Ernest needs dosing help....please!

Here's a Bouncing 101:

Bouncing is a phenomenon that occurs when the body experiences (or at least thinks it does) hypoglycemia. Luckily the body uses bouncing as a defense mechanism against this where it attempts to compensate the low blood sugar by dumping excess glucose provided by the liver in an attempt to raise blood sugar back to “normal” numbers. Unfortunately, “normal” is a relative term according to the body. For a diabetic whose body has been untreated for so long that it considered very high numbers to be the new normal, lower numbers can often make the body overreact in attempt to save itself, even if it’s not in danger.

A cat who has been suffering from diabetes for some time may at the point of diagnosis have a new “normal” of 400. When insulin is introduced and brings it down, even to 200 (still diabetic levels), the body thinks it is in danger, dumps excess glucose, and thus the blood sugar skyrockets up to the 400-600s. After enough time has passed, the body will eventually realize that 200 isn’t such a bad number, and bouncing will happen less often. Note some cats are extremely bounce-prone and a switch to Lantus/Levemir is needed.

There are three main causes of bouncing: when blood sugar drops too low (hypoglycemia), drops lower than the body is used too, or by dropping too much too quickly. Typically if a cat drops more than 50% of their blood sugar a bounce is likely to happen, or if they drop 100 points within an hour.

While bouncing can be considered as a safety net in the instances of hypoglycemia, it can look very confusing on paper.
If a kitty is on a dose that drops them lower than is safe, it can cause a bounce ... if you don't lower that dose that is now too high, the bounce clears and then starts over again. And again ...
 
Here's a Bouncing 101:

Bouncing is a phenomenon that occurs when the body experiences (or at least thinks it does) hypoglycemia. Luckily the body uses bouncing as a defense mechanism against this where it attempts to compensate the low blood sugar by dumping excess glucose provided by the liver in an attempt to raise blood sugar back to “normal” numbers. Unfortunately, “normal” is a relative term according to the body. For a diabetic whose body has been untreated for so long that it considered very high numbers to be the new normal, lower numbers can often make the body overreact in attempt to save itself, even if it’s not in danger.

A cat who has been suffering from diabetes for some time may at the point of diagnosis have a new “normal” of 400. When insulin is introduced and brings it down, even to 200 (still diabetic levels), the body thinks it is in danger, dumps excess glucose, and thus the blood sugar skyrockets up to the 400-600s. After enough time has passed, the body will eventually realize that 200 isn’t such a bad number, and bouncing will happen less often. Note some cats are extremely bounce-prone and a switch to Lantus/Levemir is needed.

There are three main causes of bouncing: when blood sugar drops too low (hypoglycemia), drops lower than the body is used too, or by dropping too much too quickly. Typically if a cat drops more than 50% of their blood sugar a bounce is likely to happen, or if they drop 100 points within an hour.

While bouncing can be considered as a safety net in the instances of hypoglycemia, it can look very confusing on paper.
If a kitty is on a dose that drops them lower than is safe, it can cause a bounce ... if you don't lower that dose that is now too high, the bounce clears and then starts over again. And again ...

So where we are with Ernest at this point, are we okay to continue with Prozinc? ...just give it time for his body to realize Prozinc is his friend?...
 
Prozinc is a good insulin, I would not write it off immediately. Some people say to give it a few months before switching. Panic was on Prozinc 6 months and I just wasn't happy with the results so I made the switch. That said, Lantus is a really, really good insulin. If you want to switch, even "just because" I would not try to convince you to wait. It's not like it's a step back.
 
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Prozinc may be Ernest's "friend", but the 2U dose should not be held for more than 7 days, when using the SLGS dosing protocol/guidelines/method.

If his body was "catching up", I don't think you would be seeing so many pinks with those mid-cycle tests.

It's very possible that Ernest is dropping lower at night, but there is no data to tell us what is going on in the PM cycle.
 
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Prozinc may be Ernest's "friend", but the 2U dose should not be held for more than 7 days, when using the SLGS dosing protocol/guidelines/method.

If his body was "catching up", I don't think you would be seeing so many pinks with those mid-cycle tests.

It's very possible that Ernest is dropping lower at night, but there is no data to tell us what is going on in the PM cycle.

Okay, I got a 2+ pm test tonight. I'll set my alarm and get another one in about 3 hours.
I'll try to test a couple of times the next couple of nights.
So we should increase to 2.25 within a couple of days? or tomorrow?
Thanks!
 
Shoot sorry Ja, forgot to reply to your post yesterday. :nailbiting: I am thinking he's ready for an increase.

No worries, I really appreciate all of the time and advice you guys offer!!
Ernest def needs your help to get better. We don't know what we're doing and our Vet is nice but working with 25 year old info.

We will increase in the morning to 2.25u.
Thank you!!!
 
No worries, I really appreciate all of the time and advice you guys offer!!
Ernest def needs your help to get better. We don't know what we're doing and our Vet is nice but working with 25 year old info.

We will increase in the morning to 2.25u.
Thank you!!!
Yes, please increase the dose to the 2.25U dose. Starting for 9/12/20 AM shot, since it looks like you already gave Ernest the PM dose for 9/11/20.

p.s. Please start a new thread in the AM, and link this old one in at the top please. This one is getting long.
 
Yes, please increase the dose to the 2.25U dose. Starting for 9/12/20 AM shot, since it looks like you already gave Ernest the PM dose for 9/11/20.

p.s. Please start a new thread in the AM, and link this old one in at the top please. This one is getting long.

Got it! Thank you so much!
 
I think you are stuck in glucose toxicity. I think you are going to see high numbers until you hit the breakthrough dose. If it were MY cat, I would do 2.5 tomorrow.
 
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