numbers up and down like a yo-yo. Help!

Discussion in 'Prozinc / PZI' started by PatJ, Feb 2, 2020.

  1. PatJ

    PatJ Member

    Joined:
    Sep 23, 2018
    Hello everyone,
    I'm getting to the end of my tether with my cat's blood levels. Just when they seem to be going well again, up go his levels again and I'm back where I started.:banghead: I'm doing something wrong but what is it? He's been on 2.00 mmol/L units and has gone into the greens a couple of times so I didn't want to go up too high and dropped a bit,because he drops easily to hypo numbers . Now on 2.00 units he's gone way up again. The vets visit didn't help but that was a few days ago and today he's at 24.0. Could someone take a look at his spreadsheet for me and give an opinion? Would be most grateful. Thanks.
     
  2. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    First of all, would you "drag" the 2020 spreadsheet tab to the left. Drag by your mouse cursor or finger on a smartphone?? I'm guessing here. Don't have a smartphone. By default, when we click on your SS link in the signature, it takes us to the leftmost SS tab.

    Thanks.
     
    Last edited: Feb 2, 2020
  3. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    You certainly test a lot.
    Would you confirm for me what you mean when you have the s, vf, and f in front of your dose.
    s = skinny
    vf = very fat
    f = fat

    Is that correct?
    Dose is in Units.
    BG numbers/readings are mmol/L for most of the world and mg/dL for the USA. Where we still haven't converted to the metric system in the past 50 years.:rolleyes:

    Guessing you are in Europe since you have the word "tinned" in your signature when referring to the canned food. See you are in France according to your profile.

    How well do you understand English? Do you use google translate to help you understand what we write to you in our replies to your post/Thread?
     
    Last edited: Feb 2, 2020
  4. PatJ

    PatJ Member

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    Sep 23, 2018
    Thanks for replying Deb. Yes, the s,vf and f mean skinny, fat etc. 'William's spreadsheet' has never worked in my signature.:( Don't ask me why, I didn't set it up as I don't understand computers and someone very kindly set it up for me. If you click on 'William's spreadsheet' in this thread the spreadsheet will come up.
    In answer to your question, I'm English, living in France, so, No, I don't need a google translation, but thanks for asking, it did make me smile:)
     
  5. Deb & Wink

    Deb & Wink Well-Known Member

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    Ok thanks for confirming English is your primary language. May use a bit of American slang so bear with me. (I'm helping someone else in Spain with a kitten who does not speak or write English, (neither kitten or human) so I need to use google translate with the human and it still isn't 100 % accurate. Plus 1 of our members from Mexico is acting as an intermediary to help explain things. I'm also helping a young guy from Argentina that writes ok in English but I need to not use abbreviations and suchlike and make my grammar a bit clearer with him.) So if I look at the members user profile and see a non-English country, I ask.

    You have to go into your google account to edit the spreadsheet and make any changes. We have "view only" access to the link in your user signature. Keeps us from being able to edit it, make changes and "mucking it up" too much.
     
    Last edited: Feb 2, 2020
  6. Deb & Wink

    Deb & Wink Well-Known Member

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    1. He's bouncing. A lot. Frequently.
    2. You are changing the dose too often. Making the bounce worse. You need to give the bounce time to clear. That can be anywhere between 3 to 6 cycles on average, (a cycle being a 12 hour time period).
    3. 1/22/20 PMPS shot 2 hours late can be like doing a dose increase. Due to the shorter cycle until the next pre-shot and insulin dose. There was probably some overlap. And why you got that low pre-shot for 1/23/20 AMPS.
    4. I've never seen anyone shoot BG levels this low with Prozinc. You've got guts lady. But, I wouldn't recommend shooting below 90 mg/dL (5 mmol/L). No wonder William is going so low and then bouncing like a rubber ball.
    5. You are trying to rush things. You need to slow down with the dose changes. Hold them for longer to let William "settle" into a dose.
    6. You are looking for no more than a 50% drop between PS (pre-shot) tests and nadir. More than that and the dose is likely too high. With that low on AM 1/25/20 cycle you dropped the dose for PM cycle to 1.5 but then increased the dose from 1.5U to 1.6u and then to 1.75 U too quickly. Then you gave William no time to clear the bounce before you increased from 1.75U to 2U. I would have dropped the dose to 1.5U after AM low of 77 and SLOWLY made changes, giving William time to clear the bounces.
    Slow down with the dose changes. Please.

    66% drop on 1/25 am cycle
    70% drop on 1/22 am cycle
    71% drop on 1/27 am cycle

    Slow down. You can't "force" the numbers down by increasing the dose as frequently as you are. Prozinc dose changes are NOT based on the Pre-shot number alone.

    7. If you change your remarks on the SS to give the + hour reference, it's easier to assess what is going on. No idea when 2 am was your time on 1/23/20. Nor do I know what cycle that referred to, AM or PM cycle. People have all different schedules when using insulin for their cat.
    8. Where any of those doses possible "Fur shots"?
    9. How old is your bottle of Prozinc? Storage conditions?
    10. Any changes to the food you are feeding? What specifically are you feeding?
    11. Any other medical conditions for William?
    12. Any other medications not listed in your signature?
    13. Does William have a good appetite?
    14. Dental back in December 2019. Has he been better since then? worse? about the same?

    I'm not real experienced with Prozinc. Have some experience with other in and out insulins and trying to help people the best I can. Other members that used to help in the Prozinc forum had family emergencies or deaths in the family and are not around right now. Doing the best I can to help people in the Prozinc forum.

    Even without a lot of personal experience using Prozinc for one of my cats, I still know a lot about the general guidelines for in-and-out insulins like Prozinc. And know how to "read spreadsheets" and see issues with what you are doing.

    Those are my "general knowledge" suggestions with reading William's SS. Hope that helps.

    Found a couple of your old threads, but have not had the time to read through all of them yet. Linked them below so I'll have them for reference and can find them easier. Only about the last 6-8 months worth.
    Not too sure how much to dose my cat tonight.
    My spreadsheet is impossible to use, could someone please help?
    Need dosing advice please
    How much should I dose tonight?
    Why are BG levels so much higher than AMPS


    You might want to go back and read through some of them, to see what other's have suggested to you.

    Hope that helps. I'm usually around in the Prozinc forum daily. Might take a while to get around to answering your thread, as I'm helping lots of people with Prozinc right now. Need to wade through my tags, alerts, inbox and still have a "life". Like my cat is meowing at me right now to get some playtime and maybe another snack. She feels neglected if I'm at my computer too long. ;)


    Synopsis 1. reduce dose to 1.5 2. make changes slowly 3. post here more frequently than once every couple of months.
     
    Last edited: Feb 2, 2020
  7. PatJ

    PatJ Member

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    Sep 23, 2018
    It looks as though you didn't receive my message which I sent nearly an hour ago, because there's no sign of it on my thread. Just in case you didn't, just to reiterate, s, vf, and f mean skinny, fat, etc, and 'William's spreadsheet' in my signature doesn't work and never has.:( The only way to get to his spreadsheet is by clicking on it in a thread. Also, I'm English living in France, so don't need google translation!! But thanks anyway:)
     
  8. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    A couple more things I forgot to say/ask ( I never remember everything).

    1. Cats can be more insulin sensitive after dropping to very low, near hypoglycemic numbers.
    2. We want to keep your kitty safe.
    3. How is William's weight? and Body Condition Score?
    4. Test for ketones at least once a week. Please.

    These are all suggestions, ideas, places where I see that changes are needed. I'm a layperson who has treated a few diabetic cats. Run everything I said by your vet.
     
  9. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Did get the explanation. You may not have "refreshed" your computer. Hit the F5 button to do that on a PC.

    "The refresh button may also be a button in the browser that resembles one or two arrows going in a circle, like the picture shown on this page. Pressing the F5 function key can refresh the Windows desktop screen. On a Mac, pressing ⌘+R will refresh the page you are currently viewing."

    Not sure how you refresh on a smartphone. Don't have one, don't want one.

    After you do that refresh, look for lots more info back in your thread. Lots there to read. Ask questions if you do not understand anything I said.
     
  10. PatJ

    PatJ Member

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    Sep 23, 2018
    Thank you so much for all the trouble you've taken to reply. As soon as I sent the last thread then your posts all came up! To answer your questions,

    1. No there have been no fur shots. I always check that the needle is right in and that his fur isn't wet.
    2. Prozinc bought on 27th November and stored in salad compartment of fridge.
    3.He eats Sheba Fine Flakes, Felix as good as it looks and a kitten food which is low carb
    4.Have listed his medical conditions and his medication
    5.His appetite is good
    6.His dental has made it easier to eat. had to cut it up very finely for a few weeks before his dental. Apart from that, he's much the same.
    7. I test for ketones at least once every week. So far, so good.
    8. He weighs 5 kilos. I don't know what his Body Condition Score is. He was at the vet last week for vomiting, but he had tests for pancreatitis and fructosamine and the vet said he was all clear, was just a stomach upset. He's fine now.

    I really appreciate you taking all this trouble. Looks like I've made a bit of a hash of dosing, but what you've said makes sense so I'll give it a go.
    Hope your cat gets her playtime tonight!! You've certainly got your work cut out by the sound of it. Thank you so much.
     
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  11. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Let us know if we can help again.
     
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  12. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    One of our members from Europe, in Switzerland, started a facebook group for French language speakers/writers in January 2018. Her name is Stephanie, her diabetic cat is Quintus (19th birthday a couple of days ago).

    Here is the facebook group if you are interested. https://www.facebook.com/groups/chatdiabetique
    You have to ask to join the group.
    Steph (the redhead) says that google translate works well with the site.
    Quintus is the "spokes cat for the group". A burmese I believe.
    Another option for you.
     
  13. PatJ

    PatJ Member

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    Sep 23, 2018
    Hi Deb, Thanks for telling me that. It sounds interesting, although I'm not on facebook (never have been) but I can always get in touch and find out what I'd have to do. (I'll ask to speak to Quintus!) Bless his heart, what a lovely age to get to.:)
    Just to let you know that William is slowly getting into lower numbers again, so thanks for your advice. I should have asked sooner.
     
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  14. Deb & Wink

    Deb & Wink Well-Known Member

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    Don't be a stranger. Hopefully we can help William get better.

    I'll look at William's spreadsheet any time you ask. Simply post a new message to this thread and I'll look at the SS. I have what is called a 'Watch Thread" on your posts and I receive an alert whenever there is some activity on any of the Threads I am watching.

    Looks to me like William is still "bouncing".
    I think you should hold this dose for 1 or 2 more cycles to see if William's BG's will settle down a bit.
    Then we will see about a dose change at that time.

    Sound ok to you?
     
  15. PatJ

    PatJ Member

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    Sep 23, 2018
    Sounds really O.K. to me. Thank you. Will contact you in a couple of days.

    I do appreciate all your help. Thanks, Deb:)
     
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  16. PatJ

    PatJ Member

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    Sep 23, 2018
    Hi Deb, Not too sure if I should be changing William's dose or carrying on for a bit, but he's still too high, although he's not bouncing much at the moment, but I'd like to know what you think? Sorry to ask, but could you take a look at his SS for me? Thank you.
     
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  17. Deb & Wink

    Deb & Wink Well-Known Member

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    No worries. No apologies needed. Never be afraid to ask for someone to take a look at William's SS.

    I think William needs to go back up to 1.75 U.
    The 1.5U dose is simply not cutting it for him.

    Any notes you could make over in the Remarks column can be useful to us to see. Like what foods he is eating, if his appetite is off for the day, if his arthritis is bothering him. Or anything else of note is going on. Clues like that can help us as we look at the SS.

    Anyway you can move the 2020 tabs on your SS over to the left side?
    Whichever SS tab is on the left is the one that defaults to opening when we click on the SS link in your signature.
    Should be as easy as signing on to your Google account, opening your SS, and putting that little hand shaped icon on the label for the 2020 US tab and dragging it to the left. Repeat to move the 2020 World tab over next to it.

    Does he still have the gingivitis? Any dental work or vet visit recently to check his teeth?
     
  18. PatJ

    PatJ Member

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    I've moved the 2020 World tab to the left, so I hope it's all right. I'll put him up to1.75. At the moment he has no problem with gingivitis and he saw the vet no more than about two weeks ago and she checked his mouth and he was okay. Last year he had two dentals in about six months. He has got arthritis in his spine (not too much thankfully) but CBD oil seems to keep him out of pain.

    Thanks again for your help:)
     
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  19. Deb & Wink

    Deb & Wink Well-Known Member

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    Thanks for moving those spreadsheet tabs for the current year to the left side. It does help.

    Chronic pain can spike, or increase BG numbers in humans. Very likely it does the same for our diabetic cats. Especially our cats that have diabetic neuropathy.

    Nerve pain is very painful and more so when it is chronic. Some sort of pain relief for our pets is critical.

    You said you thought the CBD oil was working for William. Do you notice any days when his pain is better or worse? Might be something to note on the SS (spreadsheet).
     
  20. PatJ

    PatJ Member

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    He seems to be on an even keel at the moment. I have noticed that since he's been on that oil that he's much brighter. He doesn't like taking it, but I make sure he gets it every day.

    I'll make a note on the SS if he seems under the weather, but he seems fine at the moment. (Hope that's not tempting fate.) If he needs the vet, we go! But the oil seems to be holding it at bay, at least for the moment.

    Am going to start 1.75 in the morning. Didn't do it tonight just in case I didn't wake up and he went too low (highly unlikely, but with him you never know) and thank you once again for all the trouble that you take.
     
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  21. PatJ

    PatJ Member

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    Hello Deb, I wonder if you'd take a look at William's SS for me again? He started off at 17.1 this morning and now he's gone down to 6.9. This is where I never know what is the right dose to carry on with, once he starts going low again. Would be grateful for your opinion!
     
  22. Deb & Wink

    Deb & Wink Well-Known Member

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    This 1.75U dose is not enough for William.

    How old is your bottle of Prozinc? When did you first open it?
    Any signs of floating particles, frozen, signs of sludge, things stuck to the side?
     
  23. PatJ

    PatJ Member

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    Sep 23, 2018
    The prozinc looks perfect. No nasty bits at all. I bought it and opened it on 27th November and it's kept in the salad compartment of the fridge so it's not jostled about and it's only out of the fridge in the time it takes to draw up the needle. It's about two and a half months old.
     
  24. Deb & Wink

    Deb & Wink Well-Known Member

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    You are past the manufacturers stated life after opening. You may want to consider getting a new bottle of Prozinc.
    Once opened, the 2 different components of this type of insulin, degrade or break down over time.

    Also, since Prozinc is a suspension insulin, if the insulin is not mixed well each time before you draw the insulin, the proportions of the 2 ingredients within the suspension liquid can vary more over time.
     
  25. PatJ

    PatJ Member

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    Sep 23, 2018
    Thanks for replying so quickly. It seems to be all right at the moment. I've taken on board what you've said about its duration but have to say that I've never had problems with it and have always kept it for at least four months without a problem. At nearly 80 euros a bottle, I don't fancy throwing it out if it's not necessary, but I'll see how he goes. Also, I do roll it around for a good 15 to 20 seconds so it gets mixed up. Fingers crossed that it doesn't need chucking out yet! But if it does, I will.

    Thanks Deb.
     
  26. Deb & Wink

    Deb & Wink Well-Known Member

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    Ok on your thinking the vial of Prozinc insulin is still good.

    I see that William's blood glucose levels dropped nicely into the blue color range at +7 and +9 hours after the shot of insulin this morning.

    Let's see how high he "bounces" later. And how quickly.
     
  27. PatJ

    PatJ Member

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    Sep 23, 2018
    Hello Deb, I'm sorry to keep on asking you, but I'm so crap at dosing when he goes low and I'm really not sure what to dose now that he's gone lower. This is where it always goes pear-shaped for me because I'm really scared about sending him into a hypo so I tend to give him less insulin to be on the safe side, ( he's had a few light greens)which doesn't really do him any favours! Would you take a look at his SS for me when you get a minute? I know you said that 1.75 wasn't enough for him, so I'm not sure what I should be giving him.
     
  28. Deb & Wink

    Deb & Wink Well-Known Member

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    No worries. Keep on asking. I'll keep on helping.

    William is bouncing all over the place, when his body reacts to numbers lower than he is used to. His body releases various hormones and sugars to bring those "perceived" lows back up to what his body is "used to" and considers safe.

    It's tough to give you timely dosing suggestions, since I'm on the east coast of the USA and you are 6 hours ahead of where I am.

    Your time, when do you test and give William the insulin? 5 am? 7am? later? How about the evening or PM cycle? Test and shot times are when? your time where you live?

    I see you did a S1.75 this AM 2/12/20 (a skinny 1.75U)
    You test many times during the AM cycle. Which is wonderful, because we can see all that data for the morning cycle.

    I know you are afraid of those low numbers. I know you don't like William to drop below 5.5 (100 mg/dL). but he needs to get into those high green number ranges. And out of the pink and red color range.

    The tough part is knowing what William's BG levels are doing during the night. You do always get a PM pre-shot test. Then you usually get a +2 and or a +3.

    I'd like to see a +6 or +7 in the PM occasionally IF that is possible with YOUR schedule, and still let you sleep ok.
    Many cats go lower at night, as they are more active at that time.
    There is a good possibility that William is dropping low at night and you are not catching it.

    Even more importantly, I'd also like to see notes in the Remarks column on the spreadsheet (SS) on when William is fed. Notes should include rough quantities (1/2 or 1/4 can), when you feed noted in + hour format, specific brand and variety of food you are feeding. Preface with AM or PM so we can see what foods are fed for each 12 hour dosing cycle. Could you do that please?

    I'm asking for the food information to see if William goes higher or lower when fed a specific food.
    Thinking there may be a correlation between the food fed and the erratic BG levels.
    If you feed any sort of treat, or people food, or he has access to another pets food, or if William goes outside at night or during the day, I'd like to know. Any food left out within reach of William on counters or kitchen cabinets, what we would call "contraband" should be thought about also. So please note that too.

    Is William your only pet?

    You can do what we call "sliding scale dosing" and vary the dose based on what the pre-shot number is. Sliding scales are developed for each individual cat. So we'd have to develop one for William. It's much harder to regulate this way. Prozinc dosing adjustments are best based on the difference between the nadir and the PS (pre-shot) test. You are looking for no more than a 50% drop between pre-shot and nadir.

    I'd like to see notes on the food being fed before we try that.

    I'd also like you to rule out any other medical conditions that may be keeping the blood glucose levels high. Like bad teeth or an infection or inflammation. Your signature says William has gingivitis. That low level inflammation could be keeping his BG levels high.

    No, I did not give you a dose suggestion in everything I said. I'd like to see the food notes on the SS (spreadsheet) first please.
     
  29. PatJ

    PatJ Member

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    Sep 23, 2018
    Hi Deb, Thanks for your reply! The times I test are 8.00am and 8.00pm. He gets his shot about 5 minutes later when he's eaten enough to shoot.

    It's 10.00 in the evening here. He doesn't go out at night -ever! Too many scary noises coming from the forest and a neighbours cat went missing for good. He has gone low at night, but he's not active - he sleeps on my bed all night.

    I've got three other cats but he's not greedy (unlike two of them!) so he doesn't usually pinch anyone else's dinner, and if he does, it's what he eats anyway. I've got two dogs, but there's no chance of him ever eating their dinner. They are fed separately and never leave a thing!

    With his arthritis, he can't jump onto counters or tables but he walks on his feet and not the backs of his legs. he did start to eat the dried cat food that the neighbours put out for the strays, but they put it up out of his way when I asked them to, so no problems there now. I'm just going to write what he eats in the remarks column . He's had a dental in December(two in six months) and the vet checked his mouth for infections in January and said he was all right.There doesn't seem too much wrong with him at the moment, but I keep my eye on him all the time ( as we all do with these diabetic cats) I hope I've answered all your questions!

    Once again, thank you so very much for all the trouble that you've taken over William. It's much appreciated.
     
  30. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Have you thought about swapping to Lantus insulin?
    It is a depot insulin and may work better for William. You have had him on Prozinc for a long time.
     
  31. Deb & Wink

    Deb & Wink Well-Known Member

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    My apologies Pat, I think you've told me some of that information twice already.
    My brain is pure mush some days, trying to remember everything.

    Dental is good, food is good, no access to contraband. Prozinc insulin vial is relatively fresh, no contamination or floating particles.

    Will William eat the same food more than 1 day in a row?
    Now to see if one of the foods is lower/higher in carbs to cause William's numbers to jump all over the place.
    Or if he is simply a very "bouncy" kitty.
    Could be a combination of the two.

    Pat, would you post in this same thread next time please? That way, I'll look back and review what you said before and stop asking you the same stupid questions over and over and over again.

    Would you please make a note on the SS of your test times? Either in the Remarks column or in the SS, add a new column before AMPS and another new column before PMPS to put in your test time.

    Your 8am is only 2 am here, and I'm never up that early.
    Your 8pm is only 2 pm here, and I'm usually on the message board helping people.

    Still trying to figure out what is going on with William.

    Tagging @Bron and Sheba (GA) to come take a look. She is in Australia, so there is some hope she will be on the message board when you are on, in what are the "wee hours of the morning" for me.
     
  32. Deb & Wink

    Deb & Wink Well-Known Member

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    Hi Bron, you posted at the same time I did. I just tagged you to come take a look.
     
  33. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Hi Deb and Pat
    To me it looks like William needs an increase in dose. Is he eating completely low carb food with no assess to dry food?
    You are testing a lot which is good.

    personally I would look into one of the depot insulins. Either Lantus or levemir. You can definitely get those in France as a friend of mine used a depot insulin for her kitty in France. I was told a lot of French vets don’t know a lot about FD so you may have to shop around or be proactive.
    Once you get the insulin we could help you with dosing.
    You test enough to do tight regulation method which should get William into better numbers. And you can shoot lower numbers as well which is a real plus.
    Have a think about it.
    Some cats do really well when swapped to another insulin, if they haven’t done well on the first insulin.
     
  34. PatJ

    PatJ Member

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    Sep 23, 2018
    Hi Bron and Sheba, I asked my vet about changing his insulin, because I'm wondering if Prozinc isn't for William, but when I asked her about it she told me that you can't just change insulins, you have to be at zero (whatever that means, she doesn't speak English very well and my french isn't wonderful, although I get by) and said that their other insulin is Caninsulin. Is that any good? When I said that loads of people on this message board have changed to other insulins with no trouble at all, she looked a bit vacant. She's very good for everything else but believes in diabetic dry food and the diabetic tinned food that vets sell so I don't think that she's really into diabetes in cats and does not like to be contradicted. Your friend in France is quite right. There is a choice here between two vet practices. (We're rural here)The first vet I went to gave him steroids for ages and it nearly killed him,but in all fairness, he didn't know he was diabetic at the time,nor did I.

    We are half an hour away from the vet we go to now and the nearest vet after that is nearly an hours drive away. (Not good for an emergency and he gets so stressed going to the vet anyway) I'll give it one more try to ask about changing to another insulin. Does it matter which one he changes to - Lantus or Levemir? Thank you very much for suggesting that. I'll let you know what she says. Also, he has no access to dry food and he has sheba fine flakes which most of the time he eats but sometimes he turns his nose up at it and has felix good as it looks or kitten food which he likes.

    Thank you so much for your help.
     
  35. Deb & Wink

    Deb & Wink Well-Known Member

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    Caninsulin often has a shorter duration than the Prozinc does.
    More commonly used by vets in Europe.

    Your cat William does not need to be at "zero" to switch to a different insulin.
    By "zero" I'm guessing your vet means William has to be off one insulin before starting another.
    That is not true.
    The prior dose of the current insulin is taken into account when switching to a different insulin.

    Both Prozinc and Caninsulin are "in-and-out" insulins. Meaning that their effects only last as long as the 12 hour dosing cycle. Perfectly fine to switch to another insulin at the start of the next 12 hour dosing cycle.

    Lantus (glargine) and levemir (detimir) are both "depot" type insulins. That means some of the insulin you inject goes into a little "storage area" for later use. When switching from lantus or levimir to one of the in-and-out type insulins, you have to take the "depot" storage area into account in calculating the dose for a non depot type insulin.
     
  36. Deb & Wink

    Deb & Wink Well-Known Member

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  37. PatJ

    PatJ Member

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    Hi Deb, I've just written a post to you and deleted it, because I wasn't logged in when I tried to send it and when I did log in, you had already written about the insulin! I know very well that you can change insulins straight away, but try telling my vet that! Don't know whether to change or not. At the moment, he is at 6.8mmol/L There's just no telling with him!

    He will eat the same food for more than a day, but after a few days gets bored with it, then after a couple of days goes back to it. It really depends on the day, but he does tend to prefer the sheba which is the lowest carb at 2.5 to the others. The felix is about 6 carbs.


    By the way, please don't apologise for asking the same questions. I think you are all amazing to do what you do.
     
  38. PatJ

    PatJ Member

    Joined:
    Sep 23, 2018
    Hi Deb, Thanks for the info about the felix. Most interesting. I have to say that he's had it when he's been in the greens and stayed low, but he's also had it when he's been high. Don't know what to make of him at the moment. (Just come back from the shops with three boxes!!!! Good job there's three other cats here.) I'll keep him on the sheba for as long as he'll eat it, but he's going up even with that.:banghead: I'll have a look on the UK food chart and see what else I can give him. Hopefully they'll sell some of it over here.
     
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  39. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Hi Pat, I simply wanted to make you aware of this.

    All the "Sticky" or pinned posts in the Prozinc forum have been updated and there are a couple of new ones.

    Highly recommend that everyone using Prozinc or helping those using Prozinc read them thoroughly.

    I'll be doing that myself. Been expecting this for some time. Came about a week before I thought it would.
    Thanks Marje, and Robert, and especially Djamila for the Modified Prozinc Method. You folks are FANTASTIC!
     
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  40. PatJ

    PatJ Member

    Joined:
    Sep 23, 2018
    Hi Deb, Thanks for the info.

    I wonder if you've got a minute to give me some thoughts on dosing? William had to go to the vet emergency yesterday morning because he was sick and wouldn't eat. She did some blood tests and said his pancreas was to blame. (I took him to the vet last week for the same thing and she said he was all right, but this vet yesterday is the boss and does know a lot about diabetic cats) Anyway she gave him 2 injections ,and said he'd have to come back for a couple of mornings for the same injections. I took him back this morning, but when he woke up he didn't want to eat, but he wasn't sick. Because he didn't eat I didn't give him his shot, but she said I should have done it because of his pancreas. She told me to give him just 1U when we got back ,. and give him his normal dose, which is 2.75U at the same time tonight. However, his BG has been much lower today, even with 1U it's lower, an hour ago it went to 13.3. So do you think I should give him the full dose or would it need to go down a bit now? He's started to eat slowly but surely, and is much brighter now. I'm really bad at dosing and don't want to muck it up for him.
     
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  41. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Hi Pat,

    Could I gt a bit more information before suggesting a dose for the insulin shot.

    How was William sick the other day? Not eating, vomiting, something else?

    What tests were done at the vet? Which tests had the vet concerned?

    What kind of a shot? anti-nausea medications, pain medications, antibiotics, vitamin supplements?
    Something else?
    And what did she say was wrong with William's pancreas?
    Did she say William had pancreatitis? Or something else?
     
  42. PatJ

    PatJ Member

    Joined:
    Sep 23, 2018
    She didn't really say what was wrong with his pancreas, just that she had picked up on the blood test that it wasn't as good as it should be. She said it was possible pancreatitis. She showed me a little machine that had some blue markings on them, which indicated pancreas trouble. She gave anti inflammatory and I think antibiotic but I don't know which ones. but it was Sunday and she was the only one there, no receptionists, so I didn't ask for anything. I shouldn't have asked you. I'm sorry. It wasn't fair without more information. He's going back in the morning, so I'll ask for his printed results.

    I've just realised that when we say someone was sick, that we mean that they vomited. It means someone was ill in the US. I should have said he vomited and didn't eat, but he's a lot better this evening than he was yesterday and has started to slowly eat again. Hopefully, this might be the end of these high numbers.

    Thanks for replying.
     
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  43. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Let me know the test results Pat.
    Pain can spike the blood glucose levels. Cause them to be higher is what I mean.

    If it is pancreatitis, and William won't eat, you may need some anti-nausea medications to settle his stomach. No one, cat or human wants to eat with an upset stomach. Cerenia (works for vomiting), ondansetron (works for nausea and vomiting) are a couple of the medications I know of that cats get with pancreatitis symptoms. Sometimes, both these medications are needed.

    Also, if a cat is not eating well, the insulin could affect them more. Cause lower blood glucose numbers. I did not see that for the last couple of days with the BG (blood glucose) test readings on William's spreadsheet (SS).

    Never realized that "sick" meant something different over in France. Now I know it means vomited.

    Keep me posted Pat. I'll be thinking about you and William. Hope he feels better soon.
     
  44. PatJ

    PatJ Member

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    Sep 23, 2018
    Thanks Deb,

    Much appreciated:)
     
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  45. PatJ

    PatJ Member

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    Sep 23, 2018
    Hi Deb, Took Willi
     
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  46. PatJ

    PatJ Member

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    Sep 23, 2018
    Hi Deb, (Don't know what happened there!) I took William to the vet this morning for more injectons (anti inflammatory, antibiotic and one for nausea) and she said that he's got chronic pancreatitis. His BG is better though, since she said to give just one unit yesterday morning and his numbers were surprisingly low considering that he'd just come back from the vet, so I've just given him 1.75 instead of 2.25u and he's started to get low. His pancreas being out of sorts must have been the re
     
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  47. PatJ

    PatJ Member

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    Sep 23, 2018
    This computer is possessed!!!Don't know what's happening but I've just lost two messages to you.:banghead: Will try again later!
     
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  48. PatJ

    PatJ Member

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    Sep 23, 2018
    This computer is possessed!!!Don't know what's happening but I've just lost two messages to you.:banghead: Will try again later!
     
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  49. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    That happened to me last week. Computer non-response. Very frustrating.

    Will give you the link to an article written by some members here. Pancreatitis: A Primer On Pancreatitis
    You might want to print a copy for yourself.
    There is a lot of information there, with a lot of links to other articles and threads.

    Also this link if your vet is resistant to prescribing any medications for pancreatitis. UK article, but good readng for a vet in France too. https://www.vettimes.co.uk/app/uplo...overcoming-suspected-treatment-challenges.pdf
     
  50. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    With the pancreatitis affecting William's appetite, it's very important that he gets enough food.
    You may need to hand feed or assist feed him if he will not eat enough on his own.

    "Every effort should be made to ensure the kitty eats even if the CG must assist feed. The Feline Assist Feeding Group is an excellent resource for any CG who needs to assist feed their kitty. Assist feeding involves syringe feeding, finger feeding, feeding on a baby spoon, etc. A great video for learning to assist feed is How to Assist Feed a Cat."

    Not enough insulin + not enough food + infection or inflammation (like the pancreatitis) can lead to the formation of ketones as the cats body breaks down the fat and muscle tissue in an effort to provide energy to the cat.

    Please urine tests for ketones. With ketone test strips you can get at a drugstore/pharmacy/chemist.

    If more than a trace of ketones, that can lead to a life threatening condition called Diabetic Ketoacidosis. A vet visit is in order if that happens.
     
  51. PatJ

    PatJ Member

    Joined:
    Sep 23, 2018
    Hi Deb, Thanks so much for your reply. I'm a bit less worried than I was yesterday about his eating. He's actually asking for food today and although he's not eating as much as usual, he's still eating enough not to worry about him. Thank goodness! I took him to the vet last week for vomiting and she said he was all right but she didn't test him like the one I saw on Sunday, so poor old William ended up as an emergency.:( If they're going to be ill you can guarantee it will be a Bank Holiday, Sunday or late at night! Now what's wrong with this computer? He's been tested for ketones every day this week and he's free from them. I always do him at least once a week. He is certainly more like his old self today. Will look at your suggestions for assist feeding a cat and thank you very much for troubling so much. I didn't realise just how much in demand you are until I looked over to the main forum. I think you are all amazing!! Am also interested in the link for vets. Thank you for that.

    What a great lifeline this board is! Thank you, Deb.
     
  52. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Isn't that always the way things happen? With people too.
    Good. It gets concerning when a diabetic cat won't eat, or won't eat enough.
    Keep testing for ketones with William every day. It's important right now with his diminished appetite.
    Hope he continues to improve.

    p.s. It's not that I'm in such demand. It's that I try to help out as many new people as I can. Plus the people in the Prozinc and Vetsulin forums. Plus live my own life and all of the things we all need to take care of to live. :)
    It was 62 degrees F (16.5C) here yesterday and sunny. Had my lunch on my screened porch and got my cat to go out there with me. Unusual for New England in February, so I took advantage of the warm day.
     
  53. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Pat, it may not be your computer.

    Someone else reported an issue this afternoon (noonish 1 pm east coast US time), over in our Tech Support forum.
    Could have been some maintenance on the message board, or something similar.
     
  54. PatJ

    PatJ Member

    Joined:
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