Dosing Advice

[Adam Flowers]

Mogee started his all wet diet Thursday morning. He is on Fancy Feast Classic. The first day, Thursday, I only gave 3 units, he was at 6 and his BG dropped fast and we were at 88 by +4. Yesterday, I only gave 2.5 and he only got down to 170 by +4. Today I gave 3 units and at +3 he is already down to 62.

I feel he is getting to low to fast. Can anyone look at his SS and let me know what you believe I should do for dosing?

Thank you!

 

[JanetNJ]

Mogee started his all wet diet Thursday morning. He is on Fancy Feast Classic. The first day, Thursday, I only gave 3 units, he was at 6 and his BG dropped fast and we were at 88 by +4. Yesterday, I only gave 2.5 and he only got down to 170 by +4. Today I gave 3 units and at +3 he is already down to 62.

I feel he is getting to low to fast. Can anyone look at his SS and let me know what you believe I should do for dosing?

Thank you!

I'd do 2.5 and hold it for a few days.

 

[Adam Flowers]

I'd do 2.5 and hold it for a few days.

Thanks Janet, appreciate it!

 

[FurBabiesMama]

With Prozinc, it is recommended that you hold a dose at least three cycles. So, staying at 2.5 for at least that many would probably be a good start. It looks like you may want to try 2.75. If you do not already have them, you can get u40 syringes with half unit markings which makes it a lot easier to 'guesstimate' .75 doses.

 

[Adam Flowers]

With Prozinc, it is recommended that you hold a dose at least three cycles. So, staying at 2.5 for at least that many would probably be a good start. It looks like you may want to try 2.75. If you do not already have them, you can get u40 syringes with half unit markings which makes it a lot easier to 'guesstimate' .75 doses.

I guess I am confused. I gave 3 units yesterday, and he went to 62 at +3 in the AM and I only gave 2.25 today and he is already at 77 at +3.

Isn't he getting too low too fast? Shouldn't I be giving him less than 2.25? Don't I want him this low closer to +6? I feel like I am super stressed at these early numbers as I don't want him to go hypo. He still could go down for 3 more hours.

Also, can you look at his SS? He used to run lower at night and higher in the morning but is doing the exact opposite. We have not even been in the blue yet since making the change to wet.

Does he appear to be higher in the evenings because he could possibly be bouncing into higher numbers from going so low the past few mornings?

Thank you for the help!

 

[JanetNJ]

I guess I am confused. I gave 3 units yesterday, and he went to 62 at +3 in the AM and I only gave 2.25 today and he is already at 77 at +3.

Isn't he getting too low too fast? Shouldn't I be giving him less than 2.25? Don't I want him this low closer to +6? I feel like I am super stressed at these early numbers as I don't want him to go hypo. He still could go down for 3 more hours.

Also, can you look at his SS? He used to run lower at night and higher in the morning but is doing the exact opposite. We have not even been in the blue yet since making the change to wet.

Does he appear to be higher in the evenings because he could possibly be bouncing into higher numbers from going so low the past few mornings?

Thank you for the help!

See what it is at +4. If it's dropping too fast then you could dial it back to 2 next time.

 

[Nan & Amber (GA)]

I don't have experience with Prozinc, so I can't really offer specific dose advice, but I think you are right to be cautious. These are great numbers for him right now, but it doesn't leave you a big safety margin. As long as you are testing as regularly as you have been and have a hypo kit (high carb food, honey or karo syrup, lots of test strips) you should be able to keep him safe, but it is definitely nerve-wracking when they first get down into these good numbers!

Does he appear to be higher in the evenings because he could possibly be bouncing into higher numbers from going so low the past few mornings?

I think that's a very good guess about what is going on right now. He doesn't seem to be a major bouncer (doesn't stay up for very long) at least, which helps make dosing decisions.

Have you tried posting on the Prozinc forum? There should be folks there with a lot of experience with this insulin-- they can help you decide whether and how much to decrease the dose from here.

 

[Adam Flowers]

See what it is at +4. If it's dropping too fast then you could dial it back to 2 next time.

Mogee was 70 @ +3.5, and 79 @ +4. So these are pretty much the exact same right?

He seems to be leveling out around 70 from +3 to about +4.5/+5. I would think that is a good thing?

I still think it's crazy how he drops from 280 to 140 in 2 hours but then only drops 70 the next hour and stays there, without dropping more, before he heads back up. At least that is what I see.

I appreciate the help. I will probably only give him 2, depending on his AMPS tomorrow, as I will not be able to test until +6 or later on my break at work. I worry so much when I work about him going hypo as he just made the transition to all wet, that it is hard to get anything done. I almost wonder if he should get less than the 2.

 

[JanetNJ]

Mogee was 70 @ +3.5, and 79 @ +4. So these are pretty much the exact same right?

He seems to be leveling out around 70 from +3 to about +4.5/+5. I would think that is a good thing?

I still think it's crazy how he drops from 280 to 140 in 2 hours but then only drops 70 the next hour and stays there, without dropping more, before he heads back up. At least that is what I see.

I appreciate the help. I will probably only give him 2, depending on his AMPS tomorrow, as I will not be able to test until +6 or later on my break at work. I worry so much when I work about him going hypo as he just made the transition to all wet, that it is hard to get anything done. I almost wonder if he should get less than the 2.

I dose more aggressively when home on the weekends and more conservative during the week.

 

[FurBabiesMama]

I guess I am confused. I gave 3 units yesterday, and he went to 62 at +3 in the AM and I only gave 2.25 today and he is already at 77 at +3.

Isn't he getting too low too fast? Shouldn't I be giving him less than 2.25? Don't I want him this low closer to +6? I feel like I am super stressed at these early numbers as I don't want him to go hypo. He still could go down for 3 more hours.

While +6 is exactly mid-cycle, nadir does not necessarily occur exactly at that point. Review his history. His nadir often occurs earlier than that. He is usually rising by +6. You cannot really change when his nadir happens. Don't let it scare you.

He used to run lower at night and higher in the morning but is doing the exact opposite. We have not even been in the blue yet since making the change to wet.

Does he appear to be higher in the evenings because he could possibly be bouncing into higher numbers from going so low the past few mornings?

He could be 'rebounding' a little from going lower than he is used to in the mornings, but he is not having distinct bouncing. He still has a curve in the pm cycle (goes down then back up). If you have a bad bounce, the numbers usually go high then stay sort of high and flat for a period of time. It can take a few cycles before things calm back down.

Today's 2.25 cycle looks pretty good so far to me, but I understand your concern about not being home to test him during the week, so it sounds like you would be more comfortable dropping to 2. Please hold that dose for awhile though. Ideally, you do not want to be giving different doses at every shot. A dose's impact can actually change after a few cycles too which is probably why the recommendation is to stay with a dose at least three cycles.

He is doing so good though, so try not to be stressed but instead enjoy! We are having big time struggles over here right now, so I would love to be in your shoes.

 

[Adam Flowers]

He is doing so good though, so try not to be stressed but instead enjoy! We are having big time struggles over here right now, so I would love to be in your shoes.

I was just reading about the issues that you are having and I am sorry to hear that. Has anything gotten better?

As you know, I started Mogee on the FF Classics chicken last Wednesday. He has always been on dry. He is now fully on the wet. I noticed yesterday he had really bad diarrhea. It has continued into today. He was pretty vocal when he was going as well.

Also last night and tonight after testing him and putting his food out, he doesn't seem to want to eat. He is usually head deep in his food as I'm getting his syringe ready but the last two nights he has been done eating before I get to his shot. I have been able to inject as I will stir the food to get him to eat more but it seems he is already sick of the food or it is upsetting his tummy and he doesn't want it?

Should I be concerned about the diarrhea? 8 would think some would be normal as he has been on dry for 6 years and just switched completely to wet?

 

[FurBabiesMama]

I was just reading about the issues that you are having and I am sorry to hear that. Has anything gotten better?

Well, as you might have read on one of the threads, I gave a dose from an older vial of insulin, and her numbers dropped for the first time in days. Sure seems like something is wrong with the current vial, but maybe it was a fluke. I'm going to keep using the old vial and see. I think even so there is something else going on. We are just waiting for test results now. Back to Mogee...

As you know, I started Mogee on the FF Classics chicken last Wednesday. He has always been on dry. He is now fully on the wet. I noticed yesterday he had really bad diarrhea. It has continued into today. He was pretty vocal when he was going as well.

Also last night and tonight after testing him and putting his food out, he doesn't seem to want to eat. He is usually head deep in his food as I'm getting his syringe ready but the last two nights he has been done eating before I get to his shot. I have been able to inject as I will stir the food to get him to eat more but it seems he is already sick of the food or it is upsetting his tummy and he doesn't want

Should I be concerned about the diarrhea? 8 would think some would be normal as he has been on dry for 6 years and just switched completely to wet?

Apparently, it is not uncommon for cats to have some stomach issues when there is a food switch. I think it is less if you transition gradually, but even that does not necessarily prevent it. The part about him being vocal is a little concerning. If he continues to have an upset belly, you may want to try some other low carb wet foods. My girls were on dry food only - and the same dry food - for years without complaint, but they are more finicky when it comes to wet food. Things will be going great then they will stop eating something they were previously gobbling up. Then, I worry from wondering if something is wrong with them or if they are just sick of it. When I fed them FF, I had to add plain pumpkin to it because their poop was too small and hard (it also helps with diarrhea). Every time I think we have the food situation figured out, we hit another rough spell. It has become clear to me that I am going to have to keep a few different kinds on hand so that I have backup plans when they just start refusing to eat one for awhile. I have four different ones right now, and today, the only one Mia will eat is Sheba chicken pate. Thankfully, through all the food issues they have consistently been willing to eat the shredded chicken and bone broth I make them... and those things help get them to eat the other stuff when I mix some in.

 

[Adam Flowers]

I still cannot figure out what dose to keep Mogee at. He used to be higher in the morning and lower at night but he seems to be the exact opposite now.

Other than yesterday, his BG has been below 80 by +3 in the AM. Today, he is at 65 at +4.

I am not too worried about the PM dose as I seem to have that figured out at 2.25 units but if I give him 2.25 units in the morning, I believe he will hypo.

I gave 2 units this morning but his numbers are still low and it worries me as I am at work and don't want to come home to a dead cat.

Should I reduce to 1.75 in the AM? Can he have two different dosages or do they have to stay the same for am and pm?