hi guys. I know I am probably trying to make sense of something that doesn’t but... numbers have been flat .. the same flat on 1.1U-1.2 -1.3 -1.4 etc... with the exception of 4/8. I am now up to 1.6 sadly and thought today would be a good day as +4 was 175 -however +6 is 375!!! Anyone? Lol. That’s a huge jump in 2 hrs. A bounce from 175? Could that be?????
I really want to hope the 375 was a bad reading, but it's entirely possible that's what it is. I don't know that there is anything to make sense of - she's just decided she needs more insulin again, so doing the quick 0.1u increases is a good way to go. Now as for why she needs the increases again: the three most likely scenarios are pancreatitis, a dental issue, or a squirrel. Do you ever notice her losing her appetite and acting a little off? In cats with severe pancreatitis, they'll completely stop eating and get into serious trouble, but it's also possible to have a milder version that is harder to detect, but you can see it in the up and down dosing needs. There's really not much to be done for it if that were the case, but thought I'd toss it out there as a possibility. Dental issues can cause a rise in numbers too, so if a vet hasn't given a good careful look at her teeth recently, you might have them do so at the next visit, or do so yourself and see if you notice anything that looks irritated. Most of a cat's tooth problems are under the gum and need an x-ray, but there will usually be some sort of gum redness/irritation that hints at it. And the third most likely scenario is what Rachel calls, "Look! A Squirrel!" syndrome. Meaning it's just one of those things, and while it of course has some physiological cause, we probably won't know what it is, and won't be able to do anything about it anyway. It could be stress, arthritis, dehydration, bad sleep, an upset stomach...a zillion different things. Or it can just be that the diabetes is progressing. Also keep in mind that not that long ago she was at 2u and still wasn't actually regulated. She had some good cycles and some bad cycles, but 2u was a pretty normal range for her just a couple of weeks ago. It could be she's just heading back into that range again. So all that to say: it could be anything, and for now you just have to treat the numbers and keep an eye on her (as you always do!). If some other symptom pops up you can pursue it, but otherwise just keep doing what you're doing, and raise the dose until she gives you a reason to slow down or reduce again.
Yeah... that.. she seems normal as in no appetite change or behavior change so for now I guess it is what it is and I guess I’ll go with squirrel syndrome unless something else pokes its ugly head up. How would I know if it is in fact pancreatitis? Ketones have been negative ...
Pancreatitis is diagnosed with two rather inaccurate blood tests: the snap-fPL and the spec-fPL. The Snap is faster and cheaper -- and less accurate. The spec is more accurate, but still not great. Ultra sounds can sometimes help. The only definitive diagnosis is biopsy, and there is no way it's worth putting a cat through that for a disease that has no cure anyway. The Spec-fPL is the best bet. If it's positive, then you can trust the result. The problem is that it gives a lot of false negatives - saying that the cat doesn't have pancreatitis even when they really do. Honestly if Little is eating and not seeming off, I wouldn't worry about it. Squirrel syndrome seems like the most likely scenario here to me too. And good job keeping up on the ketone tests. They are so important to our sugar cats!
Thank you @Djamila Going In PMPs in a few. clinically all is good eating, playing,cuddling and trouble making all as per usual.
Ok Baffled and frustrated. Little has been flat for a month no matter what the dose from 1U back up to 2U. Looking at mid February and mid March numbers the fat 2 sent her hypo so not sure what to do at this point. It seems she does sometimes take a few more cycles than usual to adjust but this is crazy!! Any thoughts? Again clinically, nothing notably different. Of course I thought I’d have this worked out by now as I basically haven’t travelled for work all month. Next week I’m gone all week.
I think you just keep doing what you're doing. Looking back through your data, Little went through a pretty rocky patch that lead to the drop in dose from 2u down to 1u, but the 1u was really never enough. We kept hoping it would be, and she gave indications that kept hopes up, but overall, it just wasn't doing it for her. So moving up is the right thing to do. And yes, she is going to show hypo numbers at some point again. She likes to do the unexpected so there's really not going to be any way to avoid those popping up sometimes unless you want to leave her sit in higher numbers. But that of course ups her chances of ketones which are way worse than an occasional low number in an otherwise healthy cat. So I would say keep going up the dosing scale until she gives you a reason to slow down. Last night was certainly better, and the 400 was predictable, but I think she's going to take a smidge more. Maybe do the increase to 2.2 and then hold that for a couple of extra days since she is sensitive and you might be getting closer. Give her 6-8 cycles to clear the inevitable bounce before moving forward any further. And I really hate suggesting this because I love having you over here, especially since we've all been too busy to be around much lately, but my hunch is Little needs a different insulin. I think she'll be bouncy on anything, but it honestly doesn't look like Prozinc is doing it for her. I have a feeling she might be more of a Lantus/Levemir kitty.
I know... been putting that decision off. Scary to think of a switch. Gonna stick with 2U for next 5 days or so as I am traveling next week and then go up from there and make a decision. I think when I up her again... I have to shoot through the inevitable hypo and see if she levels off. I’ll be home to watch her like a hawk while that plays out... thanks for confirming what I was thinking.
Switching can be scary, but several people who have done it later said it was a great decision. Prozinc is a great insulin and for some kitties, it's absolutely the right choice. For others, it's just not. It might make you feel more comfortable to drop in on the L forum and just read a few threads now and then...or make your own and just say you're considering the switch and ask what folks think. You don't have to make any decisions until you're ready, but that would give you some information and maybe a few contacts over there to make you feel better. Several former Prozincers are over there and often reach out to new folks who arrive from here to help reassure and give advice from a Prozinc perspective. We would HATE to lose you as you've been great and so helpful here while we've all been busy with other things, but Little is first priority. Also know you never have to leave here...we've had several folks hang out here even after they switched to just help out other Prozincers!
I certainly know how you feel! I was very unsure of making the switch to Lantus after Teasel continued to bounce like a madman on ProZinc. I actually bought the Lantus and had it in my fridge for quite a while before taking the plunge. It ended up being ... uneventful. Much later I tried Levemir for Teasel to see if he'd flatten out even more than he did on Lantus but it made very little difference - he might have bounced a little more than on Lantus. Hard to say. I went back to Lantus when he was very ill almost a year ago because it was easier to deal with when working with the vets who had zero Lev experience.
Thanks for that info @Kris & Teasel I have read some stuff of the site but truly don’t understand the depot thing and how that makes the dosing different. I may have to truly pick your brain if I’m going to switch. Terrified I am...
Pick away! FYI, though - I don't follow the Lantus "rules" closely with Teasel. He doesn't follow rules himself so I adapt the methodology to suit the two of us. You'll find that the Lantus info becomes clearer the more you read it through so I'd encourage you to do that several times.
Will do. Gonna give this prozinc thingy a bit more and shoot through the inevitable hypo once I bump her up again. Won’t be till late next week as I’m traveling a good portion but I am hopefully optimistic? Ok maybe not but one last college try. Thanks for the support and happy holidays!!
