? Suddenly in black - Need Prozinc dose advice

Recently I was wondering if I should raise my cat's insulin dose. She was stable for awhile but everyone said that mid-high 200s were considered unregulated and I should start increasing her dose every few cycles to see if I could lower that and push her towards blues for AMPS/PMPS. As I've increased it everything has started going haywire and she's back in the 4-500s. I took her off insulin yesterday to see if that would help and there's slight improvement but after 1 unit this morning she's actually going up. She's still on her regular low-carb wet food, her ketones are negative and thus far the only sign she's showing is increased thirst but I'm really worried. Is she having an adverse reaction to the increased dose? Someone said keep increasing it because it'd take time to "break through" since she was on a low dose for awhile. I don't know how to get it back down and help her out. I really need help. Thanks for taking time to look even though its the holiday and I hope everyone has a good Christmas.

PS - I did miss a couple of tests due to the holidays being hectic so I apologize for that.

 

Sorry to hear this, I know it can be awfully frustrating. What type of insulin are you using?

 

The new vet in our current vet's office said that she just attended a conference on feline diabetes and that it's been discovered that cats in particular handle the slightly higher numbers fairly well without too much trouble. If the cat steadily stays more toward the 300 mark, you want to test regularly for ketones, but otherwise not to worry too much. Of course being closer to 160 or less is best.

 

Hi, I just had a look at Nala's SS. It would help a lot if you could get some other BSL during the cycles not just the AMPS and the PMPS. She could be dropping lower during the cycle and you would not know. Most cats will rise up higher at AMPS and PMPS so if you are only taking the BSL then you are not getting the full picture. It is possible she is bouncing from a lower number. If she is not used to dropping into the lower numbers, her body could be taking fright and bouncing.
If she has increased thirst she is probably not getting enough insulin.
Are you following the SLGS or the tight regulation protocol?
It is better not to jump from one dose to another as it stuffs up the depot.
I don't really like to give dosing advice but she looked as if she was doing better on the higher dose. Why did you think the 2 units was too high? You usually lower the dose when the cat drops under 76 I think it is for the alpha trak meter for the tight regulation.
What insulin are you using?

 

Prozinc is her insulin.
I am taking tests every 2 hours today to get a full curve.
Using the SLGS. We can't even get anywhere near tight reg yet.
She was in the mid 200s on .4 units but she's getting into the 400s on 2 units. Mogmom might be onto something. It scared me that its jumping so high.

 

I am not against dosing advice if you have good suggestions. She's still fairly newly diagnosed and this is all new to me as well. I feel like I'm stumbling around in the dark with how to take care of her even though I've spent hours reading up.

 

Hi Nala's Person.

I've just had a gander at Nala's spreadsheet and I agree with Bron. You really need to get mid-cycle numbers to see how low Nala may be going during the cycle. There could be many reasons why a cat goes higher. It may be due to a 'bounce' (as Bron describes above), from too high a dose of insulin (in which case the body signals the liver to release more glucose into the bloodstream to protect the body), or it could be due to any number of possible phsyiological reasons (e.g. infection). Gathering both preshot and mid-cycle test data into Nala's spreadsheet will at least give you some better idea about whether Nala's bouncing or may need a dose adjustment.

I see that Nala is on Prozinc. It's not a depot insulin. I'm not experienced in its use but I know from my reading here that it's an 'in-out' insulin (i.e. it doesn't build up a depot in the way that Lantus and Levemir do - there may be a little carryover between doses of Prozinc, but usually the dose is 'used up' in a single cycle). I've also read here that FDMB have developed a sliding scale dosing guidelines for use with Prozinc. It should be available in the forum stickies on the Prozinc Insulin Support Group's board.

There are some members highly experienced in the use of Prozinc here. I suggest that you rename the title of this thread* to "Suddenly in Black - Need Prozinc Dosing Advice" and switch on the Question Mark icon to attract more attention to your thread. (Go to your opening post then select Thread Tools on the right hand side of the screen to edit the thread title.) Hopefully people with Prozinc experience will be able to give you some more concrete suggestions on how to help Nala.

Good job with the ketone testing, btw. Sorry I can't help much. Yuletide blessings to you both.



Mogs
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Thanks, Critter Mom. Cute name by the way. I am currently working on mid cycle and I will be doing so over the next few days. Today I'm testing every 2 hours and then I'll probably do every 3 tomorrow depending on the advice here regarding dosing. Over in the Prozinc forum a couple people mentioned that she has a late nadir. Normally I do post there but with it being the holiday it's slow and I don't want to risk anything happening to her in the mean time.

Thanks for the title change suggestion as well. I went ahead and did that so maybe I'll get more info

 

Great that you can get several mid-cycle numbers over the next couple of days. Indeed, Nala does tend towards later nadirs. (Saoirse tends to do the opposite ... )

I hope you get some input from experienced Prozinc people soon.


Mogs
.

 

Thanks a bunch for you help!

 

She does have a confusing spreadsheet. Today, it looks like the one unit is not enough - she drops, which is good, but not enough. I am wondering whether she is a kitty that needs to be on a dose for awhile before she settles into it. The best cycles I see lately are the 1.5 ones. I wonder if the jump from 1.5 to 2 units was too much. There isn't much data for 1.6. Without the amps those two days, we don't really know what happened.

I think I'd try 1.4 or 1.6 and hold it a few cycles, getting those numbers in the +5-7 range and see what the numbers do.

 

@Sue and Oliver (GA) -

Hi Sue. Great that you could drop in. Just want to wish you and all your loved ones a happy Christmas.


Mogs
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Sue to the rescue as usual! I will go ahead and bump her to 1.4 tonight and hold it.

 

Well if you can figure out her chart you're all better off than me lol. She was 175 at AMPS so I fed her and I'm holding off on the dose. I don't know if the 1.4 was perfect. 30 minutes later right now shes 159.

 

I wish I felt comfortable enough to chime in here, but because Goof tends to be the exception to so many rules, even tho he was on ProZinc, I don't think I'd be able to offer any help. I hope you can get things figured out soon tho.

 

Hope you decide to give her something so she doesn't go sky high. Maybe .8? The 1.4 might have been a little too much but the 178 isn't terribly low and if stalling gives you a rising number, that'll work.

 

Sue, I did! I gave her .5 to see how she takes it. I'm going to try and keep her in blues all day. If she goes up slightly back into low yellows again I'll probably give her another .3 to get to the .8 you're mentioning. I'm testing her again every 2 hours to see if I can get her to stay here all day. Fortunately I'm off on vacation so I can play with her insulin a bit more to see if I can get consistently good numbers. I just wish my job would push through my teleworking so I can be home to get a midday reading or midday dose if needed.

 

I think your 0.5 is fine. I would not add any insulin if she rises - you don't want t be dealing with two nadirs.

The 178 is a little scary as you have been getting higher preshots, but it is a good number. Just as you did, get a second test to be sure it is rising and then shoot a little less. If the 0.5 looks like it isn't enough for a low 200, then we have that info the next time she has a similar number.

She may be a cat who responds quickly to a dose change or a kitty who takes awhile to settle in. Her past cycles look like she needs a little time. It looks like the 1.4 was a pretty good dose for a red, as long as you can monitor. I'll be around today so will watch for your pmps tonight.

If you are going to be around to test for the next few days, you might post on ProZinc to get more dosing advice. It may be quiet but everyone there can help with dosing. There are several people who plan to be around over the holidays. People on Health who don't use Prozinc are understandably reluctant to help with dosing.

 

Good idea. I'll move this over to the PZ forum again

Also, BIG thank you to everyone that commented and offered support and advice. I really appreciate it and hope everyone is having a fantastic holiday