Wrong dosage?

I also posted this in the general but was told I might find more info in PZI.

Once again I want to thank everyone for their help and encouragement while dealing with this, and apologize for maybe obvious answer questions. I have been reading and reading so I don't have to ask 50 questions a day lol. Brief history, I don't think I have ever introduced myself....I am Samantha and my 13 yr old male is Hidey (yes Hidey, because he hides) He was diagnosed 1/7/14 and since has been on 1 unit 2 x a day. When he was diagnosed he was 561 (alphatrak2). Since then I have switched his dry food (I am slowly getting him off of it) to EVO but am slowly introducing that as well it is 3/4 EVO and 1/4 weight control blue buffalo, so he is getting 1/3 c of dry and 1/3 can of food in the morning and at night. He gets avoderm, and tiki wet food....all no/low carb varieties. I have been getting into the habit of testing at home and luckily he is now getting better at it, and so am I Hidey's numbers have not really dropped. The lowest I have seen is 384 (Alphatrak 2) and that was this morning. I just tested him again 3 hrs later and hes up to 432 already. In the morning its generally 570's and at night low 500's. How long does it generally take for prozinc to start working or am I not giving Hidey enough?

 

Hi!

I replied on Health but will copy it here.

You used the Google FDMB one, right? If so, first save it to your favorites. Then on the right hand top corner, choose Share and then in the drop down box, to Anyone with the Link. Then in the left hand corner, choose File. then Publish to the Web. The url that comes up is the one that you copy and paste into your signature.

If that doesn't work, send me a pm (pm button in bottom left hand corner of this post) with your email address and I will set one up for you.

I'd really like to see some numbers. Then I'd be happy to give you some suggestions.

_________________

 

Welcome Samantha and Hidey!

I agree with Sue. If we cannot see Hidey's numbers, we can't help with dosing. I am thinking that it might very well be time to try an increase, but we won't know unless we can see your spreadsheet. I will try and check back later. Sue is much more experience than I am as are others, but I am willing to take a look and see what I think.

 

I had to redo it but I finally got to the point that it said publish before I didn't have that option although now google says error try back later does it take a while to be published? I copy and pasted the numbers for now. If that helps at all

Date AMPS U + 1 + 2 + 3 + 4 + 5 + 6 + 7 + 8 + 9 +10 +11 PMPS U
01/18/14 573 1.00 505 1.00
01/19/14 1.00 385 1.00
01/22/14 513 1.00 384 432 1.00

not many numbers to go off of since I just started testing and Id stop trying after 3 or 4 pricks with no results :cry: now its getting easier so I'll have more numbers.

 

It is hard to say because you are looking for a 50% drop nadir which he did but at the same time 1.0 unit doesn't seem like enough for a PS in the 500s. Have you looked over anyone else's chart? When Skipper was over 500 at the vets, they gave him 3.5 units that got him down to 195 for a +4 and then to 244 for for his PMPS. His doses were higher in the beginning and gradually dropped. Looking back, the 3.5 units the vet gave him was probably a little much. He never had close to that amount again. From what I have learned, you don't want to up his dose more that 0.25 units. I would be comfortable giving 1.25 or even 1.5 units with your numbers, but you also have to know your cat. I wouldn't jump to the 1.5 unless you are home to monitor.

If he isn't getting out of the 300s you should probably also test for ketones. IS the dry food you are feeding a low carb variety? If not, that could be affecting your numbers quite a bit. Skipper ate some of the kids cracker crumbs and bumped himself a lot!

Anyway, I am new and pretty much am going by my experience so far, so you might wait for someone else to answer! ;-) You'll get it figured out quickly with the help of al the wonderful people here!

Rae Ann

 

Good question: What is he eating?

I can't see any midcycle numbers. Have you been able to get any? At first glance, it looks like not enough insulin (or the influence of dry food if you are feeding it) UNLESS he is dropping low midcycle and bouncing back up. Once you establish that is not the case, then I'd consider an increase. But not until you are sure he isn't dropping low in the 5-7 hours after the shot.

It shouldn't take a while to publish. Not sure what is going on, but If you want me to set it up, I'd be glad to.

 

Today is the first day I have taken several tests. 7:19 before shot 513, 9:52 he was 384, 1:00 he was 432, and at 4:09 he was 476. I just spoke with my vet and she said to up it to 2 units 2 x a day......2 seems to high wouldn't you think? I have switched his dry food (I am slowly getting him off of it) to EVO but am slowly introducing that as well it is 3/4 EVO and 1/4 weight control blue buffalo, so he is getting 1/3 c of dry and 1/3 can of food in the morning and at night. He gets avoderm, and tiki wet food....all no/low carb varieties. The only day I have tested mid day was on the 19th and he was 385 2 1/2 hrs after his shot.

Any help would be appreciated Sue. I don't know what is going on with his SS, Its not like theres much LOL Ive tested him 7 times since I got his monitor and 4 were today. I know I need to test more, I just started to be able to get a blood sample. What all do you need to set it up?

 

Check your pms and I'll explain about the spreadsheet. Look at the top of the page "1 new message"

We like to up the dose by .5 at higher numbers (.25 at lower), so we don't pass over a good choice. Also with the food change, you may be seeing some movement downward and it is easier to raise than get a low number and try to reduce enough. So i"d go to 1.5. If in 3 cycles, you aren't seeing some better numbers, then up by .5 again.

 

My only caveat is IF YOU CAN MONITOR. Putting together your spreadsheet you really have no nadir numbers (the lowest point in the cycle) So we can't be sure he isn't going low and bouncing back up.

If you want to be super cautious, you could do a nadir tonight and see before you up the dose tomorrow.

 

I know :? That's why yesterday and today I'm trying to test about every two hours. I'm excited though. Last night he was 390 pre shot, then this morning pre shot he was 479, 2 hours after shot he was 361, and two hours after that he was 257. Is it bad to drop so much so drastically? Last night I only upped it to 1.25 because I wanted to be able to monitor him. This morning I started with 1.5 units.

 

He's dropping a little fast, but he had a way to go.. Generally a 50-60% drop at nadir is about right. The only time we worry is if he gets around 50.

I'd watch him for the next few cycles. The 1.5 may be a little high once he settles into the food and insulin, but it looks okay today. The other thing that can happen is a bounce. He has been used to high numbers for awhile, and when his liver senses a lower number than he has seen, it can release extra glucose and cause the numbers to bounce up. It happens to most cats in the beginning.

Isn't it great to know exactly what is going on and not have to guess whether he is too high or too low? :mrgreen:

 

Hmmmm.....back up to 431. It's been 2.5 hours since last test. Tested again 3 hrs later he's now 506

 

He still is running high. How is the food change coming? I don't like seeing those reds. It looks like you're testing today, so we'll see.

Are you testing for ketones while he is running high?

 

When we first started he was getting 1/2 cup of blue buffalo weight control dry and 1 oz of wet food at night (avoderm) I have now changed it to 2oz of wet in the morning and 1 oz of wet at night and 1/3 of a cup of dry (3/4 EVO, 1/4 blue buffalo) still cutting back on the dry and he seems to be doing well with the food change. Im trying to take his numbers about every hour today to help get a better idea. My vet said to up it to 2 units 2x a day, Im hoping with the food change he wont need to go to 2 units. As for the ketones I found some stripes at Walmart although they are not the keto-diastix. I have not been able to get a sample, I keep missing him in the litter box.

 

Maybe ditch the Blue Buffalo dry and make it totally Evo Cat and Kitten dry, which is about 8% calories from carbohydrate.

Then shift over to canned food completely.

As an FYI, many cats eat about 0.5 to 1.0 ounces of canned food per pound of body weight. Thus, a 6 pound cat might eat 3 oz am and pm. A 11 pound cat might eat a 5.5 oz can morning and night.

 

Hi Samantha,

Been watching for you and wondering what Hidey's numbers are doing. The ss stops at 1/24 and the numbers were very high. Can you let us know what is going on?

 

Hi Sue,

Thank you for your concern and help. The issue I have (and I know I'm going to be scolded :cry: ) is I ran out of test strips. I didn't notice how low I was because I didn't pay attention to how thick the test strips are, not to mention I didn't pay attention to how many I wasted trying to figure out how to test. I've been keeping a close eye on him, and tomorrow morning I'm going to the vet to get more stripes and have back up stripes arriving also tomorrow. I have also went to straight evo now as well

 

No scolding. That is one of the big disadvantages of theAlphaTrak. You can't run down to the corner drugstore when you need them. You might go to Walmart and get the ReliOn and strips so you have a backup. ( which is always a good idea)

So, get us some numbers asap. I don't like the reds and hope he has come down with the diet change.

Also I'd pick up some ketone strips if you don't have them and test for ketones.

 

While you wait to re-supply on strips, take a look at my signature link Secondary Monitoring Tools for additional assessments you may wish to make.