9/9 Sonni

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Sherry & Zoe (GA)

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Good Morning,

As you may remember, I am posting for a friend. She has lowered the dose and the numbers still don't look great. Can there be a late nadir with ProZinc?

She also bought the U 100 syringes with 1/2 unit markings on them and is using the insulin conversion chart.

I am just confused by the numbers....so if anyone here could please take a look and give me your input, it will be greatly appreciated.

Sonni's Numbers:

https://spreadsheets.google.com/ccc...UVQX3I0MDlURm1NUlZCNGc&hl=en&authkey=CLDr8asF
 
Hi Sherry,

Actually your numbers look excellent. The first .25u fixed the curve to a u curve. Yesterday at AMPS 142 it looks like .25u was too much insulin again giving you another inverse curve.

Do you have a no shoot number set. Usually with newly diagnosed kitties the no shoot number is 200, but since most of her bg's are already below 200 :-D you need a lower no shoot number like 150 maybe, either don't shoot or give a reduced dose.

With Prozinc nadir can be anywhere from +3 to +8, and for some reason within the first 45 days it can move around.

ps: please change her ss, I checked the conversion chart and see that .2 is drawn up to the .5 in the U100 syringe, but on your ss if you put in the conversion amount it looks like she's getting a half unit. It confused me at first and might confuse others as well.
 
Sonni's SS certainly isn't typical, I'll say that! ProZinc can be frustrating and confusing, particularly in the first 45 days. But looking back at your previous posts, it appears that Sonni has been on ProZinc for about 2 months already, correct? So the intial adjustment period should be over.

When you change doses on ProZinc, it can take several cycles for the dose to settle. I would hold the dose for a few more cycles (3 or so) before changing it again. You gave one 0.25u dose, then switched to 0.2u for the next 3 cycles, correct? It isn't unusual to see wacky numbers for a few cycles (NDW like lantus!) when you change dose. Be patient. It really isn't that much different from Lantus in that regard...let the dose settle.

Yes, you can get late nadirs with ProZinc! The duration also can be 10-14 hours or longer, giving you more overlap than you would expect. I saw nadirs as late as +10, +11 when I was using it....always when the dose was too high....along with very long duration. It isn't clear to me that what you are seeing is a late nadir though...it appears to be an inverse curve, which could be NDW. I would try to get some early cycle numbers (+1,+2 +3) and some late cycle numbers (+10,+11) so you can see whether you are getting long duration with a late nadir or a really early nadir (before +4) with a bounce after it. As always, more data is helpful.

ETA: What meter is being used? Could you try a different meter to check for accuracy? Some of those numbers look questionable to me.
 
I think she is using the Relion Confirm meter - but has a OTU to check accuracy occasionally.

Yesterday's curve mimics what happened on 9/3, which neither one I would call a U curve really. Sonni doesn't eat for about 3 hours before the evening shot, and eats less at night. I have been wondering for a while if the yellows mid cycle during the day are due to a larger and more frequent food consumption.

I would keep with the 0.2u dose for at least 2 more days to let it settle in. If the curves still look the same, then I personally think the dose needs to be raised, but we will re-evaluate at that point.
 
Thank you, Robin, Lori & Kelly!

The information is all very helpful. Sonni's +2 today is a 259. She is going to get a +3 and then a +10. She is obviously a little frustrated with these numbers and I can't say as I blame her. :sad:

She is more than willing to hold the dose for another day or so....but she is leaning towards wanting to increase. I agree the larger food consumption could be playing into these numbers. She feeds only low carb, grain free FF.

Would a different (higher) dose in the morning and a lower dose in the evening be appropriate in a kitty like Sonni?

https://spreadsheets.google.com/ccc...UVQX3I0MDlURm1NUlZCNGc&hl=en&authkey=CLDr8asF
 
Without knowing what the numbers are during the evening cycle, I can't recommend a staggered dose over keeping the same dose am/pm. I am a fan of consistency, just because that worked for Oscar. There are many here that can use a sliding scale successfully.
 
It does look like the #s are getting worse. :cry: With Bix when I have seen an inverse curve and then lower the dose a hair, he will sometimes pop to a nice green nadir, that's what I was going for here, doesn't look like that is what is happening. As I think Kelly (?) said in another thread, either the dose is too low or it's too high, so you try the lower direction and see what happens. I'm too tired to advise anything about what to do next, but wanted to chime in since I advocated for a lower dose and the results I hoped for aren't happening so far... so don't be married to my earlier advice. :-D
 
Just another thought to throw into the mix...I switched Tinkles from low carb FF to Special Kitty, and it was amazing the difference I saw in his numbers. FF gave him a BIG food spike. You might want to try switching to one of the other low carb foods to see if it changes his numbers. I feed SK (3-4%) and Sophisticat (0-1%) only now, and I use "low carb" FF as a medium carb food to raise numbers. You could have a carb sensitive cat here.
 
Laurie and Mr Tinkles said:
Just another thought to throw into the mix...I switched Tinkles from low carb FF to Special Kitty, and it was amazing the difference I saw in his numbers. FF gave him a BIG food spike. You might want to try switching to one of the other low carb foods to see if it changes his numbers. I feed SK (3-4%) and Sophisticat (0-1%) only now, and I use "low carb" FF as a medium carb food to raise numbers. You could have a carb sensitive cat here.

That is an idea Laurie.... do you know if special kitty or sophisticat are grain free too? Sonni has IBD and is very sensitive to grains.
 
Kelly & Oscar said:
Laurie and Mr Tinkles said:
Just another thought to throw into the mix...I switched Tinkles from low carb FF to Special Kitty, and it was amazing the difference I saw in his numbers. FF gave him a BIG food spike. You might want to try switching to one of the other low carb foods to see if it changes his numbers. I feed SK (3-4%) and Sophisticat (0-1%) only now, and I use "low carb" FF as a medium carb food to raise numbers. You could have a carb sensitive cat here.

That is an idea Laurie.... do you know if special kitty or sophisticat are grain free too? Sonni has IBD and is very sensitive to grains.

That is a very good thought....I had wondered about that in the past if Sonni is carb sensitive. I hate to sugest changing her diet too much, as her IBD is well controlled right now. I just did a little checking and Special kitty has a lot of grains....but the Sophisticat foods are grain free. Will be something to consider.

THANK YOU - all suggestions and thoughts are GREATLY appreciated! :mrgreen:
 
Bix got sick on both the SK and the Sophisticat - he has IBD too. Wellness is the only thing I've found that has worked well for him. Of course ECID, so worth a try (if the ingredient list doesn't shout to you not to of course - with Bix I don't know what specific things bother him).
 
Sorry I didn't get back to this thread until now, life has been busy! I was just giving an example of what worked for us, you would not need to use those particular foods....you could try any of the foods that are low carb from J&Bs list. I am fortunate enough to have an easy kitty as far as food, he will eat anything and I have found very few foods that disagree with his tummy. ;-) The IBD does make it more challenging, I'm sure! I know a lot of people seem to feed Wellness, and EVO is another one that seems pretty popular with some folks...naturally they are pricier too though!

Good luck, please keep us posted if you try the food change, I would love to know how it works out!

I see your friend raised the dose...I hope the increase improves Sonni's numbers! It can be so frustrating until things start to fall into place, hang in there!
 
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