? New Member- Dosing questions for post-DKA cat on ProZinc

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Karla AS

Karla AS

Member Since 2022
My cat Tanner (~14 YO neutered male) was recently diagnosed with diabetes, after having been hospitalized for DKA, cholangiohepatitis, and pancreatitis on October 8th. He has been doing great at home and recheck bloodwork was normal (with exception of being slightly anemic).

When he was brought home, he was on 2.0u of ProZinc twice a day and we switched him to Friskies pate. We adjusted the dose to follow the SLGS method (some days we skipped insulin without realizing we shouldn't be since he had DKA).

I am concerned that we are adjusting his insulin dose too frequently given his history with ketones, but according to the SLGS method, we should be adjusting it by 0.25u immediately after we get a number lower than 90 mg/dl. What does it mean if his numbers continue to fall under 90 mg/dl with new decreased doses?

Given he was 63 mg/dl at +3 (1.0u) today, should I then reduce his insulin to 0.75u at his next dose? That would be 3 dosing changes in 3 days.

I would appreciate any insight on this. I am feeling a bit overwhelmed given he got out of DKA earlier this month (have been testing for ketones and none are present).

https://docs.google.com/spreadsheet...bnxKMsbaLMTnLWx-_tzQbRnHcg/edit#gid=361360320
 
Karla AS said:
My cat Tanner (~14 YO neutered male) was recently diagnosed with diabetes, after having been hospitalized for DKA, cholangiohepatitis, and pancreatitis on October 8th. He has been doing great at home and recheck bloodwork was normal (with exception of being slightly anemic).

When he was brought home, he was on 2.0u of ProZinc twice a day and we switched him to Friskies pate. We adjusted the dose to follow the SLGS method (some days we skipped insulin without realizing we shouldn't be since he had DKA).

I am concerned that we are adjusting his insulin dose too frequently given his history with ketones, but according to the SLGS method, we should be adjusting it by 0.25u immediately after we get a number lower than 90 mg/dl. What does it mean if his numbers continue to fall under 90 mg/dl with new decreased doses?

Given he was 63 mg/dl at +3 (1.0u) today, should I then reduce his insulin to 0.75u at his next dose? That would be 3 dosing changes in 3 days.

I would appreciate any insight on this. I am feeling a bit overwhelmed given he got out of DKA earlier this month (have been testing for ketones and none are present).

https://docs.google.com/spreadsheet...bnxKMsbaLMTnLWx-_tzQbRnHcg/edit#gid=361360320
Click to expand...
Hi Karla
I am going to tag Bron for you
@Bron and Sheba (GA)
 
Meantime
If you can fill out what we call our signature that will be helpful,it's at the end of everyone's post in gray

To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Take a look at mine


We also use a spreadsheet to track our cats BG so we know how the insulin is working and how low they are dropping so we know when to either increase or decrease the dose
We adjust the dose by 0.25 units at a time . We don't adjust the dose by going by the Pre Shots

About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers
I'll give you the link to set it up , if you have trouble just ask and we have a member who will gladly do it for you


You can look at any members spreadsheet to see what it looks like, it's at the end of everyone's signature just tap on it

Link for the spreadsheet
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
 
Thank you for the information! I think I did set up my signature just now. I hope it works..
 
Hi Karla and Tanner and welcome to the forum.
Just a couple of questions first…
  • How often are you feeding Tanner? With DKA it is recommended that you feeding 1 and a half times as many calories as you normally would. This is because food helps keep ketones away. I would recommend feeding a snack of low carb every couple of hours as well as the preshot meals…except for the 2 hours preshot.
  • How often are you testing for ketones…I am really glad to see you are testing. I would recommend testing daily at the point. And if you could put the result into the remarks column of the SS that would be very helpful….backdated if you can please.
  • How is he generally…is he lethargic at all or back to his old self?
  • Did he come home on any antibiotics and were they finished.?
  • Are you testing with the freestyle libre or the ReliOn when you are getting the lower BGs? Sometimes the libre can give you lower numbers than the ReliOn meter when the BG is under100.

You are correct…it is not a good idea to skip any doses of insulin at all with a recent history of DKA.
If you get a lower than normal preshot…stall, dont feed and test again in 20 minutes and post and ask for help…change the subject line to alert us with something like ‘recent DKA preshot xxx, stalling, please help.
It looks as if you are doing a really good job looking after Tanner post DKA.
The extra food, not skipping insulin, testing daily for ketones and making sure Tanner is getting enough fluids is really important.

Sometimes to make sure the cat is getting enough insulin so that you can give the dose of insulin in post DKA kitties, we suggest giving some higher carb food so that the dose can be maintained. In saying that we have to make sure that Tanner is safe.
I am not a Prozinc user so I am going to tag @FrostD about the dose of Prozinc . Maybe we can stay with SLGS have a lower reduction number.
If she doesn’t answer you before the next shot is due, I think you will need to drop to 0.75 units providing there are no ketones in the urine.
I hope this helps
Bron
 
Bron and Sheba (GA) said:
Hi Karla and Tanner and welcome to the forum.
Just a couple of questions first…
  • How often are you feeding Tanner? With DKA it is recommended that you feeding 1 and a half times as many calories as you normally would. This is because food helps keep ketones away. I would recommend feeding a snack of low carb every couple of hours as well as the preshot meals…except for the 2 hours preshot.
  • How often are you testing for ketones…I am really glad to see you are testing. I would recommend testing daily at the point. And if you could put the result into the remarks column of the SS that would be very helpful….backdated if you can please.
  • How is he generally…is he lethargic at all or back to his old self?
  • Did he come home on any antibiotics and were they finished.?
  • Are you testing with the freestyle libre or the ReliOn when you are getting the lower BGs? Sometimes the libre can give you lower numbers than the ReliOn meter when the BG is under100.

You are correct…it is not a good idea to skip any doses of insulin at all with a recent history of DKA.
If you get a lower than normal preshot…stall, dont feed and test again in 20 minutes and post and ask for help…change the subject line to alert us with something like ‘recent DKA preshot xxx, stalling, please help.
It looks as if you are doing a really good job looking after Tanner post DKA.
The extra food, not skipping insulin, testing daily for ketones and making sure Tanner is getting enough fluids is really important.

Sometimes to make sure the cat is getting enough insulin so that you can give the dose of insulin in post DKA kitties, we suggest giving some higher carb food so that the dose can be maintained. In saying that we have to make sure that Tanner is safe.
I am not a Prozinc user so I am going to tag @FrostD about the dose of Prozinc . Maybe we can stay with SLGS have a lower reduction number.
If she doesn’t answer you before the next shot is due, I think you will need to drop to 0.75 units providing there are no ketones in the urine.
I hope this helps
Bron
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We leave the Friskies pate food out for him when we are not at home and he will finish his can by the time we take the food away 2 hours before PS (he is definitely a grazer). If he finishes the food early and seems hungry, we will feed him more food (I was told to feed him as much as he wants and to take the food away 2 hours before PS). He does drink A LOT of water- I've assumed it was normal since he is not regulated yet.

I am not testing daily- I've tested maybe once or twice a week since he came home. I will try to test daily now and upload to his SS. Thank you- I hadn't thought of that!

He did come home with antibiotics (Clavamox and Zeniquin) and is currently on Denamarin and Ursodiol for maintenance, and gabapentin (as needed). We finished the antibiotics last week after rechecking his bloodwork.

Since coming home, he has been making slow but steady progress. I've only really noticed a big change within the last week where he is acting like his normal self- grooming the other cats, being more energetic, "talking" to me, licking my face, etc. Honestly, I couldn't be happier with the progress he has made!

Currently, I am testing with the ReliOn only. He had the Libre when he initially came home so we could take time to learn how to test at home. All those initial numbers were the Libre. Anything after the 23rd is solely with ReliOn.

I just gave him 0.75 units since I tested for ketones about 6 hours ago and none were present. I will check his BG at the +2 hour mark.

Since he is a post DKA cat, does he have any chance of being OTJ?
 
FrostD said:
Welcome! Sorry about the DKA.

Yes, I would hold the 0.75U for a few cycles and see how he does; if he drops below 80 please let us know. His numbers are pretty good, I hope after a few days he settles into some more even numbers.
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Sounds good! I will check at the +2 mark today. If he drops below 80, do I alert on this same thread with a changed title or post a new thread?
 
Bron and Sheba (GA) said:
Yes. First priority is getting him regulated though. He’s doing well.

Continue with this thread for now.
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I had my husband check at +2 and he was at 63- he fed him more food at this point. At +8, he is at 183. This is with new dosage of 0.75U. I have not been able to test for ketones today yet. Should I decrease dose to 0.5U? He has been eating well.
 
How often are you feeding him, after his main meal, during the cycle? Is he eating 1 and a half times as much food per day as he normally would?
Have you checked for ketones today since posting?
I’ll tag @FrostD about the dose as I am not a Prozinc user. Melissa I am wondering about trying to feed some higher carb food to keep the BG up for a few days and stick with the 0.75 units asTanner is still only 3 weeks post DKA…what are your thoughts?
 
Bron and Sheba (GA) said:
How often are you feeding him, after his main meal, during the cycle? Is he eating 1 and a half times as much food per day as he normally would?
Have you checked for ketones today since posting?
I’ll tag @FrostD about the dose as I am not a Prozinc user. Melissa I am wondering about trying to feed some higher carb food to keep the BG up for a few days and stick with the 0.75 units asTanner is still only 3 weeks post DKA…what are your thoughts?
Click to expand...

We feed him as often as he wants to eat, except for 2 hours before PS. Ever since his diagnosis, he has been eating a lot more than he used to- mainly because I used to feed all my cats twice a day only. I would say he is eating 1 and a half times as much food per day as he normally would.

I have not checked his ketones yet. He hasn't urinated that I've seen. We are keeping a close eye on him now to get a test in soon. I will update once I have gotten a test in and will wait for a response. His PMPS is coming up in about an hour.
 
Bron and Sheba (GA) said:
How often are you feeding him, after his main meal, during the cycle? Is he eating 1 and a half times as much food per day as he normally would?
Have you checked for ketones today since posting?
I’ll tag @FrostD about the dose as I am not a Prozinc user. Melissa I am wondering about trying to feed some higher carb food to keep the BG up for a few days and stick with the 0.75 units asTanner is still only 3 weeks post DKA…what are your thoughts?
Click to expand...

We still haven't seen him urinate. His PMPs is 213, which is typical. Should I give the same dose as I gave this morning or decrease to 0.5U?
 
That's a very big drop to +2 and I suspect he went lower after it. I would give 0.5U tonight (more reply coming in a bit)
 
This is an off the wall question, but are you sure it was DKA? Did they find ketones in urine or blood? How much? Did they run a fructosamine?

Did he have symptoms of diabetes before that? How long would you say he was ill before being hospitalized?

The reason I ask is this is an unusual "ride down". It very well could be the diet change finally shaking out (we say give it two weeks) plus the underlying issues resolving.

Even with the 0.5U dose, I would feed medium carb food (10-15% carbs) in the early part of the cycle (preshot meal and up to about +4). Please do note that in your Remarks column so we know what the numbers are influenced by.

@Bron and Sheba (GA) Little bit too much downward momentum for me...I suspect 40s or lower at nadir today. If this were any other cat I'd say reduce to 0.25U actually. In these numbers I'm not quite expecting ketones to be a big issue, but that's more your area of expertise.
 
I see you did not get an answer before the PMPS and gave the 0.75 Dose.
You will need to monitor this cycle closely and feed a higher carb food for the snacks for this cycle as @FrostD suggested. If the BG does drop, make sure you feed a higher carb food and test 1 hour later to ensure that the BG does not drop further. Please keep the SS updated as we will be watching.:)

You need to follow Melissa’s advice on dosing with Prozinc and she has suggested dropping to 0.5 U so do that at the next opportunity please.
Testing for ketones is really important as Tanner is going down the dosing scale quickly. We need to make sure he is remaining free of ketones as the dose is decreased.
I did see a DKA kitty quite recently go down the dosing scale quickly and go off insulin.
 
FrostD said:
This is an off the wall question, but are you sure it was DKA? Did they find ketones in urine or blood? How much? Did they run a fructosamine?

Did he have symptoms of diabetes before that? How long would you say he was ill before being hospitalized?

The reason I ask is this is an unusual "ride down". It very well could be the diet change finally shaking out (we say give it two weeks) plus the underlying issues resolving.

Even with the 0.5U dose, I would feed medium carb food (10-15% carbs) in the early part of the cycle (preshot meal and up to about +4). Please do note that in your Remarks column so we know what the numbers are influenced by.

@Bron and Sheba (GA) Little bit too much downward momentum for me...I suspect 40s or lower at nadir today. If this were any other cat I'd say reduce to 0.25U actually. In these numbers I'm not quite expecting ketones to be a big issue, but that's more your area of expertise.
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Sorry, If didn't see your reply and gave him 0.75U to be safe. I will test him several times tonight and give him 0.5U tomorrow if he falls in the 60s again tonight.

I am certain it was DKA, along with other complications (pancreatitis and cholangiohepatitis). I took him to his primary vet, where serum ketones (+50 mg/dl) were present (they were unable to get urine) and we were referred to emergency care for hospitalization. I don't believe the hospital ran a fructosamine test.

The only symptoms he had before he was sick was increased thirst and hunger (ate mainly dry food mixed with a little bit of wet). We also noticed he was losing a bit of weigh (about 3lbs) over the last four months, despite eating so much. So he was probably ill after June 2022. He had a dental cleaning early June and everything was normal. The doctor was concerned about his glucose then (300 mg/dl), but attributed the high levels to being stressed at the hospital. They checked for ketones then and there were none (urine).

Okay, I will feed him medium carb food for preshot meal and leave it out for him to eat until +4 tomorrow. I'll make sure to make a note of this on the SS too.
 
Karla AS said:
Sorry, If didn't see your reply and gave him 0.75U to be safe. I will test him several times tonight and give him 0.5U tomorrow if he falls in the 60s again tonight.
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I would drop the dose to 0.5 U in the morning regardless if he drops under 60 or not. We need to make sure he’s safe (with the numbers) while making sure no ketones reappear.
You are doing a great job looking after Tanner.
 
Bron and Sheba (GA) said:
I see you did not get an answer before the PMPS and gave the 0.75 Dose.
You will need to monitor this cycle closely and feed a higher carb food for the snacks for this cycle as @FrostD suggested. If the BG does drop, make sure you feed a higher carb food and test 1 hour later to ensure that the BG does not drop further. Please keep the SS updated as we will be watching.:)

You need to follow Melissa’s advice on dosing with Prozinc and she has suggested dropping to 0.5 U so do that at the next opportunity please.
Testing for ketones is really important as Tanner is going down the dosing scale quickly. We need to make sure he is remaining free of ketones as the dose is decreased.
I did see a DKA kitty quite recently go down the dosing scale quickly and go off insulin.
Click to expand...

Sounds good- I will monitor closely and give him 0.5U in the morning.

That's amazing to hear! I was initially told he was resisting to the insulin and that's why he was at 2U when he came home from the hospital. I'm happy to see that is not the case.
 
It's always amusing to me when they say 2U is insulin resistant :rolleyes: (my cat is/was a high dose cat, truly insulin resistant...those cats can hit 30U+). 2U a fairly average dose for cats here, the fact that he's down to 0.5U is encouraging.

What we're trying to do is get rid of the yellows - the 0.75U was dropping him a little too hard and fast, so he bounced a little bit and up into the 200s. I think if we can get the dose and feeding strategy settled he'll settle down nicely.
 
FrostD said:
It's always amusing to me when they say 2U is insulin resistant :rolleyes: (my cat is/was a high dose cat, truly insulin resistant...those cats can hit 30U+). 2U a fairly average dose for cats here, the fact that he's down to 0.5U is encouraging.

What we're trying to do is get rid of the yellows - the 0.75U was dropping him a little too hard and fast, so he bounced a little bit and up into the 200s. I think if we can get the dose and feeding strategy settled he'll settle down nicely.
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That's good to know! Thank you for that information. The doctor definitely had me worried when they initially said he seemed to be insulin resistant.

At +11 just a bit ago, he was at 105. We are testing again in 20 min to see what it is then. PMPS isn't due until a half hour from now. Am I ok to give 0.5U if his BG is near 100? I will give med carb food too.
 
He doesn't want to make this easy!

If he's flat (close to 105) I would give 0.1U and keep an eagle eye on him. If he's above 150 I'd try 0.25U but same thing, eagle eye. If he weren't so recently DKA we'd be skipping.

This is a U100 syringe but it's the exact same concept, just barely past the zero line:
upload_2022-11-2_19-15-41.png





Did you feed the higher carb food during today's cycle?
 

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FrostD said:
He doesn't want to make this easy!

If he's flat (close to 105) I would give 0.1U and keep an eagle eye on him. If he's above 150 I'd try 0.25U but same thing, eagle eye. If he weren't so recently DKA we'd be skipping.

This is a U100 syringe but it's the exact same concept, just barely past the zero line:
View attachment 65624




Did you feed the higher carb food during today's cycle?
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At PMPS, he was at 114. We gave him 0.1U and he will be under our close supervision tonight. I will check him at +1 to see where he is at.
Yes, we did feed him med carb wet food after today's AMPS and throughout the first 4 hours. We just fed him the same med carb wet food after tonight's PMPS. Maybe I need to get higher carb wet food? The one we were feeding him has extra gravy.
 
Which food are you using for medium carb?

I would make his new dose 0.25U, if above 150. I think he's pretty much made the decision for you that he doesn't really want/need more insulin, but again given DKA we want to try to keep him on insulin a little bit longer (if it is safe to do so).

A +1 may not tell you much, but worth a try.

From 0.25U we would step it down to 0.1U, and then in his case probably a drop dose. A drop dose is when you push the plunger all the way down as far as you can to expel air, insert into vial, then release. Result is a single drop of insulin, not even visible in the syringe. When you give the shot, same thing - hold down as hard as you can, ideally for about 10 seconds to give it time to absorb.
 
FrostD said:
Which food are you using for medium carb?

I would make his new dose 0.25U, if above 150. I think he's pretty much made the decision for you that he doesn't really want/need more insulin, but again given DKA we want to try to keep him on insulin a little bit longer (if it is safe to do so).

A +1 may not tell you much, but worth a try.

From 0.25U we would step it down to 0.1U, and then in his case probably a drop dose. A drop dose is when you push the plunger all the way down as far as you can to expel air, insert into vial, then release. Result is a single drop of insulin, not even visible in the syringe. When you give the shot, same thing - hold down as hard as you can, ideally for about 10 seconds to give it time to absorb.
Click to expand...

I am feeding him Friskies- Chicken in Savory Gravy Pate (with extra gravy). I have Hills canned food too that might be higher in carbs (tender chicken dinner). I just thought the extra gravy would make it medium carb food.

I'll change his dose to 0.25U if above 150 (for preshot, right?). If he falls under 150 for preshot, then I would give him the drop dose, right?

His +1 was pretty much the same as PMPS and he slightly decreased at +2.
 
I would stick with it, seems to be keeping him afloat. I can't find the carb percent offhand, but yes I'd hazard a guess it's probably around 10%.

Yes 0.25U if preshot is above 150. 100-149 it is up to you whether a drop dose or 0.1U...lets see how he does with this dose tonight. Can you get a +4 or so?
 
I can’t see any ketone tests for the last two days in the SS. Have you managed to get a ketone test done Karla?
Melissa I’d really like to keep him on insulin for as long as possible and it is safe to do so as he’s only 4 weeks post DKA but I need to be guided by you with the Prozinc. It may mean we need to feed him some higher carb food a bit longer.
Daily ketone tests and can help guide us.
He is doing so well.
I am going to contact Sandy to get her input
 
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Bron and Sheba (GA) said:
I can’t see any ketone tests for the last two days in the SS. Have you managed to get a ketone test done Karla?
Melissa I’d really like to keep him on insulin for as long as possible and it is safe to do so as he’s only 4 weeks post DKA but I need to be guided by you with the Prozinc. It may mean we need to feed him some higher carb food a bit longer.
Daily ketone tests and can help guide us.
He is doing so well.
I am going to contact Sandy to get her input
Click to expand...
Ok. In that case I'm leaning 0.1-0.25U with the current medium carb food.

Karla how reliably does she eat early in the cycle? That's kind of my deciding factor. The 0.25U above 150 looks good - if she will eat that food early on to keep her afloat above 50.

Tonight will be another good indicator on the 0.1U dose.
 
Bron and Sheba (GA) said:
I can’t see any ketone tests for the last two days in the SS. Have you managed to get a ketone test done Karla?
Melissa I’d really like to keep him on insulin for as long as possible and it is safe to do so as he’s only 4 weeks post DKA but I need to be guided by you with the Prozinc. It may mean we need to feed him some higher carb food a bit longer.
Daily ketone tests and can help guide us.
He is doing so well.
I am going to contact Sandy to get her input
Click to expand...

I have not been able to get a ketone test done the last two days. I will get one by tomorrow morning since I have the day off. I will make sure to post the results on the SS. Are there any tips on getting a successful ketone test done? Sometimes I am not fast enough to get a strip out when he is urinating.
 
FrostD said:
Ok. In that case I'm leaning 0.1-0.25U with the current medium carb food.

Karla how reliably does she eat early in the cycle? That's kind of my deciding factor. The 0.25U above 150 looks good - if she will eat that food early on to keep her afloat above 50.

Tonight will be another good indicator on the 0.1U dose.
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Very reliably! We give a full can after every PS and leave it out for him to graze- usually done by +4/5. If he still seems hungry, we give him more wet food. The last time we gave 0.25U, he went as low as 63 at +3.. is that ok? Should we try higher carb food?

We gave 0.1U tonight and he seems to be doing well! He is at 135 at +4!
 
Ah ok that explains it! he was a little higher than we'd like last night - I mean really it's splitting hairs at these numbers but the more greens above 50, the better. So we'll chalk that up to food, today's cycle looks good. I'd keep doing what you're doing, minus the Hills lol
 
FrostD said:
Ah ok that explains it! he was a little higher than we'd like last night - I mean really it's splitting hairs at these numbers but the more greens above 50, the better. So we'll chalk that up to food, today's cycle looks good. I'd keep doing what you're doing, minus the Hills lol
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Sounds good! We did give him some Friskies flakes today that we know is 13-14% carb after AMPS and PMPS and then Friskies pate after +4. These numbers are still a little higher than what they were yesterday. Is this fine? We also did drive for about 3 hours to visit family so maybe there's a bit of stress that is influencing PMPS.
 
He's really teetering on the line between 0.1 and 0.25U! Let's see how the 0.25U goes today. It almost looks like the med carb is a little too much when shooting 0.1U, but you definitely can't shoot 0.25U that low. Thinking we need to tweak food for 0.1U doses.

Do you give the medium carb food at shot time?


Basically all of these numbers are great, and within meter variance so I wouldn't overanalyze. It is also normal for AMPS to be the last one to come down.
 
FrostD said:
He's really teetering on the line between 0.1 and 0.25U! Let's see how the 0.25U goes today. It almost looks like the med carb is a little too much when shooting 0.1U, but you definitely can't shoot 0.25U that low. Thinking we need to tweak food for 0.1U doses.

Do you give the medium carb food at shot time?


Basically all of these numbers are great, and within meter variance so I wouldn't overanalyze. It is also normal for AMPS to be the last one to come down.
Click to expand...

Yes, we have been giving him med carb food up until +4. It's a hit or miss sometimes with Tanner, but if he doesn't eat it, we always supplement the food with the regular Friskies pate (that he loves!).

Do you think we should be feeding med carb food for 01.U doses?
 
Karla AS said:
Yes, we have been giving him med carb food up until +4. It's a hit or miss sometimes with Tanner, but if he doesn't eat it, we always supplement the food with the regular Friskies pate (that he loves!).

Do you think we should be feeding med carb food for 01.U doses?
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Only for the 0.1U dose - I would try low carb at shot time. You may likely need the med carb starting around +2...it's a bit of an experiment. Sorry to complicate it so much, just trying to tweak it to keep him in a good range.
 
FrostD said:
Only for the 0.1U dose - I would try low carb at shot time. You may likely need the med carb starting around +2...it's a bit of an experiment. Sorry to complicate it so much, just trying to tweak it to keep him in a good range.
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Ok! I'll check his +1 and +2. Thank you!
 
@FrostD
He was higher than normal today, was even in the 300s for PMPS. Am I still following 0.25U or should I go higher given SLGS method? I have been testing for ketones and he has been negative thankfully.
 
That's a little odd. I don't think he's going any lower than he has been. Could be a bounce, give it a few cycles to see if he comes down.. otherwise, keep a close eye for any sign of infection, as that can also raise BG like this.
 
FrostD said:
That's a little odd. I don't think he's going any lower than he has been. Could be a bounce, give it a few cycles to see if he comes down.. otherwise, keep a close eye for any sign of infection, as that can also raise BG like this.
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His numbers seem to be getting better. Maybe it was a combination of daylight savings time and the fact that we were all away this weekend? He seems normal and I even caught him playing with the other cats, which he hasn't done since before he was hospitalized! He's due for a recheck on his bloodwork next week. Hopefully his bloodwork remains normal.
 
Good! It looks like the medium carb is too much...I'd try just the low carb if you're able to keep an eye on him
 
FrostD said:
Good! It looks like the medium carb is too much...I'd try just the low carb if you're able to keep an eye on him
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His numbers look a lot better this week!
What value is considered low enough to warrant another decrease in dosing? He had a low of 60 on 11/11 and I gave him low carb food right after.
 
Technically with SLGS it's 90, with the other method it's 50. I would now just give 0.1U across the board any time hes above 100 and can monitor. Below that i think you just have to skip.

@Bron and Sheba (GA) thoughts for next time he dips below reduction point? Add a higher LC back in, or drop dose?
 
Are you testing for ketones every day? This will tell us how he is going with the food and the dose. I can’t see any results for the last three days in the SS.
I’d really like to keep him on some insulin for as long as we can because of the DKA, and we want a strong remission and I’d like to see a lot more green BGs if possible. We can lower the reduction point (this is only advice for Tanner as he has had DKA).
I’ll have to leave the dose for you Melissa as you are a Prozinc user, but we may have to give some higher low carb at times.
 
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