Cross posting here from the main thread as my kitty is on prozinc

Hi, i just created my spreadsheet. i have looked at these threads for a while and it's super helpful. I'm trying my best - it's been a gigantic learning curve and lots of research. My cat eats Dr. Elseys and some wet food - fancy feast pates and some wellness pates. I have done some Tiki cat which she likes but don't want to give her too much fish so I try not to give it often. I went on vacation for the first time in about 4 years and left her with my mom and I'm very worried about her numbers. She seems to dive around 11 am and bounce back up by 3 pm. Can someone lend some guidance? Please let me know if you need additional information or if I have improperly done the spreadsheet. Thanks in advance, my diabetics cat name is Bella and she is a 13 year old Calico. Diagnosed weight dropped to 7.13 oz from her normal weight of approx 10 pds, she's gained most of her weight back by now.

https://docs.google.com/spreadsheet...Va3kcGJ6zvljDSyIOum5_T0wqEyg3cOwUUmf9/pubhtml

 

Hi there! Great job getting started and reading.

Based on the data you have I'd say this dose is good, but it might still be a little high based on my experience reading spreadsheets (for example, that 93 a little while ago at AMPS tells me she was probably lower overnight, and reductions are earned if they go below 90 on SLGS). You want the nadir to be between 90-120 roughly. I would actually reduce by 0.25U for safety's sake.

That said she's a pretty bouncy cat. It's normal, and I suspect also in part due to her dose being too high for too long. A bounce is when they drop lower and/or faster than they're used to (like that 592 to 109, that's a massive drop), and their liver perceives it as life-threatening -whether it actually is or not - and dumps stored glycogen and counterregulatory hormones in order to spike BG back up. The effects of that can last up to 6 cycles. There isn't a whole lot you can do about it but wait for her body to get used to lower numbers, but truthfully those huge dives she's being will pretty much always cause a bounce. We say give it about 3 months of consistent, methodical dose adjustments before considering a switch in insulin. One thing you can do to help slow the dives is feed something with a little more carbs early in the cycle, you'd have to experiment to see what works.

For now I'd just focus on getting the preshot tests in every shot (she should fast for 2 hrs before a preshot test, but any other test in the cycle does not have to be fasting). Also the +4 to +6 is helpful as that is typical nadir for ProZinc - it can and does move around.

Does she have any other health issues? History of ketones or DKA? How was she diagnosed? What symptoms did she have?

 

Yes she loves to bounce and it makes it hard for me to figure out a good dose for her. Going to try and get pre shot tests every time - I already make sure not to feed 2+ hours before her next shot. She seems to have her initial drop off around 3 hours after shot I’ve noticed. She stopped eating, lost 2-3 pounds, drinking a lot, peeing a lot brought her in and her glucose level at the vet was 430, they never said she was DKA but I suspect she was? They put her on Mirataz for first week after diagnosis to jumpstart her eating again. Her appetite is much better now and gained most of her weight back - she’s never been a large cat. I will definitely look into all your other suggestions!

 

That sounds a little more like pancreatitis. Had it been DKA I doubt she would have recovered that easily, it's usually very serious and requires hospitalization. Are you checking ketones at home at all?

Glad she's gained the weight back!

Long term you probably will want an insulin like Lantus/its generics, but it's worth giving some slower increases/food manipulation a try first and give her time to settle down a little bit.

 

Glad to know it wa likely just pancreatitis. I’m not checking ketones - I think I’d have a very hard time doing the pee ones with her but I think there may be a type I can try using blood like with her glucose levels? I’ve definitely read up on Lantus and wondered if with her being so bouncy it may be the better option. But for now I’ll try with .75 and some food changes and see if I can get her to better numbers.

 

This is great that you have a spreadsheet and are testing. This is what you need to keep your kitty safe. Please start doing a preshot test before shooting insulin both in the morning cycle and evening cycle (AMPS and PMPS). This is the only way you will know if it is safe to inject insulin at a given time.

She has had some scary low lime green numbers on a little higher dose.

Can you do this?

 

Yes - I started testing after the vet wanted me to give her 3 units because her in vet curve was still high. That’s when I ordered the alpha trak to try and start testing from home. The highest I went up to was 2.5 before reducing when I saw those low numbers. I will start testing every time before her shots AM and PM

 

I bought a Nova Max Plus blood ketone meter for testing ketones. It is done with a drop of blood just like the glucose testing. I got mine from ADW Diabetes Supply.

 

Thank you I will look into this!