Could really use some advice, here!

Discussion in 'Prozinc / PZI' started by Theri, Jul 29, 2020.

  1. Theri

    Theri New Member

    Joined:
    Jul 5, 2020
    Hello!

    I'm fairly new here, and have already posted once in to the introductions forum section.

    I could really use some advice on dosing and treatment for my 13 year old kitty, Jaime.

    He was diagnosed in April, and I have yet to get his numbers even close to resembling regulation. It's frustrating and scary to see so much black on his spreadsheet.

    Since his diagnosis, he's developed some pretty severe neuropathy, and I started him on 3mg Zobaline daily as of a few days ago.

    There were some significant hiccups in his treatment at the beginning, involving having the wrong syringes for his insulin, and his dosing was kind of a rollercoaster as a result, until we figured out the issue.

    A few weeks ago I basically started fresh with SLGS, but his numbers just don't seem to be responding.

    I am currently working on transitioning him to wet food, but he's a stubborn one. I've ordered some Dr Elsey's Clean Protein dry food as a measure to hopefully at least reduce his carbs until I can get him switched. The food hasn't arrived yet, but should be here soon.

    Would any of you be willing to have a look at his SS, and offer any advice or recommendations?
    I just want my kitty to feel better... :C

    Here is a link to his spreadsheet, as I need to update the one in my profile:
    https://docs.google.com/spreadsheet...wJjUksuvhgICjrcY7PlU_dgVizs/edit?usp=drivesdk
     
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  2. Theri

    Theri New Member

    Joined:
    Jul 5, 2020
    Signature link should be fixed now!
     
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  3. Theri

    Theri New Member

    Joined:
    Jul 5, 2020
    *bump*
     
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  4. Karen&Rocket

    Karen&Rocket Member

    Joined:
    Feb 4, 2019
    Hello! I'm sorry you haven't gotten any replies here yet. Unfortunately I'm not a ProZinc user anymore (we did use ProZinc for a few months when Rocket was first diagnosed, but like you, didn't get good results), so I can't give much advice here. What I can do is tag one of our moderators who I see on this board often:

    @Marje and Gracie

    Hopefully she can help, or tag other ProZinc folks who can help too.

    (I should note, just in case you take a peek at Rocket's SS, that he ended up being a high-dose kitty due to having Acromegaly... long story short, we had to switch to a different insulin, and, he had radiation therapy (SRT) last summer. He's currently on ~2.5 units only because the SRT reduced his tumor. His spreadsheet is NOT a normal spreadsheet.) :)
     
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  5. Karen&Rocket

    Karen&Rocket Member

    Joined:
    Feb 4, 2019
    Also tagging

    @Deb & Wink

    too; she's awesome -- she might not be on as often though (I hope you don't mind me tagging you Deb! :) )
     
  6. SashaV

    SashaV Member

    Joined:
    Apr 25, 2020
    Hmm, I'm also new so these are just my thoughts.
    Witch syringes are you using? You need those who can do the 0.25U.
    You also need to test more frequently so you get a clear picture of the cycle during the day and night. Looks like he bounces when he's red amps then goes black. If you for example had a test in between you'd know if the dropped before bouncing back up. But you get blues, those are good! I'm just staring to get blue, so be happy with those!
    I also think you need to be consistent in dosing.

    However I'm new, so I hope someone correct me if I'm wrong.
    The one thing I'm sure of, you cannot test to much. I throw a lot of tests in when I change dose, just to see whats going on. I need to do more PM testing, I suck at that. Don't lock yourself to a time to test, if you test at +2 today, do a +3 tomorrow. Makes sense? His nadir might not be in the middle of the cycle, and you won't catch him in it without spreading tests through out the day.

    I'm sure you'll get those numbers under control in no time! :D
    And welcome in the prozinc forum!:bighug:
     
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  7. Theri

    Theri New Member

    Joined:
    Jul 5, 2020
    Thank you so much for the replies!
    I am currently using the u-40 syringes. I've seen u-40 with half unit markings, but I'm not sure if I've seen any with 0.25u markings. Recommendations, here?
    As for testing, he's pretty good about it, for the most part, but recently I've been having more trouble getting blood from his ears, and have had to poke multiple times to get a sufficient sample. His poor ears are so bruised up right now...can the bruising affect the ability to take a sample? Any advice, here? I'll definitely start testing more at varied times, regardless.
     
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  8. pomflora

    pomflora Member

    Joined:
    May 4, 2020
    Hi Theri and Jaime! I am also new and my kitty Flora is on Lantus, so wanted to comment on the other issues...

    First of all, hang in there! I have had such up and down times since this journey began. The people on this board are very helpful and generous with their knowledge and time.

    I had ear poking trouble at certain times as well! Her ear was getting terribly bruised and bumpy. I don't think it makes a difference to the sample but I felt awful that she might be in pain. Neosporin ointment helped, as well as changing my poke site each time. Also warming up the ear helps. Sometimes I blow very gently on her ear and that does the trick.

    Flora is finicky and would not go near the FF pates. We found the Meow Mix Beef and Chicken Tender Favorites, which are 10 carbs. She loves.
     
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  9. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Tags are fine. I'm not usually able to help out except for some evenings east coast US time.

    There are no syringes with 0.25U (1/4 unit) markings. We wish there were. :(You do your best to be consistent with those in between the lines doses. Or use calipers to measure the doses. There is a thread in the Health Links/FAQS forum on using calipers.

    Brusing is simply blood pooling under the skin. So if you apply a bit of light pressure after the poke, that should cut down on the bruising, as it helps to stop the blood flow which stops the pooling.

    A cat that is harder to test and the blood is not flowing well could be dehydrated. Try the "pull up the skin into a tent" test and it should go right back down if your cat is NOT dehydrated. Or check the gums. Press your finger on the gums, it should turn white and then pink right back up when you remove the pressure. Piniking right back up says not dehydrated. If it feels "tacky", that is another sign of dehydration.

    If you were using U100 syringes, those WILL work with a U40 insulin. But you have to multiple the U40 insulin dose by 2.5 to know how much U40 insulin to draw up into a U100 syringe. U100 syringes help you to fine tune the dose a bit easier.

    Yes, those black BG levels are not good.

    So let's check on your insulin first. Here are a few questions for you.

    How old is your insulin? When did you first use this vial?
    Have you been mixing it well each time, before you withdraw the dose?
    Are there any "floaties" in the vial after mixing?
    Still a nice pale skim milky color, more translucent than milk?
    Good storage procedures? In the fridge, where it can't be frozen?

    The dry food is one thing keeping those BG levels high. Is Jaime a dry food addict? Wink was, and I used every trick in this document and a lot of persistence and patience to get him to eat the lower carb wet food.

    Tips for Transitioning Dry Food Addicts.

    p.s. You are either a night owl, staying up really late, or are in a much later time zone than I am. This thread posted at 2:20 AM my time. You won't find me up at that time. Not even with a few cups of this. :coffee::coffee::coffee:
     
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  10. Theri

    Theri New Member

    Joined:
    Jul 5, 2020
    Hey again!
    I'm absolutely a night owl....or an insomniac, call it what you will. I'm on the West coast.

    Regarding his insulin;
    I started this vial on 6/8, so it's been a bit under 2 months.

    The insulin itself looks good - a nice, consistent milky color, no grains or floaties that I can see.
    I store it in the fridge between doses, though admittedly, it did get left out for a few hours accidentally, late last month or early this.

    Jaime doesn't seem particularly dehydrated using the indicators you mentioned. He drinks and pees a lot, which is why I took him in to the vet in the first place, when we got his diagnosis.
    I'll keep an eye on him though!

    Again, thank you all so much for your replies. Trying to figure this kitty out so I can help him feel better...!
     
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  11. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I'm trying to figure out if Jaime is way overdosed, or if he needs more insulin.
    I see you have been increasing by 0.5U increments.
    His nadirs (low mid-cycle numbers) do support that large of an increase. Even though those larger dose increases are part of the MPM protocol, not the SLGS protocol, BG levels in the high black and red ranges do indicate that more insulin is needed. Usually. Not always, but usually.

    Another check you should be doing every day, since the BG numbers are so high, is to test the urine for ketones (or blood if you have a blood ketone meter).

    Would it be possible for you to do a "testing curve", where you test Jaime every 2 hours, from 1 pre-shot test to the next? A day off is an opportunity for that curve to happen.

    Some random spot checks for the cycles would be helpful to see. At least one more test in each PM cycle would help too.

    Any test data for today, 7/30/20? SS isn't updated yet that we can see.

    p.s. I wouldn't worry about leaving the insulin out of the fridge for a few hours. Takes longer than that to degrade the insulin and make it less effective.
     
  12. Theri

    Theri New Member

    Joined:
    Jul 5, 2020
    I'll be doing more spot checks today, and I'll get a curve done tomorrow.
    The reason for the .5u increases is me not yet having access to syringes with markings to help me fine-tune the dose. I'll be ordering some u-40 with 1/2 unit markings today, though it may be a while before they arrive.
    I'll update his SS with additional tests as I take them.
     
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  13. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Sounds like a good plan. Keep us posted please.
    We are like family here, and worry if we don't hear from people.
     
  14. Theri

    Theri New Member

    Joined:
    Jul 5, 2020
    Will definitely keep this thread updated.
    I have the Dr. Elsey's Clean Protein food coming today, and I'm really hoping getting him eating a low carb dry food while I transition him to wet will at least help us start getting his numbers down.
    I'll be testing frequently while I start him on the new food, to make sure he doesn't drop too fast.
     
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  15. Theri

    Theri New Member

    Joined:
    Jul 5, 2020
    Minor update!
    While Jaime's numbers are still cringe-worthy, it looks like he's had nice downward trend today up to +6.
    In addition, he's gobbling up the Dr Elsey's quite happily! Not as good as wet food, but much better than he's been eating.
    Yay!
     
  16. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    If Jaime likes the Dr Elseys Clean Protein chicken flavor, you might want to try crumbling a few on top of a tiny bit of wet food. Or pushing a few pieces into a tiny teaspoon of wet food. Or try the "chip and dip" method, where you dip the chip (the dry food) into the wet food and put it in a dish or on a small plate. Try with only a few pieces at a time. It will probably take time for him to accept these, but it's worth doing.

    Wink was a founding member of DFAA, Dry Food Addicts Anonymous and I learned a lot of tricks to get him to eat the wet food. One of his favorites, was to crumble the freeze dried chicken treats into a fine powder and sprinkle that on top of the wet food. I'd have to do that 3-4 times to get him to eat a small portion of his wet Fancy Feast. He came to love the Fancy Feast Turkey & Giblets flavor.

    For a while there, I'd have 3 selections out for him to eat, like a smorgasbord.

    Come on Jamie! Keep eating that lower carb dry food, the Dr Elsey's!
    Hoping he'll get lower and lower numbers with that lower carb food.
    Something needs to give and soon with his sky high BG numbers. Cheering him on!:D:D:D
     
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