Should I increase Insulin

[Angie Haynie]

@MrWorfMen's Mom @Chris & China (GA) @Nan & Amber (GA)
Trinity is having too high BG every morning and night. She consistently nadirs at six hours and I’m occasionally seeing a low day, but most are high. She is still syringe fed and grazing. Taking new medication for arthritis-see signature.

My record keeping is shabby as Mom and I have been hit with one virus after the other since August. We can’t even keep our own dr appointments-too sick to drive one another. But please look at my spreadsheet for the data I have collected.

Before Trinity stopped eating on her own she was at two units for around 2 years. Would it be safe to put her back to that even though I still have to syringe feed now?

 

[MrWorfMen's Mom]

Trinity is often getting down to decent blues and sometimes some lowish greens on 1.5u so I definitely would NOT increase the dose of insulin to 2u. It could potentially drop her BG too low and with you and your Mom not feeling well and unable to monitor consistently, that would not be safe. It looks to me like the highs you are seeing are from bouncing but without any nighttime testing and day mid cycle testing always being done at +6, it's impossible to see just how low the 1.5u dose might be dropping BG.

Bouncing is normal and there is nothing you can do about it, but increasing the insulin is NOT the answer. It may be that Trinity would do better on a longer lasting insulin like Lantus or Levemir.

I'm concerned that Trinity is still needing to be syringe fed. Has the vet been able to determine any reason for her lack of appetite/inablility/unwillingness to eat on her own?

For now I'd hold the dose at 1.5u and if possible, try to get some tests from +4 to +7 during the day cycle. One test is all you need but try to randomly change up when you test instead of always testing at +6 which may or may not be Trinity's nadir. Also when you can, grab a BG test before you go to bed at night. With no night data, you are totally missing half the picture and many cats go lower at night than during the day.

Hope you and your Mom and are feeling better very soon.

 

[Angie Haynie]

Trinity is often getting down to decent blues and sometimes some lowish greens on 1.5u so I definitely would NOT increase the dose of insulin to 2u. It could potentially drop her BG too low and with you and your Mom not feeling well and unable to monitor consistently, that would not be safe. It looks to me like the highs you are seeing are from bouncing but without any nighttime testing and day mid cycle testing always being done at +6, it's impossible to see just how low the 1.5u dose might be dropping BG.

Bouncing is normal and there is nothing you can do about it, but increasing the insulin is NOT the answer. It may be that Trinity would do better on a longer lasting insulin like Lantus or Levemir.

I'm concerned that Trinity is still needing to be syringe fed. Has the vet been able to determine any reason for her lack of appetite/inablility/unwillingness to eat on her own?

For now I'd hold the dose at 1.5u and if possible, try to get some tests from +4 to +7 during the day cycle. One test is all you need but try to randomly change up when you test instead of always testing at +6 which may or may not be Trinity's nadir. Also when you can, grab a BG test before you go to bed at night. With no night data, you are totally missing half the picture and many cats go lower at night than during the day.

Hope you and your Mom and are feeling better very soon.

The vet feels part of her desire for syringe feeding is she loves the taste and texture of the wet, but more so she loves the added attention she receives by being fed 3/day. She totally loves being hand fed.
In the past she has consistently nadired at 6 hours but I can set different alarms and test at other times.
As we can compile more data, if you still feel she needs a different insulin, I will speak to the vet about getting a prescription. thank you.

 

[Sienne and Gabby (GA)]

Prozinc is one of the types of insulin that is recommended for treating feline diabetes by the American Animal Hospital Assn. That said, it may not be the right insulin for your cat. I would encourage you to get at the minimum, a "before bed" test every PM cycle. Many cats experience lower numbers at night and without any PM tests, you're missing half of your data.

I'd also encourage you to take a look at the Prozinc forum. There's great information on the forum about dosing that you may find helpful.

 

[Angie Haynie]

Prozinc is one of the types of insulin that is recommended for treating feline diabetes by the American Animal Hospital Assn. That said, it may not be the right insulin for your cat. I would encourage you to get at the minimum, a "before bed" test every PM cycle. Many cats experience lower numbers at night and without any PM tests, you're missing half of your data.

I'd also encourage you to take a look at the Prozinc forum. There's great information on the forum about dosing that you may find helpful.

Trinity has been on Prozinc for 3 years though it may no longer be what she needs.... I will look at the forum. my Mom and I are disabled. Neither of us wakes before 10am (Trin morning shot) and we go to bed immediately after her 10pm shot. That is why you don’t see any pm numbers unless I set alarms to wake, find her, test her and try to get back to sleep.
As a side note, Today was scary. I wasn’t well awake when I tested and got 137. I remembered to reduce dose but should never have shot if she was under 200. Have been watching her as best I can today. Honey is ready if needed.

 

[Sienne and Gabby (GA)]

In general, you have 3 options with a lower than expected pre-shot:

• Stall. Don't feed your cat and retest in about 20 min. Repeat until numbers are rising.
• Shoot a reduced dose. This may work -- like today, you need to monitor. With an insulin like Prozinc, a reduced dose should be fine.
• Skip

If you've been using Prozinc for 3 years, ideally you want to start to shoot progressively lower numbers. I want to encourage you to post over in the Prozinc forum. I'm more experienced with Lantus. It looks to me like you may not be getting sufficient duration with Prozinc. However, there's also bouncing off of those blue and green numbers. (Trinity sees a low number and her body reacts by spiking her numbers back up.) I think having some members who are better versed in Prozinc may be helpful.