Need help with dosing.

jim serafini

jim serafini

Member
Hi, my name is Jim. My cat is Angelo, he is 13 years old. He was diagnosed with Diabetes in February. My vet has him on ProZinc. However, since the beginning of this journey. he has given some bad advice and the lack of things I need answered. At the beginning started at low doses and checking urine. It was always high and eventually went up to 16 units(I use a 30 unit syringe) Which led to a very expensive trip to the ER. I have been researching myself and found this group. I got a home testing kit and started checking his BG. It's high before his shot 400s and then when I check twelve hours later its 180 or so and I have no idea what to do. Oh, I decreased his dose to 1 and a half units. But, the vet keeps telling me to only give his insulin once a day. i know tht's not right. But, when his numbers are at 180 or so. i have no idea what to do. HELP!!!!
 
Hi and welcome Jim and Angelo. I am not a Prozinc user and I know that the experienced Prozinc users will chime in as soon as they can. I'm sorry that you feel that you haven't received adequate or correct information from your vet, but this is a good place to find information, advice and support.

I do suggest, so that these experienced users can review the data you have, to create a signature and a spreadsheet so that Angelo's information is available with each of your posts.
1. Setting up your signature (light grey text under a post). Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the time zone matters) Be sure to SAVE when you are finished.
2. Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. You will see how the trends and patterns emerge, and members can review his/her progress before offering suggestions or advice:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

When this is done, take some time to read the yellow tagged "stickies" at the top of this forum. The Beginners's Guide to Prozinc and the Protocol for Prozinc are going to help fill in some of the gaps in your education and give you a "road map" as to what this is all about. Reading this information is going to help you understand the advice and information the experienced Prozinc users are going to provide going forward.

Thank you so much for being such a caring, conscientious pet parent and looking further for information on what to do next. Best wishes :cat:
 
Hi Jim welcome to you and Angelo! It’s good that you’ve started home testing. If you can, set up the spreadsheet that Lou (Idjits Mom) linked. That will help us see what’s going on with Angelo and help you with dosing. If you need help setting it up, just ask and we’ll do it for you. In the meantime, you’re right Prozinc should be dosed twice a day. If Angelos numbers are too low for a PM shot, then perhaps his AM dose should be lowered. When you can, please try to get some midcycle tests too so we can see how low the dose is taking him. That, along with the spreadsheet will help us determine the dose.
 
Hi Jim, and welcome! Sounds like you've had quite the dramatic journey already! I cannot imagine getting to 16 units when you've only been at this since February. My hunch is that you are right about the quality of your vets advice. We are more than happy to help you get this sorted. It sounds like you're already doing great by getting started on home testing.

That spreadsheet that's already been mentioned is the most valuable tool we have for helping our kitties. I would say it's worth its weight in gold, but it doesn't weigh anything -- you get my meaning though, I'm sure. If tech stuff isn't your thing, just ask and we can have someone help you get it set up. Once we can see whatever numbers you have so far, we can help you figure out what to do when you get a number like 180. Dosing isn't based on just one number -- it's also based on the numbers around it, and on how many hours since the last shot, so that's why having that big picture matters so much.

Looking forward to getting to know you and Angelo and helping you both get all of this sorted out!
 
Hello Jim! Welcome to you and Angelo! Wow, what a rollercoaster this has been for you already!

I'm so glad to hear that you've started testing BG with a blood testing kit. Glucose testing in urine isn't nearly as useful because (I believe) glucose won't even spill over into urine until it's in higher numbers. BG testing with blood gives you better control.

The SS will definitely help you and us to see patterns and figure out what a good dose is for Angelo. Please ask all the questions you have...that's why we're here!
 
Thank you all for your advice. I have printed out the spreadsheets and will start using them. It has been hard on Ang and I. It seems we're in this alone at times. I do have a full time job and 2 other cats, a dog, an Iguana and pet Pigeon that need my attention (all rescues). When I got home yesterday at 5. I checked his BG. It was 328. I feed him and gave him only a half unit(not sure why I decided so low) Then the evening got crazy because of company and such. So, I checked him this morning at 6 and his BG was 83. I feed him waited an hour and checked and his BG was 96. I had to leave for work.
 
Hi Jim- Sounds like a good thing you gave him such a low dose! Did you skip the shot this morning?

What is Angelo eating? What are the other cats eating? Food can have a huge impact on BG, so wondering if that might contribute to those big swings in BG value.

As for the spreadsheet, printing it out for your use is fine, but we really need it to be online so we can see it too. Here are the instructions for how to get it set up and shared so we can all see it: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/ And again, don't hesitate to ask for help if you get stuck on any of the steps.

If you look at our signatures, you can click on each of our spreadsheets and see how we are using them. Don't worry if your work schedule doesn't let you test quite as much as some of us do! We can help you figure out the best times to get data that work with your day to day life.
 
Hi , I recently took him off hard food and put him on wet. Mostly Fancy Feast. But, he is finicky. It has to have sauce or gravy. He will not eat Pate. I also took him off his Temptation treats and give him the Fancy Feast treats in a pouch. The other cats are eating the same(though I do sneak them some hard food if Angelo isn't around.)I did skip his dose this morning. I set up a spreadsheet. But, have no idea how to retrieve it to use it. Thank you.
 
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That's great that you're moving him off of kibble! Well done! For kitties that struggle with the pate, we have a number of tricks to help them transition. The gravy foods are between 12-20% carbs, which is too high for diabetic cats. And, carbs cause their numbers to be erratic and unpredictable which can make dosing and safety an issue. But fear not! It was my cats first step away from kibble too, but it needs to be a quick step, and not a place to linger. So on to the tricks for getting them to eat pate:

1. make sure you add water to the food. The pate by itself is too thick for gravy-loving cats, so adding anywhere from 1-4 tablespoons of water will help. It make take some experimenting to figure out how much water Angelo likes, so don't give up if he snubs it a few times. Oh, and make sure to mix the food and water together well. If you want to get fancy, you could use bone broth instead of water. The point is just to thin it out for them so they can lick it better. This is the first step in all of the ideas that follow below:

2. bonito flakes: https://www.amazon.com/Kaneso-Tokuy...&pf_rd_p=71dfc2d1-518c-5342-8123-9a819de40955

You can also buy bonito flakes made for cats, but they are more expensive. And since everything about diabetes is expensive, save money when you can! To use these prepare the food with the extra water, and then put a little sprinkling of bonito flakes on top. Most cats find them irresistible. You may need to repeat this a couple of times to get through a whole can of food, but over time you can wean him off of these (at least mostly -- when you see how much he likes them you won't want to deny him the joy completely! :cat:)

3. tuna water (make sure it's tuna packed in water, not tuna packed in oil): prepare the food, and pour some tuna water over the top.

4. Parmesan cheese - same process as #2 and #3

5. Brewer's yeast or nutritional yeast. Both of these are usually sold in the bulk section of a grocery store, or in the health food section. They are different than the type of yeast you buy to make bread. They have kind of a cheesy/salty/creamy flavor, taste great on popcorn if you want to try some yourself, and my cats loooooooove it sprinkled on top of their food. Added bonus, it's high in B vitamins which are important for our kitties.

6. Fortiflora - https://www.amazon.com/Purina-Veter...flora&qid=1554256733&s=grocery&sr=1-2-catcorr There are 30 little pouches in a box, and one pouch can last anywhere from 3 days to a week depending on how generously you sprinkle it. If you give a full pouch/day, it is a probiotic which is good for intestinal health, but it's too expensive to use that way and there are other probiotics that work better for cats. So I just use this as a flavor enhancer when my kitty gets picky about his food. You sprinkle a little like you are salting the food. Most cats would eat a shoe if you sprinkle this one it, especially if you have a cat that is coming off of kibble. It seems particularly appealing to kibble cats.
 
Oh, as for the spreadsheet. Go to google.com In the top right corner, you will either see something that says "sign in", or you will already be signed in and will see nine little squares arranged in three rows of three. If you see "sign in", then you'll need to sign in. If you see the square matrix, then click on it and go to "drive". You should be able to find your spreadsheet there. Once you locate it, make sure to bookmark it so it's easier to find next time. If you still can't find it, let me know...
 
Thank you for all your help. I appreciate it. It is hard for me to get a lot of readings on Angelo. I work all day. But, I do need to get him regulated and the vet says one shot a day and I know that's wrong. But, like this morning. I checked him. He was 118. I had given him .75 of a unit at 5:30 the night before. His sugar was 425. But, my big problem is knowing what to give him with lower numbers. I'll be gone all day and I know he'll be high tonight.
 
Since he's still newly diagnosed, you need to skip the shot when he's that low. However, as you can see from the 425, skipping shots isn't good for him. So the trick is going to be figuring out a dose that allows you to safely give him insulin both morning and night.

Not to beat this to death, but the carbs in the food can cause these erratic numbers which make dosing more difficult, so it's hard for me to know what to suggest right now, except to say that 0.75u was too much last night since the AMPS was too low to shoot, so try lowering the dose tonight to 0.5u and let's see what happens.

And try to get into the spreadsheet (or let us know if you can't) to enter some of the data you have. It really does make a big difference in our ability to help when we can see the numbers you're getting.
 
Thank you. I'll get some pate today and try that. Going to see if I can get to my spreadsheet right now. Though, at this point I don't have much to enter. I intend on doing a curve, Sunday. My only day to do this.
 
All data is good data! Your +2 shows that even without insulin the food isn't causing a huge spike, so that's great to see. Assuming he's over 200 tonight, I would not give more than 0.5u. And if he's below 200, you'll probably need to skip again, or set an alarm to get up and do a test around +4.
 
Thank you for your help. I have changed all his food to pate. I added some tuna juice, then again some water and a sprinkle of Brewers Yeast(Angelo takes breaks and I add liquid on the breaks in between finishing his food. This may take an hour at times. But, he's eating good) I'm confused with his numbers. He's been in the low to high 100s since yesterday morning and as I don't know how much insulin to give him. He's had none since Tuesday evening. I thought perhaps something was wrong with the meter. But, I rechecked and it was about the same. So, I changed the batteries and rechecked and no difference. So, checked on my self and got a normal reading.
 
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Did you give him any insulin on the 211?

Will you be around this weekend to do some extra testing? He's not really low enough to be skipping, but since you aren't home during the day, it's hard to know how much is safe. If you can do extra testing on Saturday and Sunday, we can hopefully get you a plan going into the week.

And no, your meter isn't broken. :) Your cat was being dramatically overdosed thanks to your vet, and this is a not-uncommon side effect. He'll be okay, and get back on track, but hopefully you won't see any more of those really high numbers. My hunch is since you're getting him on a good, low-carb diet and learning to test and adjust the dose, you'll be able to get him very well regulated, or even maybe into remission. Time will tell.
 
No, I didn't give any. I wasn't sure how much to give and when I checked him later. He was down a bit more. Yes, I plan on trying a curve on Sunday. And I will do some extra testing on Saturday. Yes, that's what scares me about dosing him on lower numbers. I'm gone for over 8 hours. I do call my vet with his numbers every morning. But, I pretty much don't follow his advice. he says Angelo's numbers are lower because He's going into remission. which I know isn't right.
 
I think last night you likely could have given him 0.5u, but given all you've both been through, and the newness of testing, I think it's fine that you skipped. If he's up there again tonight, you could give it a try and see how he does. Or you could try 0.25u if that feels safer to you. Ideally, you want to see his numbers below 150 most of the time, and before he's off insulin, most mid-cycle numbers should be in the dark greens. Step by step though.
 
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