Prozinc injection & feeding

I just read up on this info. And I am wondering why our vet told us to make sure we give Moxie her injection w/in an hour of eating or she could get really sick?! I had no idea we were to wait 2 hrs. Ugh. Frustrating! I love this sight. Such great info. Thank you all!

 

That's a new one to me! I thought you're supposed to give the shot within 15 minutes from when they start to eat.

 

I think we may have confused you. We generally suggest NOT feeding for 2 hours BEFORE giving insulin...and then to test, feed, and shoot all within about 15 minutes. That way, food is on board when you give insulin to keep the drop from being too rapid, but food is NOT on board before you test, so your preshot test isn't food influenced. Make sense?

 

TEST. FEED. SHOOT. I read that here and even made a post it of it on my fridge. I will do this all within 15 minutes, and make sure she eats!

 

Hizzoze has another post over on Main so I'll link it here: http://www.felinediabetes.com/FDMB/...et-literally-dosing-help.180388/#post-1996986

Let's work on getting your Spreadsheet setup . If you need help, just ask!
Also, going to give you something to read ahead of time but hope you won't need: http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Just reaffirming what Myrtlesmum said, I don't think any of the members here will say "it's just a cat" These are our fur babies

Hizzoze, can you tell us the dates and amount of each increase since Moxxie started insulin?

 

Roo has a SS, Yong. The link is the entire signature. Maybe you can help CG streamline this.

 

Oh yes I know. SS link was for Hizzoze and Moxxie

 

Oops!! Senior moment ...

 

I set up the spreadsheet. I hope it works!

 

Good to go!

 

when I look at what I post, I see the entire link. Is that still correct? Do you see the link to the spreadsheet or just "Moxies Spreadsheet"?

 

The entire link. Highlight the text "Moxies Spreadsheet". On the edit tool bar above the box you are typing in click the icon that looks like a chain link. Copy the link in the popup box, click insert. Then save changes to your Signature.

 

GOt it!! Thank you!! I knew I did something wrong. But it was a simple fix. Brain fart!!

 

I read it wrong. I took it as dont give insulin for two hours after they eat. ooops. Sorry!

 

Yes, it works.

Questions:

1. I see you dropped the dose from 4.5 u to 2 u. Was that based on FDMB advice? It was a wise move.
2. What was the reason for bumping up the dose to 3 u the evening of the day with the blue AM BG? You weren't able to test that evening.
3. I see you've kept the 3 u dose since then. Is that because of the pink PS numbers you got?

Please don't feel like I'm "skewering" you with these questions. Not my intention. It's so important to know why we're giving a certain dose and that it's backed up with BG data. In the very early days (which is where you are) it's extremely important to be very methodical in how you approach dosing, both in what size of dose to give and in when to change it.

Here's what I see:

• the 4.5 u dose gave you a blue AMPS on 07 July
• it also caused a bit of bouncing - that pink you saw later in the day
• I think that's what prompted you to jump to 3 u that evening even though you had no PS test to go by
• you kept up the 3 u dose based on the two pink PSs you got last night and this AM.

Here are the knowns/unknowns:

1. Was the 4.5 u too high a dose? Quite likely.
2. Was it wise to drop the dose substantially (to 2 u)? Absolutely!
3. Were those pink and yellow test results after that blue number enough data to justify a jump to 3 u? Probably not.
4. Could your kitty still be bouncing from the drop caused by the 4.5 u dose? Yes, very likely.

Here's what I suggest:

• go back to 2 u tonight
• work at your testing technique because those pre shot tests are essential
• keep the 2 u dose for 3 cycles and get at least one other test between +4 and +7 as well as at bedtime.
• if the BGs stay yellow and pink at 2 u increase by 0.25 u on the next cycle
• hold 2.25 u for 3 cycles and carry out the same testing routine
• if no good action, raise the dose to 2.5 u for three cycles.

I hope this helps.

 

BTW - Moxie is awfully cute!

 

I honestly do not know what dose to put her on. I was going to do 1 or 2. Husband said 4. So we kind of compromised by doing 3. A week ago she was sent home after a curve, bc she was on the Hills RX hard food. He increased her dose to 5u (from being on 4, for a month while on that food). I thought it was way too high. esp since she is tiny! I asked to try the wet food and here we are, a week and 2 days later.I wanted to pick a dose and stick with it for a few days since she is going to the vet this week either for a curve or an appointment. Not sure which one yet. Her vet doesn't know I switched the dose or started home testing. I don't want him to think I'm nuts for switching her dose constantly. Also, since she will be at another Vets office from the 15-22 bc we are going on Vaca and our vet doesn't board animals. I can switch to 2, tonight. I have no problems with doing that. This is just all confusing to me. I wasn't sure how long you should stay on one dose. Thank you so much for your input. It helped and explained a lot. By 3 cycles, you mean shots? or days? I'm assuming shots (dumb question) THANK YOU.

 

I'm sorry that I've added to your confusion. I understand why you're confused, though - vet saying one thing, us another, vet visit coming up, switch to wet food that impacts BG numbers, etc.

Here are *more* suggestions:

• a vet curve isn't needed if you have a good home testing routine up and running
• you have 6 days before you go on holiday and board your kitty - time enough to experiment with a 2 u + dose
• yes, a cycle is the 12 hours from one shot to the next so you have 13 cycles between now and leaving on holiday - time enough to get info on 2.25 u/2.50 u/2.75 u (you have data on 3 u already)
• is the next vet visit essential, curve aside? If not, ask to delay it until after your holiday.
• I understand your reluctance to address dose with your vet especially if you get more hands on with it. Maybe a delay in the vet visit and a gathering of more data with her on low carb wet food and you doing more testing will give you ammo.

I'll tag a couple of other ProZinc folks to see what they have to say: @Rachel @Djamila @Yong @StephG You need support and help making decisions. It might be better for you to see what others have to say.

 

Forget the Hills Rx. Be sure to ask the vet in advance if he will see you with the current dosing. Some vets get all riled up if you don't follow their directions. I once took Chloe in for a curve and told them at that time that I was using a u-100 syringe with conversions. Four hours later, I get a call to come pick her up because they refused to do the curve. Poor Chloe-- all that stress for nothing! I found another vet who is okay with home testing.

 

Yikes! I can't believe a vet would do that! Calling first thing in the morning. Thank you for that info.

 

Another thing to think about: you'll feel a lot better leaving on your holiday if you've pinned down a safe dose for your kitty that the techs where she'll be boarded can give. I wouldn't trust others to fiddle with dosing or deal with the negative effects of a dose that's too high - even if it is a vet practice.

I've read your first thread here and I can see how worried , frightened and confused you are. A clearly laid out structured plan of action is the best antidote to that. That's where I was coming from in my previous advice posts. The others I've tagged should show up eventually and having input from more people will make you feel better. Almost all of us here treat our kitty's FD with little to zero advice from our vet. Many of us have vets we like a lot - for treating other issues.

 

Here's another roaming expert who might be around to weigh in: @MrWorfMen's Mom

 

I was wondering abt the vet curve. I was thinking of giving him a copy of her spreadsheet and see what he says. If we weren't going away, I'd definitely skip the vets. I'm more concerned about her at the other vets while we are away. They will give her the shots but not sure about checking her levels? And they asked for her records (my husband just informed me of this).I doubt they will give her the 2u I changed it to, over what her chart says from her vet (5u). Looks like I should make an appt. Ugh! Thank you for your input. I appreciate all of you more than you know!

 

I REALLY hope they don't give 5 u!!! Your tiny kitty should have started on 1 u twice a day.

 

I really like what Kris suggested. I think going back to 2 units and holding for 3 cycles, then increasing to 2.25, holding for 3 cycles...etc would be good. That will give you excellent data, especially if you can get mid cycles in as often as possible. The beginning is always hardest because you don't have much data. Moving up the dosing scale with as much data as possible will help you make good decisions (and help us help you!).

I'd probably skip the vet curve since you are home testing. Maybe call your vet and talk to them about home testing? Some vets are super supportive of it...mine was and when I brought my SS in, she basically said "you've got this, call me if you need anything or need more insulin". I was lucky in that respect. I'd also call the place where she is going to stay and ask them if they are willing to go with your dose and if they are willing to check her levels and make no changes without asking you first. They SHOULD be....

 

Btw, you definitely did not add to the confusion. You helped so much!

 

Very glad you're here, Rachel. Moxie's mom needs our input to avert a negative situation. I think she'll feel better if I'm not the only one saying this stuff.

 

Thanks, Kris!

Also, I wanted to say that I saw you said on your post on Health that you hoped it wasn't a dumb question...NO SUCH THING on this forum! We want you to ask any questions you have. Ask tons! I did that when I started and that's how you learn. Trust me, we'll never tell you that any question is dumb nor will we just refuse to answer anything. We're here to help the way someone helped us when we started! So please do just let us know whatever you need!

 

She was started on 1u, when she was first DX back in April. He increased it 1u after each curve. She had 4 curves. (Every 7-10 days) She was on 4u while she ate the Hill Rx food for a month or so. He did a curve to see if that food worked. It didn't help at all, so he upped her to 5u thinking we were staying on that food. But when I called to see if we could switch to canned pate food, he said yes, but to keep the dose the same! This was just 9 days ago we switched to canned food. And 4 days ago started home testing. 5U just scares me no matter what food she is on. 7 lbs of sugar doesn't need that high dose!

 

Curve numbers at the clinic are often inflated because kitty is stressed. That leads to bad dosing decisions. Also, increases of 1 u are huge at low doses. Going from 1 u to 2 u is a 100% increase!

High carb kibble will keep their BG numbers high. Thank heavens she was eating that HC food with a dose of 4 u!!

Bad advice. It seems your vet isn't well informed about FD treatment. He might be a great vet in other ways. One of the first things my vet told me was that Teasel would have to eat low carb canned food only.

Absolutely correct! Good instincts! Always trust your gut when something makes no sense. Few kitties will be on a dose of 5 u. Many of them end up on 2 to 3 u max after careful increases based on BG data. Some have other health issues that can up their need for insulin but they're in the minority.

 

Vet did mention insulin intolerance. He said we'd have to start looking into other reasons why she is, if she is intolerant. Teeth cleaning to remove some protien that can help lower their BG or put them into remission. That is just the first of many things he mentioned. It is so expensive to have all those tests done! Just one reason why we started home testing and canned food. I almost crapped my pants when they gave me the Hills Rx food. 8Lb bag was 48$ and it isn't even good for them! Thank you again. You have really helped. All of you!!!

 

He might have meant insulin resistance. Far too soon to say that. What you'd see on your SS is high, flat numbers as the dose is carefully increased in small fractions. You'd need quite a bit of BG data. And guess what? Insulin resistance can be overcome if it's caused by sitting too long in high numbers. If it's caused by acromegaly or insulin antibodies BG can still be controlled but the insulin dose might be very large.

 

Yes, resistsnce. Lol I'm hoping that is not the case.

 

We've had several kitties with resistance on here and the small, careful increases have helped them break through that glass ceiling. As Kris says, far too soon to tell, but if she DOES have it, we can help you control or overcome it!

 

Regular garden variety insulin resistance caused by glucose toxicity (the cells become less sensitive to insulin because of the effect of too much glucose on their ability to respond) is quite common when kitties have had elevated BG for a while. It's dealt with by increasing the insulin dose slowly and carefully until the toxicity is reversed and kitty's body starts responding better to insulin. At that point, a dose that gave only pink and yellow might start giving blue and green. The resistance has been overcome and from that point the insulin dose might have to come down, sometimes quickly.

 

On a different topic, can anyone see if my spreadsheet is updating? I also posted this in the other forum. When I click on "moxies spreadsheet " it doesn't look to be updating on my end. My last entry was today 7/9/17 at +4. It should say 240. It updated for me all morning until the last entry. Weird!

 

I see the 240 at +4.

 

I see the +4 reading. Does someone else have control of your SS? I'm seeing a green outlined box that moves periodically. That can happen when someone else has editing rights on your SS.

 

It's under my husband's Google acct. He was already logged in. It's on his computer and updates on there. But when I click the link on here, from my phone, it isn't updated. But I am signed into his Google acct on my phone now, too. He has been on his computer a lot this morning. Maybe he was on her ss. Thank you!

 

Another voice to echo what has already been suggested. I'm glad you reduced the dose and didn't follow the vet's instructions. I too would reduce Moxie's dose to 2u and stick with it for 3 cycles then re-evaluate and if need be raise it by 0.25u at a time.

Your vet, as so many do, prescribed huge dose increases and has in all likelihood passed right over the right dose for Moxie. With the recent diet change to canned food, her insulin needs will no doubt be reduced further. Too many vets don't seem to understand that dose changes needs to be done slowly and methodically so the right dose is not skipped over and obviously your vet has been sorely misinformed about the appropriate diet and its effect on insulin requirements. As the Mom of a previously kibble addicted kitty with a secondary high dose condition to boot, I can vouch for the huge difference changing to a wet diet can make.

I'd speak with the vet and/or the staff at the vet clinic you plan to board Moxie with and find out how they treat diabetics. Do they have 24 hour observation of their boarded animals? Will they test before shots/mid-cycle? Will they feed her the diet you have her on currently? Are they willing to stick with the dosing directions you give them? I'd give them permission to reduce the dose but not to increase it without contacting you first. And I'd make it very clear that they are NOT to follow any dosing instructions received from your regular vet. When boarded, you don't know if Moxie will eat as well as she does at home so reducing the dose a little more for that week might be advisable. Better to have Moxie run a little high than too low even at the vet clinic because she is most likely not going to be monitored to the extent you do at home.

And yes I am amongst the ranks of folks here who treat their cat without any input from the vet. My vet despite being great, with years of practice in a major veterinary ER clinic, had never seen my cat's high dose condition so I have relied on this board for information and with the help here I now have a more "normal" diabetic cat.

 

I agree with the advice given above.
My old vet started my cat on 7 units and that's how I ended up here.
I think Linda's advice about calling the boarding vet and being clear with instructions is spot on. I would give them a copy of your spreadsheet too.
I'm one of those that treats at home and only uses the vet for refills and other health issues. My cat is a high dose kitty but I haven't had the tests done to determine which condition is the cause--yet. He's 12.1 pounds and gets 14.4 units of lantus twice a day right now. We started on ProZinc and got up to 8 units in 7 months before switching.

 

btw, why did you choose boarding over having a pet sitter (bonded and insured) come to the house? It may be less stressful if she can stay in a familiar place. Also, have you checked out YA (Young Again) cat food? It's kibble, but made specifically for cats with diabetes (very low carb). You have to contact them directly online, it's not sold in stores. You could ask them for a sample. Also, you can free-feed with it (leave a small amount out). You're doing great so far!

 

My mom watches the cats for us. Comes down 2 times a day. But I didn't want to make her do the shots and definitely not the glucose levels. Plus they are only charging us 120$ for the week. That includes administering meds. I will have to look into the cat food. I never heard of it. I currently have Merrick grain free chicken dry food. Im going to check out that cat food now! Thanks for the info!

 

Gave Moxie her pm shot. Buuut, I don't think it went in. She tried to jump over my arm BC my daughter turned on the lazer pointer. Ahhhh!

 

Whoops! That laser will do it! Well, at least if it was a fur shot, you know you can relax as she definitely won't go too low tonight?