Douglas' ProZinc dosage question

cocokittybrown

cocokittybrown

Member
Hello everyone,

This is my first posting. I am asking for guidance with dosing. I am thinking he could be increased by 1/2 unit.

Background history:
My cat, Douglas, was diagnosed with diabetes in January 2025. He is around 10 years old and is about 12.8 lbs. He has slight pancreatitis (I plan to get a copy of his blood work to post on my spreadsheet) and needs dental work. He had dental cleaning about 1 1/2 year ago, and needs it again.

We started him on Prozinc on 1/6/25.

We did not start monitoring him until 1/14/25 with a Freestyle Libre2. That worked intermittently for a few days and then died. Then he got another Libre2 on 1/19/25 and it fell off soon there after. At that point, I decided that I needed to start blood glucose testing (which I have learned that I should do before pre-shoot at least from these sites). So I now have 2 glucose monitors (iPet Test and AlphaTrax) and I test blood at least 1x per day pre-shoot, and plan to test 2x a day in future.

Food wise, he is eating Purina DM 5.5 oz savory selects 2x a day (which I found out has 10% carbs), and I plan to look for other lower carb food. I also supplement that with either 3 oz of glycobalance or glycosupport, which have around 14% carbs (from the food chart I found on this site). I plan to find better food this weekend.

He is currently on 2 units of Prozinc. I last adjusted him 1/16/25. From his Pet meter pre-shot glucose reading and looking at his trends with Freestyle Libre, I am thinking of increasing his dosage by 1/2 unit. I would not do any adjustments in the morning, but only in the evening when I am home from work or over the weekend.

Any advice or thoughts on my plan?

I think his glucose spreadsheet should show up on the signature line.

Thanks!
Douglas' mom
 
@cocokittybrown

Hi Douglas' Mom
I'll tag a Prozinc user for you but first can you set up what we call your signature, it's at the end of everyone's post in gray letters

Here is the information we need for your signature
Just click on your name up top and then tap signature and add this information.
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

If you plan on using the pet meters from now on and not the Libre you need to change the last 2 color codes up top on your spreadsheet to reflect the pet meters
The dark green would be 68-99
The lime green would be BG<68
You can change them yourself


Just a suggestion most of us use human meters , the test strips are so much affordable

If you live by a Walmart
Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197
At least if you need more test strips you can run into Walmart and pick them up or if you're running low you can just order them from Walmart.

If you are going to stay with the Libre you can leave them like they are.

We usually adjust the dose by 0.25 units at a time
Do you have the U-40 syringes with the half unit markings?

Looking at your spreadsheet we never increase by whole units, I see there are many times you didn't test at all in the AM and the PM the pre shots on 1-19 thru 1-26
 
Last edited:
cocokittybrown said:
Hello everyone,

This is my first posting. I am asking for guidance with dosing. I am thinking he could be increased by 1/2 unit.

Background history:
My cat, Douglas, was diagnosed with diabetes in January 2025. He is around 10 years old and is about 12.8 lbs. He has slight pancreatitis (I plan to get a copy of his blood work to post on my spreadsheet) and needs dental work. He had dental cleaning about 1 1/2 year ago, and needs it again.

We started him on Prozinc on 1/6/25.

We did not start monitoring him until 1/14/25 with a Freestyle Libre2. That worked intermittently for a few days and then died. Then he got another Libre2 on 1/19/25 and it fell off soon there after. At that point, I decided that I needed to start blood glucose testing (which I have learned that I should do before pre-shoot at least from these sites). So I now have 2 glucose monitors (iPet Test and AlphaTrax) and I test blood at least 1x per day pre-shoot, and plan to test 2x a day in future.

Food wise, he is eating Purina DM 5.5 oz savory selects 2x a day (which I found out has 10% carbs), and I plan to look for other lower carb food. I also supplement that with either 3 oz of glycobalance or glycosupport, which have around 14% carbs (from the food chart I found on this site). I plan to find better food this weekend.

He is currently on 2 units of Prozinc. I last adjusted him 1/16/25. From his Pet meter pre-shot glucose reading and looking at his trends with Freestyle Libre, I am thinking of increasing his dosage by 1/2 unit. I would not do any adjustments in the morning, but only in the evening when I am home from work or over the weekend.

Any advice or thoughts on my plan?

I think his glucose spreadsheet should show up on the signature line.

Thanks!
Douglas' mom
Click to expand...
@Suzanne & Darcy
 
Hello there. Welcome to the Feline Diabetes Message Board. You are doing great to have a spreadsheet set up and inputting data. Since you are planning to transition to lower carb food, I would not make any dose changes until we see the effect of feeding lower carb food. The effect on lowering blood glucose can be dramatic and I want to make sure your baby is safe. I still need a couple more days of data as well before offering dose recommendations. I am glad that you are learning to home test as well as having the Libre. I would love to help you.
 
Diane Tyler's Mom GA said:
@cocokittybrown

Hi Douglas' Mom
I'll tag a Prozinc user for you but first can you set up what we call your signature, it's at the end of everyone's post in gray letters

Here is the information we need for your signature
Just click on your name up top and then tap signature and add this information.
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

If you plan on using the pet meters from now on and not the Libre you need to change the last 2 color codes up top on your spreadsheet to reflect the pet meters
The dark green would be 68-99
The lime green would be BG<68
You can change them yourself


Just a suggestion most of us use human meters , the test strips are so much affordable

If you live by a Walmart
Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197
At least if you need more test strips you can run into Walmart and pick them up or if you're running low you can just order them from Walmart.

If you are going to stay with the Libre you can leave them like they are.

We usually adjust the dose by 0.25 units at a time
Do you have the U-40 syringes with the half unit markings?

Looking at your spreadsheet we never increase by whole units, I see there are many times you didn't test at all in the AM and the PM the pre shots on 1-19 thru 1-26
Click to expand...
 
Diane Tyler's Mom GA said:
@cocokittybrown

Hi Douglas' Mom
I'll tag a Prozinc user for you but first can you set up what we call your signature, it's at the end of everyone's post in gray letters

Here is the information we need for your signature
Just click on your name up top and then tap signature and add this information.
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

If you plan on using the pet meters from now on and not the Libre you need to change the last 2 color codes up top on your spreadsheet to reflect the pet meters
The dark green would be 68-99
The lime green would be BG<68
You can change them yourself


Just a suggestion most of us use human meters , the test strips are so much affordable

If you live by a Walmart
Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197
At least if you need more test strips you can run into Walmart and pick them up or if you're running low you can just order them from Walmart.

If you are going to stay with the Libre you can leave them like they are.

We usually adjust the dose by 0.25 units at a time
Do you have the U-40 syringes with the half unit markings?

Looking at your spreadsheet we never increase by whole units, I see there are many times you didn't test at all in the AM and the PM the pre shots on 1-19 thru 1-26
Click to expand...

Thank you for your feedback. Thank you for your tips and patience as I figure out how to navigate this site. I think I've updated the signature line.
 
Suzanne & Darcy said:
Hello there. Welcome to the Feline Diabetes Message Board. You are doing great to have a spreadsheet set up and inputting data. Since you are planning to transition to lower carb food, I would not make any dose changes until we see the effect of feeding lower carb food. The effect on lowering blood glucose can be dramatic and I want to make sure your baby is safe. I still need a couple more days of data as well before offering dose recommendations. I am glad that you are learning to home test as well as having the Libre. I would love to help you.
Click to expand...

Thank you for the feedback. I will continue to collect data and home monitor.
 
Diane Tyler's Mom GA said:
Did you mean to enter 2.25 for this mornings dose you have 2.2
@cocokittybrown
Click to expand...
I have the U40 syringes that have the 1/2 increments markings. I am not using calipers to do the smaller dosing, but will try to figure out how to do that this weekend. I gave him a little more than 2.0 units because his AMPS per alphatrak was 424 and iPetmeter was 434. This is very stressful and anxiety provoking, and I will go back to giving 2.0 consistently (since I can read that on the syringe) until I get more data collected and get a caliper and get the lower carb food. currently he is on Purina DM, which I found had 10% carbs and glcobalance, which is 14% (but he only gets very little of that). I need to be patient and err on the side of caution. I just want him to feel better and get back to his old self. I was able to test the ketones this morning, and that was negative. I am going to call the vet and get a copy of his blood work, which was done on 12/31/24, so I can put that info in the spreadsheet and I want/need to better understand all of that. I need to get reading glasses or magnifying lens to make sure the dosing is correct too. For now, I can keep giving him the same food, give consistent 2.0 unit doses until more data is collected, get calipers, reading glasses, and blood work. Then with at least a few more days (3 days?) of data collection, then consider dosage adjustments? Sorry my mind is all over the place. Thank you for your concern.
 
You have been having some blue nadirs on the 2 unit dose. He is a little bit bouncy after the lower numbers I see. You probably can buy one of these lighted magnifying things. Here’s one I bought. It comes with quite a few different lenses with different magnification levels. The light is quite bright (with two settings.). I use it for a lot of different things.

https://www.amazon.com/gp/aw/d/B0CBBVY3MQ?psc=1&ref=ppx_pop_mob_b_asin_title

upload_2025-1-30_10-33-40.png
 

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@Suzanne & Darcy So sorry for the lack of response back until now.

I hadn't realized an entire month had elapsed.

I bought the recommended magnifying glasses and I LOVE them!!! I use them for getting blood from Douglas' ears for BG testing and drawing the insulin and when I inject him. I did not realize how poor my vision was/is until I started using these! I love the light. This has been a real "game changer" for me, so thank you so much for the recommendation.

Some updates since I have last communicated with you... I got really frustrated with trying to figure out how to use the message board, so I joined the Facebook Felines Diabetes Support group. And I started to use their insulin/glucose tracking spreadsheet. I provided a link to that updated spreadsheet in my signature line. In the previous spreadsheet I got from this group, I was doing an avg of Libre numbers instead of the hourly numbers. A person from the FB group got a copy of the csv data and uploaded it to the spreadsheet and she mentioned that I want to just enter the glucose numbers nearest the hour from the csv data onto the spreadsheet.

I've also started to use a human blood glucose monitor. I have both the Relion and the Contour Next. I like the Contour next, so I am using that consistently now.

I've also stopped feeding Douglas the prescription food higher carb stuff, and he is now eating only low carb food and mostly Fancy Feast Classic Pates.

I just opened a new bottle of Prozinc yesterday. I was using the other one for 2 months, and I think the mfg mentioned to only use 2 months. I was also questioning the potency of the first bottle.

I am still having big swings in the numbers, and it may be from me not holding the dose long enough or could be Douglas needs his dental done?

He has been back to the vet 2x since Dx just for check ups, and nothing else seems to be going on with him.

I had asked the doctor the last time about changing to Lantus. The FB group mentioned I may want to switch insulins. The vet seems reluctant about switching to another insulin. I am going to make an appt for the re-check within the next couple of weeks and bring the topic back up with the vet. Douglas has some very big swings. I've also recently started to test blood Keytones, and they are running kind of high with high BG numbers. However, the keytones come done when his BG go down. To my knowledge he has never had DKA, and I am very mindful and fearful of this.

Also, I am starting to find myself on social media too much lately and obsessing about feline diabetes, not so good for my mental health so I am trying to cut back on FB usage.

If you have a moment, I'd be interested in your thoughts on Douglas latest numbers.

Thank you.

cocokittybrown
 
I’m really glad that the lighted magnifying glasses helped. I think they’re great. I use them to trim my cats nails as well and for other things.

I started looking at your spreadsheet last night and it’s a little confusing. Let me look again and see what I want to ask you.
 
First question: from February 11-19, he was on a dose of 2 units. That dose was held for too long of a time, but my more important question is why his dose was reduced after 2/19. He needed an increase and yet he got a dose reduction which was not earned.

So he got the dose reduction and then was raised back up to the former dose of 2 units (which was already too low considering his numbers.)
 
After this, the dosing gets really confusing with doses going up and down for no reason that I understand. And how are you measuring some of these odd doses that are not in .25 increments?

I think Douglas would be much better off following an established protocol for dosing and making adjustments based upon that.
None of this is criticism. Back in 2020, I personally wasted 6 months of my cat’s life getting bad advice from a Facebook diabetes group (not the FB group associated with this FDMB but a different group) who kept telling me to reduce his dose when the opposite was needed.
 
Why was his dose decreased again most recently when no reduction was earned? From March 8 to March 9? His numbers are too high. You should hold the dose of 2.25 (not fat not skinny) for 7 days and do not decrease the dose unless he drops below 90. If he doesn’t, then the next dose should be 2.5 units— again holding the dose for 7 days unless he drops below 90.

Occasionally with ProZinc, we make temporary one cycle reductions in dose based upon a low AMPS or PMPS. I don’t see that as a problem for Douglas right now, but I am just mentioning it for future reference. After the temporary one-time reduction, the former regular dose is resumed.
 
cocokittybrown said:
am still having big swings in the numbers, and it may be from me not holding the dose long enough or could be Douglas needs his dental done?
Click to expand...
I am seeing the opposite problem here (occasionally) of holding the doses too long.
cocokittybrown said:
or could be Douglas needs his dental done?
Click to expand...
What’s going on with his teeth? Just generally gingivitis or do you think he needs an extraction? That will make him harder to regulate most certainly. I find that vets often put us in a very hard place. They say they want to wait until the cat is better regulated to do the dental, but the cat really can’t get very well-regulated until the dental is performed.
 
Suzanne & Darcy said:
First question: from February 11-19, he was on a dose of 2 units. That dose was held for too long of a time, but my more important question is why his dose was reduced after 2/19. He needed an increase and yet he got a dose reduction which was not earned.

So he got the dose reduction and then was raised back up to the former dose of 2 units (which was already too low considering his numbers.)
Click to expand...

I think the thought process behind this was that sometimes too much insulin sometimes looks like not enough insulin. So the guidance was to reduce by .25. I did not start using calipers until 2/22/25, that is why the strange not quarter numbers. I took a photo and my husband was telling me the actual dose I gave him. My goal most of the time is .25 doses, but my actual ended up being different. Then I was given guidance that maybe I should try between 2 and 1.75.
 
Suzanne & Darcy said:
After this, the dosing gets really confusing with doses going up and down for no reason that I understand. And how are you measuring some of these odd doses that are not in .25 increments?

I think Douglas would be much better off following an established protocol for dosing and making adjustments based upon that.
None of this is criticism. Back in 2020, I personally wasted 6 months of my cat’s life getting bad advice from a Facebook diabetes group (not the FB group associated with this FDMB but a different group) who kept telling me to reduce his dose when the opposite was needed.
Click to expand...

I did not start using the calipers until 2/22/25. Before then I was really trying to "eyeball" the doses. My husband looked at the photos and told me what I was actually giving...him eyeballing. I will try to start doing .25 increments in the future. I am thinking the calipers will help me meet this target goal.
 
Suzanne & Darcy said:
Why was his dose decreased again most recently when no reduction was earned? From March 8 to March 9? His numbers are too high. You should hold the dose of 2.25 (not fat not skinny) for 7 days and do not decrease the dose unless he drops below 90. If he doesn’t, then the next dose should be 2.5 units— again holding the dose for 7 days unless he drops below 90.

Occasionally with ProZinc, we make temporary one cycle reductions in dose based upon a low AMPS or PMPS. I don’t see that as a problem for Douglas right now, but I am just mentioning it for future reference. After the temporary one-time reduction, the former regular dose is resumed.
Click to expand...

I decreased his most recent dosage on March 9 because his preshot BG was 196. Then I thought that I was moving his dosage around too much and need to give his body some time to get used to it, so I was going to try to stick to one dosage for 7 days. On 2/22/25, the vet told me to stick to 2.0 and do a Fructosamine in 2 to 3 weeks. So I have an appt this Saturday march 15. He is going to get more blood work and I am going to ask the doctor about dental again and if we should consider switching to another insulin, like Lantus. I did mention these things on the 2/22/25 visit and the only thing he said was he'd hate to start him on another insulin because we'd have to start all over again. He is not currently regulated, so I am not sure I am clearly understanding that statement.

Regarding his current dosage, he has been on 2.25f (per calipers) for day three, cycle 1. I can switch him back to 2.25 tonight. I was planning to try to hold a consistent dosage until at least March 15. The concerning thing is that I am now measuring blood ketones, and I am seeing that his ketones are above the .6 amount and in the past, up to 1.10. They usually come down though. He seems really healthy otherwise.
 
Suzanne & Darcy said:
I am seeing the opposite problem here (occasionally) of holding the doses too long.

What’s going on with his teeth? Just generally gingivitis or do you think he needs an extraction? That will make him harder to regulate most certainly. I find that vets often put us in a very hard place. They say they want to wait until the cat is better regulated to do the dental, but the cat really can’t get very well-regulated until the dental is performed.
Click to expand...

With his teeth, he has had dental cleaning every year except last year because I was late with his yearly checkup. I was taking the cats in around Sept for their checkups, and in 2023 that was delayed by about 4 months and that is when we found out about diabetes. He was also showing diabetes symptoms, so we already knew and the blood work proved it. He has a history of toot resorption and had 1 tooth extracted 2022 and one extracted in 2023. The vet told us he likely would need more extractions. Currently, he needs a dental cleaning and likely an extraction(s).
 
@Suzanne & Darcy Thank you so much for taking the time to review Douglas spreadsheet and for your questions and comments.

I am trying to learn and trying to get him regulated.

I can continue with the 2.25 regular dosing for the rest of the week.

I have a vet appointment on Saturday for a recheck. I am going to discuss dental care more and discuss changing insulins. When I give him larger doses, it seems that the insulin duration is too short and his swings are very high. And this is so stressful for us, thinking he may have a hypo episode. We are at work during the day, so can't watch him closely during this time. This is part of the reason for being conservative.

I am thinking maybe not changing insulin until he has dental done? I am thinking that if his dental issues are impacting his regulation, then if we change insulins, we may still see these issues and not know how effective the new insulin or old insulin is/was.

It seems so many kitties are on Lantus, and it works so well for many of them. From what I've read, ProZinc is a good insulin too. When Douglas was first diagnosed, I did not know anything about diabetes or insulin so I did not know what questions to ask. I feel like I am a little better educated now.
 
Suzanne & Darcy said:
I’m really glad that the lighted magnifying glasses helped. I think they’re great. I use them to trim my cats nails as well and for other things.

I started looking at your spreadsheet last night and it’s a little confusing. Let me look again and see what I want to ask you.
Click to expand...

My husband used them trimming Douglas toe nails last week. I hadn't used them for this purpose, but plan to use them for his front claws! I LOVE these glasses so much!
 
cocokittybrown said:
I think the thought process behind this was that sometimes too much insulin sometimes looks like not enough insulin. So the guidance was to reduce by .25. I did not start using calipers until 2/22/25, that is why the strange not quarter numbers. I took a photo and my husband was telling me the actual dose I gave him. My goal most of the time is .25 doses, but my actual ended up being different. Then I was given guidance that maybe I should try between 2 and 1.75.
Click to expand...
Too much insulin will eventually cause a hypo. If you hold the dose for at least 6 cycles (or in your case with the SLGS protocol) the BG will drop too low.
 
cocokittybrown said:
I decreased his most recent dosage on March 9 because his preshot BG was 196. Then I thought that I was moving his dosage around too much and need to give his body some time to get used to it, so I was going to try to stick to one dosage for 7 days. On 2/22/25, the vet told me to stick to 2.0 and do a Fructosamine in 2 to 3 weeks. So I have an appt this Saturday march 15. He is going to get more blood work and I am going to ask the doctor about dental again and if we should consider switching to another insulin, like Lantus. I did mention these things on the 2/22/25 visit and the only thing he said was he'd hate to start him on another insulin because we'd have to start all over again. He is not currently regulated, so I am not sure I am clearly understanding that statement.

Regarding his current dosage, he has been on 2.25f (per calipers) for day three, cycle 1. I can switch him back to 2.25 tonight. I was planning to try to hold a consistent dosage until at least March 15. The concerning thing is that I am now measuring blood ketones, and I am seeing that his ketones are above the .6 amount and in the past, up to 1.10. They usually come down though. He seems really healthy otherwise.
Click to expand...
Just keep an eye on the ketones as you are already doing. As long as he is eating well and is not lethargic or vomiting, then he should be fine. Any sign of significant lethargy, lack of appetite or vomiting or him seeming really ill — take him to the vet.
 
You don’t necessarily need to drop his dose back down from the fat dose, but keep holding the dose and don’t drop it unless he goes below 90. After 7 days, we can see if he needs the increase.
Do not worry. He is not getting to much insulin for his current needs. I can tell this from his spreadsheet. You have definitely held his doses long enough and tried all kinds of different doses. You have increased his doses in small increments so you have not “shot past his best dose.” This sounds like some of the bad advice I got which had us spinning our wheels for months and my cat not getting enough insulin.

Regarding Lantus. It’s a good insulin. ProZinc is a good insulin for a lot of cats, too, and we’ve had several remissions recently as well as a lot of cats who are well-regulated. I would like to try to help you with it, but we can also help you with Lantus dosing. I really don’t want you leaving Douglas in high numbers because someone says you need to drop the dose down when you do not or someone says you need to do a “reset” (very bad advice.) Regarding switching insulin, you would not start over at one unit. We take into consideration the current dose of insulin and the numbers that the cat has been getting when switching to a new insulin.

Personally, I would not take my cat for a Fructosamine test at all. Fructosamine is great for diagnosing diabetes because it tells you an average BG over a period of a couple of weeks. Your own glucometer can tell you what the 7 and 14 (and usually 21) day averages are. After diagnosis, Fructosamine tests are of little value. Some vets try to use them to adjust the dose, but this makes no sense. The information we need to adjust doses is the nadir. We need to know how low the current dose is taking the cat — it’s the only way to keep the kitty safe and to know when to increase or decrease.
 
cocokittybrown said:
We are at work during the day, so can't watch him closely during this time. This is part of the reason for being conservative.
Click to expand...
But you have the Libre sensor, right? So you have full data on Douglas BG. Do you have a phone at home with him that can send ho BG data to your phone?
 
Suzanne & Darcy said:
You don’t necessarily need to drop his dose back down from the fat dose, but keep holding the dose and don’t drop it unless he goes below 90. After 7 days, we can see if he needs the increase.
Do not worry. He is not getting to much insulin for his current needs. I can tell this from his spreadsheet. You have definitely held his doses long enough and tried all kinds of different doses. You have increased his doses in small increments so you have not “shot past his best dose.” This sounds like some of the bad advice I got which had us spinning our wheels for months and my cat not getting enough insulin.

Regarding Lantus. It’s a good insulin. ProZinc is a good insulin for a lot of cats, too, and we’ve had several remissions recently as well as a lot of cats who are well-regulated. I would like to try to help you with it, but we can also help you with Lantus dosing. I really don’t want you leaving Douglas in high numbers because someone says you need to drop the dose down when you do not or someone says you need to do a “reset” (very bad advice.) Regarding switching insulin, you would not start over at one unit. We take into consideration the current dose of insulin and the numbers that the cat has been getting when switching to a new insulin.

Personally, I would not take my cat for a Fructosamine test at all. Fructosamine is great for diagnosing diabetes because it tells you an average BG over a period of a couple of weeks. Your own glucometer can tell you what the 7 and 14 (and usually 21) day averages are. After diagnosis, Fructosamine tests are of little value. Some vets try to use them to adjust the dose, but this makes no sense. The information we need to adjust doses is the nadir. We need to know how low the current dose is taking the cat — it’s the only way to keep the kitty safe and to know when to increase or decrease.
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Now that you mention it, I agree that it doesn't make sense to take Douglas to the vet for just another Fructosamine test, especially since I am using the Libre and sending them the reports. I sent the office an email yesterday asking them to help me understand why he needs another Fructosamine test and why the Libre isn't sufficient. I have an appt scheduled for this Saturday and I was asking them if I should cancel it or just schedule a phone consultation with the doctor to discuss care. Douglas is eating well, going to the bathroom normally (except more pee than usual), and energy seems improved. He is not exhibiting any other symptoms that concern me.
 
Suzanne & Darcy said:
But you have the Libre sensor, right? So you have full data on Douglas BG. Do you have a phone at home with him that can send ho BG data to your phone?
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I have a Libre2 sensor. This sensor doesn't transmit to the phone, and you have to scan it. The Libre3 does transmit to the phone and I could transmit from the phone at home to my phone that I carry with me. I asked if I could get a Libre3 instead, when they first suggested a Libre. The vet mentioned that they did not have much experience with the Libre3 and I think she'd mentioned seeing weird results with the Libre3? When I sent the email to the vet's office yesterday, I also mentioned that I'd like to try the libre3 so it can transmit data to my phone while I am at work. I don't know if they will write a Rx for it. They wrote me an Rx for Libre2. I also asked them about the dental. They just mentioned that his gums are inflamed and he needs cleaning and likely extraction(s). They did not talk about dental too much, because they are now focused on the diabetes. I will keep asking about the dental.
 
cocokittybrown said:
I have a Libre2 sensor. This sensor doesn't transmit to the phone, and you have to scan it. The Libre3 does transmit to the phone and I could transmit from the phone at home to my phone that I carry with me. I asked if I could get a Libre3 instead, when they first suggested a Libre. The vet mentioned that they did not have much experience with the Libre3 and I think she'd mentioned seeing weird results with the Libre3? When I sent the email to the vet's office yesterday, I also mentioned that I'd like to try the libre3 so it can transmit data to my phone while I am at work. I don't know if they will write a Rx for it. They wrote me an Rx for Libre2. I also asked them about the dental. They just mentioned that his gums are inflamed and he needs cleaning and likely extraction(s). They did not talk about dental too much, because they are now focused on the diabetes. I will keep asking about the dental.
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Yes. I have found that sometimes you have to push to get the dental done. As long as his pre-anesthetic bloodwork comes back normal, there’s really no reason he can’t be safe having a dental.
 
Going forward, it will be important to quickly differentiate between the Libre readings and the Contour readings. Some people use an asterisk next to a number to indicate that a different glucometer has been used, some people put an L for Libre or C for contour. You will probably just drive yourself crazy checking with different meters if you do it a lot. We recommend checking when the Libre reads low. Last night, it looks like the Libre reading would have been better (since 1 unit was not enough insulin as it turned out.) Good job not skipping the shot though!
 
It looks like he’s on track for an increase on March 16, unless lower blues that are closer to green are seen (then you could hold the dose a few more days - up to about 10 cycles.)
 
Oh, I almost forgot. We have members here using the Libre3. I have not read about more problems with this one than the Libre 2.
@Staci & Ivy uses the Libre 3 and can tell you about her experience with it. I have been trying to figure out if there is a maximum distance away from the phone that is left at home with the cat - how far away can the cat be before it’s “out of range” or is that an issue at all?
 
Suzanne & Darcy said:
Oh, I almost forgot. We have members here using the Libre3. I have not read about more problems with this one than the Libre 2.
@Staci & Ivy uses the Libre 3 and can tell you about her experience with it. I have been trying to figure out if there is a maximum distance away from the phone that is left at home with the cat - how far away can the cat be before it’s “out of range” or is that an issue at all?
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Thanks for tagging me Suzanne, I hope I can help here.

I do use the Libre 3 and started out using a Libre 2. I quickly realized that scanning my cat all the time was a real challenge and I wanted to have the data sent to my phone 24/7 so I would know what's happening with Ivy at all times.

I asked my doc for a script for Libre 3 and they told me "they had no experience with it and only use a Libre 2", but they gave me the script and sent me on my way.
I never looked back (I hated using the Libre 2). When I am out of the house (or in another area of the house) I know exactly what's going on with Ivy, that was a game changer for me.
The phone (or reader) which is used to scan your cat must be within 33 feet of your cat at all times or you get an out of range loud "beep".
I am constantly moving the phone I use for Ivy around my house to be near her (I use an older iphone with no data plan).

If you have not yet joined the Facebook group Freestyle Libre for Dogs and Cats I suggest you do. They have lots of great information and tips (where I learned most information).

If I can answer any more questions, just let me know! :cat:
 
Suzanne & Darcy said:
Going forward, it will be important to quickly differentiate between the Libre readings and the Contour readings. Some people use an asterisk next to a number to indicate that a different glucometer has been used, some people put an L for Libre or C for contour. You will probably just drive yourself crazy checking with different meters if you do it a lot. We recommend checking when the Libre reads low. Last night, it looks like the Libre reading would have been better (since 1 unit was not enough insulin as it turned out.) Good job not skipping the shot though![/QUOTE

Thank you for the suggestion. I've only recently started using the Libre for the fasting preshot numbers to give his ears a break. I am still monitoring preshot, but with the libre. I will start putting L next to them. All the mid-cycle numbers are all Libre. If I do a mid-cycle test with a BG meter, because something is off or he is low, then I have been putting that in remarks section. So current preshot can be Libre or Contour, and I will start marking. I can go back thru the history and mark the preshot BG numbers. Some of the preshot numbers were made with pet meters, before I started using the Contour.
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Staci & Ivy said:
Thanks for tagging me Suzanne, I hope I can help here.

I do use the Libre 3 and started out using a Libre 2. I quickly realized that scanning my cat all the time was a real challenge and I wanted to have the data sent to my phone 24/7 so I would know what's happening with Ivy at all times.

I asked my doc for a script for Libre 3 and they told me "they had no experience with it and only use a Libre 2", but they gave me the script and sent me on my way.
I never looked back (I hated using the Libre 2). When I am out of the house (or in another area of the house) I know exactly what's going on with Ivy, that was a game changer for me.
The phone (or reader) which is used to scan your cat must be within 33 feet of your cat at all times or you get an out of range loud "beep".
I am constantly moving the phone I use for Ivy around my house to be near her (I use an older iphone with no data plan).

If you have not yet joined the Facebook group Freestyle Libre for Dogs and Cats I suggest you do. They have lots of great information and tips (where I learned most information).

If I can answer any more questions, just let me know! :cat:
Click to expand...

Thanks! I finally got the courage to request the Libre3 again yesterday from the vets office. They had refused initially and I did not press anymore. I feel very uncomfortable "challenging" "authority figures" , so I did not press it any further until now, very politely and the vet agreed this time, to my surprise. He has 3 days left on the Libre 2 and will likely need to use the Libre2 one more time until she updates the prescription. But I am very happy that she finally agreed to give us a prescription for Libre3+. And thank you for the recommendation on joining the Freestyle Libre for Dogs and Cats. I am a member! That is how I learned about not using vet glue (which my doctor office used initially) and we started applying them ourselves. My husband and I have successfully applied 4 different Libres using the advice and encouragement from that group. Yes, I have a dedicated older phone with no data plan as the dedicated scanner. I am really looking forward to using the Libre3 in the future.
 
Suzanne & Darcy said:
Going forward, it will be important to quickly differentiate between the Libre readings and the Contour readings. Some people use an asterisk next to a number to indicate that a different glucometer has been used, some people put an L for Libre or C for contour. You will probably just drive yourself crazy checking with different meters if you do it a lot. We recommend checking when the Libre reads low. Last night, it looks like the Libre reading would have been better (since 1 unit was not enough insulin as it turned out.) Good job not skipping the shot though!
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I am trying to get more comfortable with the Libre. Because the Libre was reading in the low 200s at shot time, that is why I especially used Contour to test the BG that night. His Libre readings are typically really high preshot. I had never gotten such a low BG reading preshot. It seemed to be a late Nadir. I was too worried about giving him the full dose because he typically has swings of around 200 points, so I was being conservative and gave 1/2 dose. I fed him after I measured his BG so couldn't get another fasting preshot number. Maybe half dose was too drastic, and I was being conservative, but I was worried about hypo.
 
cocokittybrown said:
Now that you mention it, I agree that it doesn't make sense to take Douglas to the vet for just another Fructosamine test, especially since I am using the Libre and sending them the reports. I sent the office an email yesterday asking them to help me understand why he needs another Fructosamine test and why the Libre isn't sufficient. I have an appt scheduled for this Saturday and I was asking them if I should cancel it or just schedule a phone consultation with the doctor to discuss care. Douglas is eating well, going to the bathroom normally (except more pee than usual), and energy seems improved. He is not exhibiting any other symptoms that concern me.
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I canceled the Saturday appointment to bring in Douglas, and scheduled a phone consultation with the doctor for next Tuesday. In the email, she'd mentioned that the other doctor suggested the Fructosamine test to remove some of the stress from using the Libre. I did not agree with that statement because I think it is more stressful to take Douglas into the office for blood work versus us using the Libre or doing the BG checks with the meter. Douglas is a very chill kind of guy and he doesn't seem to mind us treating him. He does hate the vet's office and that really does seem to stress him out. In the doctors email, she mentioned that she doesn't want to do any dental until his diabetes is regulated and we may need to consult with an internal medicine doctor. She'd mentioned the internal medicine doctor when he was very first diagnosed. I am not having a lot of confidence that she is going to be able to help me with the diabetes, and I am not so confident that an internal medicine doctor will helpful either. I will find out more during our phone consultation on Tuesday.
 
@Suzanne & Darcy I've increased Dougie's dosage to 2.5 today. He has been on 2.5 in the past for 5 days and this dosage in the past seemed slightly better than the 2.25 dose so I am hopeful. I will plan to hold the 2.5 for 7 days.


I am not that familiar with how this message board works. If I have new questions, do I post a new message? Or continue with this one? I apologize if I am not following protocol.

I have a couple of current questions:

Question 1. I have a phone consultation scheduled with Douglas regular vet on Tuesday. I am not sure what to request/discuss. I feel very uncomfortable because I am not "following doctor's orders" and I hope she doesn't try to make me feel like a bad parent. She had told me to increase to 2.0 on 2/22/25 and I will need to tell her that is is now on 2.5 without her giving these orders. I am the parent, and I am doing what I think is best. However, I take her suggestions under advisement. I already feel like a bad parent enough, without any outside validation. I think some of that is also I am just really raw emotionally, and am taking things the wrong way and trying to be mindful of that and it may be me projecting my feelings onto her. She has mentioned a couple of times that if he is not able to get regulated, that I will need to work with an internal medicine doctor. I suspect that she will recommend this during that meeting. Even if she doesn't recommend that during this meeting, does it makes sense maybe for me to suggest this myself. I can ask her for a referral. I am not going to push dental with her anymore. It sounds like their office feels uncomfortable about doing dental with an unregulated diabetic patient, and I don't want a dental procedure being done on Douglas by someone who feels uncomfortable because I feel like that is not in his best interest. I can try elsewhere if needed. I will request the Libre3+ Rx and she already agreed to that. What are your thoughts on topics I should discuss at Tuesday's meeting?

Question 2: Ketones. Not sure how much a question is here, but more of a concern.... I am now testing Douglas blood ketones with KetoSens meter. I also try to test his urine with urine strips, but lately the urine strips have had some funky color and not sure how to interpret the urine strips (they are not expired, and have worked in past) and work on me. Yesterday, Douglas had 1.5 ketones AMPS and 1.10 ketones PMPS. What I know about feline ketones: https://www.diabeticcatinternational.com/knowledge/ketones/ When I checked mid-cycle, they went down to .5, so it wasn't developing into DKA, but DKA is more scary than a hypo event. With a hypo event, I know about giving high carb food and re-test. Even with high BG and high ketones, he seems pretty energetic, great appetite, no vomiting, or no other worrisome symptoms. But his high numbers really do freak me out!!! If at anytime I am in any doubt, I won't be shy about taking him to an emergency vet. However, if he really isn't in a crisis, I don't want to stress him out unnecessarily by rushing him to the ER. Plus, I work at an office during the day, so I can't monitor him then. Any advice about these high keto concerns?

I want what is best for Douglas, and he is my little soul kitty. And I appreciate all your suggestions so far.
 
Oh my gosh I found this thread. I kept looking for it one the ProZinc forum. How is he doing today since the AMPS I can see on the SS.
 
cocokittybrown said:
I am not that familiar with how this message board works. If I have new questions, do I post a new message? Or continue with this one? I apologize if I am not following protocol.
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Don’t worry about it. If you have new questions you can just add it to this thread. When the thread gets over 50 posts, you can start a new one and just link this thread in the first post of the new thread. To do that, you just copy and paste the “address” of the old thread.
 
I’m glad she’s agreed to the Libre 3. I don’t know how much information I would share with the vet. What is she likely to ask you? And you most certainly are NOT a bad caregiver for Douglas. Not many people would do what you are doing (sadly). The people who post here are usually the ones who will do everything they can for their babies.
 
cocokittybrown said:
She had told me to increase to 2.0 on 2/22/25 and I will need to tell her that is is now on 2.5 without her giving these orders. I am the parent, and I am doing what I think is best. However, I take her suggestions under advisement.
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I don’t think she can be critical of your approach to increasing the dose. You have been very careful and you have ‘round the clock BG readings with the Libre. You are aware of his nadirs and have adopted a very safe approach to increasing the dose. If anything, if she’s like most vets, she would want you to increase in much larger increments. I would be respectful, of course, and appreciative, but you are the one who is with Douglas monitoring him and feeding him and making sure he is safe.
 
cocokittybrown said:
@Suzanne & Darcy I've increased Dougie's dosage to 2.5 today. He has been on 2.5 in the past for 5 days and this dosage in the past seemed slightly better than the 2.25 dose so I am hopeful. I will plan to hold the 2.5 for 7 days.


I am not that familiar with how this message board works. If I have new questions, do I post a new message? Or continue with this one? I apologize if I am not following protocol.

I have a couple of current questions:

Question 1. I have a phone consultation scheduled with Douglas regular vet on Tuesday. I am not sure what to request/discuss. I feel very uncomfortable because I am not "following doctor's orders" and I hope she doesn't try to make me feel like a bad parent. She had told me to increase to 2.0 on 2/22/25 and I will need to tell her that is is now on 2.5 without her giving these orders. I am the parent, and I am doing what I think is best. However, I take her suggestions under advisement. I already feel like a bad parent enough, without any outside validation. I think some of that is also I am just really raw emotionally, and am taking things the wrong way and trying to be mindful of that and it may be me projecting my feelings onto her. She has mentioned a couple of times that if he is not able to get regulated, that I will need to work with an internal medicine doctor. I suspect that she will recommend this during that meeting. Even if she doesn't recommend that during this meeting, does it makes sense maybe for me to suggest this myself. I can ask her for a referral. I am not going to push dental with her anymore. It sounds like their office feels uncomfortable about doing dental with an unregulated diabetic patient, and I don't want a dental procedure being done on Douglas by someone who feels uncomfortable because I feel like that is not in his best interest. I can try elsewhere if needed. I will request the Libre3+ Rx and she already agreed to that. What are your thoughts on topics I should discuss at Tuesday's meeting?

Question 2: Ketones. Not sure how much a question is here, but more of a concern.... I am now testing Douglas blood ketones with KetoSens meter. I also try to test his urine with urine strips, but lately the urine strips have had some funky color and not sure how to interpret the urine strips (they are not expired, and have worked in past) and work on me. Yesterday, Douglas had 1.5 ketones AMPS and 1.10 ketones PMPS. What I know about feline ketones: https://www.diabeticcatinternational.com/knowledge/ketones/ When I checked mid-cycle, they went down to .5, so it wasn't developing into DKA, but DKA is more scary than a hypo event. With a hypo event, I know about giving high carb food and re-test. Even with high BG and high ketones, he seems pretty energetic, great appetite, no vomiting, or no other worrisome symptoms. But his high numbers really do freak me out!!! If at anytime I am in any doubt, I won't be shy about taking him to an emergency vet. However, if he really isn't in a crisis, I don't want to stress him out unnecessarily by rushing him to the ER. Plus, I work at an office during the day, so I can't monitor him then. Any advice about these high keto concerns?

I want what is best for Douglas, and he is my little soul kitty. And I appreciate all your suggestions so far.
Click to expand...
With ketones it’s extremely important to keep him hydrated (add water to his food) make sure he eats enough calories (a lot of food) and not to skip insulin shots. With my cat, and many others I have seen, the ketones usually start to come down as you get closer to a good insulin dose — even before you start to see the BG numbers come down into normal range. His ketones fluctuate with those high BG numbers. So he is not stuck in high ketones all day long at least.
 
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