New here with dosing help

[Muppy]

Hi everyone, I’m Amanda and here for my 16.5 year old boy Muppy. He means the world to me, have had him since he was a tiny baby and even have a tattoo of him on my foot. I would literally do anything for this guy, he’s my soul cat.


Last October I noticed he wasn’t his usual self and could tell something was up, after the results came back I found out he had stage 2 kidney disease. I buckled down and took in all the info I could about the disease and changed his diet completely and he did great. Noticed recently he wasn’t eating all of his food anymore, urinating so much, drinking a ton and losing weight. Called the vet for a checkup and they were amazed at how well he was doing with his age and kidney disease and so I was expecting great news.

I got the call that he has now stage 3 and diabetes. The vet put him on 1.5 units 2 times a day of Prozinc. After learning the sub q fluids and how to give the insulin I asked about checking his bg levels at home with the vet told me not to and to let the vet be the bad guy. I don’t listen and immediately went to the store and got all the supplies to check him. The vet told me not to give the full dose is he wasn’t eating (he was barely eating anything at all). Called the vet and he told me that I was being a “helicopter parent” and immediately stopped seeing him after that comment. Hello, I am new to all of this and I should be expected to have so many questions.

I joined the group on Facebook and got so many questions answered. An angel even helped me set up his chart and explained how to put the numbers in and everything.

Muppy was staying in the 400s-300s and just wasn’t doing great at all. So I took him to a new vet and she was worried he might have keto acidosis so after checking and it came back negative she said a possible uti so she gave me antibiotics, Mirataz and Cerenia and upped his insulin to 2 units 2 times a day. He finished his antibiotics and there is such a big change in him, he’s eating more and his bg is getting lower and lower everyday!


Now my problem is I have no idea what to do when he’s starting to get low. This morning at 9 he was 120 and so I stalled and he was at 118 20 minutes later. I gave him 1.5 units and checked again at 12 and he was at 67 so I panicked and gave him gravy food because I wasn’t sure if that’s too low. At 12:30 he was 86 and then I checked again at 3 and he was at 72. Is there a certain number I should be looking for to not shoot/ or lower the doseage. I attached his charts in my signature if I ended up doing it right. Any help would be so appreciated

 

[Bron and Sheba (GA)]

Hi Amanda and Muppy and welcome to the forum.
It’s great you have the spreadsheet set up and signature. We appreciate it.
Honestly I get so cross when I hear vets tell caregivers they are helicopter parents because they want to test the cats blood glucose. I am quite sure if he had a child with diabetes he would want to test and not blindly shoot. Just ignore him…you are absolutely doing the right thing by Muppy.
Next time he is lower than normal, you can stall, dont feed and test again in 20 minutes to see if the BG is rising. You can also post and ask for help.
Muppy has earned himself a reduction in dose down to 1.25u
So your new dose is 1.25 U which you will stay at unless he drops under 90 again.

Do you have a hypo box set up with some high carb food, honey or karo, the vets or ER phone number and some spare test strips?
If not, get one set up as you don’t want to be racing around looking for things if he drops low again.

Can you put you are using a ReliOn meter into your signature please.
You might like to add in the SS remarks column when he started and finished the antibiotics and what food he eats each day
Keep asking questions

I will give you the link to the prozinc dosing methods
https://www.felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/

 

[Muppy]

Hi Amanda and Muppy and welcome to the forum.
It’s great you have the spreadsheet set up and signature. We appreciate it.
Honestly I get so cross when I hear vets tell caregivers they are helicopter parents because they want to test the cats blood glucose. I am quite sure if he had a child with diabetes he would want to test and not blindly shoot. Just ignore him…you are absolutely doing the right thing by Muppy.
Next time he is lower than normal, you can stall, dont feed and test again in 20 minutes to see if the BG is rising. You can also post and ask for help.
Muppy has earned himself a reduction in dose down to 1.25u
So your new dose is 1.25 U which you will stay at unless he drops under 90 again.

Do you have a hypo box set up with some high carb food, honey or karo, the vets or ER phone number and some spare test strips?
If not, get one set up as you don’t want to be racing around looking for things if he drops low again.

Can you put you are using a ReliOn meter into your signature please.
You might like to add in the SS remarks column when he started and finished the antibiotics and what food he eats each day
Keep asking questions

I will give you the link to the prozinc dosing methods
https://www.felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/

Thank you for your reply. I think I added everything to my spreadsheet and signature like requested. I did buy Karo syrup when he first got diagnosed cause I read it somewhere that it could come in handy.

So let’s say when I check him and he is at 88, I reduce the insulin by .25 so instead of his new 1.25 I would give him 1? Sorry I just get confused by the numbers and what is considered too low to shoot. Is it better to give him some insulin than none?

 

[Bron and Sheba (GA)]

Thank you for your reply. I think I added everything to my spreadsheet and signature like requested. I did buy Karo syrup when he first got diagnosed cause I read it somewhere that it could come in handy.

So let’s say when I check him and he is at 88, I reduce the insulin by .25 so instead of his new 1.25 I would give him 1? Sorry I just get confused by the numbers and what is considered too low to shoot. Is it better to give him some insulin than none?

When he drops under 90 in a cycle (or multiple times in a cycle like today) you reduce the dose the one time.so his new dose is 1.25 U
Until you get the gist of it I would post every day and ask questions and ask about the dose if you are unsure. We are happy to help in any way.

 

[Ale & Bobo & Minnie (GA)]

Hi Amanda and welcome!

Just to reiterate what Bron said, if he drops below 90 again today, you reduce it by 1/4 again down to 1 unit. Every time he drops below 90, he gets a 1/4 unit reduction.

good thinking on stalling yesterday am. When you did that, you stalled without feeding right? If that happens and you have to stall again, post here and ask for help. But when you get a lower number after the 20 minutes like you did yesterday, the general advice here since you’re still new to you all of this is that you either skip the shot or give a reduced token dose. A token dose is 15-20% of the actual dose so for the 1.5 unit, you’d give about .5 unit. Makes sense? So in the beginning anything under 200, you either skip or give a token dose. As you learn more, the goal will be to shoot the regular dose at those lower preshot numbers. Pretty much like you accidently did yesterday anyway, but you need to make sure you’re home to monitor and we’d suggest you test regularly starting at +2 so you can use food to slow down the drop. Makes sense?

are you able to get that +2 in the evening every day? It’s really helpful to gauge how low he’s going to go overnight.

We see a lot of cats that drop considerably after the UTI infection is over and they're no longer on antibiotics. Or it could simply be that his pancreas is starting to work better again.

you have very good instincts and you’re doing everything right already for your baby! I’m not a prozinc user so tagging @Suzanne & Darcy so she can take a look at his numbers. He’s looking pretty good!

what are you feeding for the CKD? And how often are you feeding him?

btw, I love that you have a tattoo of him. He’s your familiar

 

[Ale & Bobo & Minnie (GA)]

In the meantime, you can read up about prozinc here:
https://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/

 

[Muppy]

Hi Amanda and welcome!

Just to reiterate what Bron said, if he drops below 90 again today, you reduce it by 1/4 again down to 1 unit. Every time he drops below 90, he gets a 1/4 unit reduction.

good thinking on stalling yesterday am. When you did that, you stalled without feeding right? If that happens and you have to stall again, post here and ask for help. But when you get a lower number after the 20 minutes like you did yesterday, the general advice here since you’re still new to you all of this is that you either skip the shot or give a reduced token dose. A token dose is 15-20% of the actual dose so for the 1.5 unit, you’d give about .5 unit. Makes sense? So in the beginning anything under 200, you either skip or give a token dose. As you learn more, the goal will be to shoot the regular dose at those lower preshot numbers. Pretty much like you accidently did yesterday anyway, but you need to make sure you’re home to monitor and we’d suggest you test regularly starting at +2 so you can use food to slow down the drop. Makes sense?

are you able to get that +2 in the evening every day? It’s really helpful to gauge how low he’s going to go overnight.

We see a lot of cats that drop considerably after the UTI infection is over and they're no longer on antibiotics. Or it could simply be that his pancreas is starting to work better again.

you have very good instincts and you’re doing everything right already for your baby! I’m not a prozinc user so tagging @Suzanne & Darcy so she can take a look at his numbers. He’s looking pretty good!

what are you feeding for the CKD? And how often are you feeding him?

btw, I love that you have a tattoo of him. He’s your familiar

so he has decided that his kidney food is just a no go for now, I’ve tried to sprinkle the fortiflora (I think that’s what it is) and still won’t touch it. I tried to warm the food and nope. He used to eat the Weruva cans that were good for kidney disease and so I found the food list that approves the ones with ckd and diabetes and so far no luck. He used to even LOVE Hydracare and won’t touch it now. So now I am just giving him something that he will eat and it’s the fancy feast classic pate. Not the greatest for his kidneys but it’s better than him not eating anything at all like he was doing the last couple weeks!

I am home with him all day so getting different readings won’t be a problem. He gets his check/food and insulin at 9am and 9pm so I just checked his bg and it was 148. So I’m stalling 20 and then will check again and if it’s lower, I give either no dose or .5 but what if it stays the same or gets higher? Then 1 unit??

 

[Ale & Bobo & Minnie (GA)]

Sorry I just saw this. What did you get after stalling and what dose did you give?

 

[Ale & Bobo & Minnie (GA)]

If you gave the full dose, I’d just make sure to test again at +2 and then every hour really so you can catch those lower numbers and use food to slow the drop down. You may have a reduction again today if you did. I know this can be puzzling but it’s really great news for him because it signals us that he’s starting to need less insulin and the longer he stays in those blue and green numbers the better because that’s when the pancreas can heal

I don’t see anything on the spreadsheet yet so if you can updated it as soon as you can, that would be great. Thanks!

 

[Muppy]

If you gave the full dose, I’d just make sure to test again at +2 and then every hour really so you can catch those lower numbers and use food to slow the drop down. You may have a reduction again today if you did. I know this can be puzzling but it’s really great news for him because it signals us that he’s starting to need less insulin and the longer he stays in those blue and green numbers the better because that’s when the pancreas can heal

I don’t see anything on the spreadsheet yet so if you can updated it as soon as you can, that would be great. Thanks!

Sorry just updated it, so he was 146 so I stalled without food and he was 153 so I gave him 1 unit. Where on the spreadsheet do I put the stalled number?

Also, what’s the range that I need to be worried about him going hypo and will need hc food or karo?

 

[Ale & Bobo & Minnie (GA)]

Anything below 50 is a take action number and that’s when you want Karo. Let’s see what the 1 unit will do today. I feel like you’re getting a crash course here so maybe if you’re comfortable and he’s above 150, let’s try to stick with the full dose. @Bron and Sheba (GA) do you agree?

 

[Ale & Bobo & Minnie (GA)]

As far as entering the 20 minutes later number, you can add it to the same amps cell something like 146, 155 @+20. You’ll have to fill in the color because any additional info in the cell reverts it back to no fill

 

[Sienne and Gabby (GA)]

Welcome to FDMB! I'm so glad the FB group was helpful and got you moving in a good direction.

Ale said the following:

Just to reiterate what Bron said, if he drops below 90 again today, you reduce it by 1/4 again down to 1 unit. Every time he drops below 90, he gets a 1/4 unit reduction.

I found this confusing. If Muppy's numbers drop below 90 more than once in a cycle, you only reduce the dose by 0.25u one time. (Her use of "again" is confusing.)

I would also encourage you to get some tests during the PM cycle. Many cats experience lower numbers at night -- remember, they are nocturnal. In addition, if you don't test at night, you're missing half of your data. You don't want Muppy to be in low numbers both for his safety and so you don't miss a reduction.

You can "stack" numbers in a cell. That way, if you're stalling or testing multiple times in an hour, you can track your data. If you look on my spreadsheet, you'll see what I mean. You will need to manually color code the cell.

 

[Ale & Bobo & Minnie (GA)]

Thanks @Sienne and Gabby (GA)! I was trying to explain that if he drops below 90 every day for example, he gets a reduction every day. I wasn’t really sure how to make that clear. Once even if he drops multiple times in one cycle but he’s earn back to back reduction if he drops below 90 every 24 hours…?

 

[Muppy]

Welcome to FDMB! I'm so glad the FB group was helpful and got you moving in a good direction.

Ale said the following:
I found this confusing. If Muppy's numbers drop below 90 more than once in a cycle, you only reduce the dose by 0.25u one time. (Her use of "again" is confusing.)

I would also encourage you to get some tests during the PM cycle. Many cats experience lower numbers at night -- remember, they are nocturnal. In addition, if you don't test at night, you're missing half of your data. You don't want Muppy to be in low numbers both for his safety and so you don't miss a reduction.

You can "stack" numbers in a cell. That way, if you're stalling or testing multiple times in an hour, you can track your data. If you look on my spreadsheet, you'll see what I mean. You will need to manually color code the cell.

Ok gotcha, so this morning he was at 146 so I should have given him the 2 units dose because it wasn’t under 90? Sorry I am a slow learner and all of these numbers are confusing me . I will definitely set alarms tonight to wake up to check him, would you recommend every 2 hourrs?

 

[Bron and Sheba (GA)]

Ok gotcha, so this morning he was at 146 so I should have given him the 2 units dose because it wasn’t under 90? Sorry I am a slow learner and all of these numbers are confusing me . I will definitely set alarms tonight to wake up to check him, would you recommend every 2 hourrs?

No!
Muppy’s new dose is 1.25U after he dropped under 90 yesterday am cycle. That is his new dose moving forward, unless he drops under 90 again. And then you reduce by 1/4 unit. If in doubt, post and ask us until you are more familiar with it all.
So this morning you should have given him 1.25 U. But don’t stress about it. Just go back to 1.25 U at the Pm cycle today.

 

[Muppy]

No!
Muppy’s new dose is 1.25U after he dropped under 90 yesterday am cycle. That is his new dose moving forward, unless he drops under 90 again. And then you reduce by 1/4 unit. If in doubt, post and ask us until you are more familiar with it all.
So this morning you should have given him 1.25 U. But don’t stress about it. Just go back to 1.25 U at the Pm cycle today.

Gotcha that makes sense, thank you!!!!

 

[Muppy]

No!
Muppy’s new dose is 1.25U after he dropped under 90 yesterday am cycle. That is his new dose moving forward, unless he drops under 90 again. And then you reduce by 1/4 unit. If in doubt, post and ask us until you are more familiar with it all.
So this morning you should have given him 1.25 U. But don’t stress about it. Just go back to 1.25 U at the Pm cycle today.

Ok quick question, he’s at 188 this morning and I gave him 1.25 last night and then this morning as well. He was lower in the mornings when he was on 1.5. This is fine that he’s a little higher than he has been or should I up the dose?

 

[Muppy]

Welcome to FDMB! I'm so glad the FB group was helpful and got you moving in a good direction.

Ale said the following:
I found this confusing. If Muppy's numbers drop below 90 more than once in a cycle, you only reduce the dose by 0.25u one time. (Her use of "again" is confusing.)

I would also encourage you to get some tests during the PM cycle. Many cats experience lower numbers at night -- remember, they are nocturnal. In addition, if you don't test at night, you're missing half of your data. You don't want Muppy to be in low numbers both for his safety and so you don't miss a reduction.

You can "stack" numbers in a cell. That way, if you're stalling or testing multiple times in an hour, you can track your data. If you look on my spreadsheet, you'll see what I mean. You will need to manually color code the cell.

Ok question, I was advised to give him 1.25 dose now but today I noticed he’s been higher, should I go back to the 1.5 or even 2? Just don’t want him going back up

 

[Bron and Sheba (GA)]

Amanda can you put in the signature what food you are feeding please.
I would stay with the 1.25 U for a few more days.
I will tag @Suzanne & Darcy to comment on the dose as well.

 

[Muppy]

Ok just updated to include his food