Dosing Advice

[Acey2016]

Hello!

We've been trying to get Ace regulated since his diagnosis in October of 2021. We didn't find the Facebook group until late November. I felt like we were making good progress, but over the last few days his numbers have started to creep upwards again. I have a few questions and would love some input on his dosing.

First of all, Ace's numbers are almost always significantly higher at night vs. in the morning. From what I can tell this is the opposite of most cats. Is there something I need to change? It feels like I get a glimmer of hope in the mornings, only for his numbers to go higher and higher during the day. It almost feels like the insulin isn't doing anything during the day. He does snack frequently throughout the day, but always on wet low carb food - primarily FF, although it has been hard to find lately so we've added in some Sheba when we can find it. He was on Tiki Cat in the beginning but absolutely refuses it now. I also put food out for him every night before bed, although he doesn't seem to eat much at night. He usually sleeps on the bed with me and my husband.

Secondly, Ace's first vet started him out at a 1u dose. We've briefly tried a few other doses since then, but it seems like 1.5u is what has worked best so far. He definitely has more energy than he did at the beginning of this journey, and we have hit patches of yellow and blue numbers, but based on everything I've read I still don't think it is the ideal dose for him. I'm not sure if he needs to go up or down based on the numbers that he's currently getting. We did a curve on 1/18 if that is helpful.

https://docs.google.com/spreadsheets/d/1w9E2jLBrLnFcBpFbqQuED7HD4rB8KKAs5gE7-1c4Pg8/edit?usp=sharing

Any advice is appreciated!
Thank you,

Lynnzie

 

[Bron and Sheba (GA)]

Hi and welcome Lynnzie and Ace to the forum
Are you able to get some more tests in during the PM cycle? It is just as important as the am cycle and is 1/2 the puzzle.
Even a before bed test would be very helpful. If that before bed test is lower than the preshot, it would be a good idea to set the alarm and get up and test again to see the BG has not dropped too low.
If he doesn’t snack much at night, I would make sure he eats a good snack before you go to bed.
Would he use a timed feeder do you think at night?

Have you seen the prozinc dosing methods. Have a look at this and see if you are following the SLGS method correctly DOSING METHODS
I am not a Prozinc user, so will tag @FrostD and @JanetNJ who use Prozinc as they will help you with the dosing question.

 

[FrostD]

I suspect the dose is too high, OR ProZinc isn't the insulin for him. All these blue preshots scattered in there tells me he is going low and bouncing for a few cycles, then repeating.

The 17th into the 18th as an example - at the latest, ProZinc nadirs at +8. Usually, it's +4 to +6, I don't think I've ever seen a cat here nadir after +6. So that 149 at PS (+12) tells me he was lower over night, and the subsequent shot to the moon is a bounce. You can expect a red/pink preshot tomorrow morning.

When is the next day(s) you can do a curve? Although I was glad to see your last one, the problem is you did it on a bounce cycle + a half dose shot, so it doesn't really tell us much.

Alternatively, what would be a better option to me, is getting +5 tests every cycle (AM and PM) starting tomorrow. It's hard to predict when the bounce will break, but when it does those +5 tests will give us the answer. Please go back to 1.25-1.5U tomorrow (vs the 1.75U). That 149 worries me a bit, he could have easily been 40s/50s overnight.

 

[JanetNJ]

you greatly reduced when you got that 180 reading. Next time you get a preshot under 200, stall without feeding for up to an hour and retest. If they number is going up, give the full shot. reducing the shot made his numbers higher that night then they needed to be. a preshot like that is what you WANT to see. I think you aren't getting enough mid cycle tests. any time you are home during the day try to get at least one mid cycle number, and then get another before you go to bed at night. We need to see how LOW he's going.