? New Member/ Need Help Managing My Cats Insulin Dose

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Shawn & Sir Maximus

Shawn & Sir Maximus

Member Since 2023
I need some help managing my cats insulin dose. I have been using Prozic for about a month now and can't get his levels down in the blue or green. I have been home testing and would like someone to look at his numbers. Can I upload a picture of his chart? He is off dry food and is eating only wet food Friskies under 10% carbs. I have done a curve. Currently i have him on .25 dosage to see how that works. He started on 1 unit but bounced hard so lowered the dosage to .50 and then bounced again.
 
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Welcome to the FDMB. We have a spreadsheet we use to track the bg and I’ll get you the link. I’m not a Prozinc user but we raise and lower the dose in .25 increments. Cats’ bg often bounces if in lower than used to bg for the cat. As their bodies get used to more normal bg the bounces are less severe.

Are you using a human or pet meter?
Does your cat have any other medical issues? On any medication? Did d your vet say if there were ketones when diagnosed? How did you determine the diagnosis? Anything else we should know?
 
He is using the Relion Premier Classic Human Meter with U-40 Syringes with half marker readings. No Ketones when Urinaysis and blood work was good. He is a senior 15 years old. Big boy half Mancoon around 16lbs. When he was 2 he did have a UTI surgery but no issues since then. I will need help in setting up a spread sheet. He on no medication. I currently have a chart on my home testing.Thank you
 
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Hello and welcome. I have a soft spot for black and white kitties. :)

This post has some information on how to load basic information, including spreadsheet, into your signature, making it easier for people to basic information about Sir. Maximus.
New? How You Can Help Us Help You!

We also have some dosing methods for people using Prozinc PROZINC DOSING METHODS. Using the dosing method tells you when you need to increase and decrease the dose. Most people start with SLGS, which has you hold the dose for 7 days, do a curve, then increase if you aren't seeing numbers in the 90-149 range. Which you mostly are not. The 94 on the AM of 12/10 seems a little out of place. Any chance you retested that number? Some of the meters will register low if you didn't get quite enough blood on them.
 
Wendy&Neko said:
Hello and welcome. I have a soft spot for black and white kitties. :)

This post has some information on how to load basic information, including spreadsheet, into your signature, making it easier for people to basic information about Sir. Maximus.
New? How You Can Help Us Help You!

We also have some dosing methods for people using Prozinc PROZINC DOSING METHODS. Using the dosing method tells you when you need to increase and decrease the dose. Most people start with SLGS, which has you hold the dose for 7 days, do a curve, then increase if you aren't seeing numbers in the 90-149 range. Which you mostly are not. The 94 on the AM of 12/10 seems a little out of place. Any chance you retested that number? Some of the meters will register low if you didn't get quite enough blood on them.
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Wendy&Neko said:
Hello and welcome. I have a soft spot for black and white kitties. :)

This post has some information on how to load basic information, including spreadsheet, into your signature, making it easier for people to basic information about Sir. Maximus.
New? How You Can Help Us Help You!

We also have some dosing methods for people using Prozinc PROZINC DOSING METHODS. Using the dosing method tells you when you need to increase and decrease the dose. Most people start with SLGS, which has you hold the dose for 7 days, do a curve, then increase if you aren't seeing numbers in the 90-149 range. Which you mostly are not. The 94 on the AM of 12/10 seems a little out of place. Any chance you retested that number? Some of the meters will register low if you didn't get quite enough blood on them.
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Hi Wendy& Neko,

I appreciate the feedback, no i didn't retest him on that 94am on 12/10. I joined a FB diabetes forum. They have helped me with a lot of stuff but i feel like the numbers just our not where they need to be since i have been following their instructions. I have personally dedicated my last 3 weeks everyday to him learning and reading so much to help him.
 
Hi Shawn!!

Glad to see you posted. I agree with Wendy about that 94 possibly being an outlier.

We suggest all new PZ members start with Start Low Go Slow (SLGS) which Wendy has linked under the Prozinc Dosing Methods. Following those, his dose should not have been decreased to where it is now. Bouncing happens and we don’t reduce the dose here for bouncing unless clearing the bounce causes the BG to drop below 90 on a human meter for those following SLGS.

Without a retest of that 94 (which is fine because you didn’t know), I’d like to be cautious about his dose. While normally I might suggest you go to 0.75u, being cautious while you collect data means I’m going to suggest you increase the dose to 0.5u bid (twice a day). You’ll want to be sure and monitor him with random tests that you change up a bit. So perhaps one cycle, do a +2, +4, +8 and then another test at other times unless the data tells you to test more often. You can post here if he starts to head under 200 and you aren’t sure when to test next or if you should shoot the next preshot. We do have some alternative methods besides just skipping shots which allow you to safely get insulin in him.

With SLGS, you would hold the dose for a week unless he earns a reduction at any time by dropping below 90. If he drops below 90, at the next shot, you will reduce by 0.25u. Again, you can always post for dosing advice.

We are glad to have you both here. Let us know your questions.
 
Marje and Gracie said:
Hi Shawn!!

Glad to see you posted. I agree with Wendy about that 94 possibly being an outlier.

We suggest all new PZ members start with Start Low Go Slow (SLGS) which Wendy has linked under the Prozinc Dosing Methods. Following those, his dose should not have been decreased to where it is now. Bouncing happens and we don’t reduce the dose here for bouncing unless clearing the bounce causes the BG to drop below 90 on a human meter for those following SLGS.

Without a retest of that 94 (which is fine because you didn’t know), I’d like to be cautious about his dose. While normally I might suggest you go to 0.75u, being cautious while you collect data means I’m going to suggest you increase the dose to 0.5u bid (twice a day). You’ll want to be sure and monitor him with random tests that you change up a bit. So perhaps one cycle, do a +2, +4, +8 and then another test at other times unless the data tells you to test more often. You can post here if he starts to head under 200 and you aren’t sure when to test next or if you should shoot the next preshot. We do have some alternative methods besides just skipping shots which allow you to safely get insulin in him.

With SLGS, you would hold the dose for a week unless he earns a reduction at any time by dropping below 90. If he drops below 90, at the next shot, you will reduce by 0.25u. Again, you can always post for dosing advice.

We are glad to have you both here. Let us know your questions.
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Do you think I should keep him on 0.25 this evening since i increased his dose this am to 0.25. Last night he was at a dose of 0.15. Then start the 0.5 dosing tomorrow morning. Just want to make sure the increase quickly will not effect him negatively.

Also i have been testing him AM before meal and shot then again PM before meal and shot and 3 hours later. Should I continue that routine?

Also he is a grazer so how important is that he eats before shot?
 
Shawn & Sir Maximus said:
Do you think I should keep him on 0.25 this evening since i increased his dose this am to 0.25. Last night he was at a dose of 0.15. Then start the 0.5 dosing tomorrow morning. Just want to make sure the increase quickly will not effect him negatively.

Also i have been testing him AM before meal and shot then again PM before meal and shot and 3 hours later. Should I continue that routine?

Also he is a grazer so how important is that he eats before shot?
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Sure you can hold the dose tonight and raise in the morning.

Typically with PZ, you want to test, then feed & shoot within about 10-15 minutes. Many members shoot while the kitty is eating because it distracts them. Same process am or pm.

Also, in general, you want to pick up food by +6 as the insulin often begins to wane so if he’s eating as the insulin wanes, it “can” cause the duration of the insulin to decrease even more. Of course, if his BG is lower than 50, you want to feed and get that up. We also try to not feed after +10 as that can affect the preshot (PS). Again the caveat is if his BG is low at +10.5, you will need to feed and perhaps stall the shot.

Anytime you have an unusual situation, best to post for help until you get used to it.
 
Marje and Gracie said:
Sure you can hold the dose tonight and raise in the morning.

Typically with PZ, you want to test, then feed & shoot within about 10-15 minutes. Many members shoot while the kitty is eating because it distracts them. Same process am or pm.

Also, in general, you want to pick up food by +6 as the insulin often begins to wane so if he’s eating as the insulin wanes, it “can” cause the duration of the insulin to decrease even more. Of course, if his BG is lower than 50, you want to feed and get that up. We also try to not feed after +10 as that can affect the preshot (PS). Again the caveat is if his BG is low at +10.5, you will need to feed and perhaps stall the shot.

Anytime you have an unusual situation, best to post for help until you get used to it.
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I Have him on a schedule shots at 9AM and PM right now, so if i take up his food at +6 he would not eat any food for 6 hours till before eve shot? Him being a grazer he wont like that lol
 
Bounces are when their numbers go up, not down. But he might bounce from this fast drop. Can you give him a couple tsps of his regular food to try to slow him down?
 
Ohh okay , yes i just gave him some lunch. Do you think I should retest in 2 hours or 3. I had planned on doing a +6 test at 3pm
Just ate and crashed on the sofa.
Thank you
 
Okay I hope it goes back up. I only have honey and dry food which I kept for an emergency. Going to the store tonight to get high carb wet food 18% and higher for emergency situations.
Thank you
 
He is at 71 now... Hopefully that will engage an upward trend. I just tried feeding him some more but he's either full or doesn't feel good enough to eat.
 
I would test at +10.

On the dose: because you are following SLGS and he dropped below 90, you will need to go back to 0.25u tonight. By suggesting 0.5u, I was trying to get him closer to a dose that seemed to work for him.

However, something I’d like to explain. First, there is no data for last night so we have no idea what his BG did or how much it might have dropped. I think after today’s cycle, you can see how the BG can start high and end up much lower. That’s why it’s really, really important you get a least one, preferably two tests in the evening cycle after PMPS. That could be a +2 and a before bed; however, you shoot really late so that doesn’t give you a lot of opportunity for both unless you are a night owl. I don’t know what your schedule looks like, but you might just want to “think” about moving his shot back in time so you’ve got the time to get a couple tests in at night. We can help you with that if you like.

Second, I’m a big fan of a +2 test with PZ, lantus, and levemir because that’s when they all onset. That means if the BG is going to head down, you might see a big difference between the PS and +2. If you do (which I am sure you would have today), you can head those lower numbers off before they get too low by feeding some LC food. If you can slow those numbers down and he doesn’t drop, then you can hold a dose a bit longer which might benefit him.

We have found that it often helps to divide up the total food portion he would get in a day into an a.m. portion and a p.m. portion. Then divide those portions into 3-4 smaller portions that you feed at PS, +2, +3, +4 to work with the insulin. Of course, at night, you probably want to do it differently so you can get some sleep. But that might help flatten the curve a bit.
 
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Okay that was a lot of great information. Right now with my schedule i can do the +2 tests.

I can also get 2 readings in the eve +2 and +4

Bedtime i leave usually a decent amount because he likes to eat overnight but still has an appetite when i awake at 8am

There will be times i might miss a reading but i will never miss a shot

Now for this eve if i test him at +10 do i need to still test him before his PM Shot? Also what is the cutoff number not to give the shot because he is to low? I doubt he will be but good information to know for the future.
 
I know his shot is due soon, if his BG is high enough. I wanted to let you know even if we get a +11, we always test before we dose. Always.

I'm going to link the info about your insulin here regarding what number is too low.

"When in doubt, ask the Forum or your vet for advice BEFORE dosing your cat.
The proper sequence for dosing insulin is: Test/Feed/Shoot. In the beginning, if your cat’s BG is not up to at least 200 mg/dL {11 mmol/L}, if your schedule allows, you can stall (without feeding) for 20+minutes, then retest the BG. You are looking for a number that is rising, not falling and up to 200 mg/dL {11 mmol/L}. If you stall once, but can’t do another round of stalling and your cat hasn’t reached a BG of 200 mg/dL {11 mmol/L}, you’ll need to skip the dose and wait until the next cycle. NOTE: Because pet meters (such as the AlphaTrak) often read higher than human meters, you may want to adjust the NO-SHOOT number to 225 mg/dL {12.5 mmol/L} or even 250 mg/dL {14 mmol/L} This gives you an added margin of safety when using a pet meter."

Info above is from the prozinc forum, 2nd sticky note listed.

Forum can be found using this link.
https://felinediabetes.com/FDMB/forums/prozinc-pzi.24/

One the experts may have different number for you to follow as you gather more data on him or until they view this info, but I would follow those guidelines until they tell you otherwise.
 
Shawn & Sir Maximus said:
Okay that was a lot of great information. Right now with my schedule i can do the +2 tests.

I can also get 2 readings in the eve +2 and +4

Bedtime i leave usually a decent amount because he likes to eat overnight but still has an appetite when i awake at 8am

There will be times i might miss a reading but i will never miss a shot

Now for this eve if i test him at +10 do i need to still test him before his PM Shot? Also what is the cutoff number not to give the shot because he is to low? I doubt he will be but good information to know for the future.
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Sybil is correct; even if you get a +11.5, you still need to test at PS. I’ve seen the BG change even in 30 minutes.

Never say never :p We all miss shots from time to time. I was fanatical about shooting on time and not skipping but there were a couple times when Gracie was in the 40s and wasn’t coming up enough for me to shoot. We sometimes will stall but not longer than two hours. There may be times when the safest thing to do is not shoot. All you have to do is post and someone will walk you through it.

If, sometime, you test at PS and his BG is on the cusp of whether you should shoot or not, don’t feed him. Post first so someone can help you decide what to do. When we decide to stall longer, we don’t feed. Once you feed at the end of a cycle (even if it is +13), it can affect the BG by raising it and you don’t want to shoot a number that is going to drop once you do shoot and the insulin onsets.
 
Shawn & Sir Maximus said:
Should i move dose up from 0.25 to 0.5 ?
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I know you would like the answer to that question now; I’ve been there :) But, we need to see how this cycle plays out. When the bounce clears, I’ve easily seen the BG drop from where he was at AMPS to low greens by mid-cycle.

I’ll check his SS during the day and see how he’s doing and post a bit later but before you would shoot.
 
Marje and Gracie said:
Ok it’s time for that dose increase to 0.5u BUT you can start it in the morning if you like just in case he decides he “likes” it if you start it tonight. I spent many a night up because I increased the dose in the evening. I learned to wait until the day cycle unless there is a health issue.
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Yes I think I will do it in the AM since I can monitor him all day n night.
 
Yes anxious to see how he reacts. He ate about 2 1/2 teaspoons for am meal. I will try and continue to feed him after reading.

I have been trying to figure how much food he should have a day. That's been a challenge

Thank you for checkin in
 
Shawn & Sir Maximus said:
Hi Marje pretty big drop from +2 to +4 this PM. Gave him a big snack to slow him down. Will also leave food overnight to snack on.
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You did just right. It’s good that he got into yellow last night. It will take a few more days for you to see what he will do on his new dose. Also, it’s not unusual for the numbers to go a little higher after and increase- just for a day or so. Darcy usually did it on the second day after an increase. We call it New Dose Wonkiness.
 
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