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Do Daa’s PZ Dosing

Discussion in 'Prozinc / PZI' started by Goose, Nov 11, 2019.

  1. Goose

    Goose Member

    Joined:
    Oct 2, 2019

    SS Updated. No change so far with 2U am/pm, still to high.

    Link to Health Thread (added by Moderator): New Here and Concerned About the Numbers
     
    Last edited by a moderator: Nov 14, 2019
  2. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    If you are also up by +10 or +11 of the pm cycle, a test then would be helpful. You would still need the AMPS.

    This thread is getting really long. It would be great if you felt comfortable posting again in the PZ forum and we will link this thread there. I know you got no responses there last time but, if you will continue to tag me, I’ll follow you there.

    Thank you!
     
  3. Goose

    Goose Member

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    Oct 2, 2019
    The pm cycle being? His pm shot? He's given insulin around 9pm every night. So I'm not understanding +10 or +11....

    Threads here don't go on for multiple pages, just one? I don't see my thread getting much attention if in a forum fewer people view.
     
  4. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    If you shoot at 9pm, +10 would be 7 am. Not every night but a few so we can see if he’s staying high all night or going a bit lower and then coming up by AMPS. You would still get the PMPS test and the +3 and +4 as you’ve been doing.

    Once there are so many posts on a thread, it goes to a second page. There are many people on the PZ forum but quite a few are newer and that might be why you didn’t get responses but I promise I’ll look for you there. And pls tag me by just typing @Marje and Gracie .
     
  5. Goose

    Goose Member

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    Oct 2, 2019
    SS Updated. No improvement. No blue numbers.
     
  6. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Thank you. I’m talking with a couple of PZ users about his BG.

    It’s really important to see some tests in the +8 to +11 timeframe both cycles. Even one within that timeframe each cycle would help. Are you willing to do that?
     
  7. Goose

    Goose Member

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    Oct 2, 2019
    To clarify, +8 would be 6am (based on a 9pm shot) and +11 would be 8am (he would be tested at 845am and shot at 9am anyway) and at night at 6pm and 8pm (tested at 845pm and shot at 9pm anyway) So the only time that would be truly different would be at or around 6am.
    I'm still trying to get it all down, please bare with me.

    Updated SS.
     
    Last edited: Nov 13, 2019
  8. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Yes...+8 in the p.m. cycle would be 8 hours after his 9 p.m. shot or, as you said, 6 a.m. And +11 in the p.m. cycle would be at 8 a.m. You would be amazed at how fast numbers can change in one hour. And yes, for the a.m. cycle, +8 would be 6 p.m. and +11 would be 8 p.m.

    You are getting a range of mid cycle tests during the day which is very helpful. Do Daa has shown, in the past that he can nadir late (9/28 at AMPS, 9/29 at PMPS, 10/14 at PMPS).

    In some cats, when they go low, the body will then respond by releasing hormones that drive the BG way up. In other cats, we see high, flat numbers because they might need more insulin. Only testing will help us determine which is happening.

    It just isn’t clear with him and I don’t want to suggest you drop the dose back and set him back because he might already be insulin resistant, but, more importantly, I don’t want to put him at risk of a hypo if we don’t know how low his nadir is.

    Even with all my experience, I can’t “crystal ball” patterns without a few more tests. Random tests between +8 and +11 help to see if he’s pulling late nadir patterns on us.

    Yes?
     
  9. Goose

    Goose Member

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    Oct 2, 2019
    So I guess we'll try and do some 6am/8pm and 8am/6pm tests. Do we still do the afternoon tests or are we reasonable sure where he is at the current dosage?
    We'll hold 2u one more day and start the other testing Friday- (maybe later this morning, I'm not sure)
    How many days? Stay at 2U initially?

    If I test him at 8am I don't need to test him 45min later when I shoot him at 9am....
     
    Last edited: Nov 13, 2019
  10. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    • Yes, please get a midcycle test each daytime as you have been doing. And the +3 at night as you have been.
    • Please hold the 2u dose until we get at least three days of increased testing.
    • If you will keep the SS updated, I’ll check in each day and let you know whether to hold the dose longer or not.
    • If you don’t want to test him at +11 and at PS, then perhaps +10 or +10.5 and PS. We don’t skip PS tests.
    Thank you for helping us help you.
     
  11. Goose

    Goose Member

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    Oct 2, 2019

    Hi,

    Updated the SS.

    Ok, we'll give it a shot. Today-Saturday as scheduled at 2U am/pm.
     
  12. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Thank you. We really appreciate it. With a little extra testing for a few days, it will help us figure out what he’s doing. Cats are sneaky with their BG!
     
  13. Goose

    Goose Member

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    Oct 2, 2019
    Sneaky is not the word I'd use, it would be extremely frustrating. :(

    Hopefully this thread will get some attention still, being moved in here. Just seems a little less active is all.

    SS Updated.

    On the SS, where do I put the 6am (474) and 8am (537) numbers for 11/14?
     
  14. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    If you are still shooting on 9am/pm schedule, then the 474 would go in the +9 PM cell and the 537 would go in the +11 PM cell.
     
  15. Goose

    Goose Member

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    Oct 2, 2019
    Hi again,
    Thanks for that, and yes, still 9am/pm schedule.
     
  16. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Excellent. Thank you for updating.

    I’ve asked @MrWorfMen's Mom and @FurBabiesMama to help me keep an eye out for you on this forum. Because we are all on at different times and some times it gets really, really busy with cats in low numbers or emergencies, then if you don’t get a response within a few hours, tag us as I have done above. But don’t list the tags horizontally if you tag more than one of us. It needs to be vertical or we don’t get the alerts.

    Yes, we understand it’s frustrating and putting the pieces of the puzzle together takes patience. We always say FD is a marathon, not a sprint, but once we identify which way is best to go in dose, he will start to make progress, I am very hopeful.

    He’s feeling fine and eating well? Does he urinate a lot or out of the box?
     
  17. Goose

    Goose Member

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    Oct 2, 2019
    Thank you all.

    He seems to be drinking more with higher dosages of insulin but not as much as he was in the beginning. He is currently up to almost a full 3oz can of FF a day plus his normal Clean protein dry food, 2+ cups a day or so. As for the urine, there is no more out of the box peeing. I think that he isn't peeing as much as he was, but he's also getting more water from his wet food now, I'm sure that helps a little. As of a couple days ago, his Kentone was negative.

    As for feeling fine, he leads a rather sedate life. He is not as lively and interactive as before he was diagnosed. It seems to have not gotten any better with what we're doing.

    All or most of the figures that are showing up in the SS are done with no food 2hrs. before each test. It seems that this way the numbers are the most accurate, No? It's more trying for him to be sure.

    Is it possible to link the old thread in the first post of this new one so people can view what went on to get to this point, please?
     
  18. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    You don’t have to go two hours without food before tests except the preshots. For the other tests, just test first and then feed him but don’t worry if, for example, you tested at +4 and he was at 90 so you fed a bit of LC food and then tested at +5. That’s normal and the way we do things. You just don’t want to shoot a BG that has a food influence so we generally don’t feed two hours before the PS test. There are sometimes exceptions to that.

    I’m sure he’s not feeling lively at these numbers. We also notice that once we get cats into normal ranges, they, at first, act like they felt better in the 200s but that passes. Is there any chance at all of slowly reducing the dry food so he only eats canned? I say slowly because anything else has the potential to radically drop the BG.

    If you look in the first post of this thread, I already linked the other thread when I made this one. The link is in dark blue and has “Added by Moderator” in bold black. We always link previous threads :)
     
  19. Goose

    Goose Member

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    Oct 2, 2019
    Yeah, he is defiantly more sluggish and non-interactive than he used to be, which is sad.

    So giving him food before all the other tests, or letting him eat all day between those tests, won't influence there results to the negative?

    As for the wet food, that will be a long road with him. Getting him to almost 1 can has been a feat in and of itself. He's a die hard dry food eater. We want to make sure he's getting enough calories and he would have to eat a lot more wet food for that to happen, and that's not yet.

    I did notice that you had added a link, but I did not click it as I thought it was something else because it didn't have my thread title, my bad. :)
     
  20. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I’m sorry. I’m hoping we can change that.

    Many members free feed. It more depends on the carbs in the food you are giving him. Cats often do best with foods that are in the 6-10% calories from carbs range. The insulin needs food to work with. For example, if you fed one meal in the morning and gave insulin and then didn’t feed again until after the next shot, it’s possible that the numbers would come flying down depending on the dose. I had that happen with my cat when one of my other cats ate her food and i didn’t realize it until it was too late. Food can help stabilize the BG a little more and small meals help the pancreas a little more. While, again, some cats are free fed through the cycle, we usually recommend that feeding be kept to a minimum after mid-cycle because it causes the duration of the insulin to be compromised. It’s like slamming the brakes on a car before you get to the stop sign. If a cat is really hungry, a small, very LC snack is fine.

    I can put the name of your thread if you prefer. Members will know what I meant and they will click on it to read the previous thread. But if you’d like to have your title on it, I can fix it. Easy. Just let me know.
     
  21. Goose

    Goose Member

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    Oct 2, 2019
    He's not free fed throughout the day, unfortunately the other cats would eat all his food. So he has to be regulated in that respect. I just didn't want to feed him something if he's hungry before say, a +4 or +5 reading in the afternoon and have that reading completely off. What is "LC"? If you could put my thread title on the link I'd appreciate it.
     
  22. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Sorry; LC is low carb. MC is medium carb. HC is high carb.

    If he’s hungry before a +4 or +5 feeding, feed him a LC snack. Many members feed their cats mini-meals at PS, +1, +2, +3 or a variation that works best for their cat as to how the insulin affects them.

    I’ll change the title on the link.
     
  23. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Is Do Daa actually eating 2 cups of the Clean Protein himself or is that shared with the other cats? A cup of the Clean Protein has 544 calories. If Do Daa is consuming even half the dry food, it is going to effect his BG adversely not to mention his weight which also needs to be controlled to help get his BG down. Even a larger cat doesn't need anywhere near 600 calories per day so even if Do Daa eats one cup of the dry and a can of FF, he's getting far more calories than he needs.
     
  24. Goose

    Goose Member

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    Oct 2, 2019
    No, I mis-typed. He's getting almost 2/3 of 1 full cup a day per the Vet's recommendations. And almost 1 can of FF (140 calories?) He is not eating all of almost 2/3 1 cup of CP per day right now. We are trying to transition him to only wet food, this will take some time.

    She said that Clean Protein, 1 almost full cup was, 450-470 calories per day based on his weight of 14.5lbs.

    What do I do when his BG is at +11 (8pm) and its 254. Do I shoot him with 2U or nothing?

    SS Updated.

    Waiting to do this soon......
     
    Last edited: Nov 15, 2019
  25. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    BG can change a lot between +11 and +12 so I would still get a PMPS (+12) test to know exactly where Do Daa is when you are ready to give insulin. That said, you can still give the same dose of insulin and I would suggest you get a +2 post shot test to see where BG is going. If BG is higher , the it's unlikely it will be an a active cycle however if it the same or lower, it would be advisable to get another test at +3 to catch any further drop in BG and determine if further testing or any steering (feeding according to BG) is needed. Please let us know how things are going tonight.
     
  26. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    On the food front, 2/3 of a cup of Dr. E's plus a can of FF (about 80 to 100 calories depending on flavour) is still a lot of calories. Dr. E's website says calories per cup are 544 so 2/3 of a cup would be about 362 calories. Assuming Do Daa is only eating 1/3 cup his caloric intake right now would be about 260 calories which may be in the ballpark of his needs. If he is consuming more than 1/3 cup of the Dr. E's, then his calories may be too high. What is Do Daa's ideal weight?
     
    Diane Tyler's Mom likes this.
  27. Goose

    Goose Member

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    Oct 2, 2019
    We'll still test at 9pm as usual and give him 2U.

    Test him again at 11pm (+2) and if higher, test again at 12am (+3) Yes?
     
  28. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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  29. Goose

    Goose Member

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    Oct 2, 2019
    Thank you! What if he is really low at 12am?

    Yes, he is eating less than 2/3 of a cup in a 24hr period plus 90% of a FF can. The Vet said 450-470 calories per day, with the above calorie figures, he's getting roughly 460 calories per day...

    How do I determine his ideal weight?

    He's weight right now is about 14.6lbs. He's gained about .1lb since September 27th when he was at the Vet last. He seems to be eating less dry food, but it will take more time for the wet food to be dominant.

    Updated SS. 9pm test 299, but he did have a little dry food around 8pm.
     
    Last edited: Nov 15, 2019
  30. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Unless Do Daa is one huge kitty, I think the vet's estimate of calories is way off. Assuming that Do Daa is roughly at his ideal weight now his calorie needs would be 13.6 X 15lbs +70 for a total of 275 (rounded) calories which is considerably less than your vet seems to think he needs. Did Do Daa lose weight since diagnosis? Had the vet ever mentioned he needed to gain/lose weight prior to diagnosis? Do you have any breed info that might suggest he's a big cat like Maine Coon for instance?

    The vet should be able to tell you based on bone structure what an ideal weight would be for Do Daa. Weight is an important part of the equation for a diabetic as weight plays an important role in BG levels and can effect insulin resistance so it's important to make sure kitty stays at a reasonable weight and not allowed get too "fluffy". If Do Daa needs to regain weight he's lost it's Ok to feed more calories right now but what your vet is suggesting seems excessive to me.

    If BG is really low at 12am, then we feed and steer BG and test until BG is in good range and holding on it's own without the need for extra food. We'll keep an eye on you.
     
    Diane Tyler's Mom likes this.
  31. Goose

    Goose Member

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    He's a fairly large cat, every bit the size (bone structure) as two Maine Coon's that we had a number of years ago. At 14.6lbs, he's gained .1lb since at the Vets. He is virtually unchanged if you were to look at him now, verse September. The Vet has not suggested one way or the other about his weight being good/bad. He has lost 4lbs over last year's wellness check at the Vets, I believe he was 18 or 18.5 lbs.
     
  32. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    If Do Daa is more the size of a Maine Coon and looked better at 18 lbs then calorie requirements for the average cat of that ideal weight would still only be about 315 calories per day.....not 400+ as suggested by your vet. If Do Daa needs to gain weight then extra calories are fine to a point but his weight needs to be watched so he doesn't gain too much. The calories I am suggesting are average for a cat of average activity level. If Da Daa is a couch potato, then calorie needs may be less or if he is hyperactive, they may be slightly more but the adjustment for either situation wouldn't normally amount to anywhere near 100 calories per day.
     
  33. Goose

    Goose Member

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    Oct 2, 2019
    He looked more over weight at 18, there was a belly (hanging down) visible. His belly is much smaller now. He was imposing to the other cats. He is more of a couch potato it seems now with the BG issue and the insulin. He is an indoor cat but is allowed to be outside with someone in a section of the yard, but now it's cold and snowy, he doesn't go outside.

    So 90% of a FF can, and (2) 1/3 cups per day is too much? It's sometimes hard to get him to eat that. He hasn't eaten near a full cup in a while now. I just want to make sure he has what he needs and isn't hungry at all if he has to be poked this many times a day.
     
  34. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    If you back off the amount of food a bit and he gets hungry I have no doubt he will let you know. It's Ok to indulge him with a little extra until he gets regulated but try to monitor what he IS eating for a couple of days and then we can possibly come up with a reasonable calorie recommendation. Consistent feeding is also a factor in regulating a diabetic.
     
  35. Goose

    Goose Member

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    Oct 2, 2019
    SS is Updated. He eats every 2.5 to 3 hrs. for sure, he's been and is being monitored. He eats little each time, being a grazer. The times we get him to eat wet food, he has to be coaxed into it as appose to choosing the dry. I've seen him hungry before, but not famished. Hungriest after preshot testing.
     
  36. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    How about dishing out 1/3 cup of the dry food in the AM and then re-measure the left overs the following morning for a few days to see how much he is actually consuming? Only top up the bowl to the 1/3 cup again. It's easy to know how much canned food he eats but the kibble is a little more difficult to gauge by vision alone and it's very calorie dense so quantity needs to be controlled more so than with the canned food. An extra 1/2 can of wet food would be about 40 to 50 calories whereas an extra 1.5oz of dry food would be about 100 calories.
     
  37. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I see Do Daa has dropped back into yellow. Can you set an alarm +6 or at latest +7 to see what BG is at that time tonight? Looks like this could be a more active cycle tonight and getting that test would help us see just how low Do Daa is going on the 2u dose and especially overnight when kitties often go lower.
     
  38. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Thanks, Linda, for checking in today. I’ve been a bit under the weather but just wanted to check in before I went to bed. I’m very happy to see these yellow numbers! Let’s hope we get a clue tonight as to what this boy is doing.

    Goose...I hope you can grab a couple more tests so we can try and catch his lowest point (nadir). I might have some thoughts on the food/calories tomorrow and if I have anything to add, I’ll let you know.
     
    MrWorfMen's Mom likes this.
  39. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    Here is a body condition chart that may help you determine if your cat is at a good weight versus too thin or to heavy:
    [​IMG]
     
  40. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    How did it go last night? We are all anxious to see how low he got.
     
  41. Goose

    Goose Member

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    Oct 2, 2019
    Hi all,
    SS is updated.
    There were no addition BG checks before the 6am (+9) hour. I wasn't online for the last messages.

    3 days have gone by, have we come to a consensus about amount?
     
    Last edited: Nov 16, 2019
  42. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    We are discussing Do Daa and will advise as soon as we have a consensus of opinion. It looks to me like Do Daa dropped more than we are aware of last night and is now bouncing back up to higher numbers. He's still a puzzle.

    Most cats on ProZinc will reach the lowest part of the cycle between 4 and 7 hours post shot and most go lower at night than during the day. Is there any way you could, when needed, set an alarm to test Do Daa within that time frame at night? This is not only to try to sort out what is going on with Do Daa but also to keep Do Daa safe.
     
  43. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Let me add to Linda’s post.

    Do you understand what we mean by “bounce”? When our cats are diagnosed, they’ve likely been at high numbers long enough that the liver “recognizes” the higher numbers as the “new normal”. When insulin is given, anything lower, and it doesn’t have to be really low, causes the liver and pancreas to release counterregulatory hormones and glucagon to raise the BG back to “safe” numbers....which are the higher ones. This is called bouncing and all diabetic cats do it for varying lengths of time. Bounces can take up to six cycles to clear.

    Eventually, as the dose improves and the numbers come down, the liver acclimated to the lower (still safe) numbers and the bouncing usually minimizes.

    The fact that he dropped 70 mg/dL in one hour last night along with the black numbers tonight tells me he went lower than his liver was comfortable with. I wouldn’t be surprised if he came down to at least mid yellow before popping back up.

    I’m with Linda that it looks like he may have been bouncing up in response to coming down into yellows. To me, he needs more insulin but you have to be willing to grab varied spot checks at night and during the day. We aren’t talking about a ton of tests but even two per cycle (in addition to the PSs), when he’s likely to be most active, will help. Once the BG starts to cone down, because cats are often lower at night, you’ll have to be willing to test accordingly to keep him safe.

    Thoughts?
     
  44. Goose

    Goose Member

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    Oct 2, 2019
    *The only tests we have not done that I can see is between 1am up to the 6am hour. We have been doing tons of testing.

    A puzzle, great, not what I wanted to hear. :(

    The lowest number I see on the SS is 254 at 8PM and he went up from there. 12AM he was at 284.
    It's Highly Unlikely any testing will be done after +4 pmps which is 1AM.
    I'm not looking to alienate anyone here what-so-ever, and appreciate all of the assistance so far, however, sleep cycles are being disturbed quite a lot . I'm hoping we can figure this out with what information we have available, he's been through a lot of testing already.
    Kentone is negative.
     
  45. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    For where his BG is and the info we see, we would normally recommend increasing the dose to 2.5u. However, if you aren’t willing to set an alarm and test him at +6 or +7 when he’s headed down, as he was last night, none of us are comfortable recommending more than a 0.25u increase to 2.25u twice a day.

    We’ve all been there on lack of sleep. If you look at my Gracie’s SS, you’ll see when she was headed up, I didn’t test much after +5 which was midnight for me. But headed down, we would set alarms and take turns testing so that one of us would do one night and the other the next so we could sleep.

    It’s great you are testing ketones and you’ve done a great job on our experiment so we can see he needs more insulin. But the only way to keep him safe is through testing.
     
  46. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    I want to also clarify the above. I’m not talking about 4-5 tests a cycle. I’m talking about the preshots and then 1 or 2 tests during the cycle. @FurBabiesMama is a long-time PZ user so I’ll let her suggest the best times.
     
  47. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    Goose, don't feel like your cat is the only 'puzzle'. That is often what it feels like when trying to figure this stuff out. Unfortunately, none of it is black and white, so there is a degree of experimentation involved in figuring out what works. That is why so much focus is put on getting as much data as possible through testing. You're in a rough part of it right now, but it will be worth it once we 'crack the code' and get Do Daa on track. (I like his name. :D) A lot has been said about testing, but let's step back a minute and talk about what is needed and why.

    Regarding testing, as has been stressed already, you obviously want to test before every shot. Hopefully, that part is beginning to feel very routine already... test, feed, give shot. The main point of that is to keep Do Daa safe. When you are seeing so many high numbers, it may not seems so important, but you never know when he could surprise you with an unexpected low number. And, besides, that test gives you a starting point from which you can then see what impact the insulin has during the cycle. The mid-cycle tests are important so you can see the impact of the dose, and again, safety does come into play. Even though he seems to always be high, a low number can come out of nowhere and testing allows you to catch it when things are heading that way so you can intervene and avoid any kind of crisis. Now, as much as we would all love to know what his glucose is every hour of the day, obviously, that is not reasonable (well, unless you got a Freestyle Libre, but that's a different discussion). So, for your normal daily testing, I would suggest doing your mid-cycle tests between +3 and +9. This is the time ProZinc is usually most active with the lowest point usually falling between +4 and +7. If you can get a couple of tests in during each mid-cycle right now while we are trying to figure things out, that would be terrific. It is important that at least one of them is between +4 and +7 - and if there is a cycle where you can absolutely only get in one test, make it during that time. I know the impact it has when you have interrupted sleep over an extended period of time. So, I understand what you are saying on that, but it is so important that we know what is going on both during the day and the night. Not trying to get too personal here, but do you get up to use the restroom during the night?? That might be a good chance to do a test without interrupting your sleep too much. If you don't, then it really is worth setting an alarm to do a test in that crucial +4 to +7 window. You can vary the time.. one night +5, the next +6, and so on, so that you begin to get a better picture of what is going on. Another thing you might consider is doing a curve on a day when you can. A curve means testing at pre-shot then every two hours (or three, if you cannot do two) up until the next pre-shot. Doing that gives you a snapshot of what a cycle looks like, when the insulin starts working, when Do Daa goes the lowest and when he starts heading back up. In my early days of ProZinc use, I found it helpful to do one at least every couple of weeks. If you cannot do one, it just takes longer to gradually accumulate enough data at different times during the cycles to figure out the same things.

    That was really long (sorry), so to summarize:
    Test at every pre-shot.
    Test twice during every cycle, if at all possible, between +3 to +9 with at least one of the tests being between +4 and +7. Vary the times some within those ranges.
    If possible, do a curve periodically.

    Do you think this is reasonable and doable for you?
     
  48. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Hey Goose

    I see you held the dose today instead of increasing. Do you have questions of us?
     
  49. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    Hi,
    I'll start the increased dosage of 2.25U (best guess on syringe) Tuesday am.
     
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  50. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Thanks for the update. We'll be watching to see how the increase goes.
     
  51. Goose

    Goose Member

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    Oct 2, 2019
    Hi,
    I took a break and wasn't online, that's why I didn't increase today.
     
  52. Goose

    Goose Member

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    Oct 2, 2019
    Are we suppose to try this new dosage for 3 days and see what the results are?
     
  53. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    You want to hold a dose at least three days (6 cycles) before increasing. The only exception is if a dose takes him too low. Then, a reduction can be done sooner.
     
  54. Goose

    Goose Member

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    Oct 2, 2019
    Updated the SS.
    Thanks!
     
  55. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Thank you for updating the SS. The first day on a new dose is usually not indicative of how well that dose might work so just stay the course for the moment, be patient, keep the SS updated and we'll see if Do Daa's numbers improve.
     
  56. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    The last couple of days we've been scrutinizing his food intake. He's eating 1/3 cup of Clean Protein in 24hrs. and he's eating 1 can of FF classics of various flavors in a 24hr. period. He is still a huge fan of the dry food, but we hope in time to transition him completely to wet. So, while the dosage might not be correct yet, at least some improvement in his health is happening.
     
  57. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    A quick calculation suggest that is a rough caloric intake of 270 calories which may or may not be enough for Do Daa. If he seems to need more food, try leaving him some wet food to fill that void. Getting him onto a totally wet diet would be optimal but Do Daa has to eat and if he has to have kibble, the Clean Protein is at least low carb.

    My girl was a kibble addict from the day she joined our family at 10 wks old. I tried to transition her to wet food from day 1 but she was having none of it. At the time, it wasn't of urgent importance so we didn't push the wet food but rather coaxed her. Needless to say, 4 yrs later with a diagnosis of diabetes, I was ruing the day I gave up trying to get her onto a wet diet. I had two other cats eating the perfect diabetic diet and she wouldn't touch wet food of any kind. Interestingly, one day I think hunger got the better of her and I caught her pilfering some of her brother's left over wet food. I immediately, stopped offering kibble unless her BG was low and I had no other option. It took a lot of standoffs but she is on a strict wet diet now. She'd still kill for kibble but having got her into remission, I am not taking any chances. Maybe a little hunger when it's safe to do so will convince Do Daa that wet food is better than he thinks it is. Good luck with the transition. I know only too well how difficult it can be. ;)
     
  58. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    SS updated.
    Currently he has to be kind of tricked into eating the wet food. We drop some dry food into a small porcelain bowl which makes a noise suggesting hard food. He ends up licking the dry into the wet and eating both, but being a grazer, he doesn't eat much at one sitting. He's probably getting around 300 calories a day, with the bowl trick. Thanks for the story.:)
     
  59. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Sounds like a good start at transitioning Do Daa. Just stick with it and eventually you'll get him to thankfully eat the wet food. Patience and perseverance are key. Grazing is fine as long as you take the food up 2 hours before AMPS and PMPS so those 2 tests are not food influenced.
    300 calories at this point in time is probably Ok but keep an eye on his weight. You want him at an ideal weight but not getting "fluffy".
     
  60. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    Grazing in the sense that he just picks at his food and doesn't eat much/enough while someone is with him eating. All food is up 2hrs. before AMPS and PMPS.
     
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  61. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    As long as Do Daa is eating, it doesn't matter if he nibbles many many times per day or gobbles his food down. He just needs enough calories to keep him from needing to burn fat for energy which results in ketones and you don't want those. Have you checked Do Daa for ketones at all?
     
  62. Goose

    Goose Member

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    Oct 2, 2019
    Ketones were negative as of Tuesday. We're checking him 2-3 times a week.
     
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  63. Goose

    Goose Member

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    Oct 2, 2019
    SS Updated.
     
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  64. Goose

    Goose Member

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    Oct 2, 2019
    SS updated. I quoted the wrong post.
    Ketone negative.
     
    Last edited: Nov 21, 2019
  65. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    SS
    SS Updated. I don't really see 2.25u working after 4 days. He was at 232 and was given 2.25u, will watch and test later tonight.
     
  66. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    I would check him at +3. This may end up being a really good night to get in a test closer to mid-cycle, too. Last time he had a pre-shot test result in the 200s, he had just started to drop by +3, but we have no idea how low he ended up going since there was not another test until +9.
     
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  67. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I agree a mid cycle test tonight would be invaluable. I know it's tough getting up to test but figuring Do Daa out and finding the right dose will make all of this so much easier on you and Do Daa in the long run and the only way to do that is to see how low he is going at night.
     
  68. Goose

    Goose Member

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    Oct 2, 2019
    9pm at 232 , just tested at (+3) 12am 478. He might have had some food at 11pm, can't remember. Either way, he went way up in 3hrs.
     
    Last edited: Nov 22, 2019
  69. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    Are the Dr. Elsey's and the FF Classics the only foods to which he has access or is there the possibility that he is getting into something else?
     
  70. Goose

    Goose Member

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    Oct 2, 2019
    SS updated.
    (+7) 410
    It's taking him 2 months to do what we have done so far, especially the wet food, so this will have to be at the moment. It's been mentioned here that even if he did have a little food, that it doesn't effect the numbers to a meaningful degree. So...
    I'll check back late afternoon or later.
     
  71. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    I do not understand what you are saying here. I was not asking you to feed him something different, if that is what you thought. My question was whether he could be getting into some food other than the Dr. Elsey's and FF. I want to know if he has access to something with higher carbs, because if he does, that would definitely affect his glucose - and yes, it could have a 'meaningful' impact on his numbers. Even a few bites of higher carb food can have significant impact, especially if a cat is particularly carb-sensitive.

    I'm just trying to figure out if there are any factors we are missing here as to why his glucose is so high.
     
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  72. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    Goose, @MrWorfMen's Mom and I are thinking it may be time for another increase for Do Daa. Assuming everything today goes as it has been (meaning no unexpected big drop), we suggest going to 2.5 units tomorrow while, of course, continuing the testing.

    With how high Do Daa's glucose is staying, we are wondering if something else might be going on with him. Dental issues very often cause increased glucose. Has he had a dental check recently?
     
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  73. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Howdy everyone! I’m glad to see that yellow on Do Daa’s SS! Progress. :)

    I would definitely agree it’s time to increase the dose to 2.5u bid. Please be sure there is no less testing.

    Goose...have you ever tried to kind of pulverize a bit of the dry and put it on top of the wet and then gradually decrease it? That works for some members on getting the kitty off dry food and totally on wet.
     
  74. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    Hi,
    Sorry.
    I misunderstood what you were saying. He is not getting into any other food. All food for all the cats is out of his reach during the necessary times. I am puzzled by those results as well.
     
  75. Goose

    Goose Member

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    Oct 2, 2019
    He has no dental issues. He was at the Vets on 9/27 and she said his teeth were fine, ever so slight plaque near the rear teeth. No other issues on the blood panel except high BG.
     
  76. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    SS Updated.
    His dose will be upped to 2.5u in the AM.

    Slow, borderline arduous progress.
    The way his food is delivered to him seems to be working for him, I'm not going to rock that boat yet.;)
     
  77. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Ok. Thanks for letting us know your plan.
     
  78. Goose

    Goose Member

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    Oct 2, 2019
    SS Updated.
     
  79. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Thank you. Let’s hope he will settle into this dose better.

    There’s always a benefit to grabbing one test during that +4 to +9 timeframe if he’s flat pink. The 390 and 416 last night are basically the same and he might have slipped down to yellow.
     
  80. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    That timeframe is a hard one. So only should be looking at the +4 to +9 if he's in the pink or really close to it? How close?
     
  81. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    ProZinc onsets around +2 and by +10 it's generally wearing off so any testing you can do in that period is beneficial. All data is good data but when you can, getting tests in the +4 to +7 timeframe are often the most telling because that is when ProZinc is usually at its peak action and the lowest BGs will occur. That said, some kitties will reach peak action a little earlier and some later, so all data helps.
     
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  82. Goose

    Goose Member

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    Oct 2, 2019
    :)
    SS updated.
     
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  83. Goose

    Goose Member

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    Oct 2, 2019
    SS updated. Not seeing a lot so far that's different.
     
  84. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Do you recall what food and how much Do Daa ate at 2pm yesterday (24th)? That 552 at +7 is one heck of a jump in BG for 2 hours post food considering BG was at 404 at +4. A small food bump would be normal but that is excessive. I presume the PMPS was not food influenced (food had been withheld for at least 2 hours prior?
     
  85. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    SS Updated.

    Less than a tablespoon of wet food and 15+ pieces of Clean Protein for the crunch he needs to eat the wet food, as usual during the day.
    All food is withheld from him 2 hours before Every test except for the 4 and 6 am tests we have done. We're trying to get as accurate numbers as possible.
    He is most hungry AMPS and PMPS.
    The rest of the time (day and night) he picks at the food but eats in smaller amounts. Someone is always here to watch him and to feed him because of all the other cats.
    Nothing unusual happened to get that 552, small amount of food per usual, we were puzzled as well.
     
    Last edited: Nov 25, 2019
  86. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Can you take a BG reading +1 hour post meal and shot tomorrow AM or PM? Want to see what that BG is compared to fasting pre-shot BG.
     
  87. Goose

    Goose Member

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    Oct 2, 2019
    So do you want me to test him right now at 10pm? He just had his shot at 9pm.

    Just tested him at a little after 10pm. He's at 596
    He ate normally as stated above.
    (+3) at 376
     
    Last edited: Nov 25, 2019
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  88. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Not what I expected but it certainly speaks volumes to the food bump Do Daa gets. If measuring in cups, how much would 15+/- pieces of Clean Protein be equivalent to?
     
  89. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    That is definitely a big food spike also evidenced by the fact he came down at onset.
     
  90. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    Are you feeding him the Dr. Elsey's Clean Protein CHICKEN? That is the one that has between 4 and 5 % carbs. The salmon one is higher in carbs. Just want to confirm and not assume you are feeding the lower carb chicken one.
     
  91. Goose

    Goose Member

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    Oct 2, 2019
    The Clean Protein are quite small, maybe slightly larger than the size of a BB from a BB gun or Smaller than an eraser head. So in a 1/3 cup, it's virtually nothing.
     
  92. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    SS Updated.

    Chicken, Yes. He did not like the Salmon the one time we tried it a month ago.
     
    Last edited: Nov 26, 2019
  93. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Thanks. If you can test at +7 again tonight and he’s still 300 or above, I would increase the dose to 2.75u in the morning unless you get a yellow AMPS. If you get a yellow AMPS, I would increase to 2.5u in the morning.

    Let’s hope we start to see some movement.
     
  94. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    SS Updated.
    Kentone negative.

    It won't be tonight, but I'll try tomorrow. He's currently at 2.5u am/pm.
     
    Last edited: Nov 26, 2019
  95. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    I’m sorry.....I was looking at his SS but for some reason, only saw 2.25u. I thought it had been updated.

    At any rate, let me change my recommendations. If you haven’t increased his dose to 2.75u yet and he still hasn’t seen any yellow, I would increase to 3u from 2.5u. If you increased his dose to 2.75u this morning, then go ahead and hold that dose for six cycles (so we can be consistent with dosing) unless we, miraculously, see a number below 50. In that event, you would reduce the dose by 0.25u.
     
  96. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    SS Updated.
    I did not adjust his dosage to 2.75u, so we'll start at 3u Thursday thru Sunday and see what the results are. I'll check the pmps (+7) Thursday into Friday morning since the dosage will have been changed.

    Below 50? Wouldn't that be a crash number?

    Have a happy Thanksgiving :)
     
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  97. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    50 is not a crash but rather an warning that BG is dropping toward potentially dangerous lows and your call to action of getting BG propped up so Do Daa doesn't have a hypo episode. Unless you see physical symptoms of hypoglycemia, it's just a low reading.

    Happy Thanksgiving to you and your family! :)
     
  98. Goose

    Goose Member

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    Oct 2, 2019
    SS Updated.
    :)
     
  99. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    Can you please confirm that your ProZinc is kept in the refrigerator and that you gently roll the vial before drawing out a dose each time? Also, is the appearance of it slightly milky but with no 'chunks' or 'strings' floating in it?

    I am still just trying to think of and rule out any factors that could be impacting his glucose.
     
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  100. Goose

    Goose Member

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    Oct 2, 2019

    Yes, it is refrigerated at 40 degrees for the last 2 months and Yes it gets gently rolled each time before use.

    The appearance is slightly milky no strings, a slightly small mass that's insulin colored at the bottom of the bottle, nothing is floating in the insulin that is left.

    However, with the fact that his numbers are Not improving with the ever increasing amount of insulin, we are Very concerned that he is getting or is insulin resistant and/or the Prozinc is, or never did, work for him.

    We are getting to the point real soon where we do not feel comfortable giving him even more insulin (6U daily now). He is not showing any improvement with any of the increases, past or present.

    He is the most regulated cat we have ever had, and as we look at the SS, no amount of dosage seems to be helping.
    We do not want to do long term internal damage.
    We also assume that the insulin can't be stopped Cold Turkey and has to be regulated back down and then off.

    He's to sweet of a cat and has been an amazing sport through all of this to put him through this with no point to it.

    SS is updated.
     

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