Mikey’s chart

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I will tag a prozinc user for you but first can you
Please read helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
 
The info Diane requested will be helpful to answer a lot of questions I have. Namely any history of ketones, other health issues, other medications, and what his diet is. Also how he was diagnosed.

Your dosing is kind of all over the place, I'd suggest reading through the dosing methods we have here: https://www.felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/

Once you choose one we can better help you. You likely should have reduced after that 65 a little bit ago rather than gone up. Dose is based on nadirs, or how low the cat goes, not preshot.

It looks like he's hitting the lows and bouncing back up. This is pretty normal, although without some more midcycle tests it's a bit hard to see if it's partially because the dose is too high, or if the food carb content isn't ideal.

Can you to try to get a few more +6, +7, and +8 tests? That seems to be about where Mikey's nadir is.
 
I am curious why you lowered your dose so much? After the 65 it should have been reduced from 3.5 to 3.25. I think you need to go back up. We want to see lows around 80-100
 
I will tag a prozinc user for you but first can you
Please read helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
I thought I did that when I signed up.
 
The info Diane requested will be helpful to answer a lot of questions I have. Namely any history of ketones, other health issues, other medications, and what his diet is. Also how he was diagnosed.

Your dosing is kind of all over the place, I'd suggest reading through the dosing methods we have here: https://www.felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/

Once you choose one we can better help you. You likely should have reduced after that 65 a little bit ago rather than gone up. Dose is based on nadirs, or how low the cat goes, not preshot.

It looks like he's hitting the lows and bouncing back up. This is pretty normal, although without some more midcycle tests it's a bit hard to see if it's partially because the dose is too high, or if the food carb content isn't ideal.

Can you to try to get a few more +6, +7, and +8 tests? That seems to be about where Mikey's nadir is.
Yes I will try to get some 6, 7 and 8’s thank you
 
I will tag a prozinc user for you but first can you
Please read helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
I updated my signature and linked my spreadsheet.
 
Do you think I should stay with the 3u a little bit more or is this too low for him? I’m home today so I can do some mid tests. I just did a +4 and he’s 243, and then gave him a small meal.
 
Let's stick with 3U through tomorrow so he has 6 cycles at this dose, then re-evaluate. It does appear to be too low but let's give him time to settle into a dose before changing.

I linked the dosing methods earlier in this thread, did you have a chance to look them over?
 
If following Modified Method this is fine, but by default I assume SLGS until they've had time to read and decide.

Hi we did three full days of the 3u now. His numbers are pretty high today 383 am and 411 pm. Do you think we should go to 3.5 tomorrow?
 
Hi we did three full days of the 3u now. His numbers are pretty high today 383 am and 411 pm. Do you think we should go to 3.5 tomorrow?
It depends on which method you would like to do. Per SLGS you would hold since he had that 123 (and I suspect some other low blues during times you're not testing).

With MPM yes you could increase to 3.25U, not 3.5U. But I'd recommend doing that only if you can be around to test the first two cycles on that dose.
 
Well I was thinking modified since we’ve been at this for a while. But I just read about the methods again and I’m not sure what would be best. Maybe it would be best to give 3u a full week? I don’t know. This is all very confusing to me.
So the main difference in the methods is the BG range you want Mikey in, and how often you can test (well, and no dry food on MPM but that's not a factor here).

MPM aims to keep BG in the "healing greens" as much as possible so pancreas can heal, and better shot at remission. That said, it can require more testing and food intervention - because once they start flirting around that 50-60 mark on a human meter, we have to be careful not to let them go too much lower. Take a look at my spreadsheet before remission - although we were using a different insulin, the concept is the same. You can see how much testing I had to do and some food intervention.

SLGS keeps them a little higher but still in good numbers. It's overall usually less testing, but also smaller chances at remission. Some people find themselves stressed by low numbers or interrupted sleep or potentially having to leave them alone all day while at work, and choose SLGS for that reason.

It's really whatever you're comfortable with. My two cents is if you're not comfortable and your gut is telling you to hold, then hold for now. You can always change your mind later.
 
Hi we did three full days of the 3u now. His numbers are pretty high today 383 am and 411 pm. Do you think we should go to 3.5 tomorrow?
I would wait another 2-3 days, being sure to get mid cycle readings, then try 3.25. I say this because of the blue numbers you got.
 
So the main difference in the methods is the BG range you want Mikey in, and how often you can test (well, and no dry food on MPM but that's not a factor here).

MPM aims to keep BG in the "healing greens" as much as possible so pancreas can heal, and better shot at remission. That said, it can require more testing and food intervention - because once they start flirting around that 50-60 mark on a human meter, we have to be careful not to let them go too much lower. Take a look at my spreadsheet before remission - although we were using a different insulin, the concept is the same. You can see how much testing I had to do and some food intervention.

SLGS keeps them a little higher but still in good numbers. It's overall usually less testing, but also smaller chances at remission. Some people find themselves stressed by low numbers or interrupted sleep or potentially having to leave them alone all day while at work, and choose SLGS for that reason.

It's really whatever you're comfortable with. My two cents is if you're not comfortable and your gut is telling you to hold, then hold for now. You can always change your mind later.

Yeah I worry because I work a lot. The testing on my ss now is really the best I can do, unless I was on vacation. So I think sticking with 3 for the whole week and seeing how that looks may be the best choice. Maybe then if there’s not much improvement I’ll go up to 3.25?
 
I suspect he is bouncing from missed lows on the days you didn't get midcycle tests. I would hold through tomorrow and see what happens, please try to get a few midcycle tests tonight and tomorrow. My guess is yes he'll need an increase, but want to be safe
 
Normally when switching insulins, (except between the depot insulins) you'd want to start at a dose where you were getting some decent numbers. Looking at your SS and the more recent numbers on 3u of Prozinc, I'd start with 3u of Semglee. I wouldn't start any lower than that, since the last few days the best nadir was only 210.

Can you put a line in your SS to show the break /change in insulin, and just include "switching to Semglee" in the new line. Good luck with the switch :)
 
I agree with Christie on dosing. Starting any lower is going to take you longer to get this under control. Remember it will take a week for the depot to build. Some cats do dramatically well the first day or two but most take time to build the depot.
 
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