finding that fine line in dosing for Logan

Discussion in 'Prozinc / PZI' started by Logan & Sandy, Dec 11, 2020.

  1. Logan & Sandy

    Logan & Sandy Member

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    Nov 17, 2020
    hi All! After a few rather low days 124 at pmps dec 6th, and 124 pmps dec 7th, and 32 amps 12/8,I took Logan to vet Dec 8th at 315pm (calif time (+5)vet checked logan with alphatraxx (+5) 419 & with my reilon it was 380. Said high end is 250+ and low end no stress is 70-130 using alphatrax.. and no shoot if below 70-80 using alphatraxx. Using Relion (which is 40 pts lower than Alpha they said) no shoot if below 110-120. If i run a curve do it every 2 hours eg. shoot at 730, test (+2)930.(+4)1130. 130.330.530.730. And they emphasized go with how Logan is acting verses all these numbers and to quit trying to micromanage him he's not a machine.. might make him cringe everytime he seems me if I test him often, so i'm offering him a treat afterwards now... they said if i want to run a curve eg every 10 days.. just to check.. so long as he's acting like he feels good, no need to test, but i still may test amps/pmps. Since Dec 9th I've been giving him a "skinny" 1.5. i tested him this AM amps and he was 296 using the Relion prime. i tested him again at +6 and he was bg251.. is this still considered high? Thoughts? this coming monday I am going to have them run a curve and use both meters alphatrax and the relion.
     
    Last edited: Dec 11, 2020
    Reason for edit: adding more infor.
  2. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Hi Sandy!

    A few things. ReliOn/human meters run higher than pet meters, but there is no comparison between the two. The lower the number, the closer the two meters will match, and the higher the number, the farther apart they will be. Because the low numbers are what's important when it comes to accuracy, and too high is too high, this works for us. It's best to stick with one meter, ideally the ReliOn simply because it's cheaper and all the information found here is catered to human meter numbers.

    For new diabetics, we recommend no insulin if BG is below 150-200. This applies to both Alphatrak and ReliOn. Once you get more data and learn how Logan's BG reacts, you can lower that threshold.

    Most of us here offer treats at testing time, it's why so many of our sugar cats look forward to it! While I didn't necessarily give treats every time I tested Panic, she loved that we'd have a "cuddle session" right before and after the tests, so she was hardly irritated over testing time. And there were times when she was running low that I had to test her every 15 minutes for several hours. Eventually Logan will be used to it and won't even care. :)

    So for curves, most of us don't even do them. The reason for this is that as long as you're "spot-testing" every day - getting in every test before insulin, and at least a couple throughout the cycle - that is going to paint a better picture than one all-day curve every once in a while. Plus, there's a lot of ways a curve can be "ruined" and inaccurate. For example, if Logan got into some contraband, his BG would be running high, or if he dropped too low the night before and his BG "bounced" high, that would also be an inaccurate representation of a "normal" day. When you take Logan to the vet as well, he will be stressed - increasing his BG, and causing the vets to think he needs more insulin than he really does. Personally I would cancel the curve and save your money.

    On Prozinc, we want the BG to act like a "smiley face" - a gentle curve before rising back up. We want all kitties to drop below 150 consistently during midday, so yes 251 is still a high number, however that doesn't mean Logan needs more insulin. Like stated above, he could have been having an off day. In fact I would be very wary of increasing his insulin, since his current dose caused him to drop to 32 a few days ago. I think it would benefit you to test before every shot, then sporadically each day. Here's a loose example you could follow:

    Day 1: Pre-shot, +2, +4, +6
    Day 2: Pre-shot, +1, +3, +5

    By doing this, you will see the effects of the insulin and how low it is taking him. For all you know, between this morning and +6 he could have dropped and bounced back up. That's why "spot-checking" is so helpful. The other thing you want to do is give small snacks to help "steer" the BG safely. We don't want it dropping too fast, so you could give mini meals at +2, +4, and +6 to start, then as you learn when Logan onsets (when the insulin starts taking effect, usually around +2), and nadirs (when it drops BG the lowest, usually between +5 and +7) you can adjust meals accordingly to control the drop.
     
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  3. Panic

    Panic Well-Known Member

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    Your vet is incorrect. There are more times than not that a cat will be dangerously low without showing any symptoms. If we weren't testing, we would have never known. If a cat is acting off, that is red flags and immediate ER visit, we don't wait until it gets to that point, the whole point of testing is to prevent emergencies and intervene before it gets ugly.
     
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  4. Logan & Sandy

    Logan & Sandy Member

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  5. Logan & Sandy

    Logan & Sandy Member

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    Nov 17, 2020
    thankyou for that Panic.. that is what i am afraid of.. if i just LET the VET help me without all this testing and something bad happens...
     
  6. Logan & Sandy

    Logan & Sandy Member

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    Nov 17, 2020
    Thankyou Panic,, i printed out your reply,,, what you mentioned was very informative and important,, and yes i've begun to offer logan treats,, (human tunafish),, i cant always get that many tests during the day,, and unfortunately when i work 3 evenings a week,, sometimes less, i can't test that time in the evening, but i can at least have Logan get his shot thru someone else. but she won't test.. at least not at this point,. but when i'm not working I should be able to do that.thx for the example about the "smiley face". that helps.. and i have begun to give him snacks too.


     
  7. Logan & Sandy

    Logan & Sandy Member

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    Nov 17, 2020
    hi Panic,.. just tested logan at+8 he was at bg192..
     
  8. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    There's many people here that can't test frequently, we have some people who work 12 hr shifts, etc. but we make it work! For those that work during the day, getting evening cycle testing in helps, and those that struggle with crazy schedules during the week try to get the tests done during the weekend. Just do what you're able!

    A lot of us use PureBites freeze-dried treats since they are diabetic-friendly or bonito flakes (they're very stinky though!). I always made baked chicken and pulled them into treat-sized pieces for my girl, it was cheaper than buying PureBites all the time haha!

    Yes ... they can call you paranoid all they want but they're not the ones living with a diabetic cat. I've heard horror stories of vets who didn't take numbers seriously - even one vet who admitted their own diabetic cat had probably died from hypoglycemia when he was at work. You have to trust your gut on this one.
     
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  9. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    I am wondering if Logan needs a reduction. If he is not over 200 by shot-time I think I would skip tonight and look at lowering his BG to 1u or 1.25u ...
     
  10. Logan & Sandy

    Logan & Sandy Member

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    Nov 17, 2020
    hi Panic.. i had to work this evening and just saw your post. Plus I had to leave before he could get tested so I really don't know if he went over 200 or not,, Someone else gave him his full shot... so far tho he seems ok,,+2 after his shot, tomarrow satur, i will be able to monitor him fully,,,,
     
  11. Logan & Sandy

    Logan & Sandy Member

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    Nov 17, 2020
    i don't think that WE are being paranoid,, i know that my 2 vets that spoke to me at the same time were telling me to not monitor his everything, essentially, and to let them help Logan,, well I do plan to test him more often now,, i think like most of you guys that it is imp, and testing is getting a little easier,,
     
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  12. Logan & Sandy

    Logan & Sandy Member

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    Nov 17, 2020
    measured logan at the amps this am before his shot, he was high at bg371 oh well. am gonna test him at +5 or +6
     
  13. Logan & Sandy

    Logan & Sandy Member

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    Nov 17, 2020
    just tested logan again at +6 and his BG was 191.. been giving him the full dose since last nite of 1.5 or prozinc using the relion prime.. this is still high right/? i really don't want to raise his insulin back to 2.0 as he had some incredibly low readings,,,. thoughts?
     
  14. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Definitely no increases right now. Can you try to get some +2 and +4 readings by chance when you are free to? You can also get some later tests (+10 or so) to get an idea of what his PMPS will be. He seems to have a long duration.
     
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  15. Logan & Sandy

    Logan & Sandy Member

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    Nov 17, 2020
    yes. i was trying 2 cut down on the testing a bit cuzz logan is so skittish.. i plan to do a pmps test tonite in about 40 mins from now.
     
  16. Logan & Sandy

    Logan & Sandy Member

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    Nov 17, 2020
    just tested logan at 630+11 he was bg366... i'm wondering if he should have stayed at the 2.0??? BUT I DON'T PLAN TO CHANGE HIS INSULIN LEVELS FOR A BIT, WILL GIVE HIM 1.5U IN 20 MINS
     
  17. Panic

    Panic Well-Known Member

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    No, we base insulin dose on how low the dose takes them, not how high their preshots are. Stick to 1.5 for now unless we see him needing less. Remember, preshots are the last numbers to go down. He could also be bouncing. I'm going to give you a bouncing 101 so you understand what that entails.

    Bouncing is a phenomenon that occurs when the body experiences (or at least thinks it does) hypoglycemia. Luckily the body uses bouncing as a defense mechanism against this where it attempts to compensate the low blood sugar by dumping excess glucose in an attempt to raise blood sugar back to “normal” numbers. Unfortunately, “normal” is a relative term according to the body. For a diabetic whose body has been untreated for so long that it considered very high numbers to be the new normal, lower numbers can often make the body overreact in attempt to save itself, even if it’s not in danger.

    A cat who has been suffering from diabetes for some time may at the point of diagnosis have a new “normal” of 400. When insulin is introduced and brings it down, even to 200 (still diabetic levels), the body thinks it is in danger, dumps excess glucose, and thus the blood sugar skyrockets up to the 400-600s. After enough time has passed, the body will eventually realize that 200 isn’t such a bad number, and bouncing will happen less often. Note some cats are extremely bounce-prone and a switch to Lantus/Levemir is needed.

    There are three main causes of bouncing: when blood sugar drops too low (hypoglycemia), drops lower than the body is used too, or by dropping too much too quickly. Typically if a cat drops more than 50% of their blood sugar a bounce is likely to happen, or if they drop 100 points within an hour.

    While bouncing can be considered as a safety net in the instances of hypoglycemia, it can look very confusing on paper.
     
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  18. Logan & Sandy

    Logan & Sandy Member

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  19. Logan & Sandy

    Logan & Sandy Member

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    THANKS A LOT... that was verY helpful.. just am trying to do the right thing...its not easy (at least for me..and poor Logan)
     
  20. Logan & Sandy

    Logan & Sandy Member

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    Nov 17, 2020
    i'm gonna print this out.. thanks again....
     
  21. Panic

    Panic Well-Known Member

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    Of course <3 If Logan drops below 90 at any point he's going to need another dose reduction as well.
     
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  22. Logan & Sandy

    Logan & Sandy Member

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    Nov 17, 2020
    over the last few days his lowest was bg 191,, so i will just wait and see i guess,, and i will test before amps tomarrow,
     
  23. Logan & Sandy

    Logan & Sandy Member

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    Nov 17, 2020
    logan for the Amps was at bg380 this AM dec12 sunday
     
  24. Vicky100

    Vicky100 New Member

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    Jan 5, 2021
    Im sorry new here.. can you explain the following:
    Day 1: Pre-shot, +2, +4, +6
    Day 2: Pre-shot, +1, +3, +5

    I dont know what that means.
    Thanks!
    Vicky
     
  25. Deb & Wink

    Deb & Wink Well-Known Member

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  26. Vicky100

    Vicky100 New Member

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    Jan 5, 2021
    Thank you..i finally figured out what it meant! I appreciate your reply..lots to read but like the CDK site..pick a subject and search..trying to take it all in will overwhelm! Thank you again! Vb
     
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  27. Logan & Sandy

    Logan & Sandy Member

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  28. Deb & Wink

    Deb & Wink Well-Known Member

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    There is so much information here, that it can be overwhelming.
    The Health Links / FAQs about Feline Diabetes forum has an index Sticky at the top, that has a list of many other documents.

    Don't try to digest it all at one time. Take one document at a time, for topics that interest you. Many of those threads, have links to many other threads. Like I said, one at a time.

    Ask questions. It's how we all learned at the beginning.
     
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