? Dosing Advice Prozinc 1

Discussion in 'Prozinc / PZI' started by Bear & Lora, Sep 28, 2018.

  1. Bear & Lora

    Bear & Lora Well-Known Member

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    My cat Bear was diagnosed 8-16-18 with Diabetes. The vet started him on 2 units twice daily. The next week he was monitored and his dosage was raised to 3 units twice daily 8-28-18.

    Last night his pre-shot testing was 87 BG. I didn't give him any insulin and because I am very new to this (Home testing for 4 days) I had no idea of the protocol and I immediately fed him instead of stalling.

    He is overdue his first shot and he just tested 317 BG. Can anyone help me with lowering his dosage?

    The needles I bought at the Vet's office are UltiCare Vet RX U-40 Insulin Syringe and doesn't have 1/4 or 1/2 lines.

    Should I go down a unit?
     
  2. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I see from the "notes" section of your spreadsheet that you're working on getting him to make the switch to only low carb wet food. How far into that are you? I ask because the dosing advice would depend on that. If he's still eating some kibble as well as higher carb, gravy style canned food he'll be able to handle a slightly higher insulin dose. Once he's eating only low carb wet food the dose might have to be reduced.

    We know that 3 u is too high a dose at this point. Deciding how much to drop a dose is a challenge. I suggest you go back to 2 u for this upcoming shot. Test him again at +2 to see what he might be planning. These are the guidelines we follow:
    • if +2 is higher than the PS the cycle is likely to be uneventful (ie., no big drop) and you can go to bed in peace if it's evening
    • if it's significantly lower (maybe 100+ points) be prepared to test again at +3 and start intervening with small snacks of low carb food to try "steering" the BG away from a precipitous drop
    • if +2 is similar to PS, get a +3 and if there's no significant drop you can relax a bit. I'd test again around +6 though. All data is good data as we often say here.
    I'm guessing at 2 u and am being guided by the mixture of foods he's getting. Once you have a lot of data on your spreadsheet it'll be easier to make better suggestions.

    Re fractional dosing: We like 0.25 u dose changes here so if your syringes don't have half unit marks, do your best to eyeball the fractions. Consistency dose to dose is more important than absolute accuracy. It can be really helpful to draw up a "reference" syringe with coloured water at the mark you decide is the fractional dose. Use that syringe as a visual reference for other doses.

    Later on we can help you understand how to use U100 syringes and a special conversion chart to give ProZinc. Many fractions are possible with that method.
     
    Last edited: Sep 28, 2018
  3. Bear & Lora

    Bear & Lora Well-Known Member

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    He didn't have any kibble yesterday because he ate wet very well and with some enthusiasm. I was only giving him very few kibble to bring his calories up to what Dr Pierson's article said was needed for a 16 lb cat. He is majority transitioned to wet. I have a baby scale ordered which will be here Tuesday.

    I will go give him his 2 unit shot real quick and feed him and come back to look over and put in my head your information. Thank you so MUCH!
     
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  4. Bear & Lora

    Bear & Lora Well-Known Member

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    I haven't been feeding him any canned food with gravy or sauces only Pate, flaked and freeze dried chicken breast treats.

    His dosing schedule is so far out of whack. We were at 11-11:30. I would like to work it back to at least 9 eventually.

    As far as tonight's shot 2 units and is Midnight a safe time to dose him since he had his first shot at 1:45 PM?

    Wow, this change in BG felt like a truck was heading straight for me head on. I so was not expecting it this quickly.
     
  5. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Let's see what the 2 u does. As for the timing of tonight's shot I wouldn't give it before 12:45 AM. That's 11 hours from this recent shot. You have the option of skipping the evening shot tonight and going back to your preferred AM time tomorrow. That would be a lot simpler. If the idea of missing a shot concerns you think of it as a "fur shot". When those happen we DON'T give a second (replacement) injection.

    Kitties make it their business to surprise us. You'll get used to it. Having a spreadsheet full of data to refer to is a huge help!
     
  6. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Hi Lora. You are doing just fine with Bear, he's in good hands and you should be proud of how far you've come so far. Rest assured this will get easier even with all the other responsibilities you have on your plate. Remember to breathe!

    I agree with Kris about not shooting before 12:45am especially since he's popped his first green reading and needs a dose adjustment. Doing a longer cycle today and then shooting tomorrow am at your preferred time would be the simplest and safest way to get back on your schedule. I've had to resort to "extended" cycles due to other commitments/responsibilities and it's much easier than trying to ease your way back to preferred time when you get that delayed. Bear will be fine.
     
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  7. Bear & Lora

    Bear & Lora Well-Known Member

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    You know Wednesday Morning's shot might have been a Fur Shot. I heard a noise when I injected the syringe. I looked studiously through his very thick fur and couldn't find any wetness. I just put that on his spreadsheet.
     
  8. Bear & Lora

    Bear & Lora Well-Known Member

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    Ok, two agreements from experience is great! I will do that.
     
  9. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I used the sniff test after any shot I was iffy about. I think Kris does too. Insulin has a distinct odour. Just another way to check although chances are good you'd feel some wetness but a double check never hurts. :)
     
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  10. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You beat me to it! Yes, I sniff if I think a shot went amiss. Smell the insulin sometime when you're drawing up a dose - it's an unmistakeable very strong Band-aid like smell.
     
    Last edited: Sep 28, 2018
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  11. Bear & Lora

    Bear & Lora Well-Known Member

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    Thank you both (Linda & Kris) for being there for Bear and I. My heart feels bigger and words can't convey how much I appreciate your help. :) :)
     
  12. Bear & Lora

    Bear & Lora Well-Known Member

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    +2 is 198 ( 119 drop in BG). So we are looking at a possible event. Retesting in an hour.
     
  13. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Good call Lora! You've got this. Once you get to the right dose, things will calm down. Will check back in for next test result. :)
     
  14. Bear & Lora

    Bear & Lora Well-Known Member

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    +3 175 BG, still going down. I gave 1 oz of food. So should I retest at +4?
     
  15. Bear & Lora

    Bear & Lora Well-Known Member

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    So that was only a 25 point drop +2 to +3. If I understand the protocol, I feed Bear if it is a significant drop? I don't know if I made a mistake by feeding but Bear usually eats around this time.
     
  16. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I think you are probably Ok to leave him till +5. He's slowed down some now and with the food (yes that's fine to feed his usual snack), that should keep him slowed down. He should be fine. I'm thinking he bounced after that beautiful green number but he seems to clear bounces quickly. Just an hypothesis right now that will be proven or disproven with a little more data.
     
    Last edited: Sep 28, 2018
    Reason for edit: added "now" to correct sentence
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  17. Rachel

    Rachel Well-Known Member

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    Hello Bear and Lora! I've been at work all day so I just saw this conversation. Yes, it's fine to feed him when you normally do. Most of us feed our kitties little snacks throughout the day and you want to keep things normal for him. That is a pretty big drop from preshot but it's NOT unsafe yet...I'd test at +5 as Linda said and let's see what happens there. :)
     
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  18. Bear & Lora

    Bear & Lora Well-Known Member

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    Hi Rachel,

    It does seem like a big drop, especially since Bear's last shot was reduced by one unit.
     
  19. Bear & Lora

    Bear & Lora Well-Known Member

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    Plus he didn't get his evening shot last night with his 87 BG. I'm confused I will admit.
     
  20. Bear & Lora

    Bear & Lora Well-Known Member

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    Ok, we have a 243 BG. So this means the food is bringing his BG up? This is a long acting insulin so is he still in jeopardy of having a drop in BG that could be dangerous?
     
  21. Bear & Lora

    Bear & Lora Well-Known Member

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    I will do whatever I have to for Bear's safety but I think we might have to make a Burrito Bear if we have to test him soon. :)
     
  22. Rachel

    Rachel Well-Known Member

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    Yes, it looks like the food brought him back up. My guess is he'll be fine now. With MOST cats the nadir (mid way point of the cycle, when BG is lowest) is around +5 to +7. This, of course, is ECID (every cat is different) meaning that not all cats will nadir then. We have one here who often nadirs at +3 and another who nadirs at +8. And, of course, the nadir can and does change in some cats. We don't know when Bear's nadir is yet, and only data over time will tell. However, he is in a lovely yellow at +5 and has some food on board to keep him propped up. With the knowledge that he's probably near nadir based on what we know about most cats and the fact that you know he has about 200 points to drop before you'd take action on a hypo, I'm going to say I think he'll be fine tonight.

    If you're up and want to grab another test or two, that's fine. If you're not or you both need a break from testing (which it sounds like you might!) that's fine too. I really think he'll be fine tonight and you both deserve a break!

    This is very confusing, but we're here to answer any questions you might have! Please don't hesitate to ask..we want to help and we know what a steep learning curve this is!
     
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  23. Bear & Lora

    Bear & Lora Well-Known Member

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    I hit the wrong reply, lol. I will do whatever I have to for Bear's safety but I think we might have to make a Towel Burrito Bear if we have to test him soon. :)
     
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  24. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Nothing to worry about. Numbers can wobble a bit when you're adjusting a dose. Could be food too. You can take a break from testing until tomorrow's AMPS because he's in very safe territory.
     
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  25. Bear & Lora

    Bear & Lora Well-Known Member

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    @MrWorfMen's Mom @Kris & Teasel

    Good Morning & Help. Bear is at a 122, which is pretty dang good. Now I am an inexperienced person for this situation but my math says we are looking at a .5 unit or less???? Could he be starting to get close to a remission???
     
  26. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I just checked his spreadsheet about a second before you posted and was thinking about what dose would be best! :woot: Not stalking you but curiosity got the better of me given the extended cycle and how well Bear has been doing. This is wonderful and yes it means his dose needs reducing more or that he could be heading for diet controlled remission. I am a little worried that even 0.25u might drop him too much right now. He's been bouncing a bit so it's hard to tell exactly how each dose is working. I'm inclined to say skip and see what he does. I'd love to get an opinion from @Kris & Teasel, @Rachel or @Djamila who have more experience with ProZinc than I do. Let's see if anyone else is around. Max I would try if giving a dose would be 0.25 but I fear even that might drop him too much.

    .
     
  27. Rachel

    Rachel Well-Known Member

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    Give me one second! Checking SS now
     
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  28. Rachel

    Rachel Well-Known Member

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    Also, have you fed yet? If not, can you grab another test real quick?
     
  29. Bear & Lora

    Bear & Lora Well-Known Member

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    You can stalk Bear and I anytime. If we skip I would want to know what his BG is doing every few hours.
     
  30. Bear & Lora

    Bear & Lora Well-Known Member

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    Just a few freeze dried ckn breast treats. I labeled the corresponding food consumption with the times and testing in my remarks. He last ate at 2 AM -1 oz of wet.
     
  31. Rachel

    Rachel Well-Known Member

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    Okay, yeah I think I'd skip. You and Bear are still so new to this and he had no shot last night but is STILL at such a low number this morning. I think it's just a bit too soon to start dosing at such a low number.
     
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  32. Bear & Lora

    Bear & Lora Well-Known Member

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    Alright, this should be very interesting. :)
     
  33. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    What I would do is feed Bear then test him again about 3 hours later. If his BG is similar or lower, we'll know his pancreas is working. If he's up a good bit, then it's likely he still needs a little insulin support. I'm betting that his BG will be similar or down. Let's see if my gambling instincts are working! ;)
     
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  34. Rachel

    Rachel Well-Known Member

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    Yep, I agree with Linda. And tonight at PMPS time, we'll see where he's at. If data from today shows we were wrong, then we'll know that for next time and we can adjust accordingly. :)
     
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  35. Bear & Lora

    Bear & Lora Well-Known Member

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    @MrWorfMen's Mom @Rachel

    +3 = 271 BG Would you guys consider this middle ground? Some Insulin support or we don't have enough info and we need wait and see what his PMPS BG is?
     
  36. Bear & Lora

    Bear & Lora Well-Known Member

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    @MrWorfMen's Mom @Rachel
    So looking at yesterday's reading and yesterday's +3 is the exact situation as far as food consumption but with 2 Units yesterday. Yesterday he also hadn't had food for 3 hours since his AMPS. So we are looking at a 96 point variance with 2 Units of insulin.
     
  37. Bear & Lora

    Bear & Lora Well-Known Member

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    @MrWorfMen's Mom @Rachel

    Well today can not really be a full duplicate, the time of day is different (different biorhythms), plus different stressers (his back feet seem to be bothering him more today), and water consumption (who knows).
     
  38. Rachel

    Rachel Well-Known Member

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    Well the yellow tells me you probably still need some insulin support. That's fairly common and is honestly what I expected. Even if the pancreas IS working, it rarely (if ever) starts working all at once. It sputters on and off for a bit before really kicking in. The 122 you had this morning was nice, but it was at the top end of what we consider normal for a kitty not on insulin here. Usually they have lower numbers.

    So tonight, let's see what his BG is. You'll probably want to give insulin, even if it is just a small amount, to give him some support and help keep that BG down. :)
     
  39. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    AWWW Bear is not quite there yet. DANG!:( It was a long shot but his reactions so far are still very encouraging.

    It would be nice if it were that simple but its not. If you look at Bear's numbers each day, he has definitely been bouncing from some dramatic drops and that really muddies the picture. The trick is to find a dose that doesn't set off the dramatic drops so Bear eases into being in good numbers again and doesn't set off his system's "low sugar" panic button. You have to nudge them down into normal numbers. I think it's clear that 3 units is definitely too much and 2 units is still causing a lot of bouncing and that the ProZinc is lasting well through the cycle for Bear and perhaps causing a tiny bit of overlap.

    After the extended cycle yesterday and no shot this AM, his system should be leveling out to it's more normal current state. Right now I'm thinking something between 0.5 and 1 unit might be a good place to start tonight but let's see what his pre shot is. You never know.....he could surprise us all again.:cat:
     
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  40. Bear & Lora

    Bear & Lora Well-Known Member

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    @Rachel @MrWorfMen's Mom

    So we were at my brother's wedding. My husband Jeff came home to test Bear. There was a misunderstanding I asked him to post to you and he misunderstood and kept checking for you guys to post to him. Opps! So when I got home I asked what you guys thought. He said no one sent a message. Lol. So he went by the last post of Linda's and gave 0.5. Jeff said Bear's won't hardly eat. He ate 10 Chicken treats and barely any wet. So his PMPS and his +1 BG are on his SS. What do you guys think? Sorry for the misunderstanding. Jeff thought you both must be in bed.
     
  41. Bear & Lora

    Bear & Lora Well-Known Member

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    @Rachel @MrWorfMen's Mom

    By the way ladies I know my best guess doesn't hold a candle to your knowledge and experience. I definitely defer to experience. :} I truly appreciate your help.
     
  42. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I am very happy to see that Bear didn't rise much higher through the cycle. I think the 0.5u was a good call. He'll likely go through this cycle with a little less drama.

    I know Bear is not happy with testing but with his shenanigans the last few cycles, I'd be inclined to test him again around +3 before giving him a snack (you dont need any sleep do you?:blackeye:) just to be sure he isn't dropping too quickly. Has he eaten anything other than the treats between the shot and now? If not, then I'd try to get him to eat something to try to keep him from dropping too much/too fast.

    Too funny about the communication mix up. I checked in a couple of times and then I DID crash on the sofa. I'll be up for a short bit yet. Will check back in before I head to LALALA land. :)
     
  43. Bear & Lora

    Bear & Lora Well-Known Member

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    Since I hadn't heard from you within the hour of my first post I thought you did go to bed. I went by your earlier advice and had Jeff test at +2 and Uhhh Bear is at 335. I guess I will be confused alot by Bear's BG. I fed Bear after that +2 testing because I felt sorry for him and Jeff's worry transferred very well to me. I also feed him before I go to bed and thought I would go to bed soon, lol. So tell me what do you suggest. Bear just ate a whole ounce of wet.
     
  44. Bear & Lora

    Bear & Lora Well-Known Member

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    This neuropathy issue that Bear possibly has. You had said it is common in Feline Diabetes. The last two days Bear doesn't want to walk far, I would say as little as possible. I know Bear is bouncing all over with his BG, if it is neuropathy can he or would he get worse?
     
  45. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Ok so as confusing as it seems, the preshot 291 and the +1 278 are virtually the same reading. If Bear is now up to 335 and you've just fed him, he'll probably be fine for the night. Now that said, he's being a tricky soul so I would leave a bit more food out for him overnight. If you do happen to get up middle of the night, grab a test but otherwise I think he'll be just fine.
     
  46. Bear & Lora

    Bear & Lora Well-Known Member

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    I
    Ok, that sounds like a good deal for me. You know Bear's dosing schedule has been somewhat chaotic and I really want to keep it on track, so getting some sleep would be great for me. No need to answer my other question tonight. Let's get some sleep. :)
     
  47. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    As far as the neuropathy is concerned, is he walking on his hocks or just seemingly week in the back legs? Cats recover from the neuropathy as their BG gets regulated and some folks give them a supplement called Zobaline (you can order it online) to help as well. Some of what you are seeing is possibly just Bear feeling off with all the ups and downs of his BG lately. Some cats tend to get a bit lethargic when they are bouncing around like Bear has been.

    I would suggest just to be on the safe side particularly given he wasn't eating tonight that you get some Ketone testing strips (they can be dipped in urine) and check him for ketones just to be keep an eye on him. The other thing you can pick up is U100 syringes which can be used with a conversion chart (I think Kris mentioned this before) to give more precise and partial unit doses.

    Don't think I'll be around for tomorrow morning's shot (going to a train show) but Kris, Rachel and Djamilla likely will be, so post for help. If you don't get a response in ProZinc forum in a reasonable timeframe, you can always post in Health as it gets more traffic and there might be someone there to help you out. I would stick to the recommendation of no shot if he is under 200 unless you have someone monitoring with you at this point in time.

    Signing off. Sweet dreams.
     
  48. Djamila

    Djamila Well-Known Member

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    Hi Lora. I was just reading through your thread here and shaking my head a bit. What a couple of days you've had! I'd like to summarize/infer a bit and make sure I'm understanding all of this. It sounds like...

    1. Bear has just recently been taken off of all kibble - like in the past week? Is he still getting any at all? Or is he all on low carb food and freeze dried treats now? No judgement either way - it just helps us decide on the best dosing advice.
    2. He has been on insulin since 8/16, and you started home testing on 9/24 using a human meter?
    3. The 3u dose was determined by the vet and was changed based on the PMPS on 9/27?

    Can you let me know if I've got that right? I'd love to help you get your Bear stabilized a bit and want to make sure I'm understanding where things are before moving forward.
     
  49. Bear & Lora

    Bear & Lora Well-Known Member

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    Thank you for responding. I know both of us could use some help. Yes you have everything correct except, Bear's dosage was increased to 3 Units August, 28th. I will tag you on the other Threads on the Health Forum.

    I think Bear and I have been on a rollercoaster since he was transitioned. He has not had any high calorie Kibble since 9-26-18 and it was only 5 pieces to get his calories up.
     
  50. Bear & Lora

    Bear & Lora Well-Known Member

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    August 26th, 2018 is when he went to 3 Units twice daily. My coffee hasn't kicked in well enough, lol.
     
  51. Bear & Lora

    Bear & Lora Well-Known Member

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    @Djamila

    Bear AMPS is 433 BG. Well we are rising to the top again. :(
     
  52. Djamila

    Djamila Well-Known Member

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    I'm not convinced that 3u was really too much. Sometimes there's just a weird cycle like that low PS (although I haven't read the earlier posts on Main, so maybe it is :)). However, since the data is new, and he hasn't been a diabetic for very long, and everything has been so inconsistent and wonky the past few days, here is what I propose: We just hit reset and start over.

    What are your weeks like? Are you away from the house for work? Are you mostly at home? Depending on how much you're around and can monitor will determine the plan going forward.
     
  53. Djamila

    Djamila Well-Known Member

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    I'm thinking for today, you give 1u. Both this morning and tonight. Then assuming the data is high, we start the increases. Nice and slow and methodical until we get to something that gives better numbers.
     
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  54. Rachel

    Rachel Well-Known Member

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    I agree with Djamila. We've basically spent the last several cycles reacting instead of trying to proactively figure out how to get Bear into good, steady numbers. I hate to see him jumping up and down like he has been. I think it's time to try to get him where he needs to be following a methodical approach. This is partly my fault because I've been just reacting with Bear and haven't taken the time to really sit down and figure out where to go from here in the future.

    What do you think of Djamila's suggestion? I like it a lot. It will allow you to move Bear up instead of guessing how far to decrease him if he hits a weird PS. It will also give you really good data at different doses so that if you DO get a weird PS at some point, we'll have a better idea of what to do for it.
     
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  55. Bear & Lora

    Bear & Lora Well-Known Member

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    I am my Mother's caregiver, she has Cardiovascular Severe Dementia, which means majority of the time I am home she can't be left unattended. My schedule is ridiculous and at times very upside down. My mother has taken a turn for the worst as she is fighting a antibiotic bacteria which is in her wounds on her leg. In the next few weeks we are looking at many tests, and different specialists, possibly hospitalization with IV Antibiotics.

    My husband can help on weekends and evenings but he can't stay up late, after 10PM.
     
  56. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Lora, I'm here too (got up with a cold so skipping my planned outing:blackeye:). Well he is certainly giving us a range of readings. I have to wonder if he came back down last night at some point given he didn't soar to the red range after two missed shots in a row. I'm still convinced 3 units was too much but it's possible 0.5 isn't enough.

    I see Djamila has suggested 1u and Rachel agrees. So do I. We have been reacting (but then again, I'm not sure Bear gave us much choice given the drops he was dishing out! :banghead:
     
  57. Bear & Lora

    Bear & Lora Well-Known Member

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    I like it. Going to dose now. Be right back.
     
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  58. Djamila

    Djamila Well-Known Member

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    @Rachel, not your fault at all! I absolutely think you did the right thing considering what you were seeing. The NS's were right since there isn't much data. Sometimes a kitty has to have a few days like that before we see enough to get a sense of next steps. And my hunch is that Bear is going to be a bit of a bouncer which will make this one heavier on the "art" side of the dosing.
     
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  59. Djamila

    Djamila Well-Known Member

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    Linda, I understand how it looks like that, and in the end, he hopefully won't get back up to 3u since he's off kibble now, but it's important to remember that Prozinc doesn't behave quite like the insulins you're used to. It does give weird cycles on occasion and it's important not to react to each cycle as it's own thing, but to consider them within the larger patterns.

    All the way through section A, 3u wasn't too much. upload_2018-9-30_7-29-30.png

    Then 24 hours after his last kibble, we see a weird cycle. Now that could have been a wonky test strip since he was almost 300 just a few hours before, and two hours later he was nearly to 400. Or it could have been a legit number based on the body recalibrating to the reduction in carbs, or it could have been simply an anomoly. Either way, it's set off some days of randomness that we need to correct now. Prozinc doesn't do well with inconsistent dosing, so we need to get back on track and try to get this poor little Bear stabilized so he isn't bouncing hither and yon like this.
     
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  60. Bear & Lora

    Bear & Lora Well-Known Member

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    Sep 24, 2018
    His appetite sucks. Wet is a no go. So I gave him Chicken Treats with testing and more for his insulin- 11 total = around 33 calories.
     
  61. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Lora, is that normal for Bear? Does he usually eat his wet food well? And when you say you gave chicken treats...do you mean he just got some treats for breakfast and isn't eating anything else?
     
  62. Bear & Lora

    Bear & Lora Well-Known Member

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    Sep 24, 2018
    He definitely feels like yuck. As I was petting trying to stimulate his appetite he moved away with small tail swishes.
     
  63. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Do you have ketone test strips at home? If not, can you go to the pharmacy and pick some up? They are about $15 and you test by sticking a test strip in some urine as he pees (we can share some tricks on how to do that).
     
  64. Bear & Lora

    Bear & Lora Well-Known Member

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    Sep 24, 2018
    He has been eating wet well but somedays not and that is why I resorted to Kibble on the 26th and am logging/weighing all his food before and after he eats.
     
  65. Bear & Lora

    Bear & Lora Well-Known Member

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    Sep 24, 2018
    Yes Linda also said this. I will get some today.
     
  66. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Here are a few things that sometimes help a kitty that isn't loving the wet food:

    https://www.chewy.com/purina-pro-plan-veterinary-diets/dp/49853 This is sold as a probiotic, but it's relatively useless in that regard. However it's an amazing flavor enhancer that many cats go crazy over. You sprinkle just a little from a packet on top of the food and they'll gobble it up. So one packet can last like a week.

    https://www.amazon.com/Kaneso-Tokuy...pID=51XK5uUQxWL&preST=_SY300_QL70_&dpSrc=srch Bonito flakes. You can buy this is pet-specific packaging for three times as much. Or you can buy this. :)

    Grocery store options: Cheap dried parmesan cheese - you know, the stuff in the green canister (or whatever brand you have at your store). Nutritional yeast or brewer's yeast. That is different than bread yeast, so make sure you get the right kind. It' soften sold in the bulk food section which is nice because you can buy just a little until you know if your cat likes it. Mine go nuts for the nutritional yeast. Tuna water. Find tuna that is packed in water and pour a little of the water on top. Be careful though because this can also adding a lot of extra sodium, so I wouldn't use this more than rare occasions.

    And I would still encourage you to test for ketones while his numbers are this high.
     
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  67. Bear & Lora

    Bear & Lora Well-Known Member

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    Sep 24, 2018
    I am also weighing him but am not too sure on the accuracy of my scale. A baby scale will be here Tues. His weight is fluctuating quite a bit. Yesterday it was 16.4, .4 is tenths. a few days before 15.6
     
  68. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    Yes, I'd encourage a ketone test as soon as you can manage it today. You want to stay on top of things just in case, as ketones are much easier to treat if caught early.
     
  69. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    How to test for ketones:

    You need to put the strip into fresh urine, and then carefully time it and compare it to the color key in good light. The timing is important as the strip will continue to darken. Dark is bad. So you want to look at it right at 15 seconds or 30 seconds or whatever your brand says for the most accurate results. The good light is important because the shades of color aren't super dramatic so you need to be able to see it well.

    To catch urine: If you have a cat with no modesty like mine, you just go in and stick the strip behind him while he pees. Sam actually lifts his butt for me to make it easier. If your cat is more modest, but will still let you in the room, some people use a long handled spoon to catch the pee. Then they just label that spoon as the cat pee spoon and don't use it in the kitchen anymore o_O. If your cat is sneaky about their habits, you can take some plastic wrap and wrinkle it up and stick it in his favorite corners of he litter box. Then a little pee gets caught in the wrinkles and you can test from there. You still need to be vigilant in noticing he's using the litter box though to try to catch him before he covers the whole thing in litter.
     
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  70. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    @Djamilla I realize ProZinc doesn't work like the insulins I used with my girl but I have used it in the past albeit briefly. You, Rachel and Kris definitely know the nuances of ProZinc far better than I do :). I can see your rationale about the 3 units and admit I interpreted his numbers a little differently and probably did so with other insulin "glasses" on to some degree. We all agree that the bouncing is a problem and really muddying the picture and that we need to find a more consistent dose for Bear. I for one am glad I can learn more from all of you.

    Given Bear is not eating well right now (he was fussy yesterday too if memory serves), I wonder whether he is just being stubborn or if he has something else going on that is contributing to the rollercoaster numbers. Definitely think testing for ketones would be a good idea.
     
  71. Bear & Lora

    Bear & Lora Well-Known Member

    Joined:
    Sep 24, 2018
    @MrWorfMen's Mom

    No need to guess Linda, my Obsessive Compulsive Disorder (OCD) is a positive skill set in this situation. I have put every ounce of food on Bear's SS in remarks.
     
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  72. Bear & Lora

    Bear & Lora Well-Known Member

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    Sep 24, 2018
    @MrWorfMen's Mom The only thing I haven't been specific about is how many chicken treats he is eating, since they are only about 2 calories for a full size dog portion.
     
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  73. Bear & Lora

    Bear & Lora Well-Known Member

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    Sep 24, 2018
    3 calories=full size dog treat
     
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  74. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    :rolleyes:Yeah but I am in a brain fog right now and forgot to go look. Apparently need more :coffee::coffee::coffee::coffee:. :woot:

    Love your detailed accounting of Bear's intake. Just a thought and for my pea brain....when you are documenting food it would help to indicate PS (pre-shot) or +1, +2 etc instead of actual times. We are in different time zones so using the same "details" as the readings would make it easier for us all to put the full picture together at any given time. :)
     
  75. Bear & Lora

    Bear & Lora Well-Known Member

    Joined:
    Sep 24, 2018
    I will make sure to have those +'s. A lot of the times I am not feeding Bear right after testings so I can only put the time I fed but I will add more details.

    So at this point in our time spent corresponding I know you don't have a pea brain, lol.

    Depending on stress levels my brain jumps off the train track multiple times sometimes in a very short period of time. Sorry about your cold and missing your train show. :)
     
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  76. Bear & Lora

    Bear & Lora Well-Known Member

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    Sep 24, 2018
    @Rachel @Djamila @MrWorfMen's Mom
    Ok, we have Ketone Strips and are set up for testing.

    I don't know if you read the Thread Unstable Diabetic Cat, but I'm wondering if that Blood Panel at the Vet's tested Ketones specifically? I remember the Vet going over Kidney function and Liver and that he said everything on the Blood Panel was all good except Blood Glucose.

    I guess I need to request copies of Bear's medical records from the Vets.
     
    Last edited: Sep 30, 2018
    Reason for edit: Should have made an additional note
  77. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Ketones would not be part of a regular blood panel. Some vets might test for them once a diagnosis of diabetes was assumed but I think that would be rare unless the cat was seriously dehydrated, not eating and very lethargic along with a high BG at the diagnostic visit. If the vet didn't mention ketones as something to watch for, they likely didn't check it.

    Good luck with the ketone testing. If the strips should prove to be a problem with Bear, there are meters you can get to test ketones in the blood. The strips for them are more expensive but it can be easier with a shy/litter fussy cat.
     
  78. Bear & Lora

    Bear & Lora Well-Known Member

    Joined:
    Sep 24, 2018
    Bear is an 80, which is considered large. One below the highest. So nurse Linda what is the protocol for this?
     
  79. Bear & Lora

    Bear & Lora Well-Known Member

    Joined:
    Sep 24, 2018
    @MrWorfMen's Mom @Rachel @Djamila

    HELP! Bear's ketones are 80. In the large on the graph for Relion Ketone Test Strips. This is one below the highest which was 160. Just tested Bear's BG it is at 288.
     
  80. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Lora, are the strips ketone only or glucose & Ketones? I have never heard of ketones strips giving you a number. The ones I am familiar with are a colour graph and you have to read the strip within so many seconds and compare its to the colours on the strip vial. Anything over a trace is considered reason for a vet consultation.
     
  81. Bear & Lora

    Bear & Lora Well-Known Member

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    Sep 24, 2018
    Just Ketones and the graph has colors to compare in 15 seconds.
     
  82. Bear & Lora

    Bear & Lora Well-Known Member

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    Sep 24, 2018
    Bear's color is one color block away from the highest. His color has an 80 and shows large. The highest is also in Large and has a 160.
     
  83. Bear & Lora

    Bear & Lora Well-Known Member

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    Sep 24, 2018
    So this constitutes emergency Vet?
     
  84. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    OK I just looked up the strips. Now I understand. Sorry Canadian here!

    I think you need to contact your vet or take Bear to the nearest ER. High ketones can turn into ketoacidiosis which is not only very dangerous but also very expensive to treat.
     
  85. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Definitely not something to mess around with. If your vet is not open today, ER is the best option. They will probably put him on IV to flush his system of ketones and give him some medication to help his appetite along with regulating his BG. :(
     
  86. Bear & Lora

    Bear & Lora Well-Known Member

    Joined:
    Sep 24, 2018
    I have called his vet and left message on emergency line. It said if no one calls in 15 minutes to contact 2 other optional places.
     
  87. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Lora, I would call the optional places unless your vet is open today or you know they will come in to deal with an emergency case. I don't want to panic you, but the sooner you get Bear to the vet, the better. It's likely they will keep him overnight or even a few days to get him stabilized.
     
  88. Bear & Lora

    Bear & Lora Well-Known Member

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    Sep 24, 2018
    On our way. TTYL.
     
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  89. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Oh no! I'm so sorry Lora. I was away this afternoon. I see you're on the way to the ER...please check in tonight when you can and let us know how things are.
     
  90. Crista & Ming

    Crista & Ming Well-Known Member

    Joined:
    Jun 10, 2018
    I'm sorry, Lora. Thinking of you and Bear and wishing you both luck at the ER :bighug:
     
  91. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Oh Lora! Sending you and Bear so much love. We have a funny expression we use around here - we say we're sending "healing vines". It's kind of like prayers or good energy, or positive vibes, or whatever you believe in. Please know that there are tons and tons of healing vines heading your way. And please keep us posted as soon as you know something. We all worry about every cat on here as if it is our own.
     
  92. Bear & Lora

    Bear & Lora Well-Known Member

    Joined:
    Sep 24, 2018
    @MrWorfMen's Mom @Rachel @Djamila @Crista & Ming @Kris & Teasel

    Great News! Bear is home after getting subcutaneous fluids, (IV fluids under the skin). He is not out of the woods yet, by far. I met a great DVM who is well educated on high protein, low carb diet for felines. She was side line working at this clinic this weekend but has her own practice also.

    I told her I was home monitoring and she asked if Bear's BG had been really high. I told her no, and after a series of other questions I told her about Dr Pierson's article and how it led me to this group. I had asked her earlier if she wanted to see Bear's SS and she didn't seem too interested. After she had asked multiple questions and we talked about the success rate of high protein, low carb diet I could see her interest was peaked so I gave her my phone with Bear's SS on it.

    She said, 'Wow, you are serious!" She took some time and looked at his figures. She told me the SS gave her the evidence to back up what I had said about his BG. I told her and pointed out what Djamilia had said about Bear's recent bounces as a possible occurrence and the upper readings being more the norm. She nodded her head as in agreement and looked at me in amazement and said so the group is overseen by Drs. I said no just people with a lot of experience and knowledge.

    i talked about how another person thought Bear's pancreas is possibly sputtering on and off during these bounces and about skipping a dose when Bear was so off schedule so there wouldn't be an overlap, plus the multiple advice to test Bear's ketones. I can tell you the info and things you guys have talked about with me impressed this Dr a lot.

    She said she thinks when Bear had his 517 BG was when his liver dumped the ketones and she pointed to my remarks and said here were he was vomiting also leads me to that.

    His blood panel and urine test again was good except (urine-Ketones), and his BG went up to 423 which she associated to stress at the clinic. His white blood count was slightly elevated but she said it wasn't due to infection but I think she said to the ketones maybe?

    She gave me options and explained what they entailed, including overnight stay with IV fluids and regulating insulin or subcutaneous fluids and go home with a follow up with his regular Vet and if I felt comfortable with giving Bear the fluids myself I could ask explain to my Vet that I had been shown how to do that there at the clinic and if he said no I could always (and she smoothed out her scrub so I could see her name) find this Dr and where she works at during the day.

    I asked her, "How dire is it with ketone levels like Bear's because I had heard even a trace amount was an emergency?" She replied she had seen a cat with much lower levels die within a few hours but usually patients with high ketone levels have and have had for a while unmonitored testing and extremely high BG numbers.

    So a tech showed me how to administer fluids and I will be going to get an IV bag from an amazing Dr. tomorrow!!!

    YOU GUYS ARE AMAZING AND IF BEAR MAKES IT, IT IS DUE TO YOU!

    ((Now I need some advice Bear's PMPS is 328, are we looking at a repeat of 1 Unit?)))) :) XOXO
     
  93. Crista & Ming

    Crista & Ming Well-Known Member

    Joined:
    Jun 10, 2018
    YAY!!!! I'm so glad Bear is okay and you spoke to a nice doctor :) I'll leave the real work to the experienced on the forum. I'm just here to say I'm so happy to hear the good news!
     
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  94. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Oh Lora I am so very very relieved. :)I have been kicking myself all evening for not mentioning the ketone testing sooner. Glad you found a vet that was willing to listen and appreciate the hard work you've invested in his wellbeing. Some don't and actually tell people to stop testing so much!:banghead::arghh:

    Anyway, I think it's important to get some insulin into Bear but I need to think about this for a minute and have a few questions. I don't see anyone else on right now. You've had a heck of a day/night and I'm sure you are in need of sleep.

    Has Bear eaten since you got home? Will he eat something even if you have to give him his beloved kibble? Whether he will eat or not and your need for rest have to be considered here.
     
  95. Bear & Lora

    Bear & Lora Well-Known Member

    Joined:
    Sep 24, 2018
    We just feed him 1 tuna. He had Chicken Treats with his testing of course.
     
  96. Bear & Lora

    Bear & Lora Well-Known Member

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    Sep 24, 2018
    Sorry 1 ounce which is about a half a can.
     
  97. Bear & Lora

    Bear & Lora Well-Known Member

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    Sep 24, 2018
    I am doing pretty good. I do believe things happen for a reason. I'm not sure of your belief but I believe God really had a hand in this. :) I still have adrenaline and I don't feel tired yet.
     
  98. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Oh that adrenal rush will drift off and you will suddenly be drained no doubt.

    If that's Fancy Feast cans they are 3.3 oz. If it's Friskies, aren't the cans more like 5oz? I was just looking to see how much he had been eating and for his weight, it doesn't sound like he's eating enough and that may be contributing to the issue.

    I'd be inclined to give him 1 unit with testing at +3 along with a snack and another test sometime in the middle of the night (say +6 or +7) and again leave food out for him....something you know he will eat. That would keep your dosing consistent from this morning.
     
  99. Bear & Lora

    Bear & Lora Well-Known Member

    Joined:
    Sep 24, 2018
    Good grief, 1 ounce is 1/4 a can. I guess my brain is showing that I'm tired.
     
  100. Bear & Lora

    Bear & Lora Well-Known Member

    Joined:
    Sep 24, 2018
    Friskies 5 ounces. So 1 Unit now, at +3 testing and snack, then test at +6 or+7 and leave some food out. The Dr was impressed by his BG numbers with Bear being recently food transitioned.
     

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