Help with looking over spreadsheet and dosing advice

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Kim3803, Apr 2, 2021.

  1. Kim3803

    Kim3803 Member

    Joined:
    Mar 19, 2021
    I also posted this in the Prozinc forum (sorry if that's not ok), I uploaded the SS wrong but I think I fixed it.

    I've posted a couple times but I'm very new to this and need some guidance. I unfortunately have no support from my vet. I've only been home testing for about 7 days now. (My vet had told me I didn't need to home test when he first was diagnosed). The dose he was given was 2 units of Prozinc. Looking at his numbers they are pretty high. At first I was thinking maybe he needs a increase but I've been trying to read and understand as much as I can on this forum which it can be very complicated and overwhelming at first. I've read that the recommended starting dose is 1 unit for Prozinc and than got to reading about "rebounding". So now I'm thinking is he getting too much and that's why he is so high? I don't have the syringes with the half units yet I do plan on ordering them for when I do need to adjust his dose. I know I haven't been testing for long but if there is any info you can give me by looking at his numbers so far will help. I haven't tested past +3 in the pm because I'm in bed by 9pm and up at 5am. Any advice is greatly appreciated. Thank you.
     
  2. Oscar and Carrie

    Oscar and Carrie Member

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    Feb 20, 2021
    Hi Kim,

    Looking at your spreadsheet, your pre-shot numbers are pretty consistent and Jax doesn't seem to be dropping too low mid cycle, which suggests he may need an increase.

    I would suggest getting a curve (testing every 2 hours for 12 hours) once you have a day where you're around to test that often. This will show exactly how the insulin is affecting him, and identify the nadir (lowest point). Dosage changes are based on the nadir so it's important to get that.

    It's useful as well to try and get a couple of tests during the night at around +4 to +7, again just to get some data so you have a better understand of what happens at night. You'll need to set an alarm to get up. It's tough, but needs must! I have to say, coffee has become my best friend since my cat got diagnosed. :coffee::D
     
  3. Oscar and Carrie

    Oscar and Carrie Member

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    Feb 20, 2021
  4. Kim3803

    Kim3803 Member

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    Mar 19, 2021

    I did a curve on 3/30. I tested every 2 hours.
     
  5. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Kim.
    Yes it’s fine to post on this main forum. If you could link the post from the Prozinc forum, that would be good so we can see if anyone answers there as well.
    I can see Deb and Janet answered you but your SS wasn’t viewable at the time so I’ll tag them here as I can now see the SS @JanetNJ @Deb & Wink.
    They both use Prozinc and are experienced. I don’t use Prozinc and don’t give Prozinc dosing advice, but will look at your SS.

    Well done setting up the SS and home testing. Sadly a lot of vets do not know a lot about feline diabetes but you have come to the best possible place for help and support.
    It’s a good idea to post often and people will get to know you and your kitty and you will make friends and get support which is important.

    I can see you are feeding a wet diet which is good.
    Do you have a hypo kit set up in case you need it? This is a good link with information about the hypo kit and other important information for new members
    https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

    Are you feeding during the cycle as well as before each insulin dose?
    Looking at Jax’s SS I can see he is reacting well to the insulin which is good. Also by +2 he has dropped a lot which can trigger a bounce. If a cat drops too fast, or too low or lower than he is used to his body can react and dump glucose into his system and his BGs will go up.
    If I were you I would try giving him a snack of ordinary low carb food around +1 to try and slow that big drop. At the moment he is going from mid reds to yellows in 2 hours which is too fast a drop. If you can slow that down he might not go so high at the next preshot. I would also give him another snack around +3 or +4. It is trial and error.
    It does look as if he needs more insulin but I’ll leave that up to Deb or Janet.
    Bron
     
  6. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Answered her over in the Prozinc ISG.

    Yes, I do think that Jax could use a tiny dose increase soon. Would like to see a few more cycles of tests before that increase is done.
     
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  7. Kim3803

    Kim3803 Member

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    Mar 19, 2021
    I was told NOT to feed in between his cycles. He throws tantrums and meows and jumps on the counters. I am currently feeding him 1 1/2 cans of FF (AM and PM). He is 10.5lbs. Before he was diagnosed he was eating 4-5 small meals throughout the day so he is not used to this new schedule. I feed at 6am so I should give him maybe 1/4 can at 7am?
    I do have honey in case of hypo.

    I appreciate all the help.
     
  8. Kim3803

    Kim3803 Member

    Joined:
    Mar 19, 2021

    https://felinediabetes.com/FDMB/thr...dsheet-and-dosing-advice.245569/#post-2771176

    Here is the link I posted on the Prozinc Forum. I'm not sure how to link it.?
     
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  9. Kim3803

    Kim3803 Member

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    Mar 19, 2021
    If he is dropping that much that fast within 2 hours
    If he is dropping that much that fast within 2 hours, would it still be ok increase his dose? Should I try the little meals in between and see how his numbers are first before I increase?
     
  10. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Was it the vet who told you to not feed between the shots? That is old thinking
    With the newer insulin it is better to feed more like it sounds you were feeding before the diagnosis.
    So I would give a meal before the shot, then the one around +1 to see if we can slow the drop and the again once or twice, preferably during the first half of the cycle or up to +7. It is better for the pancreas to have smaller meals.
    You can divide the current food up into a main meal and snacks if you think that is the correct amount he should be eating.

    When Sheba was first diagnosed I was told to only feed at shot time as well and the poor girl was always asking for food.
    Jax will be much happier and more settled if he can have snacks during the cycles.....don’t forget the snacks in the pm cycle as well.
     
  11. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Deb said to get another curve in before you increase, so use that time to implement the new feeding regime as well.
    Many cats drop quite a bit at onset of the insulin so don’t worry. As long as you are aware of it and give the snack before the drop you should be fine.
    Follow Debs advice re increasing the dose. I am a Lantus and Levemir user and haven’t used Prozinc.

    Let us know what Jax thinks of his new feeding regime! He will probably be less stressed around preshot because he isn’t as starving hungry.....I’d be throwing a tantrum too if my food was taken away!
     
  12. Kim3803

    Kim3803 Member

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    Mar 19, 2021
    Yes it was the vet that told me that. Ok great this makes me feel so much better that I can feed him little snacks throughout the day. Hopefully this helps his numbers and his behavior. Thank you thank you so much
     
  13. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    You are welcome. Give the dear boy a hug from me and tell him to enjoy his food!
     
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  14. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Kim another thing you can do to help him feel fuller is to add a little bit of warm water to the food, if he will tolerate it. That will help with hydration and also fill up his little tummy more. Some cats won’t eat food with water in it. I feed a raw diet to my cats and I always add a little bit of water to each meal....not too much or they will vomit. Every cat is different.
     
  15. Kim3803

    Kim3803 Member

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    Mar 19, 2021
    Yes I have been adding a little water to his food to try and slow him down. He eats so fast! I even put down a silicone lick mat with half of his meal to slow him down as well.
    I'm figuring out a new schedule to start tomorrow morning and I will do another curve on Tuesday. He'll have 3 full days on the new schedule by then.
    Thank you for all your help I appreciate it so much.
     
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  16. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    One of my cats likes to bolt his food. I now feed on a large plate and spread it all over. It has stopped the vomiting from bolting.
     
    Kim3803 likes this.
  17. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Yes definitely feed in between I always fed morning, noon, evening and before bed.
     
  18. Kim3803

    Kim3803 Member

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    Mar 19, 2021
    Thank you, I am starting a new feeding schedule today. @Bron and Sheba suggested I give a little snack @+1 since he was dropping so much so fast. I also just ordered the syringes with the 1/2 markings for when i need to adjust dosing.
     
  19. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Also, remember that a diabetic cat can't process their food as well, because their body isn't working as well. So you may need to increase the AMOUNT of food you feed Jax, as well as the number of times you feed him.
     
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  20. Kim3803

    Kim3803 Member

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    Mar 19, 2021
    @Deb & Wink , @JanetNJ , @Bron and Sheba (GA)
    I started Jax's new feeding schedule on 4/3. For a few days he was staying in the 200s and low 300s as you can see on his SS. Of course the day I did his curve which was yesterday 4/6 his numbers were all over the place and started to get really high and even this morning at AMPS he was 479 which was his highest yet. I didn't change anything since the new feeding schedule and he was looking somewhat consistent and now i'm just confused and worried. What do you guys think? I appreciate all the help.
     
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  21. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    He could be bouncing a bit from that string of lovely yellow numbers. It’s normal to bounce and it’s normal for the numbers to go up and down as he gets used to the insulin. . Bouncing can happen if the cat drops too fast, too low or lower than he is used to. He is new to yellow preshots so that could have panicked him into dumping glucose into his system to ‘save himself’ and sent the BGs up high again. Bouncing can last from 1 to 6 cycles.
    He is only newly diagnosed and it will take a bit of time for him to settle down.
    It looks as if he could do with an increase in dose but I’ll leave that up to the girls who use Prozinc.
    How is he enjoying his nw feeding regime?
     
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  22. Kim3803

    Kim3803 Member

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    Mar 19, 2021
    Ok I see, I thought he was doing pretty well with the consistency but than it started to go so high again.
    I have to start understanding the bouncing better. He is doing a bit better with his new feeding schedule. He is enjoying his snacks.
    He is drinking a lot of water again like before he was diagnosed so I will see what the Prozinc ladies say about an increase. Thank you for your help I appreciate it so much.
     
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  23. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Yes, I think Jax could use a dose increase. I recommend increasing by 0.25U. So the new dose would be 2.25U for Jax.
    Syringes don't have 1/4 unit markings, so you have to use your best judgement on getting the syringe plunger placement in the right spot. Just "eyeball" it and do your best to be consistent when you draw up the dose.

    You may want to hold off on the increase until the AM. If you increase in the PM, I'd strongly suggest you get another BG test later than that +2. More around the +4 to +6 time frame.

    Even if you wait until the AM, a test in the +4 to +6 time frame will give you more pieces of the puzzle, and let you know how Jax is doing on the new dose.
     
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  24. Kim3803

    Kim3803 Member

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    Mar 19, 2021
    Ok, thank you. I just ordered new syringes today with the half markings so I won't have them until next week.
     
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  25. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    U40 syringes with the 1/2 unit markings will come in handy.

    But, if you were to increase before you get the new syringes, you would put the end of the plunger closer to the 2U mark with your old syringes, to give 2.25U. Not on the line, but a bit above the line, closer to the plunger end of the syringe.

    Use your best judgement to draw up the correct amount of insulin.
     
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  26. Kim3803

    Kim3803 Member

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    Mar 19, 2021
    Ok got it, thank you so much. I appreciate your help.
     
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  27. JanetNJ

    JanetNJ Well-Known Member

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    I agree. I would do 2.25, hold for several days, and then we can reevaluate and see if 2.5 would be better since we aren't seeing any blues yet.
     
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  28. Kim3803

    Kim3803 Member

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    Mar 19, 2021
    Thank you Janet. Jax hit 502 AMPS this morning for the first time. I really want to wait til I get the half marking syringes to increase so I feel more comfortable giving the right dose.
     
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