Should I increase dosage to 3 units?

Chellie

Chellie

Member
*Posted this on the main forum but wanted to put it here too. It’s more direct than my longer post, and my spreadsheet is now updated. Thanks!!

2.5 units of ProZinc is starting to finally keep him mostly under 400, but the nadirs are still pretty high. Cash was diagnosed with steroid-induced diabetes late February. Was started on 1 unit 2x a day for two weeks, then went to 2 units for a week. Based on his numbers, vet recommended a jump to 3 last Friday but I opted for 2.5. This dosage has been really promising so far, but 220 is the lowest I’ve ever seen his BG. It’s only been 3 and a half days, so maybe I should give it longer as I do see small gains every day (but also backslides). Ideally, I would change his diet first before moving to 3, as his current food is probably around 20-22% carb (z/d hydrolyzed/ instinct rabbit mix) but he has IBD and there’s no guarantee something else might work/slow transition time etc. I’m not sure how dangerous it is for him to continue with high numbers (and change food option) versus using 3 units to get him down now. Any thoughts youhave would be very helpful, thank you! Spreadsheet is updated.

link to my first post is here:https://felinediabetes.com/FDMB/thr...sage-newly-diagnosed-cat.299402/#post-3256671
 
Chellie said:
*Posted this on the main forum but wanted to put it here too. It’s more direct than my longer post, and my spreadsheet is now updated. Thanks!!

2.5 units of ProZinc is starting to finally keep him mostly under 400, but the nadirs are still pretty high. Cash was diagnosed with steroid-induced diabetes late February. Was started on 1 unit 2x a day for two weeks, then went to 2 units for a week. Based on his numbers, vet recommended a jump to 3 last Friday but I opted for 2.5. This dosage has been really promising so far, but 220 is the lowest I’ve ever seen his BG. It’s only been 3 and a half days, so maybe I should give it longer as I do see small gains every day (but also backslides). Ideally, I would change his diet first before moving to 3, as his current food is probably around 20-22% carb (z/d hydrolyzed/ instinct rabbit mix) but he has IBD and there’s no guarantee something else might work/slow transition time etc. I’m not sure how dangerous it is for him to continue with high numbers (and change food option) versus using 3 units to get him down now. Any thoughts youhave would be very helpful, thank you! Spreadsheet is updated.

link to my first post is here:https://felinediabetes.com/FDMB/thr...sage-newly-diagnosed-cat.299402/#post-3256671
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I don't know. Tagging someone who might!
@CORKY
 
Since you are new to this whole thing, you should be following the SLGS dosing method at this point — so you should hold this 2.5 dose for 7 days before increasing the dose. Okay?
 
Regarding a diet change, moving to LC food would definitely lower his BG and so changing food should be done gradually with close monitoring of BG. He likely would need less insulin. It’s really your call if you want to do that now or later. My only recommendation is to transition slowly when you can monitor his cycles. All food changes in cats need to be done slowly anyway, in order to minimize GI upset, but in this case you have the extra consideration of lower BG.
 
Have we talked about ketones yet? With these high numbers, you should be testing for ketones — either with the urine strips or with a blood ketone meter. If he does have high ketones, we would probably be more aggressive with the insulin increases. He is making some progress and I am optimistic for the future.
 
Thank you for your help and advice, Suzanne. I am holding his dose at 2.5. In two days we will reach a full week on this dose, and at that time I might be back here with more questions! His numbers are coming down slowly and more yellow is starting to pop up on the spreadsheet, but I am still worried we have not gone lower. I don't know anything about ketones and need to look into how I might also test for those. Do you recommend the blood meter or the strips? I might be partial to whichever I can actually buy locally quickly. I'm also starting to feel a bit guilty about deciding to increase the dosage to 2.5 instead of 3 which my vet recommended. But honestly, so many things have gone wrong with his treatment because he was over-medicated or prematurely treated for something while other things I was worried about were ignored. I have had to constantly push for tests and additional checkups he very much needed, and I'm almost certain Cash is only still here because of my attentiveness. Can you relate to this?

Also, I believe I've filled out my signature. Thanks again!
 
I definitely can relate to that! We sometimes have to advocate for our cats and push the vets.

Do not feel guilty about not increasing immediately to 3 units. We need to know how low the dose is taking him in order to keep him safe from a hypo. Also, he’s newly diagnosed and it takes a while for the cat’s body to properly use the insulin. We will know more in a few days. 3 units may be okay or it may not be we will get there safely.
 
Chellie said:
But honestly, so many things have gone wrong with his treatment because he was over-medicated or prematurely treated for something while other things I was worried about were ignored.
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What kind of medication? What conditions was he prematurely treated for? What medications does he take now?
 
Posted a new thread, but also putting it here in case Suzanne will see.

This morning at 6:15 his pre-dose numbers were in the low 300s and by 8:30am he was at 190 and dropping rapidly. It's now 9am and he's down to 142 and I'm worried. He's never been this low (which might be good), but it happened very fast and the Libre still shows he's dropping fast. We have been slowly lowering the amount of high carb wet food mixed in with his newer low carb food, but maybe we should have waited to do that until he had 7 full days on this new dose. I offered him a few more bites of food and am staying home from work this morning to monitor. Should I offer him high carb food now? wait and see? I'm very nervous thank you!
 
Chellie said:
Posted a new thread, but also putting it here in case Suzanne will see.

This morning at 6:15 his pre-dose numbers were in the low 300s and by 8:30am he was at 190 and dropping rapidly. It's now 9am and he's down to 142 and I'm worried. He's never been this low (which might be good), but it happened very fast and the Libre still shows he's dropping fast. We have been slowly lowering the amount of high carb wet food mixed in with his newer low carb food, but maybe we should have waited to do that until he had 7 full days on this new dose. I offered him a few more bites of food and am staying home from work this morning to monitor. Should I offer him high carb food now? wait and see? I'm very nervous thank you!
Click to expand...
 
His BG number is g00 with ProZinc's low is 50, no, no high carbs or any medium or Karo, just monitor with testing if he gets in the 60's range just for you, not Chelly she's fine, is for you to relax, she is safe if she get in the 2 digits lets say 70 or less, just feed her 1-2tsp of Low carb test in 1 hour, and repeat, in the mean time I will tag Suzanne for her to assist you ( to relax you see Corky's Spreadsheet he uses ProZinc):bighug::bighug:
:cat::cat:
@Suzanne & Darcy
 
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