Some advice, please

Zoey has been cruising along in mostly pinks, with some yellow, preshot numbers. I've tried increasing her dose to 1.4, but that seemed to drop her too low, so I am now back at 1.2 with a reduced dose at lower numbers. She is very inconsistent, and will sometimes throw a number too low to shoot (like last night!)

Any suggestions on dosing to try to get her into lower preshot numbers without bouncing? It's been 2.5 years now and I don't see a lot of improvement in her numbers. Maybe she will always be inconsistent?

Otherwise, she is doing well: eating well, all 3 P's are good. We have a vet visit coming soon. Luckily, I have a mobile vet who comes to my home. Do you think I should ask him to do some testing on her? And if so, what exactly should I ask him to test for?

I've thought about switching her to Lantus, but I really need the flexibility that ProZinc allows due to my and my DH's work schedules.

Thanks for any advice you can give me!

 

Hey Carol! Hmmm...that's a tough one. It does look like bouncing to me, and honestly, there's not a ton that can be done about bouncing but to wait it out. It is interesting that she's had those lower numbers the last two nights though...looks like it might have been long cycles. Any chance you can grab some tests in the later part of the cycle soon? Some numbers from +7 - +11 might shed some more light on what's going on (I don't mean a test every hour then..just one or two tests in that timeframe).

The mobile vet sounds cool! I need one of those. I'm not sure what tests you could ask for that would help...maybe just have him do a general checkup to make sure there's no infections or dental issues that could help push her lower?

 

Hello Carol and Zoey!
It is very possible Zoey is a bouncey like a few here.
Some questions:

1. How often are you not able to stick to 12/12 and by how much time?
2. Is her feeding schedule consistent?
3. Just curious as to the reasons for different doses sometimes with similar AMPS and PMPS numbers?
4. Are you able to do a before bed test, just to see where she's headed in the evening. Might shed some light on AM numbers. For most full-time employed, that before bed test seems to be between +2 and +4.

We'd love to help you find the rhythm to her sugar dance

 

In answer to your questions:
1. It's only occasionally that we miss the 12/12, and then I try to work up to it by moving her doses 15 minutes each time. Usually it's no more than 1/2 hour off.
2. She is very consistent in her eating. I give her one can of Friskies or Merrick pate in the morning at shot time, and one can in the evening at shot time. If I will be home, then I give her half a can each time with another half can at about +4. The food is usually gone by the time I get home from work or get up in the morning.
3. She seems to be more affected by the insulin with the PM shot, so if it's close, I choose to give a slightly lower dose.
4. I do a before bed test quite often, usually at +3.

I'm not sure she has a rhythm! I think she's more of a "freestyle" dancer!

Thanks for your questions.

 

Okie dokie, everything sounds in order and she may just be a bouncey kitty . With that, she is bouncing after the green from PM cycle 20 June. Can last up to 6 cycles (a couple kitties can even last more than 6) So this morning's cycle is cycle 3.

We're pretty sure it's musique only kitties can hear and sometimes we'll sync up with them for a little bit .

 

I will try to do some later tests to see what is going on. Thanks.

 

I'm wondering about the food. Some of the Merrick flavors are around 4% carbs which is great, but others are 11-14% carbs which is too high and might contribute to the inconsistent numbers. Can you double check the flavors you're feeding on the list? (If you've already done that, just ignore this part) http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Another thought is that some kitties get bouncy whenever there is a change in dose, so if the dose is shifted often, it can make the numbers in the following cycles a little unpredictable....which then leads to more dose changes....which then leads to more wonky cycles, and on and on. Sometimes you can't do anything about it - the number is just plain too low to hold the dose. But you might try (if you aren't already doing this) stalling without feeding for 20 minutes and retest to see if the number rises. You can repeat that for up to an hour (if the kitty doesn't try eating you first!). Often just the 20 minute stall is enough to get the numbers into more consistent territory.

You've been at this for awhile, so you may know all of that already, but figured it was worth mentioning just in case.

 

Thanks, Djamila. I did use the food chart and buy only the low carb Merrick pates. I also try the stall technique when I am able. Sometimes I just have to leave for work and she doesn't get a shot, but usually I have time to stall.

I'm trying to decide if 1.2 units is just too high, or if she will eventually adjust to the dose. I worry that if I give her the 1.2 when she is lower (say 250) that it will drop her too low, so then I shoot 1 unit.

I've been using 1 unit for a while, but it just didn't seem to get her low enough during the day. Would you suggest sticking with the 1.2 or dropping back to 1 unit for all numbers (except below 150, which is my no-shoot number)?

 

Do you have any data from yesterday?

 

I don't have it with me, but she was in the high 300's at both AM and PM. I gave her 1.2 both times.

I think I will stay at 1.2 over the weekend and get more tests.

 

I did more testing over the weekend. Of course, we started with having to stall for 30 minutes! I think I'm going to continue with the 1.2 units, but I am wondering if that is too much for some of the lower numbers. I do not shoot below 150, and I'm thinking of doing a modified sliding scale with 1 unit between 150-300 and 1.2 for numbers over 300. I would like some advice on whether or not to do that.

Thanks!

 

Good job getting some extra tests
Looks like Zoey might be a slightly bouncy kitty, nothing bad or wrong about that! However, if it's true, sliding scales usually don't bode well for such kitties. They're usually reserved for the first insulins you used but Prozinc is gentler and longer lasting. Some of your best steady PS numbers were on the 0.8U dose. We also recommend sticking as close to the 12/12 hour schedule as possible. If she is not getting a shot for one cycle and a later test shows her numbers rising, do not give insulin. Wait until next scheduled time to resume. It looks like that has been done a few times and it messes her cycle up.

Please note, I am not trying to be hurtful in any way . Just giving suggestions based on Zoey's data and my own experiences. Overall, I think you should go back to 0.8U every 12 hours if her BG is over 150 as you stated is your no shoot number . The choice is always yours, this is just my opinion.

 

Not hurtful at all! That's exactly the advice I was looking for. So are you saying not even to stall for 20-30 minutes to see if her numbers are going up? And everything over 150 I should give .8? Just want to be sure I understand.

 

I think what Yong is saying is that you want to stick to 12/12 as best you can, but that does NOT apply to stalling. If you get to the preshot test and it isn't high enough, we definitely recommend stalling 20 min without food and then checking again to see if she's high.

I believe Yong was only referring to if you have to skip a shot and then you see about 3 hours later that her numbers are higher....then it would be best to wait until the next preshot to give insulin so you don't mess up your cycles.

Yong, correct me if I'm wrong?

 

Yes Rachel, sorry for any confusion. Stalling is fine because if a shot is given, it's within the hour. And yes thinking you should try sticking with 0.8U every 12 hours as long as she's above 200. If she's between 150 - 200, you may want to reduce the dose to 0.25U, and work your way back up slowly, since the couple times she has been given a shot at these BG ranges, we don't know how she reacted in most cases. If you are able, always try to get another test between +2 and +4 to see if she can get more at the lower range.

 

So, last night her PMPS was 373. I gave her .8. At +3 she was down to 287. This morning her AMPS was 183. I hadn't read your posts yet, and I hesitated about whether to shoot or not, but I gave her .5. I looked back over her spreadsheet for the past 6 months and made the best guess I could. She has lots of food and has never had a hypo incident so I'm sure she will be fine. I'm going to stay with the .8 for a week or two (unless she's below 200) and see how that goes. Thank you both so much for your advice!

 

Whew! I think that sticking with 0.8 u for a while is a good move. It's wise to settle on one dose and not change it AM/PM when you're trying to sort out what's going on. If you have a spare minute to update your SS that would be great.

 

Updated spreadsheet. She was high again last night and this morning!

 

Looks like a classic bounce cycle to me. High and flat after a lower number is usually a telltale sign.

 

Hi Carol and Zoey,
Just checking in on some members I haven't seen post for a while. Hope you are well. Please update your SS when you have a moment . Wondering if you should try 0.6U with Zoey

 

Thanks for checking in. I updated her SS on Monday. It looks like the morning dose of .8 is working better because the PMPS numbers are in the yellows. However, she is still in the pinks in the morning. And on Monday, she was 455! I think that might have been another furball because there she vomited on the floor during the day. I was actually thinking about increasing her dose at night, possibly to 1 unit. Maybe a decrease would be better. I don't know because she doesn't seem to be dropping too low at night causing a bounce. I ordered some Gluco Ensure and Pancreas Booster and thought I might start her on those. From reading the information about those supplements on this site, I would guess 1/2 capsule twice a day. She only weighs about 8 pounds.

My vet came out yesterday to give her and Marley (Maine Coon boy) their shots. We talked about Zoey quite a bit. He thinks she's doing well, even though her numbers don't seem to be stabilizing much. I showed him the supplements and he is supportive of me trying them. He wants a report on how they seem to be working. I'll try them for a month or so to see if I notice any improvement.

Any advice you can give me will be much appreciated!

 

Could've been a hairball or she could've gone lower over night. Grabbing some before bed tests can help shed light on her PM cycle and just based on what I see, I am thinking decrease for a couple days. If you do decide to try 0.6U, just update SS and I'll check to see how it's going. And then chime in again . I've been told Pancreas Booster is 1/2 capsule twice a day but I'm not sure about Gluco Ensure. @jayla-n-Drevon is the one to ask so I'll tag her for you

 

Hi!
Yes the recommended dose for a cat is 1/2 a capsule 2x a day..... However Dre is almost 20 pounds and I give him a whole capsule 2x a day.
He was getting a bit annoyed with the pis so we are taking a break and unfortunately his numbers reflect that

 

Do you just sprinkle it in his food? Was he on both or just one of them?

 

They work best together but 1 is better than none.
Mine will not eat anything mixed in the food. I give Dre gel caps but I realize he is very tolerant and I hive him breaks. I don't really think he will ever be otj but regulated would be awesome.

 

She is a good eater and not too picky so I think I will try to mix them both in her food. I'll try it for a month and then re-evaluate.
Zoey is the same way. It's been 2 1/2 years, so I don't think she will go OTJ, but a little stabilization would be nice!
Thanks for the information!