Terry's curve

Tomorrow I will make a curve. I will write the results here.

 

We started this morning with a blue score of 198. I tested again 20 min later. Still the same 198. So I waited for 20 min more ( without food). Amps then 245. I shot 2 IU.
+ 2 was 337 . Higher than I expected....

 

+ 4 is 292

 

Hmm could be food influence at +2. I'm interested to see where this cycle goes...it's interesting so far for sure!

 

Hmm I don't know what to think about his curve so far... Could you please check my sheet and tell me what you think? he didn't really got in to the green or blue zone. But he started with a blue 198. +2 could be high because of the meal he had ( like rachel said) . But he didn't got under the 198 . How is that possible?

 

It looks flat but the levels are not high. I like your 2.25 for the pinks; it gave you a mid 200s preshot this am. Maybe 2 is a little low for a higher mid range yellow (245/250). 2.25 might work better. Something to try next time.

But in general, not bad ranges. Regulation is mid 200s for pres shots and lower 100s or double digits for nadir, so you are on your way there. What I don't see are any Reds or blacks, which is great. Just steady progress.

 

Fabienne, I think Teasel and Terry are related. His curve is fairly flat which might suggest that you need a slightly higher dose (2.25 u again?) but I defer to the experts.

Oh -and anything is possible with diabetic cats! Especially kitties like Terry and Teasel.

 

So I should increase the dose to 2.25IU for BG 13.5 ( 243) and higher. And 2 IU for 11-13.5 ( 198-243)? Or could that last range be wider? From wich number I should stall? lower than 198?

 

It sounds like a great couple! Terry & Teasel . If I ever take another cat I will call him Teasel . All my cats' names start with a T. I had Toy ( died of kidneyfaillure at age 4 ) and now have Terry ( diabetic) and Tyson ( has a heartproblem and survived an infection of his brain ( Vet thought tumor at first) ) So Teasel would match perfecty . Or maybe I better pick an other first letter, since all our T's aren't perfectly healthy

 

I prefer to think of it as "special needs" kitties that come to people who are willing and able to take care of them. I've had a few others in the past that started me on grey hair.

 

I wouldn't shoot under 180 and at that range, maybe 1.75 - if you can monitor. (That could be a smidge low, but better safe than sorry. You can raise it later). Maybe 2 for 200-250? All of these ideas are a starting point. Your data will will help us sharpen them up.

 

Thank you @Sue and Oliver (GA) . It's clear.

I nead help again... terry is now lowering his numbers. Now his amps is 250. Surprise .
Is this mr P? And if it is can I shoot 2.25???

 

I think Fabiënne should shoot 2.25 because this amps was almost the same but Terry didn't drop like we would want to see.
Like to hear what you all think about that!

 

@Bobbie And Bubba @Alexi @Kris & Teasel what do you think?

 

I am not sure.......without any PM test last night and for the two nights before, it's hard to know if he is bouncing from the PM cycle. And with it going into the PM cycle now and Fabienne increases, can you test him some through the night? Especially get a test before you go to bed so you know he's safe and get an idea if there is going to be any movement.

 

Oke I Will test him before sleeping.

I just tested again to see if he's dropping ( didn't shoot) . Bg is 256. But.... he just ren the stairs up and down 6 times chasing his brother and wrestling. And he ate about 45 minutes ago.
What do you think??

 

Shoot 2,25 or 2 or less? Maybe he hasn't reached nadir yet.

 

@Robin&BB can you maybe help? 2.25 or 2? I think 2 is a little too low...

 

I think 2 u is a bit low as well but I don't feel experienced enough to be definite in giving advice.

 

I am thinking maybe a 2 u tonight but if numbers are similar in the morning to try a 2.25 u and get some testing in around nadir as he tends to run a little lower at night from the limited data we have.

 

I think either 2 or 2.25 ( if you can monitor). With the 20% variance, he is fairly stable and he still is clearly in a shootable range. But yes, it could be Mr. p visiting. There is just no way to plan for that; you have to roll with it. If you were cautious every time because it might be his pancreas, I think it'd slow your progress.

 

Thank you all. I already shot 2.25 before your replies. I will test him before going to bed to see what his bg is.
Yes you're right Sue. Careful is oke but being to careful could slow the progress.

 

Terry's amps was 236. I accidently shot 2.25. It should have been 2IU

I will test +4 today to monitor

 

@Sue and Oliver (GA) @Rachel can you maybe explain (if there is an explanation even for it) why Terry get's low amps's and the mid cycles are higher? It should go down (normally) after insulin but Terry seems to keep wanting to stay higher... Today his amps was 245 and his +4 was 295. Yesterday was the same... I just want to understand it but I can't seem to understand it... I do find since Terry had gotten help from you all he's doing way better then before, no real bouncing and he's giving nice yellow numbers!

 

Teasel does the same thing. I wonder if it's connected to how they respond to food intake in the hours after a meal? And I think (some) cats will do things we'll never understand even though the analytical types among us need answers!

 

Yes, he is doing much better.

 

I would also say it has something to do with his food intake. He just gets higher foodspikes although it's raw food don't you think? Haha yes i'm analytical type so yes I need some answers
And yes he is indeed doing much better than before

 

It might having nothing to do with the carb content of the food, Ruby. They're able to get energy from protein by a different biochemical pathway. Maybe the events that occur in this pathway cause BG increases in some cats (ECID!). Just speculating ...

 

I think it is one of those uncontrollable variables - like whether he gets constipated, or whether he gets excited by another cat or whether he decides to eat a little more or a little less. Dr. LIsa once said something about this: she said the only things we control are the food we give them (carb count) and the amount of insulin. The rest is ever changing possible variables.

The only thing you can do is expect that it might be his pattern - that he tends to rise at +2 and sometimes continue to +4 (sometimes ). The good news for me is that he then drops down.

The other thing I am seeing lately that I haven't seen before is several cats react to a new dose, or even the same dose, on a lower than usual pre shot, with the next number being higher. I wonder if it has something to do with possible overlap.....ProZinc can last from 10-14 hours, especially if there is some pancreatic action. So our magic 12/12 is convenience for us. But sometimes when they have a late nadir or are coming up at +12, but slowly, adding insulin may give us an unexpected first test. Not that it's a bad thing, just a little confusing.

Someone could write a long book on how insulin works in cats, but they should dedicate it to "ECID"

 

Now my bottle of prozinc is almost empty I need to decide if I will go on with prozinc or I am going to switch to Lantus.
Terry is feeling much better than before but al those strange numbers are making me nuts. Although there are no black or red numbers, he keeps surprising me. Not dropping like Ruby described. This night a high pmps. I don't know what to think.... but on the other hand his numbers were never as good as they were te last week.
The people on the dutch forum are trying to convince me that Lantus is a much better insulin for Terry. They think he will be more stable on lantus. And that it will give more rest for me and terry because lantus requires less tests. How do you feel about that?
Do you think lantus is more suited for him or could he be regulated any time soon on prozinc so it takes less testing?

@Bobbie And Bubba I understood from Ruby that you switched from Prozinc to Lantus? Did you get more " rest" from it when you switched?
Are there the same kind of overlaps as @Sue and Oliver (GA) mentioned?

 

You'll never know until you try it. I don't know how expensive Lantus is in the Netherlands but you might be able to buy a small "pen" vial instead of the full sized 10 mL vial. You could try it for a month or two to see if Terry does better. Some cats do and some don't, some smooth out and some still bounce. As we keep saying ECID. The experts here will be able to guide you in the changeover if you decide to go that way.

 

Hi, I did not get more rest with Lantus and simply because shortly after Bubba started on Lantus, he had insulin resistance and would not budge and also developed ketones. With the help of the Lantus forum, I was giving him another short acting insulin in adjunct to the Lantus to break through the insulin resistance and break up the ketones so I was testing a lot more in the beginning.

As far as not needing to test as much on Lantus, you will still need to get pre shoot test and try to find the nadir of the cycle and as many more that you can that gives you information on how the dose is working for him. I tend to test a lot because I can, as I am home all day taking care of my 89 year old mom too and because I wanted to get him to the right dose that would break through and start getting him in better numbers and for Bubba that was 5.25 units twice a day and then he went racing down the dosing ladder earning reductions like crazy and so lots of testing to keep him safe. He was Off the Juice by 7.28 and we enjoyed 5 weeks off insulin and on Sept. 5th he lost remission due to a bad tooth which is being removed on Wednesday so he is back on the juice again and hopefully when that is removed he will go back into remission.

Sorry for my long winded explanation but I don't want you to think that you will go on Lantus and he will magically get regulated without testing. But I will say this, the Lantus curve once they are regulated is very flat compared to ProZinc. And yes, Lantus can have overlap and carryover from one cycle to the next also. One thing I really like about Lantus is that you can shoot much lower preshots after you have enough data to see how your cat will respond. In the beginning on Lantus you would not shoot anything under 150 and after data collecting you can eventfully shoot as low as 50.

I noticed that Terry just switched to Low Carb food on 9/4 and by the looks of the SS he is in much better numbers and it can take a few weeks for the insulin and the new lower carb food to adjust. I am not trying to talk you out of Lantus because it worked for us and Bubba was OTJ in 7 months on it.

If you decide to go on Lantus, post in the Lantus forum a few days before to ask for guidance with a start dose. I wish you luck in your decision and I know how torn you must feel as I did too.

 

It's easy to get hung up on the numbers but just look at what has happened since you changed the food, you are needing less insulin overall, the overall trend in the numbers is down and most importantly, Terry seems to be a lot better.

It takes time to get a cat regulated, Cappuccino also gets flat looking curves but - she is being monitored carefully as part of the clinical trial and her fructosamine level dropped after less than two weeks on Prozinc and before she had her first appointment for the trial. Her numbers continue to drop (but of course she is in a trial so it may not just be the Prozinc).

Based on the results you have so far I would say things are looking good for Terry so far and would encourage you to persist with Prozinc.

 

Thank you for your support!!it's really helpfull.

I was planning on persisting on Prozinc but started doubting again because of what is said on the dutch forum.

Bobbie, why did you switch to lantus? How long did you try to get him regulated on prozinc ?
I hope he gets OTJ again soon!!

Kris, what is ECID?

 

ECID = every cat is different

 

Bubba got stuck in insulin resistance after he had teeth extracted and 5 weeks later his right eye removed. And to make matters worse his numbers were so confusing. His lowest numbers were at his AM and PM pre shot tests and numbers went up as the cycle played out only to come down lower again at the next Pre shot test. It was very confusing. So after giving ProZinc 6 months I decided to switch to see what would happen. Two of the moderators helped me understand that Bubba was a late nadir cat and that his mid cycle test were actually his pre shot numbers and his AM and his PM preshot numbers were his nadirs. (Are you confused, yet? LOL) The great thing about Lantus for us was that I could shoot those lower preshot numbers which would have been scary to do had he had a normal nadir at +4 -+7 .

In case you are interested in looking at his SS, if you switch to 2015 you will see that we made the Lantus switch on December 1st and then flip to 2016 and you can see the progression.

Why don't you give it another two months on the ProZinc which would only be only 4 months on ProZinc and reevaluate whether to switch him then. I would recommend for you to get some more test during the PM cycle so you will know how low the dose is taking him. At least one before you go to bed. Are you able to get a +11 when you wake up. It will let you know if he is rising or falling. All info you can get helps to put the pieces of the puzzle together and helps with the dosing.

 

I agree, I'd give it some more time on ProZinc before you decide to switch. Lantus is a great insulin, but so is ProZinc...since you still have ProZinc, I'd stick with it for a little longer.

 

You have gotten lots of good advice/info. The bottom line is it is, of course, up to you.

I agree the data gathering/tests will not lessen. It might be easier to deal with the Netherlands forum who are in your time zone. I think he is making good progress but yes, he has been a challenge at times. I would give him more time if he were mine - but he isn't.

 

Thank you so much!

I decided to stick with prozinq a bottle longer

This morning terry had a great amps and after stalling still not shootable. Een hour later he got up to 380 . We gave him 2iu.
How can he get up so fast?

 

Oh my husband just told me he was vacuumcleaning just before the 380-test...

 

This is why we can't let one number make us crazy! And as Alexi said above, it's easy to get hung up on the numbers. It's good once in a while to stand back and look at how your kitty is doing overall. That's very important - and easy to forget when you're busy testing and filling in a spreadsheet several times a day.

 

Today wasn't a real good day... the numbers stayed high. Maybe a bounce from last night.

It is hard to let go of the numbers sometimes.... but overall Terry is feeling much better since you helped me .

 

Yes, I think it's probably a higher, flatter bouncy cycle after a low. (The amps of 86 might not have been the lowest he went...)

 

Fabiënne, you know a little about my story but let me tell you, after reading this and like Alexi and Kris said 'it's easy to get hung up on the numbers' pfffff I was sooo frustrated about Baco... These lovely people here know alllllllll about that, don't you all?? I was also really hung up on the numbers and tried to understand them, but sometimes we can't and you just need to go with it. The most important thing is if Terry is feeling good, and he is! Those numbers will come down eventually but it needs time. Everyone here knows that. The Dutch forum is unfortunately not yet understanding prozinc for the full 100%. Like Sue said earlier, it seems like 'they' want to see quick results and that is not the case with Prozinc. It's a slow process and needs a lot of patient... As we all refer to here 'put on those patient pants' @Bobbie And Bubba has a really nice pink one for you if you need it !
There is a beginners guide renewed on the prozinc part, see the link, that you can read if you have time. It gives you really nice tips/advise and information!


http://www.felinediabetes.com/FDMB/...prozinc-pzi-insulin-for-diabetic-cats.164995/

 

Fabienne, here there are! I know that Ruby looked fabulous in them as I am sure you will too!

 

Thanks for the compliment! That is hilarious Bobbie

 

I LOVE these!!! Where can I get a pair???

 

Hahaha you can get them for free from Bobbie!

 

Aren't they fun! I had to get the granny edition for me. LOL.

 

Here's your very own pair @Kris & Teasel

 

OMG - I'm putting them on NOW!

 

They feel nice right Kris?

 

I feel like a million in these pants!

 

Yep, Fabienne, remember that your kitty is more than just a number! If he is feeling okay, sometimes weird numbers are just that...weird numbers.

 

Thanks Ruby!!

 

Thank you Bobbie !! They indeed look fabulous on me!