Need advice

Discussion in 'Prozinc / PZI' started by Celi, Mar 26, 2020.

  1. Celi

    Celi New Member

    Joined:
    Feb 26, 2020
    Angel was diagnosed almost two months ago and put on 4U twice a day. After I joined this group, I lowered the dose and thought she was doing pretty well until I did our first curve and saw the steep drop - in 2 hours from 199 to 63. Now I am unsure of what dose to give her. I posted her curve and spreadsheet on the FB group site.
     
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  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hello and welcome. Any chance you can copy that spreadsheet over here? It'll help even more if you can put it in your signature. Here's how and what we need:

    New? How You Can Help Us Help You!"

    People here need to see that spreadsheet, I suspect whatever dose you are giving now, may be too high. What food are you feeding? Has that changed lately?
     
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  3. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I know of at least 5 different facebook groups for feline diabetes, in 3 different languages.
    We have no idea which facebook group you belong to, or the name you use there.

    Wendy gave you the link for setting up your signature and linking your SS there.

    When you get your spreadsheet linked here into your signature, I'd be happy to take a look. Tag me if you want. It's the @ symbol directly followed by my user name. @Celi There I just "tagged" you.

    What meter are you using? That's very important to know also. That info goes in your signature too.
     
  4. Celi

    Celi New Member

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    Feb 26, 2020
     

    Attached Files:

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  5. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Ok, I can see some of the spreadsheet, but when I try to zoom, the numbers become blurry. I can see the colors on the SS, but when I try to zoom it to see the actual numbers, they become too blurry to tell if the numbers are low blues, <150 or high blues >150.

    The 1U was too much. Our protocols here for Prozinc would have you reduce the dose if your cat's BG's fall under 90 mg/dL.That is using a human meter and the SLGS protocol.

    You reduced the dose on 3/24/20 after getting that low green, looks like in the 60's somewhere. Good. I see you also reduced the dose on 3/26/20, after you got another low green, another 60 something. Good.

    I would not recommend more than the 0.5U dose you are giving now. You do need to test during the mid-cycle, every day that you can. You also need to test at night, or you are missing half your data. Many cats go lower at night.

    What is your life/work/responsibilities like these days?

    I have no idea what meter you use, or what protocol you are following. Would you please add some information to your signature, so we know what meter you use. Also, your first name, cat's name age and sex, DX (diagnosis date), insulin used, meter used, protocol used, and any other pertinent info. Also please include the link to the spreadsheet (SS).

    Please, please, please give us a bit more info so we can help you better.

    Sorry Celi, but that is only a temporary attachment.

    If you follow these instructions, it will permanently attach a read-only view of your SS to your User Id "signature".
    FDMB Spreadsheet Instructions

    Would you please do that?

    Thank you.
     
  6. Celi

    Celi New Member

    Joined:
    Feb 26, 2020
    Spreadsheet above. Angel eats mainly wet food weruva chicken cherish and wellness tiny tasters chicken are her current favorites. Also have freechoice out for her and my other cat Young
    Again
     
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  7. Celi

    Celi New Member

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    Feb 26, 2020
  8. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Thank you, thank you, thank you, so much for that signature info and the SS link in your signature. It makes a huge difference, when we are short handed and trying to help so many people these days. Covid-19 has hit us here too.

    Would you please add you meter to the SS (spreadsheet). Up at the top of the SS, there is a spot that says "Meter:" It's an orange colored box, below the dosing method. So it should say Meter: Alphatrak.

    Knowing you use an Alphatrak makes a BIG difference when seeing BG (blood glucose) numbers <100 and in figuring out if you need to increase/decrease the dose.

    Angel is bouncing, because you skipped the dose last night. Also, it's very likely that Angel dropped lower at night. A regular before bed test is a good idea, every day. Would you be able to do that PM test?

    Are you able to get any BG tests in during the AM cycle today? Please get a BG test this AM as soon as you are able to. I have a feeling that Angel will be dropping too low. You do not want her lower than 68 mg/dL when using an Alphatrak pet specific meter.

    I think the 0.75U dose is a bit too much for Angel. Highly recommend reducing that dose to 0.5U for now. You want to find an insulin dose that you can give twice a day.

    My recommendation is that you please reduce the dose to 0.5U, Perry.

    p.s. Your SS is now a permanent view only link. I'll be able to click on the link in your signature, and open the SS to see what is going on with Angel.
     
  9. Celi

    Celi New Member

    Joined:
    Feb 26, 2020
    Last night 2/28 she was 79 so no insulin. I tested at +3 and she was 144. This morning she was 142. Gave her .5 and at +3 she was 95. I hope we are in the right track.
     
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  10. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    If you are able to test around +5 to +7 timeframe, that could be very useful.
    1. To make sure that Angel is not too low.
    2. To try and find the nadir, or lowest point this dose of insulin takes her.
     
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  11. Celi

    Celi New Member

    Joined:
    Feb 26, 2020
    Missed +7 but at +7.5 bg 100.
     
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  12. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Good job!

    That gives you a bit more information, and helps to see that there were no huge variations in the BG numbers this cycle.

    Try to vary that mid-cycle BG test. A +5 one cycle, a +6 the next. Trying to find the nadir or low that Angel gets.
    Notes in the Remarks column on the SS can be very helpful. To help interpret the swings in the BG levels during the cycle.
     
  13. Celi

    Celi New Member

    Joined:
    Feb 26, 2020
    Today 66 at +5. Fed a small portion of Weruva love connection.
     
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  14. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Woah! Good thing you gave Angel some food at +5. That 66 is kind of low for an Alphatrak.
    Would you please test again, within 30 minutes of that +5?

    p.s. Angel has "earned" another dose reduction.
     
  15. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    These pictures show U100 syringes, and you are using U40 syringes with the Prozinc.
    But the concept is the same, of where to position the end of the syringe plunger for those tiny doses.
    [​IMG]
    [​IMG]

    Do you think you can measure out that tiny 0.25U for Angel? Starting with tonight's dose.

    p.s. I think Angel may be trying to go OTJ.
     
  16. Celi

    Celi New Member

    Joined:
    Feb 26, 2020
    She was 69 at +5.5 and yes I can reduce to .25 tonight. But what if she is high when I test at +12? Should I reduce anyway?
     
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  17. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Yes, Absolutely. She "earned" that reduction, by getting that low today.

    p.s. Starting to run a fever. Not sure how much I'll be able to help the next few days.

    Please post in Feline Health forum if you don't get an answer here, in the Prozinc ISG.
     
  18. Celi

    Celi New Member

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    Feb 26, 2020
    So sorry you are not feeling well. Sending good thoughts and prayers! Thank you for all your help. I really appreciate it!
     
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  19. Celi

    Celi New Member

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    Feb 26, 2020
    I am excited about Angel’s numbers so far today. After .25 yesterday evening, she was a respectable 147 this morning, .25 this morning and 81 at 5.5!
     
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  20. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Ummmm. That's not a bad "Ummm", it's a good "ummm."

    Yes, those numbers are wonderful.
    But, if you are using the SLGS (Start Low, Go Slow) prozinc dosing protocol, that 81 today is another "earned" dose reduction.

    "Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately."

    Not sure that Angel would "Hold" a reduction down to 0 insulin. She has had back to back reductions the last few days. So although the protocol says to reduce by 0.25U again, it may be too soon.
    Option 1 would be to hold the dose at 0.25U.

    There is a second option. Reduce the dose to 0.1U. Go back up to reply #15, to see the picture of what that would look like in a syringe with half unit markings.

    Third option, is to reduce the dose to 0 (zero) and see how Angel does.
    Your choice, you hold the syringe.

    Worst case, if you reduce to 0 units which is no insulin, then you may need to restart the insulin at some point.
    No big deal.
     
  21. Celi

    Celi New Member

    Joined:
    Feb 26, 2020
    Thank you. I will hold the dose at .25 since we just started that and see what happens tomorrow. I hope you are feeling better.
     
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  22. Celi

    Celi New Member

    Joined:
    Feb 26, 2020
    Just tested and got a 55. She seems fine and ate a good lunch which will hopefully bring her numbers up. What should I do tonight? Smaller dose? None at all? Or should I wait and see what her numbers are?
     
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  23. Celi

    Celi New Member

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    Feb 26, 2020
    Tested at +6. 59.
     
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  24. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    First, what happened on 4/2/20? No row on the SS for that date.
    That 55 with the Alphatrak is another earned reduction for Angel.
    So smaller dose. Or none at all.

    The next 2 lowest doses you can do, are 0.1U or "Some" insulin. Pictures of those 2 doses are below, shown with U100 syringes, but the concept of plunger placement is the same with U40 syringes.
    [​IMG] [​IMG]

    Can you test in the PMPS cycle, at +2 and before you go to bed?
    I think Angel is trying to go OTJ, into diet controlled remission.
     
  25. Celi

    Celi New Member

    Joined:
    Feb 26, 2020
    I added yesterday’s numbers. I will give the .1 dose tonight and test at +2 or +3. Thanks so much - makes mefeel so much more comfortable knowing I have the support of someone experienced.
     
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  26. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Some of the rows on the SS seem to be out of order.
    3/29, 4/2, 3/30, 3/31, 4/1, 4/2, 4/3 is the current order.

    Would you please double check that you have the correct BG date associated with the correct dates?
    Also, if you scroll down the SS , at row 69, there is a comment in the +5 column for the PM cycle.
    Thanks.
     
  27. Celi

    Celi New Member

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    Feb 26, 2020
    i think I have the SS corrected. I will test tonight.
     
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  28. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Thank you.

    If you have read a reply, if you would click on the "Like", that let's us know you have read it.
    In my mind, that is the only useful function for the "Like". Don't care how many people are reading a reply, simply need to know that you have.

    Sometimes, I will only click on the "Like" to let you know I've read your post, but have no additional comment.
     
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