ProZinc Dosing Advice - Bouncing?

Bearcat86

Bearcat86

Member
Hello,

This is my first time posting, first off let me just say thank you for all of the support you provide!! I've been feeling so stressed and overwhelmed trying to figure out how to care for my furry boy and it's been a rough ride so far. Finding this forum has made me feel so much more informed and empowered, now I actually have hope that I might be able to get a handle on this complicated disease and get Bear's quality of life back to normal!

Bear was diagnosed in April, we started with the hands off "wait and see" approach recommended by my vet (now former vet...) and gave him 2U 2x a day. When we didn't see clinical improvements after a few weeks, we upped him to 3U based on vet recommendation. Bear is a pretty anxious kitty and he gets very stressed out anytime he has his routine disrupted - going to the vet usually requires a full day of recovery. For this reason, we didn't want to do a BG curve at the vet, but were discouraged from home testing because we were told it might ruin our relationship with our cat... :facepalm: Long story short, we found a different vet that recommended trying the FreeStyle Libre to get a better sense of his sugar cycles. Unfortunately we had to postpone placing the FS monitor until we returned from a 10 day trip abroad. While we were gone, Bear got so stressed that he made himself sick - bouts of diarrhea, puking up his food, lethargic, dehydrated - he went to the emergency vet for fluids but after running a full blood panel they didn't find anything else obviously wrong with him. So we came home to a sick cat with full blown neuropathy in his back paws and starting in his front paws - so traumatic for all of us. :(

Within a few days being home and back in the normal routine, Bear was back to his normal self - eating well, normal GI function, personality back to normal, he even gained back the pound that he had lost while we were gone. But he still has neuropathy, though it's mainly in his back legs now. We took him to get the FreeStyle Libre last week and though we got a lot of data, I think having the sensor in his neck stressed him out to the point of not eating properly and starting to see the beginnings of GI issues again. He also kicked out both sensors we placed after only a couple days, so we switched to manual testing using the AlphaTrak2 meter. As soon as the sensor was out of his neck, his eating/GI function/energy levels all went back to normal.

We've had him hovering around 3U this whole time, and I'm just not sure what to make of these numbers - they seem like they're all over the place. We've got him on 3.25U now, trying to keep him here for a few more cycles to see if he'll even out. Sometimes I think he might be bouncing, but then when we bring him back down to 3U he's flat and high all day... :banghead: I linked his spreadsheet in my signature line, we would really appreciate any advice you have about our ProZinc dosing. We are also contemplating switching to Lantus, some papers suggest there's a higher rate of remission using Lantus vs. ProZinc - any advice on switching insulins?


TL;DR: We've got him on 3.25U now, trying to keep him here for a few more cycles to see if he'll even out. I linked his spreadsheet in my signature line, we would really appreciate any advice you have about our ProZinc dosing. We are also contemplating switching to Lantus, some papers suggest there's a higher rate of remission using Lantus vs. ProZinc - any advice on switching insulins?
 
I am so very sorry that you have not had a response to your post yet. This doesn't usually happen but your post got pushed down the list and obviously got missed. :blackeye::( My sincerest apologies.

Looking at Bear's spreadsheet it looks to me like he was getting some good results at 3u and some of those higher numbers you are seeing now are simply because of the change in meter (AT2 generally reads higher than the human Libre) and possibly a phenomenon called bouncing. Bouncing occurs when BG drops to levels kitty has become unaccustomed to, drops quickly or drops to too low. It's a defense mechanism that causes stored glucagon to be poured into the bloodstream to raise BG and deal with a perceived threat that often doesn't exist. Once your cat gets more used to being in normal range BG, the defence system re-calibrates back to more normal and doesn't overreact as much.

The tricky part to all of this is that sometimes too much insulin and too little insulin can look exactly the same. What caught my eye is that dose changes have not always been done as slowly or incrementally as we would have recommended at least while the Libre was in place. We recommend dose changes in 0.25u increments. Early on dose changes were somewhat erratic and doses have been skipped. I see your last increase was only by 0.25u and that is good but I still have a feeling the dose may be a wee bit high.

On the 10th of Aug, you gave 3.25u at a pre-shot of 292. That AM pre-shot was considerably lower than what you had been seeing and makes me wonder what happened during the night before. BG went up instead of down during that day cycle and then there is no pre-shot reading for the night of the 11th. The AMPS of the 12th suggests that during the night of the 11th, Bear's BG may have dropped off leading to the low BG at AMPS on the 12th which resulted in a skipped shot. That in turn, along with what I am guessing is a bounce, led to a high PMPS of 664. Bounces can take up to 6 cycles (12 hours/cycle) to totally clear and you are starting to see that clearing now with the lower AMPS today.

I think I'd try backing the dose off to 3u for a period of at least 3 days (6 cycles) and see if numbers start coming down at all.
 
Thank you so much for your response! I was beginning to think I did something wrong :nailbiting: Really appreciate your advice! I didn't realize the AT2 readings would be that much higher than the Libre, do you know approx. how much higher pet meters read compared to human?

I think his FreeStyle Libre results at 3U are a bit misleading, he was so stressed about having the sensor in his neck that he was barely eating the entire time we had it in :( so I'm not sure it's really reflective of his normal state. We had him on 3U for about a month before we started home testing, and though it's really difficult to draw any conclusions without concrete data, his clinical symptoms didn't improve on 3U. Also, whenever I try bringing him back down to 3U, his BG stays high all day and the insulin doesn't seem to have any effect :banghead: Based on how long it takes to recover from a bounce though (6 cycles?!), it's possible that I'm not keeping him on 3U long enough for him to regulate, but his recent results at 3.25U seem promising. I'm working from home today, so I'm going to try to get a full BG curve to see how the 3.25U is working throughout the day.

One more question, he's been having some bouts of diarrhea. It usually clears up after a day or so, but I'm trying to figure out if it's a complication of his diabetes or something else entirely. He had a soft stool first thing this morning, then had 3-4 very low volume liquidy/mucusy stools (sorry if this is TMI!). In cleaning up the last of his accidents, I noticed a hairball had passed - could that have been the cause of his diarrhea? He seems much better now, less irritated and more comfortable, so I'm hoping that was it, but we'll see what happens throughout the day...
 
Bearcat86 said:
do you know approx. how much higher pet meters read compared to human?
Click to expand...
There is no way to convert pet meter readings to human meter readings. As a general rule, the higher the BG the greater the difference in BG readings. If BG is in low normal range the difference can be negligible while at high numbers there can be a difference of 100 or even 200+ points. This is because cats and humans carry glucose differently in their blood. The pet meter reads cat blood as cat blood whereas the human meter reads the cat's blood as if it were human. Human meters have been used in veterinary medicine since way before the advent of pet meters so we know the normal BG ranges per human meters as well as those for pet meters. It's best to pick one meter and stick with it. Pet meters are great (I was a diehard pet meter user myself for a long time) but they are extraordinarily expensive to use when you test often.

I would expect that if Bear was agitated by the Libre sensor, that his BG would have been elevated and yet the readings taken on the day cycle of the 7th were absolutely terrific. Of course by then, Bear may have been getting used to the Libre being there. :p

Whenever possible checking Bear's BG during the day cycle between +4 and +7 post shot would help identify when he is a nadir (peak insulin effect). Knowing how low the dose of insulin is taking BG is critical to figuring out best dose and ensuring BG does not drop too low. I realize this can be difficult if you are working. Sometimes adjusting shot time by an hour earlier if feasible, can allow you to get another test in either before leaving the house or shooting later to get one when you get home. All data is good data and helps to fill in the missing pieces to the puzzle. Right now, it's hard to see what is really going on because you have no idea just how low the insulin might be taking BG mid cycle. Our kitties also have a habit of going lower at night than they do during the day, so periodically setting an alarm or using a mid night bathroom break to grab another BG test can also be very insightful.

Curves are fine but they don't tell you a lot if kitty is in the middle of a bounce, having a very good or a very bad day. They show a snapshot of one day while random testing gives you more of a running movie of what's going on over time.

I have no idea about the diarrhea. I would expect a hairball to cause constipation more so than diarrhea but then the diarrhea could be overflow. Have you changed anything diet wise lately? Any reluctance eating? Is Bear being his usual self or is he more lethargic? Is he playing, purring, preening and peeing as usual?
 
Thanks so much, all good info! I agree that it's really difficult to tell what's going on without the in-between readings, I'll try to get more of those going forward. I suspect Bear's nadir is closer to +7 than +4, hopefully the curve today will at least help us determine when he reaches his nadir. I'll just keep getting as much data as I can, hopefully a clearer picture will start to emerge soon.

As for the diarrhea, nothing has changed diet wise, he's been on the Purina Pro Plan DM wet food (1 can 2x/day) for a few months now - thankfully he likes it! I did start giving him Zobaline 3 days ago (1 tablet/day) to try to help his neuropathy and it seems to be having a positive effect, so hopefully it's not causing GI upset. His appetite has been good, his behavior has been mostly normal (he's been a bit irritated at all the poking and prodding, despite lots of cuddles and a treat after each blood draw to make it a more positive experience). No changes in his preening, peeing, playing, purring that I've noticed - his coat actually looks better than it ever has! He hasn't had any diarrhea since he passed the hairball, so I suspect that was it. After some research it does seem that hairballs can trigger diarrhea as a mechanism to help them pass. I also put a call in to Bear's vet for her opinion, just in case.
 
Curious if anyone has dosing advice after yesterday’s BG curve? I was hoping to catch his low today with the +8 reading, but it was much higher than expected and now I’m completely confused. I’ll keep acquiring data, I know there’s not enough for a clear picture yet, but I’m wondering if I should stick with 3.25U tonight? He seems to be bouncing, but I’m not sure if I should stay consistent and let it resolve or back down to 3U for the next few days...? I’ll try to get a mid-cycle reading tonight to get an idea of what’s going on at night - I tried last night, but after a day of being pricked Bear was not cooperative enough for me to get a sample :banghead: Any advice would be much appreciated!! :)
 
Bounces are just par for the course.. That actually isn't a bad curve at all but Bear is definitely bouncing from that 85 yesterday. I'd stick with the 3..25u for now. Bounces can take up to 6 cycles to clear but he may clear it sooner so grab those mid cycle tests when you can.
 
Thanks for the quick reply! Bouncing makes everything so much more complicated... :blackeye: I’ll stick with 3.25U for the next few cycles and get as many mid-cycle readings as I can.
 
I think Bear's bounce may finally be resolving, but I'm not really sure what I'm looking for? When a bounce "clears" does that just mean his body begins responding to the insulin more normally? Now that his BG is at 84, I'm worried he's just going to bounce again... Based on the last few days of data, any new thoughts on dose? Thanks for your help and support!
 
You are likely right about Bear bouncing again tonight. Bounces occur when BG drops quickly, drops to levels kitty has become unaccustomed to which is relative and not necessarily low or kitty drops low. That's quite the drop today from 561 down to 84 and precisely the set up for a bounce.

I would make it a habit to get a test before bed every night. Even an early test at night can give you clues as to what the cycle will look like. If BG at 2 or 3 hours post shot hasn't changed much, it's unlikely to be an active cycle but if BG has dropped by then, cycle may be more active and those are the times when using bathroom breaks or setting an alarm can be very helpful at filling in the missing parts to the puzzle.

I'm wondering how low Bear might have gone last night since PMPS was so much lower than it has been. I might be inclined to reduce the dose to 3u for a few cycles to see if that smooths out those drops at all.
 
Hi again, I reduced Bear’s dose down to 3U for the last few cycles and I have no idea what to make of the numbers I’m seeing - any insights or advice?

I’ve been trying to get more nighttime/mid-cycle tests, but Bear has been really irritated at all the poking and prodding we’ve been doing so I’m really trying to keep the number of tests to a minimum to reduce his stress. He’s started peeing in our front hall, not all the time but usually in the middle of the night, and I think it’s because he’s so irritated/stressed out. I’m feeling really defeated and frustrated :arghh:

He’s still got the neuropathy, he’s been on Zobaline for a little over a week, but it’s really difficult to tell if his gait is getting better or worse :banghead: It’s so upsetting to see him hobbling around and we’re trying so hard to get his BG regulated so his legs can get better, but he gets mad every time we test his blood, no matter how pleasant we try to make it for him! Sorry, I think I also just need to vent - it’s been so hard. :( Would really appreciate any advice you can offer.
 
First of all, vent all you need. It can be very frustrating trying to find the right dose for these furry wonders and when they have neuropathy, it's that much more upsetting.

The Zobaline will help but as much as the website suggests the improvement will be pretty swift that is rarely if ever the case. It takes time and getting the BG regulated is a big part of getting the neuropathy to improve.

I understand your difficulties testing Bear but it is really the only way you are going to get the data you need to sort him out. Are you giving him treats for each test whether successful or not? Are you uptight when you test him? Our kitties pick up on our emotions so if you are all tensed up, Bear will sense that and not be comfortable with the testing. Some folks sing to soothe their nerves while testing. You really have to approach the testing in a "can do" mindset. Bear may take while to get comfortable with testing but only by repeating the process in a patient manner will Bear start to co-operate more. If there is a particular part of testing that is causing you problems, let us know and maybe we can share some more tips to help you smooth out the process for you and Bear.

I hate to sound like a broken record but night time tests are essential to seeing what is going on. Otherwise you basically only have half the picture and all you can do is guess what is going on. On the 21st of Aug., you gave Bear 3u of insulin on a pre-shot of 221. There is no night time test but given the very high AMPS the next morning, I would guess he went lower than he is use to overnight. How low is the big question? While you might not catch the lowest point in the cycle, an early test would have provided a clue as to where Bear's BG was heading. I think that high AMPS on the 22nd is likely from a bounce. Bounces can take up to 6 cycles to clear. It looks like Bear may have cleared that bounce sometime during the night of the 23rd and gone lower again leading to a lower AMPS this morning. And now Bear appears to be bouncing yet again.

I notice that when you first started insulin the dose was increased from 2 to 3u which is a big increase and makes me wonder if 3u might still be too high a dose for Bear. While you were using the FS Libre, the dose changed so often it's impossible to see how any dose was actually working for Bear.

I'd try reducing further to 2.75u for a few cycles and see what his numbers do and try your best to get that one before bed test every night. A lot of kitties go lower overnight so that info is very helpful when it comes to figuring out how to move forward with Bear.
 
Thanks so much for all your advice and support! When it comes to testing, according to my husband, I am definitely uptight. I don't like doing it and it upsets me to have to force him into it. I have been giving him treats (freeze dried chicken) before and after each test no matter the result, and it helps a bit, but he's usually still irritated afterwards. I'm trying to be more positive or at least calm when we test, and if we can get him on the first try it usually goes okay. All that being said, I'm trying to get more night time tests so we can get a clearer picture.

You made a really good point about the initial dosing - we increased based on vet recommendation after we didn't see improvement in his BG or fructosamine levels after a couple months at 2U, but we weren't monitoring at home then so who knows what was really going on... I wish I had found this forum sooner! We decreased to 2.75U Saturday night, but after a low PMPS and skipped dose last night we lowered him again to 2.5U this morning. Looks like he's still trying to clear the last bounce :banghead: Was lowering to 2.5U the right choice? Curious if you have any additional insights based on the past couple days of data.

Also, I wasn't sure what to do with that low reading last night - I was really scared he'd go too low if I gave him anything, but clearly he shot back up only a couple hours later... In a situation like that, is it better to lowball the dose (we considered just giving him 2U, but I was worried changing the dose so much might muddy the waters even further...) or treat to it as a go/no go decision? I know it's better for him to be too high than too low, but with his neuropathy I get so stressed when his numbers go so high because I don't want it to get any worse than it already is :( Thanks for any advice you can offer!
 
I think you did the right thing skipping the shot last night. Looks to me like Bear may have gone even lower during the day yesterday and that 143 was a rising number given he then shot up to 500+ which I think is a bounce.

I also think it was a good decision to reduce his dose to 2.5u as long as you are getting shootable pre-shot tests of at least 200. Right now it looks like he may still be in a bounce so t's possible the dose may need to be reduced yet again. This makes mid cycle testing even more critical right now so the dose can be adjusted to prevent BG from dropping too low if that is what has been happening.
 
Thanks, that makes me feel better - I might be starting to get the hang of all this! I just spoke with my vet and she suggesting dropping Bear down to 2U, giving that a few days to see how it affects him, then working our way back up slowly if necessary. I’m hesitant to change his dose by 0.5U when I’m still not even sure how he’s doing on 2.5U yet. Curious whether you have an opinion on dropping down low then slowly working back up vs. continuing to slowly work our way down?
 
You can certainly drop the dose and then move back up if need be. Worse that happens is that BG goes up a bit. Best is that 2u proves to be the right dose or Bear needs another reduction. It's really up to you how you want to proceed. :)
 
Thanks, decided to go with 2U and after tracking his numbers for a couple cycles I’m really confused! Just checked his BG at 11.5h and after being high for so long, he’s now too low to shoot. He ate a bit of gravy before I tested him, but the majority of his food is untouched. Should I wait an hour and see if it goes up? I really don’t want to have to skip another dose... Could this mean 2U is still too high? Or is it not soon enough to tell?
 
I think it's too soon to tell exactly what the best dose will be. I understand your reluctance to skip another dose. If you can monitor for awhile tonight, you could reduce again to 1.5u and see what Bear does. You've never shot a number that low so you need to be prepared in case numbers drop with lancets, strips and some higher carb foods or honey/karo syrup. If you give insulin, I'd test again at +2 post shot.
 
Thank you so much for your quick reply!! We just retested 15mins later and he’s at 369... we had some issues the getting enough blood the first time, wondering if maybe it was a false reading? We just gave him 2U, I’ll still make sure to monitor throughout the night and be ready with honey, just in case.
 
Ok, we had Bear at 2U for 5 cycles and he seems to have stabilized, but I think the dose is clearly too low. Upped to 2.25U last night and it doesn’t appear to have had any effect. Should we continue at 2.25U for another 2 cycles to see if he starts responding to it? Or should I increase to 2.5U? I understand the value of being methodical and taking things slow, but with his BG so consistently high I’m really worried about his neuropathy worsening. Any advice?
 
I'd hold for another couple of cycles and see what Bear does. I know the neuropathy is concerning but it will improve as his numbers do and you aren't seeing those blacks now so he seems to be moving in the right direction and you don't want to skip a better dose.
Slow and steady wins the race.

Forgive me if this has been covered but are you giving Bear Zobaline? While it's not an instant "cure" for the neuropathy it does seem to help speed up recovery. A lot of folks order it on Amazon.

ETA Never mind.....I see Zobaline is already in the mix. Should have checked back on the posts.:blackeye:
 
Thanks for the quick reply! Yes, he’s been on Zobaline since Aug 13, some days I think it’s helping, but it’s hard to tell. I’ll stick with 2.25U for another couple of cycles. I’m am really happy to see him stabilizing and out of the blacks for so long - it must have felt awful to be ping ponging up and down all the time! I’ll do my best to be patient and give Bear’s body some time to respond. :rolleyes:
 
Hi again, Bear’s numbers have been going in the right direction, but I’m a little confused by last night/today’s readings. It looks like he might have had a mini-bounce after being in the low hundreds range yesterday, but thankfully it also seems to be clearing tonight. Debating whether we should stick with 2.25U tonight or try lowering back down to 2U for a bit. Would really appreciate your advice! Thanks :D
 
Hi, just thought I’d re-post in case my previous message was missed. Confused by Bear’s numbers over the past few days - can’t tell if he’s bouncing or if the dose is a little bit too low? We had our family visiting this weekend, so Bear’s a bit stressed after being exposed to a toddler for 4 days in a normally child-free environment... not sure if that plays a role in his higher numbers?
 
Thanks, had no idea how to tag people, that's good to know! Hoping for a response soon, my husband just checked Bear's sugar and it's higher than it's been for a few weeks :arghh: Could really use some advise on what to do, I feel like the ProZinc just isn't working for him :(
 
Bearcat86 said:
Thanks, had no idea how to tag people, that's good to know! Hoping for a response soon, my husband just checked Bear's sugar and it's higher than it's been for a few weeks :arghh: Could really use some advise on what to do, I feel like the ProZinc just isn't working for him :(
Click to expand...
Hang in there, you are just at the start of this journey and sometimes it just takes time to find that perfect dose, and for kitty's body to recognize that dropping lower than what it's "used to" is not a calamity and needs to be adjusted Right Now!
The red and black numbers are not ideal, but also not necessarily permanent. Treating diabetes is definitely a marathon and some members have to buy more than one pair of running shoes for the course.
You are taking good care of Bear and doing what you can in the moment. It may be that down the road you will want to look at another insulin, but it's early days with the Prozinc yet.

Also tagging @JanetNJ hoping she will see it
 
I think Bear is a very bouncy fella and I'd increase the dose to 2.75u and hold it for 3 days to see if that starts bringing those numbers down. While ProZInc is a good insulin for a lot of cats, you might find that a longer lasting gentler insulin would work better for Bear. Lantus or Levemir tend to pull numbers down on a gentler curve and both are very good insulins for cats.

Not sure if we discussed this before, but the Savory Select canned food is a bit high in carbs and if you can find something Bear likes that is under 10% in carbs, it might also help to pull those numbers down.

I'm sorry your post went unattended. I should have got an alert but I don't see it. Seems to be happening more often lately for some reason. You can tag me as Lou said and I'll get back to you as soon as I can.
 
Thanks @Idjit's mom and @MrWorfMen's Mom! I'll try upping his dose to 2.75U for the next few days and see if it makes any difference. I've also been considering switching him to Lantus/Levemir, but I'm worried that it will be even more complicated to figure out the proper dose because those formulations are so long acting and build over time. I'll try posting in the Lantus/Levemir forum to see if anyone has experience switching from ProZinc and has any helpful advice.

I didn't realize the Savory Select was high in carbs?! It's the ProPlan Vet Diets DM, so I thought it would be low carb based on the fact that it's supposedly specifically formulated for diabetic cats? According to Dr. Pierson's nutritional composition food chart, Bear's food (row 657) is 6% carbs, so it looks like it is under 10%. I'm hesitant to change his food because he actually loves it and his coat has looked better than it ever has since I started him on this food...
 
If you decide to change to Lantus/Basaglar/Levemir the dose is based on the lowest BG in the cycle, the nadir, and as with advice with the Prozinc, you stay with a dose for a certain number of cycles before increasing or decreasing. You do not dose based on the Pre-shot BG. It would not actually be much more difficult than what you are doing now to find the "best dose". Unless of course you see very low BG and that's another issue.

The L,B&L insulins build up a depot for the body to draw upon. When you start giving shots, a little gets stored in the fatty tissue and a little goes right to work. It takes a few days to a week to fill the depot, and the depot helps keep the BG more level and that's the gentler, longer lasting effect. You do not see a drastic impact when you begin using them.They are actually very effective for feline diabetics and you can read about them in the stickies at the top of the Lantus forum, if you decide to consider one.

They are more expensive than Prozinc, but you can get the Rx and mail it to (or vet can fax it to) Marks Marine Pharmacy in Canada to be shipped to you for 1/3 to 1/2 the cost (plus shipping options) here in U.S.
https://rxcanada4less.com/

I do see the reference to the Purina ProPlan Veterinary Diet in the food chart, and that is 6% carbs. I am not familiar with "Savory Selects" and was not aware it was the same? I guess there could be a Savory Selects variety of another brand? or possibly the name of another brand?
It would be helpful, even if just to educate me, if you would take a picture of the can so I (and others) can see what you are using.
 
Thanks, that's all great info! I'll have to check out the stickies on the forum. Also a great tip on how to get them for cheaper if I do decide to switch! After looking at the forum briefly, it looks like I should use a human meter to monitor Bear's BG if I switch to L/B/L insulin - so at least I'll save money on test strips! o_O

Here's a link to the Purina ProPlan Vet Diet DM Savory Selects food I order from Chewy. I think it's just a slightly different formulation of the other ProPlan DM canned food - chunks in gravy vs. minced. Bear loves gravy, and I dissolve his Zobaline into the gravy to make sure he gets all of it - he always starts by licking up all the gravy before slowly eating the rest of the food throughout the day. According to Chewy's website, "This formula has a Carbohydrate content of 3.13% on an as fed basis and 13.30% on a dry matter basis." Any idea what the difference between "as fed" and "dry matter" would be? Worried that 13.3% is actually the carb content of this version of ProPlan DM... :blackeye: Do you know of any lower carb options that still have some sort of gravy?
 
There is Purina DM which is 6% (a pate) and there is DM Savory Select which is 10%. While that is technically within acceptable level of carbs, it's right at the top and some cats are more carb sensitive than others. Most folks are feeding no more than 6% carbs for regular diet. The mention of the gravy makes me fairly sure you have the higher 10% carb food. Bear has to eat and if he likes it, that's fine but a little less carb might help.

I can't help with a low carb gravy food alternative. My fussy girl was a one flavour of FF wonder. Wouldn't eat anything with gravy in it. If you post specifically for low carb gravy foods I'm sure someone will be able to make some suggestions.:)
 
Thanks @MrWorfMen's Mom! I also just found the Savory Selects version on Dr. Pierson's spreadsheet and yup, it's 10% carbs :banghead: Luckily Bear isn't super picky, as long as there's gravy of some sort he's a happy camper. I was feeding him Tiki Cat Succulent Chicken for over a year before he was diagnosed with diabetes, and it looks like that actually has 0% carbs! So glad I listened to the vet when he suggested I switch to the more expensive DM vet diet food... :spam:

I still have some Tiki Cat cans left in the back of the cabinet, maybe I'll try switching him back for a few days and see if that makes any difference. Should I hold the dose at 2.5U while I switch? Might be hard to tell what the effect is if I up the dose and switch the food at the same time...
 
Try the food first if you like and then increase or vice versa. See if he'll still eat the Tiki food. You know how these characters can be sometimes. I agree doing both at once muddies the effect of the food. I doubt however that there is any danger of BG changing that much that the increase dose would be a problem.
 
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