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technically we would have to wait for at least 6 cycles after the bounce right? not just 6 cycles after the dose increase? Have a good night. . . will talk tomorrow
 
I think if he doesn’t see any action (like yellows) tonight and if he’s still in pink in the morning then go ahead and increase. If his nadirs are pink, we know that he won’t be in danger from an increase and that he still needs more insulin.
 
Hooray, Opie! That’s great. I’m so glad you were able to get up and check on him. I don’t see why we can’t proceed with the increase. We’ve held this dose long enough, and if he has a yellow preshot then so much the better. You have shot yellow before. He will probably bounce, but the only way to get him less bouncy is that he spends more time in lower numbers so his body can adjust to them. Please keep me posted. I’m kind of excited to see his morning preshot. I hope he won’t have started a bounce by that time, but either way, go ahead and increase if he’s yellow and you will be able to monitor his cycle as usual.
 
so glad you were able to leave me a message this morning so I knew what to do. He is pink but low pink so he should drop down this morning. Hoping for lots of yellow today. . . we shall see. . .
 
That’s what I was trying to do — to think of possibilities so that you could just proceed. I was sitting in my car early a.m. (out taking care of feral cats) and I usually will check my phone anywhere between 5:30 and 6:30/7 a.m. I hope for yellow too.
 
gosh, i was hoping to at least see the yellow before he bounced but he already bounced

you sound like me, outside feeding all the outside cats. . . love them all, wish I could bring them ALL inside with me
 
Ack! I was afraid of that. He already started his bounce from last night’s yellow. Well let’s see how long it takes….
 
Oh gosh. I’m so sorry that you are going through this. I remember what it was like. I was hopeless. Let’s see what happens tonight since he had a yellow preshot maybe he’s broken the bounce. I do hope that we can follow the MPM protocol to get Opie into better numbers. With increases coming about every 6 cycles, we should know soon.
 
I’m checking in on Opie because I am thinking of y’all tonight. I don’t yet see any tests on his spreadsheet, but I may be too early for the +3-ish test. I was hoping for something lower tonight since he started in yellow. Don’t give up. We will keep on going and will know for sure this way if he just needs more insulin right now or if you need to have him tested for a few conditions that cause insulin resistance (you are not there yet because his dose would need to be higher before we would recommend those tests.). I just was so hoping to see lower numbers this evening.
 
Good morning. I think that, since Opie’s nadirs are well over 200, your next increase should be a .5 unit increase, which would bring his dose up to 3 units. This is recommended when following the Modified ProZinc method and nadirs are over 200. Would you be comfortable doing that, or would you prefer to try the .25 unit increase for another six cycles?
 
HI there, I didn't receive your last messages via email so sorry. . . actually checked here and your messages weren't there either.
I agree with you on going up .5 and was going to suggest the same thing but you beat me to it. Something is definitely strange today because he is at the same number without change. When would be the increase? So you count from last night's bounce?
Also, he was checked for any other health issues and was negative.
 
Have you started a new vial of Prozinc yet? I remember you mentioning your current vial was/is almost 5 months old & just about done - trying to rule out any possible culprits.
 
no we didn't start a new vial, we keep thinking each time will be the end but it seems to go on. . . we will start a new one tonight just in case
I suppose it is a possibility of other health issues but let's not say so just yet ok? let's rally onwards. . . when do you think the increase should be?
 
I was just trying to give you a plan for tomorrow morning when he was due for an increase anyway -- that you could do a .5 increase. It is frustrating for me to just look at his spreadsheet... so I know how hard it is on you.

Are you saying that you have already had him tested for Acromegaly or for Insulin Auto Antibodies? Those are special tests that are only run by a single lab in the United States (Michigan State University Veterinary Diagnostic Laboratory.) I'm not saying he needs these tests run as yet, so don't mistake me, but only if his dose continues to increase and then he is still very insulin resistant. We do not recommend testing for these two things until a cat is at 6 units. So I just wanted to check and make sure that you haven't run these tests yet. If you did, you would want to add to your signature that her was Acro negative and IAA negative.
 
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LovingOpie said:
no we didn't start a new vial, we keep thinking each time will be the end but it seems to go on. . . we will start a new one tonight just in case
I suppose it is a possibility of other health issues but let's not say so just yet ok? let's rally onwards. . . when do you think the increase should be?
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Tomorrow morning after the requisite 6 cycles. He's so high that I do not worry about any bounce breaks or anything. I think we need to just plow ahead following MPM. Agreed?
 
LovingOpie said:
so we opened the new vial and he is again at 278, can you believe how he goes down at PMPS ? anyway, we will do 3 units in the AM and thanks again. . .
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It looks like he tends to start breaking his little bounces by PMPS so he tends to drift down. Good luck with the increase! I’m rooting for your Opie and will check up on his spreadsheet tonight and tomorrow.
 
went down to 131 and this is still at 2.5! I think the new bottle of insulin might have made a difference though I never thought it did before. Do I still go with the increase tomorrow AM? I still have to see his numbers from tonight but will wait on you in the morning. . . and we were told that the insulin could still be used for months and didn't matter how old it was, this being told to him from a diabetes seminar for vets. . . .
 
LovingOpie said:
went down to 131 and this is still at 2.5! I think the new bottle of insulin might have made a difference though I never thought it did before. Do I still go with the increase tomorrow AM? I still have to see his numbers from tonight but will wait on you in the morning. . . and we were told that the insulin could still be used for months and didn't matter how old it was, this being told to him from a diabetes seminar for vets. . . .
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No. Do not increase tomorrow morning. Since he is having blue numbers, hold this dose for a few more days. Let’s see what happens tonight and tomorrow.
 
Having said that, we know that he will probably begin a bounce either tonight or tomorrow morning so don’t be discouraged. You’ve just had a lovely blue! Hopefully he can surf in blue for a bit this evening before the bounce, but either way it’s very good! He is responding well to the insulin tonight. So even if he’s pink tomorrow morning, just hold at 2.5 and we will see how it goes. Okay?
 
2.5 sounds just fine but he has dropped down to GREEN and is at 96. Tested 96 at +6 and an hour later he remained the same even after we gave him a few greenies. We were worried that he would continue to drop as he sometimes does, hence the greenies. Yes, he might go pink by morning but how low is too low to give the 2.5? Also, how long does this forum recommend keeping and using insulin before throwing it out?
 
LovingOpie said:
Also, how long does this forum recommend keeping and using insulin before throwing it out?
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Nice greens! I just dealt with old prozinc. Some people say it lasts longer than 3 months, I did not find that to be true sadly. Such a shame, I had 2 half bottles that went bad at the same time. I shoot 2 diabetic cats and their numbers kept climbing. I didn't think it could be the prozinc but it was. Dealing with a big drop right after I changed to Lantus right now. Good luck!
 
I had a feeling he was going green last night. I’m not prescient, I just have seen on his spreadsheet that he has had a tendency to do this.

Let’s see what his AMPS is this morning. You shoot at 7 a.m. Eastern? Or 7:30? I can be around. I will just be getting ready to take Oliver for his dental this morning. If he’s high, you should be safe shooting the 2.5 units.
 
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LovingOpie said:
Also, how long does this forum recommend keeping and using insulin before throwing it out?
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Some say they have used 5 to 6 months. I never went longer than 3.
LovingOpie said:
I think the new bottle of insulin might have made a difference though I never thought it did before.
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You watch the spreadsheet and if they start creeping up could be a sign it's losing it's efficacy. It was a little hard to tell with Opie because we didn't know what was going on at night, but with the extra testing over the last week you can kinda see it - he was so darn flat!
 
I’ve seen people use every drop of ProZinc and keep it for 6 months and the. I’ve seen people have a bottle go stale after 3-4 months— so it is variable. I am certainly glad that you had a spare. Now the question is, how long have you had the spare vial? I’m sure you keep it in the refrigerator and know about gently rolling the vial prior to drawing the insulin. I’m also sure that you check it for floating particles.
 
so we are on 8 cycles with 2.5. Do we keep this for awhile more or do we increase? Will the preshot numbers begin to go down as he gets adjusted and regulated? Sorry, don't really know what is common or not, so don't know what to look for and expect. The goal is being in the green but that is scary because my vet had a goal of 150 which is quite different. At least right now he isn't flat in pink. . .
 
LovingOpie said:
so we are on 8 cycles with 2.5. Do we keep this for awhile more or do we increase? Will the preshot numbers begin to go down as he gets adjusted and regulated? Sorry, don't really know what is common or not, so don't know what to look for and expect. The goal is being in the green but that is scary because my vet had a goal of 150 which is quite different. At least right now he isn't flat in pink. . .
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You will hold this dose for longer. We typically hold doses with blue and green nadirs for 10 cycles. And really since he just started getting blues (and even a green) last night after starting the new vial I would probably start the count with last night’s dose.
 
He is just starting to have more normal ProZinc cycles. I do hope that his preshot numbers will come down. Let’s be patient and happy that he is getting such good nadirs. It takes time for the pancreas to heal (which we hope will happen for Opie.)
 
You already know this, but feed him! Have any MC. I'd love to see this blue stretch out for a bit. Even greens would be welcome. So far things look very good because the rate of drop seems nice and steady.

You may want to start recording what and how much you feed in your SS so that you remember what works -- unless you're just giving him his same food each time -- although you can write LC at +2, for example.
 
As I mentioned, he eats all day long and only LCW. . . by MC do you mean high carb food if he drops low? If I fed him something like that he would only want that and I would have a difficult time with him. . . but if he gets hypo I will of course use it.

Glad you think he is doing good. I like to hear that.

Since he gets low at shot time I need to know how low is too low to give the 2.5. I was worried giving that much at 199 was cutting it close.
 
LovingOpie said:
As I mentioned, he eats all day long and only LCW. . . by MC do you mean high carb food if he drops low? If I fed him something like that he would only want that and I would have a difficult time with him. . . but if he gets hypo I will of course use it.

Glad you think he is doing good. I like to hear that.
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Right. Sorry. It's hard for me to keep straight everybody's feeding schedules. There are so many different people who are feeding so many different things. It's just that if I was trying to ensure a smooth cycle I would probably bring the food over to him at certain points to see if he would munch it when I wanted him to instead of relying on him to eat it whenever. Then I would put the food back in its usual place.
 
Medium carb (MC) 11-19 percent. Some of the Fancy Feast foods fit this (and others, of course). It's just something to keep in your arsenal ... a can or two... if you feel like you need to slow him down but you don't want to go to HC food. HC should be reserved for when a cat following MPM drops to 50 or below (and some cats won't need it at that point anyway because they're very carb sensitive and would do fine with a 10 or 15 percent carb.) But you get to know, over time, how your cat responds to carbs. But he's doing really well on this dose and I hope we can hold it for a while as his body gets to spend more time in these better numbers. It's very good to see.
 
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