https://docs.google.com/spreadsheets/d/1g49B9XUQ96GXFK9QiGxph7pr2qgj2EbEbwqxrQASeQA/edit Here’s Wriggley’s spreadsheet. I increased to 1.25 units ProZinc a week ago. Some days look good some don’t. Yesterday was very good for him but today it’s back up. The ProZinc numbers seem better than Vetsulin He’s strictly FF and friskies pate and his appetite is very good. He has an auto feeder for nighttime and he eats that too. Any input would greatly be appreciated!
It looks like you're headed in the right direction! Time to move up to 1.5u. Fingers crossed he hits some green numbers under 100 on it.
OK. I will go up to 1.5 tonight and do a check at +3. Hoping for good results but under 100 will scare me!
https://docs.google.com/spreadsheets/d/1g49B9XUQ96GXFK9QiGxph7pr2qgj2EbEbwqxrQASeQA/edit Started 1.5U with PM shot on 9/24. So far numbers are very discouraging to say the least
Some kitties need a couple days for the new dose to work. Did you shoot 1.5u this morning? It says 1.25u on your spreadsheet.
Increased to 1.5u on 9/24 pm shot. Numbers are terrible! He’s 8 weeks on insulin and averaging 400 on nearly 200 tests on AlphaTrax. If you take away the very few 100s test it’s 411. At what point will he start to fall apart? This is very frustrating. His numbers were better ( not by much.. 389 avg) before he started insulin. Is there such a thing as a re-start? Just stop insulin and see what happens? Can’t seem like it could be any worse. Any input is much appreciated
It's possible he dipped lower than that 289 last night after you went to bed and he's bouncing ... or that 289 made him bounce. At this point no, stopping insulin and starting over is not only going to backtrack you but also put Wriggley at risk of ketones. Once ketones are in the picture, you end up with a high risk of developing them easily. I'll tag @Deb & Wink in case she sees something I don't but I'm thinking you just gotta keep hanging with it until he hits that magic number. You are early on Prozinc so I'm in no way indicating it's not working, a couple weeks is much too soon to tell, but some people who have a hard time on Prozinc and switch to Lantus do much better. I had Panic on Prozinc 6 months before deciding it wasn't doing enough. Something to keep in the back of your mind.
No, don't restart. Give it another day or so then I'd try 2 units. You'll find your breakthrough dose.
I was thinking of getting an appointment with an internist. Should I wait a little longer? I’m just worried these high numbers will cause damage.
Just stopping the insulin means he can't process his food correctly. So he would starve to death. If he didn't develop ketones and then DKA first, by burning off his own fat and muscle to produce energy. Not a good way to go. You keep increasing the dose per our time tested protocols here, until those same protocols say to pause the increases, hold the dose steady, or your cat earned a dose reduction. Resetting the dose would simply set you and your cat back months of effort. As Janet said, another increase is due soon, if the BG numbers don't improve.
Wriggley has some pretty big drops then goes back up PM Pre shot. Since going up to 1.5 he goes up sometimes after his shot. Very weird. I don’t have kibble in the house anymore. He just gets FF and Friskies pate. Also freezed dried chicken as a treat. He does eat about every three hours and he eats at 115 am and 415am with an auto feeder. I get up to make sure he’s eaten. He always has three hours of no eating prior to pre shot testing.
Sometimes cats rise a little before dipping down, it happens. Wriggley seems to nadir between +5 and +6. Are you giving food after this time? You want to give the bulk of food before nadir because it will burn up the insulin faster and give higher pre-shots. I might feed something like +2, +4, +6 and leave anything after that to zero carb snacks.
He eats about every three hours. Not huge meals. Half or a third of a 3 oz can of FF. I have gone 4 hours a couple times if he’s not in the kitchen looking for food. Should he not eat after +6 except freeze dried chicken? I don’t think he would make it. . He’s not devouring food like he was but he is still very food motivated. He went from 490 AMPS to 209 at +3 today
Is he underweight at all? If so I wouldn't restrict food but if he's doing alright I would try to keep the bulk of the carby food in the first half of the cycle. He's doing fine, he'll probably start heading up soon. 104 is a good number. You can give him a little snack if you want.
He was 13 pounds at the vet when this started. My home scale shows him at 11 pounds. I don’t know how accurate it is. He’s definitely lost some weight though. I gave him a little pate and fd chicken I’ll check him again in two hours
Use this to decide if Wriggley is a good weight or not. Check in one hour, not two. If he is dropping more you want to catch it sooner than later. I imagine he'll be heading up though.
Didn’t see this in time. He was 170 at +8. He seems between 2&3 on the weight chart. He’s not tiny. More long and lean but now I can feel the bumps on his back and he just looks thinner. My vet had no shoot at 250 or less. This was based on a two years ago hypo incident from his steroid induced 30 day diabetic period. If he’s under 250 should I hold off still or reduce the dose? Thanks!
Okay, so he may need a little more food than he's getting now. Calorie intake should be 20 calories per lb of ideal body weight. If we assume that should be 13 lbs, he needs at least 260 calories a day. FF Classics average 100 calories per can, Friskies Pate averages 180 calories per can. Unregulated diabetics need more food, double even. Let him eat more, try to keep the bulk of it before nadir. Since you think he's underweight though, feed him when he asks, even if it's after nadir. With Prozinc, the no-shoot number is 150 for new diabetics. As you get more data, you can lower that number. Since he's in mostly reds right now, you might prefer to stick to only giving full shots over 200 for example until you gradually get used to and see how he reacts to full dose at lower pre-shots. From the Prozinc Dosing Sticky: How to handle a lower than normal preshot number when following SLGS: Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4: Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection? A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines. Below 150 mg/dl (8.3 mmol/L), don't give insulin. Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing b.) give a token dose (10-25% of the usual dose) c.) feed as usual, test in a couple of hours, and make a decision based on that value Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise. In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine. Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher. Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin once you have data and understand your cat’s cycles. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide. With experience, you may find that lowering these thresholds may work well for your cat. When you have reached that stage, the following guidelines are suggested for Prozinc users following the Start Low Go Slow approach: If the preshot number is far below usual preshot numbers: Do you need to stay on schedule? Then skip the shot. Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable. Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary. If the preshot number is near kitty's usual preshot numbers: Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot. We usually don't suggest or recommend shooting a preshot number less than 90 mg/dL when following the SLGS Method. Remember that with SLGS, generally speaking, your goal is to achieve flat numbers that are greater than 90 mg/dL. However, let experience, data collected, knowledge of your cat, and availability to monitor help in making the best decisions for your cat.
I probably would have suggested you only reduced the dose by 0.25U. So the new dose would have been 1.25U, a 0.25U reduction from the previous dose of 1.5U.
I agree. Not use to these low numbers and they are scary to me. Hypo 2 years ago when he had steroid induced diabetes. After he went hypo no more diabetes. Thought we were gonna lose him. He was fine until recently. He’s back up to 408 at +2
If possible, and you are still awake later, maybe another PM test around +4 or later? Don't stay up special for doing that test. Just wondering how the full 0.5U reduction will impact the later BG numbers in the cycle.
Sometimes you get 12-14 hours with ProZinc which is why the good preshot. Another option when you see a lower than normal preshot is to stall 20-30 min and test again just to see if the numbers are going up.
Wriggley’s numbers are very encouraging today. Two days in a row. Still high but great for him. He’s 190 at +9. He was 250 PM pre shot last night and I panicked and only gave him 1U instead of 1.5U. (he’s usually mid 400s pre shot.). If he’s still in the 200-250 PM pre shot should I just go ahead with the regular dose? Or drop to 1.25? Thanks
Half the learning curve with dosing a cat with insulin is gaining cooperation from your cat for the frequent testing needed to figure out what is going on. Yes, regular dose. Probably saw this too late, but remember for next time. Just checked your SS. It says you gave that 1.5U dose, which was a good call. Please try not to pre-fill the SS, as that can get confusing. Not sure you have ever done that, but just mentioning this as a "heads up" kind of deal. I've seen other people put the dose in before they actually have given their cat the insulin. You don't always know what that dose will be, which is why we suggestion you do not prefill the Units.
I'm impressed with all the support your getting here! At least your kitty is showing a lot of blues on your spreadsheet! That's encouraging!
