Copying from Main Forum Need Guidance in regards to Prozinc

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G & I

G & I

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http://www.felinediabetes.com/FDMB/...-some-help-here-guidance.188006/#post-2087524

Please refer to the main forum if possible. I hope the entire link moves the discussion here.

In a nutshell I increased the dosage and have seen rapid increase in readings. Am concerned that Goma cannot handle such high glucose numbers. What would be the best course of action to take in regards to the evening dose.

Also, is it safe to give Goma Glucosamine and Felo Form Supplements? Would this drive the numbers higher as this is also the first day she has taken these. The vet wants to cut off pain medication tomorrow and stated she needs the Glucosamine in addition to anitol (sp)to control pain. She was also given a pain control injection this morning approximately two hours after the insulin injection. She received fluid therapy as well as her liver numbers are still very high.
 
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Hi. I looked at your other post. I would not lower the 1 unit dose, and I would definitely proceed with the PM shot. Any idea when the vet is going to get you some insulin that is not expired?

Others will respond to you, but the time difference makes it very difficult. I just happened to be up to test Mia and thought about you and wanted to check in. Let's see what the more experienced Prozinc folks say in regards to their thoughts on what you should do tomorrow. Personally, I would probably increase the dose in the morning. She has just been staying so high.
 
FurBabiesMama said:
Hi. I looked at your other post. I would not lower the 1 unit dose, and I would definitely proceed with the PM shot. Any idea when the vet is going to get you some insulin that is not expired?

Others will respond to you, but the time difference makes it very difficult. I just happened to be up to test Mia and thought about you and wanted to check in. Let's see what the more experienced Prozinc folks say in regards to their thoughts on what you should do tomorrow. Personally, I would probably increase the dose in the morning. She has just been staying so high.
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Based on what I have seen today, I am very reluctant to even think about increasing dosage for at least a week. I think I may have pushed too fast since she had only been on twice a day injections for a few days. She is extremely agitated now I did inject and 1 unit at 9:15 tonight and will monitor overnight with a test in about 3 hours. Yeah, the time difference is starting to become a factor.
 
I think what you saw last night was either some leftover vet stress, a response to the pain control injection, or just NDW (new dose wonkiness). Sometimes their bodies just rebel against a dose for a cycle or two before they accept it. That's why it's generally recommended to hold a dose for a few cycles between increases.

I understand that this has been stressful, so I haven't wanted to push you too hard on the dose increases, but when you are ready you can increase doses by 0.5u at a time every third cycle. Right now we aren't really seeing an insulin response. Even the two red numbers you have are within the 20% meter variance of nearby numbers.

Do not decrease the dose. That was a tough cycle for sure, but decreasing is moving in the wrong direction right now.

As far as food, I didn't realize she isn't on a low carb food. That will most likely make a huge difference in her numbers though I understand it may be hard to know what is low carb since we don't have a list of foods for Japan. I believe you mentioned someone stateside could help with supplies. This is a freeze dried food so the weight is lighter. It is a bit pricey, but it's low carb and also good for kidneys and it's sold on Amazon US. https://www.amazon.com/Primal-Pet-Foods-Freeze-Dried-Formula/dp/B00B1H3ZYE
 
I certainly understand your concern. This is all so very new for you and we're suggesting things that are completely at odds with what your vet has been doing. All I can do is reassure you that we've seen patterns like this before and we know that, barring an unforeseen health issue, they can be improved greatly.

Djamila has given you a great assessment. She's absolutely right: what needs to happen is regular dose increases of 0.5 u after three cycles. That's how to get BG numbers moving in the right direction. The numbers on your spreadsheet right now are all in the same range essentially (20% variance allowed for BG meters). The slower you are with dose increases the harder it can be to get her responding properly to the insulin.

Please keep posting any/all questions and concerns you have here. So many of us received little support or guidance from our vet in handling feline diabetes. They just don't have enough exposure to the disease in cats.
 
Djamila said:
I think what you saw last night was either some leftover vet stress, a response to the pain control injection, or just NDW (new dose wonkiness). Sometimes their bodies just rebel against a dose for a cycle or two before they accept it. That's why it's generally recommended to hold a dose for a few cycles between increases.

I understand that this has been stressful, so I haven't wanted to push you too hard on the dose increases, but when you are ready you can increase doses by 0.5u at a time every third cycle. Right now we aren't really seeing an insulin response. Even the two red numbers you have are within the 20% meter variance of nearby numbers.

Do not decrease the dose. That was a tough cycle for sure, but decreasing is moving in the wrong direction right now.

As far as food, I didn't realize she isn't on a low carb food. That will most likely make a huge difference in her numbers though I understand it may be hard to know what is low carb since we don't have a list of foods for Japan. I believe you mentioned someone stateside could help with supplies. This is a freeze dried food so the weight is lighter. It is a bit pricey, but it's low carb and also good for kidneys and it's sold on Amazon US. https://www.amazon.com/Primal-Pet-Foods-Freeze-Dried-Formula/dp/B00B1H3ZYE
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Thanks for the info in regards to dosing and the food. Agree that food is pricey and the amount I would need makes it indeed prohibitive. Still it gives me ideas on what to look around for here locally so I really appreciate it. I am considering again on preparing my own food for her using recipes I have found in various books.

After what I am seeing today, I do not intend to increase anymore for at least a week. I feel I have moved her too far too fast since she was only on two injections a day for a few days. I did give the 1 unit dosage in the evening injection. Will complete a bg test in a few hours and monitor her all night. As I mentioned in other posts, she is extremely agitated today.
 
I think once we all get used to the time difference it won't be too bad. Your shot times are around 8am/8pm for me, which isn't bad. There will be some time during the night (US)/day(Japan) that no one is here, but Kris and Rachel are usually on pretty early in East Coast time so should be able to catch part of your daytime cycle. A low number is treated the same way regardless of insulin, so if that ever did happen you could also post out on the Main forum and there is nearly always someone out there.

You didn't push too fast. There is always some forward and backward movement in this process. Some cycles are great, and then they'll be followed by a few lousy cycles. It's just not a linear process. Prozinc allows us to safely move the dose more quickly than other insulin types which is important for cats when they are in high numbers.

That being said, you hold the syringe and need to do what you're comfortable with. We will always offer you our best advice, but the final decision is always yours and no one gets their feelings hurt.

One thing i will suggest though is that you get ketone test strips from the pharmacy. It's a urine test strip and you stick it under her bum when she pees (not every day, but once/week or so). If she won't let you do that we have some other little tricks that will work. Ketones can develop when a cat is in high numbers, not getting sufficient insulin, and have a secondary infection/inflammation. Since you already know that Goma has some other health issues, the development of ketones becomes a greater concern.
 
Oh, and if you're considering making you own food, this is what I use: http://www.foodfurlife.com/
Everything they need is already in it so you just cut up or grind the food, mix this in and you're done.

There is also a great recipe and guidance on http://catinfo.org/making-cat-food/ about making food completely from scratch at home.

My kitties are loving the homemade food these days and it's surprisingly easy to make (I use the foodfurlife version).
 
I just want to jump in and say that I agree with the more aggressive increases. I know you said you don’t want to and it is your decision but I felt I needed to chime in too. Those numbers are pretty high and the only way to get them down is more insulin not less. The longer she sits in higher numbers the more likely some insulin resistance is...which will make it even harder to bring the numbers down. If she was mine I’d increase by 0.5 every 3 cycles. Now as we said it’s your choice but I didn’t feel right unless I stuck my nose in! :)
 
Djamila said:
I think once we all get used to the time difference it won't be too bad. Your shot times are around 8am/8pm for me, which isn't bad. There will be some time during the night (US)/day(Japan) that no one is here, but Kris and Rachel are usually on pretty early in East Coast time so should be able to catch part of your daytime cycle. A low number is treated the same way regardless of insulin, so if that ever did happen you could also post out on the Main forum and there is nearly always someone out there.

You didn't push too fast. There is always some forward and backward movement in this process. Some cycles are great, and then they'll be followed by a few lousy cycles. It's just not a linear process. Prozinc allows us to safely move the dose more quickly than other insulin types which is important for cats when they are in high numbers.

That being said, you hold the syringe and need to do what you're comfortable with. We will always offer you our best advice, but the final decision is always yours and no one gets their feelings hurt.

One thing i will suggest though is that you get ketone test strips from the pharmacy. It's a urine test strip and you stick it under her bum when she pees (not every day, but once/week or so). If she won't let you do that we have some other little tricks that will work. Ketones can develop when a cat is in high numbers, not getting sufficient insulin, and have a secondary infection/inflammation. Since you already know that Goma has some other health issues, the development of ketones becomes a greater concern.
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A few days ago I ordered Ketone test strips to be sent to my daughter in Florida who will forward on to me when received along with the glucose test meter and test strips. Recent urine test (yesterday) indicated no ketones. Thanks for the information.
 
Are you still waiting on some non-expired insulin? I agree in general with the ProZinc pros that it looks like Goma needs more insulin, but if you are still working with the possibly-weak bottle, that's another wildcard to keep in mind.

This is so stressful, I know. It will get better, this just all takes time...
 
Nan & Amber said:
Are you still waiting on some non-expired insulin? I agree in general with the ProZinc pros that it looks like Goma needs more insulin, but if you are still working with the possibly-weak bottle, that's another wildcard to keep in mind.

This is so stressful, I know. It will get better, this just all takes time...
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Thanks for responding. Because I may be working with a weak bottle of insulin I am holding off any increases for now. Once I get the new bottle and give a chance for a few days I'll go from there. I still have no idea when I will get the new bottle. No one here seems to care and feel any sense of urgency about it. Well I do...And have begun looking for other sources.
 
If it's going to be a while before you can get your hands on some known-good insulin, maybe consider raising now, to try to get her numbers down a bit? You can always drop the dose back down a bit when the new insulin arrives, with the idea that it might be more powerful than what you've got now.
 
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