Dosing & monitoring of Toby

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Hailey K, Mar 31, 2021.

  1. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    Can someone please explain to me why when we increase Toby’s dose, he seems to be getting better numbers at first which then turn worse and then stay the same as what he was on the previous dose ? I thought to expect some improvement but we aren’t having much luck getting him regulated.
     
  2. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
  3. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    I guess my question is why do the numbers go higher instead of getting better or staying the same ? Is this normal for getting regulated? At one point we were all the way up to 5.5 units and I can see how we got there when he wasn’t really getting better just always staying the same.
     
  4. Ann & Scatcats

    Ann & Scatcats Well-Known Member

    Joined:
    Dec 31, 2009
    Give this 3 units dose a week so we get full data and can compare with the 2.75 units before.
     
    Deb & Wink likes this.
  5. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    Does anyone have the link for the canned foods carb contact, I don’t think it was Dr. P or Dr. Sarah’s list. It listed hundreds of different kinds of food, I went back into previous conversations and couldn’t find it. TIA
     
    Deb & Wink likes this.
  6. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    Should I be increasing the dose again?
     
    Deb & Wink likes this.
  7. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Sorry you didn't get a response
    I'll tag
    @Deb & Wink

    @JanetNJ

    to see if they can give you some advice
    Thanks ladies :cat:
     
    Deb & Wink likes this.
  8. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    I am not a Prozinc user so won’t comment on the dosing but I would try getting some tests in other than around +6 in the day and +3 at night.
    This may give you an idea of what is going on. Is he dropping fast and bouncing maybe? or is the duration of the insulin not lasting 12 hours?
    Are you feeding a low carb diet?

    It looks like he has been on Prozinc for almost 6 months so if you are not happy I would look at maybe swapping to Lantus which you can get over the counter in Canada.....just a thought.
     
    Deb & Wink and Diane Tyler's Mom like this.
  9. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    She probably has a bit of insulin resistance going. I think I'd go to 3.25
     
    Deb & Wink and Diane Tyler's Mom like this.
  10. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    I increased to 3.25 this morning. I haven’t spoke to my vet since her recommended dose of 5.5 would have sent Toby hypo had I not started home testing. I was than advised by the group to half his dose, which I did, however I do think somewhere between here and there would be his happy medium, but now it’s just a point of getting back to that without him getting too much. During the week the 6+ and 3+ is all I can get as I am gone for work, on the weekend I can get some more data. In the mean time I will be seeking out a different vet who can get on the same page as me and possibly consider changing insulin.
     
    Last edited: Apr 5, 2021
  11. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    As for low carb, I have made sure to eliminate everything, Toby only gets friskies pate, no more dr elseys even since they have been sold out. But even when we did remove the high carb food from his diet there really wasn’t any significant change like I thought there would be.
     
    Deb & Wink likes this.
  12. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    Don’t get me wrong there has been some improvement especially like seeing all blue numbers for his 6+ for the last 5 days in a row, so there is progress, but it’s just his AMPS and PMPS numbers that are still high.
     
    Deb & Wink likes this.
  13. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    It looks like the blue nadirs started when you removed the Dr. Elsey's. That's improvement. :cat: Good luck with the new dose.
     
    Deb & Wink likes this.
  14. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
  15. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    I think that must be the chart however it looked slightly different before, maybe it was an older list I was looking at or something. I see it’s the same website I was on just the format of the chart was different so I thought it wasn’t the same one lol. Thanks Deb
     
    Deb & Wink likes this.
  16. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    Did you click on Extensive Filters? I really like that function.
     
    Hailey K likes this.
  17. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    That’s the one !! Thank you Dyana!
     
    Deb & Wink likes this.
  18. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    At what point does one determine whether or not an insulin is working for their cat. Could Toby actually just need a higher dose or is it getting to the point where data is showing it’s not working for him. I like the prozinc since it gives me some flexibility on how much I can push his shot times either direction on the days that get a little hectic. I’ve heard lantus is good but I hear you have to be within 15 minutes of giving the shot which kind of stresses me out. I have a vet appointment with my regular vet coming up on the 20th (NOT the vet who has been dealing with Tobys diabetes) so I’m just looking for some things I should be discussing with my vet. I first joined FDMB not long after my last appointment so they don’t know that I have been following the advise of the group, how do you approach that topic with your vet ? I understand the vet works for me but I worry what he might think of it.
     
  19. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    If the current dose of Prozinc isn't working well for Toby, then you need to increase it. You want to see Toby dropping down into the green BG ranges.

    You increased him only a couple of cycles ago. We usually say 6 cycles minimum to see what a new dose is doing. So I'd recommend waiting a couple more cycles before another increase.

    Show your vet a copy of the AAHA Diabetes Management Guidelines.
    https://www.aaha.org/globalassets/02-guidelines/diabetes/diabetes-guidelines_final.pdf
     
  20. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    Oh of course, I didn’t mean to increase things again, I’ve got more patience than that lol. Maybe poor choice of wording but what I was trying to say was would it be wise to ask about possibly changing the type of insulin? Or do you think he’s doing okay on Prozinc and maybe just isn’t at the right dose yet for him ? I’m at the point that even if I were to switch insulin I’d have to start all over again and that maybe it’s that he just needs a higher dose until we start to see some normal numbers.
     
    Deb & Wink likes this.
  21. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    With a new insulin, you do not start all over. You base the dose of the new insulin on the dose of the old insulin. So what ever his dose is on Prozinc, that would be the dose on the new insulin. Sometimes, people drop the dose by a small percentage, maybe 10-20% from the current dose when they switch. You certainly do not start over at 1U.

    Toby is doing ok on the Prozinc. I do think he needs another dose increase soon.
    With your husband doing an "oops" and only giving Toby 3U instead of 3.25U, Toby will likely run in higher BG numbers today.
     
    Diane Tyler's Mom likes this.
  22. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    Hi Deb so sorry I missed your message the other day. I increased again this weekend to 3.5. That’s good to know about not having to start over, I’m sorta at the point where I’m not sure if I even need to bring Toby to the vet next week if everything seems to be fine. Another question I have is does the weight of the cat make a difference when it comes to higher doses of insulin? I only ask because Toby is a very large cat and I don’t mean overweight just the overall size of him, he’s about twice the size of our other cats and he is getting back up to his “normal weight” since first being diagnosed. He’s always been around 21-23 pounds (currently back up to 19 pounds) after dropping down to 12 pounds at time of diagnosis in October.
     
    Deb & Wink likes this.
  23. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Something went wrong with your entry for the AMPS today. It's only showing as the word #VALUE! on the US version of the SS, so please take a look and correct that when you have a chance. I'm guessing the formatting for the cell on the US version got messed up somehow. See if reentering it on the World version of the SS would help to fix it.

    No insulin is not dosed based on weight, although many vets still try to do that. Insulin should be dosed on the nadirs, the lows in the 12 hour dosing cycle.

    As long as Toby is not overweight, he should be ok. This body condition chart may help you decide if Toby is a good weight, his ideal weight. A cat that is overweight has a tougher time using the insulin properly.
    [​IMG]
     
  24. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    There it should be fixed! Not sure what happened there. Yes to us Toby is still a little thinner but probably would be considered ideal range now. The poor guy was skin and bones and looked horrible at 12 pounds and that’s what made us take him in to get checked out. Honestly he’s just a really big cat and I will be sure to make sure he doesn’t get too “fluffy” either. Good to know that about the weight though, I was starting to think maybe that had something to do with it since his weight has slowly been increasing over the last 6 months.
     
    Deb & Wink likes this.
  25. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Thank you for the SS fix.

    It's looking to me like Toby may be due for another dose increase soon.
    No extra "fluff" for Toby! :):D:)
     
  26. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    I’ll increase Toby in the morning !
     
    Deb & Wink likes this.
  27. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Hope that Toby's BG numbers come down soon.
     
  28. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    Toby was much lower at PMPS however I decided to give him the full dose as I will be able to monitor closely tonight. I’m hoping it pushes him into lower numbers in the following days.
     
    Deb & Wink likes this.
  29. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    What do you think should I increase to 4 units or wait a couple more days ?
     
    Deb & Wink likes this.
  30. Hailey K

    Hailey K Member

    Joined:
    Feb 17, 2021
    Just wondering if things are looking okay on Toby’s spreadsheet ?
     

Share This Page