Really high numbers, should I increase dose?

[Sally the Calico]

Sally has been on FF pate since diagnosis and been getting 2u of PZI per recommendation of the vet. Her numbers have stayed high, especially since her fur shot a few days ago.

This morning the reading said "HI", which i tried again, and still said "HI", which the booklet says a reading of 600+. I'm so frustrated that we have not been getting better numbers.

Should I increase her dose?

 

[Deb & Wink]

I don't know Prozinc well enough to tell you. Never used it with one of my cats so I'm uncomfortable with telling someone if they should change the dose or not.

Is there someone that has been helping you with the Prozinc dosing? You might try tagging the person that has been helping you on dosing. (Marje and Gracie are on vacation).

I will say it's important to get tests in at night, as well as the pre-shot number. Without that information, you are missing half your data. Most people try to get a "before bedtime test". Do you think that would be possible for you to do that?

I'm good with helping new members learn what they need to know,but we never cover everything. I'm good with some of the other insulins (NPH,lantus, Vetsulin) on the basics.

Copying this from what Marje and Gracie said to you in one of your other threads. "Normally, the dose is started at 1u and quite often at 0.5u. We only increase, in general, by 0.25u at a time so we don’t miss the correct dose. Quite often, when they are in the vet’s office getting a curve done, they are stressed (as you have noted) or they might be bouncing and so numbers might be artificially high leading the vet to raise the dose when it might not need to be."

The more you can fill in the pieces of the puzzle, the sooner we can figure out if she needs more insulin or not. The tests you want to get are always the preshot; and then 1-2 random tests from +3 to +7 in the a.m. cycle and a +3 and before bed test in the p.m. cycle. That will help us start to figure it out. As testing gets easier, you can get a few more."

Is Sally any easier to test these days?

 

[Sally the Calico]

Thanks @Deb & Wink ... I can do the before bed test... was going to last night, but hubby said to just let her rest, and I caved. I need to be a tougher sugar cat mom.

Sally is doing a bit better on testing. She still flinches and immediately shakes her head, but I've been able to get the blood on my fingernail, which was best advice ever. She doesn't avoid me or try to run, so better than I expected really. I did test for ketones and it came up negative. Aside from Marje's advice, I haven't worked on any dosing adjustments with anyone yet. Should I also post in the PZI forum?

She was supposed to go to the vet today for a curve, but I cancelled it. I aim to do it tomorrow... and that's testing every 2 hours, for 12 hours, correct? And can she eat as usual during that time?

 

[Larry and Kitties]

To be representative, the cat should eat lite it does every day during a curve. Usually curves performed at the vet are not representative since usually vet stress artificially raises BG. Since you are home testing it is best that you do the curve at home yourself.

What does did you start off? The usual starting dose is 1 unit. Your spread sheet does NOT show consistant BGs. Without being consistant, a it is hard to make a suggestion on changing dose. Is there anything different that can explain (I see one time you say fur shot) the other inconsistant reading.

 

[Sally the Calico]

When diagnosed vet started at 1.5u. A week later she went in for a curve, and vet upped it to 2u. Been at 2u since.

Didn't start home testing until after the holidays. She's been difficult to test, but starting to tolerate it more. She's been on low carb food ever since diagnosis. She's put some weight back on., which she needed. I did start her on Zobaline once a day, about a week or so ago, as her back legs seemed weak. No other changes in diet or meds at all.

 

[Deb & Wink]

Thanks @Deb & Wink ... I can do the before bed test... was going to last night, but hubby said to just let her rest, and I caved. I need to be a tougher sugar cat mom.

Tough love for Sally on those BG tests from now on.

Sally is doing a bit better on testing. She still flinches and immediately shakes her head, but I've been able to get the blood on my fingernail, which was best advice ever. She doesn't avoid me or try to run, so better than I expected really. I did test for ketones and it came up negative.

Blood drop on fingernail trick working again! Yeah! Bribes (pure meat treat) are probably helping a lot too.

Aside from Marje's advice, I haven't worked on any dosing adjustments with anyone yet. Should I also post in the PZI forum?

Do you feel ready to move over to the PZI forum? Feel ready to graduate? You have the skills - home testing, have a spreadsheet set up, know some of when to test, you are feeding low carb food.

Maybe read through a few posts over there first. (NOT Goose's but that is because it's so darn long. or EricH since he basically just repeats the numbers from the SS on his posts. It's a good idea to Read the Sticky posts pinned to the top of the forum.

When people are ready, we do encourage them to join the ISG forum specific to their insulin. It's up to you. You are always welcome to post your question here also, any time, to hopefully get more "eyes on it" as we say. Use the ? prefix when you have something you need answered. I know @MrWorfMen's Mom helps out over there. It is less active over there in the Prozinc/PZI forum.

She was supposed to go to the vet today for a curve, but I cancelled it. I aim to do it tomorrow... and that's testing every 2 hours, for 12 hours, correct? And can she eat as usual during that time?

Yes, a curve is testing every 2 hours for 12 hours, feed as you normally would. Preshot test is your 0, then +2, +4, +6, +8, +10, +12 (which is the same as your next cycle preshot test). Our cats are usually much calmer at home than in a vet's office with all those strange people and barking droolers, and funny smells. Curves at home are great!

 

[Deb & Wink]

Trish, if you have any of that curve info from the vet, please add it to your SS.

Also, a row at the beginning that shows the 1.5 U dose would be helpful.

Any notes on other meds she is on over in the remarks column. Any notes on appetite that may impact the BG readings can be helpful.

 

[Juls and Billy]

It is hard to help without any PM numbers, so I'm glad you are going to start those. To help do PM tests, I keep my Billy in the bedroom. Then I can set an alarm when I need it, test, then give Bill some freeze dried chicken as a treat. Takes less than five minutes and then I'm right back asleep. I don't know if that can work for you, but it might be worth a try.

Now, keep in mind I'm a newbie too, so take with a grain of salt. Billy takes ProZinc too, so maybe it will be useful. It's looks to me like Sally was doing pretty good on the 2 units before the fur shot, and just experiencing some bounce, which can take several cycles to clear. Then the furshot happened and it looks a little less like bounce, but that could still be having an effect. The advice Marje and Gracie gave you is awesome. If you do increase the dose, an increase of .25 is the way to do it. Then you want to give it several cycles to settle in before you make any more adjustments. With a dose increase, the mid-cycle testing, including the PM ones, will be super important. You have to know the nadir numbers to know if Sally is having a bounce effect, or if the dose is still too low. The rule of thumb I've read here on the forum is that if the nadir is less than 50% of the pre-dose numbers, bounce is a likely culprit. And bounce will fix itself with steady dosing, you don't want to adjust dose for bounce numbers or pre-test numbers, you want to look at the mid-tests when deciding to adjust dose. This will help avoid a hypo event. And Every Cat is Different. Tiny slow changes is the safest way to proceed until you know how Sally is going to react.

Once again, newbie here. If in doubt, talk to your vet or one of the more experienced folks on this board. Make sure you've read the sticky posts in the ProZinc section of the forum, and there's some great info that explains bounce here.

 

[Sally the Calico]

Do you feel ready to move over to the PZI forum? Feel ready to graduate? You have the skills - home testing, have a spreadsheet set up, know some of when to test, you are feeding low carb food.

Yes, a curve is testing every 2 hours for 12 hours, feed as you normally would. Preshot test is your 0, then +2, +4, +6, +8, +10, +12 (which is the same as your next cycle preshot test). Our cats are usually much calmer at home than in a vet's office with all those strange people and barking droolers, and funny smells. Curves at home are great!

Thanks so much! Yes, looks like I'm ready to graduate to the PZI forum.
Today's been hectic... had a repairman come over this morning and Sally goes into hiding when strangers are around. But I did get a +4 reading before I had to run several errands. Just got back and will definitely get more regular tests in.

 

[Sally the Calico]

Trish, if you have any of that curve info from the vet, please add it to your SS.

Also, a row at the beginning that shows the 1.5 U dose would be helpful.

Any notes on other meds she is on over in the remarks column. Any notes on appetite that may impact the BG readings can be helpful.

Thanks. The vet did not provide her numbers from the curve, but I can ask for them. Good idea.
No other meds, unless Zobaline is considered medication? I was considering it more of a vitamin supplement, but can certainly add it to her info.

 

[Sally the Calico]

It is hard to help without any PM numbers, so I'm glad you are going to start those. To help do PM tests, I keep my Billy in the bedroom. Then I can set an alarm when I need it, test, then give Bill some freeze dried chicken as a treat. Takes less than five minutes and then I'm right back asleep. I don't know if that can work for you, but it might be worth a try.

Now, keep in mind I'm a newbie too, so take with a grain of salt. Billy takes ProZinc too, so maybe it will be useful. It's looks to me like Sally was doing pretty good on the 2 units before the fur shot, and just experiencing some bounce, which can take several cycles to clear. Then the furshot happened and it looks a little less like bounce, but that could still be having an effect. The advice Marje and Gracie gave you is awesome. If you do increase the dose, an increase of .25 is the way to do it. Then you want to give it several cycles to settle in before you make any more adjustments. With a dose increase, the mid-cycle testing, including the PM ones, will be super important. You have to know the nadir numbers to know if Sally is having a bounce effect, or if the dose is still too low. The rule of thumb I've read here on the forum is that if the nadir is less than 50% of the pre-dose numbers, bounce is a likely culprit. And bounce will fix itself with steady dosing, you don't want to adjust dose for bounce numbers or pre-test numbers, you want to look at the mid-tests when deciding to adjust dose. This will help avoid a hypo event. And Every Cat is Different. Tiny slow changes is the safest way to proceed until you know how Sally is going to react.

Once again, newbie here. If in doubt, talk to your vet or one of the more experienced folks on this board. Make sure you've read the sticky posts in the ProZinc section of the forum, and there's some great info that explains bounce here.

Juls, you sound like a pro to me! I appreciate all your info.
Can't let Sally stay in our bedroom... it's the one room off limits to cats, as hubby and I both have allergies. It's helped to keep her out. Though at 7:30am on the dot, she's meowing at the door ready to test and eat. (well, I doubt she's thinking about the testing, but it's becoming routine) and she's more difficult to test when she's so hungry. The treats help for sure.

How long is a cycle? A full day?

 

[Deb & Wink]

A cycle is 12 hours. Cats need insulin 2 times a day. So the day is split into 2 cycles.

Just like the SS. AM and PM