Douglas' ProZinc Journey

cocokittybrown

cocokittybrown

Member
Continuation of this thread: https://felinediabetes.com/FDMB/threads/douglas-prozinc-dosage-question.297876/

I think I am doing this message posting correctly?

Holding steady at 2.5 units of ProZinc, and he is still unregulated at 10 weeks in since diagnosis. Has high ketones, but has no other symptoms besides that.

Have two timed feeders to distribute his food throughout the day. Trying to figure out the schedule. A lot of food at shot time, and then 1.5 ounces +2 and 1.5 +4 and 1.5 oz +6. and then no food 2 hours before shot.

Trying to weigh him every week. He is holding steady at around 14 lbs. He is a big dude.
 
You did the posting correctly. Thank you. It is looking like he goes down into blue and then goes high for a couple of cycles and then gets into some blue again. Perhaps tomorrow he will come back down into blue. I have seen some cat’s numbers improve a lot after a dental procedure and some cat’s BG just come down a little. Every cat is different.
 
@Suzanne & Darcy

Today marks 7 days at exactly 2.5 units of Prozinc.

It has been almost 11 weeks (2 1/2 months) since diagnosis and being treated with Prozinc

From Libre2 report:
  • 3/16/25-3/22/25 (7 days) avg glucose: 318 mg/dL >> ketones range .7 to 1.4
  • 3/9/25 - 3/22/25: 313 mg/dL
  • 2/23/25-3/8/25: 289 mg/dL
  • 2/9/25-2/22/25: 282 mg/dL
  • 1/26/25-2/8/25: 318 mg/dL
The high ketones scare me. I have read the various articles about ketones and know the recommendations, but high ketones scare me because high ketones can develop into DKA, which is very dangerous.

I met with the vet on 3/18/25 and her plan as of that date is to continue to review weekly Libre reports and assess and to keep doing this for 1 more month and then reassess the overall plan.

If in one month, April 14, some possible changes to make: changing to another insulin, doing dental care, working with an internal medicine doctor. She wasn't very explicit with what the plan was to be, she just mentioned reassessing.

I am not sure why we are not changing something sooner, and why are we waiting another month. It has been 2 1/2 months already since diagnosis. Isn't this enough data and information to think about changing plans? I believe she wants to continue higher doses of Prozinc, at 7 day intervals and she is hoping to find the magic dose of Prozinc that will work. Looking at his data, it seems to me that the Prozinc is not lasting long enough. I don't have a medical background, so I am not really qualified. My interpretation of the data is that when his body does have a response (occasional good lowish BG numbers), then it is a short duration.

If I do a dose increase, I need to do it over the weekend. I am in an office during the week and not home and can't treat Douglas if he is hypo while I am in the office. My plan is to increase the dose by 0.25 units to 2.75 units tomorrow, 3/23/25. At least he will have 2 cycles with me being home able to monitor him.

Then send the doctor the libre report on Monday and inform her I increased the dose by .25 on Sunday and why, after letting him stay at 2.75 for 7 days.

If 2.75 seems to be safe, then I will continue him on this dose for 7 days, and then go up to 3.0 for 7 days and so on.

The vet did write the prescription for the Libre3 and I picked up a couple of them from the pharmacy. His current Libre2 has 8 more days left on it, but it doesn't transmit so I don't know how he is doing while I am at work. I may just leave it on until it expires, or I may remove it early and put on the Libre3. I am still thinking about this. I can always try to come home during the middle of the day from work and check on Douglas. My office is only 10 minutes away from where I live.

I will just hold the course and hope things improve and just monitor him and do the best I can.
 
Yes. He needs the dose increase. He isn’t getting very good duration. About the only thing I can think of to help get better duration (which mayor may not help in Douglas’ case because his body may not cooperate) is to keep most of his food consumption before +4. Normally, I would say before nadir but I might try stopping food (except LC testing treats) earlier. He’s only eating the FF classic pates, right?
 
cocokittybrown said:
this. I can always try to come home during the middle of the day from work and check on Douglas. My office is only 10 minutes away from where I live.
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This would be great if you could occasionally do this. Although if you have the Libre 3 set up then you may not need to unless he drops low and you need to come home.
 
Suzanne & Darcy said:
Yes. He needs the dose increase. He isn’t getting very good duration. About the only thing I can think of to help get better duration (which mayor may not help in Douglas’ case because his body may not cooperate) is to keep most of his food consumption before +4. Normally, I would say before nadir but I might try stopping food (except LC testing treats) earlier. He’s only eating the FF classic pates, right?
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Douglas is only getting Fancy Feast pates low carb (and sometimes Fancy Feast savory selects>>which is also low carb, but our other cat mostly eats that and Douglas will sometimes eat it). Douglas gets low carb treats at test time and treatment time. I have 2 automated feeders: one for AM and one for PM, so I don't have to keep resetting the times one one feeder. Most of his food is eaten around shot time. I cut off his food 2 hours prior to testing. I will give some additional thought on the amount of food and times to change the automated feeder.
 
Suzanne & Darcy said:
Yes. He needs the dose increase. He isn’t getting very good duration. About the only thing I can think of to help get better duration (which mayor may not help in Douglas’ case because his body may not cooperate) is to keep most of his food consumption before +4. Normally, I would say before nadir but I might try stopping food (except LC testing treats) earlier. He’s only eating the FF classic pates, right?
Click to expand...
I increased his dose to 2.75 units this morning and will be carefully watching him all day. The one and only time he was at 2.75, he got a really low nadir. Regarding the feedings, and times, I will need to give that some more thought as stated in the previous post. Thank you for mentioning this as an option and I will think this through some more.
 
cocokittybrown said:
Douglas is only getting Fancy Feast pates low carb (and sometimes Fancy Feast savory selects>>which is also low carb, but our other cat mostly eats that and Douglas will sometimes eat it). Douglas gets low carb treats at test time and treatment time. I have 2 automated feeders: one for AM and one for PM, so I don't have to keep resetting the times one one feeder. Most of his food is eaten around shot time. I cut off his food 2 hours prior to testing. I will give some additional thought on the amount of food and times to change the automated feeder.
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I think you are doing everything correctly. I don’t mean to say you are not. I am just trying to think of anything to help.
 
He’s doing a lot better on this 2.75 dose. I am very happy to see it! The numbers you are putting into the spreadsheet are the Contour numbers? I see in the remarks section some Libre numbers mentioned. I’m so glad you are proficient using the Contour so you can check the Libre. I really hope you are feeling a bit better about the chance to get him regulated. He is a little bouncy, but it looks like he won’t be the kind to stay in a bounce for too long (because they can last for 6 cycles! And we don’t want that!)
 
Thanks for checking on him. I feel like the 2.75 dose is better than the 2.5 dose. I've been putting the Libre2 numbers in the spreadsheet and will mark a C if it is the Contour. The libre2 low glucose alarms have been going off late night/early morning, but sometimes I question the accuracy of those low numbers. I am very comfortable with using the hand held meter and blood testing him, so if I am ever concerned, I will pull out my handheld meters. Douglas is such a chill guy and is so cooperative. He loves treats. I own several hand held meters: Relion, Contour Next, AlphaTrak3, and iPetPro. And I've used all of these meters, and have standardized on the ContourNext.

With the spreadsheet, I only capture the closest to the hour. I've attached a screenshot of the daily glucose curves for the past two weeks. When he does get in the lower ranges, it is only for a short amount of time and when I have double checked him with the BG meter, the BG numbers are always in the normal range. I know the Libre2 is only measuring interstitial glucose, and not blood glucose and there is a lag between the interstitial and the blood glucose. So maybe if I would have tested his BG a little earlier it would have been low.

Today I am changing to the Libre3, so I will be able to check his levels while I am at work during the week. I haven't been checking his blood glucose before shots lately, and have been trusting the Libre2 if it is highish number. However, if I am testing blood ketones, I will go ahead and test his blood glucose since he is already being poked. And if I am in doubt about the Libre, I will do a blood glucose check. It gives me some peace of mind to have the Libre and I am fortunate that I can afford this for him and we've figured out how to apply them ourselves, and he seems not to mind them too much. He doesn't really like the shirts that I put on him to keep him from bothering the sensor, but he tolerates it. He is such a good boy. I take his shirt off every once in awhile, supervised, so he can clean himself.

So tomorrow, Sun 3/29/25, marks 7 days he will have been on 2.75 units. At this point, my thoughts are leaving him on this dose for a little while longer. The doctor seems to like this dose. Basically, I have been deciding the dose without her approval. and providing her updates and the reports. She asked me to provide an updated report on Monday.
 

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@Suzanne & Darcy
I wanted to give you an update on Douglas and ask for your feedback on what I am doing, and my plan going forward.
Douglas had 2 hypo events last week. The one on 3/30/25 afternoon was long lasting and could have been related to him throwing up his dinner the night before. He did not exhibit any hypo symptoms, which I am thankful for. Before doing a "hypo protocol", I always monitor with BG meter, and it was low on the Contour. I gave him high carb food and maple syrup. I also consulted with the video vet. I reduced his dose to 2.5. Then on 4/3/25 evening, he had a very short hypo event. It wasn't as low as the one on the 30th, but I reduced the dose to 2.25 because he seems not to be eating his usual amount of food compared to when he was first diagnosed. He used to eat 6 oz FF classic pate pre-shot, and now he seems to only eat 3 oz. Then I provide food throughout the day with a feeder. Last week, I tested ketones 3x, and they were 0.4, which is great. Previously, when he was on a lower dose of glucose, his ketones were high.

My plan is to leave him on 2.25 for the next 7 days, and monitor his ketones a few times. I need to do a better job of tracking how much he eats. It is a challenge, because I have another cat. Douglas has regained his lost weight back. He is a big guy. He currently weighs 14 lbs. 3 oz. The doctor gave us a target weight of 14 lbs and 4 oz. At one time he was overweight, and we had to put him on a diet. And I found out that diet food is really high carb!

Plan going forward:
I am also thinking about looking for an internal medicine vet who has experience treating diabetic cats. I am going to contact my regular vet and see if they can make a recommendation. I don't know how much experience my current vet office has with treating feline diabetes, but I was told during the initial consultation if they couldn't get him regulated, then they'd refer me to an internal medicine doctor. I think it is now time to try that. Not sure if I will get better results, but I think it would be good to get a different perspective and maybe work with someone who has more experience with treating feline diabetes, especially with one who is not yet regulated.

By the way, we have been using the Freestyle Libre3 for a week now. I love it! It gives me a peace of mind when I am at the office or away from home. With the old Libre2, I couldn't look at his numbers while I was at work, and now I can! I am glad that the vet office is willing to work with me on some things that I am requesting.

In the last email to the vet's office (3/31) the doctor mentioned "I do not ask anyone to monitor their diabetic cat's blood sugar on a daily basis. In most cases we can make appropriate adjustments based on his weight, overall health status (happy and eating well is good), and periodic monitoring of fructosamine levels. I recommend we have a recheck after about 2 weeks of being on the 2.5 unit twice daily insulin dose."

I am working with two doctors at the vet practice, and that was from the "old school" doctor who seems to have a little different perspective from the younger doctor I also work with there. I am interpreting his message as saying that he wants me to bring Douglas in for a fructosamine test around mid April. I am thinking maybe that makes sense if I am working with a new internal medicine doctor, because they will want to see him and probably get some updated lab work done. I am trying to be mindful about taking good care of my boy and not needlessly stressing him out too. He is pretty chill, so going to the vet's office is stressful, but not as bad as for other cats I've known.

I like monitoring my cat's blood sugar on a daily basis, and I am glad he wasn't the first vet I worked with at the vet practice because he may have not recommended the libre. They aren't asking me to monitor the blood glucose, but I want to! And I have learned that it is really important to do so to keep my cat safe. Now that I know more about diabetes, I'd be very uncomfortable about NOT monitoring his BG daily! Especially prior to an injection!

Below are the results for his last test.

fructosamine results
12/31/24: 636
2/22/25: 494

Let me know if you have any feedback on what I am currently doing, or what I plan to do going forward.

Thanks!
 
You cannot rely on the Libre to tell you when BG is low. They are inaccurate in low numbers and must be manually checked with a human, handheld glucometer.
 
Normal blood glucose for a cat is between approximately 50 and 120 (and the 120 would be not that often.) Many times my non-diabetic cats are in the 40s and cats we have had go into remission see 40s as well. Anything 50 and above is an acceptable glucose number. You most definitely will not see any symptoms of hypoglycemia when your kitty is in the 50s since it’s a perfectly normal healthy glucose number. It does warrant careful monitoring when they are in the 50s because of the insulin which could potentially push them lower than that. So the 50 number is fpr safety’s sake. The approach to take would be (1) check BG with human glucometer; (2) give small amount of regular LC food - that being 10 percent and under. Recheck BG in 20-30 minutes to make sure numbers are stable or rising. (3). If numbers drop below 50, give HC and test in 15 minutes (4) If numbers stay above 50, give LC and test again in 30 minutes. (5) If HC is given because numbers did actually drop below 50, BG must be monitored for a full two hours after the last HC was given to make sure numbers will not drop back down again after HC wears off (it happens.)
 
I thought we had talked about the futility of doing Fructosamine tests to adjust doses? The fructosamine gives an average of BG over a couple of weeks. Your Libre can give you an average number. Averages are useless as we need to know how low a particular dose takes the cat to adjust the dose. I am sure you already know this by now. If you included all of Douglas’ highs and lows from the last few weeks, you would get a number, but it would not tell you how low he was going on a particular day on a particular dose. And the most important thing is how low he goes… but you already have seen that. Unless Douglas has multiple health conditions concurrently— things that are difficult to manage together— I would not waste my time or money on an IM vet. They specialize in managing multiple health problems, but are not necessarily feline diabetes specialists.
 
I think I forgot to mention about the dose. Yes, I am on board with the 2.25 unit dose being held for 7 days. He earned a reduction on April 3 when he dropped below 90 (according to SLGS Protocol anyway and taking the Libre at face value, which is all we can do right now.) So his new dose would be 2.25. So you did it correctly!

I really appreciate how you are trying so hard to do the absolute best for Douglas. You are really putting everything into taking care of him. I love that. I can tell how much you love him.
 
Suzanne & Darcy said:
I am confused. I don’t see a single low number on hso spreadsheet. There’s not one number under 50.
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For the Libre, the guidance from the Libre for cats and dogs FB support group is 80 is a low number and to start giving carbs at this number. And below 60 to act more aggressively, and use simple sugars such as maple syrup. Also to pay close attention to the arrows that are displayed along with the values.

With the Libre, I will get an audio alert anytime his numbers are below 80 (low) and when they hit 55 (urgent). When a value is displayed, you also see an arrow to indicate the trend. For example, an arrow straight down means Glucose falling quickly, decreasing 2 mg/dL/min or > 60 mg/dL in 30 minutes. When I see an Urgent alarm, I always use my contour blood glucose meter to check. The contour has lights to indicate ranges also, green, yellow and red. On March 30, when he was at 52 with an arrow pointing straight down, the contour was 65 and red. My concern was mostly the arrow pointing straight down saying is glucose was falling rapidly. The Libre measures the interstitial glucose and the contour measures the blood glucose and there is a time lag between the two. I did not want to wait to see his blood glucose hit 50, so I started acting when the contour showed a red indicator at 65. I likely erred on the side of caution, but his levels stayed low for an hour.

I also joined a Libre3 human facebook group so I can get the human perspective of what it feels like using the Libre3 and when they experience low numbers, since they can speak and Douglas can't. Many of them see false lows and they doublecheck with a BG meter and some are false lows (from compression from lying on it or bad monitor or something else) and if it is really low as verified with a BG meter, they feel very faint in the 50s.

For the 4/3 event, the contour said 74 when I checked, but the arrow was straight down on the libre again and I did not want to experience the same duration as 3/30 because it was in the middle of the night and needed sleep.

I understand that the monitors are calibrated differently for humans vs animals, and for humans approximately 58% of glucose is found in the plasma (liquid part of the blood) and for cats approximately 93% of the glucose if found in the plasma. So, I am not really sure how to translate all of this. I am still trying to educate myself and understand more, and I still have so much more to learn.

The Urgent low of 55 on the Libre monitor can't be disabled either, so I minimally will do a blood glucose check when I get one of these. I may be acting too aggressively and over reacting, but am afraid not too.
 
Suzanne & Darcy said:
You cannot rely on the Libre to tell you when BG is low. They are inaccurate in low numbers and must be manually checked with a human, handheld glucometer.
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I agree. I always double check the blood glucose with my handheld contour blood glucose meter when the Libre has an urgent Low. I have seen many false lows with the Libre2. Anytime I see an urgent low on the libre, I always double check with the contour blood glucose meter. I haven't seen any false lows with the Libre3 yet. I will always double check with a hand held blood glucose meter, regardless.
 
Suzanne & Darcy said:
Normal blood glucose for a cat is between approximately 50 and 120 (and the 120 would be not that often.) Many times my non-diabetic cats are in the 40s and cats we have had go into remission see 40s as well. Anything 50 and above is an acceptable glucose number. You most definitely will not see any symptoms of hypoglycemia when your kitty is in the 50s since it’s a perfectly normal healthy glucose number. It does warrant careful monitoring when they are in the 50s because of the insulin which could potentially push them lower than that. So the 50 number is fpr safety’s sake. The approach to take would be (1) check BG with human glucometer; (2) give small amount of regular LC food - that being 10 percent and under. Recheck BG in 20-30 minutes to make sure numbers are stable or rising. (3). If numbers drop below 50, give HC and test in 15 minutes (4) If numbers stay above 50, give LC and test again in 30 minutes. (5) If HC is given because numbers did actually drop below 50, BG must be monitored for a full two hours after the last HC was given to make sure numbers will not drop back down again after HC wears off (it happens.)
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For the 3/30 event, maybe I should have waited until the contour dropped lower before giving him syrup. For low numbers, I always start out feeding Douglas regular carb food, and then progress to high carb food and as a last resort the maple syrup. The down arrow on the Libre3 scares me the most and to know that the blood glucose monitor values will eventually catch up to the Libre3 numbers. I do recheck BG every 15 to 20 minutes. I am likely over reacting and erring on the side of caution, but I don't want to see him exhibit any hypo symptoms. And I understand some cats can be hypo and not show symptoms. I do have the hypo protocol info from the Feline Diabetes forum printed and attached to my refrigerator. And I do refer to it. It is difficult to stay calm and not over correct.
 
Suzanne & Darcy said:
I thought we had talked about the futility of doing Fructosamine tests to adjust doses? The fructosamine gives an average of BG over a couple of weeks. Your Libre can give you an average number. Averages are useless as we need to know how low a particular dose takes the cat to adjust the dose. I am sure you already know this by now. If you included all of Douglas’ highs and lows from the last few weeks, you would get a number, but it would not tell you how low he was going on a particular day on a particular dose. And the most important thing is how low he goes… but you already have seen that. Unless Douglas has multiple health conditions concurrently— things that are difficult to manage together— I would not waste my time or money on an IM vet. They specialize in managing multiple health problems, but are not necessarily feline diabetes specialists.
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That is true that an IM doctor may not have a lot of experience with feline diabetes. I think I am going to look around to see if there are any vets (regardless if IM or not) who has experience in treating feline diabetes. If I do reach out to an IM, I am going to make sure they have experience in treating feline diabetes. From the current vet, he only mentioned to "recheck" in two weeks and did not explicitly mention doing blood work. And I agree with you, that I am monitoring daily with the CGM and supplementing with BG monitors, so I don't think that is necessary. I also don't think it would be helpful to do a phone meeting either, because I don't expect to get any new information. The things that keep coming up in my mind is: 1. Dental. Are his dental issues the reason why we can't get his diabetes regulated? 2. maybe we need a different insulin. Would that help get him regulated? I don't think the current vet's office is going to be able to help with these questions, as I brought them up at least 2-3 times in the past and they really aren't getting discussed. Still thinking about what I want to do here. I feel like I need to look for a vet with experience treating felines diabetes, and whose treatment protocol makes sense and aligns to what I am learning about from the felines diabetes support groups. I haven't called around yet, but on my list of things to do.
 
Suzanne & Darcy said:
I think I forgot to mention about the dose. Yes, I am on board with the 2.25 unit dose being held for 7 days. He earned a reduction on April 3 when he dropped below 90 (according to SLGS Protocol anyway and taking the Libre at face value, which is all we can do right now.) So his new dose would be 2.25. So you did it correctly!

I really appreciate how you are trying so hard to do the absolute best for Douglas. You are really putting everything into taking care of him. I love that. I can tell how much you love him.
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On April 3, the ContourNext measured his BG at 74, so I double checked the low with the BG meter. I will keep him on 2.25 until Friday, which marks 7 days. Then I will re-evaluate the dose starting Saturday morning. His nadir got down to <= to 150 one time this week. On April 6, he got down to 108 but besides that, the Nadirs have been > 150. So if this trend continues today and tomorrow, then on Saturday 4/11, I may increase his dose to 2.5.

I really appreciate that you taking the time to review my messages and spreadsheets and provide your insight and guidance. It helps to get other input from experienced people. Douglas also appreciates it. He is my little soul kitty. I would do anything for him.
 
It does look like he is on track for an increase to 2.5, but we will see! Maybe he will surprise us. Right now, his nadirs are high enough to increase so if things stay the same then you can go ahead with it.
 
Suzanne & Darcy said:
It does look like he is on track for an increase to 2.5, but we will see! Maybe he will surprise us. Right now, his nadirs are high enough to increase so if things stay the same then you can go ahead with it.
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I did increase his dose to 2.5. I've been testing for ketones, and they have been low for this past 7 days. Now I am thinking about increasing his dose to 2.75 again. His high numbers concern me. His swings are so big. I've also started marking when my husband injects vs me. I mostly inject in the morning and him in the evening and it seems he has a better response in the evening. So I am trying to learn how to inject exactly like my husband, although I thought I was. And I may be doing so still. I am just scrutinizing and questioning everything.

I scheduled an appt with an internal medicine dr for May 6th. That was her earliest appt. I may try a different office to see someone sooner. I don't know if they will be more helpful vs regular vet, but it would be good to get another opinion. What we are currently doing doesn't seem be working as well as I would like. So we may need to try something new. I am thinking about maybe a different insulin. Some cats seem to have good results with Lantus. Are you familiar of any cases where cats had a better response with Lantus vs Prozinc? And what are your thoughts switching to 2.75 again? Likely on Saturday so we can watch him more closely. The Libre3 has been great, because I do monitor him while I am at work and it makes me feel better leaving him during the day, because I know I can come home for a low number if I need to.

He seems to be doing well besides his high numbers. He his eating well and normal activity levels for a 10 year old. I am very grateful for all of that, and it helps me from getting freaked out too much about some of his high numbers. And he is currently lying on my arms helping me write this. He is so helpful when I am at my computer.
 
I’m glad you increased to 2.75. He needs it. What does 2.5 m mean (what is the m for?)

I look forward to seeing his numbers on the 2.75 dose so please update the spreadsheet if you can.
 
About the way you shoot and the way your husband shoots the insulin: I doubt if you are doing anything wrong or differently. Many (if not most) cats drop into lower BG at night. It’s a very common phenomenon. That is one reason we urge people to test not only in the daytime but also at night (we need to know the nighttime nadirs as well as the daytime nadirs to make correct dosing decisions.) Fortunately for you, the Libre tracks that for you.
 
I have seen some cats do better on Lantus than ProZinc, while many cats do well on ProZinc.

For now, I think we need to be vigilant about increasing the dose until he gets nadirs in greens and lower blues more consistently. Make sure you are not giving him food past about +6.)

April 13 puzzles me. It say Libre said lo at 79? All Libre “lo” should be checked with a regular handheld glucometer. 79 is much too high to give HC food. Only LC food should be given at that number and then test again with the handheld glucometer in about 30 minutes if you are concerned. Also, I doubt it the Libre says 79 that the Contour would have said 79.

Also, I don’t see a 79 anywhere on the spreadsheet. It’s hard to make sense of the spreadsheet unless every single BG reading is listed in the cells for the appropriate hour and indicates a C next to any Contour readings.
 
Before I switched insulin, I would get his teeth taken care of. The inflammation from his teeth can make him more insulin resistant.
 
cocokittybrown said:
the Libre, the guidance from the Libre for cats and dogs FB support group is 80 is a low number and to start giving carbs at this number. And below 60 to act more aggressively, and use simple sugars such as maple syrup. Also to pay close attention to the arrows that are displayed along with the values
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I know that the Libre group says this, but don’t rely on the Libre to begin with (regarding low numbers). They are not measuring blood glucose anyway. We need to know blood glucose in real time and so — before giving HC food — you need to check the BG with a handheld glucometer. The only way to know if you should use HC food is to use your contour meter to check. If BG is at 50, use HC. If BG is at above 50 but you feel like it’s too early in the cycle for a lower green then use Medium Carb (11-14%) in a very small amount. Using HC when the cat is in normal BG range for a cat (50-120) is not the correct thing to do and hijacks a good cycle, keeps the cats pancreas from having the chance to heal, as well as keeps the cats from having the chance to get used to normal BG numbers again. This is very important. It took a long time for Douglas to become diabetic and he won’t become regulated immediately. His body needs to spend as much time as possible in the 50-120 range for his body to readjust to normal cat BG numbers. Remember, normal, healthy BG numbers for a cat are 50-120 max. And cats spend almost all their time in the green numbers (below 100) with just occasional numbers above 100 but not more than 120.
 
Suzanne & Darcy said:
It does look like he is on track for an increase to 2.5, but we will see! Maybe he will surprise us. Right now, his nadirs are high enough to increase so if things stay the same then you can go ahead with it.
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I did increase the dose but I waited until Saturday morning so I could be home with him to monitor him. I am off work on the weekends.
 
Suzanne & Darcy said:
About the way you shoot and the way your husband shoots the insulin: I doubt if you are doing anything wrong or differently. Many (if not most) cats drop into lower BG at night. It’s a very common phenomenon. That is one reason we urge people to test not only in the daytime but also at night (we need to know the nighttime nadirs as well as the daytime nadirs to make correct dosing decisions.) Fortunately for you, the Libre tracks that for you.
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I've watched my husband give doses, and Douglas seems to flinch less than when I do it. We always give him churu while injecting his insulin, so that keeps him occupied enough to give him the dose.
 
cocokittybrown said:
I've watched my husband give doses, and Douglas seems to flinch less than when I do it. We always give him churu while injecting his insulin, so that keeps him occupied enough to give him the dose.
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How long are the needles you are using? Even if he flinches less, I doubt if it’s making a difference in hos numbers. What I see on his spreadsheet (and I look at an awful lot of spreadsheets) is the normal phenomenon of dropping lower at night. But I do feel sorry that he is flinching at all, poor boy. You may want to consider switching to the U-100 syringes and using the conversion chart. It makes small dose changes a little easier and the needles are smaller. By the way, you had asked about Lantus. Lantus can sting when injected. Some cats react to it and some don’t.
 
Suzanne & Darcy said:
I have seen some cats do better on Lantus than ProZinc, while many cats do well on ProZinc.

For now, I think we need to be vigilant about increasing the dose until he gets nadirs in greens and lower blues more consistently. Make sure you are not giving him food past about +6.)

April 13 puzzles me. It say Libre said lo at 79? All Libre “lo” should be checked with a regular handheld glucometer. 79 is much too high to give HC food. Only LC food should be given at that number and then test again with the handheld glucometer in about 30 minutes if you are concerned. Also, I doubt it the Libre says 79 that the Contour would have said 79.

Also, I don’t see a 79 anywhere on the spreadsheet. It’s hard to make sense of the spreadsheet unless every single BG reading is listed in the cells for the appropriate hour and indicates a C next to any Contour readings.
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Thank you for looking at the spreadsheet. I can see how it can be confusing for anyone else besides me, sorry about that.

For the spreadsheet, if there are any Contour numbers, then it will only be for pre-shot and have C beside it.

From reviewing the L3 csv raw data, this is how I have determined the L3 to work.

The L3 acquires data every minute, however, it only plots data every 5 minutes. It does some sort of averaging on the last 5 data points to smooth out any noise or anomalies, before it plots the data at the 5 minute mark. 12 total "averaged" glucose values are plotted on the L3 graph every hour. I only record the data from the top of the hour from the L3 onto the spreadsheet, and this is from the "averaged" data points.

Although those 1-minute data points don't get plotted, they may trigger an alarm and get logged in the "alarms logbook" for the L3 app.

On April 13, the L3 measured a 79 value and the alarm went off, and woke me up. I was tired and did not check the BG with the Contour, and just gave HC food. Then I saw that the data disappeared from the graph, but got logged in the "Log" file. This is very different behavior vs the Libre2. So a I am now figuring all of this out. I put this 79 value onto the remarks section just to capture the behavior, and to record the HC food I gave him. I now better understand how the L3 works.

In the future, I will double check "low" Libre3 values with the Contour. And if at lower than expected numbers and if I am concerned, I will feed LC food (and maybe just a churu). I sometimes over react and panic, and it is hard not to do when I am woken up in the middle of the night.
 
upload_2025-4-19_13-13-54.jpeg
29 Gauge and 1/2 inch long. These are my U-40s. The 29 gauge is larger than the 31 gauge of the U-100s. These 5/16 inch length of the U-40s also is a little shorter than the U-40’s half inch.
 

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cocokittybrown said:
Thank you for looking at the spreadsheet. I can see how it can be confusing for anyone else besides me, sorry about that.

For the spreadsheet, if there are any Contour numbers, then it will only be for pre-shot and have C beside it.

From reviewing the L3 csv raw data, this is how I have determined the L3 to work.

The L3 acquires data every minute, however, it only plots data every 5 minutes. It does some sort of averaging on the last 5 data points to smooth out any noise or anomalies, before it plots the data at the 5 minute mark. 12 total "averaged" glucose values are plotted on the L3 graph every hour. I only record the data from the top of the hour from the L3 onto the spreadsheet, and this is from the "averaged" data points.

Although those 1-minute data points don't get plotted, they may trigger an alarm and get logged in the "alarms logbook" for the L3 app.

On April 13, the L3 measured a 79 value and the alarm went off, and woke me up. I was tired and did not check the BG with the Contour, and just gave HC food. Then I saw that the data disappeared from the graph, but got logged in the "Log" file. This is very different behavior vs the Libre2. So a I am now figuring all of this out. I put this 79 value onto the remarks section just to capture the behavior, and to record the HC food I gave him. I now better understand how the L3 works.

In the future, I will double check "low" Libre3 values with the Contour. And if at lower than expected numbers and if I am concerned, I will feed LC food (and maybe just a churu). I sometimes over react and panic, and it is hard not to do when I am woken up in the middle of the night.
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That is so true (about being awakened by an alarm in the middle of the night.) Do you know how many carbs are in a Churu? I don’t recall as it’s been a long time since I’ve looked it up.
 
Suzanne & Darcy said:
I know that the Libre group says this, but don’t rely on the Libre to begin with (regarding low numbers). They are not measuring blood glucose anyway. We need to know blood glucose in real time and so — before giving HC food — you need to check the BG with a handheld glucometer. The only way to know if you should use HC food is to use your contour meter to check. If BG is at 50, use HC. If BG is at above 50 but you feel like it’s too early in the cycle for a lower green then use Medium Carb (11-14%) in a very small amount. Using HC when the cat is in normal BG range for a cat (50-120) is not the correct thing to do and hijacks a good cycle, keeps the cats pancreas from having the chance to heal, as well as keeps the cats from having the chance to get used to normal BG numbers again. This is very important. It took a long time for Douglas to become diabetic and he won’t become regulated immediately. His body needs to spend as much time as possible in the 50-120 range for his body to readjust to normal cat BG numbers. Remember, normal, healthy BG numbers for a cat are 50-120 max. And cats spend almost all their time in the green numbers (below 100) with just occasional numbers above 100 but not more than 120.
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Thank you for this advice and reminders. I tend to panic react when I see any low numbers. I will check with the Contour before giving him HC in the future. In the past, the lowest reading I read on the contour was 65 and it was color coded red, so that freaked me out. It has yellow for "high", green for "normal" and red for "low". I will try really hard not to overreact and let the Contour get down to 50 before doing the hypo protocol.
 
Suzanne & Darcy said:
Before I switched insulin, I would get his teeth taken care of. The inflammation from his teeth can make him more insulin resistant.
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Our regular vets did not want to do any dental until they felt his diabetes are regulated. We will keep trying for a few more weeks with the ProZinc. We have an appt with the IM on May 6th, that is her earliest appt. Maybe he will be better regulated by then. Seeing the IM at least gives us an opportunity to get a 3rd opinion.
 
Suzanne & Darcy said:
How long are the needles you are using? Even if he flinches less, I doubt if it’s making a difference in hos numbers. What I see on his spreadsheet (and I look at an awful lot of spreadsheets) is the normal phenomenon of dropping lower at night. But I do feel sorry that he is flinching at all, poor boy. You may want to consider switching to the U-100 syringes and using the conversion chart. It makes small dose changes a little easier and the needles are smaller. By the way, you had asked about Lantus. Lantus can sting when injected. Some cats react to it and some don’t.
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Suzanne & Darcy said:
View attachment 7362529 Gauge and 1/2 inch long. These are my U-40s. The 29 gauge is larger than the 31 gauge of the U-100s. These 5/16 inch length of the U-40s also is a little shorter than the U-40’s half inch.
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Suzanne & Darcy said:
View attachment 7362529 Gauge and 1/2 inch long. These are my U-40s. The 29 gauge is larger than the 31 gauge of the U-100s. These 5/16 inch length of the U-40s also is a little shorter than the U-40’s half inch.
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I use the same syringes, except mine are the 3/10cc instead.
Suzanne & Darcy said:
View attachment 7362529 Gauge and 1/2 inch long. These are my U-40s. The 29 gauge is larger than the 31 gauge of the U-100s. These 5/16 inch length of the U-40s also is a little shorter than the U-40’s half inch.
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I use the same syringes except they are 3/10 cc volume.
 
cocokittybrown said:
I use the same syringes, except mine are the 3/10cc instead.

I use the same syringes except they are 3/10 cc volume.
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I also have some the PetTest U40 31 gauge needles. I can try them also. Most of the time, he doesn't notice me injecting him with the other syringes. My husband seems to be better at doing it though.
 

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cocokittybrown said:
Our regular vets did not want to do any dental until they felt his diabetes are regulated. We will keep trying for a few more weeks with the ProZinc. We have an appt with the IM on May 6th, that is her earliest appt. Maybe he will be better regulated by then. Seeing the IM at least gives us an opportunity to get a 3rd opinion.
Click to expand...
A lot of vets say this. In fact, almost every single vet I know from people on this Board says that same thing. The irony is that as long as the cat has inflammation in the mouth/teeth/gingiva it makes them very hard to regulate. My own vet said the same thing. She did not want to do a dental until he was “well-regulated.” I finally managed (months later) to get her to do his teeth at the same time we had his feeding tube removed. He had to have a feeding tube after a severe DKA from being unregulated and when he got an infection, the combination of unregulated BG and the infection sent him into a very serious DKA.
 
Suzanne & Darcy said:
Good, so they’re already the smaller gauge. I would try those 31 g needles for Douglas.

Do they have the half unit markings. It’s hard to tell from the photo.
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Yes, these have half unit markings on them. I haven't used these syringes in awhile, but I can try these again to see if he reacts less to them. My husband likes the longer needles and Douglas seems okay with them when he is giving the injection.
 
cocokittybrown said:
Yes, these have half unit markings on them. I haven't used these syringes in awhile, but I can try these again to see if he reacts less to them. My husband likes the longer needles and Douglas seems okay with them when he is giving the injection.
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The longer needles are okay as long as you don’t inject into the muscle. That can send them really low in BG. As long as he’s injecting sort of parallel to or up into the “tent” of skin that you get when you lift Douglas’ skin to inject, it should be okay.
 
Suzanne & Darcy said:
That is so true (about being awakened by an alarm in the middle of the night.) Do you know how many carbs are in a Churu? I don’t recall as it’s been a long time since I’ve looked it up.
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The Churus have tapioca starch in them. I was under the impression that they had only 2.5% carbs and are mostly water (92%). I was under the impression that they had minimal impact. I can stop giving them to him. I tried the Tiki meat tube this morning, because I they don't have tapioca. I have also been occasionally giving him fancy feast savory selects because the other cat eats that sometimes. Those are supposed to be almost 0 carbs. Besides that, he gets freeze dried meat treats. Maybe I will try switching to Tiki treats. The meat tubes really keeps him focused when getting an insulin injection and he looks forward to the meat tube so much, he hops up on the counter when it is injection time. And that is after he just got done eating his fancy feast.
 
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