New Member Youde PS 104 mg/dl

[Youde]

Hello!

A Short story of Youde:
15 year old cat diagnosed 3 months ago is likely going into remission.
Right now his pre-dose level is 104 mg/dL, nadir was around 95, has been on 0.4 unit of prozinc twice daily in the past 24 hours, and 1 unit of prozinc for 7 days before that, and 2 units before that.

Long story:
Youde was first diagnosed in December and has been on U-40 Prozinc. We started with 2 units twice daily initially and the vet let us do home testing since we were comfortable with it and already had a human meter at home.
We increased the amount of wet food we give to Youde immediately after the diagnosis (from 100 g per day to 200 g per day), and 3 weeks after the diagnosis we removed dry food completely. He eats cans from a brand called Wild Freedom that we get on Zooplus, and he's been eating the food from mostly the same brand for 5/6 years now.
About 3 months after the diagnosis, or a week ago, I did a curve at home and realized his glucose levels were between 45 and 130. After discussing with the vet over the phone we lowered his insulin intake to 1 unit twice daily. He was on 1 unit of Prozinc for exactly one week and his glucose levels were between 100 and 160, and it was trending down. So yesterday we lowered it again to 0.4 unit twice daily and the levels have been between 95 and 135. My vet said if his low gets below 90, we should stop giving him insulin.
I am new to the group and really don't have much experience with charting. Everything was handwritten in a notebook. His PS is so low (104) but since the nadir is still above 90, and he's only on 0.4 U, I am not sure what to do....

Here is an incomplete file of his BGLs, we didn't manage to save all the data but hopefully this provides a good picture: https://docs.google.com/spreadsheets/d/1IxePlUPDEo-oS18MfqXzC-JnyD8vayRBDUOSs7vAkIs/

 

[squeem3]

@Suzanne & Darcy

 

[Bron and Sheba (GA)]

Hi and welcome to the forum.
Looking at his spreadsheet I can see he is not yet done with insulin but is looking good. To get a strong remission you will need to keep reducing the dose and be guided by the BG numbers in doing this. I am not a Prozinc user but @Suzanne & Darcy is and she will be able to help you with this..

 

[Suzanne & Darcy]

Hello and Welcome to the FDMB!
Your Youde is doing very well, but as you can see from tonight’s skipped shot, he’s not quite ready to go off of insulin entirely just yet. Without the insulin support in this evening’s cycle, his numbers have climbed too high. Normal blood glucose range for a cat are between about 50 and a max of 120 with the cat spending most of its time in the green numbers under 100 and very few blue numbers.

 

[Suzanne & Darcy]

When we are guiding a cat into remission, we gradually reduce the dose according to the cat’s nadirs — reducing as a reduction is earned by the cat going under 50. I say 50 because at this point your cat appears close to remission and we want to keep Youde between 50 and 99 as much of the time as possible. This is the way to ensure a true and lasting remission— as we support a pancreas that is healing and starting to produce its own insulin with a small dose of ProZinc.

Tell me, how are you measuring the .4 dose? Are you using U-100 syringes with a conversion chart? Because a U-40 syringe will only measure in .5 and .25 (if you eyeball it) measurements. Or are you giving what we would call a skinny dose of very slightly less than .5 (with the plunger just slightly below the .5 mark?)

 

[Youde]

Thank you! This morning the AMPS was 196 so we are back to 0.4 units again. It's super helpful to have the 50-99 range, I appreciate that and will aim for it with (hopefully) lower doses.

I am giving 0.4 unit because I am currently using a U-100 syringe, 0.4 unit on U-40 syringe is exactly 1 unit on U-100 syringe which is easy to measure. A

 

[Suzanne & Darcy]

Thank you! This morning the AMPS was 196 so we are back to 0.4 units again. It's super helpful to have the 50-99 range, I appreciate that and will aim for it with (hopefully) lower doses.

I am giving 0.4 unit because I am currently using a U-100 syringe, 0.4 unit on U-40 syringe is exactly 1 unit on U-100 syringe which is easy to measure. A

Thanks for letting me know how you drew that dose. I do like using the U-100s when we need to do some fine dosing with ProZinc.

 

[Suzanne & Darcy]

The good news is that — even though he climbed above the normal range with that skipped shot last night, he still stayed in the blue. He’s making progress. Let’s see how the .4 goes today. I see you got a blue +4.

 

[Youde]

We got a higher nadir today (117), I wonder if it's because we are at the very end of the vial. Waiting for the vet to send the new prescription to the pharmacy and we are so curious to know what the numbers will be once we start the new vial.

 

[Suzanne & Darcy]

Did you get an AMPS test this morning before his insulin? I don’t see a number in the cell. So it could be that he started out a little higher this morning and that is why his nadir is a little bit higher. It’s important to get those preshot tests so that you know (if it’s lower than normal) if you need to perhaps shoot a reduced dose or just keep an extra close eye on the cycle.

How old is your ProZinc vial? I hope you will have even better results with it (although I see a lot of people changing their vials out after only two months and they don’t usually see much change in numbers.) If it’s stored in the refrigerator, it can last a long time- even six months in many cases.

 

[Youde]

Did you get an AMPS test this morning before his insulin? I don’t see a number in the cell. So it could be that he started out a little higher this morning and that is why his nadir is a little bit higher. It’s important to get those preshot tests so that you know (if it’s lower than normal) if you need to perhaps shoot a reduced dose or just keep an extra close eye on the cycle.

How old is your ProZinc vial? I hope you will have even better results with it (although I see a lot of people changing their vials out after only two months and they don’t usually see much change in numbers.) If it’s stored in the refrigerator, it can last a long time- even six months in many cases.

I wasn't able to get the pre-shot numbers today so unfortunately I don't know how high they were. I will try to measure them tomorrow.

My vial is 3 months old, always stored in the fridge (on the door though), and it's a bit...cloudy? It just doesn't look too good so I just want to start a new one, plus there is very little left. But my vet somehow thinks I should stop giving him insulin so I still don't have a prescription yet, I will try calling tomorrow.

 

[Suzanne & Darcy]

Just checking in. That was a pretty fast drop last night at +2. If you have a situation like that again where the +2 is a lot lower than the preshot number, don’t stop testing because it’s a good indicator that you will have what we call an “active” cycle. I would have either stayed up or set an alarm to test in another hour or get a +4.