Buddy Dosing Advice

Discussion in 'Prozinc / PZI' started by Jess092, Oct 14, 2020.

  1. Jess092

    Jess092 Member

    Joined:
    Feb 20, 2020
    Hi there!

    I am hoping that someone can look at my girl Buddy’s spreadsheet, and give us some advice. Earlier in the year, we had her consistently in the blue pre-shot, with consistent green nadirs. These days, her pre shots are listing pink, with a few yellow. Over the last little while, we have slowly increased her from .5 units to 1.75 units. We do the changes slowly, and make the adjustments based on the nadir.

    I want to know if, at this point, there is anything else we can do to help lower her numbers. As far as I can tell, it looks like we need to up her dosage again.

    Any thoughts or advice would be wonderful!
     
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  2. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Wondering how long you have had this current bottle of Prozinc insulin open.
     
  3. Jess092

    Jess092 Member

    Joined:
    Feb 20, 2020
    Hi Deb and Wink!

    Such a good question! When the numbers started going up, we thought the insulin might be the reason, so we got a new bottle of insulin about two months ago.

    Jess & Buddy
     
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  4. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Well, at least you eliminated that as a possibility, the insulin being old.

    Any signs of infection or inflammation? From looking at your SS, it looks like Buddy is battling a pancreatitis episode. Guessing that is the case, because of the medications you have noted that Buddy is taking.

    Most common reasons for a cat to fall out of remission are pancreatitis, bad teeth, gaining too much weight. Those same factors can cause a cat that is very well regulated, in the blues and greens, to lose those good BG numbers. Those are the most likely causes for Buddy's higher numbers.

    Ever since Buddy got the antibiotics and fluids back in August, he lost his good regulation.

    Did Buddy go with you when you went to "The Cottage"?
    Any changes to the feeding schedule or what you are feeding?
     
  5. Jess092

    Jess092 Member

    Joined:
    Feb 20, 2020
    Yes, she came with us to the cottage, but the feeding schedule stayed the same.

    We feed her four meals a day of fancy feast pates. She hasn’t gained any weight this year.

    In mid August she was treated for a possible infection- 10 days of antibiotics. Then in mid September we were told she likely had pancreatitis based on blood work and her not wanting to eat for a bit, which is very strange for her. She was also throwing up pretty frequently. We treated her with pain meds and anti nausea meds, for about 10 days again. She seems to be feeling better and the throwing up has mostly stopped.

    She had all of her teeth out in the early summer. I don’t think she has any current inflammation or infection- but based on the reasons above that you listed for coming out of regulation/remission, it makes me think that she may still be dealing with pancreatitis at the moment.
     
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  6. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    If she does still have pancreatitis, but you aren't sure, you can treat her as if she does have pancreatitis. Treating it empirically.

    Or another visit to the vet for some bloodwork, for the Snap fPL which is a quickie yes or no answer (normal or abnormal). If abnormal then the Spec fPL test should be run to tell you the level.
    Often, the pancreatitis has to be in the active phase for it to show up on those tests.

    Just in case you haven't seen this before, or you didn't bookmark it, here is the link to the primer from the Health Links/FAQS forum.
    Info A Primer On Pancreatitis

    Cats shouldn't throw up for no reason. So there has to be something going on, to still cause Buddy to be throwing up occasionally.
     
  7. Jess092

    Jess092 Member

    Joined:
    Feb 20, 2020
    Hi again Deb,

    We are treating her for pancreatitis again, and have had her back on pain meds for a few days now. Her numbers are not really changing, though, so I think she may be due for another increase.

    Jess
     
  8. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I've never had a cat with pancreatitis, but my understanding is that the pain can cause the BG levels to remain higher.

    So yes, another increase is worth a try. I'd say it's time to up the dose to 2.25U for Buddy.

    Hope that Buddy gets over this latest pancreatitis attack real soon, and gets into better BG ranges.
     
  9. Jess092

    Jess092 Member

    Joined:
    Feb 20, 2020
    We treated Buddy with painkillers for 8 days, thinking she might be dealing with pancreatitis, and it didn’t seem to bring her numbers down at all. I really don’t know what is going on. She does not seem to be sick, in pain, or having other symptoms that I associate with pancreatitis (or infection). But her numbers just don’t seem to be coming down. They aren’t going down, but her pre shot numbers are just stuck in that blue range (with a rare yellow number). She should be due for an increase again, to 2.5 units. I am so frusterated I could cry. I really don’t know what else to do, other than continuing to up the dosage if the numbers call for it. But then when does that stop- do we just continue upping her dosage again and again until the numbers start to come down? It is confusing and frustrating since we originally had her well regulated on just one unit, and now we can’t seem to figure out what is going on.

    Thank you again for any help.

    Jess
     
  10. Jess092

    Jess092 Member

    Joined:
    Feb 20, 2020
    (Sorry- pink numbers, not blue!)
     
  11. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Yes, she is due for a dose increase. BUT not quite yet.

    And yes, you do keep increasing the dose by 0.25U until Buddy's BG levels come back to a more normal range, until the BG levels start to come down.
    Buddy had 2 very good green range BG numbers yesterday on 10/28/20. So the 2.25U dose does seem to be helping her.

    I'd hold that 2.25U dose for a couple more cycles and try to get more tests in around her nadir times, to see if she is dropping into the green zone BG level wise. She may even be going lower than the 5.3 mmol/L (95 mg/dL) that you caught with a test. If so, then she gets a dose reduction.

    Dropping into lower than usual BG numbers causes a bounce. So that is why you are seeing the pinks for last nights PMPS and the AMPS for 10/29/20. She bounced from those greens in the previous cycle. Let's see how long it takes Buddy to cleat this bounce. It can take anywhere from 3-6 cycles for most cats to clear a bounce.
     
  12. Jess092

    Jess092 Member

    Joined:
    Feb 20, 2020
    Thanks so much Deb! We will hold the dose for now, and I will make an effort to get more tests/tests at different times, and run one full curve, and then we will reevaluate in a few days to see how she’s been doing and how her numbers are!

    Thank you again!

    Jess
     
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