Clueless since insulin switch..?

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Monica & Josie

Monica & Josie

Member Since 2017
Hello everyone,
we finally switched Josie to ProZinc 4 days ago and I didn't expect immediate miracles but her readings are even more confusing now than when she was on Caninsulin..?!:banghead:

Numbers don't seem to go down much mid cycle or not at all.. How long do you think before we will see some response? Vet suggested 0.75u as starting dose but maybe we should up the dose asap?

I just feel so bad every time I get a high reading and really sorry for poor Josie for having to run on high numbers for so long now :(

Amazingly otherwise she is very happy, cuddly, playful and eating very well with no visible symptoms of FD.
She's also been diagnosed with Chronic Pancreatitis but again showing no visible symptoms of that either..

I am totally clueless as of what we should do now or whether these numbers were normal at the beginning of an insulin switch and I am just being impatient...?
I've been wearing my heavy-duty sugar dance pants for a little while now but it just doesn't feel like I am getting anywhere..:(

Please advise, any opinion would be much appreciated - many thanks!
 
Hi Monica, and welcome to Prozinc! You can change the dose every three to six cycles on prozinc. It looks like you're on the 9th cycle, so yes, raise the dose to 1 unit. It looks like Josie is going to need more insulin. I'm curious why you didn't try more than one unit while on Caninsulin? Was that on vet advice?
 
Djamila said:
Hi Monica, and welcome to Prozinc! You can change the dose every three to six cycles on prozinc. It looks like you're on the 9th cycle, so yes, raise the dose to 1 unit. It looks like Josie is going to need more insulin. I'm curious why you didn't try more than one unit while on Caninsulin? Was that on vet advice?
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Thank you Djamila!
I'm waiting to hear back from the vet re. dosage increase but if she doesn't get back to me today I think I might just do it anyway tonight as I agree that it is needed.

As for Caninsulin we went though a few waves with dosage, found that lately she responded almost the same to lower dosage as to higher but she had bigger dives when given higher dose.
At the end it would've been an option to go 1.25u and above but feedback from board and vet suggested we might be better off trying a less harsh acting insulin and take it from there instead of increasing dosage giving Josie more abrupt curves.. hope that makes sense..?
Besides after her 2 scary hypos I think I turned very cautious and wanted to keep her relatively safe as I can't be there to check on her all the time and catch if happens..
 
It looks like you are feeding her a good, low carb diet if the foods in your signature are current. The odds of her having a dangerous, clinical hypo are really quite low (though not impossible). You are monitoring her well, and dosing carefully, so you are doing the right things to keep her safe.

In these numbers, I would be more concerned about ketones than a hypo episode. That's why I would encourage you to do the increase. From your original post, it sounds like you're also concerned about the long time in higher numbers.

Some small, steady increases should help bring her numbers down into safer territory.
 
Yes she is on 1% carb single source protein wet food, was not easy to find something that suits her needs esp. with the pancreatitis but we got there..

That you so much for your reassurance, yes I do try to stay on top of things. Sometimes I feel like a helicopter just hovering over her all the time trying to make sure she's ok!:rolleyes:

Again thank you for your reply!
 
@Djamila Hello, we gave Josie 1 unit last night but this morning her readings were higher than ever since she was diagnosed at 27.1!? Do I continue with the 1unit or take it back to 0.75?? Many thanks!
 
@Yong @Tuxedo Mom @Kris & Teasel would you have any thoughts on these numbers please if you don't mind?

I just feel so bad constantly these days for being unable to get her out of the high numbers and every time I test her and the numbers are the same or even higher I feel even worse and more clueless..:( I can't help it.

I know it's a marathon not a sprint but it just doesn't seem like we are getting anywhere..
 
Monica

I feel your frustration :bighug:

Is Josie acting normally over all...eating, pooping, peeing, activity? As well doing regular ketone checks would be advisable. If she shows no signs of any problems at this point then the increase in dose would seem to be the best approach. You have enough tests in that she does not appear to be dropping low and doing any major bouncing. I would hold the 1.0 unit a few days and see where the numbers go. If you can try to get tests around +5 or +6 this should show whether the 1.0 unit is working better or whether a further increase might be in order. The longer a kitty stays in higher numbers, the more their body "thinks" this is the "normal" range that it should be in.
 
I agree with what Mary Ann suggested. Keep in mind she might not need the higher dose forever once her numbers start improving and she spends more time in healing numbers. Slow increases of 0.25U every couple days will also help prevent glucose toxicity. Maury got to 3.0U and that was kind of his "breakthrough" and we started backing down the scale. A similar thing happened when I switched him to Lantus but I'll still have to tweak his dose some :smuggrin:. The 1.0U is getting her to yellows but she still has plenty of room to drop. Let's see some blue nadirs soon, Josie :cool:
 
Yes, I agree with Mary Ann and Yong. It's hard to see those high numbers, but a lower dose wasn't working for her, so if all other health issues are good, holding the increase, and then continuing upward until she starts to respond is the best route.
 
I also agree with Mary Ann, Yong, and Djamila! I know it's tough, but it will get better. You might have a bit of insulin resistance going on and in that case, increases will help as eventually you'll break through it.

Remember also to pay attention to how she FEELS. Josie is more than just a number. It's easy for all of us (me included!) to get stuck on what the numbers are, but it's also important that she is happy and acting like herself.
 
Thank you so much ladies for taking the time to respond, you are all very kind.

Also you are all making some really good points here.

Yes otherwise Josie is acting absolutely fine and happy, no excess water drinking, poop, wee, weight loss or any other issues. I just can't help being concerned about what must be happening on the inside with all these numbers.. Her happy behaviour is totally contradicting her nonsense numbers and I know it's silly but sometimes I think it would be better not knowing her BG readings cos that's when I get confused, stressed and worried whenever I see those unexpected high numbers..
Anyways I'll hold the 1u dose for a few days and let's see what happens.

On a separate note we noticed that Josie has a flat lump on her right side which seem to be tender to touch, taking her to the vet next week to have a look at it.. She hates her sides being touched anyway so good luck to us..!

Again thank you all for your support and guidance, as always it is much appreciated.

Have a lovely weekend everyone :)
 
It might be an insulin lump that can happen. Maury had one for the first time a couple weeks ago and I said, "Oh so that's what it feels like" :smuggrin: It went away in a couple days. Hopefully, nothing serious of course!
vibes.gif
:cat: healing vines for Josie, just in case ;).
 
Yong said:
It might be an insulin lump that can happen. Maury had one for the first time a couple weeks ago and I said, "Oh so that's what it feels like" :smuggrin: It went away in a couple days. Hopefully, nothing serious of course!
vibes.gif
:cat: healing vines for Josie, just in case ;).
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Thank you, let's hope so!
 
Hello everyone, just wanted to get an opinion on whether it was time again to increase the dosage further from tomorrow?
Josie finally had some yellow numbers today which was really good to see but nowhere near low enough for mid cycle so thinking of increasing to 1.25u from tomorrow.
Any thoughts please?
Thank you!
 
Yes, definitely time for an increase. I would suggest holding a dose no longer than three days if you don't see something dramatic happening. You can increase as often as every three cycles if you are around to monitor. Do keep an eye on that evening cycle though - most cats run lower at night, so that's where you really have to be careful.
 
Djamila said:
Yes, definitely time for an increase. I would suggest holding a dose no longer than three days if you don't see something dramatic happening. You can increase as often as every three cycles if you are around to monitor. Do keep an eye on that evening cycle though - most cats run lower at night, so that's where you really have to be careful.
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Yes that’s great thank you Djamila!
Will try to keep an eye on the evening cycles although for some reason Josie is much more difficult to test at night and I don’t really want to force her or annoy her too much.
We made such a fantastic progress with her since started testing and I don’t want to put her off or go back to struggling again.
But will try and thank you again for your reply!
 
Hmmm...is anything different about your evening routine that could make the testing harder? It's interesting that she only is tough to test at night! Maybe something about nighttime tests stress her out?
 
I feel like sometimes Maury can be more antsy for PM testing but I think it's just him feeling better and he doesn't want to sit still. He'd rather go play before dinner :cat:. I think you are testing enough to increase every 3 days, numbers permitting ;). For an evening test, Maury also knows he has to get his before bed poke before he gets his PM wet lunch. Maybe you can train Josie with a similar "trick" :smuggrin:.
 
Rachel said:
Hmmm...is anything different about your evening routine that could make the testing harder? It's interesting that she only is tough to test at night! Maybe something about nighttime tests stress her out?
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I know it is odd! I don't think anything is different, same spot same treats same method... she sits nicely daytime most of the time but keeps fidgeting in the evening in a bad mood and tries to scratch me.. No idea why. Maybe she can sense I am tired, I must admit I struggle to see straight past 11pm..!:(
Stayed up til 1am last night for a +5 test and BG didn't even go down.. I felt very frustrated thinking well that was a waste of time...:banghead:
 
Yong said:
I feel like sometimes Maury can be more antsy for PM testing but I think it's just him feeling better and he doesn't want to sit still. He'd rather go play before dinner :cat:. I think you are testing enough to increase every 3 days, numbers permitting ;). For an evening test, Maury also knows he has to get his before bed poke before he gets his PM wet lunch. Maybe you can train Josie with a similar "trick" :smuggrin:.
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Yes now you got me thinking, she must be hungry and very eager to eat her midnight feast so maybe that's why very fidgety right beforehand?
I usually start prepping her food to show that she's going to eat straight after but maybe I will leave all food prep until after testing so she's not distracted.. It might work, will try out tonight! Ooohh... exciting!:cat:
 
You got a blue!!! Hooray!

And as for getting that PM test - as Rachel says, "all data is good data", so even though it showed she was flat, that's helpful information to know how she's responding during that cycle, and to confirm that she's safe enough to be increasing right now.

Here's to more of the those pretty blues!!! :cool::cool::cool:
 
Djamila said:
You got a blue!!! Hooray!

And as for getting that PM test - as Rachel says, "all data is good data", so even though it showed she was flat, that's helpful information to know how she's responding during that cycle, and to confirm that she's safe enough to be increasing right now.

Here's to more of the those pretty blues!!! :cool::cool::cool:
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Aaawww... thank you @Djamila @Yong and @Rachel you all are such sweethearts for rooting for us!:)

Yes it was such a nice surprise to see those blues today! Although Josie didn't eat much today which isn't like her..

Sadly the PMPS shot up to 26.3! :(
It's been quite a steep drop and back up today - I'm just wondering if it was still ok to keep her on 1.25u for next few days and see if bounce will clear or shall take her back to 1u tomorrow morning? Any thoughts please?

Thanks so much!

Ps. Yes I suppose you're right above, any data is good data..
 
Yes, hold the dose at 1.25 for another cycle or two. She will likely stay high and flat for a few cycles since she isn't used to going into the blues. Are you testing for ketones? The lack of appetite is always worrisome in our FD kitties.
 
Yes will hold dose then thank you. I thought I should but the big drop got me a bit concerned.
Appetite is back, she ate very well this morning and asked for seconds..
Testing for ketones is very tricky for us as she doesn't have a litter tray and always goes far out under the bushes to do her business.. She's been tested a few times whilst at the vet and it's been clear so far.
 
Glad her appetite is back! That would be tricky with an outdoor cat. Mine are both captives in my 4th floor condo, so not much way Sam can escape from the ketone sticks!

Nice to the see the PMPS back down a bit again. Hopefully they'll keep moving in that direction. :)
 
They do make blood ketone monitors...the strips are super expensive, but you could try getting one of those just to use for ketone tests. It might make it easier for ya.
 
Rachel said:
They do make blood ketone monitors...the strips are super expensive, but you could try getting one of those just to use for ketone tests. It might make it easier for ya.
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Interesting, didn't realise there was one for blood, thank you Rachel. Just looked it up, yes they are not cheap!
Will have to justify whether we really need it at this point as can't really afford it right now on top of other everyday essentials she needs..:(
 
Update:
Vet visit yesterday had good and bad news..
Larger flat lump on Josie's side disappeared, on the other hand upon having a good feel around in her belly the vet found a marble sized lump but can't be sure what it was so we need to go back in a couple of weeks time for a follow up.. :(
 
Oh that's unnerving! Try not to worry too much about it. If it was something the vet was concerned about, she wouldn't have suggested coming back in a few weeks. As long as Josie is acting okay and the vet wasn't worried, I'd try not to worry too (easier said than done I know!).
 
Monica, I'm so sorry to hear that the vet visit added some stress. It does seem like if it was something serious the vet would have pushed for tests instead of just saying come back in a couple weeks for a follow-up. Hopefully it's nothing.

On a different topic, it looks like it's time for another little increase if you are comfortable with that and there is a cycle you can monitor.
 
Rachel said:
Oh that's unnerving! Try not to worry too much about it. If it was something the vet was concerned about, she wouldn't have suggested coming back in a few weeks. As long as Josie is acting okay and the vet wasn't worried, I'd try not to worry too (easier said than done I know!).
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Thanks Rachel and Djamila - let's hope so!
 
Djamila said:
Monica, I'm so sorry to hear that the vet visit added some stress. It does seem like if it was something serious the vet would have pushed for tests instead of just saying come back in a couple weeks for a follow-up. Hopefully it's nothing.

On a different topic, it looks like it's time for another little increase if you are comfortable with that and there is a cycle you can monitor.
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Oh @Djamila I must say I am still none the wiser regarding working out Josie's response to ProZinc!:banghead:

Yes you might be right about a dosage increase and I was thinking the same however today she had a low reading of 12.0 at +8 ( must admit I got a little excited I might be seeing lower pmps..) but by then BG jumped up to 25.0!?

Would you have a theory why? Could she be still bouncing? Big jump from 12 to 25 within just a few hours or is it not and kinda makes sense to you?

Any thoughts would be much appreciated!
 
Alas, that jump up is totally normal. Prozinc lasts roughly 10 hours in cats, so the last hour or two of the cycle can see huge increases. The good news is that a "good" cycle will show a 50% drop from pre-shot to nadir, and it looks like she did that today. Now it's just a matter of nudging those nadirs down into a healthier range, which is the reason for suggesting the increase. Then she'll most likely start bouncing around for a bit, and then finally the pre-shot numbers should start to come down. This whole process can take awhile. It's often said that it's a marathon, not a sprint. So it's just a matter of continuing to move forward little bits at a time.

The protocol recommends dose increases every three to six cycles until you get into lower numbers, or until you need to pause to manage the bouncing.
 
Hello everyone,
just posted on the main forum an asap post but maybe this will reach someone here sooner...
Josie's readings gone unusually low for her in this current cycle and seem to be still going lower, she is showing hypo symptoms although her latest +11 readings were only 10.3.
She's been acting weird in past hour, walking very very slowly with head down, not responding to call, no eye contact and not interested in her favourite treat.
Last time I saw her like this she was having a hypo.. she's just standing and staring into space
I know it's not the case now with these readings but I'm supposed to shoot her now with her evening dose of insulin.
Any suggestions please as I am totally confused as what to do now...

Thanks so much!
 
Those symptoms sound like a number of possibilities. Is she licking her lips or sitting like a meatloaf? That could be nausea. Ketones are also a possibility. I would test again at shot time, and let’s see if she eats. If she won’t eat, you might want to consider a vet visit.
 
Djamila said:
Those symptoms sound like a number of possibilities. Is she licking her lips or sitting like a meatloaf? That could be nausea. Ketones are also a possibility. I would test again at shot time, and let’s see if she eats. If she won’t eat, you might want to consider a vet visit.
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She sits in meatloaf most of the time anyway so it's not unusual for her. Not licking lips just sitting in meatloaf now with eyes half closed.. Will test her again soon, thanks!
 
Are these symptoms at all similar to how she acts when she’s having a pancreatitis attack?

Do you have bupe and cerenia that you could give her if it is?
 
She hasn't had a pancreatitis flare up for a while now but when she did she was just off food no funny slow walking.
I've got nothing at home as been symptom-free for a couple of months now
 
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Hope Josie is ok :bighug:. Another possibility for her behaviour is that her body still isn't used to seeing lower numbers so she feels "weird". My boy did the same when he would get nice numbers in between all the pinks.
 
Yong said:
Hope Josie is ok :bighug:. Another possibility for her behaviour is that her body still isn't used to seeing lower numbers so she feels "weird". My boy did the same when he would get nice numbers in between all the pinks.
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Yes that could be probably the most sensible explanation..
It was very confusing to see hypo symptoms at 10.3, didn't think it was possible but then here's my girl to show us how it's done!:cat:
 
Djamila said:
Hi Monica! How's Josie today?

I'm going to link the other conversation just so they don't get lost.
http://www.felinediabetes.com/FDMB/...dvice-needed-asap-please.185426/#post-2058825

If she's back to normal and eating, you might still consider raising to 1.5u when you're able to monitor. I do worry about ketones with those higher numbers and would love to see her numbers start to come down some more.
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Hello Djamila,
Josie's been fine today, seems back to normal and eating for England again..!:)
Yes will start 1.5u from tomorrow morning, wanted to see how she was today and only increase if she was back to acting normal.

Must admit I'm getting a little bit out of my comfort zone here as she's never had this 'high' dose before but it makes sense and if you think that this is the way forward I will certainly give it a try.

Thank you for including the link above ( good thinking! ) and for keeping an eye on us.
Also most importantly thank you so much for taking the time to give us guidance and such support, myself and wondercat are truly grateful for it!:cat:
 
Glad to hear she seems to be feeling better! I agree that it's time to raise the dose and see if we can get those numbers down. As she gets more used to lower numbers, she should feel better at them. :)
 
Hi guys,
Just tested Josie and her PMPS is unusually low 14.0 compared to her usual readings 19-25.
Can anyone advice what dosage to give her now please??

Shall I always stick with the same dose regardless ps numbers and if so how low should the ps numbers go before reducing her dosage??

Many thanks!
 
Hey Monica! I'm so sorry we weren't around to answer earlier...I was at work and it was just one of those days where I couldn't check in much. It looks like you stuck with the 1.5 dose? I would have done that too. Consistency is key and since the number is still high enough to shoot, it's good to be able to give him the same dose and see if you can see some nicer numbers tonight!
 
Nice job holding the dose! That's always so hard when the PS is lower than normal. Generally you can stick with the dose at least to 200, and some of us shoot lower than that if we can monitor through the nadir. Much of that depends too on what type of numbers you're seeing during the mid-cycles. Right now your mid-cycle numbers are still pretty high which gives a bit more of a buffer. Whenever you're shooting a "lowest number so far" you want to monitor though to make sure the reaction is in line with what usually happens.
 
Thank you Rachel and Djamila. And @Diana&Tom @Squalliesmom for your support.
I said it on the other thread in the main forum that I am getting really frustrated with these random numbers mostly being all over the place ever since we started in April and I feel I have no hope left in me that we will ever get it right.

Tonight is a typical example of this when I get an unusually low PS reading of 14-15/ 250-280 but I still shoot the same increased dose of 1.5u ( the same dose what I normally shoot at around 25/350-400) , I stay up to test as feeling concerned she might go too low with same dose, I am so very tired and Josie is in a really bad mood for testing but after several attempts and 2 strips I finally manage to get the reading at +4/0:30am only to find out that it is 26.7/ 481!?!? Now I can spend the night worrying about Josie being in HIGH numbers instead of low!:banghead:
I have actually got tears rolling down my face as I'm writing these lines because I feel so frustrated, tired and fed up with it all.
It still just doesn't make sense and we are all still just guessing and hoping...
I honestly feel I would be better off not knowing what her BG readings are at all because that is what really stresses me out with worry as otherwise amazingly the cat is looking very happy and healthy in spite of the constant high numbers and diagnosed pancreatitis..

I know I will have to continue testing to keep her safe before shooting so I will but I really feel I don't want to know her readings anymore or wanting to try to understand what's happening and why as I am slowly losing my sanity and my spark...

And this is coming from me who is usually full of beans, got a positive attitude and a good sense of humour!:(

Ps. Please don't get me wrong I appreciate everyone's help and support here, I really do!
 
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Oh Monica, we know how hard this is! Looking over your SS, I think you've got some insulin resistance going on. I'd say continue on as you are...raise the dose every 6 cycles if you don't get those low numbers and you'll break through. I know it seems like this has been going on forever, but for awhile you were holding the dose for a pretty long time...so it's really only recently that you've started treating more aggressively. I think consistently raising the dose and keeping at it will get you there in time. I know that's terrible to hear...you want her better NOW and I totally get that.

Remember to focus on how she SEEMS. Josie is more than just a number. Is she acting okay? Is she happy and acting like herself? That's important too. It's easy for us to get hung up on numbers (I'm guilty of that) but all of our cats are more than that!

I prescribe some rest for you. Tomorrow night, depending on the number you get preshot, DON'T stay up to test...get some sleep. If you happen to wake up on your own, you can get a test if you want, but really, she's shown that she will usually stay high enough to be safe. That means you can get some sleep...and you NEED it. It's important to take care of yourself too and if you're exhausted and burnt out, no WONDER you're feeling so down! Seriously, tomorrow, I want you to come home, test Josie, give her her insulin and whatnot, and as long as she didn't hit some strange blue number preshot or something, go to bed early and allow yourself to NOT worry about her and sleep! It'll do wonders, trust me.

We're here for you, Monica. :bighug::bighug:Vent anytime you need (we've all done it!) and don't worry...we know you appreciate the help! We've all been in your shoes and know how you feel!
 
Oh Monica! I so wish I could give you a hug! It does all seem so hard and confusing at times. Try to hang on to the fact that she's feeling good and is happy. The numbers are just the numbers. And you really will see progress in time, but for many kitties, it takes awhile and lots of adjustments along the way.

Josie is going to need some more insulin, and the steady increases will get her there. At some point she'll break through and you'll start to see some better numbers, but it's going to take some persistence. Please know that everyone here has had those moments when we were overwhelmed with all of this. In fact, I've shed a few tears myself this week over my kitty's numbers. You are always welcome to come and vent and know that you are not alone in this journey.

Rachel's post just came through and I can't agree with it enough! Her suggestions to take care of yourself are exactly right. Please do get the sleep you need. Sending you lots of love!!!
 
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