Here is Dolo's chart so far: https://docs.google.com/spreadsheets/d/15lMB_4BUNQKMNfnYpQ58839OHPSj3iQN4AOTwAwgr58/edit?usp=sharing Dolo started on 1 unit which wasn't really touching his numbers much. We bumped to 1.5 which seemed to give better numbers but with way too much differential between preshot and nadir. 1.25 seems like a good spot in that he's not on such a roller coaster but his overall numbers aren't fantastic (not horrible either I'd say). Yesterday and today he had preshot numbers of 163 (I even tested him twice yesterday since I was sure the device was broken). He is 8 years old. His sister was diagnosed in July 2019 and we weren't able to save her even with treatment (and one DKA that put her in the hospital for a week, she never really fully recovered from that). So here we are a full year later trying to do our best for him. He's a good size, around 12.5 pounds.
Welcome, Meghan. I'm sorry you lost Dolo's sister. I never used Prozinc so am tagging @Deb & Wink @Panic to look at your spreadsheet.
Hello Meghan! *waves* So sorry about Dolo's sister, DKA is very hard to recover from. A couple questions: Are you using a human or pet meter? What food are you feeding? Are you feeding any sort of dry food? When was Dolo diagnosed? With Prozinc there are two different dosing protocols used. Start Low, Go Slow (SLGS) and Modified Prozinc Method (MPM). Link to both here. If you are using any dry, you cannot use MPM. That said, SLGS has you holding the same dose for 7 days, and then re-evaluating the dose, either by doing an all-day curve, or if by having at least two tests done between pre-shot tests each cycle and looking at the data to decide if an increase is needed. SLGS also has reductions earned if Dolo drops below 90 at ANY point in time. Reductions are typically done by 0.25u each (as are increases). MPM has you re-evaluating every three days, and you need to be getting at least two tests in between pre-shots every day. Reductions are earned if BG drops below 50. Once you pick a protocol, it's important that you stick to the guidelines, but you can always switch to the other if the current protocol isn't working for you (just don't flip-flop between the two, try to stick to just one). Looking at it from a SLGS perspective, Dolo would have earned a 0.25 u reduction on the 19th with that 62, and again the next day, but it took you a couple days to reduce. That said, you reduced from 1.5u to 1u, and we really recommend sticking with the 0.25 increase/decreases. You seem to be flip-flopping the dose a lot based on pre-shot. Here's the information pasted from the link above about lower-than-average pre-shots. How to handle a lower than normal preshot number when following SLGS: I do not know what your schedule is like, but if possible it will be beneficial to get a +2 every cycle (even at night). This number is often indicative of how "active" the cycle is - ie a noticeable dip at +2 is a warning to "keep watching" and be able to intervene if necessary BEFORE there is a hypo crisis. Hypo numbers don't necessarily mean hypo. Testing Recommendations: +2 every cycle (if possible) One "before bed" test Alternate your testing times. Day 1: +4, +6 | Day 2: +3, +5, +7 (these are loose guidelines, you basically want to be filling in the gaps in your spreadsheet) Meal-time Recommendations: Mini meal at +2 A couple more mini meals before nadir - possibly +4 and +5, depends on what Dolo's nadir is This advice is for BOTH cycles ... a lot of people forget about night-time feeding, but kitties drop lower at night and a kitty in low numbers will seek out food. Make sure there is some available. Unless Deb has a different recommendation, I would suggest trying 1.25u a few days. Get those tests in so we can see all of what Dolo is doing on the dose. Do not be tempted to give MORE insulin if pre-shot is higher. That's like thinking if you put more gas in the car it'll drive faster. It doesn't work that way.
Thanks. He's on FF pate wet foot and Friskies (and some Tiki Cat. All Pate's). thank you for the advice. Will go from there. We have him on 1.25 and plan to keep him there except his morning numbers the past few days have been lower so we've done 1.0 instead in the morning. Will see if I can to +2. It's already alot of testing and we are on the alpha trak so it's $1 every time (more if we mess up and get an error message). Trying to do our best. Thank you for the advice.
Okay, can you do me a favor and add Alphatrak to your spreadsheet. And make a signature Signature Instructions Alphatrak numbers are a little different than the numbers we list here. I believe (someone correct me if I'm wrong) the no-shoot number on Alphatrak is 250, not 200. You don't really want him to go below 100 on Alphatrak, and the take-action number is 68, vs 50 on human meters. If you ever get low numbers, please specify upfront that you're using Alphatrak! Speaking of human meters, most of us use them for cost-effective reasons. Are you located in the US? Most of us use Walmart's ReliOn Prime meter. Available on the shelf, no need to special order it. Strips are $0.17 each vs Alphatrak's $1 each. The cost will definitely start eating at you. There's no benefit to using Alphatrak, it just seems to make the vets happy when you use them.
We have a relion and we've used them side by side to see the numbers and they usually are pretty close. He just doesn't bleed enough to use the relion regularly.
I believe the ReliOn Confirm requires the same blood droplet size as the Alphatrak. It is discontinued; the strips are still available (for now). A bigger lancet size may help.
His number this morning was more typical (235) and I tested him 2 hours later and he was 195. Can you explain about feeding between meals? I know he would love this but how does that affect the insulin? Thank you for your help.
Food can slow the drop of BG as the carbs "burn up" the insulin. It's why we don't recommend meals after nadir. When insulin starts to tank BG, usually around +2, giving a little food is like tapping on the breaks on a downhill. It helps BG from dropping too fast.
