Hold the current dose?

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Sharon555

Sharon555

Member Since 2023
I recently started using the Modified Prozinc Method. Initially we held the dose of 2.25U a few cycles longer because 1) it looked like he was bouncing and 2) I had started feeding him Dr Elsey’s dry food at the same time I increased his dose and it appeared his BG was spiking because of it. So we gave him some time to get it out of his system. I now know that I shouldn’t be feeding him even the low carb dry foods while using the MPM. Now, for two days his daytime nadirs have been green. As I understand the protocol, that means I hold his dose. I just want to clarify that is the case. Does it make any difference that his nighttime numbers are not as low? I’m wondering if that is because he isn’t getting any small meals during the night unless he “asks” for it before I go to bed between 11 and 12. He always gets 1 or 2 small meals during the day.
 
I am not a Prozinc user but I would stay at the same dose as you have been seeing green nadirs. No it doesn’t make a difference if he does not drop to green for all the cycles.
I would leave out a snack for him overnight when you go to bed. It’s always better to feed the same carbs and meals /snacks for both the cycles of you can.
I will tag @Suzanne & Darcy to give an opinion as she is a Prozinc user.
 
Should I hold the current dose as long as his nadirs are green? Even if his nighttime nadirs are still blue?
 
Bron and Sheba (GA) said:
I am not a Prozinc user but I would stay at the same dose as you have been seeing green nadirs. No it doesn’t make a difference if he does not drop to green for all the cycles.
I would leave out a snack for him overnight when you go to bed. It’s always better to feed the same carbs and meals /snacks for both the cycles of you can.
I will tag @Suzanne & Darcy to give an opinion as she is a Prozinc user.
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Leaving out overnight snacks is impossible around here. I have 4 other residents and 2 adult fosters that roam the house. I do give him a small meal/snack before I go to bed if he wants it between 10 and 11. Occasionally he’ll get something at 2 or 3 am if I wake up and go to the kitchen for water and he jumps up on the counter. I also now have a microchip feeder which I need to set up and teach him to use so he can eat when he needs to anytime.
 
I would give him a before bed snack. It may actually help him. It's interesting because many cats actually drop lower at night. I would wait and see if he get back into green today or tonight -- maybe even tomorrow. With the amount of testing that you do, you may have room for an increase and still keep him in safe greens (over 50). He is very bouncy.

And your house sounds like mine... I saw in your notes about a foster cat and picking up kittens from surgery. My house right now is kind of insane with kittens that I have rescued. Problem for me is that the rescue that I have been working with for several years has closed it's cat program and has abandoned 200 kittens in various foster homes. The woman who did this is evil. Now I guess I will have to find homes for these kittens in another way. It's incredibly stressful and when my husband finds out this bit of information, he's gonna flip his lid!
 
Sharon555 said:
Leaving out overnight snacks is impossible around here. I have 4 other residents and 2 adult fosters that roam the house. I do give him a small meal/snack before I go to bed if he wants it between 10 and 11. Occasionally he’ll get something at 2 or 3 am if I wake up and go to the kitchen for water and he jumps up on the counter. I also now have a microchip feeder which I need to set up and teach him to use so he can eat when he needs to anytime.
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Sounds like you have a good plan. What's his feeding schedule like generally -- on a regular day?
 
Suzanne & Darcy said:
I would give him a before bed snack. It may actually help him. It's interesting because many cats actually drop lower at night. I would wait and see if he get back into green today or tonight -- maybe even tomorrow. With the amount of testing that you do, you may have room for an increase and still keep him in safe greens (over 50). He is very bouncy.

And your house sounds like mine... I saw in your notes about a foster cat and picking up kittens from surgery. My house right now is kind of insane with kittens that I have rescued. Problem for me is that the rescue that I have been working with for several years has closed it's cat program and has abandoned 200 kittens in various foster homes. The woman who did this is evil. Now I guess I will have to find homes for these kittens in another way. It's incredibly stressful and when my husband finds out this bit of information, he's gonna flip his lid!
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Thank you for the suggestion of possibly increasing while Beau is in the greens. The thought did cross my mind because they aren’t low greens. And I’ll make sure he always gets a before bed snack, whether he’s hungry enough to ask for it or not. Hopefully it will help his nighttime numbers. It’s interesting about the food outside of mealtimes. The Vet was so adamant about only feeding twice a day. So I did like the rule-follower I am for nearly two months until I admitted to myself that it wasn’t helping. I was already part of the group and reading posts daily until I realized there was a better way. Out with the “prescription” food and two meals. In with low carb and snacks or small meals whenever he tells me he’s hungry … and he does. It’s been slow to get to this point, but very obviously the right way to do it, and logical. The Vet told me a couple of weeks ago that his numbers were looking good ‍and to continue with the 2U, which he was getting because I was following the SLGS protocol and reducing when warranted. He had been wearing a Libre (which I had already thrown out a week earlier) with me constantly double-checking readings manually and I was sending her graphs. She thought he was still on 3U in the am and 2.5U in the pm, which I never did because that didn’t even make sense. She didn’t suggest curves, either there or at home, or testing at home, even before shots. Again, made no sense to me. She doesn’t even want to see him again until May, the anniversary of his diagnosis. I can hardly wait until Beau is a little more regulated so I can send her a surprise curve!
Yes, I have a total of 12 fosters right now, between the ages of 11 weeks and two. That is so terrible to hear about your cat foster program with the rescue. How could she do that? I can’t even imagine. 200 kittens is a lot! That means the fosters, if they aren’t already, are now responsible for buying food, vaccines and possibly even spay/neuters?! Then getting no help with adoptions? Just unbelievable! That makes her even worse than the people who abandon those kittens who end up in our care.
 
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Suzanne & Darcy said:
Sounds like you have a good plan. What's his feeding schedule like generally -- on a regular day?
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During the day, he always wants something to eat between +3 and +4 and will generally eat not quite 1/2 can. Then maybe again around +8 or +9. Sometimes it’s more like between +10 and +11, but he’s out of luck because it’s too close to test time. Perhaps I shoulc start offering it at that earlier time instead of waiting for him to wake from his afternoon nap and tell me.
 
Usually we don't recommend feeding after nadir because it can shorten duration of the insulin. Maybe moving it forward a little would help in general.
 
Yes, if you are following MPM you can go for the lower green numbers (50 and above,) with the amount of testing that you do. I would give him a little more time to see if he gets green again and then, if you feel you're ready and can monitor and intervene if necessary, go for the .25 increase. It will be important for him to get those snacks, but then you already know that. :-)
 
Suzanne & Darcy said:
Usually we don't recommend feeding after nadir because it can shorten duration of the insulin. Maybe moving it forward a little would help in general.
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Oh, that’s interesting. I had not heard that. So nothing after nadir? Maybe his body knows that and it’s why wanting food in the afternoon isn’t a daily thing? I can’t believe the things I’ve learned or have become aware of since starting to post on the message board. The more I know, the better. Thank you.
 
Sharon555 said:
Oh, that’s interesting. I had not heard that. So nothing after nadir? Maybe his body knows that and it’s why wanting food in the afternoon isn’t a daily thing? I can’t believe the things I’ve learned or have become aware of since starting to post on the message board. The more I know, the better. Thank you.
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Well if you have a cat who absolutely must have a snack after nadir, if it’s small and very low carb it would probably be fine. Or if you are dealing with a cat who is post-DKA where you have to get as many calories into them as possible, that would be another time where it would be okay. Of course, they can still have their low carb treat at testing time as well if you are testing after nadir. But, in general, it helps the cycle if they don’t get much after nadir.
 
So, here with are with a third cycle and a green nadir … 91 +6, 95 +7, then 101 +8. I’ll test him again at +10, then PMPS. Unless something wacky happens overnight, should I do that increase tomorrow? I’ll be home all day to monitor him. It’s a little scary and I hope he doesn’t drop too low, but I’m game.
 
Suzanne & Darcy said:
Not a really high preshot tonight. Can you test some tonight?
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I’ve shot at 152 before, but it’s the lowest I've gone in the evening. I have shot lower in the morning … 130s and 140s.
I will definitely do plenty of testing tonight. Even setting my alarm if I need to.
He has had great numbers all day.
Do you think I should increase in the morning as we discussed or wait to see how tonight goes?
 
Sharon555 said:
I’ve shot at 152 before, but it’s the lowest I've gone in the evening. I have shot lower in the morning … 130s and 140s.
I will definitely do plenty of testing tonight. Even setting my alarm if I need to.
He has had great numbers all day.
Do you think I should increase in the morning as we discussed or wait to see how tonight goes?
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Well yes. I was thinking you should wait and see how it goes tonight. If he’s only really high green then you may want to proceed with the increase.
 
I saw those other times where, in the a.m. cycle m, you shot lower numbers. It looks like he started heading into bounces from there. So we will see what happens tonight.
 
You could also try just fattening the dose a little. But you would have to just eyeball a little shave more than the current 2.25 units.
 
Suzanne & Darcy said:
You could also try just fattening the dose a little. But you would have to just eyeball a little shave more than the current 2.25 units.
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He does have a history of bouncing, which makes me a little crazy. Keeping fingers crossed that doesn’t happen tonight.
Then you think, as long as he doesn’t drop below high greens, maybe 70 - 99, that I could increase in the morning. Possibly cautiously, giving him a fat 2.25. Eyeball halfway between 2.25 and 2.5? Or less than that?
 
Good morning!! So, Beau never dropped into the greens last night as of +8, but stayed in the blues. I doubt that he dropped much lower in the 3 1/2 hours until wake-up. AMPS of 226 and I went with a fat 2.25U. Hoping for another good day.
Do you think that his staying in yellows and mid-range blues at night is bouncing from his good day? I did make sure he got a snack before bedtime, about +4.5
 
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