05/31/2015 Sonny

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BJM

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Hello so Sonny has been on insulin now for 3 1/2 months and we have changednhis diet. His sugar level, which we check every evening, is between 350 and 500. We have gone from 2 units 2 times a day to 4 units 2 times a day. I have seen a slight drop in urination, but I was hoping for more. Any thoughts on what else I can try? Inreally don't want to increase his insulin, shouldninhave my vet change insukin types? I was looking through previous posts - no for humalog?
Any help would be appreciated.

SLJ - Rockaway, NJ Sonny 5 year old male Ginger. Dx 2/12/15; Insulin 4units, 2 times a day -ProZinc.
No allergies. No other health issues to date. Dry 1/2 cup BM food and Classic Fancy Feast 1 can twice a day
[https://drive.google.com/file/d/0B5kB0JNDzX3KVU51MHJsNVA1SG8/view?usp=sharing]Sonny's Spreadsheet
 
Dry food is not recommended.

Your spreadsheet is not up to date - we really need to see recent tests at pre-shot and mid-cycle to see how low he is going.
Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.

 
It is hard to tell what is going on. As BJ says, more mid cycle numbers and more recent numbers would be helpful. There is the possibility that he is getting too much insulin, not too little. And yes, getting rid of all dry food could certainly help. If you are giving him the dry to eat while he is alone during the day, you can do the same with Fancy Feast, either freezing it or using an automatic feeder.

If I were you, I'd get a preshot before each shot, try for a number in the 5-7 hour range and see what the numbers look like. If he starts lower than midcycle, it could be an inverse curve, indicative of too much insulin.

Have you seen the protocol we put together for ProZinc? It is blue in my signature.

And no, Humulin is a harsher insulin that tends to have a shorter cycle than ProZinc.
 
I updated my spreadsheet so you can see his numbers. His numbers have been so high I am only testing once in the evening.
 
The problem with only one test a day is that you could be missing the whole picture. Say, for example, he is in the 400s at his evening test (you test beore eating, right?) And then in 5-7 hours, he drops to the 100s. That big of a drop will cause a bounce - his liver detects a lower number than it is used to and it releases extra glucose, to bring up that number. So, the insulin is countered by natural extra sugar, and by the next test, he is high.

He may not be bouncing, but until you know that for sure, any increase would make the problem worse. Once you are sure he is generally high and flat through the whole cycle, then you can start a regiment of increasing by .25 or .5 units, checking his numbers for 3 cycles and if he doesn't drop, then increase again.

Is there a day when you could get some numbers - like every 3 hours during a cycle to see if and when he drops and by how much?
 
As Sue said, those mid cycle numbers could tell more of the story that we aren't getting. It could be surprising information too! Prozinc is generally dosed based on both preshots AND mid cycle numbers. A curve like Sue mentioned will really help us to advise you better.
 
You might do one curve as pre-shot to pre-shot with tests every 2 hours (traditional curve), then the next day, test on some of the other hours (ex +3, +5, +7, +9, +11).
 
So I did a curve today, didnt get every 2 hours but close. It's been complicated because on Thursday I had to take Sonny to the vet. He stopped eating and was not acting like himself at all and had vomited 3 times in a 12 hour timeframe. His numbers stayed around 500, I was afraid to give him 4 units becausemhe wasnt really eating. The vet diagnosed pancreatitis. He was given an antibiotic, fluids, anti nausea medication and pain meds. When I got him home he did eat a can of food. Friday he ate 1/2 can of food and licked up all the gravy. Today, Satuday 6/6, he only licked the gravyband drank a little, still urinating but not acting like self. getting concerned, but vet said tongive him a little more time since he is still eating a little and urinating.
Help.
 
The spreadsheet in your link appears to go to an old Excel spreadsheet with no current data.
If you have some idea of how much drop you get with a dose, so long as the glucose is high, it can be safe to give some insulin. Pancreatitis can spike them through the roof.
 
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