1st time raising dose

NicoleC46237

NicoleC46237

Member
We saw the vet tech/vet yesterday and the vet recommended raising Lou from 1 unit to 2 units. After reading through all the info on here I learned not to jump that fast so I'm doing .25 at a time. Just to verify - I need to do 3 cycles between changes while monitoring his nadir before changes, right? Tonight would be his 3rd on 1.25 so I wanted to be sure before his morning dose :) TIA

p.s. his SS is up to date to check
 
Yes, 3 cycles on the dose before you increase.
Unless Lou gives you a spectacularly low BG reading first. <90 mg/dL.
Lou is still in the pink and yellow ranges at mid-cycle.
I'd bump the dose up to 1.5 in the morning. 2/19/2020
 
Deb & Wink said:
Yes, 3 cycles on the dose before you increase.
Unless Lou gives you a spectacularly low BG reading first. <90 mg/dL.
Lou is still in the pink and yellow ranges at mid-cycle.
I'd bump the dose up to 1.5 in the morning. 2/19/2020
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I thought so but wanted to make sure I was understanding it correctly :) Thanks Deb!
 
Nicole, you had asked me this in a PM. I wanted to reply publicly, so other people could see the response.

"Is it normal that his first bump up in dose would have a higher +6 test? I expected it to be lower than his yesterday +6 doses but it was higher so it worried me. His first +6 on his first bump up was higher than normal too so maybe that's normal?"

Yes, that can happen. They even have a term for it over in the Lantus forum. NDW or "New Dose Wonkiness".
There is a document that explains the phenomena. It was written about Lantus insulin and the TR (Tight Regulation) protocol specifically. But many of the things we see happening with Lantus, can also be seen with other insulins. Like the Prozinc you are using.

Many of the same concepts apply across the various insulins. With Prozinc, the effects of a dose change may be seen a bit earlier than the 2nd day mentioned in the link. Not really studied much, so we don't know when or even if this NDW occurs in cats using Prozinc.
New Dose Wonkiness

Hope that helps.
 
Deb & Wink said:
Nicole, you had asked me this in a PM. I wanted to reply publicly, so other people could see the response.

"Is it normal that his first bump up in dose would have a higher +6 test? I expected it to be lower than his yesterday +6 doses but it was higher so it worried me. His first +6 on his first bump up was higher than normal too so maybe that's normal?"

Yes, that can happen. They even have a term for it over in the Lantus forum. NDW or "New Dose Wonkiness".
There is a document that explains the phenomena. It was written about Lantus insulin and the TR (Tight Regulation) protocol specifically. But many of the things we see happening with Lantus, can also be seen with other insulins. Like the Prozinc you are using.

Many of the same concepts apply across the various insulins. With Prozinc, the effects of a dose change may be seen a bit earlier than the 2nd day mentioned in the link. Not really studied much, so we don't know when or even if this NDW occurs in cats using Prozinc.
New Dose Wonkiness

Hope that helps.
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You ROCK lady! I knew you would know something to ease my worry. I'm glad you shared it here too! Anything to help others not be as worried about this craziness :) Thank you so much! I'll read up on it now!!
 
Hi Nicole, I simply wanted to make you aware of this.

All the "Sticky" or pinned posts in the Prozinc forum have been updated and there are a couple of new ones.

Highly recommend that everyone using Prozinc or helping those using Prozinc read them thoroughly.

I'll be doing that myself. Been expecting this for some time. Came about a week before I thought it would.
Thanks Marje, and Robert, and especially Djamila for the Modified Prozinc Method. You folks are FANTASTIC!
 
Deb & Wink said:
Hi Nicole, I simply wanted to make you aware of this.

All the "Sticky" or pinned posts in the Prozinc forum have been updated and there are a couple of new ones.

Highly recommend that everyone using Prozinc or helping those using Prozinc read them thoroughly.

I'll be doing that myself. Been expecting this for some time. Came about a week before I thought it would.
Thanks Marje, and Robert, and especially Djamila for the Modified Prozinc Method. You folks are FANTASTIC!
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Thank you! I'll hop over there and read up! :)
 
I am so frustrated! Why is it his numbers were better during his curve when he was still at 1U than now when we have slowly raised him up to 2U?? I feel like I have to be doing something wrong! :(
 
Let me take a look at Lou's spreadsheet (SS). I'll get back to you.

Well, that was fast. Lou has never been down in "good" BG numbers.
Yes, he has been down in the yellow ranges at mid-cycle (nadir).
But never in the blue and/or green BG ranges.

Time to raise the dose again. By 0.25U. So from 2 to 2.25U total.
Wait to do the dose increase when you are home to monitor.
I would not do the increase in a cycle where you head to work immediately that cycle.

With Prozinc, it's the AMPS and PMPS numbers that come down last.
You have to take those pre-shot tests into consideration, but it's really the mid-cycle nadirs you need to base a dose adjustment on.

Nadirs are still above 150 mg/dL (>150 ).

There is now a SLGS dosing protocol and a Modified dosing protocol for Prozinc. It's in the newly posted sticky, just posted today, 2/24/2020. You might want to print yourself a copy.
PROZINC DOSING METHODS

Lou has never been below 90 mg/dL. You have plenty of room to increase the dose. Dose increases should be no quicker than every 3-6 cycles.
Check back in a few days, after the dose increase, and I'll take a look at Lou's SS again.
 
NicoleC46237 said:
I feel like I have to be doing something wrong!
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You are not doing anything wrong. Not a thing. Not in the slightest. You have my assurance on that.
Lou simply needs more insulin until his nadir BG readings tell us otherwise. Or a low pre-shot test.

You've only been home testing for 2 weeks now. Please, cut yourself some slack hon.
You only joined the message board 3 weeks ago. That is very new to be a member here and learn what we have learned over years.
It takes as long as it takes.
We'll get Lou better. Don't worry.

:bighug::bighug::bighug:

p.s. Calling in a few of the Prozinc support crew, to perk up your spirits. (I always tell people I'm good at the technical stuff, but I'm really bad at the emotional support stuff.)

Would you mind lending a hand here, to give Nicole a better idea of how well she is managing the diabetes with her kitty Lou? These 3 people are fairly new too, joined in the last couple of months. So they know what it's like at the beginning of this diabetes journey.
@Juls and Billy
@HelloKrystie
@Dana & Ninja

Check in on each others threads, make comments, ask questions. It's how we all learn and make it through the tough times. With support from our friends and FDMB family. You are a part of that family now Nicole. Never forget that.
 
Deb & Wink said:
You are not doing anything wrong. Not a thing. Not in the slightest. You have my assurance on that.
Lou simply needs more insulin until his nadir BG readings tell us otherwise. Or a low pre-shot test.

You've only been home testing for 2 weeks now. Please, cut yourself some slack hon.
You only joined the message board 3 weeks ago. That is very new to be a member here and learn what we have learned over years.
It takes as long as it takes.
We'll get Lou better. Don't worry.

:bighug::bighug::bighug:

p.s. Calling in a few of the Prozinc support crew, to perk up your spirits. (I always tell people I'm good at the technical stuff, but I'm really bad at the emotional support stuff.)

Would you mind lending a hand here, to give Nicole a better idea of how well she is managing the diabetes with her kitty Lou? These 3 people are fairly new too, joined in the last couple of months. So they know what it's like at the beginning of this diabetes journey.
@Juls and Billy
@HelloKrystie
@Dana & Ninja

Check in on each others threads, make comments, ask questions. It's how we all learn and make it through the tough times. With support from our friends and FDMB family. You are a part of that family now Nicole. Never forget that.
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Thank you Deb. I just felt like they should be showing more progress already if I was doing everything right even though I have read that it could take a while to get him where he needs to be. Sometimes it's just hard to not freak out and feel that my "patience pants" are a little too snug for comfort. I can know it in my head but my heart feels things a lot stronger sometimes. I really am so thankful for this family I've found in you guys and your sugarcats ♡
 
NicoleC46237 said:
I am so frustrated! Why is it his numbers were better during his curve when he was still at 1U than now when we have slowly raised him up to 2U?? I feel like I have to be doing something wrong! :(
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Nicole, you aren't doing a dang thing wrong. You are taking excellent care of Lou. And you're frustrated because it's frustrating. We always want to get our babies fixed up as soon as possible, but diabetes doesn't work like that. I'd bet you anything that Lou is already feeling better, even if he isn't getting those blues and greens yet.

I had type two diabetes over a year ago. I kicked it to the curb. Now, my Billy's in remission from the same thing. I know a thing or too about diabetes. The thing is, a pancreas doesn't heal all at once. One day, it thinks, "I think I'll make some insulin today." Then the next it's all, "I'm tired. I need a break." Lou will get there because you are awesome and you're doing all the things! But it does take time and patience pants, as Deb likes to say.

Instead of focusing on the numbers, focus on Lou. Does he look and act like he's feeling better than he did at diagnosis? Is he loving his new Friskies pate diet? Take the time to see how he's doing better, even if those numbers aren't down yet.

I agree with Deb that it looks like Lou is ready for 2.25 units. Right now, you are fine tuning the dose, ever so slowly, to find those blues and greens, which will give Lou's pancreas what it needs to heal more. You might have to adjust many times, both up and down during this process. That's just part of it. It will give Lou what he needs to get better.

And, not all cats reach remission. Every cat is different. But Lou's got the best chance at remission because you are giving him the best treatment. With remission or not, Lou's going to have a happy healthy life because you are taking such good care of him.

Now, make sure you take care of you too. Get yourself some of the good chocolate. Watch a favorite movie. Have some snuggles or playtime with Lou--some quality time that isn't treatment based. Write "I am awesome!" on a sticky note and put it on the bathroom mirror. Because you are!
 
Juls and Billy said:
Nicole, you aren't doing a dang thing wrong. You are taking excellent care of Lou. And you're frustrated because it's frustrating. We always want to get our babies fixed up as soon as possible, but diabetes doesn't work like that. I'd bet you anything that Lou is already feeling better, even if he isn't getting those blues and greens yet.

I had type two diabetes over a year ago. I kicked it to the curb. Now, my Billy's in remission from the same thing. I know a thing or too about diabetes. The thing is, a pancreas doesn't heal all at once. One day, it thinks, "I think I'll make some insulin today." Then the next it's all, "I'm tired. I need a break." Lou will get there because you are awesome and you're doing all the things! But it does take time and patience pants, as Deb likes to say.

Instead of focusing on the numbers, focus on Lou. Does he look and act like he's feeling better than he did at diagnosis? Is he loving his new Friskies pate diet? Take the time to see how he's doing better, even if those numbers aren't down yet.

I agree with Deb that it looks like Lou is ready for 2.25 units. Right now, you are fine tuning the dose, ever so slowly, to find those blues and greens, which will give Lou's pancreas what it needs to heal more. You might have to adjust many times, both up and down during this process. That's just part of it. It will give Lou what he needs to get better.

And, not all cats reach remission. Every cat is different. But Lou's got the best chance at remission because you are giving him the best treatment. With remission or not, Lou's going to have a happy healthy life because you are taking such good care of him.

Now, make sure you take care of you too. Get yourself some of the good chocolate. Watch a favorite movie. Have some snuggles or playtime with Lou--some quality time that isn't treatment based. Write "I am awesome!" on a sticky note and put it on the bathroom mirror. Because you are!
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You're right! Yesterday he was playing with a paper towel with me, pushing things off the table and tried to chew my arm off when I was trimming his claws..... all things he hadn't been doing lately. I need to remember to enjoy and "see" the good things as they are happening and not get bogged down by the steps. I am home every day all day except to take my son to and from school and maybe run to the store so it sounds like tomorrow morning he's going to bump up another .25 so I can do some spot checks during the morning and mid-day just in case. While I've been changing his doses I'm making sure to keep an eye on his +6 since that seems to be his lowest time.

Here's a pic of Lou post-meal during his full belly nap lol
 

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Take your pick.
purple patience pants.jpg


Sorry, I don't have ones small enough to fit Lou. Hope these are ok.

p.s. Full belly naps are important. To get better faster when you are sick.
 

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Nicole I have to say you are doing an awesome job taking care of Lou.
Teal'c was dx November 7th and it has taken me till just this last week to start seeing good numbers increasing little bits at a time and believe me I cried and worried wondered what I was doing wrong. I've been in your shoes I know how you are feeling.

With the help from Deb and Juls I am now seeing a light at the end of the tunnel and you will to. With some kitties it takes time. Slow and easy wins the race. Eventually you will find the right dose and the day you start seeing better numbers is a feeling like no other. I was in my kitchen jumping up and down in celebration with Teal'c looking at me like I might be nuts. Stay the course you will get there too.
 
Patty & Teal'c said:
Nicole I have to say you are doing an awesome job taking care of Lou.
Teal'c was dx November 7th and it has taken me till just this last week to start seeing good numbers increasing little bits at a time and believe me I cried and worried wondered what I was doing wrong. I've been in your shoes I know how you are feeling.

With the help from Deb and Juls I am now seeing a light at the end of the tunnel and you will to. With some kitties it takes time. Slow and easy wins the race. Eventually you will find the right dose and the day you start seeing better numbers is a feeling like no other. I was in my kitchen jumping up and down in celebration with Teal'c looking at me like I might be nuts. Stay the course you will get there too.
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Thank you! I'm so happy for you and Teal'c finally getting the good numbers :) I appreciate the support and you giving me your experience to learn from. ♡ This journey is frustrating and I have to keep reminding myself that immediate gratification is not the goal :cat:
 
Hello, Nicole!
Sorry for the late arrival. (Can anyone tell me why my alerts aren’t working?!? Arrrgh! So frustrating!)
Anyway....
From what I’ve read here, it looks like you have a case of worried cat mom syndrome. It feels like everything you’re doing is exhausting and frustrating, and WORRISOME!, and also it all feels like it’s not enough, and somehow, and in some way, you’re falling short, and you should be doing more. More more more. Why aren’t I doing more?!?

Don’t worry, that’ll go away...once you calm down and see the bigger picture. Like already discussed, it’s all in how your kitty is feeling and acting. That’s the tell-“tail” sign that you’re doing everything right.
I do NOT have patience, and I certainly cannot exercise clear and rational thinking when I’m overly worried and stressed out. I honestly thought my cat was going to die. (Truth be told, there are some days that I still cry thinking he still might from this, even though I know I’m being crazy)
If Lou is starting to act his normal self, you’re well on your way to getting this thing right. It takes time, and ....dun-dun-duuuun....patience! My kitty has only been on insulin for under 2 weeks now. (He was diagnosed a month ago, but we had a little...incident of sorts) In the 2 weeks that he’s been getting a steady dose, he’s doing so much better. Playing, purring, random zoomies....And it’s all because I found this place and had Deb helping me. I still feel lost a lot of the time, but it is getting easier, and will continue to. We just have to keep on keeping on, and remaining patient.
I’ve seen it posted here multiple times:
Our kitties didn’t developed diabetes overnight, so we’re not going to cure them overnight.

Patience, young Padawan. =^..^=
 
HelloKrystie said:
Hello, Nicole!
Sorry for the late arrival. (Can anyone tell me why my alerts aren’t working?!? Arrrgh! So frustrating!)
Anyway....
From what I’ve read here, it looks like you have a case of worried cat mom syndrome. It feels like everything you’re doing is exhausting and frustrating, and WORRISOME!, and also it all feels like it’s not enough, and somehow, and in some way, you’re falling short, and you should be doing more. More more more. Why aren’t I doing more?!?

Don’t worry, that’ll go away...once you calm down and see the bigger picture. Like already discussed, it’s all in how your kitty is feeling and acting. That’s the tell-“tail” sign that you’re doing everything right.
I do NOT have patience, and I certainly cannot exercise clear and rational thinking when I’m overly worried and stressed out. I honestly thought my cat was going to die. (Truth be told, there are some days that I still cry thinking he still might from this, even though I know I’m being crazy)
If Lou is starting to act his normal self, you’re well on your way to getting this thing right. It takes time, and ....dun-dun-duuuun....patience! My kitty has only been on insulin for under 2 weeks now. (He was diagnosed a month ago, but we had a little...incident of sorts) In the 2 weeks that he’s been getting a steady dose, he’s doing so much better. Playing, purring, random zoomies....And it’s all because I found this place and had Deb helping me. I still feel lost a lot of the time, but it is getting easier, and will continue to. We just have to keep on keeping on, and remaining patient.
I’ve seen it posted here multiple times:
Our kitties didn’t developed diabetes overnight, so we’re not going to cure them overnight.

Patience, young Padawan. =^..^=
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You'd think after bottle feeding 2 week old baby goats I'd have learned a thing or two about patience but apparently not enough lol

Imma gonna keep on keepin on and focus on the positives! Or at least tell myself to more often :rolleyes:;)
 
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