1 Feb 16 Rocky's still difficult to regulate

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Marlena

Marlena

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http://www.felinediabetes.com/FDMB/threads/22-jan-rocky-back-to-the-beginning.151394/#post-1590979
What do we do with late onset and nadirs?
I think the situation with Rocky is:
1. on 0.5u dose - too small and doesn't bring his BG down much at all
2. 0n 0.75u dose - that seems to be working better but we're getting very late onset and nadirs which makes PM shots difficult to manage and the drops are very steep
3. with the nadir which is at the time of PM shot, checking his BG again 30 mins later and it is the same so giving him reduce dose of 0.5u a bit later than his normal time gives us red number again in the morning which I'm inclined to think that he did not have enough insulin.
This morning his red number might also be a bounce from 30 Feb when he went much lower than normal.

This , what I like to believe, is my logical thinking and how I see things but I might be totally wrong so please chime in with your opinions and ideas what to do.
My vet warned me that Hypurin PZI might produce very long cycle and she suggested once a day shots but somehow I don't see this working!
I'm sending best wishes and lots of hugs to fellow "sufferers" (all of you) and your furry purry kitties - you're doing amazing job!
 
I don't have any thoughts for you about what to do Marlena... But will be checking back to see what others say. Happy Monday to you, and may we all have a good week getting out kitties closer to the goal of good regulation!
 
Sister,
I can see how difficult this sugar dance is for you and Rocky. I don't have enough experience to give you advice beyond what we already talked about. I just wanted to give you encouragement and send blue/green vibes for Rocky.

@julie & punkin (ga) could you please look at my sister's post and ss. to evaluate dosing/insulin strategy.

Elizabeth and Gus
 
Marlena said:
....gives us red number again in the morning which I'm inclined to think that he did not have enough insulin.
This morning his red number might also be a bounce from 30 Feb when he went much lower than normal.
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Hi Marlena,

I think it's also possible that he dropped low last night and bounced from that.
The patterns of the numbers from yesterday and the day before are similar: In both cases the numbers were trending downwards at evening preshot.

If it is frequently the case that the evening preshot number is still falling (or indeed is too low to shoot) then there are a couple of things you could try.
You could try reducing the dose slightly. That would mean finding a dose between the .5 and the .75. ...If the .5 didn't drop his blood glucose, but the .75 is producing cycles that are too long (and then the overlaps are producing steep drops), then it seems logical to try a dose in between.
In fact I see that you did try a fat .5 for 6 cycles. But maybe it would be worth trying for a bit longer..?

Or, I wonder if there's another way of doing it. Might it be worth trying .75 in the morning, and .5 in the evening for a few days…? That might also mean that he's less likely to drop at night (when you are less able to test...), but there are no guarantees....

In addition, it can be the case that higher doses produce longer cycles, and lower doses produce shorter cycles (but 'your mileage may vary'...). If that turns out to be the case with Rocky then you could also experiment with changing the shooting schedule so that, for example, the higher dose shot of .75 is given an hour earlier so the cycle has an hour longer to run (a 13/11 schedule instead of 12/12).

It is still very 'early days', Marlena. And you're doing great. So please try not to worry. Sometimes finding what works can involve quite a bit of trial and error. :bighug:

Eliz
 
Ok, tonight Rocky's BG is high, higher than midday so I gave him a dose which is between fat 0.5 and 0.75 - really difficult to say!
I'm going to get up at night to test him 6 hours after his PM shot just to see what happens at night because so far I did not do lots of testing at night.
Now, thinking about this insulin: if it is producing such late nadirs it might be very tricky to use so I will probably struggle a lot. Does anybody know anything about Hypurin Bovine Lente insulin which is also long lasting but not as long lasting as Hypurin Prozinc?
 
I'm afraid I can't help with dosing on ProZinc. I just don't know enough about how its action in a cat's body. I do know that cats metabolize insulin more quickly than dogs or people, which is the reason that typically shots are given every 12 hours.

I'm guessing you're outside of North America, Marlena, is that right? Do you have access to Lantus or Levemir where you are? If you are going to switch insulin, I'd look into one of those. They both are long-lasting insulins, around 12 hours in a cat's body, which is pretty good.

By the way, something is wrong with the formatting on Rocky's ss. The US tab only shows 1 number. I'm not sure what's wrong, but would suggest you post in the tech forum and ask for some help straightening it out.

Just a general comment - for a kitty that has been in remission twice before and is now back on insulin again, the experience here on FDMB is that one has to be more aggressive with getting the cat into normal range (green numbers) if there is to be hope of remission another time. Perhaps that's not your goal, though, but I thought I'd throw it out there for your information.
 
julie & punkin (ga) said:
I'm afraid I can't help with dosing on ProZinc. I just don't know enough about how its action in a cat's body. I do know that cats metabolize insulin more quickly than dogs or people, which is the reason that typically shots are given every 12 hours.

I'm guessing you're outside of North America, Marlena, is that right? Do you have access to Lantus or Levemir where you are? If you are going to switch insulin, I'd look into one of those. They both are long-lasting insulins, around 12 hours in a cat's body, which is pretty good.

By the way, something is wrong with the formatting on Rocky's ss. The US tab only shows 1 number. I'm not sure what's wrong, but would suggest you post in the tech forum and ask for some help straightening it out.

Just a general comment - for a kitty that has been in remission twice before and is now back on insulin again, the experience here on FDMB is that one has to be more aggressive with getting the cat into normal range (green numbers) if there is to be hope of remission another time. Perhaps that's not your goal, though, but I thought I'd throw it out there for your information.
Click to expand...
Julie,
thank you very much.
My goal is to get my cat regulated and into remission.
I will get technical department to look at Rocky's SS.
 
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