Help with Tuck's dose

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AbyResq

AbyResq

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I still can't figure out how to get Tuck better regulated. He's been on 1.4 units for many cycles and his numbers are still too high. He had several high flat cycles. I thought he needed a higher dose so I raised him from 1.4 to 1.6 last night. His blood sugar went from PMPS of 461 to 101 at +4. While not a hypo number the rate of drop seems awfully steep. He gets meals at his dose time and at +4. I fed him as usual at +4 and retested at +5 to make sure he wasn't still dropping.

Tuck's AMPS of 515, definitely suggests a bounce. I reduced his insulin to 1.2 assuming he'll be sensitive to insulin today. To recap:

PMPS - 461; fed a meal and shot 1.6 U
+4 - 101 (fed a meal, he always gets a meal around +4)
+5 - 124

AMPS - 515; fed and shot 1.2 U
+3 - 342

He's definitely had cycles where the nadir fell 50% below his PS number. The ProZinc protocol suggests this may indicate too high of a dose even if the nadir itself isn't a hypo number.

Can the ProZinc experts look at his sheet and tell me what you'd do now? Would you leave him at 1.2 U for a while or some other dose?

In other news, Oliver has a nice gentle curve. I wish his nadir were a bit lower but I'm really happy with the gentle curve. He's had some cycles go beyond +12. I'm leaving his dose alone to see if his body keeps adjusting and making better use of the insulin. I'm assuming the longer cycles may indicate that he's headed for a reduction in the near future.
 
I agree, Karen. He looks like he is bouncing, and high! I know we have mentioned before the two options: waiting till he decides those lows are not so scary and stops, or lowering the dose and hoping for a flatter curve. The third is trying a depot insulin. They tend to produce flatter, longer curves - but not always...

And you give him a snack when he drops low, right? You could try one unit for a few cycles and see what it does. Or 1.2.

I wish I had something else brilliant......or even helpful.
 
Yes, I give him some of his low carb Fancy Feast if he's low or I catch him dropping really fast. His regular food is all he ever needs to bring his number up.

I'd be happy with a gentler curve for a while even if the numbers themselves were a bit up. He's always begging for food so I know he's feeling the effects of the rapid drops.

I would really like to keep him on ProZinc. With 2 diabetic cats it's easier for me if some things are consistent. I fear a late night mistake of pulling out the wrong insulin for the wrong cat, or goofing up the U-40/U-100 conversion for one of them. I also have a cat starting on inhaled steroids every 12 hours so early mornings and evenings there's a bit to remember around here.
 
Today's cycle after 1.2 units was too high the entire time. If Tuck stays like this overnight would you continue 1.2 units for one more cycle tomorrow or increase the dose? I'm beginning to worry that he's staying high for too long. I tested for ketones and he was negative. If he really has been bouncing how long does it normally take for the lower dose to start stabilizing things?

My sheet is updated but here are the most recent results from last night through now:

PMPS - 461; fed a meal and shot 1.6 U
+4 - 101 (fed a meal, he always gets a meal around +4)
+5 - 124

AMPS - 515; fed and shot 1.2 U
+3 - 342
+4 - fed meal no test
+6 - 370

PMPS- 497; fed and shot 1.2 U

I know the insulin isn't bad because Oliver's numbers are fantastic from the same vial.
 
I am wondering if Tuck is bouncing today from the big drop last night from 461 at PMPS to 101 at +4. That is definitely a big enough drop to start a bounce.
 
Tuxedo Mom said:
I am wondering if Tuck is bouncing today from the big drop last night from 461 at PMPS to 101 at +4. That is definitely a big enough drop to start a bounce.
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That's my thinking too. He's had a lot of cycles where his nadir is significantly lower than his pre shot numbers. I need help setting my own expectations for how long to let him ride high in the hopes he'll stabilize. I think I'm just frustrated because he seemed relatively easy to regulate in the beginning but we've been off track for a while.
 
AbyResq said:
That's my thinking too. He's had a lot of cycles where his nadir is significantly lower than his pre shot numbers. I need help setting my own expectations for how long to let him ride high in the hopes he'll stabilize. I think I'm just frustrated because he seemed relatively easy to regulate in the beginning but we've been off track for a while.
Click to expand...


I don't personally use Prozinc, but I do understand the logistics with it. When I look at the spreadsheet and see times when it appears he is bouncing it seems that it takes from 1-2 days to clear the bounce. That was a big drop last night..even though he didn't hit really low numbers, a drop of that much can certainly trigger a bounce. My thoughts would be to hold the dose another day and see if there is any movement.
 
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