Need advice...

Status
Not open for further replies.
Pam Barnes

Pam Barnes

Member
We are at 3.75 U of Prozinc twice a day, and it doesn't seem to really be making a difference. I started giving Bo zero carb foods in the evening only on 5/10, 5/11, and 5/12. He also ate zero carb all day Sat (5/13) and Sun (5/14). It seemed to help lower his numbers a little, but then they would shoot back up to the 500s. You can check out his chart in my siggy.

Any suggestions on what we could do? I am getting frustrated!!!
 
Hi Pam! I can understand being frustrated, looking at your spreadsheet! Great job on testing though! My first thought is that you may be holding doses for too long. We recommend going up by 0.25u every 3-6 cycles until you start to get some more active cycles, and then maybe slowing that down a bit. From your testing patterns, I'm guessing you work away from home most days? If so, then make sure you increase when you can be home to monitor, or increase at night since it looks like you monitor pretty late into the evening cycle. And please feel free to post here as often as you like! It really does help to know you're part of a community of people who are all dealing with this too! Even if sometimes it's just to say, "hey there! I'm frustrated!" :banghead: :):):)
 
Djamila said:
Hi Pam! I can understand being frustrated, looking at your spreadsheet! Great job on testing though! My first thought is that you may be holding doses for too long. We recommend going up by 0.25u every 3-6 cycles until you start to get some more active cycles, and then maybe slowing that down a bit. From your testing patterns, I'm guessing you work away from home most days? If so, then make sure you increase when you can be home to monitor, or increase at night since it looks like you monitor pretty late into the evening cycle. And please feel free to post here as often as you like! It really does help to know you're part of a community of people who are all dealing with this too! Even if sometimes it's just to say, "hey there! I'm frustrated!" :banghead: :):):)
Click to expand...

The reason the doses hold for so long is because I give him the new dose for 7-10 days and then do a BG curve. Then I wait for a couple days for the vet to get back to me and let me know should happen next. Then I have to wait for a couple days before I can start the new dose. This time, the vet is out of the office until tomorrow so the dose has been held for even longer.

What do you mean by 3-6 cycles? I'm not familiar with that term. I want to have information so I can talk to the vet tomorrow and let her know what I would like to do. She is open to my suggestions.

I do work away from home. I am a teacher, so I will be off this summer which will give me more time to be able to observe him and make changes as needed.

Thanx!
 
Lol...you would not believe how many of us are, or were, teachers! Welcome to the club! A cycle is a 12-hour period. So there are two cycles per day. When you're looking for a good dose, we recommend changing about every six cycles if you're getting some activity in the cycle, but if the numbers are really high and flat, sometimes we recommend moving a little faster - like every three cycles. But we only recommend increasing by 0.25u at a time, not the bigger jumps that you've been doing with the vet - so that makes it possible to move a little more quickly between doses - baby steps.

With your work schedule though, it does make sense to move a little slower so that you can monitor, but you could do a dose change on Friday night, and maybe a second one on Sunday morning, (if you can monitor over the weekend), and then hold the dose through the week.

It looks like you're in CA, so you get out mid/late June, right?
 
Djamila said:
Lol...you would not believe how many of us are, or were, teachers! Welcome to the club! A cycle is a 12-hour period. So there are two cycles per day. When you're looking for a good dose, we recommend changing about every six cycles if you're getting some activity in the cycle, but if the numbers are really high and flat, sometimes we recommend moving a little faster - like every three cycles. But we only recommend increasing by 0.25u at a time, not the bigger jumps that you've been doing with the vet - so that makes it possible to move a little more quickly between doses - baby steps.

With your work schedule though, it does make sense to move a little slower so that you can monitor, but you could do a dose change on Friday night, and maybe a second one on Sunday morning, (if you can monitor over the weekend), and then hold the dose through the week.

It looks like you're in CA, so you get out mid/late June, right?
Click to expand...

Thank you for the information on cycles. The crazy thing about his values is that every time I do a BG curve, he has a near perfect curve...they just aren't the numbers we want. Never had a flat one or a curve that was all over the place.

It was my understanding that it takes 7-10 days for a dose to make a difference. Is that not correct?

I am in Sacramento, CA...June 1 is my last day...11 more days!!! YAY!!!!!
 
Pam Barnes said:
Thank you for the information on cycles. The crazy thing about his values is that every time I do a BG curve, he has a near perfect curve...they just aren't the numbers we want. Never had a flat one or a curve that was all over the place.

It was my understanding that it takes 7-10 days for a dose to make a difference. Is that not correct?

I am in Sacramento, CA...June 1 is my last day...11 more days!!! YAY!!!!!
Click to expand...
Another teacher here.... Although I don't get out until June 22. I agree you are waiting too long. No need to hold at an ineffective dose for so long. Time to up it.

If 4 units isn't getting you to the mid blues after 3 days, go up another.25. You don't want Bo in these high numbers long term.... Gotta get him diving into the blues.
 
Haha welcome to the teacher club! Former teacher here. :)

Not sure why the vet would say it takes that long for a dose to be effective. It's not true. I don't think any insulin takes that long to take effect..we see cats who needs a few cycles to settle in to a dose, but never that long. Actually, what can happen is that he sits in these higher numbers for awhile and then develops a bit of insulin resistance...where he just has these high cycles. My guess is you may be seeing that here.

I'm with everyone else. I'd up his dose when you can monitor (maybe tonight?) and then go up every 3ish cycles (just making sure you can monitor when you go up). Once school lets out it might be easier for you since you can monitor more during the day then if you increase in the AM. We usually suggest holding for 6 cycles, but with your higher numbers, I'd say 3. I know it seems like a lot, but usually with insulin resistance, we see these higher numbers, and then one day, they just hit the right dose and start sliding back down the scale! Let's hope that happens here too!

One other thing, are you testing for ketones?
 
And another teacher here too! I spent 6 and a half months (slow learner!) doing curves for my vet and got nowhere. I now know why: my cat is an extreme bouncer and the curves all looked like he wasn't responding to the insulin because they captured only a day's data and there was no "historical context". Once I came here to FDMB and started doing things the way this site recommends I learned SO MUCH MORE about Teasel's patterns and how to dose him. I learned why a curve every 7 to 10 days wasn't getting me anywhere. Don't get me wrong - he's still a huge challenge and nowhere near getting regulated but I understand his responses and that's been a huge leap forward. My vet (and I like her a lot!) knows what I'm doing now and I check in with her periodically but that's the only role she plays in Teasel's FD treatment. I even decided on my own to take him off ProZinc and put him back on Lantus because I can buy Lantus OTC here in Ontario, Canada. I told her after the fact so she could update his record.
 
I think the vets say that because the manufacturer recommends it. But that is based on doing jumps of a full unit, and not monitoring. So they have to have time for a dose to settle out on a fructosamine test which is a rather blunt tool for measuring. Since you are monitoring at home, you can make quicker, more agile changes to the dose, and keep your kitty safe at the same time.

It's great that your vet is open to your suggestions! Hopefully as the two of you work together, you can start to make some progress. Most vets just don't get a lot of training on feline diabetes, so with a collaborative vet and the info here, I'm sure Bo will start to make some progress!
 
Pam Barnes said:
It was my understanding that it takes 7-10 days for a dose to make a difference. Is that not correct?
Click to expand...
Hi Pam! I'm one of the non-teachers in our Prozinc group :p. The others can correct me if I'm wrong but I was under the impression this statement was more true for depot insulins, which Prozinc is not. So nice you get perfect curves! I swear, my boy knows when I'm going to do one and does all sorts of weird things :confused::facepalm:. I agree with the others to not holding a dose so long, since he's still in red ranges, and for other mentioned reasons. Are you testing for ketones?
 
JanetNJ said:
Another teacher here.... Although I don't get out until June 22. I agree you are waiting too long. No need to hold at an ineffective dose for so long. Time to up it.

If 4 units isn't getting you to the mid blues after 3 days, go up another.25. You don't want Bo in these high numbers long term.... Gotta get him diving into the blues.
Click to expand...

God must realize teachers are nurturing people and give them sugar babies...LOL!!!! There is no way I could wait until June 22!!!

Thanx for the advice!!!!! I just don't want him to suffer or not feel well.
 
Rachel said:
Haha welcome to the teacher club! Former teacher here. :)

Not sure why the vet would say it takes that long for a dose to be effective. It's not true. I don't think any insulin takes that long to take effect..we see cats who needs a few cycles to settle in to a dose, but never that long. Actually, what can happen is that he sits in these higher numbers for awhile and then develops a bit of insulin resistance...where he just has these high cycles. My guess is you may be seeing that here.

I'm with everyone else. I'd up his dose when you can monitor (maybe tonight?) and then go up every 3ish cycles (just making sure you can monitor when you go up). Once school lets out it might be easier for you since you can monitor more during the day then if you increase in the AM. We usually suggest holding for 6 cycles, but with your higher numbers, I'd say 3. I know it seems like a lot, but usually with insulin resistance, we see these higher numbers, and then one day, they just hit the right dose and start sliding back down the scale! Let's hope that happens here too!

One other thing, are you testing for ketones?
Click to expand...


Lol...another teacher!

I was wondering if he could be developing insulin resistance...but I wasn't sure if there was such a thing. I am worried about upping his dose tonight because I wouldn't be able to watch him during the day tomorrow. The earliest I could watch him for 3 cycles is starting Friday night.

I am testing for Ketones every couple of days.

Thanx for the advice!

Pam
 
Pam, I think with his numbers being what they are he would probably be OK if you decide to increase to 4.0U tonight or if you've already given shot, tomorrow morning. Please feel free to ignore my opinion though, heeding on the side of caution is not looked down upon :bighug:
 
Kris & Teasel said:
And another teacher here too! I spent 6 and a half months (slow learner!) doing curves for my vet and got nowhere. I now know why: my cat is an extreme bouncer and the curves all looked like he wasn't responding to the insulin because they captured only a day's data and there was no "historical context". Once I came here to FDMB and started doing things the way this site recommends I learned SO MUCH MORE about Teasel's patterns and how to dose him. I learned why a curve every 7 to 10 days wasn't getting me anywhere. Don't get me wrong - he's still a huge challenge and nowhere near getting regulated but I understand his responses and that's been a huge leap forward. My vet (and I like her a lot!) knows what I'm doing now and I check in with her periodically but that's the only role she plays in Teasel's FD treatment. I even decided on my own to take him off ProZinc and put him back on Lantus because I can buy Lantus OTC here in Ontario, Canada. I told her after the fact so she could update his record.
Click to expand...


Apparently, I am a slow learner as well. We have been at this since January! LOL! Thank you for sharing your experience with Teasel. It makes me feel better about what is going on with my Bo!
 
Yong said:
Hi Pam! I'm one of the non-teachers in our Prozinc group :p. The others can correct me if I'm wrong but I was under the impression this statement was more true for depot insulins, which Prozinc is not. So nice you get perfect curves! I swear, my boy knows when I'm going to do one and does all sorts of weird things :confused::facepalm:. I agree with the others to not holding a dose so long, since he's still in red ranges, and for other mentioned reasons. Are you testing for ketones?
Click to expand...

It's okay if your not a teacher...we will still let you play! LOL!!!!

I am testing for ketones every few days. He has already had DKA, and I sooooooo don't want to go through that again!
 
Yong said:
Pam, I think with his numbers being what they are he would probably be OK if you decide to increase to 4.0U tonight or if you've already given shot, tomorrow morning. Please feel free to ignore my opinion though, heeding on the side of caution is not looked down upon :bighug:
Click to expand...

What about giving him 4U at night and the 3.75U during the day until Friday night?
 
Since he's had DKA, I'd definitely be in favor of an increase. You don't necessarily have to watch him for 3 straight cycles...we suggest going up when you can monitor for THAT cycle...since it's a new dose, we just want you to keep an eye on things that first cycle especially so you see what the new dose does.
 
I'm so jealous that you get out on June 1st! Our last day is June 26! Although to be fair, the sun doesn't start shining until July, so it's not like we're missing summer or anything. :(;)

I agree with the 4u dose. His numbers are plenty high to stay safe at this point, and DKA is bad news (as you well know!).
 
Status
Not open for further replies.
Back
Top