? Advice, please!

I haven't posted for quite a while, but for the past month or so I haven't been able to get Zoey's numbers below the yellows. I've increased her dose twice, from .8 to 1 u to 1.2 u. I still can't get her nadir into the blues, let alone the greens!

I've gotten a new bottle of ProZinc but that didn't seem to make any difference. I'm thinking of raising her to 1.4 but it will have to wait until the weekend when I can be around to test.

I know this isn't good for her and she is starting to look a little scruffy and just not acting like her normal self. I'm considering switching her to Lantus or Levemir but probably not until the first of the year because we are leaving for a week over the holidays and someone else will be taking care of her.

Any advice anyone has for us will be greatly appreciated!

 

IF it was my cat I'd try 1.8-2 units.

 

I've been kind of afraid to jump too fast because she used to be so sensitive to even a .2 increase! But maybe she's past that now and just needs a bigger boost. I'm still nervous to increase too much because I can't be around mid-cycle to test her until the weekend.

 

You've got along way to go. If you are nervous to do 1.8 or 2 until the weekend then do 1.6 until then.

 

Hi Carol! The protocol does say that when the nadir is over 200, you can make increases of 0.5u as long as you can monitor. That being said, we often say "Know Thy Cat" around here, and if you know that Zoey is sensitive to increases, that it's absolutely fine to stick with the 0.2u increases at a time, but maybe do them at the 3-6 cycle frequency since you do want to get her out of those numbers.

It looks like Zoey has been at this dance for quite awhile, and looking through your past data, I do see the dives and spikes that give you some concern. A few things that we've found to help with bouncing:
1. Low carb food. Low carb snacks. Anything medium carb or high carb, even just a little, will cause volatile numbers
2. Consistent food. I feed my cats three different low carb foods, but they are in a consistent schedule. so it doesn't have to always be the same, it just needs to be steady and about the same nutritional values.
3. Consistent test and shoot times.
4. Consistent dosing. Prozinc can be dosed on a sliding scale, but the more consistent the dose, the more consistent the nadir is likely to be. So if you don't have to change the dose, try not to. Some cats you just have to, but with many, you can hold the same dose even when the PS changes, and end up with similar nadirs.

So those things help reduce bouncing in some cats. But some cats will just bounce no matter what. And sometimes our lives just don't let us be as consistent as we'd like. You've been at this long enough, that I'm guessing you have all or most of that in place already. So assuming that is true, I do think you could do a 0.2u increase now and be safe. Then in a few days, do another 0.2u increase (assuming she holds steady with the numbers you're seeing). Then by the weekend, she might be starting to show some better numbers.

You're testing late enough into the PM cycle that if she is going to go wonky, you'll see it.

And as always, you hold the syringe, so if that still feels too aggressive, it's okay to ask more about it, or to wait until the weekend. We can give our best thoughts, but at the end of the day, the choice is always yours because you know Zoey best, and you have a long history of taking care of her through all of this.

 

Thanks so much for all of your advice. She did go down a little last night. Her PMPS was 279. That's the first time she's been below 300 for quite a while. But back up to 350 this AM!

In answer to your statements above:
1. She only eats Friskies Pate or Fancy Feast Classics. I occasionally give her cheese, egg, or chopped meats. The only treats she gets are freeze dried minnows, chicken, or turkey. She does occasionally try to kill herself by getting into the dry dog food and gorging herself! She pays for that for a couple of days. But I've moved where the dog food is stored, so hopefully that won't be a problem anymore. She's a Houdini cat who can open cabinet doors!

2. She gets fed twice a day if I'm not home during the day to spread it out. She gets one can of Friskies or 2 cans of Fancy Feast twice a day. She isn't overweight, staying between 7 and 8 pounds, so I don't think she's being overfed. She does not get any food for 2 hours prior to her shots.

3. We try to stay consistent with 8 am and 8 pm shots. If we need to change the schedule, we try to move it 15 min to 1/2 hour each day before and after the necessary scheduling conflict. I have a friend who will test her and give her shots when we have to be gone.

4. I do hesitate to give Zoey the same dose if she goes below 250. She used to react to even tiny dose changes by going quite low and then bouncing. But lately she's been staying consistently high, so I may have to be a little more aggressive. She's just so little that I worry if I'm not home to check her.

Again, thanks so much for your advice. I appreciate the extra support even though we've been at this for almost 3 years!

 

Is there any way you can keep her away from the dog food? If you are quitting meds or supplements, I wouldn't change the dosage for a week or so to see how that affected her. I don't think her numbers are too bad. If you look at my Chloe's SS, it's much the same. I've finally gone off panic mode and into patience mode. If she's yowling for food at breakfast or dinner, then I know all is right. Also, she drags around empty tins of cat food and makes weird sounds, so I know she has a good appetite. I've even woken up to empty tins on the bed. Lately, I've been giving her extra to eat because Chico and Cheddar push her away. I think she's also gaining weight which is a good sign.

 

I moved the dog food to a pantry that has a door that she can't open. However, she is very, very sneaky! I'm keeping her at 1.2 until the weekend. Then I think I'll go up to 1.4. I don't think I can go up more than .2 without her overreacting. She is looking better and acting more like her old self, so maybe things are calming down. She never seems to gain weight, no matter how much she eats!

 

She'll probably gain weight as she gets more under control. They usually do.