Starting over with dosing … advice and encouragement please?

Could you please review Shyloh’s SS – When the vet recommended 12 units (ProZinc) – that’s where I met my threshold. I started over at 1.5 – just couldn’t go all the way down to 1U after 11U. (I am checking Ketones) I am excited that there is a steady trend to lower #’s even if it is taking a long time – after all the increasing dosage resulting in creeping upward #’s. Being patient is killing me because he has had high #’s since Christmas.

We still have symptoms – a little weight loss, loss of furze, lots of water drinking, lots of water output (puddles are getting smaller tho), listless, ravenous appetite more under control; today he was ALMOST enticed to play and looked cheerful. Maybe it was the sunshine.

My question – does he seem to coming down at a good pace? I am so happy to see ANY positive results I’m afraid to tweak the current dose. Could he go maybe even lower than 1.5 U? Or should I just be happy to have him where he is for now? I tried 1.75 once and the next reading was higher rather than lower so I went back to 1.5. I know what they say about not making judgments based on a single test but he doesn’t have wide swings so what you see is pretty much where he is.

How will I know when it is time to adjust the dose – higher or lower?

Lastly, since he is looking so steady, could I back off testing twice a day (for just once) for a few days since his ears are getting pretty chewed up? I mangled the left one very early one morning so I’m working on just the right one for now and sometimes there are two pricks before I get a drop.

Thank you ALL for taking the time with us!

 

Have you considered testing for the most common insulin resistance conditions? Acromegaly and IAA? (Insulin autoimmune antibodies)

If you haven't yet, please visit the High Dose Insulin Support Group and read the sticky posts about these conditions.

Also, it could be that your kitty is just not reacting to the Prozinc -- have you considering switching to Lantus or Levemir?

You've been treating him for over a year -- I think you can make dose changes after 3-4 days -- check the NADIR though -- how low does your kitty go during the 12 hour cycle? I would not make dose changes based only on pre-shot BG numbers.

So -- I would suggest doing a 12 hour curve to see what time he "peaks" or bottoms out. Then later, you can do some spot checks at that time (might be +7 hrs after injection?? varies for different cats and different insulins)

 

Decidedly not a dosing expert here, just have learned some things from reading: From your spreadsheet, it looks like you are doing certainly no worse on 1.5u than you were on 11u, and you may be doing a bit better, so it doesn't look to me like you've got a high-dose kitty.

Since lowering the dose has made the numbers get a little better, I'd be tempted to try lowering it a bit more and see what happens (but be ready to put it right back up if things get worse).

I presume your vet has ruled out infection, bad teeth, stuff like that. Such problems can definitely cause problems with regulation. You say you are checking for ketones; that's good. Very important to do that frequently when the numbers are high, especially when you are lowering the dose.

As I said, I'm no sort of dosing expert. If someone with dosing experience in your sort of situation comes along and contradicts me, please forget everything I said!

 

Pat, congrats on your tenacity and your good judgment in starting over.

A high dose kitty is far less likely in this situation than a kitty on rebound. Shyloh has been on a reduced dose for 10 cycles now. He needs a curve so that you can have appropriate info about the 1.5U dose.

I won't let you off the hook for preshot testing. In my 4.5 years here, I have never given a shot without a preshot test. If I am too tired or too busy to do a test, I am too tired or too busy to give the shot. I know your reasoning is different than mine (mangled ears), but I find the bruising from the pricks heal fairly rapidly on my cat.

I tend to be where Jean is on the dosing.

I also find alot of wisdom in Phoebe's comment.

We used to have a saying on the PZI Board years ago when it was just starting up and my Maxwell, and then my Ennis, were on BCP PZI. "Just sit on your hands." We always gave dose increases a week. I'm not sure what the PZI group does now. I've done "start low, go fast" with Ennis, but that was with Levemir, which has a whole different action than PZI.

Best of luck. You are doing a great job. And I read you profile and Shyloh's physical description. I would love to see a photo. I love tuxies, and I've never seen a MC tuxie.

Venita

 

Welcome to another Shyloh. I bet yours is as precious as mine! Donna

 

Thanks to everyone for the comments. I have made a change and will closely monitor Shy this weekend and if I don't see results I'll contact the vet about switching insulins. I'm embarrassed to admit that this never occured to me. I had heard so many wonderful things and success stories with PZI-type insulins. Ahh well ... poor Shy just needs to hang in there a little bit longer.

Speaking of switching insulins, I've noticed that most of you have strong opinions about what you have settled on using for your particular need. Is there any where on this board where I can find a comparison of insulins? It might be good to go to the vet with a little more knowledge this time.

 

There are sticky posts in each Insulin Support Group about the different insulins -- and the Pet Diabetes Wiki has some general comparison type info, but it may be a bit outdated.

 

just wanted to say hi as I am from the phg area as well. about 15 mi SE. little town called WALL
not on the board as much anymore but do pop in from time to time
there are a few from around here sheridon, wexford south side.
we do get togethers in august to meet and discuss cats and have fun. maybe we will see you at one this august

 

Sorry if I missed it but what does Shyloh eat? Dry or canned food?

 

Thanks for asking ... For some time Shy has eaten FF tender beef supplemented with a few spoons of warm water and a few ounces of poached chicken tenders. He gets about 12 OZ a day canned (4 cans / 2 per feeding) and about 1 tender per day. His appetite is enormous. If I try to feed him less, he loses weight. I've read the board and taken all the advice and tried to do everything right no matter the cost which is what makes this all so frustrating.

 

Wow that does seem like a lot of food for one cat. I have four and one of them is huge but they only eat 33 oz a day which breaks down to about 8.25 oz each. I wonder if the quantity of food has something to do with your cats numbers. confused_cat

 

I think once he is more regulated he will eat less. he has been running in the 400's