Dosing Thread

Discussion in 'Prozinc / PZI' started by Bobby Smith, Aug 30, 2020.

  1. Bobby Smith

    Bobby Smith New Member

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    Jun 22, 2018
    edited from privacy
     
    Last edited: Feb 3, 2023
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  2. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Hello Laura. :cat:

    The access to your spreadsheet is denied; you may have to make it public for web.
    You're right, alternating the dose at AM/PM doesn't work. If you can get your spreadsheet public I'd be happy to take a look!
     
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  3. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Perfect! Thank you. :)

    Hmm. Might need to tag @Deb & Wink for opinions. I think, because of the dose switching, it's going to be hard to understand what's going on. She appears to be doing better on 3.25 than 3.5 but I can't be sure. Have you been testing the whole time or just recently? Cats' insulin needs fluctuate almost weekly, so if Angela has been on 3.5u for over a year that's not great.

    I would say, with what skewed info we have (unless Deb says otherwise), to do 3.25u for AM and PM for a few days. Would you be able to get some specific tests in too please? As a rough guide, +2, +4, and +6 on Day 1 and +1, +3, +5, +7 on Day 2? You're getting at least 1 spot in check each cycle which is good, but it doesn't really tell us what the cycle is doing. Getting in a couple extra tests will help paint the picture better.

    Also noticed the DM dry - you said you've lurked, not sure what you have/haven't seen but it's high-carb food which increases her insulin needs. Crazy right, considering it's for diabetics! Switching her to low-carb wet will get her better regulated. If she's a dry food addict there are a couple low-carb dry options as well (but wet is better of course).
     
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  4. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Whenever you're available to do so will be just fine. :) Feed as normal, multiple small meals.

    That is great to hear! Fancy Feast Classics is a great low-carb food if she can be tempted. If you haven't already seen it, there is a PDF for transitioning kitties from dry to wet that may help. I have a couple stubborn cats that don't like wet either so I feel your pain. Switching to low-carb can lower BG up to 100 points so do monitor closely during the process if you can convince her.

    Did your vet have a reason not to decrease? That is the goal after all! Glad you are feeling confident enough to make the changes she needs. Most cats don't even need more than 3u. If she drops below 100 at any time she needs a 0.25u reduction.
     
  5. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Angela seems to be doing ok on the 3.25U dose for now. Let's leave her at that for at least 6 cycles AM and PM, maybe more and see how she does.
    Reduction needed of course if she drops below 90 mg/dL.

    Have you seen the Transitioning Dry Food Addicts document? It was a lifesaver for me, in switching my diabetic cat Wink from dry to wet.
    He loved the Halo Liv-a-little chicken treats, crumbled to a powder and sprinkled on his food. I'd have to do that 3-4 times to get him to eat about 1.5 ounces of food.

    Absolutely NOT! Yes, Deb is very strongly opinionated on NO W/d food for a diabetic cat. The vet and shelter had Wink on that, and when we were able to transition him off the high carb dry and eating the low carb wet, he quickly went into remission and stayed there for the rest of his life.

    The Hill's W/d dry is 37% carbs, the wet is 26% carbs. Way too high for a diabetic. Keep the W/d wet for your hypo kit, in case you need to bring the BG levels back up with a higher carb food.

    Insulin dosages should be consistent for both the AM and PM cycles. Keeps the cat's body at a more even keel, than changing the dose every cycle.
    Plus, it gets really hard, difficult to see what is going on when looking at the SS, if the dose changes every cycle.
     
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  6. Panic

    Panic Well-Known Member

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    I think you're right. You could get one more test before bed if you like and leave it at that. The curve from today looks great!
     
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  7. Deb & Wink

    Deb & Wink Well-Known Member

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    Wink's favorite Fancy Feast Classic Pate flavor was the Turkey & Giblets. But he came around to like the other flavors.

    A curve is testing every 2 hours, from 1 pre-shot test to the next pre-shot test. You don't have to go all night long with the curve testing.

    But you do want to get some numbers at different times during the cycle. You don't have to do it all in one day, or even 2 days.
    You are trying to fill in some of the blank spots in the middle, putting books on the bookshelves ( the mid-cycle tests) between the bookends (the pre-shot tests).
     
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  8. Deb & Wink

    Deb & Wink Well-Known Member

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    If you change too many factors at once, it's difficult to tell WHICH change made a difference.

    Angela has plenty of room within the BG levels for that dose increase. She isn't even down in the greens. So the increase back to 3.5U was fine I think.

    p.s. Please do not go back and change your reply. When we read threads, it takes us to the first unread reply, so changing a prior reply may not be seen. It's better to add another reply, than to change a previous reply.
     
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  9. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    So with that lower BG at Pre-shot on 9/7/20 PM, you'll want to try to get a +2 this evening, to see where Angela is headed BG wise.

    That 217 isn't terribly low and I would not expect this dose to take Angela down to the green BG ranges (<99 mg/dL) but cats can surprise us.
    Low blues would be fine, as would higher BG numbers in the greens. You just don't want your cat to fall into the 50's and lower without being able to monitor and feed.
    Those first low numbers can be scary. Post in the Feline Health forum for assistance if you need it. Prozinc ISG gets pretty quite later in the evening and overnight.

    Got your hypo toolkit ready, just in case?
    First food to try when you cat is in the lower greens, lower than you have seen before, is the regular LC (low carb) wet food, then the medium carb (MC) food and then the HC (high carb) food.
     
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  10. Deb & Wink

    Deb & Wink Well-Known Member

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    Some cats on Prozinc can have what is called a "double dip", where they get a second low BG number later in the cycle. It might not happen every cycle, but only on occasion. No way to tell why it happens some cycles (12 hour dosing period) and not others.

    No, you do not want to give Angela more food towards the end of the 12 hour cycle if at all possible. If you do that, you will not know if the pre-shot test you take is only higher because of the food influence. So it's safer to hold off on food until after that pre-shot BG test. You want to try and have the pre-shot test done without any food influence for 2 hours before that particular test. That is not always possible, but do the best you can. There will be times you WILL need to feed Angela before the pre-shot test. All tests after that pre-shot test, up to around the +10 test, we expect to be food influenced.

    It's in one of the "Sticky" or pinned posts at the top of the Prozinc ISG forum.

    The exception to giving a cat food later in the 12 hour cycle, within 2 hours of the pre-shot test, is if your cat is in low numbers and you need to feed her to bring her BG levels back up to a safe level. So any BG tests that are <50 mg/dL, you want to feed your cat to bring those BG levels back up.

    Any food after about the mid-point of the cycle, the +6 time frame, will usually cause the BG levels to rise rapidly in the last half of the insulin dosing cycle. That is because the insulin is "used up" and the food has no insulin to balance out the BG levels. Food causes the BG levels to rise, insulin lowers the BG levels. So you want to try and have the two factors influence each other, balance each other out and keep the BG levels more steady.

    It takes time to achieve that though. Patience is key.

    There are some cats that have steep BG rises (increase in BG numbers) in the last hour of sometimes 2 of the dosing cycle. So at +10 to +11 to +12 (pre-shot test time) there can be a dramatic increase in the BG levels. So getting a test in the last few hours can be helpful.

    For instance, on 8/25 PM cycle, Angela got that BG of 73 at +10. Next time something like that happens, try to get a test at +11 as well as the pre-shot to see how fast her BG levels rise in the last couple of hours.
     
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  11. Deb & Wink

    Deb & Wink Well-Known Member

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    Yes, this was another of my "long winded" explanations. I'm really bad at "short and sweet" answers most times. I want people to have some background and more info when I reply.

    We've seen a lot of different situations on this message board, more than your vet has probably seen in all their years of practice. Happy to pass some of the information along that we have gathered over the decades on feline diabetes.
     
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