Help with looking over spreadsheet and dosing advice

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Kim3803

Kim3803

Member Since 2021
I also posted this in the Prozinc forum (sorry if that's not ok), I uploaded the SS wrong but I think I fixed it.

I've posted a couple times but I'm very new to this and need some guidance. I unfortunately have no support from my vet. I've only been home testing for about 7 days now. (My vet had told me I didn't need to home test when he first was diagnosed). The dose he was given was 2 units of Prozinc. Looking at his numbers they are pretty high. At first I was thinking maybe he needs a increase but I've been trying to read and understand as much as I can on this forum which it can be very complicated and overwhelming at first. I've read that the recommended starting dose is 1 unit for Prozinc and than got to reading about "rebounding". So now I'm thinking is he getting too much and that's why he is so high? I don't have the syringes with the half units yet I do plan on ordering them for when I do need to adjust his dose. I know I haven't been testing for long but if there is any info you can give me by looking at his numbers so far will help. I haven't tested past +3 in the pm because I'm in bed by 9pm and up at 5am. Any advice is greatly appreciated. Thank you.
 
Hi Kim,

Looking at your spreadsheet, your pre-shot numbers are pretty consistent and Jax doesn't seem to be dropping too low mid cycle, which suggests he may need an increase.

I would suggest getting a curve (testing every 2 hours for 12 hours) once you have a day where you're around to test that often. This will show exactly how the insulin is affecting him, and identify the nadir (lowest point). Dosage changes are based on the nadir so it's important to get that.

It's useful as well to try and get a couple of tests during the night at around +4 to +7, again just to get some data so you have a better understand of what happens at night. You'll need to set an alarm to get up. It's tough, but needs must! I have to say, coffee has become my best friend since my cat got diagnosed. :coffee::D
 
Oscar and Carrie said:
Hi Kim,

Looking at your spreadsheet, your pre-shot numbers are pretty consistent and Jax doesn't seem to be dropping too low mid cycle, which suggests he may need an increase.

I would suggest getting a curve (testing every 2 hours for 12 hours) once you have a day where you're around to test that often. This will show exactly how the insulin is affecting him, and identify the nadir (lowest point). Dosage changes are based on the nadir so it's important to get that.

It's useful as well to try and get a couple of tests during the night at around +4 to +7, again just to get some data so you have a better understand of what happens at night. You'll need to set an alarm to get up. It's tough, but needs must! I have to say, coffee has become my best friend since my cat got diagnosed. :coffee::D
Click to expand...


I did a curve on 3/30. I tested every 2 hours.
 
Hi Kim.
Yes it’s fine to post on this main forum. If you could link the post from the Prozinc forum, that would be good so we can see if anyone answers there as well.
I can see Deb and Janet answered you but your SS wasn’t viewable at the time so I’ll tag them here as I can now see the SS @JanetNJ @Deb & Wink.
They both use Prozinc and are experienced. I don’t use Prozinc and don’t give Prozinc dosing advice, but will look at your SS.

Well done setting up the SS and home testing. Sadly a lot of vets do not know a lot about feline diabetes but you have come to the best possible place for help and support.
It’s a good idea to post often and people will get to know you and your kitty and you will make friends and get support which is important.

I can see you are feeding a wet diet which is good.
Do you have a hypo kit set up in case you need it? This is a good link with information about the hypo kit and other important information for new members
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Are you feeding during the cycle as well as before each insulin dose?
Looking at Jax’s SS I can see he is reacting well to the insulin which is good. Also by +2 he has dropped a lot which can trigger a bounce. If a cat drops too fast, or too low or lower than he is used to his body can react and dump glucose into his system and his BGs will go up.
If I were you I would try giving him a snack of ordinary low carb food around +1 to try and slow that big drop. At the moment he is going from mid reds to yellows in 2 hours which is too fast a drop. If you can slow that down he might not go so high at the next preshot. I would also give him another snack around +3 or +4. It is trial and error.
It does look as if he needs more insulin but I’ll leave that up to Deb or Janet.
Bron
 
Answered her over in the Prozinc ISG.

Yes, I do think that Jax could use a tiny dose increase soon. Would like to see a few more cycles of tests before that increase is done.
 
Bron and Sheba (GA) said:
Hi Kim.
Yes it’s fine to post on this main forum. If you could link the post from the Prozinc forum, that would be good so we can see if anyone answers there as well.
I can see Deb and Janet answered you but your SS wasn’t viewable at the time so I’ll tag them here as I can now see the SS @JanetNJ @Deb & Wink.
They both use Prozinc and are experienced. I don’t use Prozinc and don’t give Prozinc dosing advice, but will look at your SS.

Well done setting up the SS and home testing. Sadly a lot of vets do not know a lot about feline diabetes but you have come to the best possible place for help and support.
It’s a good idea to post often and people will get to know you and your kitty and you will make friends and get support which is important.

I can see you are feeding a wet diet which is good.
Do you have a hypo kit set up in case you need it? This is a good link with information about the hypo kit and other important information for new members
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Are you feeding during the cycle as well as before each insulin dose?
Looking at Jax’s SS I can see he is reacting well to the insulin which is good. Also by +2 he has dropped a lot which can trigger a bounce. If a cat drops too fast, or too low or lower than he is used to his body can react and dump glucose into his system and his BGs will go up.
If I were you I would try giving him a snack of ordinary low carb food around +1 to try and slow that big drop. At the moment he is going from mid reds to yellows in 2 hours which is too fast a drop. If you can slow that down he might not go so high at the next preshot. I would also give him another snack around +3 or +4. It is trial and error.
It does look as if he needs more insulin but I’ll leave that up to Deb or Janet.
Bron
Click to expand...

I was told NOT to feed in between his cycles. He throws tantrums and meows and jumps on the counters. I am currently feeding him 1 1/2 cans of FF (AM and PM). He is 10.5lbs. Before he was diagnosed he was eating 4-5 small meals throughout the day so he is not used to this new schedule. I feed at 6am so I should give him maybe 1/4 can at 7am?
I do have honey in case of hypo.

I appreciate all the help.
 
Bron and Sheba (GA) said:
Hi Kim.
Yes it’s fine to post on this main forum. If you could link the post from the Prozinc forum, that would be good so we can see if anyone answers there as well.
I can see Deb and Janet answered you but your SS wasn’t viewable at the time so I’ll tag them here as I can now see the SS @JanetNJ @Deb & Wink.
They both use Prozinc and are experienced. I don’t use Prozinc and don’t give Prozinc dosing advice, but will look at your SS.

Well done setting up the SS and home testing. Sadly a lot of vets do not know a lot about feline diabetes but you have come to the best possible place for help and support.
It’s a good idea to post often and people will get to know you and your kitty and you will make friends and get support which is important.

I can see you are feeding a wet diet which is good.
Do you have a hypo kit set up in case you need it? This is a good link with information about the hypo kit and other important information for new members
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Are you feeding during the cycle as well as before each insulin dose?
Looking at Jax’s SS I can see he is reacting well to the insulin which is good. Also by +2 he has dropped a lot which can trigger a bounce. If a cat drops too fast, or too low or lower than he is used to his body can react and dump glucose into his system and his BGs will go up.
If I were you I would try giving him a snack of ordinary low carb food around +1 to try and slow that big drop. At the moment he is going from mid reds to yellows in 2 hours which is too fast a drop. If you can slow that down he might not go so high at the next preshot. I would also give him another snack around +3 or +4. It is trial and error.
It does look as if he needs more insulin but I’ll leave that up to Deb or Janet.
Bron
Click to expand...


https://felinediabetes.com/FDMB/thr...dsheet-and-dosing-advice.245569/#post-2771176

Here is the link I posted on the Prozinc Forum. I'm not sure how to link it.?
 
If he is dropping that much that fast within 2 hours
Bron and Sheba (GA) said:
Hi Kim.
Yes it’s fine to post on this main forum. If you could link the post from the Prozinc forum, that would be good so we can see if anyone answers there as well.
I can see Deb and Janet answered you but your SS wasn’t viewable at the time so I’ll tag them here as I can now see the SS @JanetNJ @Deb & Wink.
They both use Prozinc and are experienced. I don’t use Prozinc and don’t give Prozinc dosing advice, but will look at your SS.

Well done setting up the SS and home testing. Sadly a lot of vets do not know a lot about feline diabetes but you have come to the best possible place for help and support.
It’s a good idea to post often and people will get to know you and your kitty and you will make friends and get support which is important.

I can see you are feeding a wet diet which is good.
Do you have a hypo kit set up in case you need it? This is a good link with information about the hypo kit and other important information for new members
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Are you feeding during the cycle as well as before each insulin dose?
Looking at Jax’s SS I can see he is reacting well to the insulin which is good. Also by +2 he has dropped a lot which can trigger a bounce. If a cat drops too fast, or too low or lower than he is used to his body can react and dump glucose into his system and his BGs will go up.
If I were you I would try giving him a snack of ordinary low carb food around +1 to try and slow that big drop. At the moment he is going from mid reds to yellows in 2 hours which is too fast a drop. If you can slow that down he might not go so high at the next preshot. I would also give him another snack around +3 or +4. It is trial and error.
It does look as if he needs more insulin but I’ll leave that up to Deb or Janet.
Bron
Click to expand...

If he is dropping that much that fast within 2 hours, would it still be ok increase his dose? Should I try the little meals in between and see how his numbers are first before I increase?
 
Kim3803 said:
I was told NOT to feed in between his cycles. He throws tantrums and meows and jumps on the counters. I am currently feeding him 1 1/2 cans of FF (AM and PM). He is 10.5lbs. Before he was diagnosed he was eating 4-5 small meals throughout the day so he is not used to this new schedule. I feed at 6am so I should give him maybe 1/4 can at 7am?
I do have honey in case of hypo.

I appreciate all the help.
Click to expand...
Was it the vet who told you to not feed between the shots? That is old thinking
With the newer insulin it is better to feed more like it sounds you were feeding before the diagnosis.
So I would give a meal before the shot, then the one around +1 to see if we can slow the drop and the again once or twice, preferably during the first half of the cycle or up to +7. It is better for the pancreas to have smaller meals.
You can divide the current food up into a main meal and snacks if you think that is the correct amount he should be eating.

When Sheba was first diagnosed I was told to only feed at shot time as well and the poor girl was always asking for food.
Jax will be much happier and more settled if he can have snacks during the cycles.....don’t forget the snacks in the pm cycle as well.
 
Kim3803 said:
If he is dropping that much that fast within 2 hours


If he is dropping that much that fast within 2 hours, would it still be ok increase his dose? Should I try the little meals in between and see how his numbers are first before I increase?
Click to expand...
Deb said to get another curve in before you increase, so use that time to implement the new feeding regime as well.
Many cats drop quite a bit at onset of the insulin so don’t worry. As long as you are aware of it and give the snack before the drop you should be fine.
Follow Debs advice re increasing the dose. I am a Lantus and Levemir user and haven’t used Prozinc.

Let us know what Jax thinks of his new feeding regime! He will probably be less stressed around preshot because he isn’t as starving hungry.....I’d be throwing a tantrum too if my food was taken away!
 
Bron and Sheba (GA) said:
Was it the vet who told you to not feed between the shots? That is old thinking
With the newer insulin it is better to feed more like it sounds you were feeding before the diagnosis.
So I would give a meal before the shot, then the one around +1 to see if we can slow the drop and the again once or twice, preferably during the first half of the cycle or up to +7. It is better for the pancreas to have smaller meals.
You can divide the current food up into a main meal and snacks if you think that is the correct amount he should be eating.

When Sheba was first diagnosed I was told to only feed at shot time as well and the poor girl was always asking for food.
Jax will be much happier and more settled if he can have snacks during the cycles.....don’t forget the snacks in the pm cycle as well.
Click to expand...

Yes it was the vet that told me that. Ok great this makes me feel so much better that I can feed him little snacks throughout the day. Hopefully this helps his numbers and his behavior. Thank you thank you so much
 
Kim another thing you can do to help him feel fuller is to add a little bit of warm water to the food, if he will tolerate it. That will help with hydration and also fill up his little tummy more. Some cats won’t eat food with water in it. I feed a raw diet to my cats and I always add a little bit of water to each meal....not too much or they will vomit. Every cat is different.
 
Bron and Sheba (GA) said:
Kim another thing you can do to help him feel fuller is to add a little bit of warm water to the food, if he will tolerate it. That will help with hydration and also fill up his little tummy more. Some cats won’t eat food with water in it. I feed a raw diet to my cats and I always add a little bit of water to each meal....not too much or they will vomit. Every cat is different.
Click to expand...

Yes I have been adding a little water to his food to try and slow him down. He eats so fast! I even put down a silicone lick mat with half of his meal to slow him down as well.
I'm figuring out a new schedule to start tomorrow morning and I will do another curve on Tuesday. He'll have 3 full days on the new schedule by then.
Thank you for all your help I appreciate it so much.
 
Kim3803 said:
Yes it was the vet that told me that. Ok great this makes me feel so much better that I can feed him little snacks throughout the day. Hopefully this helps his numbers and his behavior. Thank you thank you so much
Click to expand...
Yes definitely feed in between I always fed morning, noon, evening and before bed.
 
Also, remember that a diabetic cat can't process their food as well, because their body isn't working as well. So you may need to increase the AMOUNT of food you feed Jax, as well as the number of times you feed him.
 
Deb & Wink said:
Answered her over in the Prozinc ISG.

Yes, I do think that Jax could use a tiny dose increase soon. Would like to see a few more cycles of tests before that increase is done.
Click to expand...
@Deb & Wink , @JanetNJ , @Bron and Sheba (GA)
I started Jax's new feeding schedule on 4/3. For a few days he was staying in the 200s and low 300s as you can see on his SS. Of course the day I did his curve which was yesterday 4/6 his numbers were all over the place and started to get really high and even this morning at AMPS he was 479 which was his highest yet. I didn't change anything since the new feeding schedule and he was looking somewhat consistent and now i'm just confused and worried. What do you guys think? I appreciate all the help.
 
He could be bouncing a bit from that string of lovely yellow numbers. It’s normal to bounce and it’s normal for the numbers to go up and down as he gets used to the insulin. . Bouncing can happen if the cat drops too fast, too low or lower than he is used to. He is new to yellow preshots so that could have panicked him into dumping glucose into his system to ‘save himself’ and sent the BGs up high again. Bouncing can last from 1 to 6 cycles.
He is only newly diagnosed and it will take a bit of time for him to settle down.
It looks as if he could do with an increase in dose but I’ll leave that up to the girls who use Prozinc.
How is he enjoying his nw feeding regime?
 
Ok I see, I thought he was doing pretty well with the consistency but than it started to go so high again.
I have to start understanding the bouncing better. He is doing a bit better with his new feeding schedule. He is enjoying his snacks.
He is drinking a lot of water again like before he was diagnosed so I will see what the Prozinc ladies say about an increase. Thank you for your help I appreciate it so much.
 
Yes, I think Jax could use a dose increase. I recommend increasing by 0.25U. So the new dose would be 2.25U for Jax.
Syringes don't have 1/4 unit markings, so you have to use your best judgement on getting the syringe plunger placement in the right spot. Just "eyeball" it and do your best to be consistent when you draw up the dose.

You may want to hold off on the increase until the AM. If you increase in the PM, I'd strongly suggest you get another BG test later than that +2. More around the +4 to +6 time frame.

Even if you wait until the AM, a test in the +4 to +6 time frame will give you more pieces of the puzzle, and let you know how Jax is doing on the new dose.
 
Deb & Wink said:
Yes, I think Jax could use a dose increase. I recommend increasing by 0.25U. So the new dose would be 2.25U for Jax.
Syringes don't have 1/4 unit markings, so you have to use your best judgement on getting the syringe plunger placement in the right spot. Just "eyeball" it and do your best to be consistent when you draw up the dose.

You may want to hold off on the increase until the AM. If you increase in the PM, I'd strongly suggest you get another BG test later than that +2. More around the +4 to +6 time frame.

Even if you wait until the AM, a test in the +4 to +6 time frame will give you more pieces of the puzzle, and let you know how Jax is doing on the new dose.
Click to expand...
Ok, thank you. I just ordered new syringes today with the half markings so I won't have them until next week.
 
U40 syringes with the 1/2 unit markings will come in handy.

But, if you were to increase before you get the new syringes, you would put the end of the plunger closer to the 2U mark with your old syringes, to give 2.25U. Not on the line, but a bit above the line, closer to the plunger end of the syringe.

Use your best judgement to draw up the correct amount of insulin.
 
Deb & Wink said:
U40 syringes with the 1/2 unit markings will come in handy.

But, if you were to increase before you get the new syringes, you would put the end of the plunger closer to the 2U mark with your old syringes, to give 2.25U. Not on the line, but a bit above the line, closer to the plunger end of the syringe.

Use your best judgement to draw up the correct amount of insulin.
Click to expand...
Ok got it, thank you so much. I appreciate your help.
 
I agree. I would do 2.25, hold for several days, and then we can reevaluate and see if 2.5 would be better since we aren't seeing any blues yet.
 
JanetNJ said:
I agree. I would do 2.25, hold for several days, and then we can reevaluate and see if 2.5 would be better since we aren't seeing any blues yet.
Click to expand...
Thank you Janet. Jax hit 502 AMPS this morning for the first time. I really want to wait til I get the half marking syringes to increase so I feel more comfortable giving the right dose.
 
JanetNJ said:
I agree. I would do 2.25, hold for several days, and then we can reevaluate and see if 2.5 would be better since we aren't seeing any blues yet.
Click to expand...
@JanetNJ , @Deb & Wink , @Bron and Sheba (GA)
I wanted to just check in quickly, I am going to start Jax's increase to 2.25U tomorrow AM, I'll be home all day so I can monitor him and test him throughout the day. His behavior is so much better with the extra feedings so I thank you all for that advice. Is there a certain number that I shouldn't give the 2.25? Also any other last minute notes or suggestions for me? I'm a little nervous increasing for the first time. I appreciate all your help.
 
I’m so glad the new feeding regime is working and Jax is so much happier.
I see Jax wouldnt eat at the pm shot so you skippped the dose. Did you wait a while and then offer him food again before deciding to skip?
Is he eating now?
Are you testing for ketones with Ketostix? If not, I would.
I don’t use Prozinc so let’s see what the Prozinc users say about an increase.
 
Bron and Sheba (GA) said:
I’m so glad the new feeding regime is working and Jax is so much happier.
I see Jax wouldnt eat at the pm shot so you skippped the dose. Did you wait a while and then offer him food again before deciding to skip?
Is he eating now?
Are you testing for ketones with Ketostix? If not, I would.
I don’t use Prozinc so let’s see what the Prozinc users say about an increase.
Click to expand...

I did wait and offer again he was not interested. He did take a treat after I tested him.
This is the first time he’s refused food. He’s had low energy today and is drinking lots of water.
I’m not testing for ketones. I don’t know anything about it but I’m looking into it and need to get the strips.
 
Kim3803 said:
I did wait and offer again he was not interested. He did take a treat after I tested him.
This is the first time he’s refused food. He’s had low energy today and is drinking lots of water.
I’m not testing for ketones. I don’t know anything about it but I’m looking into it and need to get the strips.
Click to expand...
I just posted on your other thread. Definitely get the Ketostix today and test. If he’s lethargic and not eating, that is a red flag.
 
Deb & Wink said:
Is he sniffing at the food and turning his head away? And walking away from the food?

Try to tempt him with any sort of food. It's important that he eats something, even without insulin.
Click to expand...

He did sniff it and walk away. Not in a “I don’t like this” but in a “nope not interested” way.
Lots of water though.
 
Kim3803 said:
3 hours.
Click to expand...
Are you happy with the schedule you have at the moment? The reason I am asking is that you could bring the next shot forward to a better hour if that suits.
For example if you normally shoot 8 and 8 and you would rather shoot 6 and 6, you could do that because have skipped a dose, does that make sense?
 
Bron and Sheba (GA) said:
Are you happy with the schedule you have at the moment? The reason I am asking is that you could bring the next shot forward to a better hour if that suits.
For example if you normally shoot 8 and 8 and you would rather shoot 6 and 6, you could do that because have skipped a dose, does that make sense?
Click to expand...
Yes I get what you are saying. My current schedule is great right now and works for us with our schedules.
 
Kim3803 said:
He did sniff it and walk away. Not in a “I don’t like this” but in a “nope not interested” way.
Lots of water though.
Click to expand...
One of the signs of pancreatitis is a cat sniffing at the food and then turning their head away and moving or walking away.


Kim3803 said:
Jax just ate about half of a can and some chicken treats. He ate nice and slow and is cleaning himself now.
Click to expand...
Was the flavor of food he ate, different than the first food you tried?
Notes on the SS in the Remarks column can be really helpful. Like what flavor of food and how much he ate.
 
Deb & Wink said:
One of the signs of pancreatitis is a cat sniffing at the food and then turning their head away and moving or walking away.



Was the flavor of food he ate, different than the first food you tried?
Notes on the SS in the Remarks column can be really helpful. Like what flavor of food and how much he ate.
Click to expand...

Yes the flavor was different. This morning he did get up and meowed for his plate but than just stood there. I placed him by the plate and sprinkled treats on top and he did wind up eating most of it. I was able to to give him his AM shot. He also got up for his snack, did the same exact thing but he did eventually eat it.
 
Deb & Wink said:
One of the signs of pancreatitis is a cat sniffing at the food and then turning their head away and moving or walking away.



Was the flavor of food he ate, different than the first food you tried?
Notes on the SS in the Remarks column can be really helpful. Like what flavor of food and how much he ate.
Click to expand...
Jax has been pretty lethargic today. He hasn't drank any water or peed since this morning. I was able to get the ketostix. I placed him in his litter box and he wound having diarrhea. No pee so I wasn't able to test for ketones yet. He just had a chicken treat after testing and I gave him some water with a dropper. I don't want him to get dehydrated from the diarrhea. (He was drinking so much water yesterday and even early this morning before AMPS. I see that the pancreatitis symptoms are lethargy, diarrhea and decreased appetite. I'm going to try to get him to pee so I can get the ketones results and go from there. I'm thinking I'm going to have to take him to an animal hospital tomorrow if he gets worse or nothing changes. It feels like 1 thing after another. Is this common? Diabetes, Ketones and Pancreatitis all together? I'm new to any illness at all so this is freaking me out.
@Deb & Wink @Bron and Sheba (GA) @JanetNJ
 
Skipping the dose last night probably has a lot to do with him being lethargic today.
Neither people or pets feel good if their blood glucose is high.

A cat having both diabetes and pancreatitis happens fairly often. The ketones develop when they aren't eating enough and not getting enough insulin. A cat will burn off their own body fat and muscle for energy, and that is when the ketones form.
 
Kim3803 said:
Jax has been pretty lethargic today. He hasn't drank any water or peed since this morning. I was able to get the ketostix. I placed him in his litter box and he wound having diarrhea. No pee so I wasn't able to test for ketones yet. He just had a chicken treat after testing and I gave him some water with a dropper. I don't want him to get dehydrated from the diarrhea. (He was drinking so much water yesterday and even early this morning before AMPS. I see that the pancreatitis symptoms are lethargy, diarrhea and decreased appetite. I'm going to try to get him to pee so I can get the ketones results and go from there. I'm thinking I'm going to have to take him to an animal hospital tomorrow if he gets worse or nothing changes. It feels like 1 thing after another. Is this common? Diabetes, Ketones and Pancreatitis all together? I'm new to any illness at all so this is freaking me out.
@Deb & Wink @Bron and Sheba (GA) @JanetNJ
Click to expand...
Deb & Wink said:
Skipping the dose last night probably has a lot to do with him being lethargic today.
Neither people or pets feel good if their blood glucose is high.

A cat having both diabetes and pancreatitis happens fairly often. The ketones develop when they aren't eating enough and not getting enough insulin. A cat will burn off their own body fat and muscle for energy, and that is when the ketones form.
Click to expand...
He still hasn't peed so I didn't get to test for the ketones yet. I've been giving him a little water at a time with the dropper. He didn't have anymore diarrhea yet. I'm just hoping he eats for his PM shot. I know he's showing a lot of symptoms that don't look too good. His numbers have been pretty much the same today no reds yet. He needs to get regulated. Hopefully the .25 increase will help. Thank you again for everything.
 
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