? Target BG range

I have just recently been able to begin home testing and am still struggling to be able to test every single AMPS and PMPS. I was originally instructed by the vet to give 2 units of Prozinc twice a day until we ended up in hypo and got that straightened out thanks to the help of this group. Now Keiffy's dose has been reduced to 1 unit and only if his preshot level is over 200. I will talk to the vet and share his spreadsheet but I'm not sure where to go from here and not sure I trust the vet's advice. I don't know if now his dose should be adjusted lower and be given more regularly or keep doing what I'm doing. I don't even know what the range is for ideal levels. Now that Keiffy is much more cooperative and I'm better at getting a blood drop, I want to try to do a curve but need to wait until my work schedule allows a full day free to do that.

Any advice and info is GREATLY appreciated. Thanks!

Carol

 

@Deb & Wink

@JanetNJ

@Chris & China (GA)

Thank you ladies

 

Hi Carol,

The normal feline BG reference range as measured on a human meter is 50-120 mg/dL. (I'm sorry I can't help with the dosing side of things but I haven't used Prozinc.)

Keiffy is a very handsome boy. Gorgeous face!


Mogs
.

 

He sure does have a beautiful face

 

You may be able to give 0.5 if over 150ish, but you would need to get more data mid cycle. Can you get a +4-5 before bed and tests mid day? If you work during the day perhaps extra tests on days off/weekends?

 

I will try to test like that this weekend. I think it’s a good suggestion. I feel like we need more details and info. Thanks!

 

Thank you Janet

 

He sure is a pretty kitty!

 

Gesundheit

 

Curves can be useful, but even more helpful is getting some more BG tests in during the middle of the cycle, so you can see what the nadir (how low) a particular dose drops your kitty.

It was good that you got a test on the PM cycle on 11/28/20, that showed Keiffy needed a dose reduction.

It takes time to get good at testing, and gaining cooperation from Keiffy. Bribes, like yummy food, extra attention, maybe some play time or brushing are all good methods to use to get your cat used to testing. Any kind of pure protein treat is a good food for a diabetic cat treat during testing. Many people shake the container of freeze dried treats, and their cat comes to associate that sound with a yummy treat.

Filling in those blank spots in the middle of the cycle, is like putting "books" between the "bookends" (the pre-shot tests).

You want to be able to find a dose that you can give the insulin shot in both the AM and PM cycles. But to judge better what that should be, some testing to put "books on the bookshelves" is needed. So right now, it's kind of a "catch-22" situation, with not a lot of data for us to go on to see what the dose should be.

Having said that, I think that you have had to skip shots, and that has not sent Keiffy's BG levels sky high, into the pink, red or black BG ranges, indicates the 1U dose is too much for him. So I'm in agreement with Janet on trying 0.5U for now. Ultimately, you are there and know your schedule and needs and how Keiffy acts better than we ever will, so the final choice is yours.

You test when you can. We know that most people have LOTS of other life responsibilities, like work and grocery shopping, and cooking, and taking care of your family. So sit down and take a few minutes to see when else you might be able to test.

p.s. This thread I'm linking for you, has an overly dramatic title, but it does have a very good list of hypo symptoms to look for, and what to do in case of a hypoglycemic episode.
Sticky How to treat HYPOS - THEY CAN KILL! Print this Out!!
You can find this and lots of other information (sometimes too much to digest) over in the Health Links / FAQs about Feline Diabetes forum.

 

Thank you Deb

 

So today I was able to test every two hours. I'm thinking maybe I shouldn't have given him any insulin this morning because he was barely 200 but he didn't go really low so I don't know. I'm going to send his spreadsheet to the vet and see what they say but I'm more interested in the advice I get here. He's eating well. He's playful and seems to feel good! He's like a different cat than a month ago.

 

Ok, we'll look at Keiffy's SS and give you second opinions. No charge.

That curve you ran today on Keiffy looks pretty good to me! He got into the low blue BG range, which is really nice!
You dropped the dose down to 0.5U too, and he still got good BG numbers.
Ideally, you want some BG numbers down in the green number range, <100 mg/dL but above 50 mg/dL. We call those the "healing numbers" because it gives a cat's body time to rest.

I'd expect Keiffy to bounce for the next AM cycle, since he went low today and you skipped the evening (PM) shot.
Do you know how to "stall"? If you get a BG that is lower than you expected, don't feed, retest in about 20 minutes, and see if the BG number is rising. Stalling for no more than 1 hour is suggested with Prozinc.

You might try to get at least 1 test in this PM cycle 12/13/20, to see how high he goes without insulin.
A "before bed" test is a good one to get each evening.

What did Keiffy "snack on" around +4?

If even the 0.5U dose takes Keiffy down to those low blues, and you have to skip the next shot, you might want to consider giving him even less insulin. A dose of 0.25U would be the next increment down in dosage. There are no syringes that have lines on the syringe barrel for those 1/4 Unit doses. So you have to do your best to judge the dose by "eyeballing" it. Doing your best to be consistent is what you are trying for.

 

I have read about stalling. I'm sure he won't appreciate it but I'll try when it's appropriate. I have a tight schedule so it's impossible for me to do anything in the mornings beyond testing and giving a shot if he needs it.

He snacked on some dry Dr. Elsey's that his brother had left in his bowl. I doubt he ate more than a few pieces because he is not a fan of dry food at all. His diet is almost all "soup" - either Tiny Tiger, Fancy Feast or Friskies Pates blended with equal parts of warm water. Lately it's been all Tiny Tiger.

I just checked him as I have to get to bed and he was 192 - a little higher but not a lot. This was actually two and a half hours after the PMPS reading.

Thank you for the info and advice. And for "no charge!" Lol!

Take care,
Carol

 

Well he just mystifies me. He went up a little before bed, then down a little during the night and was higher at PMPS. since he was over 200 I gave him half a unit.

I emailed the link to his spreadsheet to his vet. A tech called me today with instructions to “keep doing what I’m doing.” When I said I had dropped to half a unit if he was over 200 rather than one unit she said that’s fine. I think I need to find a new vet. I’ve had one actual conversation with him. Everything else has been messages relayed by his staff. It’s hard to have specific questions Answered.
I’m still not sure what the best course is.

 

Keep asking for help here, on this message board?

And this too.

 

Umm ... did I say something wrong? I would love help and advice on dosing going forward.

 

No, I was replying to what you vet's had said back to you. Not to anything you had said. Sorry for the misunderstanding.

We'll keep giving dosing information, as well as other help as long as you keep asking.
So one thing that would really help us to help you better, is to see how low a particular dose is taking Keiffy.
Some random tests when you are able to. In other words, not a day you are away from home working or taking care of other commitments. But other days and times when possible.
Getting a "before bed" test every evening (PM) cycle really helps too.

Will Keiffy let you do that, do you think?

All our dosing experience takes those mid-cycle tests into consideration. Knowing how low Keiffy goes, even if you end up skipping the shot, giving him zero(0) insulin for a 12 hour cycle, can be informative.

 

Perhaps we could answer some of those questions for you, that you have not been able to ask him. It doesn't hurt to ask. So ask away please. If we don't know, we'll say so.

 

Thank you so much! I will definitely try to get some more data and more frequent tests. He did amazingly well yesterday being tested every two hours. Was easy this morning but not so agreeable this evening. Everyone at work is hoping we will get a snow day Wednesday so that day might give me an opportunity to do some testing in the middle of a cycle. My main question is at what level I should shoot and how much. Is it important to keep a consistent dose for a time as long as he doesn’t go sky high or hypo low? Or Is it better to stick to a rule that is something like shoot over 200 and don’t shoot under 200 (or another number)?
I thought I was kind of getting a feel for how his numbers go but I really expected him to be high this morning and he wasn’t.

 

I might try 0.25 over 130, 0.5 over 200.

 

Sounds like a plan. We’ll see how it goes. Thanks! Hope you have a good night.

 

So....this morning he was surprisingly high at 301. Out of the blue. I sort of panicked and gave him 1 unit. After, I thought maybe I should have rechecked - that 301 might not have been correct? Anyway thanks to a snow day I can check him again off and on today. 100 at +4.
Are these swings normal?
Only other change was switch from tiny tiger to friskies pâté four meals ago. Gave him tiny tiger again this morning but he ate very little.

 

My cat has a higher than normal number today. In going to blame it on the snow.