Bouncing, wondering about dosing

Mer and Max

Mer and Max

Member
Hello! So I wanted to post here to maybe get some feedback on my guy Max's spreadsheet and see what other you experienced people thought about his bouncing numbers.

We were DKA back in early January, and it has been a slow recovery as you will see (though luckily we have much less black and red on there then before!), but he's been giving us much better numbers recently, as well as eating much better, and his behavior is almost back to his pre-sugar days! But, we still seem to be bouncing around a lot, and essentially are forced to fluctuate between 3 and 2 units, bc on some days when he gives us the lower numbers I'm nervous to give him too much, but then he always seems to bounce back to a high number, and so on.

It just seems like we are going in the right direction but can't quite get there, or stay there. TY!
 
Here are my comments:
  • You need to find a dose that you can give both AM and PM, not have to skip a shot because PS is too low or change the dose because of a lower PS. Consistency is key.
  • It's best to avoid increasing or decreasing by a whole unit. Between 2 u and 3 u you have 2.25 u (eyeballed), 2.5 u and 2.75 u. One of those might be a good dose.
  • Get BG tests at different times in the day not just at +6 because nadir can move around.
  • Aim to get a before bed test every evening if you can because kitties often run lower at night. Some of those blacks could be rebound after dropping too low at night.
  • Check out this guide to using ProZinc to learn how we dose it here: http://www.felinediabetes.com/FDMB/...prozinc-pzi-insulin-for-diabetic-cats.164995/
I hope this helps a bit! :)
 
Hi there! Kris has given you some good suggestions. Have you had a chance to read the stickies at the top of the prozinc forum to learn about how we recommend making dose adjustments? My hunch is that the large inconsistent changes in dosing are part of the problem. I definitely think there are ways to help improve what you’re seeing.

Can you tell us a little more about your history? It looks like you have a few numbers scattered back in 2018. Were those from the vet? From home? How were your dosing decisions made? The more we know about your history and journey, the better we can help you get this sorted out. :)
 
I have read thru a few of the stickies, though I have to admit sometimes it's hard to figure it all out in relation to our circumstance. But we're trying to learn it all!

Most of the numbers from 2018 were from home testing, I was admittedly not great at keeping up at it, but mostly just checking in. The dosing suggestions have almost all been from our vet. He started at 1u when diagnosed last March, and then our vet had him go up to 2u when he showed some neuropathy symptoms. It was pretty steady until Christmas when he went DKA from a UTI and not eating enough, and probably too high numbers (our vet is also suspicious there might be some kidney disease now that might be playing a part). She had us go from 3 to 4 after he was hospitalized around new years to try to get his numbers down (he was fine when on the fast acting insulin in the hospital, but spiked when we brought him home), but we decided to stick to 3 for the most part because we thought 4u might be making him bounce too much.

We're going to try 2.5 for a few cycles to see if that does anything... I feel like we're slowly going in the right direction, but we're happy at least that he is acting happier and healthier! He is very mischievous, our biggest challenge is keeping him away from the carbs, his biggest vice is sneaking dog kibble (ugh!)!! And just this morning he stole a donut and was running around the house with it in his mouth (not the smartest diabetic, ha!)

Thank you both!!
 
Given the 58 you saw yesterday, I would encourage you to get some tests at other times today if at all possible. +6 is sometimes a cats nadir, but quite often it isn't, so scattering the tests around can really help. If you're around today or tomorrow, getting a curve (testing every two hours throughout the cycle) would be helpful information at this point.

Unfortunately, you've seen first hand what can happen when feline diabetes isn't carefully managed, and a cat that has been DKA requires even more careful monitoring to try to avoid going through that again.

Prescription kidney food would be a bad idea at this point. That is only recommended in late stage kidney disease as it's too low in protein to be a healthy long-term diet for a cat. Also, there shouldn't be "suspicion" of CKD, there should be blood work that either confirms it or not. Do you know if those tests have run and if so, what the values were? I'm not an expert in that area, but there are folks around here who are and can help you figure out a good diet for Max that will support both his kidney health and his diabetic needs.

It can take a few reads of the stickies before they start to make sense, and even then asking for help is always a good idea as there is a lot of "art" to dosing prozinc. In short, you generally don't want to make dose changes of more than 0.25u at a time, and keeping the dose as consistent as possible is the aim. You have good nadirs at 2.5u right now, but your pre-shot numbers are still higher than I'd like to see for any cat, but especially a DKA cat. Please keep posting over the next few days to keep eyes on your situation. And while it's not fun, please test as much as you can this weekend, including a couple of tests during the PM cycle if at all possible. The more data you have, the better we can help Max.
 
I appreciate this info... I think the ckd suspicions my vet had were bc we weren’t seeing immediate improvement post hospitalization, the vet said his creat was getting better but the BUN wasn’t, and she said there was a chance it just might not. I think she also though it could be a cause of his numbers being so high after his hospitalization, despite him seemingly getting better. She didn’t get us the exact numbers tho, and he’s shown a lot of improvement since then, so we def need to go back to see how his levels have changed/improved. In the mean time, we have swapped Rx food for food I’ve tried to find that he likes that is low carb/lower in phos, just in case...

I am going to try to do a full curve tomorrow, I will be able to get some off-time numbers today (I don’t think I’ll be able to get the +6 today anyways)... and get some more data. I appreciate the notes!!
 
Any data you can get will definitely help us to help you! And the curve tomorrow would be great too.

As for the stickies, they can be confusing at first. I had to read them all several times to sort of figure out what they said and get a better handle on things. And as Djamila said, we're here to help with any questions and with dosing too...it's hard to do on your own at first and since Prozinc does require some art, it's good to get help. You develop a sort of sense of what will work with your kitty over time, but it takes some time and data to build that up!
 
You might consider raw food if you're looking for low P, a good CA:P ratio, and low carb. There are several raw foods on the market that are easy to feed and good for all of those factors. I like Vital Essentials and Primal. If you happen to live in the northwest of the US I could also recommend a couple of local companies. :)
 
@Djamila I have always been interested in raw food, but the price tag keeps scaring me away! Do you give it to your cats in addition to other foods? He does like the weruva chicken which seem to be good on all the levels, and I mix it with ff/wellness or other stuff to make it last longer.

In terms of data for the week, I've got a curve in there from yesterday, and I will try to get more night readings – my husband and I both work all day the next few days, so Max will get a little break from day-time ear pokes (tho he doesn't seem to mind luckily) :-)
 
First, that was supposed to say Calcium:Phosphorus ratio. Apparently if you type a : and then a P it turns it into the pink emoji!

Anyway...yes, I fed a mix of raw and canned for a long time because it IS expensive. It helps that cats eat less when they are eating raw, but still.

I finally made the switch to nearly all raw (I still feed a can about once or twice/week) when I began making it myself using the foodfurlife supplement. It’s super easy, and ends up being cheaper than canned, so feeding mostly homemade with some commercial raw has made it affordable.
 
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