Frodo advice pls

Hi!! So I’m looking for some advice, here’s link to my old post which I kinda updated today
Thank you

https://felinediabetes.com/FDMB/threads/frodo-new-member.250342/

 

Hi Paulina! Been awhile since you posted good to see you start a new thread with a new Subject line. The link to your previous post is perfect too.

All that being said, Yes, I think you could go back up to 2, but there were also times when you should have reduced the dose. On 5/9/21 he dropped below 2.8 so he "earned" a reduction from 2.75 to 2.5 (which you took so that's good) but then over the next several cycles, he dropped below 2.8 again and you should have reduced to 2.25 on 7/9/21

On 12/9 and 19/9 he also dropped below 2.8 so should have earned reductions on those days but none were taken until he dropped again on 25/9

Then, you reduced the dose 3 times (from 2.25 to 1.75) when he really didn't earn them!

The way this whole thing works is when they drop below 2.8, they "earn" a reduction and you should almost always reduce by .25 at the next shot and hold that lower dose for at least 6 cycles or more to see how they do on the new, lower dose.

Also, when you reduce depends on the dosing method you decide on. Most new members use the Start Low, Go Slow method which means you'd reduce when he drops below 5! On the more aggressive Modified Prozinc Method (which you test enough to do if you want), reductions are earned when they drop below 2.8.

You should read through the ProZinc Dosing Methods and decide which one you want to use and put it into your "Signature". If you choose MPM and it's not for you, you can always go back to SLGS and vise versa so you're not "locked in".

There's a lot of nuance in diabetes treatment and it takes experience in reading spreadsheets to know when to reduce, when to hold and when to increase. If you'll try posting daily, it'll really help.

You don't necessarily have to say much. Just something like "Frodo seems to be doing OK today but checking in in case I'm missing something" is more than enough

 

Looking again, I think I'd hold the 1.75 for a few more days. On Oct 2 and 3rd, he dropped close to 90 so I'd hold the 1.75 for 7 days....so until Oct 9th/10th (unless he drops below 90 (5) again)

If you decide to go with MPM, then yes, the 2U dose would be appropriate.

 

Hi! Quick reply. Im updated frodos Numbers and would love if someone can have a look at them. Just to let u know i did 2u as it was past his shot time when i got advice from Chris to stay with 1.75. So im doing 2u and using MPM instead of slgs, i read about MPM but it’s a lot for me so im gonna need HELP here. Thank you all

 

I'll tag
@Chris & China (GA)
For you

 

Thank You

 

Your welcome, going to tag
@JanetNJ
She is a prozinc user

If you are going to go with MPM you should add to your signature switched to MPM and the date, also on your spreadsheet you didn't put SLGS up at the top, you can put that and then put MPM and the date so members know

 

When you want to tag a member that might have helped you in the past
You would do this after your last word ship a space then @the first couple of letters of the person you want to tag, then you will see some members names tap on the one you want
I'll tag you to show you @Paulina

 

Done!! Also added his sugar reading +4 after evening shot.

 

I hope you fed him. That's a pretty big drop. Sorry I wasn't around earlier but if you see a big drop like that, it's a good idea to plan on testing at least 1 more time to make sure he isn't still dropping.

 

@Chris & China (GA) thanks Chris, did you see she switched to MPM?

 

I would definitely post if you don't understand something when following MPM ,
it's a lot to remember Good luck with the new dosing method

 

Yes, I read her comment and saw she'd changed her signature.

She tests more than enough to do MPM and hopefully it'll help get Frodo spending more time in better numbers.

 

Hi! Thank You for ur replies. So I did 2u this morning too. And should I keep going with it or change it this evening? I would hold the dose till tomorow anyways as he has the vet appointment to check his teeth. What do u think?

 

@Chris & China (GA)

 

@Chris & China (GA) hi! U there ?

 

Please update your spreadsheet with today's dose and numbers.

With MPM, you could increase. The basic instructions are to hold the dose for 3 - 6 cycles. You're seeing lower nadirs at night and some bouncing by the AM cycle. You do have room to increase but it's fine if you want to wait until after your vet visit.

 

just back home-on my way to the computer

 

DONE! If u think its Ok to hold the same dose i would do that as tomorrow he will be in stress anyways because of the car trip and vet visit so I prefer to wait till tues maybe.

 

If you look at the MPM instructions, you hold the dose up to 6 cycles. With any dosing methods, if life is intervening, you may need to hold the dose a bit longer. It's your decision. You could always raise the dose at PMPS tomorrow.

 

Yes actually I can do that too. Will check his sugars tomorrow and update them and then decide. thank You

 

What's the vet visit for?

 

Hi Chris! I have to check his teeth and also I think urine test too. Maybe I’m wrong but I think it’s more smelly last few days…

 

So the vet said xray tomorrow morning and urine sample will be taken too. So half the dose of insulin today evening and no insulin tomorrow morning. He also suggested changing the insulin to glargine which is Lantus I think am I right? But he said first we gonna check the teeth as he think it’s a root that bothers my kitty. Also I showed him the spreadsheet (And can u believe it he said I’m the only person to do that in his clinic - that’s how bad it is if no one else do that) and looking in the numbers he thought checking for acromegaly would be good idea. Is that really necessary?? Like Frodo is not that bad yet isn’t he? Or is the vet right? It’s very expensive test so pls let me know what u think.
thank you

 

Hi again. @Chris & China (GA) @JanetNJ @Diane Tyler's Mom. So Frodo had extractions done again!! (last one was just back in the end od August) he has that tooth resorption thing so no surprise here and urine sample didnt show anything No ketones etc which is good. I updated his numbers - I hold the same dose to see how he gonna be after the extractions. I think according to MPM I should increase by 0.25? Pls see my previous comment also about changing the type of insulin recommended by vet.

 

No, it's not necessary at this time. We don't recommend it until a cat has gone to over 6U and Frodo is nowhere near that. Just say "no" but you'll keep it in mind.

Yes, Glargine is the generic name. Brand names are Lantus, Basaglar, Semglee and Optisulin.

I think you could do either....hold the 2U dose a few more cycles to see if the dental cleaning is going to improve his numbers fairly soon or go ahead and go up to 2.25. My cat? I'd probably go up and just keep a close eye on the numbers.

Again, up to you but if Frodo has been on ProZinc for 6 months or more, I think it would be a good idea to try a different insulin. Not all insulins work well in all cats. He may do better on the Lantus but if you do change, you're going to have to get used to a different way of thinking since Lantus is a depot insulin and ProZinc is not.

 

Thank you for a quick reply Chris. I’m gonna do 2.25 u in the morning then. I’m going back for a check up this week to see how his gums healed and then I’m gonna discuss changing insulin etc not even sure what’s the price of it here.
I didn’t ask for acromegaly test while he was at the vet office as couldn’t afford it anyways because of the costs of dental etc.

 

Definitly no need for an acro test. We don't suggest that until they hit around 6 units.... And your cat is showing obvious response to 2 units. Weird the vet would suggest that.

 

Hi again. Just a quick update i did 2u not 2.25 as his Numbers were bit lower in the evening and in the morning also my Kids got sick and we had pretty nasty night and day so didnt want to change anything just in case I have to go with them to the doctor etc. and would be not home and he would go low etc
I will do 2.25 tomorrow morning then?
p.s. forgot to tag u - @Chris & China (GA) @JanetNJ @Diane Tyler's Mom thanks!

 

Perfectly good reason to wait.

Sounds like a plan....as long as everybody is feeling better!

 

Thanks Chris. I’m gonna try to have some sleep now but I have a look in the morning before shot if anybody replied anything else, he was 7.8 at +6 (like an hour ago). Thanks again

 

Hi so we r the third day on 2.25 and he seems to be bit higher again on preshots times but in greens around midnight What should I do? Keep the dose? thanks

 

Yes, hold the dose

Wonder if it would help to try to feed him some slightly higher foods early in the cycle to stop those huge drops

 

Hi Chris. Thank you. Yes i think i have to try that also he was quite low this morning also two days ago I feed him around 3pm in the afternoon which I usually don’t do and he wasn’t that high in the evening so hmm a bit mistery he is as before it worked for him if I did that 1/3can at shot time then 1/3 +1, 1/3 +2 and then 1/2 at around +5 and nothing until shot time in the evening.

 

Hi @Chris & China (GA) @JanetNJ @Diane Tyler's Mom and everyone else who might see my post. So it has been a long while and I’m sorry about that but we r all sick again since my last post (when my kids got sick) I was literally trying to survive just day by day, even now I’m not back to normal it’s just first day that I don’t feel that crappy and have energy to write something longer.
I updated Frodo’s numbers and just wondering what I should do. I was in touch with the vet as I had to drop Frodo off last week so they could check how his gums are healing after the extractions. they said it’s still bit reddish but otherwise looking good. I was asked about what’s the procedure is when changing the insulin as we gonna change to lantus next week or so as that’s when our prozinc bottle gonna be empty….

 

You have a very bouncy kitty. 2.8 is the very bottom of normal. You may find a reduction in your near future. It would be fine to reduce to 2 now if you want to see if that evens out some of the bouncing.

 

Yes he is bouncy I try to feed him bit more carbsy food but it’s not always helping. I’ll try 2u this evening and thank you for ur input

 

Hi everyone. @Chris & China (GA) @JanetNJ @Diane Tyler's Mom. I know Chris is sick so No worries if she wont see my message. Hope U feel better Real soon Chris
so a quick update - Frodo was changed to Lantus few days ago. Vet recommended 2.3u. I’m doing a curve today he’s quite “green” so I was wondering what my next step is? Pls let me know. Thanks a mill

 

He was in light green so earned a reduction

 

tráthnóna maith – great day to do a curve. glad you caught the green numbers. frodo's new dose should be 2.0 units.

if you are concerned about the rest of this cycle, you can feed small amounts of low carb food. you want to keep him "surfing" the greens as long as possible to get his body used to green numbers.

 

Thank u for a quick reply Just checked and he is blue now 5.8 (two hours before his evening shot at 7.30pm) so 2 u then this evening

 

Your spreadsheet still says Lantus.
Also, I want to make sure that when you switched from Prozinc to Lantus, you also switched from U40 syringes to U100 syringes. (I apologize if you've said this before – I'm not online as much as I used to be.)

 

We switched to Lantus from Prozinc so I did the empty line and add a note there. Is that ok? Yes I did switched to different syringes. Thank you for the concern. I appreciate it a lot as there are things I don’t know so I could easily make a mistake here as I might have missed it so thank you

 

Grand.