4/8 Buddha

Discussion in 'Prozinc / PZI' started by Donna & Buddha, Apr 8, 2010.

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  1. Donna & Buddha

    Donna & Buddha Member

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    Dec 29, 2009
    A couple of days ago, I was all set to report that Boodz was doing much better, getting much stronger and longer reaction to insulin. Ha.

    Today, he had a amps of 461,
    then 2u of Prozinc and breakfast,
    +3 355
    +6 174
    +7 402!!!

    I'd be willing and able to shoot at +8 and then at midnight (though I won't be awake to monitor him through the night!) But I don't understand how to do TID. I would shoot a different dose at +8 and 500 then I would at +12 and 500 right? Or should I monitor today and make sure he doesn't come back down? Or do I feed him and see what happens (he's been hungry since I woke him up at +6.)

    Grrrr. I really truly thought he was improving.
     
  2. Hope and Aria

    Hope and Aria Member

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    Feb 25, 2010
    If you can, I would run a good solid curve on him before you go TID. I knew how long it took for Ari's injection to kick in and when her nadir's happened, so for us, TID worked best for her body (I couldn't get her to stay regulated BID). If you can do a +4 or +5 test and then the +8 test and Buddha is already zooming, then as long as the 4/5 was lower (the curve isn't inverse or holding solidly high) then I'd shoot and run that pattern for a while to see what results you're getting. For us, Ari's longest duration after a shot is right at 10 hours but she takes about 2 hours for a shot to do anything.
     
  3. Donna & Buddha

    Donna & Buddha Member

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    Dec 29, 2009
    Fed him a bit after +7 and now at +8 he's at 449 (a gain of 47). Sigh.

    I'd really like to give him a little insulin now. But if not now, then at least by +10 and hope his next cycle is better, 'cause despite all my bestest intentions, I just don't drag myself outta bed at 5 a.m.

    Hey, Gator! You're always bringing up constipation. Boodz poops VERY regularly, but its harder stool. Very firm when I pick it up. He was pooing yesterday when I was cleaning the boxes, and I noticed that there was a thin coating of blood on it. Could that be affecting his cycle today? Is hard stool what you mean by constipation, or straining and the inability to pass stool?
     
  4. Gator & H (GA)

    Gator & H (GA) Well-Known Member

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    Jan 3, 2010
    LOL thanks for thinking of me. :D
    Straining can be a sign of constipation. Pain [internal/abdominal] is a sign but hard to tell in a cat. Also pooping I would say less than once a day or at least once every other day is a sign. You don't want to let it go on very long or their colon can get all stretched out and then you have bigger problems. Right now H poops less frequently than I would optimally like [within two days] but the consistency is right and no portion of it is super soft/barely formed or runny. Poop that is too soft can be hard to distinguish in the litter box since the litter draws moisture from it and also makes it kind of set up.

    Also the color of it it kind of an interesting point. When I first started the home cooked his poops got hard and light colored approaching something like that of the kitty poop pictured in raw eaters. But when I started the lactulose his poops got dark again. So I have thought that the color is related to the amount of moisture.

    I would contact your vet about the blood, that doesn't sounds good.

    Of course constipation is fairly easy to fix. It is mainly a problem with the colon absorbing too much water. This can sometimes be an issue with dehydration so sometimes vets will suggest LRS. Then there is also the lactulose or Miralax [each has their own advantages and work well]. But the main thing is to first ensure you kitty is getting enough water.

    If your kitty IS constipated it can play havoc with BGs....

    As long as the cat is getting enough fluids, trying Miralax is kind of low risk. Or ask you vet for a lactulose prescription [I order 473ml or 1 pint of it at a time from Costco]. And the LRS is always something good to have on hand and if Buddha has no heart problems it is pretty harmless [I've posted before about the best way to acquire or I'd be happy to post it again]. Unless your vet says otherwise, fiber is not the solution for constipation in cats.

    Also I've found that when the poop is dry it tends to be smaller, but when I started the lactulose the poops actually seemed to get bigger [and darker]. Those big poops I don't find ideal [I don't want things to get too stretched out in there]. So I do try to keep it as soft as reasonable.
     
  5. Donna & Buddha

    Donna & Buddha Member

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    Dec 29, 2009
    Buddha is very prolific in the poo department. He leaves at least one, sometimes 2 movements in the box every day. At least, that's my recollection, I don't chart it. And there is NO confusing the what the 2 cats leave. Buddha's is solid and firm, and Lemur's is a puddle.

    At +10.5 or so, bg is 479, so it didn't continue to zoom, but stayed high. I'm going to shoot a 2u like I would at +11 or 12. I'm inclined to go slightly higher, but will resist.

    I don't want to go TID full time, but on days like this one, where the insulin poops out early for no apparent reason, I'd like to able to shoot early. I'm just unsure if I would shoot as full a dose as I would at +8 or at +12. Or is it simply a trial and error thing. I would not be tempted to shoot early if the numbers weren't rising and weren't well over 300.
     
  6. Hope and Aria

    Hope and Aria Member

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    Feb 25, 2010
    Also (slightly off the poop discussion), if he is dehydrated, that could be causing funky numbers too. After Ari came home from the vets from their 24 hour IV fluids, her numbers improved immensely. Better numbers, more consistent PS's and I'm even having to lower the dose slightly.
     
  7. Joanna & Bix (GA)

    Joanna & Bix (GA) Well-Known Member

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    Dec 28, 2009
    There is some trial & error on the dose, but generally speaking if you shoot early there is increased overlap, so you would want to account for that by reducing the dose. Something like a +11 is probably irrelevant, with Bix at +10 (he gets awesome duration though compared to many cats, meaning he might have gotten better overlap at +10 (and hence warranted more of a dose reduction) than most) I would generally reduce by something like 0.1 or 0.2u, if shooting at +9, maybe reduce by 0.2u or 0.4u depending on what seemed to make sense to me at the time.

    In general terms, if the rate of zoom is a lot you'll likely need more insulin, if the #s are flattish but still rising, you won't need as much to get results. Others have had more success than I did with TID, so can probably tell you better how to judge the dose. I'm thinking you more or less take the 24 hour dose and divide by 3 instead of by 2, but I'm not sure if it's really that tidy.

    The 400s look pretty reboundy to me given the timing of the dramatic rise. I wonder if maybe the drop was just too steep today - certainly doesn't look like he hit any low #s. If I were you and could stomach the timing/testing stress, I would probably try shooting a lower dose to soften the drops a bit, and then try to catch it on the upswing like you have said, either trying TID or trying something like +10s. It can be pretty stressful though. It seems like he might do better on a slightly lowered dose, but I know you've tried that for BID and it didn't really work - but maybe it would work better if you are short-shooting...?
     
  8. Gator & H (GA)

    Gator & H (GA) Well-Known Member

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    Jan 3, 2010
    First I've heard of dehydration causing issues with BGs but I don't doubt it. I know I've said this again and again so I thought I would take the opportunity again to repeat myself. :smile: I cannot recommended enough that every bean/cat [that does not have a heart issue] should have SubQ LRS on hand and the knowledge to use it. It is pretty low cost and potentially high reward. It is so easy and it seems so frequent that cats run into are hydration issues. Thanks for letting me plug the LRS. :smile: End of message...
     
  9. Donna & Buddha

    Donna & Buddha Member

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    Dec 29, 2009
    Typical Buddha swing, this morning amps at +13 (yawn, stretch) is 212.

    I don't *think* he's dehydrated, but I really don't know all the signs to look for. He's looking healthy, but was scratching a lot yesterday. Might be time for the ~monthly flea treatment.

    Also, he ate a TON the day before. Not high carb food, but maybe just all the extra calories were still in effect.

    I've never shot at +8 before. When his bg shot up so high/so quickly, I wanted to respond. But I wanted to to do TID for just the day, 'cause otherwise it seems that we're seeing some better duration.

    For TID, it seems logical (like Joanna said) to divide the daily dose into 3 instead of 2. But if I've already shot half the daily dose and it's not working then, still trying 1/2 of the 1/2 remaining dose at +8 or a bit more? Or just be brave and try it, monitor it and learn?

    Happy Friday! Rain yesterday brought cooler temps and washed the pollen off of things. Gotta go run and check the pool for frogs and the scary spiders.
     
  10. Terry and Puttz

    Terry and Puttz Member

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    Dec 29, 2009
    ( For us, Ari's longest duration after a shot is right at 10 hours but she takes about 2 hours for a shot to do anything.)

    Just to add our two-cents worth, Puttz is on that same time cycle as Ari, if that helps anyone questioning "common" time frames.
     
  11. Joanna & Bix (GA)

    Joanna & Bix (GA) Well-Known Member

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    Dec 28, 2009
    Yeah, looks like rebound wearing off to me. On the ? of shooting at a +8 or so, personally when it is something like what you saw here, I would just stick with 12/12. With rebound you can compound the problem by overshooting, (or even with a good dose, you might seesaw him back too quickly and trigger more rebound). Bix's response to early shots was often really good, so with him I got to a point where I wouldn't shoot before +10 unless I was super-clear I had undershot on the previous shot and he was already in high #s because of that (vs. rebound, where the #s may have risen the most at +8, for example, and then start settling down after that).

    Unless you are doing early shooting with some regularity, or have data already on his response, the dose is to some extent a guess. So my view in general terms is if it only occasional, probably either skip it and stay with 12/12, or shoot a regular dose (or maybe 0.1u lower) at +10 or +11 if the #s are really climbing, and the risk is probably fairly low in that case. You might try shooting at a +11 one day and see what happens, and a +10 another day, and start collecting data that way so you'll have more sense of what works for him at different times.

    Again others have had more success than I with early shooting, so may have better suggestions on how to figure out a dose.

    On the "common" time-frames, I think I was told for PZI Vet that onset is typically something like +1.75 to +2.5, nadir +5.5 to +7.5, and duration for many cats is 8 - 10 hrs, which puts it pooping out around +10 or later (assuming a typical onset of around +2). Those #s aren't exact, I can never seem to remember the exact timeframes I was given. It seems like ProZinc may nadir a little differently than PZI Vet? I'm not sure, not having used ProZinc myself or studied others' #s all that closely. I have seen apparent earlier onset too, typically where there is really good overlap from the previous dose and/or the dose was too high, but technically from what I understand PZI is not a quick onset insulin, so it's not even possible to have it start working at +1 for instance (I don't know if that is true though, since certainly some cats when overdosed have dropped by +1, which really makes no sense to me, but whatever!).
     
  12. Gator & H (GA)

    Gator & H (GA) Well-Known Member

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    Jan 3, 2010
    AFIK the common two potential signs of dehydration in cats are:
    1) The skin test - pull up a chunk of their skin. If it does not drop quickly and kind of hangs then dehydration might be an issue.
    2) Color of the gums - they should be nice and pink.
    But I don't think either of these is fool proof.

    Lots of Google reading on the topic:
    http://www.google.com/search?q=feline+dehydration

    OR one can administer LRS to their kitty and see if they notice any improvement....

    I have found the quantity of food consumed even very low carb food [≈2-3% carbs as %Kcal] to be 1000% correlated with how much insulin H needs. Since H is a sometimes anorexic, this is why we shoot on a sliding scale [and even use PZI] to account for these sometimes rapid changes in appetite. And seemingly it's full effects are usually not realized in just one cycle.
     
  13. Hope and Aria

    Hope and Aria Member

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    Feb 25, 2010
    I have to second Gator's food comment. Ari also tends to go all Annie kitty on me now and then and her numbers correlate. When she does that, my shooting looks all over the place.

    I've tried the skin test and I really can't tell. I pull up and it drops, but it drops slowly but doesn't hang. No idea what that means. I'm thinking maybe because she lost so much weight in the beginning that she has some extra baggy skin so I can pull more up which is why it takes so long to fall. I've got a vet appt tomorrow. I'll put the question to her for ways to tell (more reliably) if a cat is dehydrated.
     
  14. Donna & Buddha

    Donna & Buddha Member

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    Dec 29, 2009
    I'm just so stinking tired of rebound. If I see it, I want to shoot it early and make it go away.
     

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