I posted this on the main page but got no replies. I’m hoping someone can help me before tonight’s dose. On May 18 Lenny went to the vet and was diagnosed with hyperthyroidism (early case). My vet said until his thyroid is under control he’d probably need more insulin. He used to get 1-1/4 to 1.5 (prozinc) but I increased it to 1.75. His thyroid is now in the normal range but I’m getting high preshot numbers. Do you think I should be giving more insulin or decreasing the dose? I noticed he’s having a fairly large drop 2 hours past his evening dose. Also, how soon after eating should the insulin be given? I usually give it 10 minutes later. Thank you.
Bouncy kitty! His nadirs on non-bounce cycles are ok, so I would stick with this higher dose. That is the nature of ProZinc in some cats, drops them pretty hard. The way you currently feed and shoot is fine. You can try waiting a little longer before shooting to see if it helps the drop, or you could try a small snack around +1.5/2
So now that Melissa has said this about ProZinc, I will tell you what I thought about when I looked at your spreadsheet. Have you ever considered switching insulin to one of the depot insulins like Lantus (and the similar versions) or Levemir? It looks like ProZinc is not the best insulin for your kitty. A depot insulin would probably smooth things out quite a bit. I see he’s been on ProZinc for a long time. I’m glad you have his thyroid levels down to normal. That’s great news!
I’m not sure I know what a depot insulin is. What makes it different from Prozinc? If I switch insulin and it wouldn’t work, can I always go back to prozinc?
How are you determining when to change dose? Is it guidance from the vet? He isn't doing too horribly on ProZinc, I suspect it's more an issue of not the right dose/doses being held too long. But I will never argue against depot insulins! I wish everyone started straight on Lantus/its generics. Depot insulins are where a small amount of insulin gets stored under the skin...in a nutshell it allows for much flatter cycles compared to ProZinc, which allows you to increase the dose more safely and get them better regulated. Yes you can always switch back. You would need a new script from your vet and 0.3cc U100 syringes with half unit markings. If you are in the US you can actually get the Lantus generics (semglee and "insulin glargine") for about the same or even cheaper than ProZinc.
When Lenny was diagnosed with hyperthyroidism (1 month ago) his numbers were too high at preshot. She suggested giving a higher dose plus my thinking wad also to give more since the numbers were so high.
Remember that dose is based on nadir for safety reasons - we want the lowest BG of the cycle to be around 90 to start (there is a more aggressive methods that would go down to 68 for your meter but I prefer to start conservative). He's not quite getting there. The only time you adjust insulin based on preshots is if you get a lower than usual preshot (may be wise to do a temporarily reduced dose or skip) OR if over time data shows a sliding scale is better.
I’m planning on switching insulin to Lantus and spoke to my vet about it. I won’t be able to get the script until next week. Is there something I should do in the meantime to help with the high preshots?
