Finally see a decent nadir and we bounce. UGH.

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JenM

JenM

Member Since 2013
This is driving me angry(2)_cat !!!!

I've upped to 1.8u of ProZinc 2x/day. FINALLY see a decent nadir (109 @ +5, followed by a full meal) and apparently it causes a bounce as he's 457 the next morning. He ate a regular meal immediately after the 109, at his regularly scheduled meal time - so I can't imagine he could have ventured much lower with a meal in his belly and so close to mid-cycle... I'm SO baffled!

I'm trying 1.8u during the AM cycle and 1.6 at night, since he seems to stay lower in the evening, and the one 1.8 PM dose caused the bounce... but I'm not seeing anything LOW enough by doing this! What would you all suggest? I dont know how that 457 is anything but a bounce as he's not had anything that high at AMPS in awhile.

HELP ME!!! @-)
 
Going a bit less at night is OK, as many cats go lower at night.

Bounces just mean he's not used to it. He'll get there.
 
Do you suggest I stay with 1.8 then? We're generally not getting below 180ish for a nadir, if we even leave the 200s. I was thinking about 2u in the morning and 1.8 in the evening, but then we saw that bounce. I can't imagine he went anywhere near hypo territory, with 109 at +5, plus a full meal... but who knows for sure.

I almost feel like the ProZinc isn't going to cut it this time - like I should try Lantus or something... but I dont know. I LIKE ProZinc - and it's obviously working to SOME extent - I just hate seeing his numbers SO high for SO long. I feel like every time I raise the dose his numbers just raise accordingly so we're still in the same place. We haven't had more than a couple decent numbers for well over a month now.

I get paid later this week, so hoping to get him in for some bloodwork, just to make sure nothing else is going on.
 
He'll bouce until he doesn't.

Some folks have found that duration isn't quite long enough on ProZinc so they switch to a depot insulin.

I'd hang in with it. Another option is to try TID and see if more continuous insulin levels worked better. You'd take the total dail dose and divide by 3 (though you can slightly reduce overnight, as needed).
 
I think TID would work best for him, but I'm not sure I can DO it with my schedule. Best I could do would be 7am, 4pm & 10pm. It might work, if the 4 & 10 doses were smaller and the 7 larger maybe?? I dont know!

I'll try just sticking with the 1.8-2u for now and see how it goes. Hopefully get that bloodwork done ASAP too, just to rule out other issues. He ACTS fine, though isn't as playful as he was when in remission. I just worry with his numbers being so high for so long that he's going to get super sick again and I REALLY can't afford it right now. I've spent over 2 months pay on him and the dog since November. I can get insurance for the dog, but it would be pointless for him at this point - everything would be tied back to the "pre-existing" diabetes.

I was mostly just worried that the bounce meant he'd gone hypo on that dose... but if it was just because he isn't used to being in the 100 range... that makes me feel better (that IS what you're saying, right?).
 
Yes, that is what I'm saying. :smile:

That's the nice thing about ProZinc, it let's you adjust to what you see.

And yes, if you test on a day you can monitor, you might be able to try what you mentioned.
What you may find helpful is to visualize 3 wide U shapes of slightly different heights for the different doses and then line them up by number of hours of coverage so you can see where the overlap is and where you might need to check the most. I find graph paper works well for this.

The effect of 1 shot will be less, so the overlap is more likely to add up to where you want it to be. To help you really grasp what overlap does, you may find it helpful to read about the depot in Lantus and Levemir.
 
I'm still on the 1.8u dose, but I've started experimenting with giving his PM dose a little early, based on his +10 reading (which has been in the 300's, but goes to the high 300s or even 400+ if we wait till +12). I'll update the SS later, so sorry that the info isn't available at the moment. Gave it two hours early the first day and 1hr early yesterday - still feeding at normal time (so fed at +2 & +1 respectively). It SEEMS to really be helping. Since he surfs lower on his PM dose, his AMPS's haven't increased any by doing this, and it is preventing him from going too high at PMPS. We got a 311 this morning for AMPS, which is lower than we've been seeing for the most part. I'm hoping this might help us get regulated.

I'll try to get a curve in this weekend and think about upping his AM shot to 2u. Still not getting great nadirs, but I've not been able to test at the best times either. At least the numbers seem to be starting to come down a bit - which is a relief. Red and even pink scare me a bit with his DKA history.
 
:YMSIGH:

Wanted to start the 2u AM dose yesterday, but his AMPS was yellow, so I stuck with 1.8. Flat cycle. Then this morning, we're in the red (why? doesn't look like a bounce, just a high cycle??) so I went ahead with 2u. Dropped pretty fast first 3 hrs but I'm continuing our curve, so HOPEFULLY we see some green (good green) today.

I'm SO confused with how the insulin reacts in his body. Look at 7/17 & 7/18. Similar(ish) PMPS #'s, same dose... yet one day at +2, his # is 40pts higher than at PS, while the next day it's almost 50pts lower at +1. @-) It makes no sense! And on 7/18 at PM +9 he was at 373, but back down to 283 two hours later at AMPS.

Is this normal to see with ProZinc, when still working on finding the right dose? Or should I be considering that ProZinc might not be the insulin he needs to get regulated? I understand that FINDING the right dose takes trial and error... but I would expect the same dose to work at least KINDA the same on a day to day basis. It just seems like there is no predictability whatsoever in what any given dose is going to do. His "curve" looks more like a crazy rollercoaster.
 
Don't get too hung up on specific numbers - the glucometers aren't perfect measuring devices, just 'good enough' for home monitoring. The FDa allows meters to be sold which will read within 20% of what a lab would get. See my signature link Glucometer Notes for more details.
 
Dr. Lisa had a great post that addressed this issue. She said that the insulin shot is only one of the many variables you are looking at with a diabetic cat. The levels can be influenced by the stress or excitement a squirrel out of the window caused, or maybe pooping took a little longer than usual this am or you fed his favorite or least favorite food or he has a hairball that is bothering him. It is far from an exact science. That's why we say we are looking at trends and patterns. If 2 units takes him generally down to a nice nadir, then it is probably a good dose to try for that number next time. But you can't expect the same results the next time, just a trend.

The one I do find interesting is the 7/18 when he dropped after a higher +9. Wonder if there is a chance his pancreas woke up for a little while? Or, you know, maybe he had a satisfying poo between the two numbers. :mrgreen:
 
:lol: or maybe he pooped... :lol: Thanks for the chuckle!

So... we SAW GREEN!!!!!! :RAHCAT However, with these last couple lower cycles, we have also seen red at AMPS. I'm going to try to hang with the 2u doses (though I'm a nervous wreck at work, not being home to test) and see how it looks after a couple days. It'll be interesting to see if a combination of the 2u dose and playing with shot/feed times will help with the bounciness.

Currently, when I give his PM shot early, I'm not feeding till his regular time (6pm). No particular reason, other than it seems to give the insulin a little time to work, rather than spiking his BG right at shot time with a meal. But... since the AM cycle is looking ok on 2u... a more normal feeding routine might work for PM too. I COULD also tweak mornings and give his shot, then wait an hour to feed - and I might do that if I keep seeing this high numbers... but I dont know.

I understand the meters arent exact... but when he drops nearly 100pts from +9 to AMPS, it sure makes me wonder what the heck is going on. Or when it goes up instead of down. But... the stressors and such do make sense. Every few days my crazy cattle dog pup blows past me at the door, before the baby gate is up, and her favorite thing to do is plop down on kitty and nuzzle them to death. Kitties dont find this nearly as much fun as she does - so that could easily be a stressor right there. Of course they LOVE tormenting her THROUGH the gate - but it's all fun and games till someone forgets to latch the gate. :lol:

Disclaimer: she is in NO WAY aggressive toward them - she's just REALLY excited. Two of the cats play with her from the kitchen bar - one will even venture into the kitchen and sit on the step stool to play with her... but Tink usually keeps his distance if given the choice.
 
The cycle with the green looks very nicea as does last night's. Hard to know if the amps is a bounce or because the shot is later or a combination of both (I am assuming the amps is really +14?) maybe stick with two units and go back to 12/12 and see what happens? I know it's hard when you are not there. You leave food out for him? They are usually good about eating and bringing themselves up when they drop low.

If the food routine seems to be working in the am, I'd stick with it awhile. It's difficult to tell exactly what is working (or not)when you make several changes at once.
 
I can't leave food out for him - he's a vaccuum and consumes all available food when it's given. I also have 4 cats - ONE of which would be a candidate for free-feeding - the others are all vaccuums.

Tink DOES have a PetSafe5 and gets a meal at +5. And yes, AMPS is currently at +14. Depending on what his +10 looks like today, I might try to wait till true PMPS to dose him and see if that helps. I think TID dosing would be best for him, but I just can't do it with my schedule.

I'll stick with the 2u for a bit and see how it goes. Hoping to see more of yesterday's numbers!
 
Hi, I'm just wondering if you feed fancy feast? I'm asking because my Frog was doing great for a long while, and just this last couple of months his numbers have been 'going crazy' just like what you're describing. (Wondering if maybe they changed something...)
 
No, I feed Wellness. I did suspect the food, but WellPet has told me numerous times (I keep calling to see if the answer changes) that they've not changed their formula. Though someone else got a list of "as fed" and "dry matter" carb content for Wellness recipes, and they seem higher than the 4% shown on the "easy foods list" that's located on here somewhere (shows foods with 8% & lower). But... I haven't been able to wrap my brain around the carb calculations we use here - so I'm kinda "S-O-L" on that one. I did try feeding Weruva, which is only like 1% or 2% carbs to see if it made any difference, but it didn't seem to. And it's expensive enough that I'm not sure it would even be an option long-term anyway. Wellness is bad enough - the only reason I can feed it is because they have the big cans, but I'm still spending WAY more than I'd like to be on cat food.
 
There can be batch to batch variations because of the labeling - not less than, minimum X, maximum Y.

So they may not have 'changed' the formula, but the formula is not an exact ratio of items, it is whatever generates the most profit for the batch.
 
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