? Prozinc 1unit 2x/day -2 weeks in

Milah and Maxine

Milah and Maxine

Member
Hi there . Maxine here with My 12 year old 14 lb girl Milah. We are very new to this forum but have been reading through old posts. My cat is newly diagnosed with diabetes .she was walking on her hocks and very wobbly . The vet said it was diabetes and wanted to try and control it before changing food. Her numbers are always high in the 300-400s .( we have an alphatrak3)She is not eating so well at the moment and is dehydrated and constipated. Only passing small hard nugs of poop. I’ve been giving her “kittenlyte” electrolyte drink and trying to feed her can food.

she is on prozinc 1 unit 2x a day. For one week now. She was also taking an antibiotic for 10 days and an appetite stimulant that we have to cut in 1/4 and make a liquid. We finished the antibiotics and are still continuing the stimulant(although it doesn’t seem to be working to me)

We saw the vet today but he didn’t really check her. I had some concerns about her food and her not eating so well or passing poop. She just is weak most of the time. He told me I should be giving her whole milk in a syringe to make her go. Also told me I can increase the dose to 2 units 2x a day if her numbers stay above 300. Not sure how safe that is with her not eating well. I also work 8-12 hrs a day 6days a week. I’m afraid something will happen when I am not home.

some kind people on here were helping me on another post .they gave me a link to a spread sheet and some info. I decided to try and change my cats food from her RX hills C/D food to fancy feast classic pate. What should I look out for in terms of testing and dosing with this new food?i am currently on the search for a cat friendly vet in NYC I can change her to. It’s all so overwhelming and chaotic at the moment. i will take all the help and advice I can get. Please and thank you !
 
The previous post is here.

The minimum number of tests you need to get is 4. You should test before giving insulin (your AMPS and PMPS tests) and at least once during both the AM and PM cycles. I'm a testaholic so I tend to think more is better.

It will be very helpful if you can set up a spreadsheet to keep track of your cat's blood glucose tests along with information about your kitty in your signature. The information is in this post on helping us to help you. I believe Bron provided you with the link in your previous post. Please let us know if you need help with getting the spreadsheet set up. @Bandit's Mom
 
Old posts with NYC area vet suggestions:

https://felinediabetes.com/FDMB/threads/nyc-vet-reccs.260985/
https://felinediabetes.com/FDMB/threads/seeking-vet-in-north-jersey-nyc-area.67227/
https://felinediabetes.com/FDMB/threads/recommendations-for-nyc-im-vets.190831/
https://felinediabetes.com/FDMB/thr...ecommendations-in-the-nyc-queens-area.297186/ (no recommendation actually given but try sending a PM to those members)

I'm not familiar with Prozinc but @Suzanne & Darcy is one of the experienced members who can offer tips and advice.
 
Is there sugar of any sort in the kittenlyte?
What kind of appetite stimulant is that? What is the name?
Giving whole milk in a syringe is a very odd suggestion to get a cat to poop. Yes, it may upset her stomach and cause diarrhea (since adult cats cannot digest the lactose in cow’s milk and many will get diarrhea from it — which is not what we would want because diarrhea will further dehydrate her.)

The above comments are just my first impressions at reading your introductory post. My husband just came home from work. I need to eat dinner with my family and I will come back. Let me look at your spreadsheet and we can talk about food and your dose and everything. Okay? I am on Eastern time so it’s 8:49 here right now now. What’s your time zone.
 
im not sure now I was just worried about her becoming dehydrated. I added in what it says on the back. the vet said it was okay but his advice hasn't been the best thus far...
the appetite stimulant he gave us is called mirtazapine 15mg its a tablet that I have to cut in 1/4s and give 2x a day. we've been using since last week Friday.
okay no problem at all. I'm working on the spread sheet now. I am also in the same zone it is 9:15pm.
 

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I see you have a spreadsheet set up. Could you please start getting tests with your AT meter before every shot and at least one test during each cycle? At night tests are very helpful, as many cats tend to drip into lower numbers at night. Do not increase her insulin dose at the same time as you are making the switch to low carb wet Fancy Feast food — not without testing to see where her nadir is (lowest point in the cycle.) Since you are not home a lot of the time, you can do a curve on a day you are not working.
 
Milah and Maxine said:
im not sure now I was just worried about her becoming dehydrated. the vet said it was okay but his advice hasn't been the best thus far...
the appetite stimulant he gave us is called mirtazapine 15mg its a tablet that I have to cut in 1/4s and give 2x a day. we've been using since last week Friday.
okay no problem at all. I'm working on the spread sheet now. I am also in the same zone it is 9:15pm.
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Has she had bloodwork done recently? Do you have copies of her bloodwork? I am concerned about the dehydration and constipation. It would be best to start with a 1/4 tsp (or even 1/8 in the beginning) of MiraLax mixed into her food. Most cats don’t even notice it. It’s unflavored. How frequently is she having a bowel movement? Are you adding water to her Fancy Feast for extra hydration?
 
Milah and Maxine said:
im not sure now I was just worried about her becoming dehydrated. I added in what it says on the back. the vet said it was okay but his advice hasn't been the best thus far...
the appetite stimulant he gave us is called mirtazapine 15mg its a tablet that I have to cut in 1/4s and give 2x a day. we've been using since last week Friday.
okay no problem at all. I'm working on the spread sheet now. I am also in the same zone it is 9:15pm.
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Yes. That’s full of sugar (dextrose is one form of sugar). It will definitely cause her blood glucose to go up.
 
Let me know when you have some numbers in the spreadsheet and I will take a look at it. I am so sorry you are having these worrying troubles with Milah.

Oh, about the diabetic neuropathy (walking on her hocks) have you started her on Zobaline or another Methylcobalamin? She needs that to recover from the neuropathy.
 
these are the results we received on the first day we went in. her numbers since we've been home have been a lot higher. but now I am questioning this alpa Trak tester. I tested a while ago and it read 576 I panicked and tested again 3 minutes later the number was then 393mg/dl so not sure if my numbers are even accurate.
also might be worth mentioning that he took an X-ray the same day as blood work and he says she has a very large bladder and wasn't able to empty all the way.
(she had some infection and was given 10 days of antibiotic ). he also said her kidneys are small for her body and that they were not working properly.
 
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Suzanne & Darcy said:
Let me know when you have some numbers in the spreadsheet and I will take a look at it. I am so sorry you are having these worrying troubles with Milah.

Oh, about the diabetic neuropathy (walking on her hocks) have you started her on Zobaline or another Methylcobalamin? She needs that to recover from the neuropathy.
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no I have not. I can order this right away .
so no more electrolyte water then right? I should stop giving her this?
 
Milah and Maxine said:
no I have not. I can order this right away .
so no more electrolyte water then right? I should stop giving her this?
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Yes. No more kittenlyte. I would add regular water to her food to make it more moist, if she will eat it that way. The Zobaline should be started as soon as you can get it.
 
Suzanne & Darcy said:
From the bloodwork you posted, I see she had a urinary tract infection. How many days of antibiotics did she have and what was the name of the antibiotic?
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Suzanne & Darcy said:
From the bloodwork you posted, I see she had a urinary tract infection. How many days of antibiotics did she have and what was the name of the antibiotic?
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yes
also might be worth mentioning that he took an X-ray the same day as blood work and he says she has a very large bladder and wasn't able to empty all the way.
(she had some infection and was given 10 days of antibiotic -Clavamox 1 ml 2x daily ). he also said her kidneys are small for her body and that they were not working properly.
 
Milah and Maxine said:
View attachment 73048 View attachment 73049

these are the results we received on the first day we went in. her numbers since we've been home have been a lot higher. but now I am questioning this alpa Trak tester. I tested a while ago and it read 576 I panicked and tested again 3 minutes later the number was then 393mg/dl so not sure if my numbers are even accurate.
also might be worth mentioning that he took an X-ray the same day as blood work and he says she has a very large bladder and wasn't able to empty all the way.
(she had some infection and was given 10 days of antibiotic ). he also said her kidneys are small for her body and that they were not working properly.
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It does look like she may have chronic kidney disease. I can’t be sure because those blood and urine values were taken when she was sick with a UTI. She was/is dehydrated so that also can affect the results. She does need to be kept well-hydrated and I would recommend repeating the bloodwork before too long. Having diabetes can also throw off a lot of the bloodwork, so I hope we can get her moving in the right direction with her insulin and BG numbers.

For the constipation, I definitely recommend starting with a small dose of Miralax and increasing a little at a time until you get her pooping on a regular basis.
 
Suzanne & Darcy said:
It does look like she may have chronic kidney disease. I can’t be sure because those blood and urine values were taken when she was sick with a UTI. She was/is dehydrated so that also can affect the results. She does need to be kept well-hydrated and I would recommend repeating the bloodwork before too long. Having diabetes can also throw off a lot of the bloodwork, so I hope we can get her moving in the right direction with her insulin and BG numbers.

For the constipation, I definitely recommend starting with a small dose of Miralax and increasing a little at a time until you get her pooping on a regular basis.
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thank you so much for your time I really appreciate it. I did try giving her 1/8 miralax today. I will continue with this is the miralax just once a day?
 
Milah and Maxine said:
yes
also might be worth mentioning that he took an X-ray the same day as blood work and he says she has a very large bladder and wasn't able to empty all the way.
(she had some infection and was given 10 days of antibiotic -Clavamox 1 ml 2x daily ). he also said her kidneys are small for her body and that they were not working properly.
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Clavamox is a very good drug for a UTI. I just hope she doesn’t have a kidney infection. That’s why I recommend repeating the bloodwork and urinalysis to make sire that her White Count (neutrophils, etc.) have come down and her urine no longer has bacteria in it. Is she urinating normally now? No signs of discomfort? No squatting for extended periods of time with little to nothing coming out? If her BG numbers are high, we would expect to see large urine clumps, of course.
 
Milah and Maxine said:
thank you so much for your time I really appreciate it. I did try giving her 1/8 miralax today. I will continue with this is the miralax just once a day?
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If today was the first day of Miralax, I would try 1/8 again in the morning with her food. If she doesn’t have a BM during the day, I would give another 1/8 tsp. in her evening meal. See if this helps doing both a.m. and p.m. If not, move to 1/4 tsp. If her stool gets too soft or she has diarrhea, decrease the dose back down a little bit. You just sometimes have to do a little trial and error with Miralax until you get to the dose that works for your cat, but doesn’t cause diarrhea.
 
oh boy I hope not . I will schedule blood work again ASAP. she is urinating a lot. she goes in a few times during the day. I bought the test strips for her urine but they were expired I'm going to exchange them tomorrow.
 
I’m sorry to dump so much on you all at once. I did notice in her bloodwork that her phosphorus levels were a little too high. In order to help spare her kidneys a lot of excess work, I recommend switching her food to something that is low carb and is also lower in phosphorus than the Fancy Feast. I feed Weruva BFF PLAY pates to my cats for this very reason (it will help protect their kidneys). Phosphorus control is very important for a cat with kidney disease. It will help her. You don’t have to make this change immediately, but it would be very good for her if you can try in the next few weeks to find a food she will eat that’s low carb (for the diabetes) and low phosphorus (for her kidneys.)

I am going to try to attach a food list for you of low carb/lower phosphorus foods.
https://www.bizave.com/foodlists/CKD Diabetes Food List.pdf
 
If you want to continue with the Alpha Trak meter it’s okay (although the test strips are expensive). A majority of our members here use the ReliOn Meters from Walmart. The strips are about $17.88 for 100 of them. Our dosing protocols were written for human glucometers, but we can adapt them somewhat for the AT. The most important thing to know is that the AT meter will generally read a little higher than a human meter — so we use a little bit higher number for a dose reduction point for those who are using the AT.
 
Suzanne & Darcy said:
If you want to continue with the Alpha Trak meter it’s okay (although the test strips are expensive). A majority of our members here use the ReliOn Meters from Walmart. The strips are about $17.88 for 100 of them. Our dosing protocols were written for human glucometers, but we can adapt them somewhat for the AT. The most important thing to know is that the AT meter will generally read a little higher than a human meter — so we use a little bit higher number for a dose reduction point for those who are using the AT.
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I may have to get a human one. the 50 count test strips cost just as much as the whole testing kit. I was worried when I first read about needing to test before shots(the vet did not tell me to test just told me to feed her wait an hour then give insulin.) I didn't know I could use a human one so I ordered the first pet glucose tester I could get my hands on.
 
It sounds like you have not had much good help from the vet. With ProZinc, you do not need to wait after feeding to shoot the insulin. ProZinc takes about two hours to onset (start to lower BG) in most cats. You can test, feed and shoot the insulin all within a few minutes time. Does she eat well usually? It’s important to feed her a small amount of low-carb wet food a few more times during each cycle At +2 (two hours after the shot) is usually a good time to feed because that is when the insulin onsets and another snack/small meal at about +4 and perhaps even at +6, but that one kind of depends upon the cat. We don’t want to feed much food after nadir (low carb treats given with BG tests don’t count) because it can shorten the duration of the insulin and cause numbers to rise prematurely. If you are not at home most days, you should look into an automatic feeder to dispense the small meals during the cycle. These will help prevent steep drops in BG and will help to keep Milah safe.
 
Suzanne & Darcy said:
It sounds like you have not had much good help from the vet. With ProZinc, you do not need to wait after feeding to shoot the insulin. ProZinc takes about two hours to onset (start to lower BG) in most cats. You can test, feed and shoot the insulin all within a few minutes time. Does she eat well usually? It’s important to feed her a small amount of low-carb wet food a few more times during each cycle At +2 (two hours after the shot) is usually a good time to feed because that is when the insulin onsets and another snack/small meal at about +4 and perhaps even at +6, but that one kind of depends upon the cat. We don’t want to feed much food after nadir (low carb treats given with BG tests don’t count) because it can shorten the duration of the insulin and cause numbers to rise prematurely. If you are not at home most days, you should look into an automatic feeder to dispense the small meals during the cycle. These will help prevent steep drops in BG and will help to keep Milah safe.
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I have not. that's why I'm so happy to have come across all of you. she does not eat well right now. before she was a little monster wanting to eat everything in her path. since getting sick she will not touch the c/d dry food. I had her using the automatic feeder since Im gone most of the day but now she doesn't even look that way. I started giving her the c/d cans the small 2.9 oz ones but she barley eats a whole can during one sitting now. I have to be on top of her mixing her food and pushing it her way. she gets tired and goes to lay down . ill go to her a few moments later put the dish in front of her and she will start licking again. takes us about an hour before she stops wanting any. shell sleep most the day and even if I leave food out while I'm gone shell take a nibble then leave it. if I'm not there to push her she won't eat. this is what has me worried the most.
 
I have another appointment tomorrow morning with a different animal hospital. My girl doesn’t want to eat she threw up around 3 AM. Just overall not anywhere near herself . I gave some more miralax this morning though she didn’t eat all the food I put it on.
 
Milah and Maxine said:
I have another appointment tomorrow morning with a different animal hospital. My girl doesn’t want to eat she threw up around 3 AM. Just overall not anywhere near herself . I gave some more miralax this morning though she didn’t eat all the food I put it on.
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I hope they will have some answers for you! Please keep us posted on how she’s doing! ❤️
 
And you had to leave her alone all day?

She may be nauseated from the elevated BUN. Perhaps the vet will give her some subcutaneous fluids which can help with nausea and also constipation. I always gave my CKD cats fluids at home. I would start giving her Cerenia (Maropitant) at home as well to see if it helps her appetite. It’s not a good idea to give an appetite stimulant unless possible nausea is addressed with meds first. The best anti-nausea medication is a human one (used all the time in cats) called Ondansetron (Zofran). It’s very effective, although I would hesitate to start it until her constipation is under control because it can cause or worsen constipation. I would start with Cerenia as that will help with vomiting and somewhat with nausea. Constipation also can cause vomiting and a loss of appetite, depending upon the severity. I really hope this vet is a good one.
 
Milah and Maxine said:
Hi there . Maxine here with My 12 year old 14 lb girl Milah. We are very new to this forum but have been reading through old posts. My cat is newly diagnosed with diabetes .she was walking on her hocks and very wobbly . The vet said it was diabetes and wanted to try and control it before changing food. Her numbers are always high in the 300-400s .( we have an alphatrak3)She is not eating so well at the moment and is dehydrated and constipated. Only passing small hard nugs of poop. I’ve been giving her “kittenlyte” electrolyte drink and trying to feed her can food.

she is on prozinc 1 unit 2x a day. For one week now. She was also taking an antibiotic for 10 days and an appetite stimulant that we have to cut in 1/4 and make a liquid. We finished the antibiotics and are still continuing the stimulant(although it doesn’t seem to be working to me)

We saw the vet today but he didn’t really check her. I had some concerns about her food and her not eating so well or passing poop. She just is weak most of the time. He told me I should be giving her whole milk in a syringe to make her go. Also told me I can increase the dose to 2 units 2x a day if her numbers stay above 300. Not sure how safe that is with her not eating well. I also work 8-12 hrs a day 6days a week. I’m afraid something will happen when I am not home.

some kind people on here were helping me on another post .they gave me a link to a spread sheet and some info. I decided to try and change my cats food from her RX hills C/D food to fancy feast classic pate. What should I look out for in terms of testing and dosing with this new food?i am currently on the search for a cat friendly vet in NYC I can change her to. It’s all so overwhelming and chaotic at the moment. i will take all the help and advice I can get. Please and thank you !
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Hey, I hope you’re able to work out a system that works for you and Milah, I saw you where looking for an NYC vet who are good with cats. I started going to “The Cat Practice” on West 24th in Manhattan when my cat was diagnosed. They’re a cats only vet with one main doctor who has experience with both diabetes and CKD. They’ve been great for me and my 16 year old cat. Hang in there, I know it’s so overwhelming but it gets better!

vets info: https://www.thecatpractice.com/
 
Suzanne & Darcy said:
And you had to leave her alone all day?

She may be nauseated from the elevated BUN. Perhaps the vet will give her some subcutaneous fluids which can help with nausea and also constipation. I always gave my CKD cats fluids at home. I would start giving her Cerenia (Maropitant) at home as well to see if it helps her appetite. It’s not a good idea to give an appetite stimulant unless possible nausea is addressed with meds first. The best anti-nausea medication is a human one (used all the time in cats) called Ondansetron (Zofran). It’s very effective, although I would hesitate to start it until her constipation is under control because it can cause or worsen constipation. I would start with Cerenia as that will help with vomiting and somewhat with nausea. Constipation also can cause vomiting and a loss of appetite, depending upon the severity. I really hope this vet is a good one.
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yes =( I had to leave her to go to work and ask for next day off. I will mention what you suggested to the vet. Thank you!
its been very up and down with Milah. sometimes she acts like she is starving and can't wait to get food. I get excited & bring the bowl over. She will just lick around the bowl. 5 minutes later and she is uninterested in the food completely.
 
Ailish’s Brother said:
Hey, I hope you’re able to work out a system that works for you and Milah, I saw you where looking for an NYC vet who are good with cats. I started going to “The Cat Practice” on West 24th in Manhattan when my cat was diagnosed. They’re a cats only vet with one main doctor who has experience with both diabetes and CKD. They’ve been great for me and my 16 year old cat. Hang in there, I know it’s so overwhelming but it gets better!

vets info: https://www.thecatpractice.com/
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you all have been so comforting & helpful. Thank you for that recommendation ! I will check them out.
 
Milah and Maxine said:
yes =( I had to leave her to go to work and ask for next day off. I will mention what you suggested to the vet. Thank you!
its been very up and down with Milah. sometimes she acts like she is starving and can't wait to get food. I get excited & bring the bowl over. She will just lick around the bowl. 5 minutes later and she is uninterested in the food completely.
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That does sound like she is nauseated. A classic symptom is that the cat will sniff food and walk away or just lick a little of the surface or the liquid (broth/gravy) and walk away. I hope the vets will help her.
 
Suzanne & Darcy said:
Will you be with her today to get a few BG tests? I see she’s had a yellow AMPS.
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yes I will be with her today we have a vet appointment in a few hours then I will bring her home and stay with her. I'm feeling hopeful because she is eating a tiny bit more. she finished a whole can of the FF ( I had to really mash up the pate and add lots of water to it so it was soupy.she licked it all up.
she also ate a little of the a soupy food mixture I left out for her yesterday while I was at work. it made me so happy to see the empty bowl when I got back. she hasn't been touching any food unless I sit in front of her and push push push.so that was encouraging.

I also am running out of the test strips for her Alpha Trak3. I had ordered another pet one off amazon. not sure if its any good. its called Vet mate by i-sens.
wondering if I should try to buy more of the test strips for alphatrak3 (sooo expensive.. I had not checked out replacement supply prices before ordering the device in a panic) or if I should even stick with a pet monitor. also considering a human one ...
 
Hi ! sorry It’s been something. We went to the vet they ran more tests and $900 later I have the same info. They said they won’t know how chronic the kidney disease is until infection has cleared. She still has a UTI so 2 more weeks of the antibiotic and then more testing. they gave her fluids. They said her kidney values were high still around the same as the first testing. They also gave an anti nausea medication and she has been eating a bit more! Oh and Miralax is working a bit also . She’s gone and it’s a little softer. She still has trouble passing .
 
How much Miralax are you giving? Canned pumpkin puree (not pie filling) is supposed to help with constipation too.

A drawback with pet meters is that you can't buy the test strips at any pharmacy. So you need to remember to order more online and always keep at least 2 boxes on hand. It's a good idea to have a Human meter and test strips for it on hand as a back up just in case. I'd go with an inexpensive brand name meter that is sold at any pharmacy so you can easily pick up test strips if needed. Some of the ones sold online are not sold in stores so you also run into the same issue of having to remember to order more before you run out.
 
Keep on with the Miralax and adjust the amount down if her stool gets too soft. So you have another ten days of Clavamox? That is what I said about the bloodwork you posted. You can’t tell about the status of her kidneys until the infection has cleared. Did they send you home with anti-nausea medication or did they just give an injection. The Cerenia injection (Maropitant) lasts about 24 hours. There are tablets you can give at home to continue with it.
 
squeem3 said:
How much Miralax are you giving? Canned pumpkin puree (not pie filling) is supposed to help with constipation too.

A drawback with pet meters is that you can't buy the test strips at any pharmacy. So you need to remember to order more online and always keep at least 2 boxes on hand. It's a good idea to have a Human meter and test strips for it on hand as a back up just in case. I'd go with an inexpensive brand name meter that is sold at any pharmacy so you can easily pick up test strips if needed. Some of the ones sold online are not sold in stores so you also run into the same issue of having to remember to order more before you run out.
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yes luckily I had ordered 2 meters( I wasn't sure which would arrive first) so I had a back up Vetmate reader. I have since received my AT3 test strips so we are back in business baby haha. also we have tried the pumpkin when she first started showing signs of constipation. Milah loves pumpkin but it did not work for us.
 
Suzanne & Darcy said:
Keep on with the Miralax and adjust the amount down if her stool gets too soft. So you have another ten days of Clavamox? That is what I said about the bloodwork you posted. You can’t tell about the status of her kidneys until the infection has cleared. Did they send you home with anti-nausea medication or did they just give an injection. The Cerenia injection (Maropitant) lasts about 24 hours. There are tablets you can give at home to continue with it.
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I've been giving 1/4 tsp Miralax. The stool is still pretty firm and she kind of struggles to go a bit still. I'm worried about how long I can keep her using the Miralax because of her Kidneys.
and yess you said the same thing the Vet said ! so 14 more days on the antibiotic. They gave her fluids and a Cerenia injection. That made her eat better the same day. They sent us home with 2 pills of Cerenia .1/2 tab every day if needed she said.

so I've been noticing that Milah asks for food at about 5 am that's +9 hours after her PM shot. I tested and then gave a little can food. I've read that its ok to give a little food at 5 and hold off until 7am for more food and insulin. is this correct??
 
Milah and Maxine said:
yes luckily I had ordered 2 meters( I wasn't sure which would arrive first) so I had a back up Vetmate reader. I have since received my AT3 test strips so we are back in business baby haha. also we have tried the pumpkin when she first started showing signs of constipation. Milah loves pumpkin but it did not work for us.
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And as one of my other friends on this forum recently found out - the pumpkin raised her cat’s BG. :(
 
Milah and Maxine said:
They sent us home with 2 pills of Cerenia .1/2 tab every day if needed she said.
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Boy are they stingy with the Cerenia! They could not even give you a box of 4! Many cats need to be on Cerenia daily- especially cats with Pancreatitis or kidney disease. Most cats do very well on it. It’s great for motion sic too - if you have a cat who vomits in their carrier in the car (although the dose is higher when used for motion sickness.). I hope Milah will turn the corner though and not need it, but don’t hesitate to give it if she starts sniffing the food and walking away or if she licks a couple of times and walks away. Cerenia is extremely bitter and should be put into a number 4 size gelatin capsules so she won’t taste it. If she tastes it, she may start foaming at the mouth or drooling badly.
 
Milah and Maxine said:
I've been giving 1/4 tsp Miralax. The stool is still pretty firm and she kind of struggles to go a bit still. I'm worried about how long I can keep her using the Miralax because of her Kidneys.
and yess you said the same thing the Vet said ! so 14 more days on the antibiotic. They gave her fluids and a Cerenia injection. That made her eat better the same day. They sent us home with 2 pills of Cerenia .1/2 tab every day if needed she said.

so I've been noticing that Milah asks for food at about 5 am that's +9 hours after her PM shot. I tested and then gave a little can food. I've read that its ok to give a little food at 5 and hold off until 7am for more food and insulin. is this correct??
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We usually ask for people to try to not give any food for two hours prior to the morning or evening pre-shot BG tests. The reason for this is so that the test number will not be elevated due to the influence of the food. This way, you have an accurate fasting BG number to make dosing decisions. When a cat is new to ProZinc and we don’t have a lot of data on the spreadsheet or experience shooting lower numbers, we sometimes will shoot a reduced dose for one cycle if the preshot BG is low. This situation is very individual to the cat and is based in their patterns and, of course, previous spreadsheet data.
 
Milah and Maxine said:
so I've been noticing that Milah asks for food at about 5 am that's +9 hours after her PM shot. I tested and then gave a little can food. I've read that its ok to give a little food at 5 and hold off until 7am for more food and insulin. is this correct??
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So the bottom line on this is that +9 would be okay for her to eat a little LC food — it’s three hours until shot time. Usually, I tell people to not feed much food after nadir (because it can shorten the duration of the insulin,) but in Milah’s case, I think it’s very important for her to eat and she may need that for her tummy to not get upset. Just try to feed her the lowest carb food that you have for this snack. Clavamox is quite hard on the GI tract as it is. Many cats will lose their appetite on Clavamox or vomit or have diarrhea. I have cats at home who tolerate it very well and some who just cannot take it.
 
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