Panic

    Panic Well-Known Member

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    As far as I understand, 2.20 just means a third into the hour, or 20 min past +2.
     
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  37. JL and Chip

    JL and Chip Member

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    A decimal by definition means “tenths” so 1/10 of an hour is 6 minutes and 2/10 of an hour is 12 minutes.

    One-third of an hour (twenty minutes past the hour) would be +2.33.

    But thanks — I think I understand what’s happening now. :)
     
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  38. Panic

    Panic Well-Known Member

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    Yes I see where you're coming from too! That's just the way I was taught to input data, I suppose there's multiple ways to do it as long as the reader knows what you mean. :confused:
    Perhaps it would make more sense if it was 2:20 instead!
     
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  39. JL and Chip

    JL and Chip Member

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    To the best of my recollection, we always talked in 15 minute (quarter-hour or 0.25) increments, but I was here way before the FDMB spreadsheets even existed. I suspect someone along the line got confused and then the erroneous math propagated forward. It’s a technicality, I suppose, but I’d sure like to go back to teaching newbies the (technically) correct way to record results. Anyway, I took this thread way off topic so I’ll drop it now. I’ve been wondering about this for awhile so thanks for answering!
     
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  40. Panic

    Panic Well-Known Member

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    You raise a good point though - because I also would do 2.5 for half hour, but 2.40 is supposed to mean more than 2.5 so now I'm re-evaluating everything. :confused: I'm very bad at math so never questioned the technicalities of it all. So I'm assuming you just rounded up/down if you tested in 20 min, so instead of 2.20 it would be 2.25 for "15". Blech, making my head hurt just thinking of it! I've seen it done multiple ways (2.20, 2.25, 2.33, etc). Wonder if there's a note on it on the spreadsheet instructions :bookworm: But yes thank you for bringing that up, gonna go look into it.
     
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  41. JL and Chip

    JL and Chip Member

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    You put multiple BG values in one cell along with the amount of time (in 15 minute increments) since the last shot. You’ll also have to manually color code that cell. So +2 is two hours after the last shot, +2.25 is two hours and 15 minutes after the last shot, +2.5 is two hours and 30 minutes after the last shot, and +2.75 is two hours and 45 minutes after the last shot. (Hopefully that makes sense)

    To the best I can interpret the time stamps on your posts, you tested at +2, +2.5, and maybe +3?

    If so, in the +2 cell, you’d put:
    98
    107 @+2.5

    And in the +3 cell, you’d put the 126.

    It’s not an exact science — some people prefer parens to the @ sign — but the important thing is that we can quickly assess where in the cycle the readings occurred and how quickly they’re shifting. It also helps to add notes in the column at the far right to notate if you intervened with food to help bring up the numbers.

    The whole diabetes thing is a lot to wrap your head around and you’re doing great. :)
     
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  42. Mhpfed

    Mhpfed Member

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    thank you for all the assistance yesterday, everyone! I've updated Furril's spreadsheet with more info of glucose and BG from the vets office. I will add all the other dates like DebandWink suggested but am not able to do so right now.

    I'd like some help with insulin this AM as well. His BG was 132. This is all so confusing! I feel like it should be a good thing that I skipped insulin last night and his sugar is still pretty low but it seems like it just makes it more complicated.
     
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  43. Shelley & Jess

    Shelley & Jess Member

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    If I calculated right, should be coming up to shot time. How's he doing BG wise?
     
  44. Mhpfed

    Mhpfed Member

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    I took BG at 8 am, which was his normal injection time before yesterday. It was at 132. I'm thinking skip again?
     
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  45. Shelley & Jess

    Shelley & Jess Member

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    Definite no insulin/skip number. Can you get a couple of tests in today see how he does without insulin?

    How long ago did you remove all dry food?

    ETA - Have you been doing a transition or stop all at once?
     
    Last edited: Sep 17, 2020 at 9:43 AM
  46. Mhpfed

    Mhpfed Member

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    switched to all wet food by 8/28. Will do some more BG today
     
  47. Shelley & Jess

    Shelley & Jess Member

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    Thanks. Good to know. I'll be watching for those numbers (with fingers crossed)
     
  48. Mhpfed

    Mhpfed Member

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  49. Mhpfed

    Mhpfed Member

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    It's time for insulin tonight. Not sure if he should get a shot or not. Hasn't had one since yesterday AM. BG at 191. I'm so scared of another late night hypo event.

    @Deb & Wink if you have a moment to advise
     
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  50. Panic

    Panic Well-Known Member

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    Deb may not be online yet.

    How would you feel about just a token dose, 0.10u? He is heading up but I think 1.5u is too much, especially since you've been skipping lately.
     
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  51. Mhpfed

    Mhpfed Member

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    thank you! thought it may be too late for you to be on. I can try doing it .10 seems really small for the u40 syringes I have
     
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  52. Panic

    Panic Well-Known Member

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    It's only 8 PM here for me. :)

    [​IMG]

    This is for U-100 but itll be the same spot as U-40s
     
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  53. Mhpfed

    Mhpfed Member

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    that helped, thanks!
    Do you think I should do a BG in a few hrs to make sure it doesn't drop too much? would it show in 2 hrs....I go to bed early! lol
     
  54. Panic

    Panic Well-Known Member

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    Yeah get a +2 and let me know how he's doing! Maybe Deb will be online by then and have better dosing advice. I'm not sure how low she wanted you to go.
     
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  55. Deb & Wink

    Deb & Wink Well-Known Member

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    I would not let Furril drop below 90 mg/dL.
    You don't have much test data, to know how he will react to the insulin yet.
    Plus, he is likely to be more sensitive to insulin since that hypo a few days ago.

    I wouldn't shoot any pre-shot BG that is < 150 mg/dL. Not until you have more test data.

    Would you be willing to cut the dose in half again? Down to 0.75U?
    Basing that suggestion on the 3U causing a hypo, and the 1.5U being still a bit too much that you have to skip shots.
     
  56. Mhpfed

    Mhpfed Member

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    Cutting it down to .75 is fine with me, anything to avoid the hypo.

    I just did the +2 and bg was 226. He does kinda graze I cant get him to eat a lot at 1 time. I do make sure to not have him eat 3 hrs prior to the preshot readings tho.
     
    Last edited: Sep 17, 2020 at 9:46 PM
    Reason for edit: Misspelling
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  57. Panic

    Panic Well-Known Member

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    Okay he'll probably be alright tonight. You can get another test in later if you want but I think you'll be good.
    Thanks Deb for the dosing advice!
     
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  58. Deb & Wink

    Deb & Wink Well-Known Member

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    The only BG test we need (like) to see without a food influence, is the pre-shot test. All other BG tests we expect to be food influenced.

    You only need to take the food up 2 hours before the pre-shot test.
    If even that is not possible, than it's not possible and we have to know that information in order to help you better.
     
  59. Mhpfed

    Mhpfed Member

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  60. Mhpfed

    Mhpfed Member

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    Furril is at 167 for pre shot number. I do have to go into work this AM and am nervous about any insulin. Please advise. It's so close to a 150 reading

    @Panic @Deb & Wink
     
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  61. Shelley & Jess

    Shelley & Jess Member

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    Do you have time to stall without feeding and retest in 20 to 30 minutes?
     
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  62. Mhpfed

    Mhpfed Member

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    No I have to leave
     
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  63. Shelley & Jess

    Shelley & Jess Member

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    Either skip or give a token dose = 0.1u - that tiny dose noted above in post #52.
    What are you comfortable with?
     
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  64. Shelley & Jess

    Shelley & Jess Member

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    Sorry for the short reply above, I didn't want to leave you hanging. (Trying to get the men out the door to start the day - we start early around here)

    Since you couldn't stall to see if he was on the rise it's always better to be safe.

    The Prozinc Dosing sticky says:
    How to handle a lower than normal preshot number when following SLGS:
    Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
    Last night, as far as I can tell (spreadsheet not updated) you gave .75u so a token dose would be between 0.1 & 0.2 units (rounded for ease of amounts)

    I agree, with lack of data and just starting to see the preshot numbers now you want to be around to be able to test when you shoot full doses on those lower numbers for the first time. Safety first!
     
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  65. Mhpfed

    Mhpfed Member

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    Thank you so much for the quick reply earlier! I ended up skipping because I wont be home til 5pm and I'd just be worried the whole time. Luckily I only go in in fridays so can do more other days.
     
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  66. Mhpfed

    Mhpfed Member

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    Good morning everyone. would appreciate some help on if I should give full .75 dose this am after 179 bg. I am heading out in a bit but can be back in a few hrs to retest

    @Panic @Deb & Wink @Shelley & Jess
     
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  67. Shelley & Jess

    Shelley & Jess Member

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    Ah shoot, I checked in between 8 & 9 am to see how you were doing around your shot time - thought no news was good news.

    Good job stalling this morning! And perfect decision about the dose!

    Let's see what @Deb & Wink has to say about the dose going forward when she's around next - hopefully tonight.

    If you can grab a test an hour or two before your shot time might help to see if he's on the rise at shot time or give us a clue what's going on.
     
  68. Mhpfed

    Mhpfed Member

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    Thanks so much! Yea we were behind an hour or so this time around. I did another check. Curious to see what bg will be closer to shot time
     
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  69. Deb & Wink

    Deb & Wink Well-Known Member

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    Well, 3U was too much.
    1.5U was too much.
    0.75 looks like too much too.

    So you are microdosing for a while.
    Good call on the 0.1U dose this morning.
    Furril had a BIG drop even on that teeny tiny dose.
    Try feeding at +1, to try and keep the BG levels more steady. Test then also, if you could please.
    Sometimes that food at +1 helps, to slow the drop after the shot.
    Still feed after the pre-shot test too. Just a snack, like 1 teaspoon at the +1 time or later.

    Onset with Prozinc is usually +2, but cats can have earlier onsets than that, and Furril may be one of them.
    Some tests at the +1, +1.5 time frame may tell you more of what is going on with him.

    Did he eat well this AM?


    p.s. New thread please, and link this one in at the top?
    Long threads get the attention of the mods, and we don't want them to complain.
     

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