Increase needed?

Jamie N Gizmo

Jamie N Gizmo

Member
So this little kitty was in remission for a couple years. Fell out of remission. I had him on prozinc for a couple days before i started logging numbers due to being out of test strips. By the end of a couple days when i got test strips, he was still in the 400 range on 1 unit prozinc. Next couple days were a wash because i bounced between insulin thinking it wasn't working. Yesterday and today i had him on prozinc only, 1 unit and it seemed to be trending down. Tonight he's not even at nadir and he's 460. I'll see what tomorrow brings. How long should i wait before increasing? a week?
Thanks in advance!
https://docs.google.com/spreadsheets/d/14PPcQ8mKEEk-KkJk_wlACcyQWs3Lg28oGxx7EwyU7b0/edit?usp=sharing
 
Hey, Jamie!

Is there a reason you're flip-flopping between two different insulins? It doesn't look like you're waiting long enough either on a dose or insulin type enough to see what Gizmo actually needs. I would ditch the Novolin and focus on the ProZinc.

Could you tell me what food Gizmo eats and what time(s) you feed him?
Are you able to get earlier tests in the cycle? ProZinc nadirs typically between +4 and +7. It would be nice to see what's going on in hour 3 through 5.
What insulin was he on before he went into remission?
 
Panic said:
Hey, Jamie!

Is there a reason you're flip-flopping between two different insulins? It doesn't look like you're waiting long enough either on a dose or insulin type enough to see what Gizmo actually needs. I would ditch the Novolin and focus on the ProZinc.

Could you tell me what food Gizmo eats and what time(s) you feed him?
Are you able to get earlier tests in the cycle? ProZinc nadirs typically between +4 and +7. It would be nice to see what's going on in hour 3 through 5.
What insulin was he on before he went into remission?
Click to expand...
He was on prozinc in 2013-2014, when he went into remission. He gets fed friskies pate at shot times at 430am and 430pm. I give extra for him and his brother, 2 of the smaller cans that they don't finish right away and snack on for several hours. vet in January prescribed novolin and it wasn't working. Vet refused to give me prozinc. Went to a different vet to get the prozinc since he was still running in 400s. I ran out of test strips and had to order more. He was on prozinc from i believe 9/19-9/25, 1 unit twice a day. I only have the end of 9/25, and as you can see is still in 400s. Next morning 3 hours after his shot, he was still climbing. That's when i thought maybe the prozinc wasn't working? so i gave the novolin too. It was suggested the 500 numbers are probably because the novolin is too harsh and dropping him too fast, so it was suggested i switch him back to the prozinc. It seemed in a downward trend the first day, now seems to have stabilized in the 300-400 range.
 
If ProZinc got him into remission in the past then I'm sure it will help him now. :) He won't get better overnight though.

Let's focus entirely on just ProZinc for now. Stick to administering insulin 12 hours apart no matter what his BG looks like during the cycle. Can you get any earlier tests in, maybe +3 or +5 one day and +4 and +6 the next? We don't want to bother poking him every hour of the day so alternate days. Hold the dose 3 days and nights and then we'll have enough information to know what to do next.

Give him food with his insulin and you can either leave more out (assuming he and his friend don't eat it all at once) or offer mini meals throughout the day. Take away food two hours prior to shot time. :)
 
Panic said:
If ProZinc got him into remission in the past then I'm sure it will help him now. :) He won't get better overnight though.

Let's focus entirely on just ProZinc for now. Stick to administering insulin 12 hours apart no matter what his BG looks like during the cycle. Can you get any earlier tests in, maybe +3 or +5 one day and +4 and +6 the next? We don't want to bother poking him every hour of the day so alternate days. Hold the dose 3 days and nights and then we'll have enough information to know what to do next.

Give him food with his insulin and you can either leave more out (assuming he and his friend don't eat it all at once) or offer mini meals throughout the day. Take away food two hours prior to shot time. :)
Click to expand...

On day 4 of ONLY prozinc every 12 hours. started a mini curve tonight between the +3-+5 as suggested. His numbers don't seem to be budging at all, and i gave an extra .5 at PMPS. He's extremely good at testing time, which is nice and i got very lucky. I'm 100% certain it was not a fur shot. =( The vet found no infection or anything in his blood work. It seems like some days it half works and others not at all..
 
You're not being patient enough. It's possible 1 unit is too much and this is why his BG is so high but we can't tell if you don't hold the dose.
 
He's no longer bouncing...he's pretty consistently in 400s now where he was at the vets. It's making me think the prozinc isn't any good
 
Are there particles floating in your vial? If not it's unlikely the vial has gone bad and it's more so the dose isn't quite right. It can take days for a cat to clear a bounce so he could very well still be in a bounce or starting a new one. You really need to be more patient. I don't think you need to test him any more tonight.
 
Nothing floating in it. What makes me suspect is that it's normally an insulin they have to order, but they had it on-hand. I'm assuming it was refrigerated, as they asked if i needed an ice pack for the ride home. The bottle is good until april next year. I would expect atleast a little drop in numbers after insulin.. There is no drop for a bounce to occur. We'll see what tomorrow brings
 
If the dose is too high you often won't even see the drop, just the bounce. If you look at the spreadsheet in my signature, you can see how my cat reacted to being overdosed in the very first Vet Curve. She went from 470 to 541 all the way up to 700. No lowering at all, just up and up. There are several examples of this on her spreadsheet, and she only improved once the dose was lowered significantly. Please keep him on 1u in the morning no matter the preshot number, unless @MrWorfMen's Mom thinks you should lower it more. :)
 
I cannot stress enough the importance of holding a dose and not reacting to individual numbers as they happen UNLESS they are low numbers that make dosing at the current dose dangerous. If you keep changing the dose you can end up encouraging bouncing and never see how any one dose is working. The only dose you held for at least 6 cycles was 1u and even that is iffy because there is no dose listed for the PM dose on the 2nd of Oct. so I' don't know if the dose was skipped or if given, how much. Sometimes the dose has to beheld longer than 6 cycles to truly it's effect.

Right now my best guess is that the best dose might be somewhere between 1 and 2u but that is just a shot in the dark since there are a couple of back to back cycles with no mid cycle tests to know what happened.

My suggestion is to give 1.5u from tonight provided BG is high enough to give insulin and hold that dose for at least 3 days unless BG drops lower than 90 mid cycle. If numbers are coming down at all, then hold the dose for another 2 days. Then re-evaluate. If BG happens to be too low to give insulin, then post for advice. Get mid cycle tests as often as possible and always get a minimum of a before bed test on the night cycle to see where Gizmo is headed.
 
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