Ineffective insulin

dnelle06

dnelle06

Member
I am at the end of my rope. I am not sure what to do for poor Artie. He was first on vetsulin up to 4.5units and was unmanaged. we switched to Prozinc and are at 3.5units and can’t seem to get a consistent number. Most mornings he’s in the 500 PS AM around 9 am sometimes drops to 380s around 2pm and back up to 480-520 by 4 pm. 580s by PS PM shot.

His curve today has been crazy. He started off way lower than ever. No food past his parking shot. Am PS 366 , 1:30p 342, and now 4:30pm 474. How can his numbers go up already?

Yesterday’s curve was similar only staying down for an hour tops . Should I raise the dose?
 
dnelle06 said:
I could work on putting it into a spreadsheet
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@Bandit's Mom is usually over on the Lantus forum but helps a lot of people put spreadsheets together. She may be able to help or point you to someone else who can. They’re really helpful for us to be able to see exactly what’s going on with your cat and whether it looks like it’s getting too much or not enough insulin etc.

I’m using Lantus now, but I used Vetsulin and then Prozinc at first too so I’d be curious to take a look.
 
Spreadsheet is easiest, but in the meantime any sort of screensots? Like a weekly or monthly view?
 
dnelle06 said:
  • Glucometer using AlphaTrak 2 with human freestyle lite compatible strips
  • What you are feeding: Fancy Feast wet grilled or chunky, supplement with 1/4 cup dry Purina One Healthy Weight/ High Protein
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I am responding to some of the information you sent me via PM for setting up your Signature and SS, here:

Not sure if using human freestyle lite strips with an alphatrak could affect the accuracy of readings? You might want to look at using a human meter. Walmart's ReliOn Premier is only $9 and the strips are $18 for 100 strips.

Also, Fancy Feast Classics, Roasted, Chunky and Flaked are low carb but other variants are too high in carbs (Grilled in Gravy). As is the Purina One dry food. You could see a significant improvement in his numbers if you switch him to low carb food.

You can check carb% of many canned foods here:
https://catinfo.org/chart/index.php
 
Thanks that food carb% page will be very helpful. I can try to human meter. Early on I had one, a different brand, and compared side by side for a few weeks and it was pithing 10pts. I believe the strips for freestyle lite are the same manufacturers as the alphatrak strips, obviously coded differently. However I will give the human meter a try. I will fill in the previous weeks details and get this posted asap.

Any recommendations for a dry food that's low carb - non prescription? I am trying to avoid the prescription as it is quite expensive.
 
Spreadsheet updated for this year... Should I go back further? Sadly I work during the day so couldn't get many curves done.
 
A human meter reads lower than a pet meter but is just as accurate. Most of us use human meters since the strips are much cheaper and we test a lot.

If you can get Artie to eat only low carb wet food, that would be great since wet food provide cats with much needed hydration that dry foods don't. There are a low carb few options in dry food as well - Young Again, Dr. Elsey’s Cleanprotein (chicken flavour) and Wysong Epigen 90 - none are prescription, but are on the expensive side. We've found that even low carb dry food raises the blood sugar in some cats - even though they are low carb.

Looking at the data on your SS - can you get a before bed test at night? Some cats go low at night and stay high in the day. When you get tests only in the day, you are only getting half the picture.
 
dnelle06 said:
Spreadsheet updated for this year... Should I go back further?
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Not required. Was no insulin given in the AM of 1/14 and 1/15?

It's hard to say without tests in the PM cycle, but it looks to me like Artie needs more insulin.
@JanetNJ
@FrostD

Not sure if you have seen our Prozinc / PZI forum and the stickies at the top with a whole lot of information including PROZINC DOSING METHODS.

ETA: If you switch him to a low carb diet, which I recommend you do, you might want to hold the dose while doing that and get enough tests to see how his BG is responding to the removal of carbs from his diet.
 
His Am dose is around 9:30 am and so his PM dose is are 9:30 pm which is usually before bed. I can get some tests post PM dose.
I will remove the dry food from his diet and wait a couple cycles and report back. Thank you all!
His Brother Marvin is not diabetic so I will separate them for feeding.
 
If your schedule permits, you could slowly move the shot times ahead, so you can get a test before bed.

You might want to switch Marvin also to a low carb diet at some point. Not only is it good for him, you also wouldn't need to worry about Artie getting into his food.
 
Got the relion meter- tonight we do low carb only no dry food- the strip reading is very different 606 on the cat meter 526 on the human meter. Even for him that’s so high
 
Those are all the same number when you consider meter variance. Be careful the next few days, it will take a little time for all the carbs to work their way out but hopefully you see BG down considerably
 
Nice to see the Blacks going away and some Blues :cool: and Yellows appearing. It looks like the low carb wet food only diet is doing its thing! Fingers crossed that the trend continues.

I hope you have read the PROZINC DOSING METHODS sticky that Bandit's Mom mentioned. As Artie's numbers come down you need to know how to handle lower than normal pre-shot numbers. I had to "stall" many times and post a message asking for advice on what to do as Spy Kitty's pre-shot numbers came down.
 
Yes!! Thanks so much for checking in! They are dropping. Strangely he hasn’t had anything different than normal and his numbers gave not been consistent. Is he still shedding the carb heavy food he used to have? Abs yes I have read the prozinc dosing for when numbers get lower.
 
dnelle06 said:
Is he still shedding the carb heavy food he used to have?
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My main mentor on this forum gave me this information: "I've seen the full effect of removing all dry take anywhere from a few days to a week or more." Your SS says you stopped all dry food on 01/20 so it has been twelve days now. That does not mean that Artie's numbers will not continue to improve but, I do believe it means that it is now safe to change Artie's dose (up or down) based on his numbers (according to the Prozinc Dosing protocol). I will leave that up to a senior member (@FrostD) to make any recommendations in that regard.

Do you have your Hypo Kit together?
 
Technically yes it is safe to reevaluate the dose know that transition is complete, BUT...I would actually hold this dose for now. The blues and yellows you're getting now lead me to believe he is probably hitting (safe) green and then bouncing.

Is there a day sometime soon you can do a curve?

Also, I would not shoot that full dose unless he's above 200, especially if you can't be around to test. 150-199 I would shoot maybe 1-1.25U, 125-149 either skip or 0.25U, below that skip
 
For my two cents worth, I would encourage you to test as often as your schedule and Artie allow. The more data you have the better others can help guide you in your care of Artie. I did a lot of daytime testing since I was at home, and I was amazed at what a senior member could "deduce" from all that data, and then educate me on what those numbers most likely were saying (nothing is ever 100% certain!).

With Artie starting to get PS numbers that are below 200, it would be helpful if you could test an hour before PS (when possible). That will let you know if Artie's BG is trending up or down before his shot. Very helpful information when you are getting new lows at PS. The more data you have the more "tailored to Artie" the advice you receive will be.
 
Just checked in on Artie's SS. You have now gone over a week without a Black. :bighug: I always celebrate even small milestones!

Can you get some more testing in? Things seems to have dropped off since January. @FrostD noted the most important window of +4 to +6, but if your schedule does not permit that, then testing at any time will provide useful pieces to the puzzle. With more data, you will probably not need to make such big dose reductions when you test in the high blues. And if you are unsure what to shoot, you can stall 20 to 30 minutes (without feeding) and post on the main Feline Health forum with a title like "Help - Stalling". A lot more eyes are on the Felline Health forum compared to the Prozinc Forum, and when you are stalling you need a quick answer. If you have enough data in your SS, a senior member can help you with that decision. And answers almost always depend on whether you are around to test until Artie hits his nadir.
 
Good to see some more testing! @FrostD can you comment on whether dnelle06 should still be going down to 1U for the blue numbers she has been getting? It's like a ping pong game between 3.5 U and 1 or 1.25U.
 
Yes and no lol

What's happening is you're breaking through some glucose toxicity, which is great! I should think all the carbs are gone by now. The downside is it's causing a bit of bouncing, which makes it unpredictable.

What's a little wild is it looks like nadir has shifted. It is quite rare to have a +9 nadir on ProZinc, it's a bit of a bounce break so that is likely part of the explanation.

What we can see now is sometimes the 1/1.25U I recommended works (2/2 for example), and sometimes it doesn't (the other times). When it doesn't work, its because he is bouncing. The bounce combined with lower dose lets the numbers get high. Now, the flip side is there is always a risk he doesn't bounce, like on the 2nd. We don't know how low he went that day, but the two blue preshots tell me it was probably green somewhere, just hopefully not lime (he probably would have bounced immediately from lime). The trouble is right now, we have no way of predicting his bounces. A +10 or +11 won't even help right now.

For now, I'm inclined to hold everything way it is for another 3-4 days then reevaluate. You could try increasing to 3.25U if you'd like, but given all these blues (and im assuming some greens in there) I personally would not unless I could monitor all day...it may also worsen bouncing. You could also try sticking to 1.25U if between 150-199 if you're comfortable, that appears to be a good balance between the risks of bounce vs no bounce. I really would try to get a before bed or middle of the night test especially when you get those blue preshots.

Your signature still says 1/4 cup dry food...is that still being given?
 
Wow this is wonderful. Thanks guys. I need to change the signature. That is not being given anymore. Previously his nadir used to happen around +9 or +11 I assumed it was from the dry food but super frustrating leading me to think it wasn’t working right having such a late onset.. now it’s interesting that without the carbs that’s still super late with nadir. I am also okay riding out the bouncing even though I am not sure why it’s bouncing. If I shoot 1.25 with a blue I will be better about getting a reading in the night. I am able to do some more testing today before I go back to work tomorrow. I’m hoping for a more leveled out day!!
 
I notice your test numbers seem to be a day behind. You just posted an AMPS of 467 for 02/06. Was that for Sunday or for today (Monday) which is 02/07?
 
I am not sure at all when things went wrong. I’ve done it every day.. maybe it’s been wrong since the beginning. Oops
 
Last week, I started my 12-year-old cat on insulin. Every 12 hours, she was recommended 3 units of ProZinc insulin (using U-40 syringes). I also changed her meals to two cans of Purina Pro Plus - dietetic management each day (though she's only eating about 1.25-1.5 cans - she's still getting used to mealtime vs. grazing). This weekend, I started checking her levels as well. Can anyone shed some light on the findings? I'm guessing her dosage needs to be reduced, but could she be in remission soon?
 
Mark E. Burgess said:
Last week, I started my 12-year-old cat on insulin. Every 12 hours, she was recommended 3 units of ProZinc insulin (using U-40 syringes). I also changed her meals to two cans of Purina Pro Plus - dietetic management each day (though she's only eating about 1.25-1.5 cans - she's still getting used to mealtime vs. grazing). This weekend, I started checking her levels as well. Can anyone shed some light on the findings? I'm guessing her dosage needs to be reduced, but could she be in remission soon?
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We're more than happy to help, could you start your own thread please? We'd need to see any data you have
 
Still following Artie's SS. I see you got a AMPS of 217 so were able to shoot a full dose of 3.5U. It would be soooo helpful to get as many tests today as possible.
 
Hi. I tried my best with working a full day away from home. Tried to pop in and out whenever I could get away. It seems that he never went even close to his preshot numbers and nadir again way late in the day.
 
Good job with the testing today! And what wonderful numbers Artie! I think there is a lot to be learned from your numbers today. @FrostD what do you think?
 
Hmm. I rather think she's bouncing from low numbers, these random oddly low preshots are a bit of a clue. It's late now but can you get a +4/+5 tonight?
 
dnelle06 said:
Hi. I tried my best with working a full day away from home. Tried to pop in and out whenever I could get away. It seems that he never went even close to his preshot numbers and nadir again way late in the day.
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It's interesting, I suspect the flat yellow was fighting off a bounce which is great, it's progress
 
FrostD said:
It's interesting, I suspect the flat yellow was fighting off a bounce which is great, it's progress
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Unfortunately I think a bounce is in the future . 134 amPs :( I didn’t see this request for a nighttime shot or I would have set my alarm, sorry about that.

should I try .25 shot or skip? I didn’t have time before work for a long stall sadly. I wish I worked from home for Arties sake.
 
So that 134 means he definitely saw green overnight, question is how low. I would proactively reduce to 3.25U as new dose.

Today, if you haven't already shot - 0.25U or skip. If you won't be home, I'm leaning skip.
 
Thanks for your support in all ways. He’s got a bit of a mystery case for the doctors. I hope they figure it out soon. Also 8 weeks pregnant, so yes. There’s a lot on my plate :) . Artie has been consistent. However I had to shoot an hour late this evening and he’s low instead of high. Any ideas why? I realize you have very little data to examine. I will try to get a couple overnight tests.
 
Unusual preshots on ProZinc (in an otherwise consistent cat) are a clue he's probably dropping lower when you're not testing. Not a criticism right now! Just explaining my logic. So those 2 pinks were a clue he probably went lower overnight, and now especially combined with the 175. I see a 1 in the column, if that's what you shot I think that was good idea (I probably would have done half dose, but it's really up to you, your comfort, ability to monitor, etc).

I would reduce next shot to 3U to be safe. Possibly 2.75U if you really can't be around, because it's possible he's going well below 90.

Congrats! Diabetic cat + pregnant and/or with newborn is a lot, I've been there (my kids are 2 years old, and just turned 1 last week). Especially first trimester, so exhausted. Is this your first?
 
FrostD said:
Unusual preshots on ProZinc (in an otherwise consistent cat) are a clue he's probably dropping lower when you're not testing. Not a criticism right now! Just explaining my logic. So those 2 pinks were a clue he probably went lower overnight, and now especially combined with the 175. I see a 1 in the column, if that's what you shot I think that was good idea (I probably would have done half dose, but it's really up to you, your comfort, ability to monitor, etc).

I would reduce next shot to 3U to be safe. Possibly 2.75U if you really can't be around, because it's possible he's going well below 90.

Congrats! Diabetic cat + pregnant and/or with newborn is a lot, I've been there (my kids are 2 years old, and just turned 1 last week). Especially first trimester, so exhausted. Is this your first?[/QUOTE

thanks I’ll try the lower dose since I won’t be around a ton.
Aww so seeet! Those are hard ages to have at the same time! Yes it’s my first.
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