What are ProZinc dosing recommendations for an acro cat?

Discussion in 'Acromegaly / IAA / Cushings Cats' started by varlene, May 10, 2021.

  1. varlene

    varlene Member

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    Those from main/welcome forum suggested I post here. Smoky's IGF-1 is 234. He is currently on ProZinc (since June 2018), and because I just bought a new vial I won't be switching to recommended Levemir right now. Are there basic guidelines for ProZinc users? I see that I shouldn't wait too long, but I don't know what that means. What constitutes a cycle, a dosage or two doses for the day? As you will see in Smoky's spreadsheet, I just upped his dose by .25 today, now at 8.75 units, but don't know if that was enough or even warranted. Also interested in cabergoline, if my vet will prescribe it.
     
  2. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Cycles are 12 hours long. You have an a.m. cycle and a p.m. cycle. Yes, a dose increase is definitely warranted at those high numbers. I just counted on your spreadsheet and you had Smoky at 8.5 units for 28 cycles with very little improvement in glucose numbers. Under either protocol (SLGS or TR) you have held the dose for too long. Holding a dose that is too low -- for too long is not good for a lot of reasons. You don't want your kitty to get too comfortable in the high numbers, which Smoky would be by now.

    Have you read through the information about the Start Low Go Slow and Tight Regulation protocols? With the amount of testing that you are doing (good job, by the way) Smoky would be a good candidate for Tight Regulation (TR), which would allow you to increase at a faster pace and hopefully get to a better dose and get Smoky's numbers down more quickly into a healthier range.
     
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  3. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I used to use ProZinc, as well. This was before I knew that my cat had Acromegaly. I kept trying different insulins (been through all of them) because I thought maybe it was the insulin. It was the Acromegaly, which I only found out about this year. My kitty was on VERY high doses of insulin. We started Cabergoline and after about 6 weeks, his insulin requirements dropped dramatically. He got as many as 41 units twice a day and is now down to about 3 units twice a day.
     
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  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    tagging @JanetNJ who managed her acro cat on Prozinc.
     
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  5. JanetNJ

    JanetNJ Well-Known Member

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    Hi! Try the 8.75 a few days but don't hold it too long. If you don't see any movement id go to 9 on Wed or Thurs
     
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  6. varlene

    varlene Member

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    Thank you, Janet. Will do.
     
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  7. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Smoky is a gorgeous grey baby!!
     
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  8. varlene

    varlene Member

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    Thanks, Suzanne. Smoky was a cutie that just showed up one day. We used that picture trying to adopt him out because he didn't get along with our other cats but then we ended up paying to officially adopt him ourselves when he was returned to Florida Humane because he didn't get along with a cat. He's always been a bit different but very sweet. He loves bedtime when he gets to sleep with us. Your Mr. Darcy is very handsome, but his readings on your spreadsheet would scare me to death. I am just hoping I can get Smoky's pre-shot numbers to ≤300 with a nadir in the normal range. I can't imagine going up to 41 units. Yikes. Cabergoline seems to have been the answer for Mr. Darcy. Any problem having your vet prescribe it? How much do you give?
     
  9. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I give Darcy .4 mL of Cabergoline. The strength is 200 mcg/mL, so that means he gets 80 micrograms in his dose. Note that I had been giving him Cabergoline daily, but recently he went into renal failure (hopefully an acute kidney injury that will be reversible) so I have reduced his dose to every other day. I'm just trying to give him a break for the time being until I am sure he will stabilize.

    At first, my vet seemed disinclined to prescribe it based upon another vet's advice, but I provided her with some information (from Wendy and the Board) and she readily allowed me to try it. Several FDMB kitties are taking Cabergoline now and are doing very well on it.
     
  10. varlene

    varlene Member

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    Thank you for your reply. Good to know that cabergoline is out there if Smoky needs it. I hope Darcy gets better soon!!!!
     
  11. varlene

    varlene Member

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    Hi, all and especially @JanetNJ. Smoky is at 11 units ProZinc and due to go up tomorrow. I am thinking I should try 12 instead of 11.5 but I am too new at this to do without advice and support, especially since Smoky seems to be out of sorts, not happy, not eating, and BG curves don't seem to be getting better. Thank you.
     
  12. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Janet may not be on, she is recovering from a surgery. I think you'd be fine going up to 12 units. For Lantus and Levemir, we increase by a full unit over 10 units dose, especially if not seeing anything under 100.

    I'm worried about the not eating. Maybe time to take him to the vet. Any chance he's constipated?
     
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  13. varlene

    varlene Member

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    Thanks @Wendy&Neko. Sorry to hear about Janet. I hope that her surgery was a success and that she will have an easy and speedy recovery. Thank you for your concern. At 2 hours before the PM shot, Smoky started eating again and did not vomit, so all's well for now thankfully. I scooped up poop earlier from the litter box that he only uses, so that's good too. I will try 12 units tomorrow and hope for the best. Many thanks.
     
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  14. JanetNJ

    JanetNJ Well-Known Member

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    Hi I'm doing good after surgery. :). Taking it slow and easy. I liked those blues last week. Wish they would have stuck around. I think skipping to 12 is a good idea. Crossing fingers for you. My cat had to hit 13 before going down.
     
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  15. varlene

    varlene Member

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    @JanetNJ So glad to hear you are doing okay and taking it easy. Hope you will continue to improve with each passing day. I liked those blues too!!
     
  16. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I'm rooting for Smoky! I hope the 12 units does the job. My kitty had to go very high in dose but he's a case! I hope that your Smoky won't need much more insulin to start responding.
     
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  17. varlene

    varlene Member

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    Thank you, @Suzanne & Darcy. I too am hoping we are getting close.
     
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  18. JanetNJ

    JanetNJ Well-Known Member

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    Just have to keep reminding yourself that he needs what he needs
     
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  19. varlene

    varlene Member

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    Seems like moment of truth and need help. Today first time all yellow & blue. PMPS at 154. He's looking at his food but not eating. I'm due to shoot 16 units now. Yes or No? @JanetNJ @Suzanne & Darcy @Wendy&Neko
    UPDATE: After 1/2 hour, BG was 208 and he's eaten a bit, so I shot 16 units and will test through the night.
     
    Last edited: Jun 9, 2021
    Reason for edit: Updated
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  20. JanetNJ

    JanetNJ Well-Known Member

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    Sorry I missed this post. You did exactly what I would have suggested. I hope this means you will now start setting progress.
     
  21. varlene

    varlene Member

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    Thanks @JanetNJ. This morning's PS was 159, then after 1/2h delay 181 so gave 16 units and will monitor. Nadir that I caught was 94 at +10.5h after PM shot, but I might have slept through a lower one.

    Looks like the next TR step is "when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing" but since I am an hour behind schedule, if all goes well today, I'm thinking I could give a tad less tonight (15.5 or 15.75) and then back on 16 units in the morning, or I could just be brave, keep it 16 units and hope the hour earlier won't mess things up.

    Probably too early to ask about reducing, but TR rules state that you don't reduce until nadirs fall under 40 mg/dL, but since normal looks to be 64-170 mg/dL, I am reluctant go below 50-60 without intervention especially since some meters might be off, however, I don't want to ruin the process. I guess time will tell but wanted to get this question in writing just in case it happens sooner than expected and nobody is around to hold my hand.

    Thanks for your help. Hope you are doing well.

    Arlene V
     
  22. JanetNJ

    JanetNJ Well-Known Member

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    that model of 40 is with a HUMAN meter.... don't go below 68.... you are using an alphatrack. I like your numbers so unless you are really nervous i'd stay at 16. if the preshot is low and you wanna go down to 15.75 that's probably ok.... but 94 is where you wanna be! I would keep at 16 and give it a test before bed, or maybe set an alarm and check once at night.
     
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  23. varlene

    varlene Member

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    @JanetNJ: Thanks for getting back to me. I agree that 16 units is working well today. I might have been too optimistic thinking I could shoot an hour earlier tonight to get back to 9a/9p as I will be lucky if I can give Smoky his shot at +12h (10p) without a delay. But if all goes well tonight without a delay, I can try getting back to 9a/9p in smaller increments over the next few days.
    Someone worked on my "Arlene's Version of SS", and I am very grateful because the X axis spaces the hours evenly, which I didn't know how to do on my own. If it was you, please let me know how you accomplished it. I'd like to do the same going forward. Unfortunately, the curve didn't automatically update when I added the most recent BG so I could use some guidance. Latest was 176 at +6h. :)
     
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  24. varlene

    varlene Member

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    @JanetNJ: I see that I needed to reformat my date/time column to get the fixed time intervals on the X-axis. Thanks ever so much!!
     
    Last edited: Jun 10, 2021
  25. varlene

    varlene Member

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    @JanetNJ: After two wonderful days and nights, todays BG's are in the high 300s and I am thinking I need to up to 17 tomorrow, maybe even if it goes lower tonight. Weird that his BGs go lower overnight than during the day. I swear he was looking for his PM shot two hours before it was due. : (
     
  26. JanetNJ

    JanetNJ Well-Known Member

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    Mine often had different night and day numbers. It might be because he eats less at night, or is more relaxed at night, or moves more. Who know.

    The suddenly higher number could also be just a bit of a bounce from going lower than usual. Hard to say. Maybe do 16.5? See what happens? Totally up to you. You are great about testing so it's your call.
     
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  27. varlene

    varlene Member

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    Thanks, I will give 16.5 and will see what happens.
     
  28. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Just wanted to make a small clarification. We don't have a Tight Regulation dosing method for Prozinc here. This document describes what we do have:
    PROZINC DOSING METHODS The two methods are SLGS and the Modified Prozinc method.

    Tight Regulation was developed and tested with depot insulins, Lantus and Levemir.

    Nice spot of green today. :)
     
  29. varlene

    varlene Member

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    Hi, @Wendy&Neko, @JanetNJ -- Had to give glucose overnight and looks like I will be testing hourly today and likely likely giving more. Needless to say, reverting to 16 units was not enough of a reduction this morning. So for the PM shot, I am tempted to reduce a full unit to 15 but would appreciate input if it is not too much trouble. Many thanks.
     
  30. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    I'm not experienced in Prozinc, but I think a full unit reduction might be a good idea for now. With Lantus we change doses by full units over 10 units total dose, unless just trying to tweak a dose that's almost a good one.
     
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  31. JanetNJ

    JanetNJ Well-Known Member

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    Hooray!!! You finally found your breakthrough dose! Did you have to steer a lot today? It would be ok to reduce to 15. If he runs a little high you could go back up to 15.5.
     
  32. varlene

    varlene Member

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  33. varlene

    varlene Member

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    Hi, @JanetNJ Thank you. Your reply made me smile for the first time today. I have been rubbing glucose on Smoky's gums or giving him a bit of honey sugar water via syringe with each hourly test because he is not eating. If that is what you mean by steering, then yes I am. Just now at +8h = 109 and he started to eat a bit so will hold off giving sugar and see how he does, continuing to test each hour until hopefully good PMPS value so I can try 15u.
     
  34. JanetNJ

    JanetNJ Well-Known Member

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    Oh yeah then definitly lower to 15!!! This is very exciting!!! Nerve wracking for you... But exciting.
     
  35. JanetNJ

    JanetNJ Well-Known Member

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    Look in my spreadsheet for 2019.... In July I had her breakthrough and you can see the numbers really fluctuated.
     
  36. varlene

    varlene Member

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    I am going to up to 15.5 tonight, since his nadir in high 100s, I think it will be okay. I looked at your spreadsheets and it seems you dosed day by day depending on circumstances, which I like. After Smoky's AM shot at 15u, after reviewing his numbers, it seemed I probably should have given him 15.5, and wondered if okay to just give him an additional 0.5u as it was just about an hour later. However, because I was going out for several hours, I didn't do it, but wonder if it would be acceptable thing to do if it comes up again. Gotta run; now time from his PM shot. And yes, it was/is definitely nerve-wracking!!!!
     
    Last edited: Jun 15, 2021
  37. varlene

    varlene Member

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    @JanetNJ -- Smoky had a banner day. Thankfully a slow day working from home so was able to test him hourly. Tried to move his 10p shot time earlier but couldn't due to a sudden drop at 9:30p from 209 to 144; but at ~10p was 206 so shot 15.5u since his nadirs were green and 15u didn't work well the last time. Fingers crossed he will do okay overnight while I sleep. Thank you for your continued guidance and encouragement.
     
  38. JanetNJ

    JanetNJ Well-Known Member

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    Wow look at those blues and greens!!!! Hold this dose a while (unless he goes too low of course.). If the numbers go up it could be from these lovely greens and blues that he's not totally used to yet.
     
  39. varlene

    varlene Member

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    @JanetNJ: Thank you for your advice. I have been feeling like a failure seeing the pinks today instead of the seemingly perfect blue & green day yesterday and doubting I was doing the right thing. I will hold tonight per your advice and will hold tomorrow too unless BG goes too low. Thank you. Thank you. At +8.5h, I finally see a yellow, so that is some progress.
     
    Last edited: Jun 16, 2021
    Reason for edit: For clarification
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  40. JanetNJ

    JanetNJ Well-Known Member

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    You are facing a different set of obstacles. Her high numbers are not your failures.... They are just her little body out of wack. Look at the bigger picture. Uptrend your spreadsheet and look at the overall colors you are seeing in June verses what you had in May!!! Squint at it! Look at all those healing blues!!! You are leading her to this through your love and dedication. You are amazing and your cat is so lucky to have you.

    Two weeks ago your average morning preshot was 379.6. The last 7 days it was 257. Amazing.


    All we can do is take our best guess. How is she behaving? Does she seem to feel ok? Whenever you can get her to play, exercise helps the numbers too.
     
    Last edited: Jun 17, 2021
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  41. JanetNJ

    JanetNJ Well-Known Member

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    Oh! I see she even went a little low! I'm glad you didn't increase! Ok so that means she earned a reduction. I would go down to 15.25. But again don't be surprised if you see some high numbers in the next cycle from a bounce. Good job testing that you caught that.
     
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  42. varlene

    varlene Member

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    You are right, of course. Reds & Blacks are now ancient history. : ) Smoky has been in pretty good spirits, even sitting quietly when the female cats Leah & Amanda ("the girls") come into the bedroom which was his territory behind a closed door for most of his life. He such a good little guy. Whenever I call, "Hey, Smoky, time for your test" he comes out from wherever he's been resting and sits at the test spot next to his food dish. I couldn't ask for a sweeter or more obedient cat.
     
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  43. varlene

    varlene Member

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    I don't know what woke me up but when I saw that Smoky wasn't in his usual spot on the bed I sought him out. Once his numbers were back up, I entered his BGs into the SS with the hope you would see them first thing this morning, which you did, and provided guidance. : ) Thank you!!!
     
    Last edited: Jun 17, 2021
  44. JanetNJ

    JanetNJ Well-Known Member

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    Oooh Liking those numbers so far today! Going into the blues without taking a nosedive. hahahaha
     
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  45. varlene

    varlene Member

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    @JanetNJ The nosedive came. I had to head out today but had a feeling that Smoky was trending down, so came home and found him at 77 but didn't give glucose until I saw 48 with the next test. The GBs within one hour ran the gamut from 48 to 101, so I picked the lowest color for the spreadsheet. I am thinking this means another reduction with the PM shot. From 15.25 to 15?
     
  46. JanetNJ

    JanetNJ Well-Known Member

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    Yes time to lower again! Very exciting!!
     
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  47. varlene

    varlene Member

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    His numbers are not staying up and he's turning up his nose at food. At +8h I gave him commercial glucose (SOS) instead of syringes of sugar water, hoping it will work better or maybe his AM insulin dose will finally peter out.
     
  48. JanetNJ

    JanetNJ Well-Known Member

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    Maybe lower to 14.75
     
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  49. varlene

    varlene Member

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    Sounds good IF (big IF) his PMPS comes up. It was 78 at 10.5h and that is with getting glucose all afternoon. At +11.2h he is at 101 but had just 0.5h before. Today he has been skittish, hating doing testing, and running away from Leah who is taunting him and from me. : (
     
    Last edited: Jun 17, 2021
    Reason for edit: added +11h reading
  50. JanetNJ

    JanetNJ Well-Known Member

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    If he's low stall without feeding for up to an hour. If it's still low you may want to give just a small token dose.., like 4 units...
    Then at the next normal preshot would you feel more comfortable doing 14.5?
     
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  51. varlene

    varlene Member

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    It is a bit of a quandary. LOL. I would have thought today's 295 pre-shot would be work well, yet 6/15's 189 worked much better. I am going to take Smoky's food away now and see what happens for the next hour. Thanks for the 4u token dose idea if it comes to that and for suggesting where I can start off in the morning, whether at 14.5 or 14.75. Funny thing is Smoky sure has lots of energy all of a sudden to run away from me. Maybe he is feeling better or it could be wishful thinking on my part. Thank you for taking so much time from your day to help me!!!! Smoky and I are truly in your debt.
     
  52. JanetNJ

    JanetNJ Well-Known Member

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    You did an amazing job of steering today and kept him safe and in those healing numbers!!!
     
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  53. varlene

    varlene Member

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    Thank you. I am blessed to be able to work from home as necessary and be available to test Smoky and catch his lows. I definitely see progress but am hoping that a pattern might reveal itself, although I have diabetic friends who cannot make sense of their unexplained ups & downs either. I will try to keep my spreadsheet up-to-date and keep you posted. Again, many thanks.
     
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  54. JanetNJ

    JanetNJ Well-Known Member

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    So it looks like the numbers are going up. You can probably do more than the 4. How do you feel about like 9 or 10?

    If you already did the 4 though that's fine. It may be a little high tomorrow am but then you can give the full dose.
     
    Last edited: Jun 17, 2021
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  55. varlene

    varlene Member

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    Yes, sorry, gave the 4 and do see numbers going up now (but of course). Since less than an hour ago, is it okay to add another 4 or 5? Or would it skew results and confuse things even more? If I don't do today, it is something I have wondered about, especially if only maybe 30 minutes later if it comes up some other time so would like your thoughts.
     
  56. JanetNJ

    JanetNJ Well-Known Member

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    I would just wait until tomorrow. That way you can get a good night's sleep... Esp since you are now two hours past your normal schedule. Tomorrow you can go back to your normal time.

    To answer your other question... I've second guessed my doses and added a little more. Not often though.
     
  57. varlene

    varlene Member

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    I have some regret not sticking with the program, but yesterday was grueling (25 test strips) on too little sleep. Today will be an opportunity to see how fast he can recover and learn from it. I need to get out to do what I didn't get done yesterday and am thankfully fairly confident he won't drop into a danger zone anytime soon.
     
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  58. varlene

    varlene Member

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    @JanetNJ: PM Fur shot, Not sure any went in. Needle was a tad bent and I stupidly pressed plunger harder which made insulin ooze out onto fur instead of into skin. What are the odds of it happening on this particular shot that I felt would so important. He is high, think he needs something. Got resistance as soon as I started the shot and then watched it flow on top of his fur. I know I've seen, don't repeat fur shots but maybe that's when 1u makes all the difference in the world. : (
     
    Last edited: Jun 18, 2021
  59. JanetNJ

    JanetNJ Well-Known Member

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    Awe man... Don't beat yourself up too much. We've all done it. Just curious why you delayed an hour?
     
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  60. varlene

    varlene Member

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    It was late because I wasn't going to give him anything at all, but by the time I poured out 14.75 units of water several times out to eyeball how much I really saw on his fur, an hour had gone by. It turns out that I do need to delay at least an hour tomorrow anyway because my husband and I are going out to dinner to celebrate my birthday (now a Federal Holiday) and Father's Day with my 100-year-old father-in-law and his girlfriend. Can you believe that? : ) Just praying Smoky survives the night and I have not inadvertently killed him with an overdose of insulin, on my birthday no less. Oy!
     
    Last edited: Jun 18, 2021
  61. JanetNJ

    JanetNJ Well-Known Member

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    Looks like he did ok last night. Omg did you get any sleep? Happy Birthday!!
     
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  62. varlene

    varlene Member

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    Thank you, @JanetNJ. My watch says I got 6h 18m of sleep which is so much better than the other night's of 3h 49m when I had to administer glucose and watch and wait. Looking forward to seeing how Smoky will do today. So glad I redid the botched fur shot as it looks like none made it into him. Whew!
     
  63. JanetNJ

    JanetNJ Well-Known Member

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    Oh nice numbers today! :)
     
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  64. varlene

    varlene Member

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    So far, so good. : ) Fingers crossed. Thanks for checking in!!!
     
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  65. JanetNJ

    JanetNJ Well-Known Member

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    Doing good!
     
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  66. varlene

    varlene Member

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    @JanetNJ Hope you had a great weekend. I am thinking Smoky is due for reduction since nadir is at 67, so will give 14.5u instead of 14.75 for the PM shot if that sounds right to you. But, of course, Smoky's BG is trending down instead of up, so it might be watch and wait or give even more of a reduction. Oh, well.
    ~Arlene
     
  67. JanetNJ

    JanetNJ Well-Known Member

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    Yes he earned another reduction. Whooohoo

    I see you stalled and he's still pretty low. If it were me if probably shoot like 10 tonight if you can watch. And reduce that dose in the morning to 14.25.
     
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  68. JanetNJ

    JanetNJ Well-Known Member

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    I see you got brave and did 14. I'd set an alarm for +6 just to make sure he's ok
     
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  69. varlene

    varlene Member

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    Missed seeing this until now. I stalled 1.5h until he reached 194 which was same as last night but 1.5 hours later. Last night he got 14.75 so gave 14 tonight which I thought was conservative but will see how he does overnight as it is much higher than your 10u.
     
  70. JanetNJ

    JanetNJ Well-Known Member

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    It may be fine. I last saw the 145 but it went higher. I was hoping to give you a good night sleep. Ha ha
     
  71. varlene

    varlene Member

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    I would have loved a good night's sleep. Speaking of which, why were you up at 4:18? : )
    I guess I reduce again with this morning's shot, maybe to 13.75 or 13.5, which might depend on the time Smoky gets to a suitable number, the earlier the better. Time to test again.
    Hope you have a wonderful day!!!

    P.S. I joined the Feline Diabetes Facebook group over the weekend, not that I have had time to look at anything yet.
     
  72. JanetNJ

    JanetNJ Well-Known Member

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    I have no idea why I was up. I couldn’t get to sleep until after 1:30 then woke up about 3:45. Mama’s gunna need a nap later. Lol. I work up yesterday at 4, too. Lemme go check the spreadsheet.
     
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  73. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Let’s see what the preshots is. I like 13.5
    I saw in your notes that you’ve been giving honey for these slightly too low numbers. Do you have any medium carb (10-15%) that you can give as a treat instead? Usually we save the honey for lower numbers like below 60.
     
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  74. varlene

    varlene Member

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    Apr 23, 2021
    @JanetNJ. Sorry, thought I sent this earlier. Must have pressed enter instead of clicking the button. Not the first time I've done this.
    ------------
    I wasn't sure if the 67 was the beginning of a downward trend so gave Smoky a scant 0.3 to 0.4 ml of honey from a skinny syringe, most of which stuck on the syringe or on his chin that I had to wash off. The honey was right next to his food dish which still had uneaten food in it from bedtime so was handy & very quick. If BG number were lower, I would have given multiple 1 ml syringes of glucose, honey water, and/or rubbed his gums with it like crazy. While I have cases of different foods in my garage, I haven't given Smoky anything but low carb since I started here, not wanting to skew the tests. The girls eat the same food as Smoky but supplement with dry food that I keep in a small dish on the kitchen counter. Smoky will not eat dry food thankfully.
     
    Last edited: Jun 21, 2021
    Reason for edit: typo
  75. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Keep some gravy food handy. :) honey isn't always needed to just steer it up a little.
     
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  76. varlene

    varlene Member

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    Apr 23, 2021
    I will try, but he is stubborn. I have often put food down in front of him and he will refuse to eat it. However, for some reason he has been hungry today, actually came to get me so I could feed him something even though he still had some leftovers. I gave him a fresh can, and he ate it up.
     
  77. varlene

    varlene Member

    Joined:
    Apr 23, 2021
    As of +9.5h, BGs in 200s, nothing lower. Am I supposed to up it maybe .25 or .5 on PM shot or do I hold to see if it will kick in, which seemed to be the case when we were going up, up, up? Now that we reduced, not sure of the rules. Hopefully I will get the hang of it someday.
     
  78. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    No.... Stick with 13.5 for a few days. You don't change a dose based on just one cycle.
     
  79. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Oh I see you raised it and it went a little low last night. Go back to 13.5 for a while.
     
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  80. varlene

    varlene Member

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    Apr 23, 2021
  81. varlene

    varlene Member

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    Apr 23, 2021
    @JanetNJ Smoky finally ate some Gravy Lovers and with a >1.5h stall he is at 234 then 262 so I will give him his AM shot reduced to 11.5u due to delay, with the hope he can have PM shot at normal time and back at 13.5u. We'll see.
     
    Last edited: Jun 22, 2021
  82. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Yes. Next time your are stalling do it without feeding or else the number is artificially high from the food. That's why we say no food at least 2 hours prior to the preshot test. You don't want to dose based on a food influenced number or they might drop too low when the food wears off.
     
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  83. varlene

    varlene Member

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    Apr 23, 2021
    Thank you. Of course it makes perfect sense and you even mentioned it before and I believe I noted it down. I will need to make bullet point notes for myself so that one day the process might become second nature to me. Will also need to review when to use HC (like FF Gravy Lovers?) versus a MC (like FF Grilled?). It was easier just giving LC food for all meals and glucose for all low drops. Smoky was sweet overnight, but definitely out of sorts this morning. Threw up and just wants to sleep and hide. Hopefully time will reverse any of the adverse effects I caused him.
     
    Last edited: Jun 22, 2021
  84. JanetNJ

    JanetNJ Well-Known Member

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    It's a marathon. You didn't cause problems. I love the improvement we are seeing.
     
  85. varlene

    varlene Member

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    Apr 23, 2021
    It is all-consuming, and I am totally obsessed. I see a clock and instead of thinking "oh, time for lunch" I calculate the minutes to the next test or shot. LOL. It is quite amusing except that I really should be playing catchup with the rest of my life--emails, work, bills, etc. as I am soooo far behind. Smoky's numbers really have gotten better since I joined FDMB and found you, and I am amazed his dose is actually going down, which is great. We need to board Smoky for three nights in July so hoping to find a dose by then that will work SAFELY for six cycles while my husband and I are away at a conference. I have someone who will come by for our other cats and the menagerie outside by the pond, but she will not do shots. Thanks again for your encouragement!!
     
  86. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    I always did the same.... My niece or sister would watch my others and is board my diabetic.


    You're doing great.

    I wouldn't bother testing again until like +6-7
     
  87. varlene

    varlene Member

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    Apr 23, 2021
    Good morning, @JanetNJ I will be out between +6.5h and +9h when Smoky will probably nose dive. Should I leave mc or hc food for him to eat during that time?

    Also, this morning when he was trending up from 135 @10.5h to 175 @12h which would have been the AMPS time, I stalled 15 mins until he got to 190, which seemed safer. Wondering if might have been fine at 12h, considering he was trending up, or was it best to wait?

    I am not at all sure how the 13.5u will affect his BG today as I missed the overnight nadir. : ( I do know that Smoky is in super great spirits today, was out and about looking for me to bring him some food this morning, and he ate up everything with his shot.
     
  88. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    You could put out some Mc if you are concerned. Test before you leave. I'm glad he's feeling good!!
     
  89. varlene

    varlene Member

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    Apr 23, 2021
    Smoky survived my absence. No idea how low he actually got, but he seems perfectly fine. : )
     
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  90. varlene

    varlene Member

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    Apr 23, 2021
    @JanetNJ I had been so intent on keeping 13.5 for several cycles that only after PM shot, did I see that a reduction might have been due since +6h BG was <90. Since I missed the reduction for PM shot, do I reduce in AM even if he doesn't go <90 overnight or wait until I see <90 again?
     
  91. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    If it were me id keep at 13.5 as long as you could test. If youre going out then lower to 13.25. I always aimed for 80ish. Those nice, healing greens is when the pancreas can really rest and heal.
     
  92. varlene

    varlene Member

    Joined:
    Apr 23, 2021
    Thank you. Such a relief hearing from you before I give him his AM shot. Hope you have a wonderful day!!!!!
    P.S. I watched your instructional video last night and realized it is where I learned about cosmetic rounds, which was an absolute game changer. I remember thinking that CC was the best cat ever and such a pretty little girl, so it doubly grieves me to know that she's gone. So glad she had you as her human!! {{hugs}}
     
  93. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    She truely was an amazing cat. I just loved her personality. She was the leader of the other five even up to her last day!!! My son called her The Mayor of Cat Town. She was so cooperative with all the poking and proding over the years, and always ready for a cuddle. While she wasn't a lap cat, she slept on my feet just about every night. My heart still aches when I think of her and that she's gone. I really thought she had more time. She was asking great managing all her issues... Acro diabetes, Hyperthyroidism, ckd, arthritis, heart murmur, a cancerous tumor removed from the leg, had most of her teeth out..... But still she was spunky, and happy!!!

    In the end she declined quickly and we found out she had a huge cancerous tumor in her spleen.
     
  94. varlene

    varlene Member

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    Apr 23, 2021
    CC sure had lots of ailments, poor baby. Our last few losses were brutal because even though the kitties were down to skin & bones, there was such a life force in them, like they didn't want to give up, that made saying goodbye so much harder. Heartbreaking.
     
  95. varlene

    varlene Member

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    Apr 23, 2021
    @JanetNJ Thank you for sticking around at FDMB even though CC passed. If not for you, I really don't know where I'd be now, and yet I am still not really sure I know enough to do it without your support. I can never ever thank you enough. Hope all is well.
     
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  96. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    You will pay it forward to new people one day too. I was so lost and upset in the beginning... And these folks helped me. I'm happy to help.
     
  97. varlene

    varlene Member

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    Apr 23, 2021
    @JanetNJ I would like be able to pay it forward, just as soon as I know what the heck I'm doing. : ) When you get a chance, please let me know your thoughts on Smoky's dosage, to up or not to up.
     
  98. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    I wouldn't raise at this point. You got a couple of light greens in the last few days. You're still using an alpha meter right?

    How does he seem to be feeling.
     
  99. varlene

    varlene Member

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    Apr 23, 2021
    Yesterday he was miserable and not eating. This morning he has been zooming, running around, very content. There were blues overnight, so I will stay. If the blues didn't show up, I might be worried, but what a difference a day makes. Will hold. Thank you!!!
     
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  100. varlene

    varlene Member

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    Apr 23, 2021
    @JanetNJ I am not sure what is going on, but Smoky's lowest BG today was before his shot instead of after. It went up after that instead of down. Happened yesterday too. If I follow the rule about upping 0.25 if nadir is >150 which it is, at least so far today, then it would appear I should up the PM shot. However, is it possible his numbers are going up because he is getting too much insulin? He hardly eats anything anymore, maybe half a can with the shot. He used to eat one or two cans in one sitting. Also, should I be starting my graphs at the time of his first shot of the cycle(s) instead of first test of the day? Sorry for all the questions.

    MORE: I looked at CC's spreadsheets to see if I could learn more and it seemed you played with the doses more up & down, a lot more than I do, maybe using the PS numbers, but not sure. Whatever you did, it worked to lower her BGs as time went on but I am not sure I know the why's of moving up and down in all cases.
     
    Last edited: Jun 27, 2021
    Reason for edit: Add

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