At wits end...

I need to know what safe numbers are... I keep seeing so much information I'm trying to take in to help my cat and I feel like I'm not doing the right thing because every time I think I'm doing the right thing, something else messes up.

Whats a good number to shoot my kitty at?
He just got a 122 at what would be his preshot and I am stalling because he is going down (pretty late in the cycle for some reason). I get to feeling bad because he needs to eat and I don't want to stall and stall and stall and him go several more hours without eating, it feels wrong. Feeding him and skipping shot shoots his number way up and stays there (recorded that data previously on my SS). I feel like giving a "token dose" wouldn't be effective and how do I know when and how much of a token to give? Its starting to feel WAY too technical and vague. I understand every cat is different but it honestly feels as though my cat is a freaking alien at this point.

I made a longer post in the Prozinc thread/forum/section with a much more detailed explanation...

 

9:15PM (only 15 minutes after usual PS time)- tested at 155 so I am giving 1F...we'll see how this goes...

 

Next time if you need replies right away about shooting please say that on the title with the number and the time like 122 @pmps shoot? So members know it’s time sensitive. With 155 I’d give a token dose. You should test again at +2 for sure to see if he’s going up or down. What does the F after 1 stand for?

 

The F stands for a “fat dose” and S would stand for a “skinny dose” basically a little bit more than 1 unit. It’s somewhere in all this info lol. And I do quite a LOT of testing so no problem there. And that’s what I don’t understand... how do I know how much of a token dose? How do I know when to give it? How do I know that a token dose is all that’s needed? What range would a token dose be warranted? This is all just really confusing, overwhelming and feels as though this will never be second nature to me...

 

Hey Ale the F means she shot a 1 Fat unit, just a smidge under the 1 unit mark

 

Hey Haylee I went over to the Prozinc forum where you posted and tagged a few experienced members for you, I hope this will help

 

Keep a dose for at least a week and do a curve. You are doing a lot of testing...its ok if your cat dont mind but +6 seems to be the nadir. My cat is also on Prozinc. You could do pre-test AM and PM and +5 or 6. A lot of testing is great but not if it stress your kit.

 

the thing with Prozinc is...lower than 50= give carbs, under 90 reduce the dose by 0.25 for the next shot. If the nadir is more than 150, increase by 0.25. between 90 and 150 maintain dose.

 

Thank you for that I really appreciate it

Length of time is also something I get conflicting info on from this forum. Last time I posted I was told that keeping the dose for a week was too long. So I changed that and held doses for 3-6 cycles per the MPM protocol. I acknowledge that a lot of testing isn’t always necessary but how else am I going to know when things happen with Tigger and what happens? Testing let’s me know especially with all the crazy numbers he’s had. He doesn’t mind the testing at all. Just the shot part he gets whiny about

 

if the Pre Shot is at 8.3 or lower, skip. if its between 8.3 and 11.1...give nothing or feed and test again in an hour. Than you can give a token dose.

 

In the Prozinc Dosing Methods, it says “if nadirs stay in green numbers (50-99), continue to hold the dose.”
Also “if nadirs are 100-200 increase dose by .25 unit”

I am following the Modified method.

 

I also don't believe we are using the same meter, the measurement is not the same and I'm unsure how to translate that.

 

Seem right. Remember that the ReliOn meter can be a bit off, but look like you are doing good

 

Wow Tigger is doing well so far but I get your stress. I think largely you have to look at the whole picture. Study the doses and see what got you, to where you are at this point. So far you're doing all the right things. Look where you and Tigger are right now!

Of course keep asking questions, thats your job! Hold on for more replies.
jeanne

 

It varies depending on the dosing protocol you’re following. What Lalkabee describes is SLGS I’m sorry I don’t know much about the modified so let more experienced members in the prozync forum help you like @Deb & Wink

we use the human meter numbers so the numbers you’re getting from the ReliOn are just fine. All meters have a 10-15% variance

 

Okay this next question might seem a little stupid.

Is it possible that my cat and his pancreas are playing favorites when it comes to who gives the shots?

I swear it feels like every single time I give him his shot his numbers are in a higher range, but when my husband gives the shot they are in a lower range. He IS technically my husbands whole heart and soul and I did get Tigger for him. I just wear the caregiver pants is all.

 

I have to admit, never heard that one before. Maybe his pancreas and your husband were soulmates in a past life?

 

Quite possibly!

 

SLGS (Start Low, Go Slow) protocol has you re-evaluating the dose every 7 days and dose reductions are earned under 90.
MPM (Modified Prozinc Method) protocol has you re-evaluating the dose every 3 days and dose reductions are earned under 50.

MPM is more aggressive and keeps kitties in better numbers longer (you may also see TR - Tight Regulation - as a method. This is just the Lantus version of MPM). More testing is needed if doing this method. You can do SLGS if it suits your schedule better.
You can find information on both protocols here.

Basically, the goal is to keep kitty in numbers below 100 for as long as possible. That's when the pancreas starts healing and repairing itself.

For SLGS:

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

For MPM:

• If nadirs are 100-200, increase the dose by 0.25 unit.
  • hold the new dose for 3-6 cycles unless the BG drops below 50. If the BG drops below 50, decrease the dose by 0.25u on the next cycle.
  • if your cat is new to nadirs under 200, you may notice that she/he feels a little sluggish and sleepy when first getting into healthier numbers. This is normal and will get better in time.

• If nadirs are more than 200, increase the dose by 0.5u. Dose increases should be made every 3-6 cycles and should continue to increase until nadir numbers begin to come down.
• If nadirs are 50-100, hold the dose for additional cycles.
  • If the nadirs start to rise, then increase the dose by 0.25u.
  • If nadirs stay in green numbers (50-99), continue to hold the dose.

• If nadirs are under 50 on a human meter or under 68 on a pet meter, decrease the dose on the next cycle.

I would print out the increase/decease rules and stick them with your log book so you can keep them on-hand.

EDIT: Re-read and missed the part where you said you were using MPM already, so ignore the SLGS part haha. A helpful tip is that you want Tigger's nadir to stay between 50-100 MOST of the time. So if in three days time he's only hit that number once, you might still need to increase. Checking with the more experienced dosers would be a good idea on that though, I know that applies to TR with Lantus at least.

 

It could be related to stress. BG numbers will go up under stress.

 

I suspect what. you're seeing is what we refer to as a "bounce." When Tigger's numbers dropped into a lower than expected range -- the 40's" -- his liver and pancreas "panicked." When this happens, they release a stored form of glucose and counterregulatory hormones which cause the spike in numbers. The more time your kitty spends in normal range numbers, the less frequent and the shorter the bounces typically are.

A couple of other observations...
I can't tell from your notes if you were giving Tigger high carb food to get the numbers out of the 40s. If you did so, please put a note on your spreadsheet. If you didn't, numbers below 50 warrant an intervention with HC food. Also, you want to test ever 20 minutes. If you wait an hour, numbers could be in the 20s and you're potentially battling with a symptomatic hypoglycemic event.

When you are reducing after numbers in the 40s, unless you have a great deal of experience, you want to reduce the dose by 0.25u.n I would not have raised the dose to a fat 1.0u. You can see the result -- Tigger was back in the 40s 2 days later.

There's a lot to absorb with managing FD. You're doing great!

 

As I have said elsewhere, I would have killed for these numbers, this early in Troubles diabetes journey.
You really are doing a good job.

 

I did not give him HC food, if I did I would have noted it in my spreadsheet. I did however give him a teaspoon of his regular food which I did note on my SS in the remarks column and that seemed to be fine for him. He DID hang out in the 40s for 3 hours but also a couple days later he dipped into the 40s again and only managed to stay there for one hour. I still intervened with a teaspoon of his LC food and it brought him up. I also do test every 15 minutes instead of 20 to see where he's headed. I know it was not noted in the SS, but I do. I watch Tigger like a hawk day in and day out and do so because of the fact that he bounces and because I need to know what his numbers do and when they do it.

I am really grateful for everyone helping me and this site in general,but it feels hopeless because I get a lot of mixed info and confusion about what I do with my kitty when I do note things on my signature and my SS. I basically know what to do I just get confused at his numbers and what action I should take in dosing and feeding. I have already been instructed on my other post so I am giving that a try but his numbers are back where they were...

 

Haylee I think you are doing a good job. I understand the mix message thing. It does happen. I think posting on the prozinc board may be the better option.
THOUGHTS ANYONE?
j

 

Yeah I was told to start posting on the Prozinc board for dosing help, I did and did not get replies from anyone. All posts around mine got replies. I made this post and mentioned that I posted in the Prozinv forum and only when someone else saw this one and went to tag experienced members did I get replies... I got help finally from Deb&Wink though.

 

It's a bit of a catch-22 ... Prozinc forum does not have hardly any seasoned members so no one visits/replies so you post in Health with more traffic and no one there is experienced in Prozinc and so they recommend posting on the Prozinc forum. All I can say is don't be afraid to ping members for assistance! Deb honestly does amazing work over there, I don't believe (?) she has any personal experience with Prozinc but she really stepped up and did her homework when she saw most of the experienced members had left.

 

No, Panic (Elizabeth) is correct. No personal experience with Prozinc. But I have tried my hardest to step into the void and help people in the Prozinc ISG group. Other people that are commenting on your post here in Feline Health might not have personal experience with using Prozinc in a cat either. Panic does. JanetNJ does. Lalkabee is new, but she is using Prozinc for her cat.

Could be that your husband measures the dose a bit differently. Or it could be the luck of the draw, and you are getting to shoot the cycles where Tigger is bouncing.

p.s. Life gets busy for me this time of year, and I'm usually only on for an hour or so in the evenings. So you might not get a reply from me, to a more urgent post, until too late. Or later than you need to make a decision. It's why understanding the dosing protocol document guidelines can be your "go to" guide, when no one answers in a timely fashion.

 

I just didn’t know if me tagging someone was acceptable I guess lol
I think it’s luck of the draw honestly. It just so happens that I give him a shot when he’s bouncing. I thank you for stepping into unknown territory with no personal experience with Prozinc.

An update on Tigger so far, his numbers are looking like they are going back to what they were when he was on 1U before. I’m hoping that with feeding him at the +2 mark and perhaps increasing him back to 1.25 after 6 cycles, that would be a good balance. I can only hope though

 

I can provide some insight in terms of my way of thinking....

I look at a lot of spreadsheets. I typically open every spreadsheet if I'm stopping by regardless of whether I leave a comment. If I don't see information, I am assuming it didn't happen. Usually, as in your case, I ask. The more experienced members likewise open spreadsheets.

The benefit of having information visible for everyone is that we don't plague you with questions. It also means that you don't have to commit information to memory. If you are looking for trends, it's also helpful to have the information in a handy place. It you think it would be helpful, look at Gabby's spreadsheet. There are ways to "stack" test data in a cell so it's all there. (You do have to manually change the color coding if you stack numbers.)

When your kitty is in the 40s, starting with some LC food is fine. However, if you don't see a change in 15 - 20 min, please move to medium or high carb. You have zero room for error when a cat is in the low 40s. Also, given that there's up to 20% error allowable for meter variance, I'm a big fan of erring on the side of safety.

It is fine to tag members. You can even send people a PM (private message/start a conversation). I only see tags when I'm logged in. If someone sends me a PM, I get an email message. Just keep in mind that everyone has lives/jobs outside of the board and we can't always break away to respond immediately. I'd also suggest looking at spreadsheets. Not only will it give you a feel for what other people are doing, it will tell you how much experience a member has.

I would encourage you to consider the dosing recommendations in the materials on the Prozinc board. Generally, early on in the process of managing a kitty's diabetes, it is best to follow the dosing strategy and change doses by 0.25u. Once you're seeing overall lower numbers, finer adjustments may be needed. It's also likely that what you're currently seeing are bounces. Due to the numbers in the 40s, numbers may bounce.

 

Oh dear yes I see your problem. I will try harder to tag the right people. Not getting any responses is VERY stressful. Heylee you keep posting in health. We will get this sorted out. I apologize for asking you to do things you've already tried. Sigh You must be very stressed. I will try harder.

 

Everyone here tries very hard to help whoever needs help. Deb does phenomenal work as do our Mods. I know that feeling of needing an answer right away. Its a very lonely place. Hopefully I can help (in some way) to right that.

 

I understand that people have lives outside of this board, I was not suggesting otherwise... all I’m trying to do is get help and it’s hard to do so when I post in the correct forum and all other posts people have made even after mine get responses but mine does not.

I have also taken a look at others’ spreadsheets just to get an idea of what other info I can add or what I can change to make it better for others when they do help. I have opened a LOT of spreadsheets for that reason. I don’t ever comment on others’ posts because I am still new and still learning and I don’t believe that warrants me giving advice especially when I’m not at all using the same method/meter/insulin AND have no experience to help others as I don’t want to be responsible for messing something up for someone else.

I will start stacking any 15-20 minute interval tests I do in a cell as suggested. I have already lowered his dose to 1 unit which is .25 below what he was when he was in the 40s per the protocol.

 

It is stressful, however I can still post in the Prozinc board if needed, I would just tag members so it’s seen or just send them a PM like suggested. You, just like the rest of us, are doing the best we can in these times especially!

 

Thank you for your generosity . It IS appreciated.

 

I want to say that I think we have all been there, at least I have, so it’s not just you. I’ve posted before on the Lantus forum and in this one and got no replies while other posts get tons. It’s a community and it’s kinda normal that people post on threads by members they “know” or maybe the title drew them in or it showed up first on their queue or they feel some unexplained connection to one cat more than others. The reason doesn’t really matter because we’re all human and it’s not a popularity contest, so I learned to not take it personally and just tag the people whose input I value and want. I’m just sharing my experience and how I deal with it. It’s life. It sucks a little when you feel you need help you’re not getting so again, tag away and I’ve even PMed members too because as someone pointed out already they get an email about it while the tag is not 100%. I’ve been tagged before and not seen or gotten the alert. We’re all doing the best we can and we’re all in this together. So if you need help and you feel you’re being “overlooked” give us a shout at the top of your lungs via tag or message. And by us, I really mean the board since I’m no prozync expert

 

Thank you, I will try to do so in the future. I just have anxiety with tagging people and messaging I guess because I don’t want to bother people.

 

"Tag and PM" away when you need to. We wouldn't be here helping, if we didn't think we could make a difference and don't consider it being "bothered".

Replying to other threads doesn't have to be dosing advice.You can reply to other peoples threads with encouragement and understanding of the situation they are going through. Even an emoji can be a reply. You are letting someone know that you care, when you respond.

p.s. Don't stall for more than 1 hour. No need to keep your kitty waiting for food more than that. "better too high for a cycle, than too low"

 

Notifications, weather via PM or a tag, depend on how the person has set that up in their User Id Preferences.
It also depends on if they have "Watch Thread" turned on or off.

Please don't assume that if you PM or tag someone, that your tag or private message will result in an email to the message board member.
How those notifications preferences are setup is a very individualized choice.
Personally, I do not have email notification setup.

 

I guess I do for messages but not for the thread alerts