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News and possible changes

Discussion in 'Prozinc / PZI' started by Bobi, Aug 16, 2019.

  1. Bobi

    Bobi Member

    Joined:
    Jul 13, 2019
    Hi everyone

    I've been missing but we have some news from Bobi

    His numbers are still going up and down :(:(

    We went to endocrinologist and he made an ultrasound and several blood work:
    The only strange results were about his bilirubin that is a bit high - he is going to repeat it on next Monday.
    ALT (alanine aminotransferase) and AST (aspartame aminotransferase) were also a bit high at the first blood work.

    If the results are still high the vet wants to make a liver and gallblader puncture or a liver biopsy to rule out possible occult cholangitis or other thing.
    On the ultrasound: pancreas, liver and adrenal are within normal size but at upper limit.

    We are still waiting for the IGF-1 and aldosterone.

    This new vet (endocrinologist) is considering about changing him from Prozin to Lantus.
    Can I have your opinion about his SS and this possible insulin change?

    I’m going to read all stuff at Lantus Forum but this “depot stuff” is making me a bit nervous… I’m so afraid of hypos – I never deal with one but…

    This is our first thread here: http://www.felinediabetes.com/FDMB/threads/new-to-the-forum-and-confuse.216767/

    Thank you all:bighug::bighug:
     
    Last edited: Aug 16, 2019
  2. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I'm so sorry. I meant to respond yesterday and got pulled away and lost track of your post.

    I see you had a lower pre-shot this AM, gave Bobi a reduced dose and Bobi had a much better blue cycle today. I was thinking the dose might be too high and Bobi seems to have confirmed that today. The 1.4u may be a bit low but somewhere between that and 2.4u is probably where he'll get the best result. Let's see what he does in the morning. I think you could try holding the lower dose for a few cycles and see if he stays around the same range of readings. Easier to do small increases if needed than to try to reduce if too high. Good call taking him down to 1.4u yesterday.
     
    Bobi likes this.
  3. Bobi

    Bobi Member

    Joined:
    Jul 13, 2019
    Hi all

    What do you think about his numbers today?
    .Yesterday Vet was happy with his numbers .and said to mantain Prozinc...
    ... but then this red number this morning and then a green at +7

    @MrWorfMen's Mom

    :bighug::bighug:
     
  4. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    All those lovely blues are great and a big improvement but there is still room for a bit more drop in those numbers. One thing that sticks out for me is that you have no data on the night cycles at all. Only testing during the day really only gives you half the picture of what Bobi's BG is and how much the insulin is dropping BG.

    If I had to guess about that red this morning, it could be that Bobi went lower last night than usual and that AMPS is a bounce from Bobi's BG dropping to a level he is not used to, or dropping quickly to a lower BG or even possibly lower than ideal although I don't think that is likely. Our kitties for some reason often go lower at night than they do during the day and knowing how low a dose is taking BG is important in determining best dose.

    I'd suggest that you make it a habit to get a BG test before bed every night to try to get a better idea of what he's up to overnight. Testing before bed can give you an idea of where he is heading and if you get up during the night grabbing the odd test later in the night cycle can be very helpful info. Some folks periodically set an alarm to get a night test mid cycle.

    Right now it looks to me like a little more insulin may be needed but I would get a couple of night tests before increasing just to be sure he is not dropping more than you think at night.
     
    Bobi likes this.
  5. Bobi

    Bobi Member

    Joined:
    Jul 13, 2019
    Good morning

    Thanks for your answers dear @MrWorfMen's Mom
    I know that I should take some numbers during the night but i have this labyrinthitis problem and if I woke up many time during the night and as I have such a dificult to sleep again, in the morning I can't get up because all around me is spinning :confused:. But I will try.
    You know as i was having this blue numbers so many times I was thinking that nothing strane couldn't happen during the night.

    Now today is had 95 and I read in "Journal of Feline Medicine and Surgery - ISFM Consensus Guidelines...." that if the pre-shot was between 80-142 (I supose this would be on a pet meter) I should reduce the dose 0,5U so I only gave him 0,6U (1.4 - 0,5 = 0,9) .
    What do you think of this?

    TY so much for your help... :bighug::bighug:

    @MrWorfMen's Mom
     
    Last edited: Aug 22, 2019
  6. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    On the testing front, just do what you can. This has to be a partnership between you and Bobi and your welfare is just as important as his. After all he needs you so you have to look after you as well as if not better than you look after him. Getting a test before you go to bed, can give you some good data about where Bobi is headed for the night.

    That's interesting that his AMPS was so much lower yesterday and today. That can indicate the dose needs to be reduced and you definitely did the right thing reducing today. Just be sure to monitor him closely today to ensure he doesn't go too low. I don't see a pre-shot test from last night. Did you test and what dose of insulin was given if any? I would caution against shooting without testing to ensure BG is high enough to give insulin especially when pre-shots are that low.
     
    Bobi likes this.
  7. Bobi

    Bobi Member

    Joined:
    Jul 13, 2019
    TY for your answer <3

    Ops I didn't wrote the pre-shot number from yesterday night
    Now @+4 he is 70.
    I will take a close look at him during the day

    @MrWorfMen's Mom
     
  8. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Give him a little snack now to help keep him from dropping more but keep him surfing in that BG range. :)
     
    Bobi likes this.
  9. Bobi

    Bobi Member

    Joined:
    Jul 13, 2019
    I did because I always give him food at +4.
    I gave him half meal (wet) and then tested him and saw that 70
     
  10. Bobi

    Bobi Member

    Joined:
    Jul 13, 2019
    MrWorfMen's Mom likes this.
  11. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Probably a bounce from those lower BGs. He might be higher again tonight at PMPS but I wouldn't go back to 1.4u given the lows you got today. You don't want to react to higher numbers from a bounce. You could hold the 0.6u dose for a few cycles and see what Bobi does. You can always increase again if needed and that's easier than having him go too low especially when testing at night is difficult.
     
  12. Bobi

    Bobi Member

    Joined:
    Jul 13, 2019
    The endocrinologist (vet) also saw is numbers (he has the link too) and was very happy with it and he wants me to go down to 1.2 for a week and see how he will be doing. I will be with him tonight and check some of his numbers and how he is doing.

    @+8 he is 476 ;-(

    Thank you so much for your help it's really precious to me...
    I'm a very emotive person and you can't imagine (I cried) how happy I'am with this numbers - he had so many black and red for so long...

    :bighug::bighug::bighug:
     
    Gypsy's Parent likes this.
  13. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Oh my that was a swift jump. He's bouncing from the lows earlier and this too shall pass. Great to hear the vet is happy with his progress. You are doing just fine! :D
     
    Gypsy's Parent and Bobi like this.
  14. Bobi

    Bobi Member

    Joined:
    Jul 13, 2019
    Good morning

    @MrWorfMen's Mom
    What do you think about my baby's numbers now?
    Vet said to drop to 0,5 U and think that he has good chances to go into remission but we must go slow now.
    Today he was 77 in the morning but he puked (he ate to quickly I guess) so I didn't give any insuline.
    but before he puke I was thinking on giving him only 0,2U.

    In a normal situation (without puke) - with 77 would you gave him insuline?

    Thanks for your help :bighug:
     
    Last edited: Aug 29, 2019
  15. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Bobi is looking great. So pleased to see those lovely normal readings cropping up more and more. A very good sign that Bobi may be heading toward remission. I agree with taking it slow. I notice you increased the dose when you got a higher pre-shot after some of those great normal readings. Those higher readings are called bounces and they happen when BG drops to levels Bobi has become unaccustomed to. Bobi's body has to learn that those lower numbers are safe. Right now it's like his emergency system goes into action earlier than necessary. This is normal and it will slowly stop as he gets use to the lower BGs.

    The important thing is not to react to those higher readings and give a higher dose. Those bounces can break any time and if you give higher insulin doses because of bounce numbers, you run the risk of BG going too low. Hold the dose through the bounces.

    You made the right decision this AM. I would not give insulin for any BG below 90. You may find you will need to reduce to 0.2u to keep numbers from dropping too low. I would aim to keep BG at about 90 or above again for safety reasons.

    So pleased to see Bobi's progress. Fingers crossed he keeps moving in the right direction and gets to the finish line soon. :joyful:
     
    Gypsy's Parent and Bobi like this.
  16. Bobi

    Bobi Member

    Joined:
    Jul 13, 2019
    Thank you so much for your encouraging words. I'm so happy.
    Vet mailed me today because he is always cheking his SS and wrote - give him 0,25 - so almost like you said :):). Not easy to give 0,25 but I will try :cat:
    :bighug::kiss:
     
  17. Gypsy's Parent

    Gypsy's Parent Member

    Joined:
    Jul 24, 2019
    Wow, you seem to have one of those rare vets that has experience managing diabetes! I guess you did say he is an endocrinologist :) While specialty vets are extremely pricey, you get a doc who deals with the same illness week in and week out, unlike most mom and pop shops that mostly deal with common ailments.
     
  18. Bobi

    Bobi Member

    Joined:
    Jul 13, 2019
    You are true it's a "little" pricey but it was the best option because his numbers were a bit crazy in the beggining and my normal vet asked me to go to a endocrinologist.
    Bobi is having a problem with potassium too so I made this "sacrifice" to spend more money. Like someone I heard at the vet - I will eat sausages and rice all the rest of the month for my baby .

    I saw in your SS that you were looking for a new wet food - this endoc asked me to give him canned Purina MD.
    I gave him sometimes and it's OK but only the can, the sachets no - too much gravy
     
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