Gizmo - dosing difficulty

WYMoreta

WYMoreta

Member Since 2020
@Deb & Wink & @JanetNJ

Here are my 2 previous posts:

Hello - Gizmo and I are new to the forum

Trying to figure out dosing for Gizmo


We kept the dose at 1.25 for a week, but the morning numbers seemed high (as did the the evening numbers, just not so much). We tried a jump to 1.5 but that may be too much. I think we're dialing back to 1.4 now. Thoughts?

Also, I have a couple of questions:

Fancy Feast Chicken pate has been difficult to get enough of right now, so I've been alternating it with other fancy feast pates (whitefish, salmon (although that doesn't appear to agree with her), turkey and giblets, tender beef feast). I've read Dr. Pierson's paper the cat food and amount of fat/protein/carbs in each. Could some of Gizmo's fluctuations be because of the 1-2% difference in carbs? Should I feed her all one kind of food (i.e. turkey and giblets) until it's all gone and then switch to the next pate? I didn't think that small of a difference in carbs would matter that much, but perhaps it does.

How much could a new bottle of prozinc cause her numbers to differ?



Thanks so much!
 
WYMoreta said:
Could some of Gizmo's fluctuations be because of the 1-2% difference in carbs? Should I feed her all one kind of food (i.e. turkey and giblets) until it's all gone and then switch to the next pate?
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Not likely the minor difference in carb levels between one flavor of FF and another could cause those fluctuations in the BG levels. All those FF pates are pretty close in carb percentages, and shouldn't make a difference. Cats like variety, so it's good to have different flavors for your cat. But I wouldn't go so far as to feed a single flavor for a week or two. But that's me.

I fed Wink all the different flavors of Fancy Feast and he was fine with them.

A new bottle of Prozinc could make a difference, if your current bottle has been open for more than a few months. Prozinc does degrade after it has been open, with the passage of time.

The lines on the barrels of the insulin needles are not marked exactly the same from batch to batch, or even from syringe to syringe in the same batch or box. That could make a bit of a difference in drawing up the dose.

It's possible you could have a small air bubble in the syringe, so that could make a difference too. Try your best to be as consistent as you can in measuring the dose.

The most likely reason for the variation in the BG levels is that you can't control all the factors that go into the BG levels. Sleeping more or less than normal, playing more or less than usual, being stressed if your cat sees another animal in their territory outside, compensatory hormones causing bouncing, etc.

You just have to try to be consistent and remember this is a marathon not a sprint.
 
I like the 1.5 dose. If you get a little low of a preshot, stall without feeding for up to an hour. If it is going back up over 200, shoot the reg amount.


Any of the ff classic flavors are fine to feed.
 
@JanetNJ & @Deb & Wink,

Gizmo still seems to be all over the map. I'm leaning towards just a dose of 1.25 rather than 1.5. Her numbers of 82 on 1/30 worried me a bit. I can't figure out how/why she did this.

Thanks!

Angela
 
@JanetNJ & @Deb & Wink,

Gizmo is continuing to defy settling on a normal dose. I have read about some of the more advanced methods (specifically the 11/13 method). Thoughts about what I /should/ have done differently over the past few weeks, and what I might try now?

Thanks,

Angela
 
I think you are lowering your dose too much in the evening.

You might try lowering the am dose back to 1 so the pm preshot and am shot are more equal. Then you will feel more confident shooting 1 am and pm.
 
In January (1/16-1/22) we kept the dosage at 1.25. Mostly Gizmo was in the yellows, but pinks weren't uncommon, and there was a single blue. After that we tried to go to 1.4, saw some low numbers in the mornings (130s). Went back to 1.25 saw lots of pinks and yellows (~2/16-2/22), then back to 1.4. Now we are seeing okay numbers in the morning (mostly... sometime we have to stall there to), but afternoon dosages have been moved and/or been token doses. This darned cat just won't be easy to dose. On 2/28 we took several measurements and that implied nadir was +6.

Any advice?

Also, I read about the 11/13 schedule, and it wasn't clear to me if the food & shot together moved by an hour, or just the shot.
 
If you have a day off coming up soon, you might want to run a full curve. Testing from one pre-shot to the next, every 2 hours for a total of 12 hours.

I think you need to learn to shoot those lower pre-shot numbers, and not reduce the dose so much. Looks to me like everytime you do that token dose for the PM cycle, because of the low pre-shot BG, that Gizmo shoots back up really high for the next morning (AM) pre-shot time.
"Shoot low to stay low."

The next time you think of doing a reduced dose because of a low pre-shot, you should try to get some tests later in the cycle. My recommendations is to get at least 2-3 spaced sometime in the middle of the cycle. The +5 to +7 hour time frame. You might need to set an alarm to wake you up to do that.

WYMoreta said:
Also, I read about the 11/13 schedule, and it wasn't clear to me if the food & shot together moved by an hour, or just the shot.
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Both. Shot of insulin and food are both moved, so they are 11 hours one cycle, and 13 hours the next cycle.
People that have odd work schedules, that don't allow them to use the normal standard 12/12 hour schedule might have to use the 11/13 schedule instead.

Anything different happen since 3/3? That appears to be the time when you started to get the low PM pre-shot tests, and did the reduced doses, the token doses.
 
@Deb & Wink,

That's probably when the weather started to get nice in our area. Gizmo started going out on our deck. I didn't think she was getting much more activity, but perhaps she was?

Thanks for the info on 11/13.

Angela
 
@Deb & Wink & @JanetNJ


I finally had a chance to run a full curve when Gizmo had been "normal" for a day and I didn't have any token doses the day before.

How low can she be and still get a normal dose? We feed her in the morning, at noon, and in the evening. She's not allowed to free feed because she's already overweight, and I want her to be willing to eat right before her shots.

Is it normal for a curve to vary this much? (yes, I know that ECID, but you will recognize whether or not this is just a case of ECID, or if perhaps a different type of insulin or dosage is what's needed).

I was reading the felinediabites.com website page "what is feline diabetes" (probably for the 8th time), and I finally comprehended that "Manufacturers of veterinary insulins know the profile of their insulin for cats, and this information is packaged in every carton of insulin sold to vets." I do have the insert that comes with the vial of Prozinc, and I've read it, but I don't see the information I was expecting (i.e. typical nadir time, onset time, duration, action profile). I tried google and that didn't get me what I wanted either. Is that available on FDMB and I've just missed it (or since I am trying to understand Gizmo's diabetes, Sherlock and Cephas' hyperthyroidism (due to be treated with I-131 treatment 4/13), and the possibility that the hyperthyroidism has been masking CKD, that I've read it but not comprehended it).


Thanks for all your patience and support.
 
WYMoreta said:
@Deb & Wink & @JanetNJ


I finally had a chance to run a full curve when Gizmo had been "normal" for a day and I didn't have any token doses the day before.

How low can she be and still get a normal dose? We feed her in the morning, at noon, and in the evening. She's not allowed to free feed because she's already overweight, and I want her to be willing to eat right before her shots.

Is it normal for a curve to vary this much? (yes, I know that ECID, but you will recognize whether or not this is just a case of ECID, or if perhaps a different type of insulin or dosage is what's needed).

I was reading the felinediabites.com website page "what is feline diabetes" (probably for the 8th time), and I finally comprehended that "Manufacturers of veterinary insulins know the profile of their insulin for cats, and this information is packaged in every carton of insulin sold to vets." I do have the insert that comes with the vial of Prozinc, and I've read it, but I don't see the information I was expecting (i.e. typical nadir time, onset time, duration, action profile). I tried google and that didn't get me what I wanted either. Is that available on FDMB and I've just missed it (or since I am trying to understand Gizmo's diabetes, Sherlock and Cephas' hyperthyroidism (due to be treated with I-131 treatment 4/13), and the possibility that the hyperthyroidism has been masking CKD, that I've read it but not comprehended it).


Thanks for all your patience and support.
Click to expand...
Hi... nice curve! Nice to see those greens! We have all that info in this very forum in the yellow stickies at the top.
https://www.felinediabetes.com/FDMB...-the-prozinc-basics-please-start-here.164995/
 
JanetNJ said:
We have all that info in this very forum in the yellow stickies at the top.
Click to expand...

Thanks. I had read but not truly comprehended what was on that page. I think I /somewhat/ disregarded it when I first read it, because the page has a broken link to "Prozinc Website", but it sounds like the information on that page is okay as far as Prozinc's profile.
 
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