Brady Continuing His End of Cycle Low Numbers

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ECID Every Cat is Different. Why Brady is a cat that drops low at the end of the cycle, is simply the way he is. It's like his body doesn't start processing the insulin until very late in the cycle.

Maybe @Marje and Gracie would have some ideas. Or @Bron and Sheba (GA). Neither of them have used Prozinc, but they may have seen cats on lantus or levemir that do this late cycle drop, and would have some suggestions. In fact, Levemir usually has a late nadir, like Brady is getting on the Prozinc.
 
Deb & Wink said:
ECID Every Cat is Different. Why Brady is a cat that drops low at the end of the cycle, is simply the way he is. It's like his body doesn't start processing the insulin until very late in the cycle.

Maybe @Marje and Gracie would have some ideas. Or @Bron and Sheba (GA). Neither of them have used Prozinc, but they may have seen cats on lantus or levemir that do this late cycle drop, and would have some suggestions. In fact, Levemir usually has a late nadir, like Brady is getting on the Prozinc.
Click to expand...


@Deb & Wink

I found this in the dosing methods under the prozinc category what is your thoughts or anyone have any thoughts about trying this...

SLIDING SCALE DOSING

If your cat is having pre-shots in different ranges and it seems dangerous or ineffective to shoot the same dose for each pre-shot, you can consider shooting different doses for different ranges. (For example, giving 2 units on a 400 mg/dL {22 mmol/L} pre-shot can produce different results than giving 2 units on a 200 mg/dL {11 mmol/L} pre-shot.) Note: It is best to have an experienced member look at your spreadsheet history and suggest some ranges/ doses. Once you are comfortable with the concept, you might adjust on your own.
 
The sliding scale dosing is an advanced method for experienced Prozinc users, that have given both regular dosing methods a fair trial. You've only used the SLGS method. Next up, would be to try the MPM (Modified Prozinc Method) before you went to a sliding scale. Plus, testing more than you do, and learning to "feed the curve" are important to do.

You've been using SLGS and testing for about 5 weeks now. That is about the minimum amount of time to give SLGS a chance to work.

But you only started last night, to try giving the shot in his shoulder area, instead of the scruff, to see if that makes a difference. If you change too many factors at one time, you have no idea which change made a difference.

As always, it's up to you what to do with Brady. We'll support you as best we can.

p.s. I've only helped 2 people develop a sliding scale for their cat, and they were micro-dosing the insulin at that point.
 
Hi Pat

First, let me say I really admire what a great job you are doing with Brady and your commitment to him. It makes it easier for us to help when we have data like this so well done you!!

I know it makes it difficult to know what’s going on when there isn’t a clear pattern. Like you, I always wanted to understand why each number fell where it did.

I have seen early and late nadir cats on Lantus and PZ. As a Deb said, Levemir is a late nadir insulin so it’s very common to see the nadir at the next shot time or, in the case of my Gracie, she could nadir at +15 shortly before the next dose was onsetting.

In regard to Brady, he’s not what I would call a late nadir cat. These cats nadir late just about every cycle but Brady doesn’t do it every cycle. For most of the times he did it in March, he was clearing a bounce and you can expect to see the lowest number of a cycle at the next shot time when clearing a bounce. As an example, look at 3/24. That AMPS was likely the bounce clearing that started after the blues on 3/21. He likely started down on the evening of 3/22. You shot a reduced dose so he went up.

However, between less insulin and spending more time in blues, he bounced again and the 1.5u dose helped him with a short bounce cycle so he dropped into green the next day....and bounced back up.

A few things to know about bounces:
  • They can take up to six cycles to clear (and I have occasionally see it take a little longer).
  • Fast drops or even BGs in the 100-199 range can trigger a bounce.
  • As cats get more regulated and used to lower numbers, you might see green nadirs with bounces into blue instead of yellow or higher.
The PMPS of 4/2 and 4/4 both look like he was clearing a bounce. While Lantus and a Levemir have Depots that can keep the numbers going lower if you’d shoot a reduced dose, PZ doesn’t so between less insulin and duration waning, you get the BG rising after PMPS.

The blue at PMPS on 4/16 is different because we can’t see a BG that would have triggered a bounce. He did get a higher dose of insulin that day and, if his absorption increased as well as duration, you could see a late nadir.

In summary, the things that can cause a nadir at PS include:
  • Bounce clearing cycle
  • Increased absorption
  • Extended duration
  • He’s a cat ;) and we don’t know.
I found it really hard to admit that I wasn’t really in control of the FD and the cycles or the bounces. It seems that, at least for a while, we are just along for the ride until things start to settle a bit as we get to a good dose and we learn how and when to feed and how to shoot lower numbers like the blues you’ve skipped.

You are doing great by asking questions. My suggestion is that you study his SS so you can figure out his onset, nadir, and duration. That will help understand his cycles. Keep asking questions.

On a different subject is it possible to resize columns A, B, and C on the SS so it’s easier to read? If you don’t know how, pls send me a PM and I can fix it for you. Also, if you test at the +.25, +.5, or +.75 times, you want to stack those in the cell with the hour they match. For example, if you test at +4.5, just put it in the +4 cell and annotate it “125 @ 4.5” (no quotations). You can even stack several numbers in the same cell such as: 125, 110 @ 4.5, 86 @ 4.75”. You can look at my Gracie’s SS and there will be an example on there somewhere :) Thank you!!
 
Marje and Gracie said:
Hi Pat

First, let me say I really admire what a great job you are doing with Brady and your commitment to him. It makes it easier for us to help when we have data like this so well done you!!

I know it makes it difficult to know what’s going on when there isn’t a clear pattern. Like you, I always wanted to understand why each number fell where it did.

I have seen early and late nadir cats on Lantus and PZ. As a Deb said, Levemir is a late nadir insulin so it’s very common to see the nadir at the next shot time or, in the case of my Gracie, she could nadir at +15 shortly before the next dose was onsetting.

In regard to Brady, he’s not what I would call a late nadir cat. These cats nadir late just about every cycle but Brady doesn’t do it every cycle. For most of the times he did it in March, he was clearing a bounce and you can expect to see the lowest number of a cycle at the next shot time when clearing a bounce. As an example, look at 3/24. That AMPS was likely the bounce clearing that started after the blues on 3/21. He likely started down on the evening of 3/22. You shot a reduced dose so he went up.

However, between less insulin and spending more time in blues, he bounced again and the 1.5u dose helped him with a short bounce cycle so he dropped into green the next day....and bounced back up.

A few things to know about bounces:
  • They can take up to six cycles to clear (and I have occasionally see it take a little longer).
  • Fast drops or even BGs in the 100-199 range can trigger a bounce.
  • As cats get more regulated and used to lower numbers, you might see green nadirs with bounces into blue instead of yellow or higher.
The PMPS of 4/2 and 4/4 both look like he was clearing a bounce. While Lantus and a Levemir have Depots that can keep the numbers going lower if you’d shoot a reduced dose, PZ doesn’t so between less insulin and duration waning, you get the BG rising after PMPS.

The blue at PMPS on 4/16 is different because we can’t see a BG that would have triggered a bounce. He did get a higher dose of insulin that day and, if his absorption increased as well as duration, you could see a late nadir.

In summary, the things that can cause a nadir at PS include:
  • Bounce clearing cycle
  • Increased absorption
  • Extended duration
  • He’s a cat ;) and we don’t know.
I found it really hard to admit that I wasn’t really in control of the FD and the cycles or the bounces. It seems that, at least for a while, we are just along for the ride until things start to settle a bit as we get to a good dose and we learn how and when to feed and how to shoot lower numbers like the blues you’ve skipped.

You are doing great by asking questions. My suggestion is that you study his SS so you can figure out his onset, nadir, and duration. That will help understand his cycles. Keep asking questions.

On a different subject is it possible to resize columns A, B, and C on the SS so it’s easier to read? If you don’t know how, pls send me a PM and I can fix it for you. Also, if you test at the +.25, +.5, or +.75 times, you want to stack those in the cell with the hour they match. For example, if you test at +4.5, just put it in the +4 cell and annotate it “125 @ 4.5” (no quotations). You can even stack several numbers in the same cell such as: 125, 110 @ 4.5, 86 @ 4.75”. You can look at my Gracie’s SS and there will be an example on there somewhere :) Thank you!!
Click to expand...


I will respond to this tomorrow morning...heading to bed, really tired.....I will have questions for you so I may PM you...thank you
 
I appreciate all the help, im not a stupid person but I really feel stupid with this disease and what im supposed to do. Im not getting it, im trying but im not getting it. My wife and I have schedules, its tough when we both work. We have to try to accommodate everything in our lives as im sure a lot of people on her do and we are trying to do our best in keeping Brady healthy. There were a lot of suggestions made, some I understand, some I don't. Brady's feeding schedule is tough, I know the suggestion was to try to "feed the curve", that is something that will not be able to be done with my buddy....its either a two feedings per day at shot times or two nice meals at shot time and then like a little snack meal at +4 after both feedings, we cant do anything else with him. He would never wear a collar and he doesn't have a microchip. I have to pick one or the other feeding schedules and im not sure that fits the programs or dosing methods here so I guess im stuck.

Also, im trying to give him his shots in the shoulder flank area and that isn't working very well at all, he doesn't like it, he is hissing and snapping when we try to shoot him in that area. This is a big change for all of us, and I know it was a big change for everyone that is on this forum and it is one of the toughest things we have all had to go thru with our loving pets. Brady is a changed cat, he doesn't do the things with us that he used to do, come to bed at night with us, well the list goes on but he is a changed cat. The poking in the ear, the shots every 12 hours, the running down the stairs when he has to pee so I can check for ketones, he is sensing all these things and he has changed. Just like I treat him different by doing all these things, he is treating us different because we are doing these things to him.

I have read and reread the dosing methods for prozinc, all the different methods, and again im sorry, im not getting it. I always check his SS and try to figure out what is going on with his sugar and there is nothing remotely close to being consistent with him so I don't know what to do or how to help him correctly. We are up very early every morning with him, one because he does still like to get us up very early and two it works best with our schedule to start the morning off early. So when he has very low numbers in the PMPS cycle it makes it difficult to shoot at same dose as the morning because of trying to monitor him thru out the night to make sure he doesn't go hypo. I know people set alarms and wake up every hour on the hour, but falling back to sleep for us is a difficult challenge and we obviously need our rest. We love Brady, so very much and we are trying so very hard, but all these methods of treating him don't appear to be working or fit with what is happening to him with his sugar. Im scared, very scared but I will continue to try to help him the best I can in the ways we can. Maybe we just wont be able to do this. I cant have another financial challenge at this time with Brady going into the hospital for any reason, that's why going hypo scares me so much, honestly that's why this disease scares me so much.

Again I appreciate all the help and guidance, I wish I understood all this better to help our so loved cat but trying to put this altogether is so overwhelming and I guess im not doing the best things with the way his treatment is going. I know everyone likes questions posted in here, but sometimes, at least for me, one on one conversations help me so much better. Im only here to try to help my cat. So people learn and comprehend differently than others, Im glad I found this place because it has taught me a lot, more than I ever imagined. I will keep reading and trying to learn, hopefully I get this!! I know every cat is different, trust me I have known that for a very long time, plus having two cats and two different personalities explains it all with cat behavior.
 
Pat :bighug:

I might be able to help a tiny bit...Brady snapping at the flank shots? I wonder if a finer tip needle would work. That happened to us. (Now I cant remember the gauges but someone here WILL ok? ) but once we switched it was a whole new ball game. I hope this helps in some small way.
I hear your frustration and this CAN be daunting. BEEN THERE. Lets see how this post gets answered maybe little things can make the big things more doable. ;)
j
 
Irish Pat said:
I appreciate all the help, im not a stupid person but I really feel stupid with this disease and what im supposed to do. Im not getting it, im trying but im not getting it. My wife and I have schedules, its tough when we both work. We have to try to accommodate everything in our lives as im sure a lot of people on her do and we are trying to do our best in keeping Brady healthy. There were a lot of suggestions made, some I understand, some I don't. Brady's feeding schedule is tough, I know the suggestion was to try to "feed the curve", that is something that will not be able to be done with my buddy....its either a two feedings per day at shot times or two nice meals at shot time and then like a little snack meal at +4 after both feedings, we cant do anything else with him. He would never wear a collar and he doesn't have a microchip. I have to pick one or the other feeding schedules and im not sure that fits the programs or dosing methods here so I guess im stuck.

Also, im trying to give him his shots in the shoulder flank area and that isn't working very well at all, he doesn't like it, he is hissing and snapping when we try to shoot him in that area. This is a big change for all of us, and I know it was a big change for everyone that is on this forum and it is one of the toughest things we have all had to go thru with our loving pets. Brady is a changed cat, he doesn't do the things with us that he used to do, come to bed at night with us, well the list goes on but he is a changed cat. The poking in the ear, the shots every 12 hours, the running down the stairs when he has to pee so I can check for ketones, he is sensing all these things and he has changed. Just like I treat him different by doing all these things, he is treating us different because we are doing these things to him.

I have read and reread the dosing methods for prozinc, all the different methods, and again im sorry, im not getting it. I always check his SS and try to figure out what is going on with his sugar and there is nothing remotely close to being consistent with him so I don't know what to do or how to help him correctly. We are up very early every morning with him, one because he does still like to get us up very early and two it works best with our schedule to start the morning off early. So when he has very low numbers in the PMPS cycle it makes it difficult to shoot at same dose as the morning because of trying to monitor him thru out the night to make sure he doesn't go hypo. I know people set alarms and wake up every hour on the hour, but falling back to sleep for us is a difficult challenge and we obviously need our rest. We love Brady, so very much and we are trying so very hard, but all these methods of treating him don't appear to be working or fit with what is happening to him with his sugar. Im scared, very scared but I will continue to try to help him the best I can in the ways we can. Maybe we just wont be able to do this. I cant have another financial challenge at this time with Brady going into the hospital for any reason, that's why going hypo scares me so much, honestly that's why this disease scares me so much.

Again I appreciate all the help and guidance, I wish I understood all this better to help our so loved cat but trying to put this altogether is so overwhelming and I guess im not doing the best things with the way his treatment is going. I know everyone likes questions posted in here, but sometimes, at least for me, one on one conversations help me so much better. Im only here to try to help my cat. So people learn and comprehend differently than others, Im glad I found this place because it has taught me a lot, more than I ever imagined. I will keep reading and trying to learn, hopefully I get this!! I know every cat is different, trust me I have known that for a very long time, plus having two cats and two different personalities explains it all with cat behavior.
Click to expand...
Pat

First take a deep breath. Where you all are is exactly where we have all been. Every single one of us. We understand and we empathize. It might not help right now for me to say this but it does get better. Once kitties start feeling better because the BG is more consistent, they typically resort to their “old selves”. We have had cats here who literally attacked their CG at every test but with patience and some changes, I have seen even those cats come around to not only being compliant with testing but going to a testing spot. Low carb Treats are your friend if you aren’t using them.

If Brady doesn’t like flank shots, don’t do them. Get the smallest gauge syringe you can find and shoot where it is comfy for him. Even if you are only shooting scruff, you can alternate left and right and move it around a bit in the scruff area.

I also understand your feeling that you do better one on one. Many feel that way but this is a peer review board and so we have to be open with our questions and answers. With so many varied experiences, it is actually to your benefit. For example, our Gracie took everything to do with FD in stride. Nothing bothered her. Members who have had cats more like Brady can offer more suggestions to you because they’ve been there.

The best piece of advice I can give you right now is to give yourselves time to adjust to all this. What you may feel would be perfect for Brady may be a little more than you can give right now and that’s ok. Keep your goals small right now. Instead of thinking remission, just think about the cycle in front of you. Celebrate the good numbers and do not let the bounces freak you out. When you see a bounce start, use it to do what you need to do for your own mental health. In these days of staying at home, perhaps that means just taking a walk, listening to music, or sitting outside with an adult beverage. Progress is made in slow steps with FD, generally.

You don’t have to do everything everyone here suggests. Take what works for you all. As you state, safety for Brady is paramount. Your rest is also important because you can’t take care of him if you all aren’t well.

I would say feeding him a portion at shot time and then around +4 is better than just feeding twice a day. But, having said that, do what you can.

I am telling you all this in hindsight and from what I’ve learned. My husband and I devoted all of our time to caring for Gracie for 5.5 years. You can tell by just looking at her SS. Looking back, I wouldn’t have changed a second with her but I know we would have tried to relax a bit more about the FD. By that I mean that it took us a very long time to quit letting the bounces totally discourage us and, instead, use them for some self-care. Instead of pushing so hard for remission, we would have focused more on the short-term.

I don’t know if that helps but we all here have felt like you and then, with the support of this group, we vented, and then we got on with it. That’s what we do here and we will support you all through it.

It will get better.
 
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Irish Pat said:
I appreciate all the help, im not a stupid person but I really feel stupid with this disease and what im supposed to do. Im not getting it, im trying but im not getting it. My wife and I have schedules, its tough when we both work. We have to try to accommodate everything in our lives as im sure a lot of people on her do and we are trying to do our best in keeping Brady healthy. There were a lot of suggestions made, some I understand, some I don't. Brady's feeding schedule is tough, I know the suggestion was to try to "feed the curve", that is something that will not be able to be done with my buddy....its either a two feedings per day at shot times or two nice meals at shot time and then like a little snack meal at +4 after both feedings, we cant do anything else with him. He would never wear a collar and he doesn't have a microchip. I have to pick one or the other feeding schedules and im not sure that fits the programs or dosing methods here so I guess im stuck.

Also, im trying to give him his shots in the shoulder flank area and that isn't working very well at all, he doesn't like it, he is hissing and snapping when we try to shoot him in that area. This is a big change for all of us, and I know it was a big change for everyone that is on this forum and it is one of the toughest things we have all had to go thru with our loving pets. Brady is a changed cat, he doesn't do the things with us that he used to do, come to bed at night with us, well the list goes on but he is a changed cat. The poking in the ear, the shots every 12 hours, the running down the stairs when he has to pee so I can check for ketones, he is sensing all these things and he has changed. Just like I treat him different by doing all these things, he is treating us different because we are doing these things to him.

I have read and reread the dosing methods for prozinc, all the different methods, and again im sorry, im not getting it. I always check his SS and try to figure out what is going on with his sugar and there is nothing remotely close to being consistent with him so I don't know what to do or how to help him correctly. We are up very early every morning with him, one because he does still like to get us up very early and two it works best with our schedule to start the morning off early. So when he has very low numbers in the PMPS cycle it makes it difficult to shoot at same dose as the morning because of trying to monitor him thru out the night to make sure he doesn't go hypo. I know people set alarms and wake up every hour on the hour, but falling back to sleep for us is a difficult challenge and we obviously need our rest. We love Brady, so very much and we are trying so very hard, but all these methods of treating him don't appear to be working or fit with what is happening to him with his sugar. Im scared, very scared but I will continue to try to help him the best I can in the ways we can. Maybe we just wont be able to do this. I cant have another financial challenge at this time with Brady going into the hospital for any reason, that's why going hypo scares me so much, honestly that's why this disease scares me so much.

Again I appreciate all the help and guidance, I wish I understood all this better to help our so loved cat but trying to put this altogether is so overwhelming and I guess im not doing the best things with the way his treatment is going. I know everyone likes questions posted in here, but sometimes, at least for me, one on one conversations help me so much better. Im only here to try to help my cat. So people learn and comprehend differently than others, Im glad I found this place because it has taught me a lot, more than I ever imagined. I will keep reading and trying to learn, hopefully I get this!! I know every cat is different, trust me I have known that for a very long time, plus having two cats and two different personalities explains it all with cat behavior.
Click to expand...

As has been said above, take a step back and breathe. This is quite a thing to have to go through and try and learn - at what feels like all at once. This process will take time to learn, however, when it starts to click, everything will start to fall into place. We're 7 months in and I'm still asking questions and really want peoples thoughts and opinions. Take a look at Do Daa's SS (in my Sig) back in 2019 and tell me what you think compared to where you are, numbers wise.

I've found that testing with the blood strips is easier in the rear pads for us. It takes two people, and the cat needs to be comfortable in someones lap, (this takes some time but he's completely use to it now) but it's far easier on my cat than going anywhere near his ears. We tried that a couple of times, it just didn't work for us.

As for the insulin shots, we find that the scruff of the neck is, at least for now, an easy place for him to accept the prick of the needle. Lifting up the skin to find a soft pocket and don't shoot any muscle.

Edit: Are you leaving any food for him overnight? We have found the leaving 1/3 of a cup of Dr. Elseys Clean Protein down (dry food) has defiantly helped to mitigate his overnight BG numbers from going to low. Thus making AMPS higher and somewhat more reliable and not as scary to shoot a consistent amount of insulin. Make sure your other cat is not eating his food for him!

People generally on here steer people away from commercial dry food at very high Carbs. However, Dr. Elseys is 59% protein and 4.7% carbs and you can get it on Amazon and it's currently about $23 and change for 6.6lbs. We use this food in conjunction with the Fancy Feast Pate because he spent 12 years having nothing but dry food. In the past 6 months we've managed to get him to eat 70% wet food and 30% dry in the course of 24hrs.

Do you have an Auto Feeder for your Cat? If not, it probably would help given the work schedules you have.

I looked at the SS, is there any reason you are not shooting the same amount of insulin at AMPS and PMPS?
I've been told from the beginning, that constancy with the insulin is necessary.....

When it comes down to it, constancy is what is going to matter the most. Read all the stickys here about Prozinc and you need to stay evolved here with everyone not only for the moral support, but for the expertise of the members that have known about feline diabetes long before us.

You need to set a Routine and stick with it. Follow the guidance from those on this board and you and your cat will persevere. :)
 
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Goose said:
As has been said above, take a step back and breath. This is quite a thing to have to go through and try and learn - at what feels like all at once. This process will take time to learn, however, when it starts to click, everything will start to fall into place. We're 7 months in and I'm still asking questions and really want peoples thoughts and opinions. Take a look at Do Daa's SS (in my Sig) back in 2019 and tell me what you think compared to where you are, numbers wise.

I've found that testing with the blood strips is easier in the rear pads for us. It takes two people, and the cat needs to be comfortable in someones lap, (this takes some time but he's completely use to it now) but it's far easier on my cat than going anywhere near his ears. We tried that a couple of times, it just didn't work for us.

As for the insulin shots, we find that the scruff of the neck is, at least for now, an easy place for him to accept the prick of the needle. Lifting up the skin to find a soft pocket and don't shoot any muscle.

I looked at the SS, is there any reason you are not shooting the same amount of insulin at AMPS and PMPS?
I've been told from the beginning, that constancy with the insulin is necessary.....

When it comes down to it, constancy is what is going to matter the most. Read all the stickys here about Prozinc and you need to stay evolved here with everyone not only for the moral support, but for the expertise of the members that have known about feline diabetes long before us.

You need to set a Routine and stick with it. Follow the guidance from those on this board and you and your cat will persevere. :)
Click to expand...



Thank you Goose...and yes your SS looks very similar to ours.....is PZ prozinc??? My big big big fear is hypo at night while sleeping, low numbers are scary to us so badly right now....that's as honest as I can be. If Brady could wake us up saying something was wrong that would ease my mind so much, but obviously that cant happen. I do see a couple of nights you had some scary situations with numbers. Im not up late at night and that's something I would miss and that is our fear. I have to get past that fear.

How do you feed, what is your feeding schedule if you don't mind me asking?
 
Goose said:
As has been said above, take a step back and breathe. This is quite a thing to have to go through and try and learn - at what feels like all at once. This process will take time to learn, however, when it starts to click, everything will start to fall into place. We're 7 months in and I'm still asking questions and really want peoples thoughts and opinions. Take a look at Do Daa's SS (in my Sig) back in 2019 and tell me what you think compared to where you are, numbers wise.

I've found that testing with the blood strips is easier in the rear pads for us. It takes two people, and the cat needs to be comfortable in someones lap, (this takes some time but he's completely use to it now) but it's far easier on my cat than going anywhere near his ears. We tried that a couple of times, it just didn't work for us.

As for the insulin shots, we find that the scruff of the neck is, at least for now, an easy place for him to accept the prick of the needle. Lifting up the skin to find a soft pocket and don't shoot any muscle.

I looked at the SS, is there any reason you are not shooting the same amount of insulin at AMPS and PMPS?
I've been told from the beginning, that constancy with the insulin is necessary.....

When it comes down to it, constancy is what is going to matter the most. Read all the stickys here about Prozinc and you need to stay evolved here with everyone not only for the moral support, but for the expertise of the members that have known about feline diabetes long before us.

You need to set a Routine and stick with it. Follow the guidance from those on this board and you and your cat will persevere. :)
Click to expand...


Also, I see your numbers are pretty much going how they should, high at AMPS lower thru the cycle then higher at the PMPS...Brady is high at AMPS and usually drops thru the cycle and I get his lowest numbers at PMPS, that's another reason I adjust his insulin dose sometimes. If he would just get those numbers you got it would make me feel a lot better as well...high at the PS numbers and lower in the middle of the cycle.
 
Irish Pat said:
Thank you Goose...and yes your SS looks very similar to ours.....is PZ prozinc??? My big big big fear is hypo at night while sleeping, low numbers are scary to us so badly right now....that's as honest as I can be. If Brady could wake us up saying something was wrong that would ease my mind so much, but obviously that cant happen. I do see a couple of nights you had some scary situations with numbers. Im not up late at night and that's something I would miss and that is our fear. I have to get past that fear.

How do you feed, what is your feeding schedule if you don't mind me asking?
Click to expand...


PZ is Prozinc.

There is some info I edited into my other post.

Anyway, he has no food 2 hours before AMPS and PMPS. We shoot at 9am/9pm. At those times, he gets Tested first, Food second and Shot third, in that order. Depending on how low the AMPS or PMPS is, we use Fancy Feast Gravy Lovers wet food, which has a lot of gravy in it. We have a needless syringe and suck up the gravy and down the hatch it goes. How many ml we use will depend on his low numbers.
This gets used only to mitigate low numbers but usually only works for a few hours. It helps to off set the sudden drops in BG that insulin tends to introduce. He has to have solid food overnight, period, so his numbers stay relatively even keeled when he can't be monitored or tested such as overnight when people are sleeping.
 
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Irish Pat said:
Also, I see your numbers are pretty much going how they should, high at AMPS lower thru the cycle then higher at the PMPS...Brady is high at AMPS and usually drops thru the cycle and I get his lowest numbers at PMPS, that's another reason I adjust his insulin dose sometimes. If he would just get those numbers you got it would make me feel a lot better as well...high at the PS numbers and lower in the middle of the cycle.
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What are the low PMPS numbers? Maybe the reason for the skewed numbers are from the unbalanced level of insulin you are giving him at AMPS and PMPS. Someone with more expertise would have to answer that question definitively. However, his low numbers at night could be offset with gravy (or syrup if he really doesn't respond to the gravy) as mentioned. Which is what we do at +4 or later after PMPS if his numbers get into scary territory. But these are last resort tools.

What is your testing schedule? You most likely should test at least once or twice after his PMPS before bed to make sure you are on the right track (and for piece of mind) to make sure he doesn't need something like gravy or syrup to keep those numbers up overnight so he doesn't crash at or before AMPS.
 
Goose said:
PZ is Prozinc.

There is some info I edited into my other post.

Anyway, he has no food 2 hours before AMPS and PMPS. We shoot at 9am/9pm. At those times, he gets Tested first, food second and shot third in that order. Depending on how low the AMPS or PMPS is, we use Fancy Feast Gravy Lovers wet food, which has a lot of gravy in it. We have a needless syringe and suck up the gravy and down the hatch it goes. How many ml we use will depend on his low numbers.
This gets used only to mitigate low numbers but usually only works for a few hours. It helps to off set the sudden drops in BG that insulin tends to introduce. He has to have solid food overnight, period so his numbers stay relatively even keeled when he can't be monitored or tested such as overnight when people are sleeping.
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Ok, so you feed him completely thru the cycle up to two hours prior to AMPS and PMPS?? And when you say he needs solid food overnight, do you leave food out? This is another struggle right now, is Brady's feeding schedule....We have tried a couple things and what we are doing now is a little difficult. We are feeding just twice, AMPS and PMPS...im looking to make some sorta of change that would work for our schedule. So maybe if you could give me the timing of how you feed Do Daa...by the way, love that name......that would help me out a little
 
Goose said:
What are the low PMPS numbers? Maybe the reason for the skewed numbers are from the unbalanced level of insulin you are giving him at AMPS and PMPS. Someone with more expertise would have to answer that question definitively. However, his low numbers at night could be offset with gravy (or syrup if he really doesn't respond to the gravy) as mentioned. Which is what we do at +4 or later after PMPS if his numbers get into scary territory. But these are last resort tools.

What is your testing schedule? You most likely should test at least once or twice after his PMPS before bed to make sure you are on the right track (and for piece of mind) to make sure he doesn't need something like gravy or syrup to keep those numbers up overnight so he doesn't crash at or before AMPS.
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We shoot at 6AM and 6PM....we have a hypo tool kit ready to go if need be, but I guess we will have to try something...by the way, thank you ….you are helping me here.....
 
Irish Pat said:
Ok, so you feed him completely thru the cycle up to two hours prior to AMPS and PMPS?? And when you say he needs solid food overnight, do you leave food out? This is another struggle right now, is Brady's feeding schedule....We have tried a couple things and what we are doing now is a little difficult. We are feeding just twice, AMPS and PMPS...im looking to make some sorta of change that would work for our schedule. So maybe if you could give me the timing of how you feed Do Daa...by the way, love that name......that would help me out a little
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We make food available all day right up to 2 hours before AMPS or PMPS. Just make sure that no food is available 2 hours before those shots. This might be why an Auto Feeder (especially at night) may help that can be set to close off the food source so no one forgets and he ends up eating and skewing the numbers. Feeding him only twice and introducing the insulin may be another reason why he doesn't have steady numbers.

Every time Do Daa gets tested he has food, this includes AMPS and PMPS. It may not be a lot, but he has something in his system to work on.

We have 7 other cats and sometimes someone will forget to take the food up the other cats get and this will and has skewed his numbers before. Everyone else gets Fancy Feast pate or Friskies pate and a different kind of dry food because of the cost of the specialty dry food Do Daa gets. The feeding for him have to be kept separate from the other cats feedings. Does one of your cats eat more than the other? Hogging the food? If so, they should be feed separately if possible.
 
Irish Pat said:
We shoot at 6AM and 6PM....we have a hypo tool kit ready to go if need be, but I guess we will have to try something...by the way, thank you ….you are helping me here.....
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Shooting him at 6pm at night, means no food after 4pm. After 6pm, depending on how low his PMPS is, I'd test him multiple times before bed for piece of mind, if nothing else. In my opinion, if he has a low PMPS, I'd give him gravy in syringe with his food or separately at the same time to bring his BG up and not changing the dosage of insulin.

Under these circumstances, we will test once and hour if really low, and no less than every two hours until we're satisfied enough that we have helped to offset the insulin drop we know will come. At a 6am shot time, make sure he has no food after 4am.
 
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Goose said:
Shooting him at 6pm at night, means no food after 4pm. After 6pm, depending on how low his PMPS is, I'd test him multiple times before bed for piece of mind, if nothing else. I'm my opinion, if he has a low PMPS, I'd give him gravy in syringe with his food or separately at the same time to bring his BG up and not changing the dosage of insulin.

Under these circumstances, we will test once and hour if really low, and no less than every two hours until we're satisfied enough that we have helped to offset the insulin drop we know will come. At a 6am shot time, make sure he has no food after 4am.
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Thank you Goose, im going to make a few adjustments and we are going to get through this....I have met such wonderful people on here, Deb, JT, JOJI, Marjorie and you.....I had a bad moment, again today, but you guys all got me through.....thank you
 
Pat, anything that we suggest, that does not work for you and Brady, please let us know. Do what works for you and Brady. That is the most important part.

We have a wealth of knowledge here, and can likely come up with other ideas.

Hang in there. You are still in the early stages of treating the feline diabetes. Brady will get better. I truly believe that, with all my heart and soul.
 
Irish Pat said:
Thank you Goose, im going to make a few adjustments and we are going to get through this....I have met such wonderful people on here, Deb, JT, JOJI, Marjorie and you.....I had a bad moment, again today, but you guys all got me through.....thank you
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We are here for moral support as well as teaching you about FD and how it applies to Brady and your circumstances. We have a lot of tools up our sleeves :)

It looks like you’ve been doing something resembling the modified PZ dosing instead of Start Low Go Slow. I don’t know if you have a preference. My suggestion, for now, is to try and shoot 2.25u every cycle that you can for either six cycles or one week, depending on whether you are doing the modified PZ dosing (Former) or SLGS (latter) with a couple of caveats that apply to either for right now:
  • if you get 150-200 at PS, to start with, don’t feed him but post here and see if someone can walk you through shooting. The goal is to get you feeling comfortable shooting, over time, every number above 90 where you are able and available to test. In general, skipping shots is more for the CG than the cat although there are exceptions to that. We can help you decide.
  • if you get a BG below 90 during any cycle, reduce the dose by 0.25u at the next shot time.
Please ask any questions.
 
Here is an observation of ours about Prozinc which has been also been mentioned to us a few times. Prozinc it seems has diminishing effectiveness around the 6 week+ mark for us. A new bottle seems quite a bit more effective for about 80% of the way and then seems to lose its potency at the end of the bottle.

So if the numbers tend to be a little worse towards the end of the bottle and your regiment has remained the same throughout, it could be the insulin is less effective at the end. This doesn't happen with all bottles that we have used some are great right to the end.
 
Good morning everyone...Today I shot with a AMPS of 224 and sticking with the 2.25U's and going to stay with it unless a slight adjustment is called for due to his numbers. I will test a little more today due to the changes, but not going to overdue it. I have to get in some sort of pattern to prepare for the day I go physically back to work, which could be within the next month. I am going back to the 4 times a day feeding because that is what will work when we are both at work, plus I really think its easier on Brady to feed like that. My wife will be able to come home at around the +4 +5 mark in AM cycle to feed him. By then I hope to have a good dosage figured out, with the help of all of you, that's for sure.

Im glad you guys are sticking with me cause I know I can be a pain in the butt sometimes.....and honestly, cat lovers all around should be very happy that their are people like you to help. @Marje and Gracie , what does the CG stand for in your comment above "In general, skipping shots is more for the CG than the cat"....some of the abbreviations im still trying to learn but in time I will get it...

Im assuming all these different methods for shooting insulin are designed to come up with the best dosage, however, im also assuming that dosages "always" change, not right away but long term. In other words, one set dosage will never be used forever its a constant change thru time. Am I getting it? Or am I totally off?
 
Irish Pat said:
Im assuming all these different methods for shooting insulin are designed to come up with the best dosage, however, im also assuming that dosages "always" change, not right away but long term. In other words, one set dosage will never be used forever its a constant change thru time. Am I getting it? Or am I totally off?
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You're getting it Pat. Yes, the insulin dose changes over time, and will rarely stay the same over a long period of time.

ECID Every Cat is Different, Every Caregiver is Different, Every Cycle is Different.

Goose tends to panic when his cat Do Daa gets those low BG numbers, and reaches for the high carb dry treats. He's become better at that, giving fewer dry treats for low numbers, but his "instincts" are to still reach for the high carb dry. The issue with that, is the dry food takes longer to get broken down in a cat's stomach, so it takes longer to have dry food raise the BG levels up higher. Something to be aware of.

Irish Pat said:
"In general, skipping shots is more for the CG than the cat"....some of the abbreviations im still trying to learn but in time I will get it...
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CG means caregiver. So if the caregiver is short on time, or needs sleep, or needs to go to work, or something else that is taking their time, they skip insulin shots for their cats for their own sakes, not the sake of their cat.

There is more than one way to treat and manage a diabetic cat. There are a lot of nuances in taking care of a diabetic cat. Some people never learn to home test, and simply are guided by their vet on doses, have tests done at the vet clinics, have dose adjustments decided strictly by the vet, feed the foods sold by and suggested by the vet.

Other people think there should be a better way, or do research on their own and find a group like this. Not even all members that find a group like this, or people that go to a specialty vet clinic follow the recommendations that are made by the experienced feline diabetes vets. They find what works for them and their cats.
 
Well guys, here we go again another end of the cycle low number, have a little over 2.5 hours to go before we start feeding Brady but he comes in at a 90 at the +9 mark. Shot time is at 6PM so we will see where he is....he is staying par for the course, low numbers, end of cycle. I have to step out for a bit but would love some input on this. If he keeps going down, im thinking reduced insulin or skip, but could use the help....thanks
 
Irish Pat said:
Well guys, here we go again another end of the cycle low number, have a little over 2.5 hours to go before we start feeding Brady but he comes in at a 90 at the +9 mark. Shot time is at 6PM so we will see where he is....he is staying par for the course, low numbers, end of cycle. I have to step out for a bit but would love some input on this. If he keeps going down, im thinking reduced insulin or skip, but could use the help....thanks
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I would suggest you offer him a couple of tsp of low carb food. Retest a little before +10. If he’s still dropping, you can try another tsp of LC food but then hold off until just before shot time.

I can check in on you. You shoot at 6 pm, correct, which is 3 pm my time. I’ll be around to help you decide what to do.
 
Sorry, just got home and my wife didn't get home in time for a little teaspoon at +10, did give him a tsp at +9, he went up a little my wife tested he was 106 a little under an hour ago, however, he is now 81 at +11.5,....someone please try to tell me what is going on here...Is this the wrong insulin or what.....This is why I get so scared at the PM cycle, he is dropping throughout the cycle where his numbers don't pick up at the end, instead they keep dropping.....HELP.....
 
jt and trouble (GA) said:
Hopefully Deb will be here soon. Dont worry its going to be ok...I wouldnt say that if I didnt believe it ok? ;)
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I know JT, you are such an inspiration to everyone.....I get it, that wasn't a HELP like im ready to give up cause I cant handle it or anything....I just don't get what is going on....All I read about are glucose curves...he doesn't have curves he has downward slopes...haha But I do need help trying to figure him out....just isn't making sense.
 
Irish Pat said:
Sorry, just got home and my wife didn't get home in time for a little teaspoon at +10, did give him a tsp at +9, he went up a little my wife tested he was 106 a little under an hour ago, however, he is now 81 at +11.5,....someone please try to tell me what is going on here...Is this the wrong insulin or what.....This is why I get so scared at the PM cycle, he is dropping throughout the cycle where his numbers don't pick up at the end, instead they keep dropping.....HELP.....
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Pat

This is very typical of a bounce-clearing cycle. In other words, it’s normal. Let me see if I can help you through it.

I’d like to see if stalling without feeding can bring his BG up as his duration wanes. Are you all game? If so, let’s do this:

  • test him at normal shot time but do not feed him
  • 30 minutes later, test him again
  • if he is on the rise, we will see how high he is and determine if shooting is appropriate.
 
Marje and Gracie said:
Pat

This is very typical of a bounce-clearing cycle. In other words, it’s normal. Let me see if I can help you through it.

I’d like to see if stalling without feeding can bring his BG up as his duration wanes. Are you all game? If so, let’s do this:

  • test him at normal shot time but do not feed him
  • 30 minutes later, test him again
  • if he is on the rise, we will see how high he is and determine if shooting is appropriate.
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I guess I can try but right now both cats are having a big time fit not being fed...don’t want stress numbers...hissing at each other which they do sometimes around food time but they are definitely begging for food badly
 
Irish Pat said:
I guess I can try but right now both cats are having a big time fit not being fed...don’t want stress numbers...hissing at each other which they do sometimes around food time but they are definitely begging for food badly
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You might need to separate him then. The alternative is to just skip the shot. Even if we shot a reduced dose, I’d want you to stall a bit and let the numbers come up a bit more.
 
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