New Member - NEW PZI User - Looking for support!

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Thank you all for your feed back - I'm new to message boards and I am doing this while at work so it is all slow going. I will gather all the necessary information and post as soon as I can and I really do appreciate your offer to help. I have been reading the board and advice since Shyloh was diagnosed Jan 2009 and have gotten so much good information, printed out so much and read and re-read it. I have tried to do everything right - diet, home testing, etc. Encouraged by Molly's results, I have decided to lower his dose as soon as I get the keto sticks - we have the mega-snow storm too. His numbers have been so High, I'm afraid to lower the dose without them. SO many things about him aren't right - the more he eats the more he wants. Yesterday his AMPS was 342, his + 6 was 408 and his PMPS was 339. He has been in the 400's almost since beginning the 2U PZI I have done curves but Vet is increasing dosage on nadir #. He just gobbles his food (2 cans FF 2X's day ) at one sitting which I'm sure sends up his BG. (Vet says he likes the taste of the food!) Just tired of wasting time - want to see results of all my hard work!
 
Agree with your idea that as soon as you get the ketone strips, you can reduce the dose. If you have been reading, you have probably seen the info on rebound: http://petdiabetes.wikia.com/wiki/Somogyi_rebound It is possible that is what is happening.

As far as the food, unregulated cats are literally starving, as their bodies don't metabolize the food correctly. You may want to add 1/2 to 1 can of Fancy Feast a day until he is better regulated. We did that with Oliver at first; then were able to cut back to his normal amount when his blood sugars were better. You can freeze the food and put it out so he maybe will graze instead of inhale.

You are doing great. You will figure this out when you have all the pieces in place.
 
Sharing with others your earlier post, placed inside Molly's first post on Meatball.

Molly, you came to the right place - please keep letting us know how you progress. My gut tells me I am in a similar situation (new ProZinc user). My vet has all my faith but is new to ProZinc himself and his recommendations went against the conventional wisdom of this board. After never being close to regulated on Vetsulin, Shyloh started at 2 U ProZinc on Jan 15 and is currently at 7 U BID and #'s still high, higher than they ever were on the Vetsulin. Each increase in dose registered practically the same results. Very frustrating so I hope to gain some confidence through your experience.

Support coming your way!!! I understand you not wanting to reduce until you have the ketostix. When do you think you might be able to get out? You might want to post your location (city,state,province) in case one of us is around and can get out.

It's a great thing you are hometesting; that's the first best thing you can do.

You also might want to start a spreadsheet for Shyloh. The guidance for doing that is on the tech forum here.

Welcome PLF303 (what's your name?) and Shyloh!!!
 
Thanks - I feel better already and more resolved! Sticks will be picked up at lunch today.
I'm Pat and Shyloh is a 10-year old Tuxedo Maine Coon - as soon as I figure out this board stuff I'll include a picture of him as he was in his handsome days.
1. Should I test with the stick before lowering the dose for a base line considering he's been high for some time? (Should have been doing this anyhow, huh?)
2. If you get a positive reading for Ketones - rush to Vet?

Actually looking forward to playing in the litter if it helps - we have both suffered so many indignaties this past year - he's a trooper.
 
PLF303 said:
Thanks - I feel better already and more resolved! Sticks will be picked up at lunch today.
I'm Pat and Shyloh is a 10-year old Tuxedo Maine Coon - as soon as I figure out this board stuff I'll include a picture of him as he was in his handsome days.
1. Should I test with the stick before lowering the dose for a base line considering he's been high for some time? (Should have been doing this anyhow, huh?)
2. If you get a positive reading for Ketones - rush to Vet?

Actually looking forward to playing in the litter if it helps - we have both suffered so many indignaties this past year - he's a trooper.

Hi Pat. Scritches Shyloh.

It wouldn't hurt to get a baseline before you lower the dose. But don't put off lowering the dose if he gives you that "you're going to do what with me pee?" look and refuses to give you any of the liquid gold.

A trip to the vet depends on how much in the way of ketones and how he's otherwise feeling. Molly is dealing with apparent trace ketones on Meatball. You might want to follow the advice she is getting, including the link I gave her to the wiki article on ketones. viewtopic.php?f=3&t=5916
 
Here are some guidelines on the ketone testing: http://petdiabetes.wikia.com/wiki/Ketoacidosis

A test now would be good. If he has ketones now, you would not reduce the dose. That could mean we are wrong about rebound and that, for whatever reason, he may be a high dose kitty. That, I think, is unlikely. But if he had trace ketones or higher, yes, a trip to the vet is probably in order.

You are taking ketone tests while reducing the dose so you can be sure a lower dose of insulin is not impacting him negatively. You can find that out by blood sugar tests (hometesting) and ketone testing. Both are vital.
 
Hey there Pat,

Just wanted to say welcome. Good to hear you guys are back. You are getting some wonderful help and advice from the others.

Please feel free to join us in the PZI group anytime.

Also, the spread sheet is the more important thing to get going but also if you could [in your spare time ;-) ] put together your profile [instructions also in Tech] that would be helpful too.
 
Hi Pat! Welcome to the FDMB. :) It sounds like you are really doing great so far with all the reading you've done and info you've retained. It's overwhelming at first, but you are on top of things and it will only get easier (antijinx!).

As Gator said, please do stop over in PZI and introduce yourself and post over there as well. It's getting a lot more active recently and someone is usually around over there. It's still best to post your emergency/immediate needs questions in both PZI and Health because Health has a bigger audience and you will probably get an answer quicker.

Can't wait to see a picture of Shyloh when you have time; I know you have a lot going on, so no rush. :)
 
Hi, and welcome! With those #s, I would definitely consider decreasing the dose. Did I understand correctly that he is on 7u BID? That is quite a lot, and although some cats do need that high a dose, it is less common. Unless you know of any reason that a high dose would be warranted or he has a history of ketones, personally I would drop the dose immediately.

You have an inverse curve it looks to me, which as far as I understand it is generally a sign of the dose being too high. If you are in high #s with a dose that is too low, you should either see a shallow U-curve or a flattish line. When the dose is too high, you can get several patterns, one of which is the inverse curve you described. I can't say for certain that is what is going on, but that is how it looks to me with limited data.

If you haven't figured out the spreadsheet yet, would you be able to post your earlier curves and when dosing changes were made? It's possible we'll be able to see where the dose was too low, and then can confirm if it looks like it is now to high, and how much to reduce by, if indeed that is what is needed. Often with PZI small dose changes can really make a difference, so if your vet increased the dose in 1 unit increments, it is quite possible that the right dose was missed. With my cat for instance, 2 units was too much and 1.5 not enough, and he did magically very well when I tried 1.8 units. Don't worry right now about trying those little increments of course, for right now focus on getting in the right ballpark, but just to mention it as an example.

Also if you changed to lower-carb food after you started the insulin, his insulin need might be lower than it was initially, which can confuse the dosing decisions (i.e. if your vet isn't aware how much the food might be changing the picture).

Keep us posted how things are going, and again... welcome!!! :-D
 
You all are really great - thank you SO much for taking the time to help. Sometimes I am paralyzed by confusion. I tested for ketones - full cooperation was a surprise as was the negative result! I've attached the spreadsheet - that I was able to do it surprised me - thanks for the superb instructions. I hope its enough information - some of you are so tuned in to these numbers its like you read something that is invisible to the rest of us. Please let me know your thoughts. He looks well now (better at least) and the numbers are coming down, he is regaining some needed weight and taking less trips to the litter box (drinking less water) and I am LOATHE to do anything that will take him back to the high numbers that he has been experiencing for about the last 2 months. But the increased appetite is a new wrinkle and the results are coming SO slowly - for 7 units I expected a more noticeable change. Especially when I see how well others are doing on so much less. Also if it is OK to increase his food intake a little since he is now so hungry how will that affect his readings?
 
Remember the rebound thing. His higher numbers may be due to the 7 units.

Yes, increase his food. He is unregulated and will probably be more hungry than usual.

Were you going to decrease the insulin today?
 
Thanks - his diet has not changed - still 2 cans of Fancy Feast low carb Tender Beef twice a day - one thing I can say about Shyloh is that he is practically mechanical in his predictaility - I swear he has an internal clock. I was planning to lower his dose last night after the Ketone test but really wanted a second (or third, fourth - fifth?) opinion on his BG #s before doing so. So the Spreadsheet is posted (I hope it is!). I can start this evening and watch him over the weekend. Do I inform his Vet that I am doing this? I'll need to get the different syringes from him. He doesn't have the best bedside manner.
 
The only way to find out if the dose is too high is to lower it. You are safe to do so because you are hometesting and ketone testing. If you are anxious, wait until tomorrow morning. Then you can test during the day and watch him and get a good handle on what is happening. You are planning to go with one unit, right?

If he continues to want to eat, you would be fine giving him a snack in the middle of the day or a little more at night to tide him over - 1/2 to 1 can of Fancy Feast more.

If I were you, I would be tempted to wait to tell the vet until you have tried the lower dose. Then send your spreadsheet with the improved numbers to him noting that you decided you would try to start over - and look it worked!

What syringes are you looking for?
 
More food??? Shyloh loves you all!
RE: syringes - the U100's? In the past year, I've started from ground zero two times with the vetsulin and now twice with the PZI - I really don't want to risk passing up the best dose.

I home test but I don't love it even though he is good about it - not great, but good enough.

Will start at 1U since everyone agrees on that and I'm in your hands now. How long til I know to increase? Thanks for the advice - seems like a responsible way to go forward!
 
Actually, to do a test for rebound, I believe you only need cut the dose in half...better get some confirmation on this.
 
Jen, I was thinking one unit since her spreadsheet indictates she started at 2 units and increased from there. Her numbers have been pretty consistent since - 300's, 400's. I will certainly defer to your experience.

Pat, please start a new thread with the syringe question. I am not sure if there needs to be a conversion when using 100U syringes with PZI.
 
No rebound experience here at all, just lots of reading. I'm always concerned when someone is on a high dose and is advised to start over at 1 unit, when I've read that cutting the dose in half is perhaps a safer place to start. Again, I defer to people with more hands on experience...
 
For Vetsulin at least, what I have seen for a rebound test is to cut the dose in half or go to 1 unit, whichever is lower. (Source: http://www.vetsulin.com/vet/Cats_Monito ... mogyi.aspx - near bottom of page)

I would feed him as much as he wants and not worry about that with the BGs too much. Heavy eating can come with high #s or with low #s - in either case it is the body's way of protecting itself from danger, so I am in the camp of feed as much as they want whenever they want (for a diabetic cat not struggling with being overweight, that is). Yes, it can affect the BG readings, but if they are acting really hungry in my experience it is often for a reason.

Personally I wouldn't worry about switching syringes immediately unless you really want to. You can eyeball 1/2 unit increments on the U-40s, and get U-100s if & when it looks like you really need them. Some people are more comfortable going ahead and getting them, I felt more comfortable using up the syringes I already had and getting at least close to a working dose before tackling the conversion and all that (it's easy, but if you are already stressed it's just one more thing to think about). Totally up to you whether or not to switch syringes at this point - if you do, keep us posted and we can help you figure out how to use them and which ones to order, etc.

As far as the vets, I would do what you feel comfortable with. If the vet is making you feel uncomfortable, I wouldn't bother reporting what you are doing. With my vet I found it doubled my confusion to get her opinion vs. differing opinions here vs. what made sense to me, so ultimately I found it easier to report things to her after the fact. As someone else suggested, you tend not to get as much grief from the vets when you can report good #s and successful results!!! Otherwise they are going to, by nature (since it's their job) tell you what to do, and if you disagree, it makes it more uncomfortable. That was my experience at least - everyone has their own approach, so go with whatever your comfort level is.

As far as the dose, it's pretty hard to tell for sure what is going on (at least it is for me! :-D ), and even when there were apparent moderate results the night of 2/2 on 5u, that could well be that you were shooting through rebound. I agree it makes sense to try 1 unit since the starting dose was 2u, and back on 1/17 that looks like potential rebound already. I would give it a couple days to settle out and see where you are (no more than 3 days tops) on that dose, checking for ketones daily and watching his behavior as well. Ideally you will start seeing more of a U-curve and then can more confidently increase the dose in 0.5u increments every 2 or 3 days. Although I believe the Start Low Go Slow doc (see sticky on PZI forum) says one week between doses, that is very conservative for PZI and generally from what I have seen 2-3 days is all you need on a dose to see if it is working. If not, you raise. Some people like to wait longer (and there's more room for that if the #s are at least getting down in the 200s, then you can be a bit more leisurely with it), but with Bix at least, I generally found 2 days (4 cycles) to be sufficient.
 
Joanna - thanks for this; spending more than a few days at 1U was holding me back - I don't want to trade one problem for another (Ketones). I feel better now - he's already spending time in the 400's might as well do it for a good cause.
Can you come stay with us for about a week?
 
I am a brand new member to this board. I just received a call from our vet that Max, my 6 year old siamese/ragdoll has diabetes. I have an appointment with her later today to discuss our treatment plan. I am petrified.
 
Hi Laurie, no worries, we'll help you thru this. yes in the beginning it can seem a bit overwhelming but in a couple weeks you seriously will be wondering what you were so overwhelmed with :)

if you'd like, start a new thread of your own and introduce yourselves so you don't get lost down here in this one.
 
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