Dosage Help/High BG Numbers

[Jeanette Morris]

Hi Everyone,

We are fairly new to this journey. I have posted a couple times on here, but I wanted to start a fresh thread in hopes that somebody would have any guesses on what is going on with our sugar baby Simon. We have been fluctuating between .75 units and 1.5 units over the past few months. He has had two hypo episodes at 2 units in the past. We have never gotten his numbers regulated or even in what seems to be a decent range. It also seems that every time we increase his dose to try and get his numbers down, his levels seem to go up. This last time his numbers weren't low enough to trigger any bouncing. I know that 1 unit might not be enough, but I'm not sure what to do when his numbers just seem to get worse every time we increase. We are pretty consistent with Fancy Feast pate wet food. I occasionally give them Friskies pate or the Fancy Feast roasted and chunky options (still low carb). I would like to add that Simon doesn't seem to be acting out of the ordinary even with the high numbers. He doesn't have any symptoms like when we took him in and got his diagnosis. He isn't drinking any extra water and is climbing his cat tree and looking out the window like he normally does and always has. Obviously taking lots of naps during the day.

Any advice would be much appreciated. I do test frequently and can test more during the day if needed as I am home with our child. Our spreadsheet is up to date.

Thank you!!!

 

[JanetNJ]

Hi Everyone,

We are fairly new to this journey. I have posted a couple times on here, but I wanted to start a fresh thread in hopes that somebody would have any guesses on what is going on with our sugar baby Simon. We have been fluctuating between .75 units and 1.5 units over the past few months. He has had two hypo episodes at 2 units in the past. We have never gotten his numbers regulated or even in what seems to be a decent range. It also seems that every time we increase his dose to try and get his numbers down, his levels seem to go up. This last time his numbers weren't low enough to trigger any bouncing. I know that 1 unit might not be enough, but I'm not sure what to do when his numbers just seem to get worse every time we increase. We are pretty consistent with Fancy Feast pate wet food. I occasionally give them Friskies pate or the Fancy Feast roasted and chunky options (still low carb). I would like to add that Simon doesn't seem to be acting out of the ordinary even with the high numbers. He doesn't have any symptoms like when we took him in and got his diagnosis. He isn't drinking any extra water and is climbing his cat tree and looking out the window like he normally does and always has. Obviously taking lots of naps during the day.

Any advice would be much appreciated. I do test frequently and can test more during the day if needed as I am home with our child. Our spreadsheet is up to date.

Thank you!!!

Definitly time for a dose increase. We want to see blue and dark green numbers around 100 I'd go back to 1.5.

You were doing 2 u and then dropped it all the way down to 0.5. It should only have been dropped to 1.75. You dropped too far. When you go too low drop it by 0.25.

 

[Jeanette Morris]

Definitly time for a dose increase. We want to see blue and dark green numbers around 100 I'd go back to 1.5.

You were doing 2 u and then dropped it all the way down to 0.5. It should only have been dropped to 1.75. You dropped too far. When you go too low drop it by 0.25.

Hi Janet,

Thanks for the response! He went hypo at 2, then we decreased down to 1 that low per another person on here's suggestion because we just started a new bottle of Prozinc. So it was suggested to go to 1 to see where he would be. Then we went out of town and put him on a vacation dose of .5 units since our pet sitter wasn't testing. Unfortunately, this all happened right before we were leaving, and we didn't want to have anything happen to him. Those are the reasons we didn't go to 1.75. We have slowly worked our way back up to 1, which is where we are right now. I did put notes in the SS to try and explain this.

We will increase the dose to 1.5 tonight. Do you have any idea why his numbers would increase when we increase the dose?

Thank you!

 

[JanetNJ]

Hi Janet,

Thanks for the response! He went hypo at 2, then we decreased down to 1 that low per another person on here's suggestion because we just started a new bottle of Prozinc. So it was suggested to go to 1 to see where he would be. Then we went out of town and put him on a vacation dose of .5 units since our pet sitter wasn't testing. Unfortunately, this all happened right before we were leaving, and we didn't want to have anything happen to him. Those are the reasons we didn't go to 1.75. We have slowly worked our way back up to 1, which is where we are right now. I did put notes in the SS to try and explain this.

We will increase the dose to 1.5 tonight. Do you have any idea why his numbers would increase when we increase the dose?

Thank you!

Insulin needs fluctuate. He may be a little insulin resistant to the current dose and just needs a bit more.

 

[Jeanette Morris]

Insulin needs fluctuate. He may be a little insulin resistant to the current dose and just needs a bit more.

Thanks so much! We figured it was probably something like that. He has just been so all over the place! We will give that a try!

Thank you!!

 

[Jeanette Morris]

Insulin needs fluctuate. He may be a little insulin resistant to the current dose and just needs a bit more.

Hi Janet,

This morning was our second dose at 1.5 units. Simon was 400 this morning around 6:30. We are at a little over +3 hours and he has gone all the way down to 107. Since we are so early on in the cycle, I'm going to test every hour because I have a feeling he will go too low. I have some shreds, honey, and syrup on hand. Any suggestions on what to do after this happens? I always feel like every time this happens, he goes super high for a while and then bounces around. I know that might be unavoidable, but just wondering if there's anything I can do. After getting the food, he will probably be super high tonight. Do I skip that shot and then try 1.25 tomorrow morning? Should I give him a little shreds right now to avoid going down too low?

Thank you!

 

[JanetNJ]

Hi Janet,

This morning was our second dose at 1.5 units. Simon was 400 this morning around 6:30. We are at a little over +3 hours and he has gone all the way down to 107. Since we are so early on in the cycle, I'm going to test every hour because I have a feeling he will go too low. I have some shreds, honey, and syrup on hand. Any suggestions on what to do after this happens? I always feel like every time this happens, he goes super high for a while and then bounces around. I know that might be unavoidable, but just wondering if there's anything I can do. After getting the food, he will probably be super high tonight. Do I skip that shot and then try 1.25 tomorrow morning? Should I give him a little shreds right now to avoid going down too low?

Thank you!

Oh! A nice 89 today! Yeah let’s do 1.25 and see what happens. But don’t skip his shot tonight.

 

[Jeanette Morris]

Oh! A nice 89 today! Yeah let’s do 1.25 and see what happens. But don’t skip his shot tonight.

Yes! He is back up to 460 again this evening pre shot, but I think 1.25 would be the safe way to go.

Thank you!!

 

[Jeanette Morris]

Oh! A nice 89 today! Yeah let’s do 1.25 and see what happens. But don’t skip his shot tonight.

Hi Janet,

We tried 1.25 a few days, and his mid cycle numbers just weren't getting low enough. I went back up to 1.5 last night and today. +2 we have a number in the low 200s, so that is good so far. Going to check him again in a couple hours to see where he is. He always has food out, so he will be able to snack.

We are going out of town for Easter for a day and a half and having somebody come by and do his shots and feed both cats. The last time we did this, we reduced to .5 units. I know we still have some time, but I'm also thinking about what we should do when we are gone.

Thank you!

 

[Dyana]

I would get a +3 test in, if you can today, since it looks like he's coming down pretty fast in this cycle.

 

[Jeanette Morris]

I would get a +3 test in, if you can today, since it looks like he's coming down pretty fast in this cycle.

That first test was actually a bit closer to +3 now that I look back at when I posted this. I did grab a test a bit later, and he was still in the mid 100s. I left food out and he still went down to 56 the next time I checked after I put my son down for a nap. He was not acting out of the ordinary or having the same hypo symptoms we've seen previously. I gave him a bit of shreds mixed in with his normal food for lunch and rubbed a little honey on his gums. He scarfed it. I will check him again shortly and see where he is. It looks like 1.5 is too much but 1.25 isn't enough? I'm a bit confused on what to do about it.

 

[Dyana]

I don't have experience with Prozinc, so I'm tagging @JanetNJ for dosing advice. I would say that with that 56, you need to reduce the dose this evening, especially if you are still using an AlphaTrac.
The honey wears off fast. I used to test every 20 minutes when in the 30s and 40s, and I used to test every 30 minutes when in the 50s, and then every hour once he was in the 60s and rising.
He'll probably bounce high later today, but until he gets above 100, I would keep testing.
I'm guessing he went lower on the evening of the 20th after that 95 you saw

 

[Jeanette Morris]

I don't have experience with Prozinc, so I'm tagging @JanetNJ for dosing advice. I would say that with that 56, you need to reduce the dose this evening, especially if you are still using an AlphaTrac.
The honey wears off fast. I used to test every 20 minutes when in the 30s and 40s, and I used to test every 30 minutes when in the 50s, and then every hour once he was in the 60s and rising.
He'll probably bounce high later today, but until he gets above 100, I would keep testing.
I'm guessing he went lower on the evening of the 20th after that 95 you saw

Thanks for the advice! I just tested him and he was in the 80s. So I should test him in another hour then? He is kneading the blanket next to me and purring now. He just went back and ate more food as well.

He ate immediately after we got that 95 test reading on the 20th so we were not worried that he was going to get super low that night. But then we did not get any low readings after that.

 

[JanetNJ]

well that 56 was a surprise today! 1.25 is not enough, and 1.5 too much. lol Maybe do a FAT 1.25

 

[Jeanette Morris]

well that 56 was a surprise today! 1.25 is not enough, and 1.5 too much. lol Maybe do a FAT 1.25

I know! I was totally surprised when that happened after seeing his numbers on 1.25. Alrighty, well we tried a little more than 1.25. Thinking I may need to order some syringes with the half unit marks if this keeps happening! Haha

Thanks to both of you!

 

[JanetNJ]

I know! I was totally surprised when that happened after seeing his numbers on 1.25. Alrighty, well we tried a little more than 1.25. Thinking I may need to order some syringes with the half unit marks if this keeps happening! Haha

Thanks to both of you!

Oh yeah half unit markings really help.

 

[Dyana]

I know! I was totally surprised when that happened after seeing his numbers on 1.25. Alrighty, well we tried a little more than 1.25. Thinking I may need to order some syringes with the half unit marks if this keeps happening! Haha

Thanks to both of you!

I would reduce by the full 0.25 units per the protocol in the Prozinc forum

Reducing the dose:

• If your cat is in the first 3-6 months of diagnosis, reduce the dose by 0.25u anytime you see a BG below 50 on a human meter or 68 on a pet meter.

 

[Jeanette Morris]

Thank you, Dyana. I just saw this post. We are struggling between those numbers and have in the past, but he is still newly diagnosed. After a fat 1.25 last night and a higher test before bed, we saw his numbers go down to 254 this morning (double checked a bit later). I wasn't sure what to do and didn't think I would get an answer in time, so I reduced his dose this morning to 1 in hopes of him not dropping too much. I'm not sure if that was the right thing to do, but I will monitor him throughout the morning.

Thank you!

 

[JanetNJ]

Thank you, Dyana. I just saw this post. We are struggling between those numbers and have in the past, but he is still newly diagnosed. After a fat 1.25 last night and a higher test before bed, we saw his numbers go down to 254 this morning (double checked a bit later). I wasn't sure what to do and didn't think I would get an answer in time, so I reduced his dose this morning to 1 in hopes of him not dropping too much. I'm not sure if that was the right thing to do, but I will monitor him throughout the morning.

Thank you!

looks like it's back up. you probably just got a longer duration from last night. I think if it's over 200 go ahead and give the full 1.25F. If that makes you nervous, you could always stall without feeding an extra 30-60 min and see if it's heading upward.

 

[Jeanette Morris]

looks like it's back up. you probably just got a longer duration from last night. I think if it's over 200 go ahead and give the full 1.25F. If that makes you nervous, you could always stall without feeding an extra 30-60 min and see if it's heading upward.

Thanks, Janet. And I totally agree with you on doing 1.25 when he is above 200 now that I did 1 today. I'm normally home with him to test. Just so I know, if he does happen to go below 200 at some point (wishful thinking seems like right now), I've seen people say to skip, but I don't know if that would be the best option for him. If we are giving 1.25 and he goes below 200, should we do 1 or .75?

Thanks so much!

 

[JanetNJ]

Thanks, Janet. And I totally agree with you on doing 1.25 when he is above 200 now that I did 1 today. I'm normally home with him to test. Just so I know, if he does happen to go below 200 at some point (wishful thinking seems like right now), I've seen people say to skip, but I don't know if that would be the best option for him. If we are giving 1.25 and he goes below 200, should we do 1 or .75?

Thanks so much!

If he's below 200 stall for up to 60 min without feeding and see if it goes up. If it's still low you could reduce the dose.

 

[Dyana]

If we are giving 1.25 and he goes below 200, should we do 1 or .75?

Part of the decision will be how comfortable you are when you see a PS below 200. Will you be home, have you shot the full dose on the same or close to the same number before and how did he do, is he eating and acting well? Eventually, your PS number that you will consider stalling on (without feeding), or doing a one time partially reduced dose, or a skip of the dose entirely, will lower as time goes by and as you get more data to look back on and are more comfortable. For now, I would suggest sticking with the 1.25 dose per the protocol that I mentioned above, if he is 200 or over at PS time.

 

[Jeanette Morris]

Part of the decision will be how comfortable you are when you see a PS below 200. Will you be home, have you shot the full dose on the same or close to the same number before and how did he do, is he eating and acting well? Eventually, your PS number that you will consider stalling on (without feeding), or doing a one time partially reduced dose, or a skip of the dose entirely, will lower as time goes by and as you get more data to look back on and are more comfortable. For now, I would suggest sticking with the 1.25 dose per the protocol that I mentioned above, if he is 200 or over at PS time.

Sorry for the late response. That all makes sense to me. I think we had a bit of variable numbers going on this weekend, so we are just waiting that out to see what happens this week. I am usually around to test during the day and at night and don't have any problems testing alone, so I will follow the protocol. We will just need to figure out what to do when we are out of town for a bit next weekend.

Thanks so much for the advice and guidance!

 

[Jeanette Morris]

Do either of you guys think that the type of insulin may be the issue with not being able to get his diabetes under control? I'm not familiar with what makes the different types more effective or less effective in cats. Just wondering if we need to switch or if we should stick with prozinc.

Thank you!

 

[Dyana]

I think either Prozinc or Lantus or Levemir are preferred for cats. I would keep the same dose for the full 7 days and then see if you need to increase or decrease depending upon the mid cycle numbers. He could have gone into the green numbers on the 26th and bounced, an sometimes bounces will last from 1 to 6 cycles, so I would try to get at least a before bed test tonight.
Did you get any more tests today?

 

[Jeanette Morris]

I think either Prozinc or Lantus or Levemir are preferred for cats. I would keep the same dose for the full 7 days and then see if you need to increase or decrease depending upon the mid cycle numbers. He could have gone into the green numbers on the 26th and bounced, an sometimes bounces will last from 1 to 6 cycles, so I would try to get at least a before bed test tonight.
Did you get any more tests today?

Yes, I did get some tests yesterday, and I've updated the spreadsheet. We grabbed one at +3 hours last night and he was still in the 400s. He was pretty high most of the day when I tested him. I figured he may be bouncing and was wondering what to do about it. We thought we had this happen in the past also. I will keep this dose the rest of the week and see where he is on Friday before we go out of town. We will only be gone a day and a half, but I don't want his dose to be too high and have something happen.

Thank you!

 

[Jeanette Morris]

Good afternoon,

I think we may be starting to get out of the bouncing time with our numbers last night and today. Fingers crossed! We are now a couple days away from when we will be going out of town. We are only leaving Saturday after am shot and coming back midday on Sunday. I'm just thinking I should maybe decrease his dose while nobody is testing him as a vacation. Maybe .5 or 1 unit? I'm not sure what to do.

Thank you!

 

[Dyana]

It's best to have the vacation dose be on a line, so I would go with the 1.00 unit dose. It's good you will only be gone for 2 shots. I would leave the hypo instructions with your hypo kit in a sealed container on the counter, and also a sample syringe with colored water or something in it to compare the dose they draw up to.
Do you have an automatic feeder that the pet sitter can use?
When you return, depending upon his numbers, I would go right back to your current dose.