Do Daa’s PZ Dosing

Discussion in 'Prozinc / PZI' started by Goose, Nov 11, 2019.

  1. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    If you are considering stopping the insulin, whether you stop it cold turkey or back the dose down slowly till he's off it, the result would be the same. Assuming the diabetes diagnosis is correct, Do Daa could develop ketones and DKA or he might simply have a very prolonged decline and eventually death.

    High numbers for a prolonged period of time will cause damage but cats are remarkably resilient animals and it takes a long time for damage to occur.

    There are secondary conditions which sometimes cause a cat to need more insulin than most. My girl, who is now in remission, had IAA and was at one time on 16u of insulin twice daily and she by no means holds the record for big doses. There are tests that can be done to rule out those high dose conditions but they usually aren't done until the cat gets to a dose of 5 or 6u twice daily. While most cats don't need large doses of insulin, a cat needs the amount of insulin it needs.

    It's possible ProZinc isn't the right insulin for Do Daa and a switch to Lantus or Levemir might work better. It's also possible he has developed glucose toxicity and is going to need more insulin for a time to get past that and then the dose will decrease.

    This is a marathon not a sprint and you are still in early days of treatment. I urge you not to give up.
     
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  2. Goose

    Goose Member

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    It sure is frustrating though and comes through in what gets typed sometimes. It just doesn't seem like the numbers are lowering with any amount of insulin. We really don't want the prolonged high numbers to damage him.
    16u twice daily is amazing. Did she show any signs it physically affected her? What should I watch out for with high dosages? He does seem to be eating more wet food when he does eat, so that's better at least.

    How would we determine if he has glucose toxicity? Or is there a way? What is IAA?
    How do we determine if Prozinc isn't right for him? When does the time arrive to try a switch, does that take another 4 months?
     
    Last edited: Nov 29, 2019
  3. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Believe me, I understand the frustration all too well but every cat is different and while some get regulated in short order, others take time.

    My girl remained in good health other than high BGs despite the time it took me to realize there might be something else going on. And she remains healthy now.

    IAA is Immune Auto Antibodies. Her immune system was stopping her from using insulin efficiently. The condition is self limiting and eventually my girl was on more normal doses of insulin and then went into remission. The large doses of insulin didn't harm her because that is what she needed to overcome the antibodies and be able to use insulin to get the energy she needed from her food.

    There are other high dose conditions....Acromegaly and Cushings that can also cause kitties to need higher than normal doses of insulin. If Do Daa's dose gets high enough, then you can consider testing for those conditions.

    You monitor a high dose cat just as you do any other cat. In some cases, they can be a little less predictable but with monitoring and getting to know your own cat's patterns, you can keep the cat as safe and healthy as any other diabetic cat.

    Given how long Do Daa's BG has been elevated, I think it's likely you are dealing with some glucose toxicity. There is no test or way to confirm but with doses being held for extended period despite little to no movement in BG, it's seems a logical assumption.

    Usually we'd suggest you try an insulin for 3 months to give it a reasonable trial before making a change but that is really an individual decision. There is no recipe for determining whether it's the right insulin or not. The right insulin is the one that works for your cat.
     
  4. Goose

    Goose Member

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    SS Updated
    I remember somewhere over the past 2 months in my thread or another, someone said 6 months to wait to switch. That's why I mentioned another 4 to go.
    Thank you for the help.
     
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  5. FurBabiesMama

    FurBabiesMama Well-Known Member

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    This sounds odd. There should not be a mass in the insulin.

    I don't think Do Daa is in crazy big dose territory yet. While most cats can be regulated with a dose between 1 and 3 units, it can take more for some cats. He is 14.5 pounds which does factor in here some. (ProZinc documentation indicates weight is a factor in dosing.). Even if he is experiencing resistance or toxicity, he could have a breakthrough at any time. After 3 days on a dose with his numbers remaining high, I would up the dose again.

    6 months is supposed to be the amount of time to truly evaluate an insulin. I have read that a few places but also had a good conversation about it with an Internal Medicine Specialist. Not to say that there are not circumstances where the decision to change needs to come sooner, but as a loose 'rule', 6 months is about right. You are only 2 months in which is really still early. Some cats jump into remission with a couple of weeks, but a lot of cats don't. Like Linda said, this is definitely a marathon for most of us, not a sprint.
     
  6. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I agree with all Linda and FurBabiesMama have said. Do Daa is still on a relatively low dose. If you think 16u twice daily is high, we’ve had several cats in the forum over the years who had acro and their doses were 60u twice a day and I’ve seen it go higher. We don’t even recommend testing for high dose conditions until the dose is at 6u twice a day.

    Please do not stop the insulin or back down the dose or you will be setting him further behind. Because we are raising the dose in appropriate amounts and you’ve done such a great job working with us on testing (and doing that +7 test at night is really fantastic so thank you so much), we know that he is not overdosed.

    If you were to decide to switch to another insulin like Lantus or Levemir, we’d start the dose right where he is now on PZ. Because those two insulins are depot insulins, you definitely have to hold doses for specific number of cycles. I’d recommend we just keep at this for another month with PZ and see where he is and then revisit it. It was me that said we usually wait six months on an insulin but let’s just see where he is in a month.
     
  7. Goose

    Goose Member

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    It was not there just a few minutes ago. Maybe it didn't get rolled quite enough, or maybe it got to cold? I don't know, but it's not there now.
     
  8. Goose

    Goose Member

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    60u+ twice a day, holy smokes! :eek:

    Thanks for that. I know I keep saying it but we appreciate everyone's help. Yeah, that +7 isn't enjoyable...but I'm glad the numbers help. It certainly won't be every night, but some numbers are better than no numbers.
    We are roughly 65%+ through the 1st bottle of Prozinc, so we'll be staying with it and getting another bottle next month.

    SS Updated.
     
  9. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Excellent! Thank you and Do Daa!
     
  10. Goose

    Goose Member

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    :)
    His ketone was also negative today.
     
  11. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Great. I’m glad you are staying on top of it.
     
  12. Goose

    Goose Member

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    SS Updated.

    This is Do Daa's 4th day on 3u am/pm. Should we think about a slight increase tomorrow AM?
     
  13. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I’m sorry one of us didn’t catch the cycle count. Holidays :confused:

    I would increase his dose to 3.5u. The plan is to increase every six cycles by 0.5u until you see yellow numbers. Then we will reassess.

    Great job on grabbing those tests!
     
  14. Goose

    Goose Member

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    No need to be :confused: :D
    I didn't/don't expect people to be online 24/7 especially through the Holidays :)
    Thanks! for the update, we'll do 3.5u for 3 days first starting tomorrow am.
     
  15. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Sounds great. Paws crossed!
     
  16. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Just checking in but I see the dose hasn’t been raised yet?
     
  17. Goose

    Goose Member

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    Hi,
    SS Updated.
    It was raised I just didn't put the .5 in, I forgot.
     
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  18. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Thank you! Two more cycles at 3.5u and if you don’t see any numbers below 300, please increase to 4u.
     
  19. Goose

    Goose Member

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    SS Updated.

    So you want 4 days and not 3? We're at the end of day 3 now with 3.5u...

    What are we looking for to indicate better results? How many numbers throughout the day need to be below 300?

    I've noticed within the last month that he has dead skin flakes, like dandruff, but bigger from his shoulders to the base of his tail. He has not ever had this before. Is this a bi-product of the insulin or high BG or?
     
  20. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    No, 4 units not four days. That means raising the dose in the morning to 4u. I see he had a 291 today.

    We will see progress once we start seeing some numbers below 300. A singular one is not significant so we’d like to see either a few during one cycle or see at least one each cycle. Then we increase by 0.25u until we hit 5u. Once we hit 5u, if the dose gets that high, then we increase by 10%.

    Yes, the dandruff is due to the higher numbers. My kitty was well regulated but her BG tended to rise in the winter and even #00-something numbers could cause her to get dandruff.
     
  21. Goose

    Goose Member

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    I was referring to the fact that today is day 3 at 3.5u. I was asking if you wanted an additional day (4 days total) at 3.5u. (two more cycles, an additional day the way I read it). I did realize you meant 4u starting tomorrow morning for 3 days.
     
  22. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Sorry...I thought you misread 4u for 4 days.

    With only one yellow number and a high one at that, I’d increase tomorrow to 4u for at least three days (six cycles) and then reassess. If you get a number below 200, please be sure and tag @MrWorfMen's Mom, @FurBabiesMama, and/or me.
     
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  23. Goose

    Goose Member

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    SS Updated.
    4u started today. I'll continue through Sunday. Hope to see some Yellow soon.
     
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  24. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    No...just through Saturday night at first until we see how he’s doing. If we aren’t starting to see some movement, the dose would be raised again on Sunday. So let’s check back in on Saturday.

    1st day at 4u -- Thurs
    2nd day at 4u -- Fri
    3rd day at 4u -- Sat.

    Thank you!
     
  25. Goose

    Goose Member

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    SS Updated.
    The 576 this morning I think was because he somehow got some food before amps.
     
  26. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I’m glad we are starting to see some numbers below 300. He still has a way to go but let’s hope we see more yellow numbers tonight and in the next day.
     
  27. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I was just checking in since it’s Saturday night to let you know what to do with the dose tomorrow but the SS is not updated. Please be sure and tag me when you’ve had a chance to do it so I can help you with the dosing for tomorrow. Thank you!
     
  28. Goose

    Goose Member

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    SS Updated.
    A high number in am (+7) (554) assume he had food before test. Another high number at amps (570) but he had eaten all his overnight food 3+ hours earlier.
    Ketone negative.
     
  29. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    But these are all low carb foods or dry?
     
  30. Goose

    Goose Member

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    Up until +3 pmps there is a mix of food, some FF can, some CP dry food. Overnight, there is only CP dry food (1/3rd of a cup) until it's taken up in the morning or he finishes it. None of the food has changed.
     
  31. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    If the food hasn’t changed and he’s not eating more of it, it wouldn’t be the reason for the BG increase.

    I’d increase his dose to 4.5u tomorrow.
     
  32. Goose

    Goose Member

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    The food hasn't changed, but his appetite has increased so he is eating more wet food at one sitting. He's increased at amps/pmps to about 1/2 (sometimes more, sometimes less) of the FF can.
    The dry food that is mixed in is the same minor amount. Just dry food overnight as mentioned which is mostly gone by am.

    SS Updated. (+3) 298
     
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  33. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Ok. Thank you! And please keep grabbing the tests as you have been. It’s very helpful to have those +3 and +7 tests.
     
  34. Goose

    Goose Member

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    So we are shooting at 4.5u in the morning for 3 days, correct?

    I added to my post above. +3 and +7 will likely happen on different days.
     
  35. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Yes but please be sure you update the SS and tag one of us if you see any numbers below 200. Thank you.
     
  36. Goose

    Goose Member

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    Ok. Will do.
     
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  37. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Good luck with this increase.
     
  38. Goose

    Goose Member

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    SS Updated. (amps 386)
    We gave him 4.5u so we'll see how this works out.
     
  39. Goose

    Goose Member

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    SS Updated again.

    (amps 386) (+4 326)

    We gave him 4.5u so we'll see how this works out.
     
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  40. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    That’s a good start! Paws crossed for more yellow and no red or black!
     
  41. Goose

    Goose Member

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    SS Updated. Slight elevation into the red at ( pmps 412 )
     
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  42. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Sometimes when you increase the dose, there can be something we call new dose wonkiness (NDW). Hold the course and let's see what Do Das does in the next few cycles.
     
  43. Goose

    Goose Member

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    Ok.
    SS Updated.
     
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  44. Goose

    Goose Member

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    SS Updated. This is the end of day 3....
     
  45. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Appears you're getting a few more yellow readings which is good so I'd increase up to 5u and hold for 6 cycles (3 days) barring any low pre-shots or low mid cycle tests.
     
  46. Goose

    Goose Member

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    Yeah, some yellows not a lot. 5U for 3 days is next.
     
  47. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Thank you @MrWorfMen's Mom for checking in. I’ve been swamped with a few other things.

    Goose..please don’t hesitate to PM one of us if it’s been three days and you don’t see dosing advice. All you have to do is click on our user name under kitty’s avatar to the left and then “start a conversation”. Especially around the holidays, life gets busy and three days flies by.

    Numbers are definitely improving! I see progress. How is Do Daa? Coat looking any better at all yet? He’s still fairly high in BG so that might take getting him into numbers below 150 to see less dandruff.
     
  48. Goose

    Goose Member

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    SS Updated.
    I completely understand, everyone is busy, especially during the holidays.

    DA (his shorter name) seems to be doing well. His coat is about the same, it looks fine and not ratty. He still has the dandruff up near the shoulders down the center of his back.

    We just got a new bottle of Prozinc today. The old bottle has probably 4-7 days left in it.

    Below 150, ha! I'd like to start seeing all numbers below 300 first! :)

    Once we fine his "right dose" how long does it usually take to normalize? I know it's cat dependent, but just a guess? Would he stay at say 5U + for months or? I'm just trying to get a larger picture of this.

    Thanks All!
     
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  49. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    You hit the nail on the head when you said it's cat dependent. Around here we often say every cat is different (ECID). If this is a case of glucose toxicity, you increase until you find the dose that gets Do Daa into better numbers and then the dose will likely drop again but if Do Daa happens to be a kitty who needs a little more insulin than average, then the 5u or whatever the dose is at the time, could be what he needs going forward to keep him regulated. There is no way to predict timing or dose or whether a cat will go into remission or not. We'd all love to have a crystal ball but unfortunately we don't. Some cats get regulated relatively quickly and others take a while. Best to take this one day at a time and make the goal to get his numbers down to keep him healthy and safe.
     
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  50. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I’d also like to add that it’s not uncommon for a kitty to go up and down around a good dose. Sometimes they hit test dose, stay at it a bit, earn a dose reduction, then fizzle, and have to go back up. We just take it in stride and don’t get attached to a dose.

    I’m glad he’s doing well.
     
  51. Goose

    Goose Member

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    I figured as much, I just thought I'd ask others opinions.
     
  52. Goose

    Goose Member

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    SS Updated.
    Thanks, he is doing better than 500-600 that is for sure.
    Ok, I have no attachment to a dose, just looking for him to do better with Yellows.
     
  53. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Us, too!
     
  54. Goose

    Goose Member

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    SS Updated. No steady Yellows yet.
     
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  55. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Do Daa may have hit yellow at some point today but there is no mid cycle test to know so don't get discouraged.
     
  56. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I agree with Linda...and he’s still looking better.
     
  57. Goose

    Goose Member

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    It's possible that he did, and I agree his numbers are looking better.
     
  58. Goose

    Goose Member

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    SS Updated. 3 Yellows in a row today!

    Today is the end of day 3 on 5u, should we hold or increase?
     
  59. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    That was a very flat cycle today but great it was all yellow for a change. Flat yellow cycles often suggest the next cycle could be an active one so make sure you get tests tonight so if he does drop more you hopefully catch it. I think you may need to increase again but perhaps by 0.25u this time but I'd hold judgement on that till we see what he does tonight. Fingers crossed tonight is another better cycle.
     
  60. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Great!!!!

    I agree with Linda that he still needs an increase and all that yellow is good to see. However, consider the following:

    • when the dose is lower (less than 5u) but nadirs are above 300, we increase by 0.5u until we start seeing nadirs in the 200s and that’s what we’ve done and made progress;
    • once the dose hits 5u and nadirs are still not in the 100s, we increase by 10% as it keeps the increases relative to the size of the dose. That means that it would be consistent with what we typically do to increase his dose to 5.5u in the morning unless you miraculously see a low 100 number
    As long as you keep up with testing, if he’s flat yellow tonight, I would suggest increasing to 5.5u tomorrow understanding that we might be starting to approach doses which get him lower which means some additional testing will be necessary to keep him safe. But...isn’t that the goal....to get him well-regulated.
     
    Last edited: Dec 14, 2019
  61. Goose

    Goose Member

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    So a test at +7 would be helpful to make sure he doesn't go down past 100? If for some reason there is a low 100 number (how low?) - keep him at 5u until I post numbers and we all talk about it tomorrow at some point?

    Tonight meaning +7? .. as he's had all his test already until tomorrow amps.

    So recap, 5.5u in the AM if the +7 is still in the Yellow, 5u if he goes into the 100's? Does it matter how high or low in the Yellow or Blue to shoot him with 5.5/5u? What number is to dangerous to give him insulin at this point? 100? 80?
     
  62. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    There are never any guarantees that he won’t drop after +7 but if you tested at +7 and he was in the 100s, you’d want to test again in an hour or two to make sure he was headed up. So, yes, tonight a +7 since he’s had his first all yellow day and he’s flat.

    Yes, if you get a number in the 100 range at all, I would hold off on a dose increase until we can chat tomorrow and see how low it was, when in the cycle it was, etc., unless one of the other two ladies below posts something different as they are better versed in the nuances of PZ.

    @FurBabiesMama and @MrWorfMen's Mom: with the Ls, we hold the dose at least ten cycles when first seeing nadirs in the 100s. Same with PZ or not since there is not a depot?

    If all you see is yellow tonight and in the morning, I’d suggest 5.5u as long as you are willing to test a bit more if you get a low yellow AMPS. That’s just based on using 10% of the current dose (as we typically do) and has nothing to do with the type of insulin.
     
  63. Goose

    Goose Member

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    Overnight he has his dry food available so that would probably help with him falling to low if in fact he did. Karo is on hand also. If we get a low Yellow AMPS, additional testing (a couple) during the early daytime would be helpful, correct? ... in addition to the usual afternoon time.. (additional testing times will include him having had food, we have tried really hard to have no food before all tests because they were spread out during the day - so the food may alter the results I'd imagine.)
     
    Last edited: Dec 13, 2019
  64. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    With ProZinc, if nadirs are in the 100s then I'd hold the dose for a week and re-evaluate.

    The only tests you need to be concerned with having no food influence is the pre-shot tests. Otherwise it doesn't matter. It helps though if you could make a notation like +4 (type/amt. of food) in the remarks if you know Do Daa has just eaten shortly before a test.

    If you can, moving the night testing around a bit would help too. When testing at +7 every night, it's possible we could miss a lower reading. If periodically you could grab a +5 or +6 instead of always at +7 at night, it would fill in some unknowns. Do Daa's BG hasn't been moving substantially but it looks like nadir might be occurring a little before +7 and we want to try to grab tests at the lowest point in the cycle.
     
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  65. Goose

    Goose Member

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    hi,
    I know it's possible that a reading could be missed, but we'll just need to test a little longer and try to figure it out as best we can. Randomly getting up at those hours is affecting sleep cycles too much, so some of the unknowns are likely to remain unknown.
     
  66. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Thanks for posting!
     
  67. FurBabiesMama

    FurBabiesMama Well-Known Member

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    I agree with increases of .25 unit at this point, barring some totally unexpected numbers from last night, now that there is some movement. You can always continue to increase every fourth day, if/as needed. I would just be concerned about increasing by too much each time at this point.

    Is there ever a day when you could do a curve? (Test before AMPS then every two hours until PMPS.) It would be helpful to have a better idea of when his nadir (lowest point in cycle) is.
     
  68. Goose

    Goose Member

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    Oct 2, 2019
    Hi,

    SS Updated. He was higher as Linda had suggested he might go for the +7 and amps.
    As per an above post I increased his dose to 5.5U this morning.

    Should I have not done that?
     
  69. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I had him increase to 5.5u due to our consistent dosing advice that once we hit 5u, dose increases need to be done by 10%. As an example, a cat at 2.5u gets a 10% increase of 0.25u. A 0.25u increase at a dose of 5u is only a 5% increase. That’s too low for that high of a dose and a cat still seeing these higher numbers.

    Goose...you correctly increased. The guidance above has nothing to do with the specific insulin but the dose.

    I do agree a curve would be a great help. Insofar as when the next increase would occur, let’s see how he does for six cycles.
     
  70. Goose

    Goose Member

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    Oct 2, 2019
    Hi,

    I'm glad we didn't give him to much insulin! So we'll stick to the 5.5u (3days) Saturday - Monday and reevaluate then. As for the Curve, I can't make any promises, but we'll try to do that sooner than later.
     
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  71. Goose

    Goose Member

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    SS Updated.

    Tested at +6 and he was 156 .... what to do ?
     
  72. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Just saw this but it’s at +6 so I’d do your normal feeding and test in 30 mins after he eats. If he doesn’t eat, I’d test in 30 mins. We want to be careful about feeding too much after midcycle.

    this is exciting!!!:woot::woot:
     
    Last edited: Dec 14, 2019
  73. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Just saw that 156! WOOHOO! That's more like it! :D
     
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  74. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
  75. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    My apologize. Do you want me to test him now? I know it's a little late, I got sidetracked...

    I was going to test him at 6pm anyway....
     
  76. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Actually, I wanted you to test him a while ago to keep him safe. For example, perhaps it “looks” like he dropped 100 in three hours. In actuality, he could have dropped 100 in the last hour and continue to drop.

    So, yes, please test him now. Thank you. And just a note.....once you start getting into numbers in the mid to low 100s and below, FD is not “set and forget”. You have to test appropriately.
     
  77. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    SS Updated I put the 543 in the +8.
    Tested at 533pm. Result was 543.
    He did eat at 3pm just after the test.
     
    Last edited: Dec 14, 2019
  78. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Next time you get a test like the 156, you might want to retest just to be sure it’s valid.

    For a cat to go from 156 to 543 in two hours, that tells me the following:
    • carbs from the meal were too much and completely halted his duration
    • he dropped kind of fast from somewhere and has started a bounce
    Any time we see such a huge skyrocket, it’s typically loss of duration and it’s amplified by a bounce likely starting. However, without the loss of duration, I doubt you would have seen numbers do that.

    I would continue with the 5.5u dose.

    Thanks!
     
  79. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    If we get a test like or similar to the 156, we'll test twice to make sure it's valid. He did eat quite a bit of wet and dry, he was hungry. As the insulin has increased, so has his appetite.
    We'll continue with the 5.5u through Monday.
     
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  80. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Also...I was reading back through this as I missed a couple days and I want to clarify that New Dose Wonkiness does not exist when using insulins that do not have a depot. In other words.....we only see it with Lantus and Levemir, not PZ.
     
    Wendy&Neko likes this.
  81. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    Ok.
    SS Updated.
    On 11/25/19 we tested him at pmps and then we tested him again 1 hour later and he went from 399 to 596 based solely on food. So food seems to effect him quite a lot.
     
  82. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    You would expect that to happen as the insulin is at the end of its duration. If you give him high carb dry food, it’s going to really raise his BG towards the end of the cycle.
     
  83. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hello, Marje asked me to stop in. I had a kitty that needed larger doses too.

    Looks like you are starting to see a response to the insulin. :) I am glad you went with a 0.5 unit increase today. At this size of dose, you need to get their attention with the larger increases, unless you are seeing some greens. Which you will one day.
     
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  84. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    SS Updated.

    Hi and thanks! Who's attention am I getting? No, definitely no Greens, it's hard enough to get consistent Yellows.
     
  85. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Da’s attention :) And the diabetes. Wendy is our high-dose expert. Da is not quite there yet but at 6u he will be.
     
  86. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    Ha! :) He's already getting plenty of attention as-is. We're hoping he starts to respond before he gets the label of 'high does kitty'.
     
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  87. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    SS Updated.

    Day number 3 on 5.5u....

    A Curve will be attempted tomorrow, will the dose continue at 5.5u or be increased?
     
  88. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    There are two ways you can approach it:
    • Increase to 6u as long as you don’t see any numbers below 120 tonight
    • Do a curve and then increase to 6u because he needs it but curves are always great to have
    At 6u, we recommend you test for high dose conditions. Your vet draws the blood according to the instructions and sends it in.
    Insulin autoantibody (IAA)
    Insulin Like Growth Factor (IGF-1)
    for acromegaly
     
  89. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    SS Updated. Curve was done 12/17/2019 amps - pmps.

    What's next for dosage? We are still using the original bottle of Prozinc. There is a day or so left. (80 days with this bottle) So, has it lost it's effectiveness and that is a factor with his numbers, or?
     
  90. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Great job with the curve. Those black numbers make me wonder if he dipped down a little bit last night. Still, it wouldn’t have been enough to negate the need for a 0.5u increase. I would raise the dose to 6u in the morning.

    I doubt there is an issue with the insulin. Does it have any weird floaties in it or has it changed appearance?
     
  91. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    Ok. 6u in the am Wed-Fri.
    There is no change in the insulin.
     
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  92. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    SS Updated. Virtually no change in numbers :(

    Old bottle of Prozinc is done, new one starts tomorrow morning. Maybe there will be a difference....
     
    Last edited: Dec 18, 2019
  93. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Thank you. You might want to grab just a few more tests tomorrow just in case it is the insulin.
     
  94. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Just a curiosity....what kind of food did Do Daa eat 2 hours before PMPS last night? That is an interestingly large rise in BG.
     
  95. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    Hi,
    Which extra time/test would be helpful? Preferably daytime.
     
    Last edited: Dec 18, 2019
  96. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    He has had no change in his food. 1/4 of a can of FF pate at best, and maybe 15 or so individual pieces of Clean Protein Chicken. Amps and Pmps he is hungriest, usually 1/2 can FF and the same amount of CP.

    I have no idea why that number went up so much.
     
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  97. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    I was just suggesting you test around onset to be sure there isn’t a big drop from new insulin. So +3 or so. If there is a big drop, you’ll want to test again sooner rather than later.
     
  98. Goose

    Goose Member

    Joined:
    Oct 2, 2019
    SS Updated. A couple other tests were done. Still mid to high 300's with that 600 there.
     
  99. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I have to wonder if Do Daa dropped lower in the early hours of last night's cycle and that red reading later in the cycle and black this AM is a bounce. It's great you got that +7 last night, but grabbing at least a before bed test is important too. Last night it might have shed some light on those later higher readings and it also gives you a clue as to what Do Daa's cycle is looking like (active or not) so you know whether to monitor earlier than +7.
     
  100. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    BTW, today’s date on the SS is listed as 12/18 again.

    I agree with Linda. :)
     

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