Optimal goal??

[Danielle Hrubiak]

Just got off the phone with the most recent vet I have used (who I don't claim as "my vet" because I do not like them very much--have yet to find one around that I do though).... She snidely asks me who is instructing me to change doses or if I am following my own lead and proceeds to tells me I should be waiting 2 weeks in between changing doses and that my optimal goal should be just to keep BG level below 250 and she would be ecstatic. She said aiming for below 100 is setting myself up for failure and a goal I'll never meet.

Can someone tell me what the range I should be hoping for so I know if my dose is doing its job or if I should continue to slowly increase dose? And what if I reach a good nadir but all other readings are high throughout the day. That can't be good, right? Isn't the ultimate hope for the cat to be in low numbers throughout the entire day?

She also said I could have ruined the vial of insulin by rolling it too much and allowing it to warm up a bit each time. Is this true?

I hate speaking with that office. I am always left confused and unsure if what I am doing is right or wrong.

 

[manxcat419]

I'm sorry you're having problems with your vet and that you don't like them. It's always difficult when you don't agree with what they're telling you.

The aim for good regulation for our cats is to have them in normal numbers for most of the day (between 50 and 120 on a human glucometer). If you're getting a low nadir followed by high numbers, then either Abilene is bouncing from the green numbers or the insulin isn't lasting the full 12 hours for her. 250 is too high a maximum number as a target - that's above the renal threshold for most cats, and you don't want her kidneys being put under stress by her running that high.

I can't comment on whether or not it's possible to ruin Prozinc by rolling it too much - hopefully some who uses it will see this and let you know.

 

[Sue and Oliver (GA)]

I think she is looking pretty good. I think leaving her on the same dose for a week wouldn't hurt anything - she does seem to be bouncing around the first few cycles before you see a curve that looks like the one before. Some cats do well adjusting the dose often; some take a while to settle into a dose. IMHO, you are increasing slowly and carefully. When you get nadir below 40 and then she jumps up in a higher range, it is most likely her body reacting to the low number and releasing some extra glucose. We call that bouncing. It is very common and they do it until they get used to the lower ranges. We had a cat on ProZinc that took 2 years to flatten out and then, in a couple months, he was off insulin. Every cat is different and your job is to figure out her patterns. That takes a while, especially if bouncing is part of her patten.

We consider a cat well regulated if they are in the mid 200s at preshot and in double digits at nadir, but not under 50. We figure that is a range where the pancreas can heal. Then the goal is to get her lower while still staying in safe ranges.

ProZinc needs to be rolled as it is a suspension insulin and needs to be mixed. I rolled it a few times (maybe 6 times?) before shooting. Warming it up in your hands for a few minutes can make it hurt less when you shoot. ( I had a flu shot once, right out of the refrigerator and was surprised how much it hurt!) Again, my opinion is that neither thing will hurt the insulin.

 

[Rachel]

As Sue says, it does need to be rolled. I generally rolled it 4-5 times, then turned it upside down and rolled it 4-5 times more (no reason for that...it was just a thing I did). I liked to hold it for a minute or two also to let it warm a bit so it wouldn't sting. I don't think you're harming it. Not sure why the vet told you that, but I wouldn't worry about it.

 

[BJM]

Rolled, not shaken (you'll get bubbles), is fine.

 

[Larry and Kitties]

Just note that ECID (every cat is different). Some cats just can't below 100, 200 or even 300 max.
I can generally keep my MurrFee below 300 all the time but one in a while he gets a PS above 300. He is a high dose cat: 13 units Levemir and 8 units BCP PZI twice daily
I have to struggle to keep my Badger below 400 max. He is on 3 units N and 3.6 units ProZinc twice daily
My Patches II on the other hand I can keep below 100 on 1.2 units Lantus twice daily.

 

[Mogmom and Goofus]

I've always rolled the ProZinc vial this way, roll up and count one thousand one, roll back count one thousand two, and so on until I counted to thirty. My vet said this gives a good mixing and warms the insulin a little, but not too much. Then I drew the shot and immediately put the vial back in the fridge. Also, slight warming activates the ingredients.