Low +9 and need dosing advice for tonight

PPCW

PPCW

Member Since 2017
Hello Everyone,

A little history about Coby. He was diagnosed back in 2017 and quickly went into remission. He has been fine until last month with high BG in his routine blood work. His blood work last July was slightly elevated but was normal when I checked at home. His fructosamine from last month indicated that he has been diabetic for some time. He had a dental cleaning last March and his current BUN is 43 and creatinine is normal. He is receiving sub-q (100ml) twice a day. His pancreatic number is a bit high as well.

So here we are, the 2nd time. I started with 1U and gradually went up to the current dose 1.8U. His numbers have been stubborn and remained high since starting ProZinc on 1/31/21 until he is getting 1.8U.

Here is my question: his numbers have been dropping steadily today. We are 2 hours away from PM shot and his +9 is 146! I don't think his PMPS is going to be very high, so what dose should I give him?

Thank you for your advice,

Patricia & Coby
 
That is quite an interesting trend :confused: Completely low carb diet?

Let's see where he's at at PMPS. You can always stall without feeding for 20-30 mins if still low, and ask for help here.

I kind of wonder if he's been continually bouncing. He has a day where he'll drop a few hundred points, then spring back up.

Tagging @Deb & Wink, @Elizabeth and Bertie , and @Critter Mom because I'm not quite sure what to make of this one.
 
FrostD said:
That is quite an interesting trend :confused: Completely low carb diet?

Let's see where he's at at PMPS. You can always stall without feeding for 20-30 mins if still low, and ask for help here.

I kind of wonder if he's been continually bouncing. He has a day where he'll drop a few hundred points, then spring back up.

Tagging @Deb & Wink, @Elizabeth and Bertie , and @Critter Mom because I'm not quite sure what to make of this one.
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Hi Melissa,

He has had very interesting numbers. He is on a low carb diet since his first diagnosis.
 
In the meantime, if none of the others can pop in -

If he's still trending downward or flat at PMPS, stall for 30 mins without feeding. If he doesn't come up after that, I'd probably skip the dose. If he comes up above 200, I'd lean towards a token dose of maybe 0.25U and test like you have been (a test at +3, and another later if he dropped). Above 300, I'd consider full dose with same testing you've been doing. You could also do reduced dose of maybe 0.75-1U if that feels safer to you.

By the way, great job on testing. Plenty of data to go from, usually makes it easier on us!

Do what you feel comfortable/safe with, I'm usually pretty confident when recommending doses but in this situation I'm not 100%.
 
FrostD said:
In the meantime, if none of the others can pop in -

If he's still trending downward or flat at PMPS, stall for 30 mins without feeding. If he doesn't come up after that, I'd probably skip the dose. If he comes up above 200, I'd lean towards a token dose of maybe 0.25U and test like you have been (a test at +3, and another later if he dropped). Above 300, I'd consider full dose with same testing you've been doing. You could also do reduced dose of maybe 0.75-1U if that feels safer to you.

By the way, great job on testing. Plenty of data to go from, usually makes it easier on us!

Do what you feel comfortable/safe with, I'm usually pretty confident when recommending doses but in this situation I'm not 100%.
Click to expand...

You read my mind! I am leaning towards 1u if he is up to 300. Testing in 30 minutes.
 
I see the 176 on your SS. Your call...you can skip or try token dose of 0.1U to 0.25U if you can test at +2 or +3, and again later if needed. He'll get a bump from the food, but don't want him to be too high by morning.
 
PMPS + 30 min: 176. I think I will go bold and give 1U after reviewing his past data and test every 2 hours. Yikes! I have been debating between 0.75 and 1U. :nailbiting:

ETA: the reason for shooting is because I was burned before for NS when he was close to 200. Giving 1U because he is definitely not well regulated at this point. If he was, I would consider a token dose. The hope is to prevent a big bounce back to 500-600.
 
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Yup. Everything is ready to go.

Thanks Melissa! Have a good night of sleep for me :p. Or have a good day if you are on the other side of the earth.
 
The one question I have on seeing this, is about the location of the insulin shot in relation to the subq fluids.

There can be some interference if the Subq fluids location is close to the insulin shot location. So you want to try to get them separated by distance on the cat's body as much as you can. You might think about shaving a small patch of fur in your injection area. So it's easier to see the tented area and make sure you aren't pushing the needle out the far side of the tent. Coby looks like he has VERY thick fur.

I'm also wondering if some of the BFF pates you are feeding could have some higher carb ingredients in them. I only looked at 2 of them, and the ingredients look ok. But it never hurts for you to double check the ingredients list on the can.

There have also been anecdotal reports from some people that the Dr. Elsey's dry food causes their cats to be run higher BG levels. I only remember that the dry salmon flavor is too high in carbs, from the chickpeas in that particular flavor.

So please do take some time to read and understand the stickies at the top of this forum. Especially the one about the dosing protocols. I highly recommend printing them out for study.
 
Deb & Wink said:
The one question I have on seeing this, is about the location of the insulin shot in relation to the subq fluids.

There can be some interference if the Subq fluids location is close to the insulin shot location. So you want to try to get them separated by distance on the cat's body as much as you can. You might think about shaving a small patch of fur in your injection area. So it's easier to see the tented area and make sure you aren't pushing the needle out the far side of the tent. Coby looks like he has VERY thick fur.

I'm also wondering if some of the BBF pates you are feeding could have some higher carb ingredients in them. I only looked at 2 of them, and the ingredients look ok. But it never hurts for you to double check the ingredients list on the can.

There have also been anecdotal reports from some people that the Dr. Elsey's dry food causes their cats to be run higher BG levels. I only remember that the dry salmon flavor is too high in carbs, from the chickpeas in that particular flavor.

So please do take some time to read and understand the stickies at the top of this forum. Especially the one about the dosing protocols. I highly recommend printing them out for study.
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Hi Deb,

Thank you for replying.

I was giving his insulin shots in the scruff but it was placed far from his sub-q sites then I moved to the side of chest. Now, I give his insulin in the abdomine just to be sure. He really does have a thick fur that's why I had two fur shots :(.

All the BFF pate I feed are grain-free and gluten free. No potato, rice and such. Clean protein is the chicken flavor one which doesn't contain any complex carb. He eats it at night but not much because the kibble size is too big for him so he has a hard time picking it up and swallow. my other cats usually finish the kibbles before Coby gets a chance to get eat. However the higher number at night time does make me think about the correlation.

I have reviewed the stickies again when Coby is diagnosed again.

It seems like he is going to be low again at PMPS. Have to think about how much to give him again. 1U last night was definitely not enough.

What do you think about starting from a low dose again?
 
PPCW said:
What do you think about starting from a low dose again?
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I wouldn't backtrack on the dosage amount. Coby needs as much insulin as he needs. Backtracking on the dose will simply take a lot of time to get to where you are now on the dose.

Your SS says you feed him the True Nature Grain Free food. Is that still true? They are low carb too. Just checking on what you are feeding. Cats like variety in my experience. So having other options helps.
 
Deb & Wink said:
I wouldn't backtrack on the dosage amount. Coby needs as much insulin as he needs. Backtracking on the dose will simply take a lot of time to get to where you are now on the dose.

Your SS says you feed him the True Nature Grain Free food. Is that still true? They are low carb too. Just checking on what you are feeding. Cats like variety in my experience. So having other options helps.
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I am but ran out. He was getting tired of True Nature Grain Free so I am giving him a break. I was feeding Nutro Grain Free until the company decided to change its packaging from cans to plastic packets. I think the formula also changed because none of my other cats liked it anymore. Replaced Nutro with True Nature. He has been on low carb food since his first diagnosis in 2017 so his recent diagnosis baffles me.

Thanks for your thought on insulin dosage. I am starting to doubt myself eventhough I can see how high and flat the numbers were with the low doeses.
 
With all the various shortages occurring with cat food, it's good to have backup food choices. I know that Weruva has a post on their website saying they are having production issues.
 
Dr. Elsey has issues with their pate as well. So glad I placed a huge order of food last month. Also have lots of Friskies pate for my feral kitties.
 
PPCW said:
I am but ran out. He was getting tired of True Nature Grain Free so I am giving him a break. I was feeding Nutro Grain Free until the company decided to change its packaging from cans to plastic packets. I think the formula also changed because none of my other cats liked it anymore. Replaced Nutro with True Nature. He has been on low carb food since his first diagnosis in 2017 so his recent diagnosis baffles me.

Thanks for your thought on insulin dosage. I am starting to doubt myself eventhough I can see how high and flat the numbers were with the low doeses.
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Just saying I agree with Deb. Look at my spreadsheet for late last year - I backtracked on the dose (for a number of reasons) and it was a bad idea and waste of time
 
If you run out of the regular food to feed Coby, you could feed him the Friskies pates. They are a little bit higher in carbs then what you are feeding him now.
The Friskies pates are in the 5-7 % carb range.
Some cats actually do better with a bit more carbs in their diet. The lowest carb % isn't always the best.
You might want to take a look at this discussion, from many years ago. https://www.tapatalk.com/groups/fdlibrary/low-carb-vs-lower-carb-t18.html#.UYOzScqi9Go

You might consider using the MPM dosing protocol. It's a bit more aggressive in how quickly the dose changes are done. But that could be useful in getting Cody's BG levels back down quicker.

MPM = Modified Prozinc Method
 
FrostD said:
Just saying I agree with Deb. Look at my spreadsheet for late last year - I backtracked on the dose (for a number of reasons) and it was a bad idea and waste of time
Click to expand...

I also backtracked back in 2017 but his numbers were not as bad as now and early on in his treatment.

Testing in 15 minutes to see his PMPS number then decide what to give him.
 
Deb & Wink said:
If you run out of the regular food to feed Coby, you could feed him the Friskies pates. They are a little bit higher in carbs then what you are feeding him now.
The Friskies pates are in the 5-7 % carb range.
Some cats actually do better with a bit more carbs in their diet. The lowest carb % isn't always the best.
You might want to take a look at this discussion, from many years ago. https://www.tapatalk.com/groups/fdlibrary/low-carb-vs-lower-carb-t18.html#.UYOzScqi9Go

You might consider using the MPM dosing protocol. It's a bit more aggressive in how quickly the dose changes are done. But that could be useful in getting Cody's BG levels back down quicker.

MPM = Modified Prozinc Method
Click to expand...

I read the MPM by Djamila and will read it again. Djamila helped me a lot back in 2017. Is she still around?

Thanks for the link! It is so hard to know what the kitty needs :banghead:.
 
No, Djamila isn't around any more. Family responsibilities took her away a few years ago. Life just got too busy for her.

She was instrumental in helping rewrite those Prozinc dosing protocols. They've been out there for almost a year now. Truly much more helpful than the older version. Even so, I've made a ton of handwritten notes on my printed copy.
 
In another cycle or 2, I think it will be time to raise Coby's dose to 2U.
Unless he surprises you and the rest of us with some really low BG numbers, in the blues and greens at mid-cycle.
 
Deb & Wink said:
In another cycle or 2, I think it will be time to raise Coby's dose to 2U.
Unless he surprises you and the rest of us with some really low BG numbers, in the blues and greens at mid-cycle.
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Hi Deb,

Sorry about the late reply. Got really busy with work and forgot to check the thread.

I started 2u on Wednesday and I am not sure what to think about his numbers at this point.
 
Still too high even with 2U. But it could be bouncing from a low.

2/17/21 he dropped into the mid-range blues when you first increased him to the 2U.
Let's give him another cycle or 2, to see if he clears the bounce.
 
He drops too quickly then comes back like mad. His night time numbers just won't budge regardless of dosage and he doens't have any kibbles at night now.
 
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