Jean Luc 8/3

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snorton

snorton

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Carl - hope I didn't mess up. I had to take a call and email didn't work like it was supposed. Anyway I didn't get the message until after I gave him 2U which is the same as I gave him last night. I will monitor him! Hope this is the start of a good thing... :mrgreen:
 
Wow,
Hi shannon
I was looking at you SS for the first time and I am not sure what to think
Jean Luc's preshots are so high, and I am sorry but I have not been following you from the beginiing
I dont know what you have tried, have you started over?
maybe given perhaps a .25 for a night to see what happens
has Jean Luc had ketones yet?
I hope today was a start of a good thing for you 2.. :mrgreen:
 
We haven't started over yet. Just trying to take it one day at a time. My little guy is full of surprises.

He hasn't tested positives for ketones based on the strips nor at initial diagnosis. I just updated the spreadsheet with the #'s from today. In between pokes, I had a large project to complete for work. I think we had a positive day. He was below 200 for awhile.

Just tested at +3.75 and he is at 289.
 
He has been high and flat today. +7.5 =402.
Shall I give less insulin tonight? I obviously messed up yesterday morning.
 
There is no messing up. There is just collecting data. :mrgreen: I just can't figure out how long it's a bounce or whether it just doesn't last long enough. I think 2 is good tonight.
 
Thank you. Will give 2u. This little kitty likes to make mom go um ..... wth cat(2)_steam
 
We've had some interesting readings here. Not sure what to think. I had to give shot early yesterday. At +6.5 he was between 84 and 97 (2 readings a couple of min. Apart). At +8 458 and then at normal amps was 1st 275. I thought it was weird because this is +13.5 based on early shot. I fed him ff turkey and tested 10 min later he was 544. Gave 1.75U. Then +4 = 279 and +8=127. Now at pmps his reading is HI. Thinking he is either bouncing or getting too large a dose I gave him 1.5U. Does anyone have any thoughts?
 
I think the 275 was a bad test, because it doesn't fit with the rest of the cycle. And the 544. Assuming the high readings are the accurate ones, they have to be bounces.
I'm also beginning to think there might be something up with either your meter or your strips, even though I also used the Relion. Do you have another meter you can test it against, or have you tested yourself with it?

Carl
 
I did a test with the alphatrak about 30 minutes after the 127 reading today. It was 197. I also ran a control test on the relion it was 156 with range of 99-166. I am just getting frustrated.
 
Hmmm, then it would appear the Relion is okay. The AT is supposed to read higher, so that 197 sounds like the 127 was right (on a Relion). I'm frustrated too, Shannan because I don't understand the spikes to black numbers. They don't make sense. Yes, he's bouncing, but that's a drastic bounce and the low numbers don't seem to be THAT low. I know it has to be 10 times worse for you, because you're holding the stupid meter waiting for and dreading the "beep". Damn.

Carl
 
I am hoping the 1.5u I gave tonight may slow the drop some. I am also wondering if I should just skip Aa dose on purpose to see what happens.
 
If you do that, you definitely should be checking for ketones.
 
Oh, it is an option to go without shooting, I didn't mean to say it isn't. The caution about ketones is that they can appear quickly, and one contributing factor to them appearing is insufficient insulin. So if you were going to try "zero units", you could do that for a cycle, maybe two, and see what his numbers do. But try to catch him in the act of peeing with your keto-stix and if any trace of ketones shows up, then you can't keep holding off on the insulin.

Other than that, I don't know, Shannan. Raising the dose, if his problem is "bouncing" is just going to make that keep happening, and could push his BG too low so you really have to be monitoring closely. Another option is dosing three times a day instead of two, if the problem is that the insulin just doesn't last long enough. But on your SS, it looks like some days it lasts plenty long enough. And you'd need input from people who have done "TID" dosing, and there are a couple of people here who have tried it.

Carl
edit to add- there's also the option of trying a different type of insulin. Some cats respond to a change well, while others don't. Four people who had been using prozinc for some time recently switched to Lantus or Levemir, and with decent results. Libby, Denise, LuAnn and Donna all switched within the past couple of months.
 
Thank you. Just tested a few minutes ago to see where he is and is +5 = 419. That is 1 hour after food on board and pmps over 600 (HI). His nadir seems to be +6 or later. Will see..

By the way, i have a new unused bottle of prozinc in fridge, but i think my insulin is still good based on the drops i have been seeing.
 
Pmps = HI
+5 = 419
+7 = 283
+9 = 293
Amps = 490

Gave 1.5U. Hoping with lower starting point maybe 300s at pmps. This is probably wishful thinking. Little guy did play for a few minutes this am after eating. He seems happy and maintaining weight.
 
I'm with Carl, Shannan. Jean Luc is not following the "usual" PZI patterns... When you increase, he drops into nice midcycle numbers but he is back in the blacks for preshot. If this is a bounce, we should see some improvement as he gets used to the numbers. When you lower the dose, he stays in high flat numbers.

It either isn't lasting the full 12 hours and after it runs out at 9, he shoots back up, or he just isn't responding very well to this kind of insulin.

I know this is hard as you have gotten a schedule down, and you are definitely doing all the things that should work.

Is there a chance you could try the three shots a day schedule and see if it improves his numbers? You would take, for example, the 4 units given during a full day cycle (2 every 12 hours) and divide it by 3. That would be about 1.2 on the low side. Then you would shoot 1.2 in the am, monitor and when he starts going up around +8, you shoot another 1.2. ( the important part is to be sure he is headed up before you shoot). The theory is that by shooting smaller amounts more often, he stays in the lower ranges. The big problem with this that you have to monitor more. Is it a possibility with your schedule, or if not, something you could experiment next weekend?

The only other idea I have is to try a different insulin. Lantus and Levemir typically last a full 12 hours in cats. In some cats, PZI just lasts 8 hours. I can see how that would be difficult. It sounds like you have extra ProZinc already. And I won't kid you, they are very different insulins and it is like starting over in terms of how to use it. The switch has worked for some PZI cats and not so much for others. If you think that route is a possibility, check out some spreadsheets of previous PZI cats. Arozebloom switched with numbers like Jean Luc and did beautifully, going OTJ in a month or so. Henry and Libby tried all the possibilities with PZI and switched. Henry is still being contrary, going low one day and bouncing the next but is generally getting better numbers. Sue and Samwise was a bouncer on PZI and he continues to bounce on Levemir, after several years.

All we can give you is our experiences with other cats and what has worked with PZI. And you have been so willing to try whatever we suggest. I imagine we all wake up in the morning hoping this is the day it will work for Jean Luc.

Let us know what you are thinking.
 
Sorry, it's a arozeboom, not bloom. For any of those kitties, you'd go to the Members button and get the list of members. Then Search for A Member and type in the name. That should take you to their profile and you can then choose their spreadsheet.
 
Dosing every 8 hours will be difficult during Mon-Thur due to work schedule. I am usually away for about 11 hours. I can try it during the weekend, just to see what happens. Is it possible to try it at night and not during the day?

My vet is willing to switch to Lantus. We discussed that possibility a few weeks ago. At that time, I had roughly 1/2 bottle of PZI left. I now have about 1/4 of my open bottle left as well as the unopened bottle of PZI. If I did try Lantus, what is the shelf life of that insulin?
 
It lasts at least 6 months refrigerated, I think. (longer than the info for humans because they don't always refrigerate it and they tend to use it up faster than cats) You might send a private message to one of those people I named and just ask to pick their brains about the switch. They will be honest with you about the change.

And I would read all the starred topics on the top of their forums. It is very clear about the use, dosing, care of the insulin etc. You can get a clear idea of how it works and how you manage it. I think the difficult part of Lantus is that many people use the tight regulation system and it is intense. They really want you to test often and to let the cat go low at nadir before lowering the dose. But if you don't want to use that system, you can still post on the TR forum and use the Start Low, Go Slow method. You just put in your signature that it is what you are going to do and remind them. They are great people and very willing to help. It is a much busier forum than PZI and they do have different rules about how to post etc.

I don't think I would try the TID (three shots a day) at night at first. It would be exhausting. You really want to be watching and thinking about it as you shoot. And you might want feedback on line, which you are unlikely to get at night. If it is something you are considering, we can ask bookworm or kse to join the conversation. They have both done it.
 
I know they're both "red", but that's nearly 100 points lower, so it is something positive.
 
Carl, in your opinion do you think we can get somewhere with 2x daily shots with ProZinc? I can try the 3x this weekend, but during the week it will be difficult.
 
Yes, I do think so, Shannan. I actually like what I've seen on the 1.5, and if you are able to continue getting mid-cycle readings like you did last night, during either the AM or PM cycle, I think we can find a dose that works.

Right now, I think most of the really high numbers on the SS are the result of bounces. I say "think" because I can't say for sure, because I'm just assuming some of the lows that aren't on the SS.

I think the key to figuring it out is to keep things as much as possible, consistent while testing. That means you have to keep what you "put in" to Jean Luc consistent. The only 2 things we really have control over are the dose, and the food. If he eats about the same amount of food at the same time each day, then the food is a "constant". If you dose the same for several days in a row, then that is also a "constant". What you have no control over is what his body does with this stuff once you give it to him. That's totally up to "him". And that's why the tests are critical....so you can see what he's doing with it.

If you can get several days of cycles that follow a pattern, then you can adjust the insulin based on those numbers. I'm not saying you have to stay up all night, test all day. You don't have to run curves every day. One day you could get a +3 and a +9. That night you could get a +5 or a +8. One day you could get a +6. Eventually you have a "curve", just spread out over 3 or 4 cycles.

Whether you dose once, twice or three times a day, you still have to be able to determine the "pattern". If a pattern emerges, the dosing becomes a lot more simple. You might see a pattern that indicates that if you feed on a different schedule, you can control some of the ups and downs with food. Or it might make clear that something like a sliding scale makes sense.

Basically, I'm an optimist, and I'm stubborn. So I always feel there a way to do this that will work on every cat. We just have to find the way that works for Jean Luc, because it won't be the same thing that worked for Bob or any other kitty.

Carl
 
Not sure what happened today. Was at 543 pmps. Gave him 1.5u. Cannot seem to get any patterns with him...urg!!!!!!! :twisted:
fyi - ketones were negative this am.
 
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