How dangerous is it to reset after your cat has been on ProZinc for several months? He was started at .5 units and within a week, vet upped it to 1 unit, then 1.5 after another week, then 1.75 for about 3 weeks, then 2 units for about 2 months, then another vet (i moved) upped it to 2.5 based on a curve I did. All of this was while he was eating Royal Canin Glycobalance and I wasn't home testing. I only found this website and group when he was at 2 units, so I didnt know at the beginning increasing so quickly and drastically was bad. I also switched to purely wet food (FF), got rid of the prescription dry, and his numbers are still insane. I am also doing home testing now. I also have ketostix and they show hes negative for ketones. I (based on readings here) upped by only .25 units a few weeks ago, but it doesn't seem to be helping. Honestly, at this point I kind of want to "reset" and start over, but im afraid of him going into ketoacidosis if I just start him over at .5 units and do the "start low go slow" method. With him now on FF path and tiki cat, me home testing, using ketone sticks (i have them and it doesn't seem like he even has traces of ketones), and understanding dosing, is it worth starting at the beginning and seeing how he does or would revoking all that insulin be dangerous? Should I do a slow reduction? Should I just keep increasing until his numbers look better?
Honestly I wouldn't start over. It looks like he's got some insulin resistance and you may be raising a few more times before you find the breakthrough dose. Next shot I would do 3 units. You could actually start raising in 0.5 incriments because you haven't had any numbers under 200, and I wouldn't hold it for more than a week.
Yes, you want to keep increasing the dose until you find that breakthrough dose. Resetting the dose would simply set Marley back months. Look at Emily Toumey's SS, for her cat Nico. She had to keep increasing the dose until some insulin resistance level was broken. https://docs.google.com/spreadsheets/d/1iT_G_hWaBPX4AzOeYgYGXTB-yHaRfGStnS1TpOcOP-o/edit We had Em change to the MPM (Modified Prozinc Method) dosing protocol also. That allows for faster dose changes, and can be a real game changer for breaking through some insulin resistance. The other thing you want to do, is to try and get at least one more test in during the PM cycle. What we call a "before bed" test, is exactly what it sounds like. A test every evening before you head off to sleep. One question for you. How old is the insulin you are using? How long has that vial been open?
Should I not be worried about early on dose increase that would cause a rebound? Thats what im concerned about. I've seen a lot of posts about dosages being increased too quickly and experiencing rebounds and bouncing. Like the somoygi rebound. I work and go to school, so a before bed test is typically his pre shot test. I test him as much as possible with schedules. I read the prozinc dosing but must have missed the modified dosing section. Ill go look again. I just started him on a new vial this week, so its only a few days open.
