New, background, dose/duration question

Please pardon the length of my post! We are new to the board, although I have been reading and trying to learn all I can for the last couple of weeks. Mr. Tinkles was diagnosed on 4/27/10 by blood work at the vet. He had lost weight, was drinking and peeing a lot and had an eye infection when I took him in. It had snuck up on me, I didn't realize how much weight he had lost! Anyway, his blood suger was 600, so the vet gave me ProZinc and told me to start him on 2u BID and bring him back for a fructosamine test in 2 weeks. He also was on antibiotics by mouth and eye ointment for a week. There was no mention of diet change. I had fed my cats Purina Cat Chow (indoor) forever. I started researching, found the diet info and made an immediate switch to Fancy Feast 2 days after starting the ProZinc and started hometesting. When I called the vet, she said the diet change was good, but encouraged me to look at the prescription diets, including dry food. She also did not encourage hometesting, said it was too stressful. At that point, I talked to her about TR, and she was very concerned about increasing the insulin too fast. She was willing to work with me though, including adjusting insulin dosage over the phone. After reading more, I decided to give him the 2 weeks to adjust to the 2u dose. When I took him in to see the vet, I gave her his SS, and she decided not to do the fructosamine because he was not regulated yet. She told me to increase by 1u to 3u BID. I said I would be more comfortable increasing by 1/2u BID for a week and then do a curve and see where he was before increasing more. She said fine, but put the 3u recommendation in the chart.

I had some fur shots, and I did flirt with the TR method for a day or so, but got nervous that I didn't know enough and backed off now to 2.5u BID. I did a curve yesterday, best I could. Now I'm not sure which way to go. I think he isn't getting enough duration, his numbers are still very high at +10, but he gets around 150 at nadir. I think I want to go to 2.75u (yes, I'm eyeballing it with u40 syringes) because I don't want to overshoot the mark. On the other hand, I could try the TR method again, it would take care of the duration problem, but I'm not sure about the wild dose swings. If you got this far, I welcome any input!

This site is a godsend, BTW!

I will also post in the PZI forum with a link to this post.

 

Welcome.

Already hometesting and diet change, way to go. Mr. Tinkles is a lucky guy.

When you say TR (tight regulation), do you mean shooting more than two times per day?

Is he still on antibiotics? That alone could increase his numbers. Infection increases the numbers and so does the AB, after the meds are done and infection gone the numbers may come down naturally.

Same with the food, as he gets used to canned only his numbers will start to come down on their own, usually.

 

He is done with the antibiotics, last dose was on 5/5. That was one of the reasons I waited the full 2 weeks before even thinking about changing dose, I knew that would affect his BG. By TR, I do mean shooting more than 2x a day.

I just tested his AMPS, was 139. Not sure what to do now...I know it's a no shoot #, but I also know it will climb as soon as I feed him. I posted on the PZI ISG for help also.

 

If you have switched to low-carb food (canned I hope?)....I'm glad you are home-testing, because
BG will come down.

Also, if you are home-testing, Frutosamine test at the vets is a waste of money. Your
own home-test numbers tell the best story.

Personally, I would stay at 2u 2x/day for at least a week before adjusting the dose at all.

EXCEPT if the BGs are so low you must reduce the dose .

Never raise the dose based on one spot-check. You need a curve to see what the nadir is.
In other words, don't raise the dose just because the pre-shot number is high.

And as a beginner, don't give any insulin at all if the pre-shot number is below 200. Later,
when you have more data, you can revise that cut-off number. (I used to shoot Smokey on
pre-shots of as low as 70...but he was eating several small meals per day, so I know it would rise).

Stay away from prescription diets. There are better grocery store brands. Low carb flavors of
Fancy Feast, for example. Cheaper than Rx food and better ingredients.

 

Feed, then wait a hour or two...test again.

If above 200, give some insulin. Maybe a smaller dose.

Sounds like perhaps getting over the infection and changing the food has brought the BGs down.

Consider lowering the dose.

 

I did switch to Fancy Feast, on 4/29...immediate change, no phase in. I will never feed him dry food again. I'm lucky, he eats anything.

I won't raise the dose, this morning's # made me rethink that. I will wait and test again.