Tank started at 635. Increase dose?

I am so happy to have found this website. Everyone has been so helpful and kind. Thank you for that!

Tank was diagnosed in late April. I had been going to the vet's office to check bg levels each week (I was not home testing). Each time the dr. asked me to give him more units becasue the levels continued to rise starting at 430 all the way up to 635. I kid you not, 635. So the dr. said give him 3u 2x day. That day was the day I switched him from dry DM food to Fancy Feast also. That night (after I gave him his second dose of 3u and his first can of Fancy Feast) was when I found this website and posted my first message (it's a frantic message: New to this, Tank's levels 635 please help). I received such helpful feedback about home testing that I immediately ran out and purchased a home test kit and began testing. If you have a moment to look at this spreadsheet you will see that the first night was really scary with the 3u dose situation.

I have been giving him Fancy Feast (one can each feeding 2x day and a snack before bedtime) and he is on Prozinc insulin.

I have been collecting some data but I still have some questions. Maybe someone knows the answer and can offer some advice:

1. His bg level pre am shot is always high. It's been steady now in the high 400's. I have been feeding him one can of Fancy Feast at the same time I give him his shot. Is this not a good idea? Should I fed him first and then wait to give him his shot? What works best?

2. He currently weighs 14.0 lbs, down from his fighting weight of about 18 lbs. He's a big bog, that's why his name is Tank. Is one can of Fancy Feast enough? He always seems hungry, always wants to eat, and always wants water. I understand these are the symptoms of the diabetes. I don't want to overfed, but I don't want to starve him either.

3. Is 2u of ProZinc enough? Should I try 2.5? Too soon to tell?

4. I am still learning all the language associated with fd, (onset, nadir, etc) and I am feeling a little overwhelmed.

I guess that's all for now.
Thanks, Chris and Tank

btw, Tank is 9yrs, black and white domestic shorthair, always been a big boy, has no known medical problems besides this. His potassium level dropped dangerously low which resulted in a frantic trip to the er vet. That's how all of this started. Plus, he is the sweetest, most loving cat I have ever met.

 

For a boy that size I would guess he would need 3-4 cans a day if that is the only food he is getting. Remember in the beginning you are feeding the diabetes more so than the cat. Once Tank reaches the weight that you want him to be at, you can start cutting back on the food. But most likely, once his glucose becomes more controlled, he will become less hungry and will do some of that food regulation for you. Just to give you an idea - my new foster kitty was eating 5-6 cans a day for the first few days I got him (no insulin), and Oscar has been on insulin for a while and gets 3-4 cans a day.

 

Hi Tanks mom, and welcome to pzi. our room is a little slow sometimes but don't give up on it you will get your questions answered.
first i'd stay with that 2U for a week or so and let him 'settle' with it. meaning erase the idea that he's rebounding off the 3U or that it just takes time for it to work on him. many of us did not get results for the first week....then bam, you'll gradually see improvement with that same dose. if not we will raise it in small increments, 1/4U at a time.
the nadir is the peak of when the insulin works, usually about +6 hours after his shot, he will be at his lowest # and go up from there. the onset is when the insulin starts kicking in, +1 or +2 should be the time when he starts to come down.
keep posting each day if you can.
give us the WCR whole cat report, in other words how is tank doing, eatting, playing, sleeping more, whatever.
and no question is too insignificant to ask ok?
Lori

 

Hi & welcome!!! Congrats on getting on board with testing and with the LC food, those are the hardest parts!!! Getting used to interpreting the #s and stuff can be tough too, but you'll get the hang of it as you go along.

1. Sounds like you are doing it right. Generally you want to test before you feed, so you aren't testing a food spike. With PZI I've been told as long as they good food on-board within about 4 hours after the shot, that's good. I think most people feed with the shot, or split the food into 1/2 meal with the shot, and then 1/2 meal a few hours later. Either way is fine. We free feed at my house, so Bix eats whenever he wants and that works well also.

2. I would feed him as much as he wants. If he is acting hungry and is not overweight, it is probably his body trying to get all the resources sorted out. If they are overweight it's a different question, but if that isn't the case, I would feed away!!!

3. I have mixed feelings on the dose, and am a bit on the fence. For one thing, if you do raise from 2u I would go to just 2.25u. On the 2u, I'd be curious to see a +2 and a +5 or +6 in the same cycle, and also maybe a +9 and then the PS for the next cycle. Last night you got a drop of about 50% by +2 which is pretty steep for that early in the cycle. I'm wondering if that might be causing the #s to be higher than they otherwise would be later in the cycle? Might not be that at all, but whenever I see a big drop by +2 it always makes me wonder if the dose might not be too high. If you have a low +2, then a higher +5, an even higher +9, and then the +12 is lower again, that would support the idea that the dose is a little too high. If it were me I would probably be tempted to try 1.8u for few cycles and see if the #s improve at all. I'm hesitant though to suggest a dose reduction when it seems like with many cats we see, that just leads to worse #s. So I'd probably stay at this dose as Lori suggested, and get more data. I don't think you are really risking low #s on this dose, it just might be that the drops are too steep and are causing bouncy PSs. Could be wrong though on that.

You are doing great, hang in there! It can be overwhelming, but that will ease up as you go along.

 

Hey there and welcome. I have to 2nd Joanna's post and say we need some more data. Is it possibly to get hourly tests, even just for the first few hours, then the next cycle grab the a few tests.The 183 on 6/12 is what's making me want a more precise picture of how his body is handling the insulin.

One way to get the data is to do every other hour testing and then switch the hours tested the next time. For example:

PS test
+2 test
+4 test
+6 test
etc.

then the next shot time
PS test
+1 test
+3 test
+5 test
etc.

Even if you can't get them all at once, a grouping of tests can show what the curve looks like. When we had a hard time regulating Aria, I ended up giving hourly tests just so I could prove that I wasn't giving too much and causing rebound before I raised her dosage.

 

Chris,
Welcome, everyone has covered the bases, so I will only add a little.
Sounds like you have a big boy like my Charlie (his heaviest was pushing 18lbs)

I won't offer dosing advice, as others here are more experienced in that area.
I will offer some thoughts on food, though. I would increase the amount you are feeding Tank right now. His body isn't properly metabolizing food, so more is better, for now. I always shot Charlie while he was feeding. I did this because he always ate well and it distracted him from the injection (for the most part). I would however, make sure he had eaten a few tablespoons first, just in case. And I would wait longer if it was a new flavor, just to make sure he wouldn't reject it.

IF Tank is always a good eater, and you aren't feeding a new type/flavor of food, it probably won't hurt to shoot while you feed him. You do need to make sure he eats a good amount. If for some reason he doesn't, you will need to be around to test his bg in case he goes too low.

The general rule of thumb is to test, then feed, then shoot. However, I do know there are some who shoot during feeding. Especially for the kitties who have a hard time with shots. It all depends on what works best for you and your Tank. That is a great name, btw!

 

ditto ditto ditto to everything jen (furball) said :mrgreen:

 

Great feedback, thanks!

I have been giving him more food and he seems much happier. Funny thing...when I pop in the testing strip to the glucometer it makes a little beeping noise. Tank will hear this noise and come running from his sleeping spot. He knows it's time for a treat. I guess THAT'S at least working right!!

I will definetely collect more data. It's interesting to think that he may be getting too much because of the early drop at +2. I hadn't even considered that. I only see high numbers at pre-shot and then I freak.

I will change up the testing times. I'm a teacher and I am officially on summer vacation, so I will have the time to spend collecting data! Poor ears.

Thanks again, y'all are wonderful.

Chris and Tank

 

Welcome, sorry I'm late to show up here. To help his ears I always try to put pressure on the bleed spot for 5 sec or so, to get the blood to clot, to avoid a bruise. Some folks even use neosporin wiped thinnly although I havent had to do that.

As for testing, if you can get a lancet pen with a clear top it helps me a lot. I rub his ear until pink, find a good pink spot, hold the clear top down for a good 5 sec before I pop the lancet, and then hold it there for another few seconds with firm pressure until I see enough blood through the clear top. then i lift it off his skin and test. Then hold pressure on the spot to prevent the bruise.

By the way, does he have really big paws? Does he snore by chance?

 

If possible, can you grab a +1 reading? The high 200's at +2 out off of a 400 PS isn't completely out of the normal. It may just be how Tank metabolizes. If you are getting a drop at +1 (something more than meter variance - I think that's 10%, but if someone can remember, please post), then I would say that the dose is running high and there may be too much overlap.