Morlei and I would like some dosing advice

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Becky & Morlei

Becky & Morlei

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Hello everyone,

I need some dosing advice...We've been upping the dose and are now at 2.0u twice a day with ProZinc. However, I've been looking at the numbers and we were getting blues (at the nadir) with a lower dose. I thought maybe if we upped the dose then we'd get even better numbers. But looking at the curves from 1/8/12, 1/14/12, 1/21/12, and 1/28/12 I just don't know where to go from here. And I'm confused as to why her numbers I get after work (most of the +6 to +8's) have been higher than her PMPS since 1/25/12 (we upped the dose on this day). No new food, she's had some loose stools/diarrhea since yesterday but it looks to be clearing up. Trying to get another ketone test but haven't been able to. Please look at Morlei's spreadsheet and give any advice you can! Thank you!

Becky
 
Good Morning Becky, ~O)

I am new, just like yourself but I did look at Morlei's SS. It does appear that she had better cycles on a lower dose. She had discernable curves with the lowered dose so it may be possible that you didn't hold her long enough on .50-.75 to give her enough time to settle into the dose. She was hitting her nadir in the high 100's but it is possible that if the dose was held longer those numbers would have fallen more as she settled into it.

It looks, to me, that 2 units is too high as you are seeing a few inverse curves take place. Check out 1/27 and 1/28, and many flat cycles where there isn't a curve at all like your last two runs.

I know the motto around FDMB land is start low and go slow as you may miss the right dose for your sugarbaby if you increase too fast. I think a reduction may be in order but I'm sure more experienced PZI'ers will chime in as I am one of the newer members and learning what it all means, like you.
 
I agree also - seems like she had some better numbers at the lower dose. If Morlei was my kitty I would drop her back to the .5 and hold it for several days - some kitties can take up to a week to settle in to a dose. If possible I would try and get a curve a couple of days after the change of dose so you can see exactly what's happening - which it seems like you are really good about doing. :smile:

Good Luck!
 
I'm newer too, so others with more experience may have a definitive idea.

Any way you can do a curve this weekend to get a better idea of how the insulin is working through the cycle?

I tend to agree, it seems the 2u is too much but a curve would sure help. :smile:
 
I have to say your spreadsheet confounds me. I don't think I have ever seen one like it. You are getting basically the same numbers whatever dose you give. They may be 10 more or ten less on any given day, but they are basically the same. And they are good numbers. I think we could say he is generally a regulated cat -200s at preshot and 100s at nadir. This is is wonderful. Many new diabetes bounce all around and are in reds and pinks.

I'll be interested to see what others think. There is room to move beyond regulation, getting lower nadirs, but I am not sure whether that would be up or down! I must be missing something.

What are you feeding? How often/how much?

I like the idea of a curve this weekend. Maybe that will make the picture clearer.
 
Hi Becky,
I went back and reread all of your previous posts to see if that would help me figure something out. Like you, I am perplexed as to why he doesn't seem to respond to increased doses. You were feeding low carb canned, no more dry. You were feeding two meals and two snacks per day. You were monitoring calorie intake. You read and have been following the "SLGS" protocol, testing and adjusting as indicated by the protocol. So it looks like you've done everything the right way so far. Which is awesome, but it doesn't help me! It just makes me more perplexed....

I can only come up with one thing to ask at the moment....where do you shoot the insulin, and have you always shot in the same general location? Oh, and what us the exp date on your vial of PZI? Have you always kept it cold and taken care not to shake it?

Carl
 
Wow Becky, that is tremendous that Morlei is basically regulated and you guys only started this the beginning of last month!
Sue touched on the food and I think that is important too. Our cat is very food sensitive and recently he was put on a diet by the vet and we shoot about a unit less insulin now.
Do you free feed or do you feed twice a day before insulin? Are you consistent every day with the same amount of food?
It is amazing that you get the same numbers on 1 units as you get on 2.
 
Thank you for all the responses.

carlinsc said:
I can only come up with one thing to ask at the moment....where do you shoot the insulin, and have you always shot in the same general location? Oh, and what us the exp date on your vial of PZI? Have you always kept it cold and taken care not to shake it?
Click to expand...
We shoot the insulin in her scruff area or more to the side, we try not to do it the same place every time. The insulin's expiration date is 11/2012, we always "roll" the vial and never shake it, and we keep it in the fridge.

Sue and Oliver (GA) said:
What are you feeding? How often/how much?
Click to expand...

She gets 1/2 can of Sophisticat in the morning with shot, 1/4 can when I get home from work, 1/2 can in the evening with shot, 1/4 can before bed.

I will only be able to to get a curve until +6 today but I'll be home all day tomorrow so I can do a full curve then.

Another quick question, it looks like she still has some loose stools, I saw on some other posts that you can give them fiber or probiotics? Anybody have the name of one off hand that is safe for cats?
 
Her are her numbers for today:
AMPS: 298
+2: 263
+4: 264
+6: 294
PMPS: 282

I'm going to test her every hour for 12 hours if I can tomorrow. Should I do the curve with 2 units? Or drop it down?
I think it's interesting that when the vet gave her 3 units that her lowest number was 252...I know she was probably stressed and scared but it seems like her body doesn't really want to budge from these 200s. I'm very thankful that we haven't had to deal with very high numbers but I'd really like to see some lower 200s and some drops into the 100s.
I'll post the curve tomorrow.
 
You don't have to do every hour. Your curve yesterday indicates she doesn't move.

It looks to me like she almost isn't getting insulin. How does the ProZinc look? Any floaties? I would consider calling the vet, tell him you are shooting and the numbers have not budged. Ask him if he has another vial that you can try?

The only other thing I can think is that somewhere, somehow she is getting into dry food and it is balanced by the insulin.
 
Teresa and Poopy said:
Is she still having loose stools? Would not feeling well raise her numbers?
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She's still having some so I'm going to have to get her something to help clear it up. Other than that she seems like her normal self.

Sue and Oliver (GA) said:
You don't have to do every hour. Your curve yesterday indicates she doesn't move.

It looks to me like she almost isn't getting insulin. How does the ProZinc look? Any floaties? I would consider calling the vet, tell him you are shooting and the numbers have not budged. Ask him if he has another vial that you can try?

The only other thing I can think is that somewhere, somehow she is getting into dry food and it is balanced by the insulin.
Click to expand...
The ProZinc has clear liquid for the majority of the top of the vial then there's the white liquid at the bottom that combines when we roll it. We've always refrigerated it. When I look really closely it looks like there are some floaties from where the white and clear liquid meet (bottom 1/3 of vial about) to about the middle of the vial. At first I thought it was because I was moving it but I let it settle for 10 minutes and those floaties are still there. We really can't afford to get a new bottle of insulin right now, but then again I don't really know how long ProZinc is supposed to last. My mom said that in theory it should last until the expiration date if we are wiping the top with an alcohol swab because we are only using it for the one cat. But obviously there is a risk for contamination because we are going into the vial again and again. When I asked the vet they really didn't give us a clear answer, I think they may have said like 1-3 months. I was hoping to get 2 months out of it. And there's no way she can get into dry, I have one bag of Blue Basics dry for the boys in the cupboard that seals and it has never been touched, no holes, tears, anything. Sue, if you think that the insulin may be bad then I will get a new vial from the vet. I guess that's all we can do if it's nothing else. Also, what do you think I should do for her other issue? See if it clears up, give her something, take her in?
 
Ok we called the vet and we should be getting a new vial by the time they close today. It takes a few hours for one of the vets to approve it. We're going to do a little experiment since we'll be home. We're not going to give her an AM shot and see where her numbers go over the next 6 hours. Her AMPS was 256. If she stays in that range then we know the vial is bad. If she goes up, maybe the insulin just lost some of its efficacy. I woke up my fiance and he told me he remembers the bottle being 1/2 clear, 1/2 white and now it's 1/3-1/4 white and 2/3-3/4 clear. I'll just plan the vial into our monthly budget now so we don't have to stress about it. I actually hope the problem is the insulin because once she gets the good stuff her numbers will hopefully drop!!
 
Interesting numbers with no insulin!
AMPS (no shot): 256
+2: 230
+4: 242
Got the new vial of insulin, I think we'll start her off at 1 unit tonight and go from there. Or do you think I should go lower?
I can't wait to be seeing numbers in the 100s!
 
Hope the new vial works. I would be conservative and do .5. You can always up it.

Does your vet feel any responsibility for selling you a bad or at least old vial?
 
Probably not, didn't even see the vet when we went in to get the new vial, we talked to a tech. At first they said they didn't have any more and that we could get it thru Walgreens. When my fiance told me that I was so angry! ProZinc is a cat insulin, they're not going to have it at Walgreens! To humor them, I called Walgreens and the tech said that it's not even in their system. Duh! So magically they found a vial in the fridge when the vet was looking for a vaccine. Has an expiration date of 1/2013 so it's from a different batch, hopefully it works. If we have anymore issues I'm considering finding another vet...which I don't get because supposedly one of the vets in the practice has taken an "interest" in feline diabetes...and this is the vet that wanted us to buy prescription dry food, said well if you want to home test I guess we can show you how but we dont recommend it, and basically told us to feed her then shoot twice a day and that's all there is to it...the main reason I want to stay is because they're open 7 days a week and one of the vets is on call 24/7...ok that's the end of my ranting, sorry, it really frustrates me that this seems to happen to everyone on here, if I were a vet I would want owners to take an active role in the care of their pets but I guess they weren't taught that way and/or are greedy and want all your money.

I will do 0.5u tonight and try to get another reading or two before we go to bed.
 
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