I'm exhausted trying to figure this out...

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Lynda and Louis, Apr 3, 2020.

Thread Status:
Not open for further replies.
  1. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    Hello friends.
    I have been trying to do this on my own. I finally filled out a spreadsheet. It doesn't have all days, but I put in information for what I think are key periods over the last month from my handwritten log. Louis has been all over the place. You will see I have not stayed up at night testing him.

    Over a month ago Louis developed neuropathy. My vet Poo-pooed it. Referred me to a cat Neuro specialist. I didn't go. Instead I found great information on this page and started Louis on Zobaline (B12) 2x daily. He's not better and seems a little worse. From what I've read, stable BG is key in this med working. From his spreadsheet....well I get why its not working.

    I am frustrated with my Vet and have researched new ones, but now with this virus thing (and I'm considered compromised), I don't know when I'll get him there.

    I'm testing for keynotes and he is negative

    Yesterday he had a bad day. Wouldn't eat. Even his most favorite treats. By late evening he was eating again and okay today. I'm thinking it was a bad can of tuna??? But he is sleeping a lot, and I can tell he's not really himself.

    So I'm frustrated and looking for any advice you can give. Based on reading and reading other posts and the advice given there, I'm thinking I need to ramp up Louis insulin. I realized members may not want to give this advice, but I'm getting desperate.

    TIA
    Lynda and Louis
     
    Deb & Wink likes this.
  2. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Hello Lynda--

    I'm so sorry, that sounds very frustrating!

    I can't help much, as I have not used ProZinc. Others will be around soon who can offer useful advice, but in the meantime I have a question-- how did you get to 4U (first dose on your spreadsheet)? Again, I don't use ProZinc, but I know that that would be considered a fairly high dose, and would be a really high starting dose. From your "join" date I'm guess that Louis was diagnosed last fall. Can you fill in a bit more of the history between then and the start of your spreadsheet?

    :bighug: :bighug: :bighug: Hang in there, help is on the way!
     
    Deb & Wink likes this.
  3. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Whoa that is a high starting does, sigh I wish vets would just say they dont know when they dont know. Hang on and i'll try abnd find someone to help. (GOING OVER TO PROZINC BOARD)
     
    Deb & Wink likes this.
  4. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019

    Thanks so much! No we started back in December at 2 Units and he was testing regularly then at 400+ Then we crept up to three with Vets advice, then 4 on vets advice I just didn't do the spreadsheet in the early days....It was too daunting for me then. Sorry....
     
    Deb & Wink likes this.
  5. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Its ok theres a HUGE learning curve that you vet doesnt even seem to understand sigh ( dont feel bad this happens to mant) I'm going to try and tag some help
    @deb
    Dang my tags arent working hang in there...
     
    Deb & Wink likes this.
  6. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    @Deb & Wink ? ;)
     
  7. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    I message her but fear she may be to ill maybe sienne or @Wendy & Neko

    ARRRG why arent my tags working
     
    Deb & Wink likes this.
  8. Jacque- Tiger & Jazz Man

    Jacque- Tiger & Jazz Man Member

    Joined:
    Apr 13, 2014
    @Wendy&Neko
     
    Deb & Wink likes this.
  9. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
  10. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    Thanks for trying so hard you guys!
     
    Deb & Wink likes this.
  11. Jacque- Tiger & Jazz Man

    Jacque- Tiger & Jazz Man Member

    Joined:
    Apr 13, 2014
    I just took a look see and I'm sure the experts will advise you to do more testing and to hold the units longer. They will also want to know what food etc.
    Please take a look at Tiger's SS it might help you to adjust your dosage
     
    Deb & Wink likes this.
  12. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
  13. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Nan to the rescue! thanks!
     
    Deb & Wink likes this.
  14. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Its what we do and IS our pleasure!
     
    Deb & Wink likes this.
  15. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    If you do "ramp" up the dosage please do it by small increments until you get more advice from the experts here. I am still having trouble finding someone. They do a MARVELOUS but cant be here 24/7 . I'll keep looking.;)
     
    Deb & Wink likes this.
  16. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    What I'd suggest, so we're all on the same page, is if you look over the sticky notes at the top of the Prozinc forum. If you could look over the information on dosing, it would help if you could let us know if what your vet has been suggesting is even close to what it is that we recommend.

    One other thing that would help is getting at least one PM test every night. If you noticed the way your kitty responded to those green numbers, there's a good chance you're seeing lower range numbers at night and the numbers zoom back up by the next pre-shot.
     
  17. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    Thanks everyone for trying to help me. Here are answers to some of the questions you've asked:
    Started in giving ProZinc in December after trying to regulate with diet. Vet said 2 units 12 hours apart.
    We did that for one week and numbers still high in 400's, so vet increased to 3 units.
    We did that for one week and numbers still in 400's, so vet increased to 4 units
    We have were at 4 units for 3 weeks. A few times I pulled back to 3 units when reads were low.
    Went to vet on 1/27 and he said to move to 5 units, but then numbers were lowering so I pulled back to 4 units unless reading hit 500's

    In late February is when the Neuropathy started and I rushed Louis to Vet. We did blood work and all came back normal. At that time I was feeling that Vet was frustrated with me; and in my opinion, he had reached his level of expertise in Diabetic Cats. He did not like that I had self -diagnosed the neuropathy and my research with you guys. He actually called the Zobaline "BS" and referred me to a Neuro Vet. I didn't go.

    Louis is a big eater. 3 oz Fancy Feast Pate only, every 4 hours. No dry food and only PureBites treats. I do use Greenies Pill Pockets to give him the Zobaline, but that's only 2 per day. The last two days he's dropped his appetite and refuses all treats even the Greenies PP, which he loves.

    Louis is such a good boy. He takes his shots and testing in stride. I'm the one who's a mess and admittedly why I haven't been testing him more. I hate doing it. But I will.

    Thanks, let me know if there is anything else you need. When I get a minute I will load Louis's lab work on my spreadsheet
    L&L

    PS, I will now ready the sticky notes on ProZinc thanks
     
  18. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Hi Lynda, I just signed on the message board and saw a PM and a couple of tags for my help with you and Louis who are using Prozinc insulin.

    First, some deep breathing exercises to help relieve some of the stress. Helping a diabetic cat in normal times is difficult enough. In these times of the coronavirus, it's absolutely overwhelming.
    Deep Breath, hold, release, deep breath, hold, release...................... Mindfulness breathing, helps me a lot to deal with stress.

    1. You are a real champion, for trying to do as much for Louis as you have been doing, and learning about neuropathy and everything. I know you hate testing Louis, but we need to see some mid-cycle tests to see how he is doing on this dose of insulin. :bighug:

    2. Do go take a look at the sticky documents in the Prozinc ISG forum here that Sienne and Gabby (GA) pointed you to in post #16.
    3. I highly recommend that you print out that dosing methods document, which is the blue link below,
    Sticky PROZINC DOSING METHODS and review it.
    4. I think that Louis may actually be overdosed. But to tell that, we need to see some mid-cycle tests.
    Are you able to do some tests in the +5 to +7 hour time frame? To find the nadir, or low point that this dose of insulin takes Louis. Would you do that please? Vary the test times a bit, doesn't have to be the same time every 12 hour cycle.
    5. A before bed test is a good idea. So a +2 or a +3 if you can manage it. Are you up that late after the PMPS test so you could get at least 1 test every PM cycle?
    6. Food sounds reasonable. 18 ounces a day? Is that correct? Is Louis a big cat? Like a Maine coon? He does not look that big in the picture in your avatar.

    7. Try stopping the pill pockets for the Zobaline, and putting it in a piece of pure meat, like some plain cooked chicken or some ground meat or a piece of cheese or a tiny bit of butter and putting that directly in his mouth. Some people crush the tablet, and put it in a little bit of the wet food, maybe 1 teaspoon or so, sprinkled on top. Try that.

    8. Adjustments in insulin doses, are done based on the nadirs, or lows. Not only the pre-shot tests that you have done. Also, our protocols here adjust doses in 0.25U increments. I think your vet raise the dose way too quickly. But we'll see.

    9. Do you use U40 syringes? Do they have half unit markings on the barrel?
    I know that you are exhausted, so many of us are these days. Hang in there, we'll try to help you and Louis as much as we can.

    10. I realize you may not have test numbers for every day. But we do need to see dates on the SS for each day in March. Otherwise, my brain looks at the SS and sees a row and thinks the patterns are from one day to the next.
    For now, if you could put in 1 row with a date, even if you do not put any test numbers or insulin doses, that would be helpful. Do a week at a time, starting with 3/31/2020 and working backward. Do one week for now if you could please. I'd rather see that, then the lab work on the SS for now. The labs can come later.

    Sorry to ask, but seeing a few more rows on the SS will help my tired brain process what it sees on the SS better. Thanks.
     
  19. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    @Deb & Wink Thanks so much! I think I "heard" on website that you were sick. If that is you, DOUBLE thank you for replying and being so thorough. I do have the numbers for all of March. It may take me a few hours to get it all in there. I will put them in and leave the labs til later. Louis is about 15 pounds. I may have misled you. He eats about every 4 hours but only daytime. Max about 12-15 oz a day. I will do the night testing as best I can for as long as I can. I am using U40 syringes. But the ones I got from Chewy.com don't have the markings. But it is easy for me to do a .5. But a .25 might not be so easy on these. I will review the ProZinc Dosing Methods. thanks again.
     
  20. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Saw a 157 BG test at +4 today. That's a pretty good number for starting at the low 300's (the pinks) at pre-shot today. About a 50% drop so far. Much more, and Louis will probably bounce high later.

    Would it be possible for you to test again at +6?
    When does Louis get fed next? At what + time hour?
    What are his normal + hour feeding times? AM and PM please, if you could.

    Do you have access to U100 syringes? Would purchasing some fit into your budget?
    U100 syringes can be used with a U40 insulin like Prozinc, is why I'm asking.

    It's Friday and you are probably snowed under with work. Answer when you can.

    p.s. Stay safe out there on the west coast.
     
    jt and trouble (GA) likes this.
  21. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    Yes I will test at +6...2:30PST Set my alarm And +9 as well
    Louis will probably want to eat again around 5pm Then again around 9pm
    So feeding times vary.....Best guess: 6am 10-11am 4-5pm 9-10pm and again if one up us gets up during the wee hours
    I can get the U100 syringes. Will order today, but I need help there are many choices. I looked up on Vet RX Direct https://www.vetrxdirect.com/product/view/u-100-insulin-syringes-dogs-and-cats-rx and there are 4 choices!
    Still haven't loaded the March data but I will.
    PS: Louis is eating well today and seems to be back to himself. I'm gonna guess he got a bad can of tuna yesterday.
    You stay safe too. Where are you located?
     
  22. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    The U100 syringes are human insulin syringes. There is a conversion chart you would use for using a U40 insulin like Prozinc with a U100 insulin. It's 2.5 times the U40 dose. Dose on the SS you record would be the U40 dose, not the amount you draw up in the U100 syringe.
    Here is the link to the conversion chart for U40 to U100 insulin syringes. http://www.felinediabetes.com/insulin-conversions.htm You can not do this conversion in reverse, with the U100 insulins.

    Those U100 syringes are used for human insulin. You can usually get them at other places, like ADW diabetes. adwdiabetes.com/ or at a local drug store. Call and ask what they have in stock.
    Look for U100, 3/10 cc volume, 1/2 unit markings on the syringe barrel, needle length is your choice. Many people like the shorter needle length, so they don't go thru the tent of skin when they pinch up a bit of skin to give the insulin shot.

    Would you add some more data to your signature please? Editing your Signature, Profile, and Preferences

    Sorry to overwhelm you with so many requests, but seeing things like the insulin you use, the meter you use for testing, etc, right there at the bottom of each of your posts can be so helpful to those of us helping you.

    I know I and others have dumped a lot of information on you. Please, take the time to go back and review this thread. Ask questions. Ask for clarifications. It's how we all learned at the beginning. Hang in there, it will get easier.

    p.s. I'm in the Boston area, a virus hotspot.
     
    jt and trouble (GA) likes this.
  23. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    Ok Deb and Wink, I think I've completed all my tasks.
    1. Spreadsheet complete with all data I have for March
    2. Labwork also entered.
    3. Signature modified to add info (let me know if there's anything I'm missing)
    4. U100 Syringes Ordered
    5. Also, While I was in the shower, Louis got my husband to feed him. This was around 2pm. His bowl was clean from 10:00am feeding. So he'll probably be looking for more around 6pm. This is his usual schedule.
    Thanks again. Let me know what you think. My own opinion after looking at the data on the spreadsheet is that I'm bouncing all around with insulin dosages just based on before shot readings. I think what I wasn't getting before is that dosage should be based on the lowest point of his cycle....."Do you agree?
    L&L
     
  24. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Well, that was a major all out effort on your part Lynda. Did not mean you had to get everything done today. 1000 thanks for getting that data into the SS and getting your signature set up. You're amazing.:cat:

    What does Zorbalink mean in your signature?
    Would you add the meter you are using for home testing.
    Your first name, your cat's name, age, sex is good also to see in your signature.

    Yes. Louis is bouncing because you are changing the dose too often.
    Also, the 86 at + 6, means he is due for a dose reduction.
    That number <90 means a reduction per the Prozinc SLGS dosing protocol.

    Please reduce the dose from 3U to 2.75U immediately.
     
  25. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    I think she means Zobaline
     
  26. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    HAHA, yep Chris you got that right. I misspelled Zobaline.
    I put the rest of the info in there. Thanks for suggestions
    AND THANKS FOR YOUR WORK ALL DAY!
    I'm reducing Louis to 2.75U for tonights dose!
    Have a great weekend. I will continue with my SS
     
  27. Juls and Billy

    Juls and Billy Member

    Joined:
    Dec 28, 2019
    Hello Linda and Louis! Deb has you covered with all the good advice. I wanted to say I agree with her about the dose perhaps being too high. Vets tend to change doses in by full units and it can get too high too fast. The thing is, too much insulin can look like too little where the BGLs are concerned.

    It's so good you are now doing some mid-cycle tests. Look at that lovely green today! Any reading under 90 means it's time to drop dose by .25. Yes, you are likely to see some high pre-shot numbers after a nice green low like that. When a cat's body gets used to running on high sugar levels, it can freak out when the levels drop to a more normal amount. Then the body releases stored sugar to get the BGL back up and bam. You end up with a crazy high pre-shot test. The thing is, you don't change dose based on the high readings. Stored sugar bounces will sort themselves out. You change dose based on the low readings. Now that you are awesomely doing some mid-cycle testing, you'll get a much better idea of how Louis is doing.

    Keep an eye on those mid-cycle tests, and drop the dose again if he goes under 90.

    Feel free to tag me if you need too. I'm not as knowledgeable as Deb, but my Billy used ProZinc too.
     
    Last edited: Apr 4, 2020
  28. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    Hello Juls and Billy. Thanks so much for reaching out. Deb and I have been at this all day it seems, and I feel so much better having gotten her guidance. I'm mad at myself that I didn't do the spreadsheet and reach out sooner. I was trying to figure it out myself. You've all been so kind and I hope this is the beginning of turning the corner with Lou. He is a ball of Orange Goodness. (As the gal said on her blog where I learned about Zobaline).
     
  29. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I know what that is like. I was trying to figure it out on my own too, back when I first fostered Wink. It got really tough when I was fighting with the shelter and their vets to drop his dose and they kept insisting that I give him Lantus on a sliding scale and why too much, basing the dose on the pre-shot tests, not the nadirs, using 1cc yringes (ACKKK!!!) which are just about impossible to measure small doses with. Luckily, I decided to ignore them and treated him with what I read here and another feline diabetes site. Here is much better IMHO.

    We hope so too.

    p.s. Wink is why I'm still here helping people, 7+ years later. :) That's him in my avatar, up on my kitchen island counter, giving me the side eye "stink eye" and wondering when I'm going to share whatever I'm cooking with him.
     
  30. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    See Lynda? Didnt I tell you this is a family we share sugar kitties! :bighug:
    You are doing an AMAZING job! Keep up the good work and ol' Louis, will be his old self before you know it! ;)

    Deb you as well! I am totally blown away at your guidance! FDMB is lucky you are here. THANK YOU!
     
    Deb & Wink likes this.
  31. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    On the labs, it looks like you put the test results for the urine testing in the reference range column? Or are those the reference ranges? Maybe you did not have any urine testing done, which is ok.

    Nothing on the labs jumps out at me, but I'm not real good at interpreting labwork. The potassium level looks fine, which can be another cause of the rear leg weakness, if the potassium levels are low.

    Some of the kidney values are at the higher end of the reference ranges, but still within limits. So ok for now. High cholesterol, but my civie (non-diabetic) cat has that too. Not worried.

    153 for the glucose level? When in relation to the insulin dose for that day, was the blood drawn for the labwork? What + hour if you know?
     
    jt and trouble (GA) likes this.
  32. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    Hi Deb! Happy Saturday. Wink is a doll. We had two boys--They were healthy most of their lives, and died together at the ripe old age of 19. Our black and white, Fred, was a real character. We have many amazing stories about him. Talk about a cat that had 9 lives. Some day I will tell you his story. It's amazing...nobody ever believes us. I had always wanted an Orange kitty. Louis walked into my life (and my driveway), as a stray and wouldn't leave. My "boys" were around 18 at the time. So you know the rest...Louis is my very special boy.

    On your questions.....
    Labs...there was no urine tests done that day. So anything I entered was from the blood work. Those must be the urine reference ranges you are seeing.
    The draw was done around +9 after morning insulin of 5 units (EECK...I can say that now that I "KNOW")
    So he had probably been really low during that day. Ugh!

    Let me know if you have anything else. I'm going to be as vigilant as I can today about testing, but I have to leave to take care of my 88 year old mom for a bit. Last night I slept through my 2:30am alarm, so I'm going to try again tonite. I did get the reading at +3 after PM shot. Hopefully I'll do better tonite

    thx as always,
    L&L
    I've tried to attach a picture of my Fred sitting in our mail basket. "SillyHeadFred" 304AADA4-50C7-4B51-809A-4F0A8D2A85D0.jpeg
     
  33. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Cut yourself some slack Lynda. You were exhausted yesterday, the same today, you've probably been exhausted taking care of Louis, your mom, yourself, plus all the regular responsibilities in your work and life. Covid has simply added another full time job on top of all of that.

    At least, that is how it seems to me some days. I know that I'm exhausted, and have been for a couple of months, dealing with all that is going on. Remind yourself that you have to take care of you first. So you can continue to take care of your mom and Louis.

    Sleeping through an alarm? Won't be the first time, won't be the last. Get those later tests IF you can. At least one before bed test is important. So if that is a +2 or a +3 or a +4, that's ok. We'll try to work with what you can get as far as the BG tests. If Louis is dropping low really fast, like he did yesterday AM cycle, then you may need to have a "pajama party", staying up a bit later. Not last night, with that 282 at +3, he was ok.

    Leave some food out for Louis at night, some wet food is fine. It won't go bad that quickly. Many cats will seek out food if they feel their blood sugar dropping lower than they are used to.
     
    jt and trouble (GA) likes this.
  34. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Forgot to say, if you can test around +6 and Louis is above 100, you're probably safe to go see your mom.

    For future reference, blacks=bouncing, in almost every case. It's why I thought that Louis was overdosed. He was probably dropping really low in the AM cycle and then his body's self protection mechanism kicked in and dumped sugars and hormones into his bloodstream to bring his blood glucose numbers back up to what his body is more used to. I think that is what has been happening, a lot.

    I think he may still be overdosed on the 2.75U, which is why I'd like you to get a +6 this AM cycle if that is possible.

    Getting an +11.5 is a nice headups compared to the +12 (pre-shot test) to let you see if the BG levels are rising when you do that pre-shot test. I'm probably repeating myself, and have told you that already. Life is a bit of a blur these days.
     
  35. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    Hey @Deb & Wink
    Louis due for shot in 10 mins!!!
    Take a look at SS
    He's at 195 AMPS
     
  36. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    So after I had a little panic attack, I remembered a brilliant lady pointed me to the Prozinc Dosing Methods! After reading and re-reading, I decided on a token dose of ~.75. I'll keep testing all day to see what happens.
     
  37. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Good job on making that decision when you did not get a response.
    So that is about 25% of the normal 2.75U dose.


    Yes, the protocol is great to have a printed copy on hand.
    Since we can't be here 24/7, you'll find the Sticky PROZINC DOSING METHODS to be a nice backup. I've made lots of notes on my printed copy. And highlighted sections too. I probably have as many notes on my copy, as there is text in the original. :)

    Clarifications, notes on bouncing, more details on holding and increasing and reducing the dose. More interpreting what is said in the protocol, but in different words.

    And I'll try to check in on how Louis is doing today.

    p.s. Sorry, I was off having a late brunch, and watching the birds and squirrels and chipmunks in my backyard. Lots of bird feeders out there, for "catertainment" for my little tortie girl.
     
  38. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    Thanks and yes, I'm going to print out my Dosing instructions. Right now I bookmarked for easy access, along with a couple other references you gave me. It's really hard to get the dose exact with these U40 needles. I hope my order of U100's comes soon. Gonna go check right now. Thanks again! Enjoy the birds!

    Oh and PS: Louis seems more like his old self today. Demanding and talking more like he used to. I think he feels better.
     
  39. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Lynda YOU ROCK!
    There arent enough words Deb :bighug:
     
  40. Juls and Billy

    Juls and Billy Member

    Joined:
    Dec 28, 2019
    Great job, Lynda, on the reduced dose this morning. Don't let the big bouncy numbers worry you. Lovely that Lou is feeling more like his old self. Very positive sign. I'm hoping that his days of huge doses may be over.
     
  41. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    @Deb & Wink
    Hi Deb! Would you mind taking a look at Louis's SS and tell me what you think? One reading at +6 last night. Then AMPS. I'm thinking "Stay the course and test throughout the day? I can tell Louis is getting tired of the constant testing. TIA L&L
     
  42. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Bribes, remember those bribes. Food treats - any thing pure protein, brushing, pets, some play time after. So he comes to associate the testing with something good happening.

    He's bouncing, he's bouncing hard from those low blues his body isn't used to.
    Plus the lower, safe "token dose" you did yesterday morning, 4/5/20 has him bouncing a bit too.

    You don't have to test every 2 hours. I'd suggest something along the lines of a +3 and then another test in the +5 to +7 hour time frame.

    I think you may need to reduce the dose again soon. It kind of depends on the mid-cycle nadir today, but Louis may need a decrease again, to maybe 2.5U. Not sure yet.

    p.s. Notes on the SS in the Remarks column on food? Please? In + hour format would be helpful to see. Thanks.
     
  43. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    Added the food, from what i could remember.
    I thought I'd do +3 and +6 tests today. So we are on the same page there
    Louis is a finicky dude. It's like he loves the treats and foods, then he doesn't. I think he gets tired of them. I will have to get some more variety. Right now he's loving my sliced turkey from the deli. Wants some when I eat lunch. So I will use that for tests today.
     
  44. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    There ya go get creative. cheese was always a good alternate for us.
    good job Lynda!
     
    Deb & Wink likes this.
  45. Juls and Billy

    Juls and Billy Member

    Joined:
    Dec 28, 2019
    You're doing great, Lynda! Yes, Lou is a bouncy boy. Don't fret the high numbers, look for the low ones. I wouldn't be surprised if he needed another dose reduction soon.
     
  46. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Lynda, you might want to "front load" the food.
    Giving Louis food much beyond +6, will make his BG levels rise that much faster later in the 12 hour dosing cycle.
    So food at +9, when the insulin has basically been used up, makes the BG's much, much higher later.

    So it's ok to split his meals into multiple smaller meals, with the bulk of the food at shot time and mini-meals after that. But try to feed before that +6 time if you could.

    That feeding change will be helpful I think. So no more meals at +7 or later.
    Do you think you could do that with Louis? Or will he be begging for food constantly?

    p.s. Please fix the SS for the units for the 4/5/20 PMPS cycle. Should be 2.75 not 275. Dropped a decimal point there. ;)
     
    jt and trouble (GA) likes this.
  47. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    I saw that decimal point on the SS. Fixed.
    The food is gonna be a problem. But I will try my best. The worst part is my husband. He cannot stand it when Louis is begging for food. And the Finicky thing. If he decides he doesn't like it in the am, then I've just been waiting him out and then the food may come in the afternoon and he scarfs it. But I guess throwing out a bowl of food to get a full serving in before +7 will be worth it. Just took a reading. 131 at +7 And he's gonna wanna eat again I'm sure of it. It may take me a day or two to get this straightened out with the food. I'll take a PMPS of course, but should I take another reading before that to determine dose?
     
  48. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    If you can get a +11.5, that will give you an idea if the PMPS is a rising or falling number.

    p.s. How many hours until your PMPS?
     
    jt and trouble (GA) likes this.
  49. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    I WILL GET 11.5 That is about 7:30 pm PST
    About 3.5 hours to PMPS
     
  50. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I will not be up that late. It will be 10:30 pm my time EDT, and I'll be long asleep.
     
    jt and trouble (GA) likes this.
  51. Lynda and Louis

    Lynda and Louis Member

    Joined:
    Nov 6, 2019
    Yes, I figured as much. I will test him and make the call. Is it safe to say that unless I see reading under 90, that I should stay with the 2.75?
     
  52. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Change your thread title and ask for help if you get a low number, <200 at PMPS.
    Hopefully, there will be someone on to help you then.
    Basic guidelines when following SLGS method with Prozinc are as follows. Quoting directly from the protocol, over in the Prozinc ISG forum:

    Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
    A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
    • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
    • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
      • a.) give nothing
      • b.) give a token dose (10-25% of the usual dose)
      • c.) feed as usual, test in a couple of hours, and make a decision based on that value
    • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
    • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
    • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
     
Thread Status:
Not open for further replies.

Share This Page