Kitty and I say Good Morning!

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kse

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Kitty is showing a definite trend in her BG values. I wish I could test more--but work, work, work!

As you might know--the vet started Kitty on 2 units of PZI once a day (I know---not optimal!). Tomorrow, Kitty goes to the Vet for a Glucose curve and insulin adjustments. What would you expect to see the dosing change to -----1 unit twice a day or an increase to 1.5 units twice a day? Hopefully she want suggest 2.5 or 3 units once a day.

Just curious what your thoughts are.

Thanks!
 
Welcome! Glad you decided to come over to join us. Be sure to check your thread in the am and pm as that is when people are online here. And if you ever have an emergency or question that needs to be answered immediately, post over in Health.

I know it is hard to hear advice different from your vet. But the glucose curve at the vet is very likely to be skewed high. Kitties are stressed at the vet with the strange noises and smells and animals and people who are "not the mommy". Stess raises bg levels. If your vet raises the dose based on the numbers they get, it is very likely to be too high when your kitty gets home and relaxes. That is why we rely on numbers you get at home to raise doses. Lots of people fax their spreadsheet to the vet and have him give them dosing advice based on those numbers.

I would not raise the dose. I would split it in half and give it twice daily. Our experience is that PZI lasts about 12 hours in cats and then they go back up fast. That does fit with your spreadsheet. You are getting lower numbers late in the cycle (which generally means too much insulin in that am shot) and then you are getting a high morning number. If you raise the dose and give it once a day, you could see very low numbers in the daytime cycle - maybe too low.

It is hard to consider trusting strangers on the internet. All I can say is that we have and are successfully treating diabetic cats, safely. There is a lot of collective experience here.

Will you tell us your name? Kitty is your cat's name, right?
 
My name is Kim and Kitty is my cat's name!

I live in North Carolina.

My Vet is well aware that I do not want any dose that will make Kitty go hypo. I would rather be a little high than too low. I hope she suggests we try 1 unit twice a day also. Kitty seems to be feeling better, even with the eratic numbers.

Thanks for the help and support.
 
One more thing--my vet does know I am testing at home and has asked me to bring the spreadsheet tomorrow--so hopefully this will help her adjust the insulin.

Here's hoping!
 
Great. Maybe your vet will consider all the numbers when making a decision. You are lucky. Some vets completely discount numbers from home testing.
 
Hi Kim and Kitty!
Just wanted to say hello and welcome to PZI. My cat Asher and I came here in January. Asher is on ProZync too, and gets his shots twice a day.

You will find very kind and knowledgable people here.

I too know the stress of going against what your vet says, but I find the "start low go slow” way of doing things here to alleviate some of my stress to be quite honest :) And you are way ahead of the game with testing at home and having your vet ask to see the spreadsheet, wow!

I think you have to listen to what your options are and make a good informed decision yourself. The folks here have lived this day in and day out, and some vets just haven’t had that much experience dealing with the disease specifically on a daily basis. But, if you are like me, you need your vet for emergencies and other things. It is a balancing act :) Bottom line is you want to do the best thing for Kitty!

Ask lots of questions here too. These folks know their stuff :)

Good safe numbers to you and Kitty, and welcome!

:YMHUG:
 
Welcome Kim and Kitty!
The advice we give most often is to start ProZinc at 1U twice a day. BID because this insulin just lasts in the system about12 hours, and you don't want the cat to basically be going on and off insulin (once a day is like 12 hours on and 12 hours off). And we like starting at 1U because we can then observe as the dose is slowly increased, so we can see your cat's "optimal" dosage.
Glad you are here and please keep asking questions!
 
Hi Kim and welcome,

I sure hope your vet will reconsider dosing twice a day. Prozinc only lasts 10 to 12 hours and then poops out so poor kitty is without insulin half the day, sitting in high numbers and feeling crappy.

If you split the dose in half and give her 1 unit twice a day she can maintain lower bg's for much more of the day and it won't start damaging her other organs. I don't mean to scare you but the longer they stay with bg's over 250 it starts to damage their Kidneys and other organs.

We want to see Ms. Kitty start feeling better as soon as possible.
 
Hello and welcome. I'm pretty new to the forum as well, and it has been invaluable in helping treat my kitty Max. He is doing so much better and I really owe it to the great advice from the forum. As others have mentioned, I too deviated a little from my vet's advice. I've kept my vet in the loop, but the experience and advice from this forum can't be beat. Wishing you and Kitty the best! Holly
 
Ditto to everything said so far. :-D If your vet resists going to BID dosing (1u 2x/day looks like a perfect starting place to me), one thought would be to ask her what if you tried say a two week experiment, gather data, and then reevaluate? The #s you are seeing suggest to me that the dose (given in one shot that is) may be a bit too high, and then we know from experience that no shot at night means they are just sitting in higher #s then.

If you stick with SID dosing, you would want to do a 24-hour curve IMO so you can see what is happening at night. That's another thought for your vet - if you gave her data on a night-time curve (I'd do something like a +2 and a +4 and maybe a +6 one night, and then on a different night get up early for maybe a +8 and +10, something like that so it's not one night of h*ll - spread out the fun! :lol: ). If the data shows the #s are just high all night, that pretty much shows that she does need some insulin at night. Personally I wouldn't go to those lengths, I'd just shoot BID, but brainstorming options here...
 
Sorry I haven't checked in over the weekend.

Okay---Kitty went for her Glucose Curve at the Vet on Friday. Unlike me, the Vet did not feed Kitty all day, to see what the insulin was doing without food. I feed Kitty everyday at lunch and leave a little FF down for her during the day.
Kitty had her first green number on Friday at +8 (80). The Vet said we should continue with the once a day 2 units.......on Saturday, I decided to cut back on the dose---1.7 units-- to see what would happen. Sunday morning was the first red number she has had since starting PZI. Of course, she could be having more--but, none I have captured. I started back the 2 units yesterday and this morning she was back in the pinks.

My Vet said, 25 percent of cats can be controlled on once a day dosing--and Kitty was one of them. She is scheduled to go back in two weeks, for another curve and a complete blood panel to be sure everything (especially kidneys) is looking okay with the higher protein diet.

Kitty had gained 5 onces in a week--which might not seem like a lot, but this was the first weight gain since being dx. She had been losing weight rapidly. Her clinical signs also seem to be improving--drinking less, urinating less etc.

So, here I am on a island--the only one in the group dosing once a day.

Thanks for your support and please give me your thoughts!
 
I know it is hard to hear your vet could be wrong, but I think he is. Your 80 was a lovely number. You would have gotten it whether you were dosing once or twice daily - it is a reaction to the am shot. Our concern is your high pre shot numbers in the am. You will continue to get that roller coaster pattern from pinks to blues because the insulin peters out after 12 hours.

You have tried it your vet's way for awhile. Do you think he would let your experiment trying it twice daily for a while? It won't hurt anything and it could mean that you would have nice yellow numbers every am and pm and nice drops at nadir.

A kitty is considered "regulated" here when she is around 200 at pre shots and 100 or below at nadir.
 
If I tried twice a day on my on---would you start at 1 unit twice daily?

I think two units twice daily would be too much--because she is normally high 100s or low 200s at +12. I would think I would definitely need to cut back the dose.
 
Yes, I would halve the dose. It may not be enough, but you can always raise it a hair after a few cycles. It's all about collecting data to see what works best.
 
I'm go glad you are considering trying twice a day injections.

You could try it for the two weeks until your next vet visit, keep a good record of the bg's and show it to your vet so he can see your progress and success.

It won't hurt to try and we will be here to help you with every step. I don't think you will regret it and kitty will thank you.
 
I understand how hard it is to be getting conflicting advice. Truthfully, I often did not tell my vet what I was doing, because he did not think home testing was necessary, so I really felt I could not trust his judgement. You are ultimately the one who must decide what to do, and if it is possible to get this vet to listen and work with you. There are suggestions (maYbe in FAQ on Heath forum?) on how to convert a vet, I don't know if that might help. But keep posting and we will do our best to be helpful no matter what you decide.,
 
Did your vet say why he or she thinks she would do well on SID? I would think if it works for 25% of cats.... well, I'd go with what works for 75%... better odds! :-D Bix was SID for a while, but that was only after BID for several months, and then he was doing really well at the time and was usually too low to shoot at +12. I haven't seen that too often though, and only in cats that have a sputtering pancreas and have been on insulin enough to have spent some solid time in good #s and have done some healing presumably.

One thing I would consider is to start getting a spot test in at the +12 point even if you don't give a shot then, and also try to get a spot test here and there in the nighttime hours. It will fill out the picture for you I think, so you can evaluate for yourself how she is doing on SID. If it actually works for her, more power to your vet, it just seems to me less promising than BID shots.

Thanks for the update, and please do keep posting even if we all disagree with your vet. :mrgreen: Hopefully we are not discouraging you. I struggled a lot at first with conflicting advice and wanting to do what my vet said, I think many of us have. It just takes a while to discover for yourself what works and what doesn't, and as you do, you will probably refine your sense of what your cat needs. I at times disagreed with my vet, and at times disagreed with advice I got here. Ultimately, you hold the syringe, and you need to do what you think is best.
 
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