3 wks on Prozinc and BG is higher than we started

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We started at 1 unit and went up .25 from there every 5 - 7 days or so and are now at 1.75U but although his lows are in the yellows, PS numbers are higher this past week than ever before. I am perplexed about this and wonder what's going on?
 
We started at 1 unit and went up .25 from there every 5 - 7 days or so and are now at 1.75U but although his lows are in the yellows, PS numbers are higher this past week than ever before. I am perplexed about this and wonder what's going on?
I think he needs more insulin.
It looks like he's getting about 50% reduction from the dose now but he's getting right back up there by the end of the cycle. It is a typical prozinc "smile" curve in the numbers, just too high.
 
I agree. You might be seeing a bit of light bouncing there, but I think you probably need more insulin. My guess is you might have a bit of glucose toxicity going on from all those high numbers...I'd encourage you to follow a pattern of slow, steady increases to see if that helps.
 
I agree with Steph And Rachel. He's been high for a while and has likely lost responsiveness to the insulin at this dose (effect of glucose overload on cells). I'd increase to 2 u and stay at that dose no longer than 2-3 days if you don't see more yellow and some blues. Increase again to 2.25 u for 2-3 days, etc. Once you're seeing much more yellow and frequent blues you can slow the rate of dose increase. Keeping the dose too long is contributing to the glucose toxicity.
 
Thanks for all the advice, I went up to 2U yesterday. It's nice to have an explanation for those results, because I expected to see a gradual lowering which didn't seem to happen to a considerable degree. Great to have this feedback, I really appreciate it!!
 
I have increased his dose as suggested but just seeing higher numbers than ever before--very concerned about this! Should I be lowering his dose instead? Raising it? I'm very confused about what to do. Should I try the every 8 hr. injection route, if so how and what to give at those intervals, meaning how much insulin? Help!!
 
I think you want to keep raising the dose. With these higher numbers you could increase every 3 cycles if you want...faster is better. Or you could do every 4 cycles so you can always increase on an AM or PM cycle (whichever is best for you). My guess here is you're seeing some glucose toxicity. That just means he's been in higher numbers for awhile and he's "stuck". The solution to that is steady increases. When this happens, you usually just see a bunch of high numbers and increase until you break through..then suddenly they start running back down the scale!
 
I think you want to keep raising the dose. With these higher numbers you could increase every 3 cycles if you want...faster is better. Or you could do every 4 cycles so you can always increase on an AM or PM cycle (whichever is best for you). My guess here is you're seeing some glucose toxicity. That just means he's been in higher numbers for awhile and he's "stuck". The solution to that is steady increases. When this happens, you usually just see a bunch of high numbers and increase until you break through..then suddenly they start running back down the scale!
Ok
 
Hi Rachel, thanks for the advice! I really appreciate it and will do what you suggest, is a cycle two injections in a day? I am so tempted to give him injections earlier to offset the rise in BG numbers, but you don't recommend this do you? I don't know if it was you who said that every 8 hrs was a possibility and maybe that's not a good idea but I just hate to see these very high numbers and I feel it's killing him! So I just thought if it doesn't last long enough, maybe he needs more frequent injections. I don't mind if anyone wants to tell me this isn't a good idea, but knowledge is power, so do enlighten me. I went up to 3U this morning, he's at 551 (AT) now at +7 just so high, and in 5 more hours he's going to be over 700!
 
Hi Rachel, thanks for the advice! I really appreciate it and will do what you suggest, is a cycle two injections in a day? I am so tempted to give him injections earlier to offset the rise in BG numbers, but you don't recommend this do you? I don't know if it was you who said that every 8 hrs was a possibility and maybe that's not a good idea but I just hate to see these very high numbers and I feel it's killing him! So I just thought if it doesn't last long enough, maybe he needs more frequent injections. I don't mind if anyone wants to tell me this isn't a good idea, but knowledge is power, so do enlighten me. I went up to 3U this morning, he's at 551 (AT) now at +7 just so high, and in 5 more hours he's going to be over 700!
A cycle is the 12 hours that follows a dose. It's best to stick to 12/12 dosing as much as possible. In my opinion TID dosing is very hard on the owner and it's still early in the game for you and Bundy.

Are you still using both meters daily? It's easier to spot patterns over time if you stick to one meter and get all the data on one spreadsheet. I agree with Rachel's advice to raise the dose every three cycles or every four if you want to wait until a morning to do it.
 
OK, but what about giving his injections a little ahead of time so he doesn't go so high, is that not OK? like at +10? how damaging is it for him to be in this 700+ range? and 400+ mid cycle. Yes I'm using both meters, but sometimes I don't get 2 readings at the same time and don't feel like sticking him again. I'm sort of used to doing it that way but I'll try to fill them out more, I see what you're saying. I'll try to be more consistent and use one first each time. He's been running so high that I haven't tested him each time prior to injection just because it's depressing to see that "Hi" and no number.
 
I would suggest using the human meter for regular testing. Our protocols are written based on the readings from human meters, so the stickies will make more sense for you and Bundy's patterns are likely to be easier to interpret if you go with that. Of course we can work with whatever you prefer, that's just my 2 cents. :)

As for shooting early, the problem with shooting at +10, is that then you have to wait 14 hours for the next shot in order to keep on your 12/12 schedule. And it's hard enough to wait 12 hours, let alone 14! The other option is that you keep shooting every ten hours, but then your shot time is constantly changing which means sometimes you're getting up in the middle of the night to shoot, and it's hard to plan your life around a moving shot time.

If you are consistently home every eight hours, every day, we can talk you through TID dosing, but as Kris said, it is very difficult to sustain since you need to be able to monitor each cycle so you can't leave the house much and your sleep gets interrupted. It's up to you though, some people have done it.

I think a better plan right now would to go with your plan of choosing one meter and using it first every single time so we have one cohesive picture. Then be aggressive with the dose increases - keep increasing every 4th cycle and make sure you keep monitoring the PM cycle so we can know that he's still safe. And finally, be absolutely positively certain that he is eating a low carb, complete diet, no carb treats, and no access to any other food from other pets in the house.

If he'll eat raw turkey, consider adding FoodFurLife supplement powder to make it a complete food and feed him that. Then you know it's low carb and has all the nutrients he needs.

Getting his numbers under control will go a long way to helping him gain back some of that weight.
 
I do think that the steady increases will help those high numbers. I know it's tough to see those high numbers, but we've seen this a LOT...they are stuck in those higher numbers and one day you suddenly break through! Give it time. I know that's easy for me to say :p
 
Thank you all for the advice and guidance. I agree that the TID dosing is difficult, so I'll try the increases first. I use a Relion and Alpha Trak both, so you'll be able to see those numbers in whichever format you like. I will attempt to keep them more consistent though. I'll look into the powder, raw meat is about all he'll eat these days with some stew packet gravy on top. His food intake is very low, and sometimes we have to force feed him but I'm giving the low carb types.
 
This morning increased to 3.5U, tonight we are at +6hrs at 683! He seems to be bouncing, am I right? Feedback please--I'm very worried, he doesn't seem well. @Rachel I pray you are right!
@Djamila It's called Delectables Stew Packets for Cats similar to Fancy Feast Broth packets. Look I know it may not be super low carb, but this cat just won't eat, so he gets a small amount of it on his raw meat, but he's getting very small portions and he's underweight, 16 yrs old and frail. The only other thing I can do is force feed a low carb food with a syringe. But my logic was that he was eating so little it didn't really matter that much.
 
I think he's still just stuck in those high numbers. Continue with those aggressive increases. I know it seems like this has been forever, but it really is still early days...and he just needs some time.

When you say he doesn't feel well, how do you mean? How's he acting?
 
I'm very concerned that he isn't eating and is in such high numbers. Do you know the cause of his inappetance? Have you been testing for ketones?
 
I've been trying to test him but haven't gotten a sample, he's quite lethargic this morning, of course he is FeLV + and has other health issues so any of those can be influencing his condition.
 
Lethargic, high numbers, and lack of appetite are often symptoms of ketones. I would recommend a vet visit as soon as possible if you aren't able to get a home test today. Ketones advance very quickly.
 
Can you get a ketone reading by pressing it onto a pad that is soaked in urine? I did that and got negative. But I don't think he's well.
 
If it was very recent, it's probably better than nothing, but if it's been there long at all, I would keep working to get a fresh test. If you're concerned, I'd suggest a vet visit. They should be able to check for ketones in-office very quickly.
 
I expressed his bladder and got a fresh sample, he was negative, however he is dying I can tell. I'm not going to take him to ER, not going to put him through a bunch of invasive stuff that won't work anyway. But if any of you have comments, suggestions, I'm happy to hear and accept. This has been a wonderful experience, it has bonded me and Bundy more than anything else would have. I've spent so much quality time with him just trying to figure out how to treat and learn. I am immensely appreciative and love all of you for helping so much. I want you to know if there is any chance that Bundy can be helped by a vet visit, I will do it, but I've had lots of experience with illness and death and sometimes it's best just to let it happen peacefully. He is a sweet and special soul who will soon be at the Rainbow Bridge.
 
P.S. I want you all to know, today, I made him fresh low carb food puree, force fed him throughout the day, he took it pretty well, no vomiting, he got SQ fluids, he got Cerenia and other things, so did try to support him as much as possible. He seemed to get much worse after his insulin shot this evening, so don't know what's happening with that or if there is a relationship, but his BG was very, very high.
 
He's still with us, but very quiet, not wanting to eat or be force fed, looks like his system is shutting down. The vet said we should put him to sleep, so that's where that's at, which is what I suspected. Thanks again for caring.
 
Good Evening, Bundy is still with us, he's doing better, starting to eat on his own today a little more, but still force feeding. His BG numbers are way, way down when I hit 4U last night, you can see his chart. So looking a little low at the dip today and I wanted some dosing instructions. I want to keep him in these low numbers but of course not trigger a hypo, maybe 4 is too much twice a day, but I don't want him to go back to the high numbers either. So what would you wise women suggest? I'd like to get a safe number for tonight and am not sure about it. Will keep posting his numbers if you want to check back before answering. Thanks! and yes we're very happy.
P.S. Rachel you were right!! I'm so pleased to see this at last!!
 
Good Evening, Bundy is still with us, he's doing better, starting to eat on his own today a little more, but still force feeding. His BG numbers are way, way down when I hit 4U last night, you can see his chart. So looking a little low at the dip today and I wanted some dosing instructions. I want to keep him in these low numbers but of course not trigger a hypo, maybe 4 is too much twice a day, but I don't want him to go back to the high numbers either. So what would you wise women suggest? I'd like to get a safe number for tonight and am not sure about it. Will keep posting his numbers if you want to check back before answering. Thanks! and yes we're very happy.
P.S. Rachel you were right!! I'm so pleased to see this at last!!
Wow! What a change. The advice would be to stay at 4 u if we're looking only at the AT numbers. The ReliOn numbers would tell us that a drop to 3.75 u is a good idea. The AT meter is closer to what the vet would measure so if you want to weigh its numbers more heavily, try 4 u again tonight. Get at least a before bed test.

I'm glad he's eating on his own a bit. :)
 
He's up above 600 at +12 that's quite a jump in 5 hours! So I'll go with the 4U again and retest in a few hours. Maybe the high carb food was partly responsible but I was a little worried when he was at 49/99. I looked up those action numbers and it said 50, so I wanted to be safe.
 
He's up above 600 at +12 that's quite a jump in 5 hours! So I'll go with the 4U again and retest in a few hours. Maybe the high carb food was partly responsible but I was a little worried when he was at 49/99. I looked up those action numbers and it said 50, so I wanted to be safe.
He’ll come down again. Give it time.
 
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