How frequent to test when doing a curve with ProZinc?

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Anne & Hyde (GA)

Anne & Hyde (GA)

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I am planning on doing a curve on Hyde tomorrow. Based on her latest numbers (in spreadsheet in signature), I think she is getting too much insulin. How often do I need to test if I want to catch a rebound situation? Every hour for 12 hours or less? Hyde is worried about the condition of her ears :)
 
I usually did every 2 hours for a curve. I usually also did every hour for +5-+7 to catch the nadir. Some do every 3 hours, but I liked every 2 so I could catch any bounces.

It's a tough ear day for sure, but Hyde should be okay. Just make sure to give some low carb treats every time...extra noms for extra tests!
 
I always did every 2 hours, my vet suggested that, he said it gives a pretty clear picture of what's going on. Maybe you could try testing on a paw pad a couple times to give the ear a break?
 
Usually a curve is every 2 hours for 12 hours, or every 3 for 18 hours....and if you use a little Neosporin with pain relief ointment, it'll really help with the ears.

I don't think Hyde is getting too much insulin, but it's possible. The only way to know for sure is to start getting some mid-cycle tests in if at all possible. A test somewhere around +5 to +7 on the AM cycle and at least a "before bed" test at night will help to know what's going on.

Since you started her at a reasonable dose, and have taken this long to get up to 2U, I doubt if she's overdosed though. It would really help for you to start posting daily over in the ProZinc Forum. You'll find people there who have lots of experience using ProZinc to help you with making dose adjustments

It's important that she get down out of those HI numbers, so please try getting some help over there. Those high numbers are more likely to lead to production of ketones, so it's important to try to get them down.

If you're not testing for ketones, I'd suggest you should start. If you catch them early, it's possible to deal with them at home, but if anything more than a trace, it's an emergency and she'll need to be at the vet immediately.
 
Well, we are 7 hours into the curve and her lowest # was at +3. Her food has not changed and I only gave her some turkey after each test.

I don't know what to think.
 
Just a recap for the group:
AMPS: HI
+1: HI
+3: 415
+5: 465
+6: 493
+7: 575

I will see if I can link this into the Prozinc forum and see if someone there can help.
 
So far based on what I'm seeing with this curve and previous numbers, the dose isn't too high. I second Terry's question...what are you feeding? If not wet, low carb, I'd switch ASAP to see if that helps. It can drastically lower numbers.

I think it might be time to go up to 2.5. Those numbers are pretty high and 2 clearly isn't bringing them down much. If you raise the dose, getting some mid cycle numbers is important. We need to know how low she's dropping. It's also possible the insulin just isn't lasting long enough...the nadir today seemed to be at +3 which is super early. Honestly, I'm not 100% sure what's going on, but you could try raising the dose and getting mid cycle numbers as often as possible so we can determine where the nadir is and how low this dose brings her down. That might help determine if the insulin just isn't lasting, or if the dose is just too low right now.

Also, are you testing for ketones? With the way she's been in such high numbers it is SUPER important to get tests in to make sure she doesn't have any.

These are my thoughts...I'm sure others will be along soon to offer more! :)
 
Definitely high numbers and not low nadirs that would be causing a bounce. I am with Rachel. I'd raise the dose and test for ketones.

I am inclined to think it is not that the dose is too high. If so, we are more likely to see some movement and it does look like the dose wasn't raised super fast.

As with everyone, any chance she is eating high carb food? Does she have an infections or teeth problems? On any antibiotics?
 
Well, what she eats isn't optimal but it's a long story.

Had a diabetic over 10 years ago named Alex. She was 15, over-weight and drinking and peeing a lot. Took her to the vet and she was diabetic. She lived for 2.5 years more and died of cancer at 17. She hated the DM wet and was not a "meal eater". We settled on feeding her (and the 2 civies - Jekyll and Hyde) fancy feast cans and free feeding the dry DM. The dry DM was really high in calories and on of the civies got pretty fat (22 lbs. for a male cat) After a fight with the vet, we switched all of them to Hills diabetic dry (slightly lower calories per cup). We adjusted Alex's dose to accommodate the higher carb food that she would eat. She got up to 4u of Humulin U 2x a day. When Alex passed, we switched the 2 civies to Iams hairball dry (which was the lowest carb food at the time) and 2 meals of a small amount of Friskies canned (without cheese - they are lactose intolerant). A year later, we added 2 more kitties to the family, Oscar and Emmy.

After Emmy died unexpectedly shortly after she turned 4. we got Tony because Oscar was picking on Jekyll and Hyde and thought he would play with a younger cat. Tony would not eat the Iams and if we left kitten chow out, the older cats would eat it all up. We bought a bag of dry Friskies and mixed it with the Iams (2 cups Iams to 1 cup Friskies) in order to allow the 3 cats and kitten to be together while we were at work. Oscar, now that he had tried the Friskies dry, did not want to eat the Iams. He was semi-feral when we got him and he has food anxieties now. If the dry food dish gets low, he picks on all 3 of the other cats (Tony is now 5 years old) in order to get us to put more food in the bowl.

Mid May, we took Jekyll and Hyde to the vet for their annual checkup. He did some immediate blood work on Jekyll because he dropped from 17 lbs. to 10 lbs. after having dropped from 22 lbs. the year before. His blood work came back with no issues, no infections, no thyroid issues, no diabetes. Hyde dropped from 11 lbs. to 9 lbs. and he took some blood from her too. On Monday, he called and said that her BG was 425. We had no idea that she was diabetic. No symptoms at all. She has never had ketones and Alex never did either. I know that does not mean that she never will but with 4 cats and 3 litter boxes, it would be hard to know who's pee you were testing.

Back to food, we feed them Friskies canned tuna 2x daily - all 4 probably split 1 can a day. If we change the food, Jekyll has diarrhea so he always gets the tuna. The others have tried all the other lower carb Friskies canned food and like it. Jekyll always gets pushed out of his wet food and I want to have the dry out all the time so that he does not lose any more weight. Also, Oscar gets crazy if the dry food is taken up. My plan was to just adjust Hyde's insulin to accommodate the extra carbs. No infections or teeth issues when they were at the vets in May 2015.

Maybe we should try another insulin like Lantus.
 
Evo Cat and Kitten is a low carb dry food in the US.

Also, sudden food changes can produce diarrhea and vomiting. We suggest changing about 20-25% different food each day or two, so it is gradual and not a shock to the GI tract.
 
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Lantus is an excellent insulin, but I'm not sure why you want to switch already. If Jekyll were mine, I would want to find out whether raising the dose helped. I'd want to get a nadir as often as possible to see how low she goes. That will help determine what's going on. Once you've determined that this insulin doesn't work, trying another is the next step. I'd just hate to switch so soon when there's a possibility the insulin you already bought and have been using just needs to be upped.

Again, just my personal thoughts.
 
Unfortunately, high carb food can raise blood glucose levels, regardless of the insulin you use. Although different for every cat, when we switched from dry to wet, Oliver dropped 100 points overnight.

It sounds like you have some difficult feeding issues with all your cats. If I were you, I would work on finding a way to get your diabetic on wet low carb alone, and try some of the lowest carb dry for your civvies, while working to switch them. For now, you might have to be around when they are fed and even feed Jekyll atop the dryer or something so he gets his whole calorie intake. If that is possible, then you might be able to eliminate the dry food being available all day?

If you can get Jekyll eating something other than just fish, that would be optimal also. Fish has Mercury and it's wise not to feed it all the time. Maybe try some of the Fancy Feast flavors, mixing them with fish at first.

If I understand correctly, your diabetic is Hyde and he will eat wet low carb so the trick would be to make sure that is all he eats?
 
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