Newly diagnosed--questions on dosing

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AJHJ

AJHJ

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Hello everyone,

My cat, Bunny, was diagnosed last week and began ProZinc on Sunday. His BG was 624 at the vet (no ketones, no other comorbidities). The vet prescribed 1 unit ProZinc twice daily and a low carb diet.

I switched his food to low carb (trying a few to see which he likes best--FF Classic, Soulistic LC varieties, etc). He had been overweight and I had been reducing his food to help him lose weight. He lost a lot of weight--turns out it wasn't the diet, but the onset of diabetes. He's down to 11lbs right now and I think he should be closer to 14. He seems to be hungry all the time and loves the new food. I have been feeding him 2, 3oz cans in the morning and evening (basically whatever he wants). I work during the day so haven't been doing mid-day meals. Other than the high BG levels, he acts like his normal, lovable self.

I started testing right away (see ss; day 1 +10 seemed ok; but day 2 PMPS was 520!). Unfortunately, after that reading the glucometer broke (it only read "errors"--even with my blood). I just got the new one (arrived after the PM dose time) so I tested +1 after the PM dose. It was 419. I realize the levels will still drop, but I'm concerned that the 1 unit dose may be too low to combat such high BG levels (I have been giving just a tiny bit more--just past the 1 unit line). I have read many of the threads on this forum (Thank you!) and I understand it takes time for BG to stabilize and that most recommend "low and slow". Still, I'd love some advice.

Thank you!
Angela
 
Hi Angela and welcome!

Have you seen the protocol we put together for ProZinc? It is in my signature in blue.

His preshots are high, but you are missing a big part of the picture. He could be dropping low midcycle and then bouncing back up for preshots. (bouncing is when his body perceives a level lower than it is used to and releases extra sugar, which causes a bounce up to higher levels). If that's the case, he'd need less insulin.

Or his cycle may be higher and flatter. In that case, a small increase and monitoring what that dose is a good idea.

Can you get some numbers 5-7 hours after the shot? That should tell you more about how the insulin is working.
 
Thank you for the quick reply! Yes, I will absolutely get more levels and plan to do a curve (or mini curve, anyway) tomorrow (working from home). You're right... I don't have enough data yet. I'm just worried and want to make sure he's getting what he needs.
 
You have done a great job giving him what he needs - a good insulin, low carb food and keeping track of his levels to keep him safe.

We'll watch for your new data.
 
Hi Angela! Welcome to our little forum!

Looking forward to seeing what kind of data you get mid cycle today. You're already doing a great job with Bunny!
 
Thank you for the warm welcome and support, everyone.

Today, Bunny was at 282 AMPS, 219 +4, and 273 +6.5. I will test again in a couple hours. From what I've read, the nadir generally occurs between +4-6. I was hoping to see lower level. Thoughts?

Poor guy is a pin cushion--I'm not great at testing yet. He's being a very good sport, though.

Thank you,
Angela & Bunny
 
Hi Angela, welcome to the group! You're doing a great job already. I'm curious how are you giving 1.1 units of insulin?

Since his numbers already look so much lower than yesterday, I would not increase his dose at this point. His body is just learning to use the insulin you're giving and adjusting to the lower carb diet. Try to grab at least one mid-cycle number for the next several cycles to see how he's doing.
 
Hi Angela and welcome with Bunny to this little prozinc family part of the forum:) what a lovely picture!
So you got a testing kit/ keeping track off the numbers in the spreadsheet, and giving insulin and already switched food,, wowwwww! Great work Angela! You are all set to go and ride that train of sugar :woot:
Are you already informed about always testing the preshot numbers? They are also really important to test, and indeed some mid cycle numbers to keep track off what little Bunny is doing.
Hope to see them soon, will follow your thread! :bighug:
 
1.1 is my way of notating that the plunger is at the bottom of the unit line, as opposed to exactly flush. I realize that looks a little strange!

I will keep testing--definitely pre-shot and will get a couple mid-cycle numbers in, too, as often as I am able.

I was already grateful for all of the wonderful information I've found on this site; now I am moved by the tremendous support I feel. Thank you.
 
AJHJ said:
I was already grateful for all of the wonderful information I've found on this site; now I am moved by the tremendous support I feel. Thank you.
Click to expand...
We are all here to support eachother! And we all know how it feels in the beginning of this diagnose. So we try to help everyone feel welcomed and making sure that they feel confident about starting the threatment. And we are also here to just chat haha ;)
 
Support and chat sounds pretty nice!

Bunny's pre-test was 419 this morning and his +5 was 296. His pretest last night was 432. He starts drinking lots of water about an hour before he's due for his next shot. He's been on LC food for over a week. His fructosamine was over 600 at dx, so I do think there has been a net improvement (diet/insulin). However, I'm pretty confident he's under-dosed. I'll call the vet, but curious what others think.

Thanks,
Angela & Bunny
 
I think an increase would be a good idea. My preference would be to increase by 0.25. My thinking is it's early in the sugar dance, probably part of the high preshot levels are bounces and you're getting a good drop (but he has room to drop more.). I'd go slowly with the increases, getting the data to see how the dose is working.
 
Hi again,

I spoke to the vet over the weekend and she said hold off on increasing until I can do a full curve (I will do one this week) but agreed that a small increase may be in order. This morning I got a surprise... his BG was 181. First time it's ever been blue. I won't dose. He just ate so I assume his BG will rise and any sample in the next two hours will be too influenced by food to base a dosing decision on. So I guess I just wait until tonight to see how he's doing, right?

Thanks,
Angela

p.s., Ruby... the video you posted of Baco was hysterical. Bunny and Baco have a pretty similar idea of "play" :)
 
Hi Angela,

You can check how Bunny is doing around the original +6, check how the numbers are rising and if it goes up quick or not (just for yourself, it's interesting data you know!) And then only check PMPS again after that.
Good number this morning!

Thanks, it was indeed a funny video, she is such a clown!:p
 
83 at AMPS. First ever green! Two days ago he was 181 at AMPS then 418 at PMPS. I plan on doing a full curve tomorrow assuming he has a shootable number in the AM.
 
427 at +11 (which will serve as PMPS since he really wanted to eat). What does this mean? 83 at AMPS and 427 at PMPS? I kind of hope he's high enough to shoot tomorrow morning so I can do a full curve. I find his numbers very confusing!
 
Just re-reading the protocol again. Could it be that the dose is too high? It's been twice this week that the morning level is too low to shoot and the evening level is quite high. Tonight's dose isn't for another 30 min. Anyone think I should lower a touch??
 
He's probably high because he didn't get a shot this morning. That was the right thing to do with that AMPS, but it does cause a higher preshot at the next test.

So you gave 1 unit tonight? Let's see how that works for tomorrow....
 
I gave a few drops shy of 1 unit (plunger at the top of the line instead of the bottom) since he had two cycles where the morning was low and the evening was high. We'll see where he's at in the morning. Now that I've gotten better at testing, I'm anxious to do a curve and get more data (though I would have been much happier if his PMPS was green, too!).
 
Not great numbers so far today....

AMPS: 357
+2: 337
+4: 255
+6: 298

I'll keep testing to see how he rises throughout the cycle. Based on this and last week, it looks like his nadir is around +4. And it's not very low. I'll be sending the vet the data, but would love some advice from this group...

Thanks,
Angela
 
I think she may still be reacting to that low green preshot. I'd give her another cycle or two with this dose and see if she drops. If she is still in the yellows mid cycle then increase by 0.25
 
Thanks, just finished Bunny's first full curve! Whew! That green preshot was definitely strange. So, go with the normal 1.0 dose tonight (not a couple drips light like last night)?
 
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