Late nadirs/lowered dosing question

Discussion in 'Prozinc / PZI' started by Lmiller86, Apr 9, 2022.

  1. Lmiller86

    Lmiller86 Member

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    Dec 24, 2021
    Hey @FrostD
    I feel like I have taken two steps back with my girl, Baby. Her dose was stable for awhile but I have felt like a complete rookie, and just plain mad at myself within the last week. She's had late nadirs quite a bit, I've been lowering doses and a few cautionary, away from home doses have left her all over the place. And, not to mention she is getting very finicky when I try to inject her. She kinda shivers and tries to move when I pull up skin. This has resulted in a few Syringes having blood on tip after injection which terrifies me. I'm getting very down on myself about all of this and I'm sure she picks up my anxiety. When you have a moment, if you could take a look at her chart, I would so greatly appreciate it!

    Thank you,
    Logan

    https://docs.google.com/spreadsheet...H6zZui-8kM9ExM80-7rG6Gkq228/edit?usp=drivesdk
     
  2. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    How long are the needles you are using and what kind?
     
  3. Lmiller86

    Lmiller86 Member

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    Dec 24, 2021
    They are the u100 Syringes... Been using them forever! Just a recent issue! (and no worries, i'm converting from u40 dose to u100)
     
  4. Lmiller86

    Lmiller86 Member

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    Dec 24, 2021
    Walmart brand relion
     
  5. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    But how long of a needle? Just curious. Really shouldn’t have blood on them. Although it’s possible to nick a blood vessel.
     
  6. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    For example, mine are 8 mm length, which is 5/16 inch.
     
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  7. Lmiller86

    Lmiller86 Member

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    Dec 24, 2021
    31 gauge, 6 m m length
     
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  8. FrostD

    FrostD Well-Known Member

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    May 27, 2020
    Yes the dosing really is all over the place lol the other issue is your shot times are also too variable. Is that something within your control? Realistically they should be within 15-30 mins, though up to one hour leeway can be done for most cats...I just don't think Baby is one of them.

    I think you need to go back to the sliding scale (not for lurkers we don't usually recommend this):
    • 200-249, perhaps 2-2.2U?
    • 250-299, give 2.6U
    • 300+, give the 3.2U

    Obviously, reduce all of the above by 0.2U if you get a number below 90 at any time.

    I would try 3 more weeks of consistency in dosing/strategy, and shot times. If this is still happening, it's time to look at switching to a depot insulin.

    Are you still hesitant to ditch the dry?
     
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  9. Lmiller86

    Lmiller86 Member

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    Dec 24, 2021

    Thank you for that. I am a little freaking out right now because I just read her and she's 174 at hour 1! Down from 314 and that's with dinner!
     
  10. Lmiller86

    Lmiller86 Member

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    Dec 24, 2021
    @FrostD do you think this big drop is due to the blood in syringe tonight? Ah I am so freaked out right now!
     
  11. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    That’s quite a drop!
     
  12. Lmiller86

    Lmiller86 Member

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    I know! I am extremely worried. Doing reads about every 30 mins
     
  13. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Are you feeding to slow things down?
     
  14. Lmiller86

    Lmiller86 Member

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    Dec 24, 2021
    OH Yes I am! I just don't understand this. Her eating routine and portions are always the same. Unless it has to do with blood on the syringe.
     
  15. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    It looks like you brought her back up into the yellows. I know you will make sure that she stays up.

    As for the 373 and 457 this morning with the same drop of blood, that’s pretty close to the +/- 20 percent meter variance that you can get with the same drop of blood.

    I hope she does well tonight and that you are able to be really consistent with her shot times and doses going forward.
     
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  16. Lmiller86

    Lmiller86 Member

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    Dec 24, 2021
    Thanks for your feedback. I cannot believe how quickly she went from dropping to a sharp increase. Up to 500s by hour 8. It's like her body freaked out. This is like her on Novolin. Honestly, it's very hard to feel what's right to dose at this point. I've never seen a cycle go this crazy.

    https://docs.google.com/spreadsheet...H6zZui-8kM9ExM80-7rG6Gkq228/edit?usp=drivesdk
     
    Last edited: Apr 10, 2022
  17. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    A steep drop can trigger a bounce. I hope that’s all that’s going on. At least she never dropped into unsafe territory. I do understand the stress though. What did you feed her at the beginning of last night’s cycle? You should note it on your spreadsheet for future reference (the kind of food and carb percentage if you can or at least whether it was HC, MC or LC.) @FrostD What do you think?
     
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  18. Lmiller86

    Lmiller86 Member

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    Dec 24, 2021
    She is on kidney food due to bad values... So it's unfortunately high carb. I'm about to start her 12 hour read and feed
     
  19. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I understand. My boy had to go on kidney food for the same reason. It's actually not that bad. Stangely enough, it didn't really affect his BG that much, but he was acromegaly and on Cabergoline, and I always suspected that he had a working pancreas. HC food never took him up too high for too long, so I used Karo when I needed to bring him up quickly. Of course, Karo wears off quickly too. It's okay about the food, you just need to adjust the insulin to compensate. Have you ever tried the Royal Canin kidney foods. My boy liked them as well at the KD (I think the chicken and tuna vegetable stew ... or whatever that was called, was his favorite of the Hills K/D foods, but he did like several of the Royal Canin foods as well.)
     
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  20. Lmiller86

    Lmiller86 Member

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    Dec 24, 2021
    Wow, the HC definitely affects Baby. That's great it did not affect yours! I use the RC occasionally as well. My sister is in vet school and a hills science rep, so I get the hills heavily discounted. Hard to say no to that! Now, if only I knew a zoetis sales rep lol. Going thru strips like crazy!
     
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  21. Lmiller86

    Lmiller86 Member

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    She's still at 530...gonna go ahead and feed and give her the 3.2 which was a regular dose for awhile and advised by Melissa. I'm not worried about hypo when she's 500+ I just hope it's not another sharp drop.
     
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  22. Lmiller86

    Lmiller86 Member

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    Was your kitty on ProZinc?
     
  23. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    My boy started with Vetsulin (awful) then ProZinc (no duration), then Lantus, then Levimir. I tried them all. Lantus was pretty good, but Levemir was awesome (but he was a high dose kitty for a long time, until I got things under better control with cabergoline, which is a medication to help Acro kitties.)
     
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  24. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Have you tried feeding a teaspoon of food at +1 and maybe +2 to slow down the steep drops?
     
  25. Lmiller86

    Lmiller86 Member

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    Dec 24, 2021
    B
    Baby was on Novolin from Oct 2021-feb 2022 and since on ProZinc. Durations for me are so inconsistent but I feel like I'm having more trouble on ProZinc. Novolin wore off fast and I probably adjusted the dose too much but looks like ProZinc has some curve balls for us too.
     
  26. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    What kind of kidney values does she have? BUN CREA Phosphorus, USG? Do you give her sub-q fluids?
     
  27. Lmiller86

    Lmiller86 Member

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    Dec 24, 2021
    She is alone for the workday day so I always leave food out for her, even if I'm here for regularity. She's pretty good about eating when she feels lowering (2-3 hr) but last night she was not.
     
  28. Lmiller86

    Lmiller86 Member

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    Dec 24, 2021
    Bun- around low 60s
    Crea- 2.4
    Phosphorous normal
    Urine gravity is very poor. Not sure the rank
    When we started kidney foods, the values stabilized and only went up a little after constant UTIs. Which, knock on some holy wood, she has been clear of since January.
    Sub qs- 100 every other day
     
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  29. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    You may want to consider a switch to Lantus or Levemir (the depot insulins) instead of a single cycle insulin. Of course, I don't know what your work schedule is, but I see that you do a lot of testing so you could probably do the TR protocol to adjust doses every 6 cycles.
     
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  30. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    She is very pretty! You must have been doing something right all these years to get that sweet Baby to 18! Well done!
     
  31. Lmiller86

    Lmiller86 Member

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    Dec 24, 2021
    Aw thank you! She is a love bug. I am definitely considering the depots at this point. Thanks again for all your support!
     
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