need some help please about dosing etc... cat out of 5 year remission new to prozinc

Hello. I think he may be bouncing from the blue numbers that he is not used to. If you wait 30 minutes after feeding to shoot the insulin, he is just going to have an extra 30 minutes to climb in BG before the insulin is given — and the insulin is going to take about two hours to onset anyway, so that is 2.5 hours of potentially rising BG.

Is he vomiting much? When? How is he overall?
 
Ummlee and Vengeance said:
@Suzanne & Darcy at what numbers based on venges recent numbers would you shoot no shoot partial 1.5 or etc? thanks :)
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Oh. Sorry, I don’t think I answered this question. We figure this out based on data that we will gather over time. Based on what happened on 4/28, next time I would try 2 units with the same pre-shot number as long as you can get a few tests in.

When you are uncertain about a preshot number, you can retest just to make sure it’s a valid number (within 20 percent) or you can stall without giving any food. Retest in 30 minutes and see if BG is stable or rising. Sometimes it can be falling, but generally this is due to the cat not having eaten for a long time— so stalling can sometimes make dosing decisions more difficult. We would be looking for a significant drop in BG to give is pause. Most times the previous shot is waning and the new one won’t take effect for approximately two hours.
 
Suzanne & Darcy said:
Hello. I think he may be bouncing from the blue numbers that he is not used to. If you wait 30 minutes after feeding to shoot the insulin, he is just going to have an extra 30 minutes to climb in BG before the insulin is given — and the insulin is going to take about two hours to onset anyway, so that is 2.5 hours of potentially rising BG.

Is he vomiting much? When? How is he overall?
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today was a giant hairball like directly before I was going to test him was walking to get meter and yack yack HAIRBALL lol .. he has been throwing up just water etc but it has the cat hair in it and etc like he does when hes telling me he wants more food.. I am feeding him a meal at am/pm and a middle half meal at +6ish ... so I dont know if its him actually throwing up or just him doing his thing to get me to feed him by forcing himself to throw up... hes done that almost his whole life.. strange habit... but he knows if he does it I will give extra food between meal times being I think of it as a sign he NEEDS more food when I just watch him eat a whole or half can of food in a few bites... he also never besides the hairball today throws up in front of me.. its always when I am not home or asleep or in my room and hes in other part of house and he always does it directly in my path so I find it.. overall acts normal no lethargy no diarrhea not overly drinking( he likes to play in the water so I never know if he has drank it or threw it on the floor and I walk in it lol) but he pees a lot from just the wet food.. very talkative as always responsive asshole at time cuddly at times normal Vengeance lol but I do still wonder about that last blood work and the pancreatitis thing.. BUT I dont want to take him back to my vet being shes gonna give me crap about testing and changing dosage etc.. I was looking into maybe an online vet send them the blood work from month and half ago and see what they think.... ????
 
About feeding. With ProZinc, it’s important that Venge has snacks at about +2, +4. These snacks would be about a spoonful or two of low carb wet food. The +2 snack helps prevent steep drops in BG at the time when the ProZinc starts to kick in. The mid-cycle feeding at +6 is optional. I normally don’t recommend feeding much after nadir because it can shorten the duration of the ProZinc and cause numbers to rise prematurely toward the end of the cycle. Some cats will freak out if they don’t get food though so if you just keep the snack small and low carb it’s probably okay. The rule is just that you should not feed for the two hour period before the AMPS and PMPS tests — so that the number is not inflated by food.

Of course, if he’s underweight, you can make the snacks/mini meals larger.
 
I forgot to say that if you aren’t at home for a long stretch of time, you can get an automatic feeding to dispense these snacks at the appropriate times.
 
Suzanne & Darcy said:
Do you have a copy of his latest bloodwork? Did he have a pancreatitis test. There’s a specific pancreatitis test.
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He had one when he was re diagnosed 3/11 .. and I think you pointed out in the main that it says he might have pancreatitis but she my vet didnt mention nor give any treatment for it... maybe she attributed it to him being extremely agitated aka he tried to eat them when they tried to get blood so they had to gas him out to do it..
 

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Suzanne & Darcy said:
About feeding. With ProZinc, it’s important that Venge has snacks at about +2, +4. These snacks would be about a spoonful or two of low carb wet food. The +2 snack helps prevent steep drops in BG at the time when the ProZinc starts to kick in. The mid-cycle feeding at +6 is optional. I normally don’t recommend feeding much after nadir because it can shorten the duration of the ProZinc and cause numbers to rise prematurely toward the end of the cycle. Some cats will freak out if they don’t get food though so if you just keep the snack small and low carb it’s probably okay. The rule is just that you should not feed for the two hour period before the AMPS and PMPS tests — so that the number is not inflated by food.

Of course, if he’s underweight, you can make the snacks/mini meals larger.
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hes 14.8 lbs he was 14.1 the day of the last vet visit so hes gaining weight
 
Hes at 141 right now so I am going to hold 30 mins and retest then.. check him again and +2 and give a snack... then check again at +4 and +6

update held off food and shot for 30 mins retested hes at 173 now ... so going to give the 1.5...
 
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Anyway, you probably already gave the half dose, but if you find he climbs into yellow later in the cycle like he did last time the 1.5 dose was given, then next time try a little more insulin. We will see.

If he’s in a blue number like that, you can wait 30 minutes and retest (no food) and see what hos BG is doing. If you test a +2 you should have a good idea as well.
 
Suzanne & Darcy said:
Anyway, you probably already gave the half dose, but if you find he climbs into yellow later in the cycle like he did last time the 1.5 dose was given, then next time try a little more insulin. We will see.

If he’s in a blue number like that, you can wait 30 minutes and retest (no food) and see what hos BG is doing. If you test a +2 you should have a good idea as well.
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nope I saw you were on so held off and gave him the 1.75
Suzanne & Darcy said:
Were you affected by the fires? It’s raining here. We got some good rain this week.
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nope I am north of tally so further west ... yeah this is the first actual rain we have had in months here... and still coming down now...
 
Yes. That’s right. I remember now about that high pancreatic lipase test. Hopefully it was just a temporary flare. If his appetite is good then he’s probably not suffering from pancreatitis.
 
Suzanne & Darcy said:
Wow. Have you tried (or has the vet suggested) giving some Gabapentin two hours prior to the vet visit?
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had to do that with him before and my other cats that I lost last year... but this was an emergency kinda thing so just brought him in in march soon as they opened doors was in there... and he had to wait for like 4hrs in cage before they could get to him...and hes odd at times hes fine then he decides he wants to chew their faces off... he was perfectly fine till they took him in back and was trying to get blood and they called me and said was it ok if they gave him gas otherwise they would not be able to get blood to test.... so I drove up there and said I can hold him if you want they said they didnt trust that so going to gas him out... lol
 
Ummlee and Vengeance said:
nope I saw you were on so held off and gave him the 1.75

nope I am north of tally so further west ... yeah this is the first actual rain we have had in months here... and still coming down now...
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Our entire state is in a drought. Maybe you are in that red extreme drought zone on the drought map. We are in the severe drought part, but not extreme yet.
 
Suzanne & Darcy said:
Our entire state is in a drought. Maybe you are in that red extreme drought zone on the drought map. We are in the severe drought part, but not extreme yet.
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yup and our family biz is landscaping, irrigation ,pools and custom homes and etc so tons of people asking what can they do ... put out a lot of sprinklers lol and did drive in some new biz for the irrigation dept so got a lot of new clients...
 
Suzanne & Darcy said:
Yes. That’s right. I remember now about that high pancreatic lipase test. Hopefully it was just a temporary flare. If his appetite is good then he’s probably not suffering from pancreatitis.
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I wish my vet wasnt sooooo strange about diabetic stuff that way I could take him in get rechecked but the second I mention I have changed his dose been self checking I will prob get told we cant help you anymore etc etc.. being they are a give this dose see you in 6 months kinda vet about sugar kitties.. which doesnt make sense in my head being you would not do that to a human with diabetes...
Suzanne & Darcy said:
You have the U-40 syringes with the half unit markings hopefully. It makes it possible to eyeball the .25 and .75 unit doses.
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Yup
 
Ummlee and Vengeance said:
yup and our family biz is landscaping, irrigation ,pools and custom homes and etc so tons of people asking what can they do ... put out a lot of sprinklers lol and did drive in some new biz for the irrigation dept so got a lot of new clients..
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Yeah. Our sprinkler system was torn up a few years back when the septic system was dug up and replaced. We have been having fun dragging sprinklers around to water the grass! I guess we should just replace the whole thing. Maybe they can use the existing control panel at least.
 
Ummlee and Vengeance said:
I wish my vet wasnt sooooo strange about diabetic stuff that way I could take him in get rechecked but the second I mention I have changed his dose been self checking I will prob get told we cant help you anymore etc etc.. being they are a give this dose see you in 6 months kinda vet about sugar kitties.. which doesnt make sense in my head being you would not do that to a human with diabetes...

Yup
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You are right. Don’t tell them about what you are doing with his dose. You may need them for other health issues so you don’t want to tick them off. What they don’t know won’t hurt them. Yeah, can you imagine telling a person to just give some insulin dose every day and never check your blood glucose! Seriously? I mean, they even invented the continuous glucose monitors just so people can keep better track of their BG.
 
Ummlee and Vengeance said:
update held off food and shot for 30 mins retested hes at 173 now ... so going to give the 1.5..
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I didn’t see this update until now. That was a good move — stalling and retesting. Since he is on his way up, you probably could have given 2 units or even more. But it’s alright— let’s see how he does today and next time you will have that data to help you.

I see the vet probably doesn’t want him gaining weight. He must love his food.
 
Suzanne & Darcy said:
Yeah. Our sprinkler system was torn up a few years back when the septic system was dug up and replaced. We have been having fun dragging sprinklers around to water the grass! I guess we should just replace the whole thing. Maybe they can use the existing control panel at least.
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all depends most places will try and upsale you to a new full system..
 
Suzanne & Darcy said:
I didn’t see this update until now. That was a good move — stalling and retesting. Since he is on his way up, you probably could have given 2 units or even more. But it’s alright— let’s see how he does today and next time you will have that data to help you.

I see the vet probably doesn’t want him gaining weight. He must love his food.
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so at +2 hes up to 303 so guess could have done 2 or 2.5 maybe... gonna give him a snack he was sleeping and then retest at +6 and see where it is.. oh he loves to eat thus all the trickery to get food from me all the time.. being on wet food I feed my outside cats dry food and odd you would think the wet food would be fancy or better.. but from the other side of the house he hears me getting food for them and hes like a crack addict below me wanting their dry food... he just wants FOOD same about his brother Nightwing my mainecoon mix.. both of them are eating machines... which is why I dunno about the auto feeder being they will honestly steal food out of each others bowl mid eating like NO I want yours now lol thou I am thinking on it... just to see I would just have 2 and let them both snack...
 
Suzanne & Darcy said:
You are right. Don’t tell them about what you are doing with his dose. You may need them for other health issues so you don’t want to tick them off. What they don’t know won’t hurt them. Yeah, can you imagine telling a person to just give some insulin dose every day and never check your blood glucose! Seriously? I mean, they even invented the continuous glucose monitors just so people can keep better track of their BG.
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yup then no idea what I will do for a vet... so thats why I was so thankful he went into remission so fast last time and was very lucky... but these days with online docs and etc.. thou they cant do blood work.. I can at least talk to one of those if I need too... being the next nearest vet is about 40 minutes away and Venge doesnt like car rides oddly as a kitten he did he would ride with me and lay on my old cars headrest around my neck lol... but as he got older.. NO WAY CAR MEANS VET lol
 
@Suzanne & Darcy HI hope all is well with your kitties :) was wondering if you will look at venges chart... hes having some better numbers here and there .. I wonder what had the nice greens that one night.. also he seems to have lower numbers at night I think... but hes been on 3 units for 16 days should say or bump up to 3.25 and see how it works or?? thanks so much :)
 
Hi! I was just thinking about you and Venge today. I’m glad you wrote. Yes, I do think he needs that increase to 3.25 units. You are doing an amazing job of tracking his BG.

One observation on the spreadsheet. Next time he has a mid-blue AMPS or PMPS, try 1.75 units instead of 1.5 units and see if that works a little better for him. The last two times you gave 1.5 it wasn’t quite enough and it allowed him to climb too high by the end of the cycle.
 
I see less pink and more blue on his SS. That’s progress! How is he feeling? I think he will need to go to 3.5 units, but let’s let this settle for a few more days. Okay?
 
Ummlee and Vengeance said:
@Suzanne & Darcy can you look at his chart again.. he was doing super then at nadir jumped back up.. I didnt give a dose at pmps due to being 136... should I have given a token dose ??? hmmm thanks... should I hold off on the 3.5 jump or?
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Generally it’s not good to skip shots, but you didn’t have anyone helping you with a dosing decision. No worries. Since you do not have a lot of experience, shooting blue numbers, I would have tried shooting a reduced dose of maybe 1.5 units and getting some test to see how that goes. Now I don’t think in my experience that would’ve been enough, but it’s always a good idea to start with a dose like that —a half dose — and then monitor the cycle and when you find out that it allows him to climb too high, the next time you’re shooting a similar number, you can give more insulin and gradually work your way to where you can shoot the lower numbers.

Another thing to consider is to wait 30 minutes and don’t give any food. Then test again to see if his BG is stable or rising. If it is, it’s probably safe to give the full dose or at least a larger dose …. Knowing that you have a couple of hours before the ProZinc is going to onset and start lowering the BG.

Since he’s having some blues, we should wait a couple more days before evaluating an increase. What’s your schedule like this week?
 
Suzanne & Darcy said:
Generally it’s not good to skip shots, but you didn’t have anyone helping you with a dosing decision. No worries. Since you do not have a lot of experience, shooting blue numbers, I would have tried shooting a reduced dose of maybe 1.5 units and getting some test to see how that goes. Now I don’t think in my experience that would’ve been enough, but it’s always a good idea to start with a dose like that —a half dose — and then monitor the cycle and when you find out that it allows him to climb too high, the next time you’re shooting a similar number, you can give more insulin and gradually work your way to where you can shoot the lower numbers.

Another thing to consider is to wait 30 minutes and don’t give any food. Then test again to see if his BG is stable or rising. If it is, it’s probably safe to give the full dose or at least a larger dose …. Knowing that you have a couple of hours before the ProZinc is going to onset and start lowering the BG.

Since he’s having some blues, we should wait a couple more days before evaluating an increase. What’s your schedule like this week?
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@Suzanne & Darcy gotcha yeah last time he was almost all blues and then greens so it was keeping from going hypo mostly he dropped into the blues in a few days (2020) but was a diff insulin so not sure how this one reacts seems to be way diff than the vetsulin/catsulin back then... I do notice that his nadir tends to hit more at the +7 +8 at times.. Rather than +6 then again its not exact numbers soooo... my schedule is usually what I want it to be and Vengeance comes first... I nap between tests when I do sleep which to his Bane which is pretty much a curve every day lol whats your thoughts? check out last night...
 
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@Suzanne & Darcy he was at 131 so I gave him food and 2 units.. being hes on 3.25 kinda sorta in between but not super low looking back when I had given him 1.5 at similar number he gotten back up to mid yellows at nadir... so will check him in 2 hrs and see where hes at then again at 4 etc... and see if after food spike he goes blues or greens..
 
Ummlee and Vengeance said:
@Suzanne & Darcy he was at 131 so I gave him food and 2 units.. being hes on 3.25 kinda sorta in between but not super low looking back when I had given him 1.5 at similar number he gotten back up to mid yellows at nadir... so will check him in 2 hrs and see where hes at then again at 4 etc... and see if after food spike he goes blues or greens..
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He had some awesome greens last night! Yay. So we hold his dose the same. Normal BG is 50-120 so he was right there. He probably will bounce a bit now? Today? Actually that will be a test of whether or not he’s starting to get more used to the normal BG numbers.
 
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