Numbers going up? Need advice on dosing

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MelissaEbby

MelissaEbby

Member Since 2012
I'm a little concerned because Ebby's AMPS was really high today (422.) I had already planned on upping her dose by .25 if her numbers weren't down today, and to my surprise her reading was the highest it has been since I started testing. She is on Prozinc twice a day, and has been on 1 unit for about 4 days. This morning I upped the dose to 1.25 units.

She had been OTJ for about 6 months until she got an infected tooth (which was pulled a couple weeks ago.) When she was previously diagnosed she went off insulin within a month, so I'm wondering why she might not be responding as well this time. Insulin is about 8 months old (not expired though) so maybe it is not as strong as before.

Ebby eats Wellness canned chicken, and Core canned.

I will try to get more BG numbers today, but any advice on her numbers and dosing would be wonderful! Thanks!
 
The number doesn't make much sense, Melissa, unless she got into some high carb food or she went low overnight and then bounced. She has been getting some nice blues on one unit so you probably had room to go up .25, but if it was a bounce, that complicates the process. I'd get midcycle numbers any time you can -even overnight - and do a curve maybe this weekend to see where her nadir really is. It may be that it is later than you have been getting, in which case she could be going lower midcycle and bouncing.

The more data the better so you can figure out what is really happening.
 
Ok, I've gotten a few more numbers today...been testing every 2 hours. I'm beginning to think she might have another infection, possibly from the dental work done 3 weeks ago. She has been making this weird grinding sound with her teeth when she eats. Her gums do look red, but it's hard to get a good look at them. She also acts like she doesn't feel well. Does anyone know if there would be complications with the dental cleaning? She was given an antibiotic shot that was supposed to last 14 days.

The vet said the bad tooth was actually being reabsorbed and there was an abscess. Maybe all of her teeth are doing this?
 
I don't know much about dentals, but don't think the grinding is a good sign. If she has an infection, it can send her numbers up. Can you have the vet check her out tomorrow?

Nice drop today - some nice blues.
 
Hi Sue, I am going to call the vet first thing in the morning and will get her in. Yeah, I was happy with the blues but they went away so quickly. Thanks for all of your help!
 
Did they do xrays when that pulled that 'reabsorbed' tooth, to make sure they got all of it out? Just thinking that if they did not, another infection could still be there.

Was that 14 day antibiotic shot the Convenia?
 
You know if she is dropping into low blues during the day, she could be dropping into very low greens at night and bouncing up for the morning!!! We cant tell if that is happening because you arent getting many overnight tests in and are missing some morning tests too.

It would tell you more if you can get a test between +5 and +7 test at night and make sure you get an AMPS for the next few days.

Wendy
 
Deb, They did not do x-rays. I took her to the vet yesterday, and he did a visual exam and said everything was healing pretty good and looked ok. She still paws at her mouth though, so I think you're right that maybe an x-ray should be done just to make sure. All of the infection might be below the surface too.

I think the antibiotic was Convenia, but I am not sure.

Wendy, I was able to get a +6 last night, but yesterday was a little weird. Her +11 was 113, so I waited on the shot for an hour, retested, and it was 220. I proceeded to only give her .5 units. I had never shot when her number was 220, and with fresh insulin I was worried. Might not have been the right thing to do though, because this morning she is back at 357. I will try to get more nadir readings at night, so I can get this dosing figured out.
 
Maybe it is time to see if something else is going on with her mouth. The pawing at her mouth does not sound normal.

Member Dr Lisa Pierson says this about convenia and adverse reactions in cats.http://www.catinfo.org/?link=convenia

This morning 357 could be a bounce from a low last night. Did we explain bounces to you?

We could use some testing at night. A regular before you go to bed test. Maybe an occasional set the alarm to wake up test at +6.

Many cats go lower at night and then bounce high in the mornings. No way to tell with out some data to support.
 
Deb & Wink said:
Member Dr Lisa Pierson says this about convenia and adverse reactions in cats.http://www.catinfo.org/?link=convenia
Click to expand...

Oh no! I had no idea about the convenia. I'm trying to find my paperwork from her dental procedure, but can't. I know it was a 14 day antibiotic though, so it's likely it was Convenia. Normally I would have done a lot of research before the procedure, but it all happened so quick. Because it was so infected when I took her in, they kept her and did the dental work immediately. She hasn't seemed sick in terms of not eating or drinking, and the first couple days after the procedure she was acting like her old self again, so hopefully she reacted ok to it. I will know better next time.

I've been a little confused about the bounces. If a lot of her numbers are "bounce" influenced, how do we ever know if the right dose is given. Sometimes it seems I'm giving her insulin only to bring her down from the bounce. Is this something that goes away after her body gets used to these low numbers?
 
Those bounces can be tricky to manage and determine what is going on.

Yes, the bouncing can get better controlled and occur less frequently as her body adjusts to those lower numbers.

Prozinc is a shorter acting insulin than Lantus or Levimir. The Prozinc is what we call an 'in and out' insulin. The effects usually last around one cycle, 12 hours in a cycle. ECID (Every Cat is Different) in how they react to insulin, what their onset is, what the duration is, what the nadir is.

You need to test at various times to determine what those Onset, Nadir and Duration times are for your cat.

Always test at pre-shot. To make sure the BG is high enough to shoot.
As your schedule permits, test around +5-7. Maybe a +5 one day, a +6 another day, a +7 a different day. We are trying to find the nadir or low.
As your schedule permits, test around +9, +10 to try to find the duration.

Cats often drop lower at night, not eating as much, not as active. No one really knows why but these are some likely possibilities.

Because of this, dropping lower at night , we urge you to occasionally set your alarm to get a +5 or a +6.

Looking at your SS now, I see that need for a few more random tests so we can see if this dose is the correct one or needs to be decreased or increased.
 
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