? 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.
     
  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.

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