Admin. Advice - Non Emergent, Dosing Issues

Emily Tuomey

Emily Tuomey

Active Member
@Suzanne & Darcy @FrostD

ADVISE. Nico is back on insulin after being remissive for the past year (and a few months), and I’m super bummed about it. I think this time it’s being brought on by stress; his sister is dying of terminal, aggressive AF cancer— Squamous Cell Carcinoma, and I don’t think any of us are taking it well. Needless to say, I need some help. His vet advised 2.0U as she did with his previous go-round with Prozinc, with a brief ramp up to that dose. He is now on 2.0U and I have updated my SS. I have no idea what method we should try or where to go from here. Advice would be most welcome. Words of encouragement and thoughts/prayers would be welcomed too. Times are tough in the household right now, and we are all just doing the best that we can in this moment. Savoring the last memories. :rb_icon: TIA. ~Em, Nico, & BrookieB

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Quoting my last post -
FrostD said:
ProZinc nadir is typically anywhere from +4 to +8. I've read a lot of spreadsheets in my time here, and his overall BG/dose data combined those low preshots tell me he was very likely below 90 at nadir and needs a 0.25U reduction.

With SLGS you would also be holding the dose for a week, doing a curve, then deciding whether or not to possibly increase by 0.25U, hold current dose, or possibly reduce.

I know it's difficult to see the higher numbers, but patience/being methodical is key to make sure you don't bypass a good dose and risk hypo.
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Last week I suggested a reduction down to 1.25U as I suspected 1.5U was too high. I also mentioned that a dose needs to be held for at least a week. I understand you're getting conflicting advice from your vet, but 2U is too high. The numbers you are seeing are due to bounces from numbers that are too low, very possibly hypo.
 
FrostD said:
Quoting my last post -


Last week I suggested a reduction down to 1.25U as I suspected 1.5U was too high. I also mentioned that a dose needs to be held for at least a week. I understand you're getting conflicting advice from your vet, but 2U is too high. The numbers you are seeing are due to bounces from numbers that are too low, very possibly hypo.
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So, are we thinking he should be reduced down to 1.25Unow? I can change his dosing in the morning and see what he does..?
 
@FrostD is correct. See on your spreadsheet how, when you increased to 2 units, that you started having all these reds at the preshot times, indicating that those are bounces from low numbers. When you reduce, you need to hold the reduced dose for 7 days so you can really see what's going on at that dose. I KNOW it's so hard when you see those high numbers and it "seems" like it must mean that more insulin is needed, but stay the course and make the increases gradual after 7 days to see if an increase is needed and can be done safely. So sorry about your other cat :-(
 
FrostD said:
Quoting my last post -


Last week I suggested a reduction down to 1.25U as I suspected 1.5U was too high. I also mentioned that a dose needs to be held for at least a week. I understand you're getting conflicting advice from your vet, but 2U is too high. The numbers you are seeing are due to bounces from numbers that are too low, very possibly hypo.
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my vote is that just because a vet says one thing doesn't make it God.. if i went with what my vet said I think my cat would be dead.
 
Logan & Sandy said:
my vote is that just because a vet says one thing doesn't make it God.. if i went with what my vet said I think my cat would be dead.
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My thoughts as well ;) but for a lot of us here, the FD diagnosis - and subsequent mismanagement - tends to be our first eye-opener about vets and their strengths/weaknesses. It can be hard to trust a bunch of people on the internet at first!
 
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