04-09 Panzer dose increase? Not just about dosing PLEASE READ

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Chrispooky12

Chrispooky12

Member Since 2021
I haven't posted In awhile but I'm back. I need to know if I should increase Panzer's dose. He has been on 0.5 dose since February 2nd PMPS cycle. I started a new bottle of insulin on April 4th. He had a vet visit on February 14th & was diagnosed with a UTI. He has been on Zeniquin, Clavamox, & not amoxicillin. He will be done with the amoxicillin on April 12th AMPS cycle is his last dose. He goes back to the vet for a urinalysis on April 19th to see if his UTI is gone. Where he uses the litter box 90% of the time he just goes, the other 10% he meows. He has also been more vocal than usual walking around the house. He is eating well, all of it most of the time. He takes D Mannose once a day, amoxicillin twice a day probiotic once a day & MiraLax once a day depending on his stool. By that I mean I have watched him have a liquid poop & not given MiraLax because of that the next day he struggles to go & very little comes out to none so I then give him the MiraLax. I gave him a fur shot on March 22nd PMPS cycle & then again on March 30th. His #s have been unusually high pretty much since the fur shot. I started him on the new vial of insulin to see if maybe that's what was causing his #s to be high for Panzer. He has been on it for 4 cycles now. He gets his shot in 45 minutes what should I do? Also what is your take on the other things I mentioned above?https://www.felinediabetes.com/FDMB...pmps-122-66-3-73-4-101-7.261290/#post-2932321
 
I wouldn't do a full increase, not a lot of room down to reductions at 60 - plus I don't like he's still meowing, I suspect something lingering.

Maybe just give 0.5 fat?
 
I totally agree with Melissa about not doing a full increase. He is getting those nadirs close to his reduction point as she mentioned. Have you ever considered switching to Levemir? This ProZinc seems to drive him down at +4 but doesn’t keep him down very long. I think Levemir could keep him much flatter (in a good way). He is not getting the longevity that I would like to see out of his insulin.
 
Anyway, first things first…. I don’t like the uncomfortable meowing in the box either… even if it’s only ten percent of the time.

Thinking about the liquid poop and not giving the Miralax at that time…. it is possible that he is still constipated and has some hard poop in there that’s kind of stuck and behind it is the diarrhea that squeezes around the hard stool. That’s not uncommon. Since you say when you stop the Miralax because of the diarrhea and after that he doesn’t have a BM - or very little with struggling. I am suspicious that this is what is happening. However we won’t know unless you continue to give the Miralax despite the diarrhea.

What is his dose of Miralax?
 
Suzanne & Darcy said:
Anyway, first things first…. I don’t like the uncomfortable meowing in the box either… even if it’s only ten percent of the time.

Thinking about the liquid poop and not giving the Miralax at that time…. it is possible that he is still constipated and has some hard poop in there that’s kind of stuck and behind it is the diarrhea that squeezes around the hard stool. That’s not uncommon. Since you say when you stop the Miralax because of the diarrhea and after that he doesn’t have a BM - or very little with struggling. I am suspicious that this is what is happening. However we won’t know unless you continue to give the Miralax despite the diarrhea.

What is his dose of Miralax?
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His dose of MiraLax is 1/4tsp @+8 PMPS feeding. I don't like the meowing either, he was walking around meowing, but now him & Spook are playing! He's happy for the most part. Should I skip MiraLax tonight? He had a normal bowel movement a couple of hours ago, his last dose of MiraLax was last night.
 
FrostD said:
I wouldn't do a full increase, not a lot of room down to reductions at 60 - plus I don't like he's still meowing, I suspect something lingering.

Maybe just give 0.5 fat?
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That's what I gave him possibly a little more, I didn't want to push insulin back in the vial. I will give him a fat 0.5 @ AMPS tomorrow. He's @ 81@+3 now.
 
Suzanne & Darcy said:
I totally agree with Melissa about not doing a full increase. He is getting those nadirs close to his reduction point as she mentioned. Have you ever considered switching to Levemir? This ProZinc seems to drive him down at +4 but doesn’t keep him down very long. I think Levemir could keep him much flatter (in a good way). He is not getting the longevity that I would like to see out of his insulin.
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Is levimir a generic of Lantus?
 
Chrispooky12 said:
His dose of MiraLax is 1/4tsp @+8 PMPS feeding. I don't like the meowing either, he was walking around meowing, but now him & Spook are playing! He's happy for the most part. Should I skip MiraLax tonight? He had a normal bowel movement a couple of hours ago, his last dose of MiraLax was last night.
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If you skip it he may get constipated again. I would give it or give 1/8 tsp instead. Also, on the nights you have been skipping because he’s been having liquid diarrhea, you could try 1/8 or a pinch just to make sure things keep moving on the following day. I bought a special set of measuring spoons with a pinch size included - just for Miralax.
 
Suzanne & Darcy said:
If you skip it he may get constipated again. I would give it or give 1/8 tsp instead. Also, on the nights you have been skipping because he’s been having liquid diarrhea, you could try 1/8 or a pinch just to make sure things keep moving on the following day. I bought a special set of measuring spoons with a pinch size included - just for Miralax.
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Ok...Where did you get the measuring spoons? I haven't been able to find one with an 1/8tsp let alone a pinch Lol. Is there a such thing as a fecal test that the vet can do?
 
Suzanne & Darcy said:
Yes. Levemir is a human insulin. I ordered mine (pens). from Canada. Lantus may also work better for you. It is also a human insulin and a depot insulin.
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I was also thinking an insulin change. He's been on prozinc for 10mons now. I will talk to the vet about Levemir & Lantus when we go for his urinalysis. His practice has a pharmacy/ store that they sell prozinc & vetsulin but I know he's been there long before they started it, so I may be able to get him to agree with one of those. All I can do is try he is very impressed with what I've shown him as far as his spreadsheet & the FDMB. He even asked me to print out his some of his spreadsheet for the next visit.
 
Yes I was originally hoping he would keep coming down in dose, but like Suzanne said he's not getting the duration - need him to hang in those greens longer so his pancreas can heal and hopefully get him into remission...he's close, no guarantees of course
 
@Suzanne & Darcy @FrostD I've been researching the 2 insulins & I think I like what I'm seeing more about Lantus. Although they both have similarities. Is semigle a generic for Lantus? In one article I read it said neither has a generic, another article contradicts that saying semigle is generic for Lantus & gargaline (sp?) What is it? It also looks to be Lantus as well?
 
Chrispooky12 said:
@Chris & China (GA) I have talked with you about switching to Lantus. I know you are very knowledgeable with it. What are your thoughts?
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So semglee was discontinued fairly recently and replaced by two other generics lol from what I've been seeing they run about $55/vial. I think no harm in trying a vial of one of those to start.

You would need U100 syringes if you switch.

A lot of us with high dose cats use Levemir because it doesn't sting like Lantus can at the high doses (9U+), but also it tends to give even flatter curves than Lantus. It does tend to have a later onset and nadir though.
 
Chrispooky12 said:
I was also thinking an insulin change. He's been on prozinc for 10mons now. I will talk to the vet about Levemir & Lantus when we go for his urinalysis. His practice has a pharmacy/ store that they sell prozinc & vetsulin but I know he's been there long before they started it, so I may be able to get him to agree with one of those. All I can do is try he is very impressed with what I've shown him as far as his spreadsheet & the FDMB. He even asked me to print out his some of his spreadsheet for the next visit.
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This is good - because the vet will probably trust you to handle another insulin and not worry about him going hypo.
 
Ok I guess it's really up to my vet. I'm pretty sure I have 2 boxes of U100 syringes. Panzer was on novalin when first diagnosed up until June of last year. I knew nothing about diabetes or the FB group or FDMB then that I do now & was blindly shooting him. I think the dry food & higher carb wet food was the only thing that saved him. He was diagnosed 2mons before covid & lockdown hit, so it was a difficult time for all of us. I decided to test @+6 168/162 the ProZinc is definitely wearing off but you never know, he could be lower when I test him @+8 & feed. The +6 could be higher because of the +4 feeding.
 
Suzanne & Darcy said:
This is good - because the vet will probably trust you to handle another insulin and not worry about him going hypo.
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Yes I test enough & can test more, I used to be a test aholic :p even if I have to get up in the middle of the night & test. I try to keep him close to me while sleeping wether it's daytime sleep or nighttime sleep. I've had nothing but broken sleep since he had his dental done in October so I'm used to it:bighug:
 
I did that too. Darcy slept with me and I could just keep my testing supplies nearby and reach over in the night and give him a test. He was such a good boy and never gave me any trouble. I was addicted to knowing his BG. But I am pretty good at getting back to sleep.
 
Chrispooky12 said:
His +8 # was 147 just as I suspected lower than +6.
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Just remember the difference between 168 and 147 isn't very much and not that significant -- considering the 20% meter variance, it's considered pretty flat, which is good actually -- he had a good cycle last night.... and a nice AMPS this morning and I see you gave a fat .5 so let's see how that dose will work going forward. Are you just kind of eyeballing it?
 
Suzanne & Darcy said:
Just remember the difference between 168 and 147 isn't very much and not that significant -- considering the 20% meter variance, it's considered pretty flat, which is good actually -- he had a good cycle last night.... and a nice AMPS this morning and I see you gave a fat .5 so let's see how that dose will work going forward. Are you just kind of eyeballing it?
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Okay yes I am eye balling it.
 
Nice cycles today & tonight a few high #s but much better :cat:04-11 AMPS 116/+4 @84/+9@169/PMPS 160/+3@97/+4@79/+7@96:bighug::bighug::bighug:
 
Suzanne & Darcy said:
Yes! Nice day today and tonight even better. Maybe that fat dose is helping!
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Yes I believe it is. He takes his last dose of amoxicillin @+4 AMPS. He is still doing alot of meowing which is unlike him so I'm worried about that. Hopefully we can hold out for his vet appointment next week! Spook had a vet appointment Wed because he wasn't eating well. I canceled it, turns out he's just spoiled rotten & won't eat all of his food out of the auto feeder but will out of his normal bowl!
 
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