? Really high numbers - why??

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Camille and Oliver

Camille and Oliver

Member Since 2020
Hi all,

I could use some advice. We were starting to see some blues and even some greens, but the last couple of weeks a blue number seems to be rare. At first I was concerned that it was bouncing, so decided to reduce the insulin back slightly, but now he is going higher than I've ever seen before. The last two cycles I increased .25 units but it doesnt seem to have an affect. The strange part is, he does not have an increased appetite or increased water intake/urine output like he typically does when he has these high numbers. If anything, he seems great. Has energy, in good spirits, normal appetite....

One thing I am concerned about is I am on the same vile of insulin that I originally started him with in January. Perhaps it is no longer effective? I have ordered another vile in from the vet which will arrive in a couple of days.

Should I drastically increase his dosage at this point?

Any help is greatly appreciated!!!

Camille
 
Sorry your post got overlooked. I wouldn't think the vial is bad already, they're usually good for 3-4 months. Any floating particles in it or was it left out?

He might just need a little more juice. Tagging @Deb & Wink because she's better at spreadsheet reading than me. :)
 
Sorry your post was missed Camille. 8 pm Eastern time is past my usual bedtime. ;)
Give me a moment to look at the SS.

Thanks to Panic's mom Elizabeth for tagging me. (and bumping up the post by replying)
If you ever don't get an answer, if you reply to your own post, that "bumps" it to the top of the forum so people will hopefully notice it.
 
Oliver seems to do better on the 1U of Prozinc.
I still think that he is dropping low somewhere, and you aren't catching it with a test.
For instance, 3/13/2020 Oliver went from 315 at +4 to 590 at PMPS.
That is close to a 50% rise in the BG number at the end of the cycle. 2 mmol/L (35 mg/dl) basis points per hour.
So, it's extremely likely that he dropped lower sometime between those 2 test times.
Black = bouncing.

Today, 3/15/2020 Oliver dropped to the blue range numbers with that 135 at +6.
I'd expect him to bounce up to the black range again for this evenings pre-shot, or at least into the red's.

Also a good possibility is that Oliver is dropping lower at night. If at all possible, you want to get at least 1 or 2 tests in the night cycle. One around +2. A second test before you head off to sleep. You might need to set an alarm to get a +6 test in at night also.

With Prozinc, some cats have a shorter duration. So their +10 or +11 can be a lot lower than the AMPS or the PMPS test. So, think about the possibility of getting a test now and then at those +10 and/or +11 cycle times.

Are you feeding Oliver after the halfway point in the 12 hour cycle? Are you feeding him after +6?
Do you take all food away at least 2 hours before the pre-shot tests?
 
Panic said:
Sorry your post got overlooked. I wouldn't think the vial is bad already, they're usually good for 3-4 months. Any floating particles in it or was it left out?

No, it was not left out and visually it appears good still.

He might just need a little more juice. Tagging @Deb & Wink because she's better at spreadsheet reading than me. :)
Click to expand...

I am just unsure if he is bouncing. This evenings preshot he was only 11.6? Ugh.
 
Deb & Wink said:
Oliver seems to do better on the 1U of Prozinc.
I still think that he is dropping low somewhere, and you aren't catching it with a test.
For instance, 3/13/2020 Oliver went from 315 at +4 to 590 at PMPS.
That is close to a 50% rise in the BG number at the end of the cycle. 2 mmol/L (35 mg/dl) basis points per hour.
So, it's extremely likely that he dropped lower sometime between those 2 test times.
Black = bouncing.

Today, 3/15/2020 Oliver dropped to the blue range numbers with that 135 at +6.
I'd expect him to bounce up to the black range again for this evenings pre-shot, or at least into the red's.

Also a good possibility is that Oliver is dropping lower at night. If at all possible, you want to get at least 1 or 2 tests in the night cycle. One around +2. A second test before you head off to sleep. You might need to set an alarm to get a +6 test in at night also.

With Prozinc, some cats have a shorter duration. So their +10 or +11 can be a lot lower than the AMPS or the PMPS test. So, think about the possibility of getting a test now and then at those +10 and/or +11 cycle times.

Are you feeding Oliver after the halfway point in the 12 hour cycle? Are you feeding him after +6?
Do you take all food away at least 2 hours before the pre-shot tests?
Click to expand...
Thank you for all the great advice. So tonight's preshot he was 11.6? So odd.

I will absolutely focus in on testing more during that pm cycle to give me a better idea as well as later into the am cycles.

I am not feeding him at +6 typically, and have been feeding at shot time, then around +2 for both cycles (4 feeds daily) I am wanting to switch that up though so today I fed him at +6, that may be why he didnt bounce for the PM preshot? I am going to look into an automatic feeder so he can have fresh food in the night at well.
 
The autofeeder is a big help! You may want to bump up the amount of meals though. If free feeding isn't possible it's recommended to have multiple meals available. I give 4 scheduled meals per cycle and she usually gets more snacks on top of that.

Feeding at onset (usually +1 or +2) is good, but also near nadir to help steer the drop.
 
Those yellows at pre-shot are safe to give the full dose.
Every time you get lower blues and yellows, you have dropped the dose by 0.25U.
The protocol we use bases reductions, increases or holding the dose on the nadir, or mid-cycle numbers.
Changes are not made based on the pre-shot tests.
The pre-shot tests are taken into consideration, but should only be considered as a slight influence on what dose you give.

Oliver's nadir was 7.5 mmol/L (135 mg/dL).
From the Prozinc SLGS dosing protocol:
"If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose"

If you keep reducing the dose based on the pre-shot, you'll never get Oliver down into the blue and green pancreas healing range.
You should have held the dose steady, at 1U.

Auto feeders are a great tool, to help you keep your diabetic cat Oliver's blood glucose levels more even.

p.s. Notes on the SS on what you are feeding and when are a great help. Remarks column, split AM and PM separately, make notes indicating the + hour you feed.
 
Thank you so much, all of this information is extremely helpful!

The bounce yesterday came as @Deb & Wink predicted, just a bit later as you can see from the spreadsheet update.

I will stop adjusting the dose. That mindset came from my vet who says no shot if he is below 12, and then I called her a few weeks ago and she said if he is below 12 to do a reduced dose. I will now not worry about preshot but pay more attention to nadir moving forward.

As for feeding, I am concerned he is getting bored of the food - I use a variety of flavors, but mainly stick to the pates as I was told their carb/protein content is better for diabetic kitties! He used to love his crunchy food and it was left out all day for him (most likely why he got the diabetes), is there a good low carb food that I can give him here and there to ensure he is eating enough or is it important to only feed wet food, as I switched to before his diagnosis date.

Camille
 
Camille and Oliver said:
I will stop adjusting the dose. That mindset came from my vet who says no shot if he is below 12, and then I called her a few weeks ago and she said if he is below 12 to do a reduced dose. I will now not worry about preshot but pay more attention to nadir moving forward
Click to expand...
Ok, got it. Vet advises dosing based on pre-shot numbers.
Vets try to keep cats at a bit higher BG levels. They are concerned that your cat will go too low, and have a hypoglycemic episode.

But, you are hometesting, so you are able to catch those lower BG numbers.

A BG (blood glucose) of 12 mmol/L (216 mg/dL) is certainly high enough to give insulin. Even BG numbers in the 10 to 11 range mmol/L (180 to 190's mg/dL) at pre-shot may be ok. You have to get more comfortable shooting insulin at those lower BG ranges.

If the pre-shot is < 150 mg/dL then stall, do NOT feed Oliver, post on the board for help, test again in 20 minutes.
Either change the title of your existing post to indicate you are stalling and seeking help.
Make the title in caps, "STALLING, NEED HELP, OLIVER ON PROZINC", so it stands out. Use the ? post prefix also.
Or create a new thread with the "Post New Thread" in the upper right corner. Nice to link your previous post, if you go the new thread method, since seeing some history is helpful for those of us looking at threads.

Post in Main Health, as well as Prozinc forum. More eyes in Main Health than in the Prozinc ISG (Insulin Support Group).

With Prozinc, you can do that stalling technique for up to 1 hour and still maintain your shot schedule for the next 12 hour dosing cycle.

Take another look at the new Prozinc dosing methods we use here. Updated in February 2020. Document is based on a lot of information from experienced users of Prozinc.
Sticky PROZINC DOSING METHODS
 
There are a couple of dried foods that some of the people in the facebook groups use. Personally, I don't like them, because I've helped several people that were using those foods, their cats maintained high BG levels. Once the dry foods were eliminated from the diet, the BG levels dropped.

There are some freeze dried foods that may give your cat the "crunch" he craves. Stella and Chewy's and Ziwipeak are 2 of the freeze dried foods I know of.
 
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