Dosing advice

[thewebs]

https://docs.google.com/spreadsheets/d/1g49B9XUQ96GXFK9QiGxph7pr2qgj2EbEbwqxrQASeQA/edit

Here’s Wriggley’s spreadsheet. As you can see not very good. He was on Vetsulin but switched to ProZinc one week ago. I don’t really see much of a difference. Right now 1U 2x a day. My vet wasn’t happy about the switch. Said to stay at 1U for two weeks but may an increase be needed? I did a plus 2 4 6 and 3 5 7 took a day break ( still tested) than did another plus 2 4 6 and 3 5 7. Wriggley didn’t seem to be drinking as much. Litter box is much less pee clumps. I empty it twice a day and It’s almost normal. He seems to be hiding way less and interacting more. I’d like to say he looks better but I’m thinking I’m just getting use to how he looks. We weighed him and he’s at 13 pounds. Pretty much the same. Doesn’t seem like he’s losing weight. His appetite is great. Never misses a meal! I got an auto feeder for night time. I get up to make sure he eats. He eats most of his night time food. I make sure I pick it up by 5am so it doesn’t mess up his morning test. He’s almost at two months of mostly 400’s. We had a full blood work up done two months ago and everything was good. I’m worried this will start to take its toll. He can still jump up on the bed and kitchen table but he seems slower going up and down the stairs. Thoughts...

 

[Panic]

Great job on these tests, very, very helpful! And love the picture, was a handsome fella!

Wriggley is still dealing with being unregulated, it's normal, but he sounds like he's doing better. I imagine that's the Prozinc lasting longer for him.
I am thinking he is ready for a little increase up to 1.25u. We want to see him getting below 150 at nadir. On Start Low, Go Slow dosing method, we evaluate the dose after a week to see if they need an increase. If you hold the dose longer than necessary glucose toxicity sets in, and you're stuck in high numbers until you keep upping the dose to "break" the barrier, then chase the dose back down.

I am going to tag @Deb & Wink for any input she might have (she is probably in bed by now so she'll probably be on tomorrow evening).

Are you still using Alphatrak or did you switch to a human meter?

Could you fill out your signature just a bit - food, insulin, diagnose date, meter brand, any health issues? It helps members to know the details all at once without asking and unfortunately I can't remember all Wriggley's info off the top of my head.

Super pleased with all you've been doing for Wriggley, you are definitely on the right track! Now we just need to find a dose that suits him.

 

[Deb & Wink]

You've only been on Prozinc for about a week?

Then give the Prozinc time to work. It usually does have a longer duration than vetsulin/caninsulin.
BUT, when you switch insulins, you take the dose of the prior insulin into consideration. Usually, you would stay at just about the same dose, maybe dropping by 0.25U.
You dropped the dose 1/2 a unit (0.5U), from 1.5U to 1U.
That drop was likely too much of a drop, especially since Wriggley wasn't getting down very low on the Vetsulin.

I concur with Elizabeth that the dose needs to be increased.
Please increase the dose to 1.25U.
Oops! I see you already did that for the PM shot.

One more thing please. Would you add a row to your SS, before the 9/9/20 insulin switch? So the change in the kind of insulin really stands out. Right now, it's kind of hidden. Please put something like SWITCHED TO PROZINC 9/9/20 in big bold letters all across that inserted row on the SS and color code it so it really stands out.

Thanks.

 

[thewebs]

I wrote a long essay onWriggley in my signature and have no idea where it went. I wrote it down in the box that comes up in signature and hit save.
He eats FF pate. On ProZinc. Alpha Trax meter. I bought a ReliOn but don’t trust it. Tried it on me and kept getting error readings. Diagnosed in July

You've only been on Prozinc for about a week?

Then give the Prozinc time to work. It usually does have a longer duration than vetsulin/caninsulin.
BUT, when you switch insulins, you take the dose of the prior insulin into consideration. Usually, you would stay at just about the same dose, maybe dropping by 0.25U.
You dropped the dose 1/2 a unit (0.5U), from 1.5U to 1U.
That drop was likely too much of a drop, especially since Wriggley wasn't getting down very low on the Vetsulin.

I concur with Elizabeth that the dose needs to be increased.
Please increase the dose to 1.25U.
Oops! I see you already did that for the PM shot.

One more thing please. Would you add a row to your SS, before the 9/9/20 insulin switch? So the change in the kind of insulin really stands out. Right now, it's kind of hidden. Please put something like SWITCHED TO PROZINC 9/9/20 in big bold letters all across that inserted row on the SS and color code it so it really stands out.

Thanks.

I made the changes to the spreadsheet. Thanks for your help. Plus 3 after first dose increase went up to 448. His numbers before he started insulin( 7/23 through first dose on 8/2) seemed better than most of his numbers on insulin

 

[Panic]

It may be the signature was too long, it only allows two lines. Sorry about that!

The tests from this evening are alright, it just looks like its not going to be an active cycle this time. Let's give the 1.25u a little time to work.
Believe it or not those yellows might be making him bounce - they're not low numbers, but his body thinks they are, since he's not used to them. He may also just need bumped up more (with time, not yet) to start heading down again. You two will get there!

Another method you could use is Modified Prozinc Method ... it has you increasing the dose every 3 days instead of every 7 days. You're not feeding dry and you're testing enough to try that method if you prefer. You will get him back in better numbers quicker if you do. This means he only earns reductions if he drops under 50, versus Start Low, Go Slow earning reductions under 90. I think he would benefit from it!

The ReliOn - was it doing E13! errors? That means not enough blood was on the strips if so. ReliOn requires 0.5 mcl versus Alphatrak needing 0.3 mcl. You may just need a bigger blood drop.

 

[Deb & Wink]

I wrote a long essay onWriggley in my signature and have no idea where it went.

It's on your User Profile page, under the "Information" tab, that gives more detail about you.

So that "Information" tab is not actually part of your "Signature" that shows up at the bottom of each of your posts. That is a different part of your User Profile. Try to click on your User Name, a box will pop up that lists options, select "Signature" and edit away before you save changes. You'll see that you already have Wriggley's SS in that "Signature" box.

You can just keep typing and it will wrap down to the next line of text. There is a character limit, which I think is somewhere in the 150-200 character range. Forget what the limit is these days.

Wriggley dropped down to some nice blue range BG numbers with the dose increase. Expect a bounce, since his body isn't used to those lower numbers just yet. It takes time for a cat's body to adjust. Patience is needed. Sometimes LOTS of patience.

Thanks for making the change to the insulin more obvious on your SS. Appreciate it.