Insulin going up and so is sugars

Discussion in 'Prozinc / PZI' started by Tomikka, Mar 28, 2022.

  1. Tomikka

    Tomikka Member

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    Mar 15, 2022
    Hello, chika has been diagnosed diabetes for a month now. I have gradually increased her up to 2units but it looks like as I increase her insulin her numbers are also increasing. She did go through a bit of about of constipation mid month but looks to be back to normal digestive wise. Any help with steps forward would be appreciated.

    https://docs.google.com/spreadsheet...g0FX0PAq2Xjv1S49uD_yRrS2hF4/edit?usp=drivesdk
     
  2. FrostD

    FrostD Well-Known Member

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    May 27, 2020
    You are doing a great job testing and staying on top of increases. Unfortunately you just have to keep increasing until you hit a good dose (you have a lot of data, you are not kissing any low numbers).

    What is her diet? If she's completely low carb wet food you can follow the Modified ProZinc Method (which you're already doing anyway technically) - in which case you can increase by 0.5U if you aren't seeing nadirs below 200.

    https://www.felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/
     
  3. Zorrain

    Zorrain Member

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    Mar 26, 2021
  4. Zorrain

    Zorrain Member

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    Mar 26, 2021
  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    @Zorrain I'm not experienced with Prozinc. Melissa is a better resource and she has answered.
     
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  6. Zorrain

    Zorrain Member

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    Mar 26, 2021
    Would it be worth a idea of Tomika switching chika insulin. I don’t know anything about this insulin either, she has been having a hard time with chika and seems like this insulin is not doing much.
     
  7. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Way to early to see Prozinc isn't working. Hasn't even been a month yet. Like Melissa said, he hasn't reached a good dose yet.
     
  8. Zorrain

    Zorrain Member

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    Mar 26, 2021
    upload_2022-3-30_0-41-16.jpeg

    from vet
     
  9. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Somygyi doesn't exist in cats, don't get us started on that myth. I'd like to see tests each and every preshot, a few are missing. Other than that, Chika's SS looks like every other cat new to insulin that hasn't reached the right dose yet.
     
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  10. Tomikka

    Tomikka Member

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    Mar 15, 2022
    What are your thoughts about getting the blood glucose meter that gets stuck to them, and then you can scan with your phone? My partner is having difficulty getting chika to allow him to do the test, and he is doing the shots in the evening.
     
  11. Tomikka

    Tomikka Member

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    Mar 15, 2022
    Also thank you for all the information so far, we will continue increasing until we find the right dose.
    @FrostD @Wendy&Neko
     
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  12. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    We have quite a free members who have used the Freestyle Libre. There is a discussion on it in the Think Tank forum. Depending on kitty it may or may not last the full two weeks. Putting a collar or shirt on him may help.
     
  13. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Hi Tomikka. I'm friends with Zorrain. She's probably told you about me. I am happy to help any time I can. I didn't get the tag on this one -- and I've been out a lot due to house renovations lately. I think you're doing a great job. Hang in there. Zorrain said you just got the Libre put on -- so I hope that helps a lot with gathering data.
     
  14. Tomikka

    Tomikka Member

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    Mar 15, 2022
    Hello, I have an update on chika. I'm getting concerned as her pre-shot numbers are very high.
    I have cut out her snacks, and she is only getting food at shot time.
    One can of tiki cat, or one can fancy feast. Two cans a day. She usually leaves a little bit and finishes it off a half-hour later.

    She seems to be adjusting to the freestyle libra quite well... Day three, and it's still attached. To get it put on, they had to put her under as she was being very "spicy."

    Advice in the future would be appreciated; I'm nervous about increasing her dose as it looks like as I increase the insulin, her pre-shot numbers also increase, as stated above.

    The vet did check out her teeth while she was asleep, and they look to be not a concern at the moment.

    Could there be something else that is going on?

    Attached are the curves from the freestyle, her chart, and her latest bloodwork.
    The freestyle reads about 1 point higher than strips I've noticed.


    Thank you
    Tomikka and chika
    https://docs.google.com/spreadsheet...g0FX0PAq2Xjv1S49uD_yRrS2hF4/edit?usp=drivesdk
    upload_2022-4-7_23-23-30.png upload_2022-4-7_23-24-7.png upload_2022-4-7_23-24-28.png
     

    Attached Files:

    Last edited: Apr 8, 2022
  15. FrostD

    FrostD Well-Known Member

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    May 27, 2020
    Multiple smaller meals are actually better for them, we just try not to feed after nadir.

    I would increase by 0.5U. I don't suspect anything else going on, just have to keep in reading until you start breaking through these higher numbers - then hopefully she starts to come down in dose a bit.
     
  16. Tomikka

    Tomikka Member

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    Mar 15, 2022
    Thank you for your reply, I will give snacks until +6 and increase this weekend.


    Tomikka
     
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  17. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Hi Tomikka! Yes. It's just like that with insulin sometimes (was like that for me a LOT) where you just don't seem to see much reaction until you get closer to the correct dose for your kitty. Since insulin is a hormone and not a typical medication (where you expect to see a direct correlation between how much you give and the reaction to the medication) -- so it's not a linear thing necessarily where you give more insulin and the BG automatically goes down ... at least not until you get closer to that sometimes-elusive "good dose." So hang in there. It's a marathon.

    I'm glad she's tolerating the Libre well.
     
  18. Tomikka

    Tomikka Member

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    Mar 15, 2022
    Chika update :

    I increased chika to 3u today; she dropped from 20-9 and then back up again to 21 pre-pm shot then up to 24, after shot and food.

    I posted on the FB page for advice instead of here but learned that I should be seeking guidance in this forum.

    At this point, we will continue with 3u and monitor closely. I have attached her Excel sheet and photos of info gathered from the libra. I will post once daily for the next few days with this info as going into blue numbers is new for chika and me. We need some guidance moving forward.

    (* I am going away for the weekend on Thursday ( in 3 days) and have a diabetic cat sitter coming two times a day and a family member once, do you think this is an adequate amount, chika will be wearing the freestyle libra and I have installed cameras to do visual checkins )

    https://docs.google.com/spreadsheet...g0FX0PAq2Xjv1S49uD_yRrS2hF4/edit?usp=drivesdk

    upload_2022-4-11_0-41-55.png

    upload_2022-4-11_0-41-9.png
     
  19. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Hi Tomikka! She bounced. Her body is not used to those blue numbers. From what we see now, it looks like she will be safe at this dose while you are away. How much longer do you have left on the Libre? They usually only last about two weeks. We should know more about how she is doing on this dose after she clears the bounce. Then you will know for sure if 3 units will be safe while you are away.
     
  20. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    So the neighbor or the family member will scan the Libre for you (or both of them?). Optimally, your pet sitter would check her BG before shooting in the morning, then your family member would come in and check on her at mid-cycle. I’m assuming that there won’t be anyone there to check her in the middle of the night. What about food? Will she have access to food during the day and night? Have you started using a timed feeder yet? This could help her if she gets hungry due to dropping lower than she is used to.
     
  21. Tomikka

    Tomikka Member

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    Mar 15, 2022
    Thank you for your reply, she will be getting a new libra Thursday morning before we leave.
     
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  22. Tomikka

    Tomikka Member

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    Mar 15, 2022

    The pet sitter will be coming mid day cycle and for pm shot the family member will be doing am shot. They are both instructed to spend a hour with her at shot time and mid day check in is to check number. I will see if another family member can check in later in the evening cycle around +3/ +4. I do not have a timed feeder. But I could go to the store and try to find some low carb hard food for her or instruct my sitters to leave a full can out in small amounts / multiple locations.
     
  23. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    That sounds good, Tomikka. I think she will still be relatively high on this dose, but you will have a couple of days for it to settle in and then we can see if it will be a good dose for her. Will you return home on Sunday? I hope you will have a good trip.
     
  24. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Oh, that is excellent. Then they won't have to actually test her with her ear... just scan and record the numbers (and hopefully let you know what her numbers are.)
     
  25. Tomikka

    Tomikka Member

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    Mar 15, 2022
    Yes, I gave them access to my spreadsheet so they could fill in the numbers. We will be returning Sunday afternoon. I met the pet sitter today, and she seems to be good; I'm happy that a family member will also be checking just in case she isent.

    Thanks again for all the help
     
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  26. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    You’re very welcome!
     
  27. Tomikka

    Tomikka Member

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    Mar 15, 2022
  28. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Hi Tomikka. I hope you had a good weekend! How’s Chikka been doing. I was thinking about you two! When you get a chance, would you update your spreadsheet? You are probably just getting home now or soon so I understand that you will need to get a moment to plug in some numbers.
     
    Last edited: Apr 17, 2022
  29. Tomikka

    Tomikka Member

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    Mar 15, 2022
    Hello, I will be putting the numbers in tomorrow; she read HI a few times on the freestyle, so those have been left blank on the spreadsheet. She will be changing insulin this week to Glargline.

    Luckily she was a good girl for her pet sitters, no issues with not eating or hiding .
     
  30. Tomikka

    Tomikka Member

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    Mar 15, 2022
    This is her graph for today
    upload_2022-4-17_23-27-55.png
     
  31. Tomikka

    Tomikka Member

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    Mar 15, 2022
    When we do the switch, should I go back down to one unit? The vet said two but when I started prozinc we started at 1.
     
  32. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    That’s good. Zorrain told me you were making the switch of insulin. You should get better duration from Glargine. Post on the Lantus/Levemir/Biosimilars forum when you are ready to start and we will help you! :)
     
  33. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    I agree with your vet. She is too high to restart at one. I would start her at 2 units for safety’s sake (and she has the Libre on so you can monitor her well). Then let’s see how she does. She eats all wet food? Low carb? I will send you instructions on how to set up your signature later (then I won’t have to keep asking you the same questions ). I am thinking that you can do the tight regulation protocol with Chika where any necessary increases can be made after six cycles. But it’s your call. I just would love to see Chika in better numbers.
     
  34. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Please read this when you get a chance. Since you are switching from a single cycle insulin where it’s all “gone” after 12 hours (if not sooner) to a depot insulin, this will help you to understand the Depot effect and how the previous cycle(s) can affect a current cycle. Here it is:
    https://felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/
     
  35. Tomikka

    Tomikka Member

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    Mar 15, 2022
    Thank you, chika is on all soft low carb; yes I will be doing the tight regulation with increases. Now that I have a pet sitter she can come visit china during the day to get those extra tests needed when I'm gone for 8+ hours.
     
  36. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Oh wow. That’s awesome! What a relief for you from worry!
     
  37. Tomikka

    Tomikka Member

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    Mar 15, 2022
    I did my first post in the lantus page
     
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