Dropping too fast. 107 @ +3.5

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Susan and Timmy

Member Since 2017
Timmy is 107 @ +3.5. He started dropping at +2. I have been giving a small snack and waiting 15-20 minutes to see if I can slow him down some, but he keeps dropping. Next test is in 10 minutes. Help! I'm freaking out a bit. :nailbiting:
 
He dropped from 107 to 97 but he is still above danger zone yet. When that happened with smoky I checked him every 30 minutes. Do you know when he hits his nadir, it's usually sooner than later with vetsulin.
 
He dropped from 107 to 97 but he is still above danger zone yet. When that happened with smoky I checked him every 30 minutes. Do you know when he hits his nadir, it's usually sooner than later with vetsulin.
He usually hits nadir +5ish. I will try to push the testing to 30 minutes, but I'm still not confident in my ability to steer with LC food. He just dropped so fast at +2.
 
How is Timmie doing now? In my experience with vetsulin smoky started climbing again by +5 to +6. You can also post on vetsulin forum to get some extra eyes on board.:bighug:
 
Hi Susan,

Take some deep breaths! Timmy seems to have his nadir around +5 or +6. The "intervene with high carb food" number is 50 on a human meter and you're at 97 now. You've been giving small snacks of his regular LC food and that's the right thing to do. So - snack/wait 30 minutes/retest.
 
How is Timmie doing now? In my experience with vetsulin smoky started climbing again by +5 to +6. You can also post on vetsulin forum to get some extra eyes on board.:bighug:
He is doing pretty good right now. He was hiding under the bed, but I closed off all the rooms, so now he is resting in a box by his bed. He went low a few days ago, but it was later in the cycle and I was able to steer it.
 
He is doing pretty good right now. He was hiding under the bed, but I closed off all the rooms, so now he is resting in a box by his bed. He went low a few days ago, but it was later in the cycle and I was able to steer it.
That was really good experience for you. You know how to steer with food - good tool to have. If the drop happens earlier in the cycle you can intervene sooner with food. If the drop is huge then you can jump in with a little snack of HC. These food rules aren't carved in stone. The reason for saving the HC for 50 and below (generally) is so you don't end up messing up what could be a cycle with nice greens by carbing him too much.
 
Hi Susan,

Take some deep breaths! Timmy seems to have his nadir around +5 or +6. The "intervene with high carb food" number is 50 on a human meter and you're at 97 now. You've been giving small snacks of his regular LC food and that's the right thing to do. So - snack/wait 30 minutes/retest.
I just tested him and he is 105 @+4. Should I hold the snack and retest to see if he can hold it and get into the greens, or give him another snack now. He dropped so fast so early tonight.
 
I just tested him and he is 105 @+4. Should I hold the snack and retest to see if he can hold it and get into the greens, or give him another snack now. He dropped so fast so early tonight.
Good idea. No snack and retest in 30 minutes. Now you know what to do with an early big drop. Every one of these nail biters is good experience. ;)
 
Good idea. No snack and retest in 30 minutes. Now you know what to do with an early big drop. Every one of these nail biters is good experience. ;)
Okay. I'll hold the snack and retest. He dropped so fast and so early that I was sure we were headed for lime green tonight. You're right though, it is a good experience, albeit stressful, so very stressful. ;)
 
See, I learned something new tonight too.
I tend to panic and load smoky up on carbs when he drops low too suddenly.
I heard that advice from both of you to maybe wait it out a little bit first before giving a high carb snack.
 
Do you have any HC food to give him? Smoky dropped very fast on the vetsulin too. It's one of the reasons I had to switch him to prozinc
I do have the HC food in my hypo kit ready to go if needed. I know what you mean about the drops with the Vetsulin. It is frustrating. A change is definitely in our future. I've changed my shot times so I can dose him enough at night without worry, so maybe we can hit some dark greens more often.
 
See, I learned something new tonight too.
I tend to panic and load smoky up on carbs when he drops low too suddenly.
I heard that advice from both of you to maybe wait it out a little bit first before giving a high carb snack.
I'm learning with you. :) I panic too. So I just won't give the HC food unless he is below 50.
 
He is now at 122 after holding food and waiting 30 minutes. We are also a few minutes before +5. I'll watch him for another hour or so just to make sure he is safe. Thank you all for helping and guiding me tonight. I appreciate it so much. :)
 
I see the bounce numbers after the lows last night. Stick with the 2 u for now. He's doing quite well mid cycle. The high AM/PMPSs are typical of Vetsulin and can be related to bounciness or lack of duration. Hard to know which.
 
I thought about this all night and I am done with Vetsulin. This insulin is too much of a roller coaster ride. I am getting some nice blues and an occasional green with them, but the drops and bounces/duration are just not worth it. I was trying to give it a full 6 months, but... I just got the new vial so I will use that up. That will give me time to get myself educated on the switch. My first thought was to go directly to Lantus, but after watching @Lisa and Smoky with Prozinc, maybe, that is where Timmy and I should go. What are your thoughts?
 
Glad things calmed down for you last night, you did a very good job! :bighug: He can still bounce if you switch to another insulin but those drops are a bit stressful on your heart :nailbiting:. Whichever you decide to go to, you will have help :)
 
Glad things calmed down for you last night, you did a very good job! :bighug: He can still bounce if you switch to another insulin but those drops are a bit stressful on your heart :nailbiting:. Whichever you decide to go to, you will have help :)
Thank you for the reply. I kind of burried this in this post from last night. I don't want to discourage anyone on their journey. The bouncing is a given, it's the big drops that are causing me grief. The big swings cause my boy to not feel so good.
 
Thank you for the reply. I kind of burried this in this post from last night. I don't want to discourage anyone on their journey. The bouncing is a given, it's the big drops that are causing me grief. The big swings cause my boy to not feel so good.
Hi Susan,

ProZinc would be familiar to you in its action, although it's generally slower in onset, doesn't drop them as low and has longer duration than Vetsulin. It's an "in and out" insulin so once a dose is done, it's done. You have flexibility in dose timing and how often you make dose changes similar to Vetsulin. Plus or minus an hour in dose scheduling isn't a problem when life gets in the way. However, it's much more expensive than Vetsulin ($100-$120 per 10 mL vial) and you'll go through it just as quickly.

Lantus is another universe as insulins go. It's a depot insulin so part of every shot is stored in a sort of slow release form so there's insulin acting all the time. The effects of a dose can take a few days to show because of this depot. There's very little flexibility in dose timing (12/12 is required and deviations have to be planned in no more than 30 minute increments over days) and doses have to be held as long as a week or more. There are two clear protocols to follow. You can read about them in the yellow stickies on that forum. It's a very gentle, slow acting, long duration insulin and many cats do very well on it. It's extremely expensive in the US ($400+ per 10 mL vial) so many order from a Canadian pharmacy, Marks Marine Pharmacy in Vancouver. It's a more concentrated U100 insulin so the cost ends up being similar to ProZinc or cheaper if you order from Canada.

Bouncy cats will bounce on either ProZinc or Lantus as I can attest. :confused: The bouncers can improve a little or a lot on Lantus. Teasel is in the "a little" category. I can say, though, that he feels better on Lantus than he did on ProZinc. @Lisa and Smoky had very good results switching Smoky from Vetsulin to ProZinc.

Does this help? Ask anything else you want to know. :)
 
Hi Susan,
I can tell you that Smoky feels so much better with the prozinc than with the vetsulin. He seemed to be very depressed while on vetsulin and him going deep diving scared the wits out of me. I like the prozinc for Smoky for a few reasons. It allows me to have more flexibility with his dosing schedule as Kris stated above.
I also like the fact that with prozinc you don't really have to have food on board first. I pay about $130 for a vial and it usually lasts 10-12 weeks for Smoky on 1 to 2 units twice a day. Whatever insulin you decide to go with there will be folks on here to guide you along.:bighug:
 
Hi Susan,

ProZinc would be familiar to you in its action, although it's generally slower in onset, doesn't drop them as low and has longer duration than Vetsulin. It's an "in and out" insulin so once a dose is done, it's done. You have flexibility in dose timing and how often you make dose changes similar to Vetsulin. Plus or minus an hour in dose scheduling isn't a problem when life gets in the way. However, it's much more expensive than Vetsulin ($100-$120 per 10 mL vial) and you'll go through it just as quickly.

Lantus is another universe as insulins go. It's a depot insulin so part of every shot is stored in a sort of slow release form so there's insulin acting all the time. The effects of a dose can take a few days to show because of this depot. There's very little flexibility in dose timing (12/12 is required and deviations have to be planned in no more than 30 minute increments over days) and doses have to be held as long as a week or more. There are two clear protocols to follow. You can read about them in the yellow stickies on that forum. It's a very gentle, slow acting, long duration insulin and many cats do very well on it. It's extremely expensive in the US ($400+ per 10 mL vial) so many order from a Canadian pharmacy, Marks Marine Pharmacy in Vancouver. It's a more concentrated U100 insulin so the cost ends up being similar to ProZinc or cheaper if you order from Canada.

Bouncy cats will bounce on either ProZinc or Lantus as I can attest. :confused: The bouncers can improve a little or a lot on Lantus. Teasel is in the "a little" category. I can say, though, that he feels better on Lantus than he did on ProZinc. @Lisa and Smoky had very good results switching Smoky from Vetsulin to ProZinc.

Does this help? Ask anything else you want to know. :)

Thank you, Kris. It helps, a lot. A few pros and cons from each certainly gives me a head start on making the decision. I made an appointment with my vet for early next week to get a different prescription. Now my homework begins...
 
Hi Susan,
I can tell you that Smoky feels so much better with the prozinc than with the vetsulin. He seemed to be very depressed while on vetsulin and him going deep diving scared the wits out of me. I like the prozinc for Smoky for a few reasons. It allows me to have more flexibility with his dosing schedule as Kris stated above.
I also like the fact that with prozinc you don't really have to have food on board first. I pay about $130 for a vial and it usually lasts 10-12 weeks for Smoky on 1 to 2 units twice a day. Whatever insulin you decide to go with there will be folks on here to guide you along.:bighug:
Lisa, thank you so much for this information. It is so encouraging. The difference in Smokey's spreadsheet since you went on Prozinc gives me so much hope. I know that ECID though. :) You said that Smoky seemed depressed on Vetsulin, and that kind of sums up Timmy, although there are times when I get to see the old Timmy playing and being his goofy self. I just want him to feel better. I'm paying $70 for a vial of Vetsulin at my vet, tried to get it cheaper, but it isn't happening, plus I replace it every 42 days, so price may end up okay. Kris gave some pros and cons, that, along with your information will get me started with figuring this out over the next few days. Thank you again!
 
Hi Susan,

Any more thoughts on switching insulin?
I apologize for not replying sooner, have been in bed with a terrible cold, but feeling better today. :)

Yes, I have given it a lot of thought and I want to switch to Prozinc, I think it is the next logical step up, plus I am used to the fresh start every 12 hours and having some flexibility. He's still going to bounce, I get that, but from what I can tell, it is a gentler insulin. Not to put you on the spot, but having had Teasel on both Prozinc and now Lantus, does this move make sense? Am I missing something? ;)
 
I apologize for not replying sooner, have been in bed with a terrible cold, but feeling better today. :)

Yes, I have given it a lot of thought and I want to switch to Prozinc, I think it is the next logical step up, plus I am used to the fresh start every 12 hours and having some flexibility. He's still going to bounce, I get that, but from what I can tell, it is a gentler insulin. Not to put you on the spot, but having had Teasel on both Prozinc and now Lantus, does this move make sense? Am I missing something? ;)

You're not putting me on the spot at all. :) It makes sense to try ProZinc because you're familiar with Vetsulin and a lot of that knowledge is applicable to ProZinc. If Teasel wasn't such a conundrum I'd have stuck with ProZinc. It's very flexible and forgiving. Teasel is a little less bouncy on Lantus - probably due to the "time release" effect - but he certainly hasn't done a 180. I think the much slower action has made him feel better though.

You could try ProZinc for a couple of months to see what you think. At Timmy's dose you should be able to get over 2 months out of a vial. If he doesn't settle to your satisfaction (he is a bouncer!) you can move on to Lantus. It requires a totally different mind set. Any other questions?
 
Cash eats only YAZM and his blood glucose has been staying in the 60's checked with a Relion Prime with no insulin. YAZM has brought him into remission.

I have two other nondiabetic cats (normals :) ). their blood glucoses are in the 40's with the same instrument.
 
Cash eats only YAZM and his blood glucose has been staying in the 60's checked with a Relion Prime with no insulin. YAZM has brought him into remission.

I have two other nondiabetic cats (normals :) ). their blood glucoses are in the 40's with the same instrument.
Omg I'm soooo happy for you!!!!!! From three shots a day to none. Told you that food is awesome.
 
Cash eats only YAZM and his blood glucose has been staying in the 60's checked with a Relion Prime with no insulin. YAZM has brought him into remission.

I have two other nondiabetic cats (normals :) ). their blood glucoses are in the 40's with the same instrument.
What is YAZM? I added that stands for something. :)
 
Cash eats only YAZM and his blood glucose has been staying in the 60's checked with a Relion Prime with no insulin. YAZM has brought him into remission.

I have two other nondiabetic cats (normals :) ). their blood glucoses are in the 40's with the same instrument.
Not added, lol, assume.
 
Hi Susan,

Checking in on your cutie pie, Timmy. I read the note in the comments on your SS about your frustrating vet visit. Let us know on the ProZinc forum when you make the switch. I say "us" because I'm still there as well as on the Lantus forum. I agree that Timmy's dose had to increase.
 
Susan,

These are my current recommendations to try to see more blues and dark green. I'm glad you saw a few blues but they are still a bit high for nadir.
250-300 2 u
300-350 2.25
350-400 2.5
400+ 2.75.
 
Hi Susan,

Checking in on your cutie pie, Timmy. I read the note in the comments on your SS about your frustrating vet visit. Let us know on the ProZinc forum when you make the switch. I say "us" because I'm still there as well as on the Lantus forum. I agree that Timmy's dose had to increase.
Hi Kris,
Thanks for checking on us. It has been a frustrating couple of weeks. My mom was very ill, but we were able to keep her out of the hospital and I was able to care for her, and dad. She is doing so much better now. Thank goodness!!!! Now it is on to a new normal with their care. :)

The vet visit was numbing, however, I did what needed to be done to get the Prozinc prescription. I'm not going to wait to finish up the Vetsulin like I first thought, so as soon as Prozinc arrives, Wednesday, he needs to send the prescription, the next morning I want to make the switch. A couple of questions though:

1. Starting dose. Vet said to start at 1 unit. Sticky says 0.5 units to start?

2. This sounds stupid, but do I just stop Vetsulin and start Prozinc with the a.m. dose?

3. Is it still test/feed/shoot? I have read the stickies, but I don't want to make a mistake.;)

4. The vet really made me feel stupid, even though I know I am doing everything correctly with the help of this site. The visit was very difficult. Vet said I was testing too much and should only test before each injection. That being said, I want to continue to test as often as I have been so I can get as much data with the Prozinc as I had with the Vetsulin. I'm starting over with my data with the switch to Prozinc. His numbers over the last few weeks on the Vetsulin just didn't give me any confidence at all. It seemed like his breakthrough number was 2 units, when I increased it to 2.25 is when he seemed to have red and black numbers. It doesn't really matter since we're switching, but it was confusing.

Thanks for all your help and guidance.
 
Susan,

These are my current recommendations to try to see more blues and dark green. I'm glad you saw a few blues but they are still a bit high for nadir.
250-300 2 u
300-350 2.25
350-400 2.5
400+ 2.75.

Thank you, Janet. I will try this for his dosing. His numbers are all over the place. He threw me for a curve this morning with those lower numbers. Haven't seen these preshot numbers in a while. His numbers lately had me thinking that something else may be going on with him, but vet checked him out and found nothing, which is terrific, but his numbers leave me scratching my head. In the past, sliding scale dosing seemed to make him bounce more, but he bounces a lot anyway so who am I to say. I stalled up to the last second this morning trying to get to at least 250 to give him a decent dose, but now I see he needed more today. Ugh! :banghead:
 
Hi Susan,
I'm glad the dust is settling after your difficult time with your parents - and who needs a difficult vet visit on top of that?! I'll answer your questions one by one:
  1. I think you can start at 1 unit because Timmy isn't new to insulin. The lower dose would generally be for newly diagnosed kitties and, even then, many start at 1 u. You could probably start up at 2 u but safety first! You can increase by 0.25 u after 3 cycles when you see what the 1 u does.
  2. Yes, give Vetsulin as your PM dose and start the ProZinc next AM on a day you'll be able to monitor closely - safety first! They're both "in-and-out" insulins and are gone after 12 hours.
  3. Yes, test/feed/shoot. However, ProZinc is slower in onset than Vetsulin so you can inject either as he's eating (if his appetite is good and you're sure he'll finish) or right after he finishes.
  4. If you like your vet for other things you can nod politely when he goes on about testing and then go home to do what you know is best. You know that testing and data logging keeps Timmy safe. If your vet starts getting up on his high horse too much about Timmy's insulin regimen you might want to think about a new, more collaborative, vet.
Come on over to the ProZinc forum now and introduce yourself. It's a small, friendly group with some great advice givers. :):):)
 
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