? My vet wants to increase to 3 units and I am worried that it is too much!

Discussion in 'Prozinc / PZI' started by NiandraLaDes21, Feb 9, 2020.

  1. NiandraLaDes21

    NiandraLaDes21 Member

    Joined:
    Feb 9, 2020
    Hi everyone,

    I need help figuring out this insulin dosage with Prozinc. I feel I don't know what I am doing. I am not as clueless as the beginning, but I am slowly learning, especially after having come across this forum a couple of days ago. My vet on Wednesday after getting the results of my cat's fructosamine thinks that Chia's insulin needs to increase to 3.0 units. I am scared this is a big jump from 2.0 units, so I only increased it to 2.25 units that Wednesday evening to see what it does. His AMPS/PMPS since the dose increase are lower now....maybe too low from what I am learning in this forum. In fact, I am thinking that I am supposed to skip his insulin dose tonight if it is still below 200. I am doing Chia's first blood glucose curve today. I understand I am supposed to wait 7 days after the change in dosage, but I gave him insulin this morning with a AMPS of 78. I figured I may as well do the BG curve so I can monitor the effect of the insulin dose.

    Background on Chia's diabetes diagnosis. My cat Chia had a case of pancreatitis in late September 2019 and was diagnosed as diabetic in October 2019. He was severely dehydrated and not eating . They had to put a feeding tube and spent a few weeks at the vet. He recovered, but the vet told me he needed to be on insulin. She recommended 2.0 units of Prozinc every 12 hours.

    Prior to Chia's diagnosis, he was already on a raw food diet. I give him Bobcat' s Raw Foods (from a local business here in Texas) and also Stella and Chewy's dehydrated raw food that is reconstituted with water. I used to leave extra food for both my cats since v they tend to be grazers, but now I am checking his portion size to make sure he is not overeating. I also used to give him this cheese popcorn from Trader Joe's whenever I was snacking on it (he would beg for it....he seems to like corn and breads....i have to make sure such items are out of reach from him), but since his diagnosis, I no longer give him popcorn or other human food. I believe the popcorn was what triggered the initial pancreatitis because I had given Chia some a couple of days prior to his getting sick. I hadn't had that popcorn in a while and that was the only thing that changed prior to his getting sick.

    When Chia was at the hospital with a feeding tube, they gave him a prescription diabetic canned cat food (Purina DM, I believe). Since returning home, I have put him back on his raw food.

    I started testing his BG at home in November 2019 when I bought the AlphaTrak2 the vet recommended. I wasn't that consistent with checking. I was merely keeping track of the numbers to show the vet. I also think I wasn't as consistent with the 12 hour window now that I look back at my readings.

    Chia had another bout of pancreatitis in mid-January 2020. He wasn't eating like normal and he was in pain. The vet gave me some meds to help get him out of pain and back to eating (cerenia, Bupernex, mirataz). I took Chia for a follow-up visit on Tuesday 2/4/2020 and they did some bloodwork. On Wednesday, 2/5/2020, the vet told me Chia's fructosamine was too high still and recommends increasing his dose to 3.0 units. I only increased to 2.25 units because of my concern of it being too much of a change.

    For the past couple of weeks, I also have been trying to give him smaller meals throughout the day rather than 2 large meals. On the days I work, I separate the cats and give him one large meal. Then I give him 2 smaller meals in the evening. I am looking into investing in a times feeder for when I am at work.

    Any advice on what I should do? Here is his spreadsheet. Thank you so much for whoever created this template. It is very helpful!
    https://docs.google.com/spreadsheet...ufU0t7228kEIG7gLPk5KNKL3sZI/edit?usp=drivesdk
     
    Last edited: Feb 9, 2020
  2. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Please post on the Feline Health Welcome and Main Forum. Where there are more people to help new members.
    You can copy and paste what you said here, over in your new thread on the Feline Health - (Welcome & Main Forum)

    Please put NEW Member at the beginning of your thread title over there.
    Thank you.
     
  3. NiandraLaDes21

    NiandraLaDes21 Member

    Joined:
    Feb 9, 2020
    Thank you for the advice. I will do that now.
     
  4. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    Hi. First of all, good job on not jumping up to 3 units. I think that could have been very dangerous. Also, it is great that you are doing home testing. It is good that you have been testing before each shot, but you will need to get some mid-cycle tests in to be able to see the impact of the dose you are giving. Just pre-shot test results will not give you enough information.

    I am concerned that the dose may actually be a bit too high. You have had some HUGE swings in pre-shot numbers. That is often an indication that the dose is too high. If it was 78 this morning, there is no telling how low he went during the cycle. The lowest point usually occurs somewhere between 4 and 8 hours after insulin is given. 78 on an AlphaTrak is a very low number to give a dose of ProZinc on, especially a sizable dose. Thank goodness he did not go lower today, but I suspect that may be because he is 'bouncing' up from having gone so low, and the dose counteracted that somewhat vs making him dive into dangerous territory like it could have.

    What does your normal schedule look like, would you be able to do some mid-cycle testing on a regular basis? It does not need to be every two hours like a curve, but at least one test during each cycle, and while trying to get things regulated, sometimes a couple of tests during cycles. You could vary the times a bit so that you would begin to gather enough data to get a better picture of what is going on. It's especially important to get an idea of when the insulin normally starts to act (onset) and when it normally gets to the lowest point (nadir), how long it lasts (duration) is also good to know.
     
  5. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
  6. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    Since when is the ProZinc forum not the place to post for ProZinc dosing advice???
     
  7. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    When someone is a brand new member.

    "Your first post should be on the Main Health Forum which is accessed here:

    http://www.felinediabetes.com/FDMB/forums/feline-health-welcome-main-forum.28/

    The Main Health Forum is where you will learn the basics like general feline diabetes information, feeding your cat, hometesting (if you are not already doing so), and tracking your cat’s blood glucose levels."

    Quote from
    HOW-TO USE THE FDMB: The Basics sticky in the Announcements & How to use the FDMB

    It's in the Welcome email sent to new members when they sign up.
    Even if they have been a member of the facebook sister site.
    Even if they have been using prozinc for a while.
    They may have come from a totally different cat diabetes group.
    New is new to the message board.

    Not necessarily new to prozinc.
     
    Marje and Gracie likes this.
  8. NiandraLaDes21

    NiandraLaDes21 Member

    Joined:
    Feb 9, 2020
    Yes, I was wondering just now if maybe he is entering another bounce. I am starting to understand the concept of that the more I read from the threads here. I am about to do his PMPS and see what the number is.

    My work schedule makes it hard for me to do the midday testing, but I am definitely going to do the evening ones. I am seeing I need to take more readings to get a better picture

    I appreciate your help. I am learning a lot and feeling better about this. I will also start ketone trying which I haven't been doing.

     
    Last edited: Feb 9, 2020
    FurBabiesMama likes this.
  9. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    I get that they post on the main forum to introduce themselves and discuss 'general feline diabetes info', but for dosing advice, the specific insulin forum seems more appropriate. Why does it really even matter? She posted here and someone with actual ProZinc experience took their time to respond to her to try and help. We used to be able to post here without people popping in trying to police things. This may have something to do with why it's so hard to find any experienced ProZinc users here anymore.

    I have not been posting here as much lately and had pretty much decide I would not give dosing advice anymore, but I saw this post and wanted to see if I could help. I think I'm done now. It's just not worth dealing with the nitpicky stuff.
     
    Jarvis likes this.
  10. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
  11. NiandraLaDes21

    NiandraLaDes21 Member

    Joined:
    Feb 9, 2020
    I appreciate your input very much. It helped me a great deal, and I feel more confident about being able to care for Chia. Thank you for that.
     
  12. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    I don’t want a condo hijack on a new member’s post but the ISGs are a bit more advanced. New members should post in Main Health first, get their feet on the ground, info about food and testing, do the SS and get their signature block done correctly.
    On Main Health, the no shoot number is below 200 but that might be different in an ISG.

    Please understand it has to do with helping the new member feel more comfortable with FD. They don’t have to stay there long. It’s up to their comfort level.

    @NiandraLaDes21 Thanks for posting in the Main Health forum. Also...your spreadsheet link is incorrect. If you could please send me a private message, I can help you fix it. Click on “Marje and Gracie” to the left and then “start a conversation”.
     
    Last edited: Feb 10, 2020
    NiandraLaDes21 likes this.
  13. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Just want to emphasize here, @NiandraLaDes21 , you haven't done anything wrong here. In fact, I'm really glad you posted in both places-- Feline Health gets more eyes on it, so you have a better chance of getting quick advice in a pinch, but the prozinc forum is (of course) where you have a better chance of getting more prozinc-experienced people (like @FurBabiesMama ) advising on dose. I think you've gotten some good advice in both places, luckily we all seem to be pretty much on the same page as to Chia being on too-high a dose presently, and sorting out where to go from here...
     
    NiandraLaDes21 likes this.
  14. Jarvis

    Jarvis New Member

    Joined:
    Feb 28, 2020
    I’m a new member and this was the first post I looked at. I don’t think I will be returning. The forum police seem a bit to strict.
     
  15. JL and Chip

    JL and Chip Member

    Joined:
    Dec 28, 2009
    @Jarvis I hope you reconsider and stay around. The first rule of thumb around here is that “it’s all about the cats.

    There are no “forum police.” Sometimes in an effort to help new members, or organize the “chaos” that comes with an influx of newbies and dearth of those who have time to respond, or whatever, suggestions are made that might “read” wrong on the internet. I completely understand your sentiment (my knee jerk reaction would probably have been the same, it’s just that I’ve been here for 15 years and know better).

    Frankly, I don’t give a rat’s a$$ what forum you post in, just that you post so your cat (and you) can be helped with this sometimes complicated and confusing disease. We all truly care. And you are welcome here with open arms.

    I know I’m not the only one who is capable of cycling through the various forums to see if a new thread is posted. Maybe let’s just make a concerted effort to do that, folks.

    Just my two cents. Jarvis, I’ll be watching for your next post.
     
  16. Jarvis

    Jarvis New Member

    Joined:
    Feb 28, 2020
    Thanks. It just seemed to me it would have been easier to answer the question and then give some guidance for next time. Some great information for my cat on here. I’ll stick around. Thanks again
     
  17. JOJI and Kit

    JOJI and Kit Member

    Joined:
    Dec 19, 2019
    I'm glad you'll stay. At first the forum may seem a bit police-like, but you'll soon realize that there are a few experienced people here trying their very best to help a LOT of people with their diabetic cats, and that abiding by the general rules is the best way to get the best and quickest help for your kitty. Try not to be offended. This really is the best place to get information and help. Moderators and experienced members have to do a lot of repetition with new members, so try to be patient with the way things might come across. It really is about helping owners to help their cats.
     
    Deb & Wink likes this.
  18. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    @Jarvis

    Perspective.
    1. One of the most experienced Prozinc members had an elderly cat die. She hasn't been around to help in about 2 months now.
    2. Second experienced Prozinc member had a family crisis and had to take care of that. Plus she is now away on vacation for weeks. She had the time to guide 1 person on the Prozinc forum. One.
    3. Learning the basics before going to the ISG can be really helpful.
    4. Until you have a SS and signature data setup, it's much more difficult to help you.
    5. Currently short handed on experienced members to help in ALL the forums.
    6. Welcome email you received when you signed up told you to please start in the Feline Health (Welcome & Main) forum. That is because that is the best place to learn more before you go over to the ISG to get more specific help for your insulin.
    7. Skipping the Feline Health forum is up to you.
    8. Having your own thread gets you individualized attention.
    9. Cats in crisis (DKA, pancreatitis) or needing more immediate help (hypo) get our attention first.
    10. Getting help is up to you.
    11. You can learn a lot by reading threads by other people. There are some nuances not mentioned. Go exploring. Learn all you can.
    12. You can learn a lot by reading the "Sticky" or pinned posts at the top of the various forums.
    13. There is an index in the Health Links/FAQS forum. It's the first "Sticky" or pinned post at the top of the forum. You can learn a lot from there. But, you may not know where to start. That is where having someone guide or mentor you comes into play.
    14. Sticky New? How You Can Help Us Help You!
    15. Triage. We practice triage in answering new threads or posts to existing threads. There are 2 recent DKA,s just released from the vet hospital (needing intensive mentoring), a couple of members with cats with pancreatitis (also needing intensive mentoring), new people all the time to help learn how to treat this horrible but eminently manageable disease.
    16. At any one time, I probably have 6 or more SS's open and 6 windows open to help people.
    17. We all have our own lives and responsibilities to take care of.
    18. We are all volunteers here. Please be cognizant of that.
    19. We know you have busy lives and responsibilities also. We'll brainstorm to help you the best we can.
    20. Your choice to "go it alone" or stay here on the message board.
    21. Best chance of remission is in the first 6 months.
    22. I've been "pinch hitting", trying to help the folks in the Prozinc ISG for the last 2 months. Learning as fast as I can. I can't do everything or help everyone by myself. Trying my hardest to help.
    23. NEVER, NEVER WANT A NEW MEMBER TO BE LEFT HANGING LIKE @Patty & Teal'c were when the 2 experienced Prozinc members left. Unexpectedly. Without warning.
    24. Patty & Teal'c and other members in the Prozinc forum are now getting some of the help they need.
    25. I'm probably on the message board 10-12 hours a day, trying to mentor 30+ people.
    26. Feb 9th, when @NiandraLaDes21 posted we were even more short handed than usual. Two of the moderators were out as well. Best place for her to get a quicker answer was on the Main forum.
    27. Why do some newbies never stay
    28. The experienced people that stick around to help new members? Our diabetic cats are dead. Yet, we are still here, trying our hardest to help new people learn and become self sufficient. Paying it forward to the next group of scared, nervous, anxious members of the message board.
    29.Members who may not have received the best of advice from their vets. May have been told "Your cat is diabetic, here's some insulin, feed this high carb food (sold only at vet clinics that helps to make me money and may not actually be that good for your diabetic cat but I'm selling it to you to help my bottom line), come back and see me in two weeks, give this dose of insulin (and hope it's not too much and doesn't kill your cat or drop their BG numbers so low your cat ends up with seizures and brain damage)."

    My 2 cents worth. Useless as usual.;)
     
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  19. JOJI and Kit

    JOJI and Kit Member

    Joined:
    Dec 19, 2019
    :bighug: Deb, Thank you what you do here to help us......and thank you for explaining all of that. That you and others stick around well after you are not treating your own diabetic kitties is an enormous help. :kiss:
     
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  20. NiandraLaDes21

    NiandraLaDes21 Member

    Joined:
    Feb 9, 2020
    I am glad you are sticking around. I am new, too. About 3 weeks now. I am seeing there is a reason for the guidance of new members. It makes it easier for the more experienced members to be able to help us by making sure they set us up correctly at the start. It saves time for everyone in the long run. Now when I post, all the important info is accessible for other members to better able to answer my questions and give me advice. There is a method to this madness and everyone means well, especially for the sakes of our sugar kitties!
     
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  21. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    How are things going Alma, with you and Chia?
     
    NiandraLaDes21 likes this.
  22. NiandraLaDes21

    NiandraLaDes21 Member

    Joined:
    Feb 9, 2020
    I Just saw your response and thank you for checking up on me and Chia. I am about to post a question for some dosing advice and how feeding schedule Mau influence the numbers.
     
    Deb & Wink likes this.
  23. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Ok I'll keep my eyes out for those questions.
     
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  24. NiandraLaDes21

    NiandraLaDes21 Member

    Joined:
    Feb 9, 2020
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