Why wait ?

Queed

Queed

Member
Hi all ! I think I read that Prozinc did not build up , and called it an in and out insulin. Why does my vet make me wait 2 weeks before making adjustments? We are still at 600+ before insulin, 3 or 4 hours later today it is 382. We are at 4 units a few days now, also , if he’s always 600+ in the morning and only drops mid day for a minute, how will it ever get to 200 for all 12 hours? Can I up the units every 12 hours until his mid day is 150 ?
 
Here's my take on it:
  • 4 u might be too high a dose but we'd need data from BG tests over time to know for sure
  • those highs in the AM might be from a rebound phenomenon we call bouncing that can happen for a variety of reasons, one being a dose that's too high
  • he won't stay at one BG for 12 hours - that's not how this insulin works. He'll slowly drop from the AM high to the lowest point (the nadir) about half way through the 12 hours between doses and will then rise up to a level similar to the AM in the evening. Some cats will stay at or near a good BG for 12 hours if the owner is using a depot insulin like Lantus or Levemir, the cat is moderate in his response to insulin, he's well-regulated and is being dosed optimally.
600+ said:
Why does my vet make me wait 2 weeks
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A case can be made for keeping a dose at least a week if it seems to be a sensible starting dose (often 1 u twice a day), seems to be giving decent numbers or you're waiting for BG to settle. Many cats are very erratic at the start.

600+ said:
We are at 4 units a few days now
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This is a high-ish dose for a relatively newly diagnosed cat. You also say in your signature that you're on your third insulin since diagnosis on June 6. That's a lot of change in a very short period of time. We generally recommend sticking to one insulin for at least 6 months to get to know its action well. There is the odd exception where it's obvious a kitty can't tolerate an insulin. Being volatile and not giving good numbers quickly doesn't fit in that category. This type of up and down is typical and it can take many, many months or longer to work out good dosing and to start seeing decent regulation. Was it your vet that recommended those insulin changes or were you worried that Queed didn't become regulated right away?

600+ said:
Can I up the units every 12 hours until his mid day is 150 ?
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No, this wouldn't be safe. The shortest interval between dose changes we recommend with ProZinc is after three 12 hour cycles. That's only done when you (and we, if you ask for help) can look at a spreadsheet of a lot of data to see what the current dose is doing.

This process can't be rushed. There's no quick route to regulation unfortunately, which is why you'll hear "it's a marathon, not a sprint" so often on FDMB.

The best thing you can do right now to allow us to give you the best advice possible is to set up the spreadsheet we use here and enter all BG numbers you have so far into it. There arte members who can set it up for you if you need help. @Chris & China is one.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
Hi Qweed's Mama/Papa! and welcome to Prozinc-land! Thank you so much for getting your spreadsheet set up and into your signature. That is so helpful to all of this. Do you have a name you'd like us to call you? I'm guessing "600+" is what you'd like to get rid of, not what you'd like to hold as your name! ;)

Kris has given you some very good advice. Prozinc is not exactly an in and out insulin. You'll read that often here, but it's mostly written by folks who don't have much experience with this insulin. When it's dosed well, one cycle will impact that next, so it can take a few cycles or even a few days to really know what a dose is going to do. So you can't just move the dose from one cycle to the next and expect to accomplish anything except making your kitty feel awful. Careful dose changes and monitoring are so important in getting a kitty into a healthier, happier place.

We would love to help you with that as this can all be rather tricky.

I share Kris' concern about the frequent insulin changes. I would definitely recommend that you stick with this for a good long while now and let us help you get it sorted out.

One of the first steps in that will be doing exactly what you just did - getting a test or two during the cycle as often as you can so we can monitor the impact of the dose and help you figure out if it needs to be raised or lowered from here. The most important hours to get tests are between +4 and +7 since that's the range in which most kitties hit nadir. After some time and data collection we can figure out when Qweed usually reaches nadir, but it is always helpful to scatter the tests around a bit to create the big picture.

Please make sure you've carefully read the yellow "sticky" posts at the top of the forum, read other people's threads, and ask questions/post on your own thread whenever they arise. The more you learn, the better you'll be able to help Qweed improve. :bighug:
 
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Kris & Teasel said:
The best thing you can do right now to allow us to give you the best advice possible is to set up the spreadsheet we use here and enter all BG numbers you have so far into it. There arte members who can set it up for you if you need help. @Chris & China is one.
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I set one up for her but she somehow made several copies instead of using the one I sent, but it looks like she's got one that's working and that's all that matters!!

@600+ Why don't you add your name to your Signature so people will know what to call you. You could change it and say "Annette and Queed, 17yrs, Dx 6/6/18 thought to be from steroid injection....etc. etc."

Have you started to change his food yet? The Royal Canin and Hills are both too high in carbs for a diabetic and there's nothing special in them that does anything at all good for him.

I do think you've made too many changes too quickly, but let's start where you are and see how it goes. Have you thought any about the suggestions I made the other day?

Try giving 3U every 12 hours for several days and get as many tests as you can in....Always get Pre-Shot tests and then (if at all possible) get at least 1 mid-cycle test on the AM cycle (like 5-7 hours after the shot) and on the PM cycle, get at least a "before bed" test....if you work during the day and can't get mid-cycle tests on the AM cycle, try to get at least 2-3 tests on the PM cycle and do a full curve on a day off (test every 2 hours for 12 hours)
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Kris & Teasel said:
Here's my take on it:
  • 4 u might be too high a dose but we'd need data from BG tests over time to know for sure
  • those highs in the AM might be from a rebound phenomenon we call bouncing that can happen for a variety of reasons, one being a dose that's too high
  • he won't stay at one BG for 12 hours - that's not how this insulin works. He'll slowly drop from the AM high to the lowest point (the nadir) about half way through the 12 hours between doses and will then rise up to a level similar to the AM in the evening. Some cats will stay at or near a good BG for 12 hours if the owner is using a depot insulin like Lantus or Levemir, the cat is moderate in his response to insulin, he's well-regulated and is being dosed optimally.

A case can be made for keeping a dose at least a week if it seems to be a sensible starting dose (often 1 u twice a day), seems to be giving decent numbers or you're waiting for BG to settle. Many cats are very erratic at the start.


This is a high-ish dose for a relatively newly diagnosed cat. You also say in your signature that you're on your third insulin since diagnosis on June 6. That's a lot of change in a very short period of time. We generally recommend sticking to one insulin for at least 6 months to get to know its action well. There is the odd exception where it's obvious a kitty can't tolerate an insulin. Being volatile and not giving good numbers quickly doesn't fit in that category. This type of up and down is typical and it can take many, many months or longer to work out good dosing and to start seeing decent regulation. Was it your vet that recommended those insulin changes or were you worried that Queed didn't become regulated right away?


No, this wouldn't be safe. The shortest interval between dose changes we recommend with ProZinc is after three 12 hour cycles. That's only done when you (and we, if you ask for help) can look at a spreadsheet of a lot of data to see what the current dose is doing.

This process can't be rushed. There's no quick route to regulation unfortunately, which is why you'll hear "it's a marathon, not a sprint" so often on FDMB.

The best thing you can do right now to allow us to give you the best advice possible is to set up the spreadsheet we use here and enter all BG numbers you have so far into it. There arte members who can set it up for you if you need help. @Chris & China is one.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
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Did I do it ???! I think I got it posted! I have a few more BG to list.
 
600+ said:
Did I do it ???!
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Congratulations!!! That's the most important part!! Great job!

You do have it listed twice, but it works!!

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Chris & China said:
Congratulations!!! That's the most important part!! Great job!

You do have it listed twice, but it works!!

View attachment 39462
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Lol! It takes me several times to learn something, I have a little difficulty caused by a horse riding accident years ago. I haven’t figured out how to just post anything with replying to someone, BUT !!! Let me tell you what just happened!! At 6:30 he tested 343 !! That’s 11 hours after his last shot, and being on a road trip !! he traveled very well, was probably the first cat ever to attend a dog Dock Diving event . We then stopped at Kroger’s and I got ten cans of different flavored FF Classics. He went crazy, omg , like he hasn’t eaten in months and I guess he hasn’t, the entire can gone and wanted more, I opened the second can and then thought he might get sick so I took it back and his eyes were so big and he wanted that bowl back bad , so I gave him a quarter of it. I suppose his glucose may go through the roof now ? He sleeping on me now. It’s been a big day for him, but I couldn’t stand to board him again with no heated bed and nobody around all day tomorrow, someone said feed him all he wants, is that right? He hasn’t gotten sick.
 

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600+ said:
Lol! It takes me several times to learn something, I have a little difficulty caused by a horse riding accident years ago. I haven’t figured out how to just post anything with replying to someone, BUT !!! Let me tell you what just happened!! At 6:30 he tested 343 !! That’s 11 hours after his last shot, and being on a road trip !! he traveled very well, was probably the first cat ever to attend a dog Dock Diving event . We then stopped at Kroger’s and I got ten cans of different flavored FF Classics. He went crazy, omg , like he hasn’t eaten in months and I guess he hasn’t, the entire can gone and wanted more, I opened the second can and then thought he might get sick so I took it back and his eyes were so big and he wanted that bowl back bad , so I gave him a quarter of it. I suppose his glucose may go through the roof now ? He sleeping on me now. It’s been a big day for him, but I couldn’t stand to board him again with no heated bed and nobody around all day tomorrow, someone said feed him all he wants, is that right? He hasn’t gotten sick.
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By all means let him eat. Many small meals are usually better than fewer big meals - less chance of vomiting from eating too much too fast. As long as those are Fancy Feast pates (which is what the classics are I think) they're low enough in carbs that they shouldn't affect his BG. We always recommend, though, that all food is taken away for the 2 hours prior to an insulin injection. That way you know what the actual BG is without the influence of food and can judge the appropriateness of the dose better.
 
That's great news! What a lovely BG number and how great to hear he wants to eat! He needs the food, so yes, I'd let him have it. As Kris said, we'd just recommend taking it away 2 hours prior to morning and evening shots, but other than that, let him enjoy that tasty food!
 
Rachel said:
That's great news! What a lovely BG number and how great to hear he wants to eat! He needs the food, so yes, I'd let him have it. As Kris said, we'd just recommend taking it away 2 hours prior to morning and evening shots, but other than that, let him enjoy that tasty food![/
What’s the chance he will drop to low overnight because he was less than 400 and got 4 units?
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600+ said:
someone said feed him all he wants, is that right?
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The only thing you need to be careful about is feeding him so much it makes him sick.

1 1/4 cans should be fine.....just stick to small, more frequent meals instead of huge ones.

(and yes, no food for the 2 hours immediately before shot times)
 
I don't think you'll need to worry about him going too low, but if you're worried then try to get a reading 4-5 hours after the shot and see where it's heading. I'm so glad he likes the food!
 
600+ said:
He’s crazy for it !! Eating 2 cans this morning! BG this morning at 412 !
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That's great! This diet change will be very helpful. Keep the 4 u dose for now and gather data. Here's the basic testing routine we recommend:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes (VERY important!)
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
Those tests in the +4 to +8 time period are essential so we can evaluate how well the 4 u dose is working. The AM and PM pre shot tests are mainly to see if the BG is high enough for you to give the planned dose safely.
 
I’m so glad Queed likes his new food and his bg is responding to the switch. I hope you can get the midcycle tests that Kris mentioned. They are the best way to determine if Qweed needs more or less insulin.
 
Kris & Teasel said:
That's great! This diet change will be very helpful. Keep the 4 u dose for now and gather data. Here's the basic testing routine we recommend:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes (VERY important!)
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
Those tests in the +4 to +8 time period are essential so we can evaluate how well the 4 u dose is working. The AM and PM pre shot tests are mainly to see if the BG is high enough for you to give the planned dose safely.
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I have not had any cell service where we were ! He is at 127, 7 hours after his injection! Or he is at 118. The difference is if I select fasting on the meter he is 118 and after a meal he is 127. I have never choose anything but fasting because I’ve only really checked it in the AM and PM until recently. He hasn’t eaten anything since his huge amount this morning although food has been with him. His belly is definitely full.
 
600+ said:
I have not had any cell service where we were ! He is at 127, 7 hours after his injection! Or he is at 118. The difference is if I select fasting on the meter he is 118 and after a meal he is 127. I have never choose anything but fasting because I’ve only really checked it in the AM and PM until recently. He hasn’t eaten anything since his huge amount this morning although food has been with him. His belly is definitely full.
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Wow! I'm going to be curious to see what the preshot is tonight.
 
600+ said:
I have not had any cell service where we were ! He is at 127, 7 hours after his injection! Or he is at 118. The difference is if I select fasting on the meter he is 118 and after a meal he is 127. I have never choose anything but fasting because I’ve only really checked it in the AM and PM until recently. He hasn’t eaten anything since his huge amount this morning although food has been with him. His belly is definitely full.
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That's fantastic! If he continues to drop up to PMPS that's a sign that the new diet is affecting his response to insulin and a dose decrease will be required. Let's wait to see where he is at PMPS. I'm in Eastern Daylight Saving Time so an hour later than you (you're showing Tennessee as your state, right?). I should be back here to check by 6 PM your time. If you need advice sooner. post on the main forum.
 
Kris & Teasel said:
That's fantastic! If he continues to drop up to PMPS that's a sign that the new diet is affecting his response to insulin and a dose decrease will be required. Let's wait to see where he is at PMPS. I'm in Eastern Daylight Saving Time so an hour later than you (you're showing Tennessee as your state, right?). I should be back here to check by 6 PM your time. If you need advice sooner. post on the main forum.
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Thank you !! He’s been sleeping all day. So I was a little worried, I stopped at the hotel lobby and got a shot of honey in a cup in case we need it. We will pull off the interstate in an hour for another test , that will be 9 hours after insulin 4u
 
600+ said:
I have not had any cell service where we were ! He is at 127, 7 hours after his injection! Or he is at 118. The difference is if I select fasting on the meter he is 118 and after a meal he is 127. I have never choose anything but fasting because I’ve only really checked it in the AM and PM until recently. He hasn’t eaten anything since his huge amount this morning although food has been with him. His belly is definitely full.
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So great to hear that Queed is responding in a positive manner and is liking the FF Classics...I know vets don't always like it but you can't argue Queeds response to it with him gobbling it down and his drop in BG readings! Hang in there I think with the help of these folks on here Queed is making the turn! I know you are probably on top of it but don't forget plenty of fresh water for Queed also. Hydration!!!....Stay positive it will help Queed!
 
That's fantastic!!! He's doing great! Please do post at preshot time so we can help you determine if a dose decrease is needed. :)
 
Rachel said:
That's fantastic!!! He's doing great! Please do post at preshot time so we can help you determine if a dose decrease is needed. :)
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Yes I will, I work so I won’t be able to check on him at all after shot at 5 am , I will get back home at 4 pm. His 4pm check was 137 and he did want to eat some, but dang , I’m making a mess of the veins in his ears, I couldn’t see it until the sun shined through them while sitting in my lap in the car
 
600+ said:
Yes I will, I work so I won’t be able to check on him at all after shot at 5 am , I will get back home at 4 pm. His 4pm check was 137 and he did want to eat some, but dang , I’m making a mess of the veins in his ears, I couldn’t see it until the sun shined through them while sitting in my lap in the car
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Try not to aim for the veins. You want to hit the area between the vein and edge.
ABCB0B55-41F3-4C57-9EA0-7EDDFE8571CC.jpeg
 
Annette, am I correct that you shot at 7PM tonight and will shoot at 5AM tomorrow morning? If so, that will be at +10, post here with your AMPS. I know you won’t be around to monitor all day, can you leave some food out for him?
 
600+ said:
It’s 7pm here central time.
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I think you mentioned before in the first post that he is an outdoor / indoor cat. If that's correct I am just wondering with his number jumping up like that after you got back from your trip if he was out and about and could have sourced some other food in your neighborhood? It seems during the trip when you switched his diet that he dropped BG rather dramatically and I'm assuming he was more of an indoor kitty during that time frame. I just mention it as a possibility because I had that situation happen with Sketch...he was eating hard food over at his girlfriends house where he hung out sometimes. I spoke with the neighbors and they confirmed "ya he comes by for a meal often" When I explained his situation they were more then happy to not free feed outdoors any longer which made his numbers much more consistent...he still spikes on occasion but not like he used to.
 
Sharon14 said:
Annette, am I correct that you shot at 7PM tonight and will shoot at 5AM tomorrow morning? If so, that will be at +10, post here with your AMPS. I know you won’t be around to monitor all day, can you leave some food out for him?
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Yes that’s correct, I’m going to have to get the dang opossum out that I found all cuddled up in the blanckets in the big wire cat cage that’s in the house. It’s a baby , I didn’t want to mess around with him last night and he didn’t want to move out so I closed him in there. I’m going down now and will check his BG
 
Jeff Davis said:
I think you mentioned before in the first post that he is an outdoor / indoor cat. If that's correct I am just wondering with his number jumping up like that after you got back from your trip if he was out and about and could have sourced some other food in your neighborhood? It seems during the trip when you switched his diet that he dropped BG rather dramatically and I'm assuming he was more of an indoor kitty during that time frame. I just mention it as a possibility because I had that situation happen with Sketch...he was eating hard food over at his girlfriends house where he hung out sometimes. I spoke with the neighbors and they confirmed "ya he comes by for a meal often" When I explained his situation they were more then happy to not free feed outdoors any longer which made his numbers much more consistent...he still spikes on occasion but not like he used to.
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He is confined to a fenced yard , there was no other cat food . Maybe it was from excitement of being home ? I don’t know . I’m checking him again in a minute
 
600+ said:
Yes that’s correct, I’m going to have to get the dang opossum out that I found all cuddled up in the blanckets in the big wire cat cage that’s in the house. It’s a baby , I didn’t want to mess around with him last night and he didn’t want to move out so I closed him in there. I’m going down now and will check his BG
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Oh my goodness. Lol.
 
JanetNJ said:
Oh my goodness. Lol.
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Oh my gosh ! 178 ! At 5:30 , 3.5 units last night. What do I do, put cage with baby opossum out of the house by the woods , I can leave wet food out in the house, hopefully the possum won’t go back in , but he was curled up and upside down sleeping like a baby kitten.
 
600+ said:
Oh my gosh ! 178 ! At 5:30 , 3.5 units last night. What do I do, put cage with baby opossum out of the house by the woods , I can leave wet food out in the house, hopefully the possum won’t go back in , but he was curled up and upside down sleeping like a baby kitten.
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It’s 178 ! Baby opossum was sleeping curled up and upside down like a kitty, I got that whole big cage outside by the woods ! How much insulin should I give Qweed? I won’t be home until almost 4 today
 
Are you heading out right away or do you have a little time to stall and see if his BG comes up anymore?
 
Is he eating well? If you can't stall and he eats well, I'd either skip or give a very small shot...like 0.5. Checking last night, he seemed to come up a LOT in the last few hours, which is somewhat typical. Giving the shot that early makes me nervous though, since we just don't know what's going to happen or if he will dive because of it. What makes you feel more comfortable?
 
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