? No Replies - PLEASE HELPDosing advice ASAP please

Posting this again from prozinc forum as no replies - Alfie has not been stable since being diagnosed at the beginning of the month. Started on just 0.25u prozinc then raised to 0.75. Did home testing on Sunday every 2 hours to report back to vet. Having technical issues with copying spreadsheet template so can't share this. Basically, his bloods, albeit they way too high, showed a nice curve.
Preshot 504
+2. 405
+4. 298
+6. 292
+8. 370
+10. 436
+12. 430

Really thought we were getting somewhere when the vet said just to put him up to 1.25u and do another curve the following Sunday ( can't usually do midweek due to work).
However, after this increase of 0.5u Monday evening, he was really unsettled, flooding and pooping in the kitchen all night. He was bad all day yesterday, and starving hungry. I did his blood and at 10 25pm last night (shot at 6 30pm), he was 473.
Thinking this may be as a result of too much of an insulin rise, I gave him just 1u this morning after he'd eaten half of his breakfast. He didn't eat it all in one go which is so unusual for him but had after about an hour and a half. He was also slow to eat his snack 4 hours later. His blood was 491 preshot this morning and still 482 at +6hrs then 470 at +8.
Haven't been able to do full curve today due to commitments but am frustrated and wondering why he's higher than ever! He ate his 8 hour snack hungrily and would eat more if allowed. His snacks are just protein, cooked chicken, fish and beef and he eats every 4 hours. Can't allow free feeding or he would gobble til he vomited! Sorry for this very long post but I'm wondering how much prozinc to give this evening?

 

How long was he on 0.75u before you raised it? That does look like a nice curve, with plenty of room to bring him down more, but a 0.5u increase is too much of a jump at one time. He may just be a bouncy kitty and reacting strongly to the changes in dose. The bouncing can sometimes take several cycles to settle down. I think he does need more than 0.75u but the 1.25u was probably too much of a jump at once. If you can't get mid-cycle testing during the week, all the more reason to be more conservative in your increases. Stick with 1u til the weekend and see if he settles down for you... unless he ends up going too low, then we can reevaluate.

I would recommend getting some test strips to check for urine ketones since he's off his food and his numbers are high.

 

Thank you so much for your reply. I've just given him 1 unit again tonight. He was on 0.75u for 8 days. Just did his bloods preshot again and he'd risen from 437 (lowest today) back up to 458. No ketone as yet thank goodness. He's still eating loads but is just taking longer over it which seemed like a move in the right direction as he's a grazer by nature but his bloods, drinking and urine output tell a different story.
Do you think I should keep him at just the 1u until reporting to the vet next Monday?

 

With Prozinc it's generally recommended to change doses no sooner than 3-4 cycles (a cycle is 12 hours, so 1.5 - 2 days), but some bouncy kitties need longer to settle in. You could leave him at 1u through Friday, then see where he's at and determine if you want to take him up to 1.25u. Usually after 3 days any bouncing "should" subside so you'll get a better idea of whether he needs another increase. Keep getting mid-cycle tests as you are able so we can start putting the whole picture together, and keep trying to get that spreadsheet up and running (I'm sure you've heard this before )! It is very helpful to anyone trying to give dosing advice to be able to see more than just a snippet of data.

 

Alfie's still at 489 six hours after his shot again today after having the 1 unit again so still higher than previously when on 0.75 ( had a low of 292 at least then..)
I didn't do a preshot test as I was out in a hurry but knew he was high after all the water drunk. He's getting wise to the ear prick and doesn't keep still and doesn't seem to bleed easily. I warm the area first and give a treat.
He's thin to the point where his spine is protruding and has a good appetite still and eating a lot but no longer ravenous all day long as he's taking longer over his food now.
I've messaged Chris and China about the spreadsheet

 

It does seem like he's still bouncing. If it was Spot I would stick with 1u again tonight. It is very important that you get a preshot test every time because you never know when they will suddenly decide to throw out a low number. Even people who have been doing the sugar dance for a very long time have the occasional curve ball thrown at them. Try giving him extra scratches and humming a song for a few minutes before you test. It may help to relax you both.

I'm glad Chris is helping you out with the spreadsheet

 

Hi Suzy, regarding testing, there's some tips below that I wrote out for someone else a while back. There might be something in here that helps.

1. Warm ears. Ears bleed so much more easily if they've warm. If they don't feel warm to the touch then briefly massaging can stimulate blood flow. Or you can hold something warm (ie a pill bottle filled with warm water) against the inside of the ear.
2. Resistance. The lancet needs something to 'resist' otherwise it can push the ear away rather than prick through it. Some folks hold a little bit of cotton wool or folded tissue against the underside of the ear, opposite to where they're pricking. I usually use a finger tip, but sometimes get blood from myself that way too..)
3. Two ear pricks can be better than one. Two ear pricks close together can often produce enough blood for a test where one ear prick might not.
4. Massaging below the ear prick with fingers and thumb can 'milk' more blood out. I almost always do this unless the ear is especially warm.
5. Vaseline: A teensy weensy smear of Vaseline on the outer edge of the ear can help the blood to 'bead up' rather than disappear into the fur. I found it so much easier to see the blood droplet because of it 'sitting on top' of the Vaseline. I did this for the first few weeks when I was learning to test.
6. Get comfortable. I find it much easier to test if I pop Bertie up onto my desk or a counter top. I find it easier to see what I'm doing, and I'm physically more comfortable. And my desk lamp is a good source of local light. ..Some people prefer to put their kitty on their lap, or are happy to test if the kitty is sitting alongside them. Find out what works best for you.
7. Remember to breathe... The more relaxed you are about the process the more relaxed your kitty is likely to be. Take deep breaths. Approach the situation in a 'matter of fact' kind of way if you can.
8. Rewards. Always reward the kitty for every attempted test, whether successful or not. If you ONLY give treats when giving tests, most cats will come to develop positive associations with testing. ...I actually find it easiest to crumble a few treats and then test Bertie while he's hoovering up the crumbs.
9. Reward yourself too!

Eliz