Hercules dosing needs help

Hercule's mum

Hercule's mum

Very Active Member
Hello everyone,

Hercules has been on prozinc since July. He is a very bouncy cat and I am not sure I am doing the right thing.

I started following SLGS, as I felt more confident I decide to switch to MPM. However, I fell like we are never in a stable enough situation to be able to make judgements, if that makes sense..... He is either bouncing, or recovering from a hypo.... We have been up and down between 0.6 and 1.2 a few times.

Lately, I seem to be seeing black and reds back (which have been mostly absent in the past month). He is still reaching blues most days, so doing very sharp drops (which is perhaps causing the big spikes, micrpbounces?).

Theoretically since we are not hitting greens, I should be thinking about increasing his dose. But it feels like everytime I go up to a dose where he hit forrest green, within a day or two he has a bright green event.

I am wondering... should I actually go way back down to 0.5 again and see if I can calm things down?

So as you can see, I could really use some help. small increase up, or way down?

Thanks!
 
AM cycle on 9/18/20 ( or 18/9/20 in your date format) was an almost perfect cycle. But that was a morning where Herc threw up his food, and that often causes the BG levels to go lower. So you don't want to recreate the vomiting incident but you DO want to see if you can recreate the low BG readings during the cycle.

I do not think that restarting the dose at 0.5U is the way to go. Sorry I did not say that last night and was not clear. Tired. Long day of gardening. Mea culpa.:arghh:
Hercule's mum said:
Thanks Deb. So you think I should be going up?
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Yes, I think you should go up in the dose. But only from the 0.8U to a tiny bit more than that which will probably be just about 0.9U, or a tiny bit under that. I know, I know, almost impossible to measure that tiny bit of difference.

Try pulling up the insulin in your syringe, removing the syringe from the vial, and gently squeezing out a single small drop, with a slight twist of the plunger. Holding the syringe with one hand, twist your wrist while holding onto the plunger, to squeeze out a tiny drop. Drop dosing it's called.
You might want to practice your technique, before you try it with the actual insulin. Colored water or juice can work well.
 
Thanks, Deb. I increased to 0.9 this morning. Lets see how it goes.

Hope you managed to plant your thousands of bulbs! I only have a handful of garlic and onion sets to put it down before winter is propely hear, and I didn't managed... Got sucked up on diy instead....
 
Humm.. alll of a sudden his BG is not shifting, he is acting very hungry and drinking more.... perhaps not the time to increase carefully? Should I just go up to 1? or am i being reckless? He looks unhappy...
 
Since Herc seems to be more sensitive to the dose increases, I'd only do the tiny increase.
Patience. Let's see how he does on this 0.9U dose before deciding to increase to the 1U again.

Hercule's mum said:
Hope you managed to plant your thousands of bulbs!
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Still working on it. Didn't dig enough holes before hand, so doing that takes time in my rocky soil. Plus had a number of bulbs that were missing from this latest delivery, but they are supposed to come this Tuesday, 10/20/20. Still have lots of crocus to plant and some daffodils, but got some planted today. More getting done on Tuesday and Wednesday this week.

I have 100 onion sets to put in too. After the bulbs are done, I'll get around to those. Reclaiming my veggie garden area, although it doesn't get as much sun as it used to as the trees have grown. Plus, the chipmunks have burrows in that area and many others. Hope they don't like onions.
 
I'll be patient. Thanks for your reassurance.

In my allotment the pigeons are usually the big problem, and everything has to be netted. But badgers and deers are moving in because the land adjacent has gone fallow in the last years. They are trickier to manage.
 
Your patience paid off! That and the dose increase looks like they are helping Herc's.

Now Hercules, could you please show us a few more blues? Pretty please with sugar on top?
 
Sky high again in the morning! I am suspicious about that blue... I should have re-checked. On the other hand if it was true, it would have been a sharp drop, which would explain the black this morning. Lets see what the day brings today....Unfortunately I'll have to go into work. Very strange how weird does it feel even saying so.

He was desperate for food this morning and just does not seem well. I'm really hoping there isn't something else brewing.....
 
Those HIGH BG readings can make your cat feel extra hungry.
Anytime the BG reading seems "suspicious", it's worth getting another BG test. If your cat will let you that is.

Blacks almost always mean bouncing. So again, I'm urging you to be patient with Hercules.
 
Thanks Deb. Yes, perhaps I am just being too influenced by his behaviour. Much lower AMPS this morning, so perhaps something is breaking through...

It is so confusing because PZI is usually described as in and out, but I'm very suspicious looking over hercules shet that there is certainly a build up over time. I am possibly imagining things again...

I am not sure which state you live in, but I saw a picture of people waiting to vote in north dakota with snow already, and tought I must finish clearing the allotment. I am not ready for winter yet!
 
Hercule's mum said:
@KyraCat Hi Jemma! I have been thinking about you and wandering how Kyra is doing, but I haven't seen you around. Is everything OK?
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Yes all is well (touchwood)! I am still in the process of getting Kyra slowly up to 4.5 (as per discussion with the vets) before hoping to move to Prozinc. So I am just going through the motions with that at the moment. I do keep coming on here though and having a look to see how you and Hercs are getting on :)

How is Hercs doing today? Seeming better I hope!

Can I ask, how are you finding Prozinc? I know the downsides of Caninsulin but what are your thoughts on Prozinc, it seems to have been a little bit of bumpy road for you...not saying that Caninsulin has been smooth sailing for us by any means!! Did you use Caninsulin initially or have I made that up?! lol
 
How are you changing the dosing in such tiny amounts? Are you using u100 syringes and a conversion chart ? Calipers? I would have no idea how to go from a 0.7 to a 0.8 just eyeballing it with u-40 syringes. Are you drawing it up to 1 and then releasing a drop to do 0.9. Or two drops to do 0.8?
 
@JanetNJ - I am using U100 syringes, with 0.5 marks. So each 0.5 change is equivalent to a 0.2U change, so when I dose in between marks, I consider a 0.1U change. I have considered using a caliper, but the space between unit marks is already so small that I doubt I would be more precise with a caliper. I do worry whether the markings is consistent between syringes, so I might still get one at some point.
 
KyraCat said:
How is Hercs doing today? Seeming better I hope!
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He is doing better and throwing me for a loop again! He has been in very high numbers for days, and I am starting to worry about glucose toxity, and then all of a sudden poof! we are in green at +4 and I need to go to work.....

I did do a double thinking this AMPS when it was only 12. But decided to be a "good girl" and follow protocol. It was above 11, and he hasn't seen greens for a while.... I might have to try @SashaV method because I was very tempted to reduce based on the AMPS so it wouldn't skydive....

KyraCat said:
it seems to have been a little bit of bumpy road for you...
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Most definetely! But then, I get the feeling it is for everyone.... I have been wondering whether I should try Lantus. But overall I need to remember that we do see blues and greens and he is mostly under 1U of insulin, so perhaps I am just a worry-wart! I think the problem here is Hercs, and not the insulin.....
 
KyraCat said:
Did you use Caninsulin initially or have I made that up?! lol
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No, we have started with prozinc. So I don't know if it would be any different in another insulin.

I am aware your vet is keen on caninisulin and everything; so I understand is difficult. If you want to do some deep research, you can search through actual scientific papers going to https://scholar.google.co.uk/ Warning though, it is a rabbot-hole!
 
Hercule's mum said:
@JanetNJ - I am using U100 syringes, with 0.5 marks. So each 0.5 change is equivalent to a 0.2U change, so when I dose in between marks, I consider a 0.1U change. I have considered using a caliper, but the space between unit marks is already so small that I doubt I would be more precise with a caliper. I do worry whether the markings is consistent between syringes, so I might still get one at some point.
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Ah ok that makes sense
 
Hercule's mum said:
@JanetNJ - I am using U100 syringes, with 0.5 marks. So each 0.5 change is equivalent to a 0.2U change, so when I dose in between marks, I consider a 0.1U change. I have considered using a caliper, but the space between unit marks is already so small that I doubt I would be more precise with a caliper. I do worry whether the markings is consistent between syringes, so I might still get one at some point.
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Syringes are notorious for not having the markings on the syringe barrel in the same place from syringe to syringe. One batch can be fine, and then you buy another batch that are really "off". Even the syringes within the same box can differ from each other.

p.s. I'm in northeast coastal Massachusetts. No snow here yet, but working hard to get things ready for winter here too. We sometimes get snow as early as Halloween.
 
Hercule's mum said:
No, we have started with prozinc. So I don't know if it would be any different in another insulin.

I am aware your vet is keen on caninisulin and everything; so I understand is difficult. If you want to do some deep research, you can search through actual scientific papers going to https://scholar.google.co.uk/ Warning though, it is a rabbot-hole!
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Ah I see I thought you had started on 'old trusty' caninsulin!! I must say the vet was willing to try Prozinc but suggested we try upping his levels on caninsulin and then re-asses from there. It was me 100% backing down, else she would have prescribed it....I am what is none as a push over at times!! lol

Looks like Hercs had a great day yesterday then just a little high towards the end - Go Hercs!!

I feel like Hercs and Kyra are just bouncy bouncers! Good day followed by a bounce, work through it, good day, bounce, eat , sleep, rave - repeat :D

But fingers crossed Hercs isn't on a bounce today!
 
Omg do I have a method?:oops:
Let's call it freestyling :D:bighug:

Prozinc is definitely not always an in and out insulin. The more regulated Mauer gets, the more I see how one dose effects the few next cycles.

Give it a shot, if you believe it's the right way! :bighug:
Mauer's SS is finally looking better, and it's easier for untrained eyes like mine to see whats going on without all that stupid bouncing.
 
@SashaV - Can I ask why did you changed from levermir to caninsulin to prozinc? Sometimes I wonder whether I shouls switch to Lantus, but dont know what are the signs that an insulin is not the right one, so was looking through Mauer's SS, but it wasn't obvious to me :oops:
 
Hercule's mum said:
@SashaV - Can I ask why did you changed from levermir to caninsulin to prozinc? Sometimes I wonder whether I shouls switch to Lantus, but dont know what are the signs that an insulin is not the right one, so was looking through Mauer's SS, but it wasn't obvious to me :oops:
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You can ask me anything!
First she was on caninsulin, and the vet told me to hold the dose, not change it for 3 weeks and I would se the change. So I didn't and my vet agreed with me, that it simply didn't work. I've read a lot on levemir and the chances of remission so I really wanted to try it. So I tried it, new as I was I didn't know how to dose it, depot effects and so on. So two weekends in a row we ended up at the ER vet, cause Mauer was vomiting and was nauseous and wouldn't eat. I was told, no food no insulin.
Still new, my vet and I wanted to try Prozinc. But I was rather eager to get her off the levemir, so we had a week on caninsulin again until the prozinc was ordered.

Now I see clearly that the first few days on caninsulin was a leftover from levemir.

And then I followed my vet's instructions on dosing of prozinc, and ended up giving Mauer a huge overdose the very first day, and THEN I signed in to this amazing forum and got some real help!

I have 4 pens of levemir in my fridge. And I've been thinking about switching. Deb is often reminding me that this isn't a sprint, but a marathon. My pens is in my fridgedoor, so I don't think they're good anymore.

The main reason I haven't changed to levemir again, is that Deb doesn't give advice on levemir. :oops:
I have ADHD, I like to stick to one person's advice, and English isn't my first language so I need someone who doesn't wrap their messages in ten layers of nice coating. My mind can't separate the nice and hints from the real message, so I need the straightforward answer's Deb is giving me.
I know every cat is different, and Deb is been with Mauer and me now for quite a while. She knows I'm a chicken when it comes to dosing, and that Mauer responds odd to somethings that she shouldn't. It's only because of Deb, I know she's there with her great advice I had the guts to go do my own thing with the dosing. And it seems to be freaking working!

And the main reason I ended up freestyling was that we didn't get anywhere. We didn't reach blue or green, we had nights where she earned a reduction on a dose that wasn't moving anything during the day cycles. Cats drop lower at night just as humans, the normal dosing protocols doesn't take that into account. And it seems stupid to only have her low at night and not during the day.

So that was a wall of text. Don't know if that answered your question :rolleyes:
 
SashaV said:
Don't know if that answered your question
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It Did! Thanks!

I'll keep looking for a magic bullet! It shouldn't, but it does upset me that I don't seem able to follow any protocol for the reasons you say... Hercs just don't fit the expected responses.... But, yes, we must be patient! So, I'll just keep reading about lantus and use up my vial of prozinc for now....

You are doing amazing!
 
Hercule's mum said:
It Did! Thanks!

I'll keep looking for a magic bullet! It shouldn't, but it does upset me that I don't seem able to follow any protocol for the reasons you say... Hercs just don't fit the expected responses.... But, yes, we must be patient! So, I'll just keep reading about lantus and use up my vial of prozinc for now....

You are doing amazing!
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Its really upsetting that we do all this, follow every step the best we can, and nothing is working. Every cat really is different!
It's frustrating to see others spreadsheets being blue and green, even diagnosed later than ours and ours is pink and yellow :oops:

Don't know how old your pzi vial is, but that could mean something. Also do not squeeze the insulin back in the vial, it makes the pzi much less effective. If you decide to stay on pzi, be aware that a new vial possibly could be a heck of a lot more potent, so start sloooooow.

Since Mauer has cleared the bouncing its obvious how one cycle effects the next one.
 
SashaV said:
It's frustrating to see others spreadsheets being blue and green, even diagnosed later than ours and ours is pink and yellow :oops:
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I only looked at your spreadsheet this morning and got jealous of all those consistent pinks and yellows! We really all are on individual journeys but it is so good to have such a supportive community to reach out to whether for advice or give others some sort of support!
 
KyraCat said:
I only looked at your spreadsheet this morning and got jealous of all those consistent pinks and yellows! We really all are on individual journeys but it is so good to have such a supportive community to reach out to whether for advice or give others some sort of support!
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Oh :oops: I see what you mean!
Whiskas...isn't there added sugar in?
I'd go of the caninsulin it clearly isn't working :oops:
 
He's not on Whiska's anymore - he's on Feringa.
(Tried him back on Whiskas for a short time test a theory, the other time was when zooplus were delayed with deliveries and I just needed a stand in I new he would eat...)
I have an agreement with the vet before moving him on to Prozinc, as I mentioned in a post above.
 
Just checked. Whiskas has added sugar. And it is mostly byproducts = trash :oops:
4% chicken, rest is trash. And grains and added sugar. I'd really find something else, if I were you :oops:
And not ferringa with vegetables, they spike bloodsugars too.
Does he want to eat raw?
 
Jemma, do you have Aldi in the UK? Their Topic only the big cans, they're fairly good quality. Good price too! I use them as basic food and mix in others from zooplus.
 
SashaV said:
Jemma, do you have Aldi in the UK? Their Topic only the big cans, they're fairly good quality. Good price too! I use them as basic food and mix in others from zooplus.
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We do! I'll have to see if I can spot them when I'm next in - thanks!!
 
@Deb&Wink - I went 0.1 up again, but now I am regretting. It didn't cause any major crisis, but I wanted to test something and now I can't....

If I look since the 20th of October, you can see a good day, followed by a bad day. So I wanted to test if what I am seeing is just a bounce every 24 hours, but his behaviour has been so extreme in the last 2 days that I caved in and increased the insulin.... :oops:

The point of bringing up this pattern, is becase the reason I have trouble following the protocols, is that if I look at "good days" with a 0.9 dose, it seems like he is dropping a lot, and therefore it is the correct dose and i should park there. However, if i look across all days, I would conclude 0.9 is not dropping his BG sufficiently most days. Can someone help me through this last period trying a 0.9 dose and tell me whether increasing was the right decision, and how should I take into account his continuous bouncing into consideration?

Finally, if I am not asking too much.... is there any hope things will settle eventually, or after 3 months trying with prozinc I should consider a different insulin? I don't know how long is a "good try", and whether changing insulin changes bounciness....
 
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Please be sure to get a few more tests in this PM cycle 10/26/20, since you shot on that high blue pre-shot. Only because that pre-shot is lower than you have shot insulin recently.

Things could settle down. But a talk with your vet about switching to Lantus, is in order after 3 months trying with Prozinc. Even if you do switch, Hercules may continue to bounce for quite some time. That happened when @Patty & Teal'c switched to Lantus. Took a couple of months to see the changes with lantus.

Remember, this is a marathon not a sprint. It took time for your cat to become diabetic, it will take time for Herc's to get better.

Sorry, didn't get the tag. My user ID has a space on either side of the & sign.
 
Thanks Deb, I did test him and worry for a long time how much and whether to shoot him. I just was running back to bed instead of logging the numbers :)
It looked like he was going to lay low, but he bounced again....

I though I should go back to 1U again, since we did not see any greens yesterday. Am I going to get him ever further confused with the dosing all over the place?

I'll schedule a chat with the vet, but thatnk you so much for pointing out teal'c journey! It gave me a lot of hope! (@KyraCat you should have a look too!)
 
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