I'm so frustrated for not being able to keep Mochi's BG regulated.

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Hi Trista

I'm struggling with my kitty too and can understand how frustrating and overwhelming the roller coaster of feline diabetes can be.
I am tagging @Deb & Wink who should be able to help you with Prozinc dosing.

This is our Prozinc Forum. If you post here, you should be able to get help with dosing etc.
https://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/

Hang in there!
Bhooma
 
It can take months to get anything that even sort of resembles regulation so yes, it can be totally normal!

One thing I think is important is that you don't have many tests on the PM cycle. Most cats go lower at night, so it's important to get at least a "before bed" test on every PM cycle.

Also, if you're not testing on both cycles, you're missing half the picture! Think of your spreadsheet like it's a puzzle. If all the pieces you have filled in are on the left side, it's easy to see it's a kitten but what's the rest of the picture? Is it a flower? A puppy? A pink elephant?

We don't expect you to stay up all night every night testing, it is important to get at least that one "before bed" test. If there's been a big drop from the PMPS, it might be important to set an alarm to get another test in later in the cycle to make sure kitty stays safe.
 
Trista said:
I have increased dose from 0.5 to 0.75, but it doesn't seem to be working. She has been on Prozinc for a month now, but her numbers are still high. Is it normal?
Click to expand...
I second all that Chris said in her post above. It's important to get some data for the evening cycle, even a 'before bed' test would be helpful.
And it can take time for a cat to become regulated. Some regulate quickly, some take longer, some never get regulated, some go into remission. And each cat takes its own sweet time to do what it's going to do...

A couple of thoughts. I think your kitty may have some 'bouncing' (rebound) going on.
When the blood glucose drops too low or too fast (or both) the body can see that as a threat and release stored glycogen to raise the level. 'Too low' doesn't necessarily mean 'dangerously low'; bouncing can be triggered even when a cat's blood glucose drops lower than its body has lately become accustomed to. Bouncing is pretty common...
The body can also release counter-regulatory hormones to cause temporary insulin resistance. It's a protection mechanism. And when this happens what the caregiver usually sees is high 'flat' (unmoving) numbers that seem unresponsive to insulin.
If you look at your kitty's morning cycle yesterday, for example, those numbers are flat and just didn't budge. The same happened on 13th July, and to some extent on some other days too. That 'can' be an indication of bouncing.
Another indication of bouncing is high numbers following lower numbers. If you look at the 14th July, the numbers rise quite quickly toward the end of the cycle. There is an even better example of the same on 25th June.
...High numbers toward the end of a cycle can also be caused by the insulin not lasting long enough in the kitty's system (numbers rise when the insulin wears off) but I'm not seeing any actual evidence that your kitty is getting short duration on the Prozinc, so bouncing seems more of a possibility to me...

My 'best guess' - on the information available - is that the dose is a bit too high, and that the numbers may even out a bit more if the dose was reduced.
...I do wonder how it would have been if your kitty had stayed a bit longer on the 0.25 unit, because you only tried that for a couple of days, and on some occasional shots thereafter...
Prozinc can also be quite sensitive to dose changes, and can sometimes take a few days to 'settle' into a new dose. That 'may' also be something that has added to the erratic nature of the numbers.
If you can get a pm cycle test or two routinely that may shed more light on the situation, as it will fill in more jigsaw pieces in the puzzle. :cat:

Eliz
 
Elizabeth and Bertie said:
The body can also release counter-regulatory hormones to cause temporary insulin resistance. It's a protection mechanism. And when this happens what the caregiver usually sees is high 'flat' (unmoving) numbers that seem unresponsive to insulin.
Click to expand...

I find this happens with my kitty too. This is different from bouncing? Why does this happen?

ETA: How does one break this temporary insulin resistance? By continuing with the dose increases as per the protocol followed?
 
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Chris & China (GA) said:
It can take months to get anything that even sort of resembles regulation so yes, it can be totally normal!

One thing I think is important is that you don't have many tests on the PM cycle. Most cats go lower at night, so it's important to get at least a "before bed" test on every PM cycle.

Also, if you're not testing on both cycles, you're missing half the picture! Think of your spreadsheet like it's a puzzle. If all the pieces you have filled in are on the left side, it's easy to see it's a kitten but what's the rest of the picture? Is it a flower? A puppy? A pink elephant?

We don't expect you to stay up all night every night testing, it is important to get at least that one "before bed" test. If there's been a big drop from the PMPS, it might be important to set an alarm to get another test in later in the cycle to make sure kitty stays safe.
Click to expand...
Thank you for the advice. Okay, I will do one more BG test before bed.
 
Elizabeth and Bertie said:
I second all that Chris said in her post above. It's important to get some data for the evening cycle, even a 'before bed' test would be helpful.
And it can take time for a cat to become regulated. Some regulate quickly, some take longer, some never get regulated, some go into remission. And each cat takes its own sweet time to do what it's going to do...

A couple of thoughts. I think your kitty may have some 'bouncing' (rebound) going on.
When the blood glucose drops too low or too fast (or both) the body can see that as a threat and release stored glycogen to raise the level. 'Too low' doesn't necessarily mean 'dangerously low'; bouncing can be triggered even when a cat's blood glucose drops lower than its body has lately become accustomed to. Bouncing is pretty common...
The body can also release counter-regulatory hormones to cause temporary insulin resistance. It's a protection mechanism. And when this happens what the caregiver usually sees is high 'flat' (unmoving) numbers that seem unresponsive to insulin.
If you look at your kitty's morning cycle yesterday, for example, those numbers are flat and just didn't budge. The same happened on 13th July, and to some extent on some other days too. That 'can' be an indication of bouncing.
Another indication of bouncing is high numbers following lower numbers. If you look at the 14th July, the numbers rise quite quickly toward the end of the cycle. There is an even better example of the same on 25th June.
...High numbers toward the end of a cycle can also be caused by the insulin not lasting long enough in the kitty's system (numbers rise when the insulin wears off) but I'm not seeing any actual evidence that your kitty is getting short duration on the Prozinc, so bouncing seems more of a possibility to me...

My 'best guess' - on the information available - is that the dose is a bit too high, and that the numbers may even out a bit more if the dose was reduced.
...I do wonder how it would have been if your kitty had stayed a bit longer on the 0.25 unit, because you only tried that for a couple of days, and on some occasional shots thereafter...
Prozinc can also be quite sensitive to dose changes, and can sometimes take a few days to 'settle' into a new dose. That 'may' also be something that has added to the erratic nature of the numbers.
If you can get a pm cycle test or two routinely that may shed more light on the situation, as it will fill in more jigsaw pieces in the puzzle. :cat:

Eliz
Click to expand...
Thank you for the useful info. Since she has been on the 0.75 dose for a few days now, should I wait to see what will happen after a week OR I should go back to 0.25 unit right now?
 
It took my cat two months before I saw any numbers under 300, and three months before I had a preshot under 300. Some cats just take a while to find the right breakthrough dose. You are doing awesome though, and your love and dedication will help your cat improve. It's so hard to be patient when we just want them to feel better.
 
JanetNJ said:
It took my cat two months before I saw any numbers under 300, and three months before I had a preshot under 300. Some cats just take a while to find the right breakthrough dose. You are doing awesome though, and your love and dedication will help your cat improve. It's so hard to be patient when we just want them to feel better.
Click to expand...
I'm impatient due to the fact that I'm so worried ketones will be developed with these high numbers for a long run.
 
Trista said:
Since she has been on the 0.75 dose for a few days now, should I wait to see what will happen after a week OR I should go back to 0.25 unit right now?
Click to expand...

I'd continue with the .75 while you gather some data on the PM cycle. It's possible she is going lower at night and then bouncing high by morning.....it's also possible .75 just isn't enough! The answers are in those tests.
 
Erratic BG levels are perfectly normal.

Trista said:
I'm impatient due to the fact that I'm so worried ketones will be developed with these high numbers for a long run.
Click to expand...
If you are worried about ketones, then you can test for them with urine ketone test strips, or there are blood ketone meters where you test the blood for ketones.

For information on how to get a urine sample, read this link here >>>>>> Catching and Testing Urine tips.

Did your cat have ketones before? At diagnosis or since the diagnosis?
 
Deb & Wink said:
Erratic BG levels are perfectly normal.


If you are worried about ketones, then you can test for them with urine ketone test strips, or there are blood ketone meters where you test the blood for ketones.

For information on how to get a urine sample, read this link here >>>>>> Catching and Testing Urine tips.

Did your cat have ketones before? At diagnosis or since the diagnosis?
Click to expand...
She didn't have urine ketones the last two vet visit. I'm failed to do urine test at home. She is stubborn and doesn't want to change. She refused to use the litter with all these methods. That's why I can only take her to the vet for urine test.
 
Trista said:
She didn't have urine ketones the last two vet visit. I'm failed to do urine test at home. She is stubborn and doesn't want to change. She refused to use the litter with all these methods. That's why I can only take her to the vet for urine test.
Click to expand...
Well then, it sounds like your kitty Mochi is a perfect candidate for blood ketone testing. Which you can do at home, and save yourself the trip to the vet, the stress as well as the vet charges for testing Mochi.

If you can test the cat's blood for glucose, you can test the cat's blood for ketones. You simply need a different test meter and strips.

@JanetNJ uses a blood ketone meter. She can fill you in on which one she uses and how they work.
 
Deb & Wink said:
Well then, it sounds like your kitty Mochi is a perfect candidate for blood ketone testing. Which you can do at home, and save yourself the trip to the vet, the stress as well as the vet charges for testing Mochi.

If you can test the cat's blood for glucose, you can test the cat's blood for ketones. You simply need a different test meter and strips.

@JanetNJ uses a blood ketone meter. She can fill you in on which one she uses and how they work.
Click to expand...
Thanks. I didn't know there are blood test meter for ketones. I'm going to get one now.
 
They are able to test both the blood for glucose, and the blood for ketones. But you need different test strips for the 2 different tests.
The ketone test strips are more expensive than the blood glucose test strips. But still probably far less than the vet is charging you.
Plus, being able to test for ketones at home will give you peace of mind.

You'll want to keep your regular blood glucose meter, for testing the blood glucose.
 
Trista said:
What went wrong with the dose for my 9 years old Mochi? Her BG nadirs have kept going up these two weeks. I have increased dose from 0.5 to 0.75, but it doesn't seem to be working. She has been on Prozinc for a month now, but her numbers are still high. Is it normal?

https://docs.google.com/spreadsheet...YAi03vWYvrXEetybnqN62bdCE/edit#gid=1526124902
Click to expand...

Hello,
I am a new member here. But just a quick question, how long do you have the prozinc?
With my first Lantus- I also have very high numbers. Then- I tried to replace it with a new one (after 5 weeks of using it), and the next day using the new one- she was at 100+.
I am not saying you buy a new one. One member got mad at me by giving my free opinion here that sometimes, when the insulin gets bad- it is not as potent as the new(good one).
I am not sure if my Lantus was bad from the beginning (since I got it from a small pharmacy).
The new one (I got from CVS), and her numbers get so well after using it.
Please- to all the members here— I know that insulin is expensive, but I am just telling them this based on my own experience and in no way telling them to buy a new one. I have no intention here to argue or disagree with anyone as I am not in the position to do so. I respect everyone’s opinion.
It is all up to the pet owner if he/she thinks her insulin is bad already or is still good.
Thank you.

Trista said:
What went wrong with the dose for my 9 years old Mochi? Her BG nadirs have kept going up these two weeks. I have increased dose from 0.5 to 0.75, but it doesn't seem to be working. She has been on Prozinc for a month now, but her numbers are still high. Is it normal?

https://docs.google.com/spreadsheet...YAi03vWYvrXEetybnqN62bdCE/edit#gid=1526124902
Click to expand...
 
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