Recovering from ketoacidosis

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Your spreadsheet says you gave 2.5U this morning. Did you give 2.5U, or 1.25U?

She may continue to bounce for up to 6 cycles, but ProZinc usually cuts through those bounces a little more quickly.

If you gave 2.5U this morning then continue to hold that dose. That's a pretty good curve today.

If you gave 1.25U this morning, let's try this - give 1.25U again tomorrow morning, regardless of what the preshot is, and get a +4 or +5.

I am trying to narrow down if today was a fluke, or if she's possibly bouncing from 2.5U being too high.
 
FrostD said:
Your spreadsheet says you gave 2.5U this morning. Did you give 2.5U, or 1.25U?

She may continue to bounce for up to 6 cycles, but ProZinc usually cuts through those bounces a little more quickly.

If you gave 2.5U this morning then continue to hold that dose. That's a pretty good curve today.

If you gave 1.25U this morning, let's try this - give 1.25U again tomorrow morning, regardless of what the preshot is, and get a +4 or +5.

I am trying to narrow down if today was a fluke, or if she's possibly bouncing from 2.5U being too high.
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I haven't changed her 2.5 units. That's what she got this morning, and what I just gave her.. shes been all over the place for YEARS! I've been trying to get a hold of it, even had her on a Libre reader twice. That's why I'm so scared. She was on Novolin for the 1st 4 years, they changed her to Prozinc last month during her ICU visit...
 
JBat75 said:
I haven't changed her 2.5 units. That's what she got this morning, and what I just gave her.. shes been all over the place for YEARS! I've been trying to get a hold of it, even had her on a Libre reader twice. That's why I'm so scared. She was on Novolin for the 1st 4 years, they changed her to Prozinc last month during her ICU visit...
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Ohhhh ok I understand your earlier comment now.

ProZinc is a good insulin for most cats, I wouldn't worry.

Keep giving the 2.5U. When she breaks this bounce we'll see how low she goes, but I do think she is going to need an increase to 2.75U.
 
FrostD said:
Ohhhh ok I understand your earlier comment now.

ProZinc is a good insulin for most cats, I wouldn't worry.

Keep giving the 2.5U. When she breaks this bounce we'll see how low she goes, but I do think she is going to need an increase to 2.75U.
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Ok, thank you so much!!
 
JBat75 said:
I haven't changed her 2.5 units. That's what she got this morning, and what I just gave her.. shes been all over the place for YEARS! I've been trying to get a hold of it, even had her on a Libre reader twice. That's why I'm so scared. She was on Novolin for the 1st 4 years, they changed her to Prozinc last month during her ICU visit...
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Novolin N is not a good insulin for cats…no wonder you couldn’t get her regulated. Give Prozinc a chance to work. It’s only early days with it.
@FrostD will be able to guide you with dosing.
 
I stayed up until 1:30 am.. Her BG dropped to 129 5 hours after shot. She was over 600 5 hours ago.... I gave her a bit of WD crunchy food(until my low carb food arrives) please advise.

Also, how do you take +3, +4 etc after second dose as it's the middle of the night? Her evening dose is 8pm
 
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JBat75 said:
I stayed up until 1:30 am.. Her BG dropped to 129 5 hours after shot. She was over 600 5 hours ago.... I gave her a bit of WD crunchy food(until my low carb food arrives) please advise.
Also, how do you take +3, +4 etc after second dose as it's the middle of the night? Her evening dose is 8pm
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If you get a BG that is significantly lower than the preshot, please take another BG to see it is not dropping further. Were you able to get another test in after the 129. It is possible she is dropping lower after the 129 and the @173 in the am cycle.. don’t be surprised if you see a high preshot BG again in the morning. .
You will need to get some high carb wet cans of food and some honey or Karo in case of low numbers. Look for some foods that are over 16% carbs for the high carbs. Make sure you mark them on the top with the number of carbs so you don’t feed them as a low carb food.

If needed you will need to set the alarm and get up and test. What time are your preshot doses.? If they are at a reasonable hour, you should be up for several hours during the pm cycle.
 
I wasn't able to get another reading. I'm usually asleep. I give her pm dose at 8:30 pm and I'm in bed by 9:30. It takes me about an hour to calm down from the day. Then I'm up around 7-7:30
 
I'm sure I've asked so forgive me - what times do you feed her?

Like Bron said, she will probably bounce from this again
 
She did bounce again. Just checked and the reading was HI... WHAT DO I DO????

Do I still give her 2.5??
 
We dose based on nadir, so don't ever change your dose based on a high preshot. If you get a low preshot, then we sometimes consider a one-time reduced dose.

Do you have an autofeeder?

What we want to try to do now is see if we can use food to slow down those drops and prevent bounces, but we'll need +1,+2, +3, and +4 data to see how to best do that. Doesn't have to be today or all in one day, but over the next few cycles see if you can grab those tests

The other option is she just might be one of those cats ProZinc is too harsh for, it does happen. It's a bit difficult to fix this kind of bouncing with ProZinc; usually we (1) reduce the dose and let nadir run a little higher (2) wait for numbers to come down more overall, then (3) slowly increase back up. But I really don't want to do that with a post-DKA cat.

Let's start with food manipulation first and see how that goes
 
FrostD said:
We dose based on nadir, so don't ever change your dose based on a high preshot. If you get a low preshot, then we sometimes consider a one-time reduced dose.

Do you have an autofeeder?

What we want to try to do now is see if we can use food to slow down those drops and prevent bounces, but we'll need +1,+2, +3, and +4 data to see how to best do that. Doesn't have to be today or all in one day, but over the next few cycles see if you can grab those tests

The other option is she just might be one of those cats ProZinc is too harsh for, it does happen. It's a bit difficult to fix this kind of bouncing with ProZinc; usually we (1) reduce the dose and let nadir run a little higher (2) wait for numbers to come down more overall, then (3) slowly increase back up. But I really don't want to do that with a post-DKA cat.

Let's start with food manipulation first and see how that goes
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Should I get a freestyle Libre sensor on her through this??
 
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That is really up to you. Some people really like them, but not all cats tolerate them well, they don't always last the full two weeks, and can be very expensive if you can't apply by yourself. If you can continue to get 1 or 2 spot checks each cycle, I wouldn't bother, that's all we really need.
 
I have a 1 month follow up appointment with the emergency vet tomorrow. They'll be checking her BG and ketones and make sure her UTI is completely clear. I'm dropping her off at 9 am but worry because she gets upset at the vet.
 
We'll also need you to start a new thread since this one is getting too long. I would title it "1/18 Kaia AMPS HI, +4 295"
 
FrostD said:
Was that at the vet? If so put "295 @ vet" in the cell so we know (they're usually higher at the vet), and manually change the color to yellow
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No, her vet appointment is tomorrow. I drop her off in the morning, and pick her up in the afternoon
 
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