Freya's ProZinc Saga

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It looks like maybe it was just an isolated incident because she dropped as usual today.

She is still high and very flat, though. It's been quite a while now like this, and her polyuria is getting seriously bad again. Do you think I should continue on the 2.75u or look at upping it? Or is there something else I should try?
 
Every so often, Maury has a bigger than normal pee clump, not quite as bad before diagnosis. Which now seeing his more "regular" size ones, I realize the others were not normal at all!:(. I am thinking it's time to try 3.0U. Prozinc is gentler so we aren't seeing harsh drops to green like Caninsulin did but want to at least get her some more blues! :cat:

Let's see what the others think too.
 
Ugh, yeah... Freya's had a few times during treatment that she cut back to a much more normal level, but right now, it's just crazy again. I have a small push bin type garbage can in the bathroom that I scoop it into each day since that really helps me to visualise any changes in amount, and it's back to being almost entirely filled up with giant pee clumps every day. The bin is one of those really small ones meant for bathrooms, but still, that's an absurd amount for one little cat. :(

Yeah, I'll see what everybody thinks, but you're probably right; I get the feeling an increase is on the horizon.
 
Looks like we had three votes to increase (assuming @Kris & Teasel "liking" the post indicated agreement), and it was time for her shot, so I gave her 3u tonight. Normally I'd increase during the day, but if I need to get up and check on her, so be it. Really want to see if something will break this trend. Honestly I figured she'd end up at least 3u since she was on even more of Caninsulin. We'll see what tonight brings.
 
Blair & Freya said:
Looks like we had three votes to increase (assuming @Kris & Teasel "liking" the post indicated agreement), and it was time for her shot, so I gave her 3u tonight. Normally I'd increase during the day, but if I need to get up and check on her, so be it. Really want to see if something will break this trend. Honestly I figured she'd end up at least 3u since she was on even more of Caninsulin. We'll see what tonight brings.
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Yes, I was in agreement. :)
 
Practically no change, even with the dose increase. I am getting concerned. At what point do I need to look into some possible underlying reason for this, like some sort of infection or condition? And how would I be able to tell if the insulin has gone bad?
 
Blair & Freya said:
Practically no change, even with the dose increase. I am getting concerned. At what point do I need to look into some possible underlying reason for this, like some sort of infection or condition? And how would I be able to tell if the insulin has gone bad?
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Give the increase a chance to do its work. After three cycles go up another 0.25 u. It's quite likely you haven't reached her good dose range yet.
 
May just be a touch of insulin resistance from being in the same numbers for so long. You'll break through, it just takes some steady increases.
 
I think you're seeing a bit of insulin resistance too. Basically, it means that Freya got "stuck" in higher numbers and you need to break through. The way to do that is to just go up in those small increments every few cycles. We've seen it plenty of times, and eventually you just reach the dose that works and suddenly BAM...lower numbers! Don't give up hope or let yourself worry too much (pot calling kettle black right here :rolleyes:). You'll get there!
 
Rachel said:
I think you're seeing a bit of insulin resistance too. Basically, it means that Freya got "stuck" in higher numbers and you need to break through. The way to do that is to just go up in those small increments every few cycles. We've seen it plenty of times, and eventually you just reach the dose that works and suddenly BAM...lower numbers! Don't give up hope or let yourself worry too much (pot calling kettle black right here :rolleyes:). You'll get there!
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I've been hoping that's the case. Do they usually end up needing a decrease after that, or do they tend to keep needing the higher dose?

Today's AM cycle is looking no different from all the previous ones lately. You can increase after three cycles, right? If so, I'll probably be doing that tomorrow.

She's just starting to revert some in her appearance (flaky coat) and behaviour (a bit lethargic), so that's what's been worrying me some.
 
Oh, I suddenly remembered what I was thinking about this morning. Might it help if I give her an additional meal during each cycle, so she's not eating as much at the pre-shot? Right now she's getting more food at her pre-shot meal and then about half as much at each +4. I could just add another meal time to her feeder if that has the potential to make any difference. I struggle a bit to understand optimal feeding times in the cycle, but I know smaller meals help a lot of cats. It just seems to me like it would cause the BG to start rising earlier if not given at the right time?
 
Blair & Freya said:
I've been hoping that's the case. Do they usually end up needing a decrease after that, or do they tend to keep needing the higher dose?
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Just from my experience, cos ECID ;), once you poke through the "glass floor" of insulin toxicity you might hold that dose for a little bit, numbers permitting but you'll see better cycles, you may be able to decrease. Maury highest dose was 3.0U for seven cycles, which initiated his first reduction. Now I'm hanging in this frustrating 2.0U range :p trying to see more blue and green again. Anyways, I'm not the greatest at explaining things so I hope I didn't confuse you lol. I could've just said YES but it's not definitive so I don't feel comfortable not leaving some sort of explanation :smuggrin:

You could try just splitting her meals up like you suggested. I give Maury's lunch between +3 and +4 (except today:oops:). I'd rather him have it when insulin is peaking as opposed to after he's hit nadir and it's less active. He still needs more calories so he gets same portions for now.
 
I'm really thinking 3.0U will be OK for tonight after looking at your SS for a couple more minutes. Just wanted to give you some options as fast as I could while being safe. I know how waiting for dosing advice can make time stand still ;)
 
Okay, thanks! I had a feeling it would be okay, it's just I haven't injected that low before so felt like I should get confirmation. I'll try her on the 3u and keep a close eye on her with at least a few tests. In the past, I've regretted the times I've given her less when it was kind of borderline.
 
Blair & Freya said:
Okay, thanks! I had a feeling it would be okay, it's just I haven't injected that low before so felt like I should get confirmation. I'll try her on the 3u and keep a close eye on her with at least a few tests. In the past, I've regretted the times I've given her less when it was kind of borderline.
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I know the feeling :smuggrin:
 
Ohhhh very nice preshot!

Yes, when you break through that glass ceiling of insulin toxicity, it might take a bit, but usually we see kitties start to slide back down the scale after that. I don't know all the science of it, but my guess is that the insulin toxicity means they need that higher dose to break the cycle, but the "ideal" dose is actually lower than that...it just wasn't working because of the toxicity issue. So once you finally get them to start the lower numbers, they need less insulin so they can get back to that ideal dose...and then it's on to the normal work of trying to work them down. Not sure how accurate all that is, it's just my thoughts as to what happens.
 
That makes sense, thank you.

Tonight is shaping up to be extremely disappointing. She jumped up to 342 (19) at +2. :( I guess we're facing another increase since this was the third cycle?

It's just confusing because she had been doing better just days ago. And that 2.5u she started ProZinc on looked so good for multiple cycles, and then it all went bad and her symptoms are worsening. I've even wondered sometimes if I bypassed a good dose somewhere and all this is a reaction to that? I'm not even sure how that would be determined or addressed. I've just been racking my brain for all possibilities.

One strange thing is that I've noticed her fur has gone reddish brownish in places, like on her face and neck/chest area -- possibly elsewhere, but I haven't looked. She's an indoor cat, and this is Scotland anyway, so the sun is an unlikely cause. I worry something may be going on with organ function or nutrition or something along those lines. Her fur has always been black, with lighter greyish areas near the root -- never red/brown-tinged. I can't say for sure when this started either.
 
Good job holding the dose! That's hard to do with a low pre-shot, but looking at the +2, it looks like you made the right call!
 
Oh, I inject along the sides and flanks, and try to rotate the location each time. I've been doing that except for at the very beginning.
 
Her BG has done nothing but rise today. I was trying to compensate for an air bubble that wouldn't go away this morning, so she may have even gotten a slightly fat 3u.

I think I'm going to give her some Smilla food either tonight or tomorrow to see again if something food-related is complicating matters. It's so weird that she's having many of her lowest pre-shots ever, but just not budging much during the cycle, or else continuing to rise. And she didn't appear to be sensitive to this food when I trialled it on her, but the way food sensitivities are, I know it's possible for them to develop at random. Think I'll try the Smilla Poultry with Poultry Hearts since she was getting some of her best numbers ever on that. I don't know for sure the carb content because the analysis comes out to more than 100% on that variety, so it's like... zero-point-whatever. And I'm still not convinced that's what this is.

It's getting bewildering, though.
 
As frustrating as this is, I'd continue with the slow dose increases. She was at 3 u of Caninsulin before the switch. You might be able to go higher with ProZinc because it's less likely to drop her too fast/low.
 
The pre-shots are creeping up into pink again, and cycles are barely changing. :blackeye:

I meant to give 3.25u for three cycles, but in my sleep-deprived mind this morning, it had already been three cycles when in reality it was only two. So she got 3.5u today. Looking at those stupid numbers, I doubt upping it a cycle early will be a terrible thing. It's like I'm hoping it gets results, but at the same time I'm not getting my hopes up, if that makes sense. The worst part though is seeing her symptoms acting up again.
 
The early raise should be okay -- it just might cause a little bouncing, but you know how to keep an eye on her and it will settle out (if it does happen). I'm so sorry she isn't being very responsive right now. Just keep doing what you're doing. You'll break through - it just takes some time. I think raising every three cycles right now is a good plan - especially if she's showing more symptoms again.
 
Kind of glad she got the 3.5u today. She's still too high at +4, but we're sub-200 at least? I'm just scared it'll end up like the other times where she briefly responds to a dose, then resists it again. :nailbiting: I'll test again at +5 to see what the food is doing...

Edit: Her +4 meal was a MAC's today since I had pre-portioned meatsicles of it already in the freezer to leave out. Kind of wish her breakfast hadn't emptied the Smilla can this morning, but we can test that some more another time I suppose. I want to try her on the Smilla Poultry with Fish too because she had a nice low cycle on that before.
 
God, and speaking of food, this beast managed to open the garbage can lid and was clattering around in the kitchen trying to get to it! She doesn't feel like she's lost weight since eating more calories, but here comes the polyphagia again. :facepalm:
 
I can't remember if you said she needs to gain or lose, but remember that at higher numbers, they really do need to eat a bit more (unless you're trying to get her to lose weight, in which case you can use this to your advantage). It's okay to increase her food if she's underweight though.

That's so great to see a better reaction to the insulin this cycle! What you've noticed about her having good responses to a dose change, and then flattening back out, is really normal. Frustrating, but normal.

On the food: If I gave Sam a slightly higher or lower carb food, there wasn't much immediate change. However, about two weeks after I switched him to a 6% carb food, his numbers started to creep up. I put him back on a 1-3% carb food, and now a week later, his numbers seem to be a little lower again. It might just be a coincidence, but I'm starting to wonder if food changes take longer to show up than I've been thinking, and if maybe it takes awhile to know if something is too much for our sugar kitties to handle? Just a thought since you have been experimenting with some food changes too. At this point I would say it's too early to know if it's a pattern or a coincidence, but something to consider....?
 
Yeah, she's actually gained weight recently after having previously lost it. She's already eating more calories and at the moment I don't want her to gain more weight but am keeping a close eye on it for any loss.

Oh god, it actually scares me to think what Freya would be like on a 6% carb food right now, hahah. Most of what she's eating, I believe, is 2% or lower (around 1% on the Turkey/Blueberry and Poultry/Cranberry). The highest is the Whiskas at around 3.8%. Smilla's labelling isn't quite accurate as has been noted on the food lists, because Poultry/Poultry Hearts comes out to a negative at -2.1%, and Poultry/Fish is apparently -3.6%. :rolleyes: But they are likely still low and haven't seemed to mess with her in the past. She was eating it for a good stretch of time there before and at the start of her ProZinc transition and did get some decent numbers on it. But I'm always brainstorming about her food.
 
Wow, she's 86 (4.8) at +6. Since she usually starts rising after this point anyway, do you think I should just hold off on feeding her? She's not showing any symptoms. Other times I've fed her in the greens it was because she was still due to drop and was lower than this.
 
If you don't normally feed her at this point, I don't think you need to. 4.8 is still quite safe, especially if she's due to rise anyway.

PS Good chance you'll get either a bounce or a high flat cycle tonight. But isn't it nice to see a green?!?!
 
Okay, that's what I thought. The only time so far that I've fed her in greens is when she was 61 (3.4) at +5, because she was still going to be dropping (which brought her to 56 [3.1] at +6).

I am pleased with today though and feel like at least maybe we're getting somewhere. But now I've had to delay going out for my own dinner to make sure she doesn't do one of her sudden random drops to a not-as-nice green. :rolleyes:
 
Wow that's so nice! Yeah you might end up with a bouncy higher number tonight, but at least you know the insulin is working!!!! Remember that if you get a high number today, don't increase the dose. You want to stick with your dose since that number won't be "real" if it's a bounce from today. :)
 
Now that she's dropped down to numbers low enough to bounce from, I'll hold the 3.5u for at least six cycles for sure (barring anything that would warrant reduction). Just that for a while there, she wasn't even getting low enough to bounce no matter what I did. o_O Curious what her PM cycle will bring. I take her PMPS in just over two hours from now.
 
Annnnd there's the gross bounce. Hopefully things will level out rather than shoot up only to resist this dose.

She got some Smilla Poultry with Fish tonight to celebrate and got all fluffy when she smelled it. Maybe I can bribe her with it... :cool:

Edit: Erm... she gets to lick the food-spoon after her shots as a treat. She's going crazy wondering why she can still smell it despite there being nothing left:

F5PMQg9.png


:facepalm: What a slob. Can't take her anywhere.
 
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I believe that was a scrap of fish. :rolleyes: Ever since I got the automatic feeder, she faceplants her entire head into the compartments and gets the stuff all over herself. Last week, she had a piece that started on her nose and somehow migrated up to the top of her head before she managed to get it.

She does appear to be bouncing right now, but so far today and last night, she at least got into high blues a little -- even with the bigger AM meal this morning. Anxiously waiting to see if she'll work her way back down to lower numbers again. I'll be annoyed if what happened before repeats itself.

I have to say, she's been more relaxed today -- even WALKING AWAY FROM THE FEEDER to go hang out somewhere else. :eek: I wonder if she's feeling a little less crappy already.
 
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