Help with dose for newly diagnosed cat | Feline Diabetes Message Board - FDMB

Help with dose for newly diagnosed cat

R

RoroB

Member
Hi I have a thread in feline health New member advise
but this is about dosing prozinc so I thought might make more sense here

I've been to the vets today and he wants me to give 1.5 units AM and PM. That seems much higher than what has been advise on earlier thread (0.5U). I have him on LC food and his numbers aren't that high so wanted to start on a lower dose, but that's what I've been told to give????

He's a newly diagnose 6kg 12 year old male. This will be his first dose of insulin

Also vet said not to test his blood so much as I'll scar his ears and make it harder to draw from there. That seems to go against what I've read in here about the ears becoming better at bleeding after a few weeks again I'm not sure about that?
 
RoroB said:
Hi I have a thread in feline health New member advise
but this is about dosing prozinc so I thought might make more sense here

I've been to the vets today and he wants me to give 1.5 units AM and PM. That seems much higher than what has been advise on earlier thread (0.5U). I have him on LC food and his numbers aren't that high so wanted to start on a lower dose, but that's what I've been told to give????

He's a newly diagnose 6kg 12 year old male. This will be his first dose of insulin

Also vet said not to test his blood so much as I'll scar his ears and make it harder to draw from there. That seems to go against what I've read in here about the ears becoming better at bleeding after a few weeks again I'm not sure about that?
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Hi. I am sorry I didn’t see your message earlier. I would definitely like to help you with your ProZinc dosing. Please fill in your spreadsheet with how many units you shot. Today is the first day of insulin?
 
RoroB said:
ok I gave 1 unit. Really hoping he's ok on that. I have antibiotic tablets to give in a bit
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Just get some tests to make sure. I hope everyone else has spoken to you about having high carb food on hand and karo syrup or honey (karo is a bit easier) and also some high carb food like Fancy Feast Gravy Lovers?
 
Morning thanks for your replies. Bubs doing great, been much cuddlier this morning.

Yes Suzanne and Darcey (how do I quote?) I have read the hypo sticky and printed off symptoms (on the fridge), and instructions. Have a bag with all the foods and honey+ extra test stripes and lances.
 
RoroB said:
Morning thanks for your replies. Bubs doing great, been much cuddlier this morning.

Yes Suzanne and Darcey (how do I quote?) I have read the hypo sticky and printed off symptoms (on the fridge), and instructions. Have a bag with all the foods and honey+ extra test stripes and lances.
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This is good to hear (about being cuddly). He must already be feeling a bit better! You have done a tremendous job of getting everything together and starting the testing and insulin. How is the testing going?
 
What was his preshot test this morning (20 September?) Have you been able to get any tests since then? You are five hours ahead of me, I believe, so it should be coming up on noon for you in about ten minutes.
 
Thanks! It seemed like a jump in at the deep end and get on with it situation

I'd put this mornings info in yesterday's column so have corrected that. I was going to wait an HR or so to test, we have multiple cats and always have food down (now all low carb wet) during the day, and he's just eating his lunch now. Unless you think I should?

Testing is going so/so. His left ear is definitely easier, sometimes I get it first time sometimes it takes a few goes. Thankfully he is the calmest most gentle boy and just let's me get on with it
 
RoroB said:
Thanks! It seemed like a jump in at the deep end and get on with it situation

I'd put this mornings info in yesterday's column so have corrected that. I was going to wait an HR or so to test, we have multiple cats and always have food down (now all low carb wet) during the day, and he's just eating his lunch now. Unless you think I should?

Testing is going so/so. His left ear is definitely easier, sometimes I get it first time sometimes it takes a few goes. Thankfully he is the calmest most gentle boy and just let's me get on with it
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Oh he sounds like a lovely cat. My boy was like that also. He put up with me, especially when I was just learning to test. His left ear always bled better than the right — although I did alternate ears and move up and down the ears a bit so that I wasn’t always hitting the same spot.
 
RoroB said:
I'd put this mornings info in yesterday's column so have corrected that. I was going to wait an HR or so to test, we have multiple cats and always have food down (now all low carb wet) during the day, and he's just eating his lunch now. Unless you think I should?
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This is probably okay to let him graze as long as he’s not a steep diver (a cat whose BG drops quickly). Usually I recommend feeding small snacks at +2, +4 and possibly +6 but no food after +6. There’s already been so many changes for him that I don’t really want you to have to change the feeding as well. I would probably just re pulling the food up at +6 in the cycle. Feeding much food after nadir can have the effect of causing the blood glucose to rise prematurely toward the end of the cycle. However, if your cat is frantic for food, it’s okay to give a spoonful or two of LC food.

I would hold this dose for a few more days and get some tests done at around +4/5/6 (not all on the same day) to see how he is working with the insulin. Then we can look at his numbers and make a decision about next steps. Alright?
 
That red definitely could be a bounce, although we can’t see if he dropped low —it doesn’t have to be a very low number — just a number he isn’t used to or anything perceived as a quick drop.
 
RoroB said:
his first red this morning, do you think that might be a bounce? I couldn't get extra readings yesterday but can today so will get +4 and +6
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It looks like he could be in a bounce so I would get a +3 and if it’s still really high (pink) I would stop testing at that point. Will that work?
 
No ketones at the vets from urine or blood. I did get some on test strips at home but realised now I was taking too long getting up and starting the timer so over exposing them. I can try and get another test today?
 
RoroB said:
No ketones at the vets from urine or blood. I did get some on test strips at home but realised now I was taking too long getting up and starting the timer so over exposing them. I can try and get another test today?
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Just get one if you can. As for increasing the dose, you have two options. Since he is very new to insulin, and not producing ketones? (We think) we could hold the dose for 7 days per the Start Low Go Slow dosing method or, you could try the Modified ProZinc Method and that gives us a little more flexibility to increase his dose more quickly (about every 3 days). How does he seem to you these last few days? How is his eating, drinking and litter box usage? How is his energy level and habits? Is he doing the things he normally does and sleeping in his favorite spots, etc?
 
Yes still on antibiotics so that could be affecting things. He seems largely the same as he was last week, when I switched him to all LC wet food but before he had insulin. So better - more energetic and cuddly than he was before that but less energetic than say 4 months ago.

He's eating fine. I didn't really notice any increase in drinking or litter box (multicat house)
 
If he has two more days of antibiotics remaining, then let’s wait until he finishes them and then, if his nadirs stay in the same range (mid yellow,) increase to 1.25 units.

Drawing a 1.25 unit dose will require you to draw the plunger halfway between the 1 and 1.5 marks on the syringe. You just have to “eyeball it.”
 
Yes it was a week's course. Waiting till they've finished makes sense.
His numbers look a little better today, still a way to go but slow and steady is fine.
I'm fine with eyeballing it, I can split cake pieces within a few grams
 
Bub threw up today at sometime between +4 and +8 after his morning shot. Annoyingly with his last dose of antibiotic in it. I suspect closer to+4 as that's when he had the pills which you could still see the pink from.

He doesn't seem unwell and I've checked his bs again and ketones and all normal for him. Looks like he overate, I was trying one of the LC foods and think he likes it too much and the other cats not so much so he's been able to gorge.

I'll speak to the vet when I see them next week about whether 6.5 days of antibiotics is fine or whether he needs another round. But the stress! Cats throw up it's not a big deal, but now it is jeez!
 
Am I right that if his numbers stay the same I'll be increasing his dose to 1.5U in a few days?

Also is there a reason his PM dose doesn't seem to have as much affect as his AM dose?
 
Hello. He will be ready for a .25 unit dose increase on October 3.

It’s strange about his evening numbers being higher because most cats tend to drop into lower numbers at night. It’s possible that his body is reacting to the lower numbers of the daytime cycle and causing a little insulin resistance.

How is he feeling and acting?
 
He seems happy/cuddly, still lower on energy than he would have been 6 months ago but much better than 3 weeks ago. I didn't notice any crazy drinking/ eating/ weeing but I haven't even seen him drink in the last day or so, I would guess he's less thirsty.

I'm now trying to cut his eating down a bit in the later half of his AM cycle I wonder if that's whats been causing higher night numbers- all the food still working through his system. I was already picking everything up at 2 hours before PMPS so as not to affect that too much but now I'm trying for 5 hours before. Difficult with multiple cats who are skinny and used to free feeding.

I know he doesn't each much between +5 and +12 on his PM cycle, because I can see it's not gone- I've been leaving out least favourite food that I know he'll eat if hungry. Partly to make me feel less worried about hypo's in the night.
 
RoroB said:
I'm now trying to cut his eating down a bit in the later half of his AM cycle I wonder if that's whats been causing higher night numbers
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I don’t recommend feeding much food after nadir in most cats. Feeding after a cat’s typical nadir can shorten the duration of the insulin and cause numbers to rise prematurely toward the end of the cycle as the effect of the insulin is waning. Exceptions can be made for cats who are just going bonkers for food or are very underweight and didn’t eat enough earlier in the cycle. I just recommend keeping it lowest carb and small amounts for a snack.
 
It’s a good sign that he’s not drinking noticeable amounts. That’s progress. Sometimes the “clinical signs” will improve ahead of the actual blood glucose numbers. I’m happy he’s overall feeling better and look forward to even more good news on this front.
 
Suzanne & Darcy said:
I don’t recommend feeding much food after nadir in most cats. Feeding after a cat’s typical nadir can shorten the duration of the insulin and cause numbers to rise prematurely toward the end of the cycle as the effect of the insulin is waning. Exceptions can be made for cats who are just going bonkers for food or are very underweight and didn’t eat enough earlier in the cycle. I just recommend keeping it lowest carb and small amounts for a snack.
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Yes I think you mentioned longer without food early on in the thread, but I put the sorting food timings onto the back burner while getting a bit more settled with everything else. I think it looks like his nadirs are around +7/+8 on daytime? I can't tell on the nighttime and don't really have enough data from those times.
 
Suzanne & Darcy said:
It’s a good sign that he’s not drinking noticeable amounts. That’s progress. Sometimes the “clinical signs” will improve ahead of the actual blood glucose numbers. I’m happy he’s overall feeling better and look forward to even more good news on this front.
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Ok good to know I'm still hoping to see blue, maybe it's coming🤞
 
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