Hercules and I need some ideas

Discussion in 'Prozinc / PZI' started by Hercule's mum, Nov 16, 2020.

  1. Hercule's mum

    Hercule's mum Well-Known Member

    Joined:
    Jul 27, 2020
    So, I have been trying something different in the last few weeks, adjusting the dose by the pre- shot numbers. Just a little bit, mostly between 1.0 and 0.8. It has mostly worked in the sense we haven't had big crashes, and I believe overall his numbers are a bit lower than the weeks before. However, I am still not getting a lot of green, and his numbers are stiil everywhere with lots of bouncing. This morning I woke up to an AMPS of 4! :confused: Cannot understand it!

    What would you do if Hercules was your cat? go back to fixed amounts? If so, what?

    Is there something else I can try?

    Thank you!
     
    Deb & Wink likes this.
  2. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Ideas:
    1. Hercules earned a dose reduction on the 10th of November, when he dropped into those neon green BG levels. But you did not take the reduction. When his numbers drop that low, you really do need to reduce the dose.

    2. Try getting a +10/+11 and or a +10.5/11.5. so you can see how quickly Hercules rises in the last hour of the cycle.

    3. Chalk up your experiment with varying the AM and PM doses based on the pre-shot as a failure. It really doesn't seem to be working for Hercs.

    4. The 1U dose seems to be a bit too much. Reduce your dose.

    Black and Red BG numbers are almost always bouncing, from a perceived low and the cat's body releasing compensatory hormones. Don't increase the dose just because you see higher numbers with the pre-shot test.

    5. Try 0.6 units, and hold it steady for at least 6 cycles, unless Herc's BG numbers drop below 90 mg/dL (5 mmol/L). Then he has earned another dose reduction.

    So Hercs has earned another dose reduction, when his pre-shot test for 11/16/20 was at 4 mmol/L (72 mg/dL). Please take it.

    My recommendation for the 0.6U dose is based on the 2 earned dose reductions that you did not take.
     
  3. Hercule's mum

    Hercule's mum Well-Known Member

    Joined:
    Jul 27, 2020
    and another one tonight! it 2 AM and he is a 3!! :eek:
     
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  4. Hercule's mum

    Hercule's mum Well-Known Member

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    Jul 27, 2020
    Thanks Deb! Is good to see you! I hope you went through the "watching" last week without too much stress ;)

    I will take his dose down tomorrow AM, after tonight I have to do it! :blackeye: But as a petulant child (which I can be, because it is 2 AM and I don't run a country, sorry!) I will say as I do it.... it won't work ...:arghh::arghh: We have been over this cycle so many times... lower than 0.8 and nothing happens, go over 0.9 for a few days and is too much....

    But that is OK, I'll come back begging for more ideas in a week...:rolleyes: but maybe he will prove me wrong (do you hear it Hercs? you can prove me wrong...;))

    I really do appreciate the help, sorry for all the moaning. I know it is a marathon not a sprint but there are times a just want thing to "get better".
     
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  5. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Moan away. Whatever it takes to help you through this "sugardance".

    BUT that BG reading of 3 mmol/L is REALLY saying the dose is too high.
    Yes, Hercs will bounce and go higher, but you need to be patient and wait out the bounce.
    No surprise to me that Hercs bounced up to those pink BG ranges after his drop into the neon green BG numbers last night and the addition of the HC food to bring his BG levels back up to a safe range.

    Yes, it's hard to wait out the bounces and see when Hercs BG numbers return to more normal numbers.
    It took time for Hercules to become diabetic, it will take time for him to get better.
    Please remember that things WILL get better.

    The only other idea I had was that Hercules could do better on another insulin. Lantus (aka glargine) should be your first alternative to the Prozinc.
     
  6. Hercule's mum

    Hercule's mum Well-Known Member

    Joined:
    Jul 27, 2020
    2.5 mostly flat days (despite hercs breaking into the "cookie" jar!). Time to start the journey up, you think?

    I should talk to the vet about Lantus... sometimes the devil you know sounds more appealing, but it might be time to make new acquaintances....
     
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  7. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Yes, you need to increase the dose. So try going back to 0.8U.

    1U was a bit much, 0.6U doesn't look like enough. Try for that middle ground.
     
  8. Hercule's mum

    Hercule's mum Well-Known Member

    Joined:
    Jul 27, 2020
    This is a familiar neighborhood...but the right spot has eluded me. I guess I'll give one more try. If it doesn't work I'll have to go talk to the vet and see if we can try lantus.
     
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  9. Hercule's mum

    Hercule's mum Well-Known Member

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    Jul 27, 2020
    Argh! Would you see his dip today? 21 to 5.5 in 4 hours.....Why can't he behave?! :banghead::banghead::banghead:

    I only increased to 0.7, having learned my lesson that with Hercs things always have to be slow....
     
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  10. Hercule's mum

    Hercule's mum Well-Known Member

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    Jul 27, 2020
    Look! He is not only good at diving, he can also skyrocket: 5 to 17 in one hour...... What a day! :confused: :facepalm: :arghh:
     
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  11. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    A real roller coaster ride for Herc's today. :(
     
  12. Hercule's mum

    Hercule's mum Well-Known Member

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    Jul 27, 2020
    Hi @Deb & Wink ,

    You are probably in thanksgiving mode and busy. I hope so! But when you have some time, I wonder if you can share your thoughts...

    I am back to fixed dose, and slow raise in prozinc. I think his numbers are worst then my trial phase with variable dose? Also, Hercs have not been well the last few days, he seems in pain and not very lively. This morning he ate, but very slowly, which is very unlike him. I understand that he might be unwell for some completely unrelated reason. What do you think? Maybe is just due to his numbers and I need to increase again?

    I finally decided to take the plunge and make an appointment with the vet to tray and switch to lantus to see if we get beet r results. So, I have been poring over his SS to see what my arguments for the vet are...

    1) It seems to me that everytime we get to 1 U, we get a bright green event withing a few days and have to reduce the dose. Is that what you see? or should i perhaps stay at 1U more? (vet think I should be giving >1U)

    2) He drops too fast, yet doesn't stay down very long

    3) Given how long we have been at it, I think we are still "unregulated" . Is this the correct interpretation? I would have expected that by now, we would have found a dose where we don't see so many blacks and reds, and stayed in yellows and blues for more than a few hours? Am I expecting too much?

    Is there anything I should ask to be checked, given he is unwell again?

    Thank you!
     
  13. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    A cat not eating well, can be serious on it's own. Do his gums and teeth look ok?
    Have you changed the flavor of food he is eating?

    A cat not eating well is not because of the higher BG numbers. Cats in high BG levels, are more likely to be very hungry, and gulp down their food, not eat slowly like you describe. They will usually beg for even more food.
    Those bright green numbers are telling you that Herc's is close to hypoglycemia. Giving more than 1U, like your vet wants you to, will simply drop him lower than he is already getting. You are the best advocate for your cat. Keep advocating for Hercules. You know him better than your vet ever will.

    Tell your vet that Hercules is not getting a good duration on the Prozinc. It's not lasting long enough in his system and you need to try another, longer lasting insulin.

    Hercules is still unregulated. You are correct in saying that. No, you are not expecting too much. Not all insulins work equally well for all cats. Insist with your vet that you try the lantus (glargine ) insulin. Four plus months is MORE than enough time to tell that the Prozinc insulin is not helping Hercules enough.

    Perhaps a pancreatitis test? Or checking for a UTI? Both of those issues can cause a cat to feel bad.

    I'm an independent, strong woman, living on my own, and have been for many years. I've been cooking a couple of dishes every day this week, to load up my fridge to have some variety for the week, and cooking extra to freeze for later if I don't feel like cooking. I don't specifically celebrate Thanksgiving. Since some serious health issues a decade ago, I changed my attitude and celebrate every single day. "Treasure Every Day" is my main motto. Why limit our celebrations to some national holidays? Every day is special! I truly mean that.

    Not going anywhere, because of the holiday. It's too dangerous out there with all the covid numbers spiking everywhere in the country right now. I'm not willing to risk my health or life, for some time spent gathering with people outside my household. I just wish more people here felt that way.
     
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  14. Hercule's mum

    Hercule's mum Well-Known Member

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    Jul 27, 2020
    Thanks for answering all my questions! He got a bit better towards the end of the day, and is back eating with more gusto. I do worry about something else creeping up, so I'll check if possible for pancreatitis and UTI.

    You are very right about this. When we moved to Enggland we had to adjust and declare thanksgiving in the fourth saturday of november. No holidays here and started to get difficult to cook turkey in between work and dinner.
    My worry about celebrating everyday, is that I have a ver sweet tooth. Can't imagine what would happen with me if I eat pumpkin, pecan and apple pie every day...:D;) Although strangely enough I am mostly looking for brussel sprouts this saturday...
     
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  15. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Glad I could help you with some answers to your questions, and some additional thoughts on why Hercule's needs to try another insulin. (NOT Caninsulin please, that one has an even shorter duration in cats than Prozinc.)

    Brussels sprouts, sliced in half lengthwise, sauteed in a tiny bit of butter, just enough so they don't stick to the pan too much. Fresh ones. The frozen ones just turn to mush.

    Celebrations to me do not have to be food related. But I do LOVE chocolate and other sweets. Have to watch and limit them, since when you are older, it's easier to gain too much weight quickly.
     
  16. Hercule's mum

    Hercule's mum Well-Known Member

    Joined:
    Jul 27, 2020
    I always grow brussel sprouts, and the question is whether I would eat them for Thanksgiving or christmas. Nothing better than eating the food you grow yourself, in my opinion. Unfortunately, this year I am not sure if there will be brussel sprouts even for christmas....
     
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  17. Hercule's mum

    Hercule's mum Well-Known Member

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    Jul 27, 2020
    Update: We had a visit with the vet, which tought that Hercs looked better (yay!). We continue with our crazy search for the correct dose, and I decided to take the plunge and trial a switch to Lantus. It is orderd, and hopefully we'll start on the weekend. I'm nervous and hopeful. Perhaps too hopeful, which is usually the sure recipe for disapointment....
     
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  18. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    So we won't see you anymore in the Prozinc ISG. Lantus has a wonderful group of people that help out there. You'll want to read the posting guidelines, and be sure to ask for any help you need in a daily post over there.
     
  19. Hercule's mum

    Hercule's mum Well-Known Member

    Joined:
    Jul 27, 2020
    They do look like a good bunch. I'll keep an eye over here anyway, so I am sure i'll see you around. Nevertheless, many thanks for all the help fpr the past months as I learned the ropes with prozinc!
    :bighug::bighug::bighug::bighug:
     
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