Switching from vetsulin to prozinc: Part 7

This is the place to vent, Lisa. Trust me, I've done it so many times!!!!

 

Excellent! I know that some steroids act as appetitie enhancers. I wonder if budesonide is one?

 

Maybe it takes more time for the budesonide to kick in. He has only been taking it for a few days now.

 

I gave Smoky 1.75 units in am on Jan 10, his AMPS was 242 and PMPS was 222 that day. I think it wld be OK to give him the 1.75U tonight, his PMPS was 258. I'm factoring in that the budesonide will raise his BG in a few hours after his pm shoot.
Thoughts on that?

 

Just seeing this now. Should be fine.

 

Smoky: AMPS was 202, gave 1.6 units.
PMPS was 195, might give him 1.6U for tonight. The budesonide is still making him feel yucky, just not as much.

 

I see you opted for 1.5 u. I'm glad he's adjusting to the budesonide.

 

Smoky at 327 for AMPS today. That's either a big bounce for him or it's time to open the new vial. I worked yesterday but am home today to monitor him.
Should I open new vial since I only have one day to check him this week? I cld wait until next week when I have two days off and can better monitor him?
My other option is to give him a larger dose of the older vial of prozinc and do some tests during the day. I started the older vial on 11/23/16 so it's almost 10 weeks old. Any thoughts or suggestions?

I looked over Smokys SS and I gave him 2 units with lower PS than 327 and he was OK . I will do some spot checks today in case he goes too low on the higher dose.

 

I suggest you open the new vial. One day of monitoring should be enough but maybe give a little less than 2 u because it would be fresh insulin. You could have two factors operating here - old insulin and effects of budesonide. Both of those could raise BG but it's hard to be certain.

 

I gave him two units out of the old vial of insulin this morning. I still have about 15 to 20% left in the vial. I didn't see your post until after his am shoot.
I'm still trying out a few different kinds of food for him, novel sources of protein. It's very difficult to find ones that he likes and still have them be low carb but higher calorie.

 

No problem, Lisa. I don't usually get online before 8 AM EST.

 

I just checked Smoky at +3 and he dropped down from 326 to 110. He is eating his lunch now so will check him again soon. I'm guessing this means the old vial of insulin is still working after all.

 

Whoa! Yup, that insulin is working. The pinks are likely from the budesonide. Good to know going forward. Nice blue though.

 

I'm going to check him at 1 pm EST.
About 50 min from now, it wld be a +5 test. What are good BG numbers for him to have during the cycle?

 

He dropped fairly quickly to that blue so I'd expect some greens by +5. You might have to do some steering with food. No need to panic though, just monitor.

 

I did give him 2 oz of higher carb food for lunch. The +5 will be about 90 min after he ate that. Smoky was 116 for +5 BG

 

Looks like the higher carb food did the trick.

 

Is it better to have some green numbers or just surf in the blues all day?

 

Greens are nice but feeding higher carb food for lunch was the right thing to do. That might stop the greens today.

 

Thanks Kris! I was second guessing myself when I gave him the HC food for lunch. At first I was going to give him regular LC food but decided on the HC food since he dropped so fast early in the cycle. Smoky was 122 at +7 and is eating his snack of LC food now.

 

Until you have a lot of experience with greens it's normal to be cautious. I've decided to transition Teasel to Lantus starting tomorrow AM and I'm very anxious about it. I feel that I have to try it because he's SO volatile. Don't worry - I'll still be here on this forum with my ProZinc Pals!

 

I'm glad to hear you'll be checking in with your prozinc buddies. We wld miss you if you left Kris Here are some hugs for you and some scritches for Teasel. I wish you the best of luck in trying out the Lantus for your boy.

 

Thanks a bunch, Lisa! I won't be far from here.

 

Update on Smoky: PMPS was 277.
Is there a bounce going on? I'm figuring out his pm dose now, this is his BG before giving him the budesonide.

 

If it's a bounce, it's tiny - a very slight reaction to the lowest blue maybe. This number is similar to other yellows you've had if you take meter variance into account. What dose are you considering?

 

1.6 or 1.7U

 

1.7 u should be fine. You gave him 1.75 u on a PMPS of 258 two days ago and he was OK.

 

I drew up 1.8 units but I usually pull up a little extra just in case.

 

I'm about to give him his pm shoot. I think the 1.8 might be too much. I like your idea of the 1.7 for tonight

 

I think I will have to get a pill gun.
The pill just sat in the back of his mouth for a few minutes. I finally managed to get him to swallow it

 

It's a very handy gizmo even if you use it only occasionally. How's his pain and nausea level these days?

 

His flare up seems to have cleared up now. He still has a little nausea but it is better with the cerenia.

 

I'm more certain as time goes on that the pinks are related to budesonide. You'll have to dose around them because it's more important that his IBD is treated. Are you OK with that?

 

Yep I'm OK with doing that.
He was alert and pretty hungry this morning.

 

Smoky PMPS was 198, not sure what dose to give. The budesonide will raise his BG somewhat. I gave him 1.5 units on a BG of 195 two nights ago and he hit 327 the next morning. It's so hard figuring out what dose to give him around the steroid he is taking.

 

Instead of looking at that 327 that morning, focus on those nice blues later on. I think you'll learn to predict the budesonide BG wonkiness as you gather more data.

 

I drew up a 1.5 unit dose for tonight.
I have to give him that and the budesonide pill really need to get a pill gun.

 

Order two of them while you're at it, in case you misplace one, etc. They aren't expensive. I must have at least 4 of them kicking around.

It good that you've been able to give budesonide nightly and he's tolerating it.

 

Smokys tummy is making gurgling sounds. They usually subside when I give him the denamarin.

 

Smoky was 280 for AMPS so I think I will try 1.75U. I gave him that on 2/4 with a BG of 275 and he was fine.

 

Smoky PMPS at 232, up a little from PMPS of 198. Maybe the 1.75 units was a little too much? I'm looking at his SS now to help me decide on a dose for him for tonight. Possibly a 1.6U for tonight.

 

Actually, if PS is over well 200 you could give the same dose. If you want to reduce, I'd keep it very small.

 

Thanks Kris, I wasn't sure if he bounced or not. I thought about giving the sane dose but wasn't sure if it was OK or not. He has about 5 to 10 minutes before pm shoot

 

Whatever you're comfortable with, Lisa ... you've given 1.75 u on similar (meter variance) PSs.

 

I'm alright with giving him the 1.75U plus I have to remember that the budesonide raises his BG as well. How is Teasel doing on the Lantus or is it too soon to tell?

 

Good idea about giving the 1.75 u because of the effects of budesonide. Would you say that there's an improvement in how Smoky is feeling with it?

It's early days for Teasel and Lantus but we had BG go down into yellow today instead of all pink yesterday. The dose effects are delayed because of that insulin depot that has to fill or empty with an increase or decrease. It's different from ProZinc that usually gives an immediate result.

 

Yah for yellows go Teasel!
I think Smoky is a little better, his appetite is improving and his tummy is not making so many gurgling sounds now.
It does seem to make him a bit lethargic for about 3 hours but he is more alert after that.

 

I see that pink from the budesonide. I'm sure you'll figure out a dose to work around it.

 

I gave him the 2 units this morning.
I figured that would be a good dose for him since he was in higher pinks.

 

Smoky at BG of 258 for PMPS, it was the same on 2/4 and I gave 1.75U and he was fine. So I'm thinking either 1.75U or pushing it a little and trying 1.8 units?

 

Try an experiment with 1.8 u. You can test before bed this evening.

 

I have to wonder how accurate that will be with the budesonide. The before bed test I mean, it wld have to be a +2 though.
I'll try the 1.8 unit dose tonight.

 

It'll tell you what his BG is. Whether it's higher from the budesonide or not it'll give you an indication of what the 1.8 u will be able to do. All the insulin "cares" about is what amount of glucose is in the blood to act on if you get my meaning.

 

Yep, I got it. I just wish the budesonide would not make him so sleepy.

 

Checked Smoky at +2.5 after pm shot.
His BG was down a little from PMPS, 258 to 221. I'm a little suspicious and will have to check his chair where he gets his meds. in case he spit pill out but I don't think he did.

 

This number could be within meter variance. However, I've had kitties spit out pills after I thought I'd given them successfully. They're crafty little beasties!

 

I checked for the pill but didn't find one.
I think he swallowed the pill though, his BG was high this morning.

 

Smoky BG at 206 for PMPS, was 300 for am today. I'm wondering if 1.75U dose wld be too much to give. I was thinking 1.6 units but have to compensate for the budesonide causing a rise in his BG.

 

You need data for this dose so why not try it and test before bed.

 

Are you referring to the 1.75 unit dose?
I'm thinking the new med didn't raise his BG until after I checked him at +2.5 the other night

 

I was referring to 1.75 u, Lisa. Your call though.

 

Smoky lost weight again so am getting panicky. He is down to 8 lbs, was 8.6 lbs at vet visit on 1/26/16. I really need to find him some high calorie food that is not too high in carbs.

 

I was thinking the 1.75 unit dose as well. I just wish I cld get him to gain weight. He is not eating as much and what he eats seems to be going right thru him. I have about 10% of old vial left and was thinking of starting him on the new vial soon. The old vial of prozinc still seems to be viable yet though.

 

The vet said 2 to 4 weeks for the budesonide to take effect? It might take many weeks longer after that for more gut healing to happen.

 

The vet told me at least 2 to 4 weeks to start working but as long as 60 to 90 days for full effects depending on severity of IBD. He has only had 10 doses so far. I will try the 1.75U and check him before bed.

 

Just tested Smoky at +2.5 hrs after pm shot. I gave him the same dose am and pm, 1.75 units. So... AMPS was 300, PMPS at 206, +2.5 was 181. I gave him the budesonide which is causing his BG to go up a bit. He is really stressed out for some reason tonight so skipped the cerenia and cyproheptadine today.

 

I see you gave 1.75 u this AM. Re stressing: I wonder of budesonide can have mental effects on kitties like other steroids have on humans?

 

Actually Kris it was more of a 1.6 unit dose. I depressed too much insulin out of syringe, shld have left it alone.
Smoky has been out of sorts for a few months which is about the time the IBD started. You may be right on about mental effects.

 

I know steroids always make me feel really weird, so I could definitely see them causing some stress for Smoky.

 

I just noticed that when Smoky is standing that his left foot is close to the floor. He doesn't walk on his hocks but the right foot is held higher up then the left when standing. I have to test him for ketones again, I do that once a week.
Anyone have any thoughts on that?

 

Hmmm..I've never run across that. Could be the beginning of neuropathy?

 

I had thought of that too since his appetite has dropped recently. He lost weight again but really want to check him for ketones with him standing that way.
Smoky BG at 203 for PMPS, that is before I give him the budesonide so need to dose accordingly. My idea is to give him the 1.75 unit dose tonight. Ideas or thoughts for that?

 

The odd stance might indicate neuropathy although I thought it was symmetrical. If it is, a form of B12 supplement is supposed to be very helpful. I think you should try 1.75 u tonight. He was OK last night with that dose.

 

I will give him the 1.75 units for tonight.
I think I will post on main health board too for advice on treating possible neuropathy. I don't know much about that at all. I need to find some higher calorie low carb food that he will eat. I don't get it Kris, his BG numbers are good but he is not gaining and even still losing weight.

I'm trying to be patient and wait for the steroids to kick in but I worry. I have not had a chance to check in on how Teasel is doing on the Lantus. Are you seeing any more yellows or even a blue?

 

The specific B-12 is methylcobalamin.

 

Thank you. How do I know what dose to give him? Is it according to his body weight? Given orally or are you referring to B-12 injections?

 

I suspect the weight issue has to do with the IBD and the impaired absorption that causes. It's hard to know what's causing what when your kitty has several things going on at the same time.

Teasel had given me some yellow today and a very nice PMPS of 229. That's progress.

 

Wow Kris! That's a great BG number for Teasel to have. He is almost in the blue numbers. Yah Teasel Does the Lantus seem to be agreeing with him otherwise? Smoky seems a little better with the prozinc than with the vetsulin which made him depressed.

 

Yes, it was a nice PS. So far he seems OK with the Lantus but it's early days.

 

I don't get this whole dosing around the budesonide. The steroid is raising his BG a lot. PMPS was 240 and gave him 1.75U and now AMPS was 373. I had given Smoky the 1.75 units for several cycles now. It's hard for me to tell if I shld give a higher dose for am to cover the increase in BG. How do I know if it's the steroid or if it's a bounce and I need to lower the dose? I'm getting a bit confused here.
The insulin will be 3 months old on Wednesday but it seems to still be working. Whenever I do mid day checks his blood sugar does go down.

 

I agree that this is a tricky situation, Lisa, and I don't have any really good advice other than the usual, gather data. Smoky was a relatively easy to dose, non-bouncy kitty before the steroid and now he's more like Mr. Unpredictable who lives with me. I think the pinks are less about bouncing and more about elevation due to the steroid.

The pinks are always AM so that tells you it's the budesonide given in the PM. It's the mid cycle numbers that will carry more weight and on your workdays you'll have to rely on evening tests. If you're off today, I'd advise doing a curve so you can see what happens after this AM's high PS. I paid more attention to Teasel's middle BGs.