update and still need advice

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Patty & Tiger

Patty & Tiger

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I am using ProZinc. When first diagnosed was told to give 2u twice a day. Tiger dropped to 28 one morning and I had to do the syrup and syringe feed, because he was severely dehydrated and not eating. He is eating now and has been doing good. I am trying to get a dose that will help him get to normal levels. I am home testing, too. I tested Tiger about every 3 hours yesterday. After the AM shot not sure how much I got in. I had 1.50 units to put in, but he moved and some didn't go in. I have recently started to give 1.25 units regardless of what the numbers show per advice of this board (thank you). Tiger has been eating good and loves boiled chicken. Should I continue with the 1.25 for awhile longer or up to 1.50. Need advice.
 
Re: Dosing advice needed

Hi! Welcome to the PZI board. (Carl and I post in both here and Health so you'll see us both places.) It is not as busy a board as Health but everyone here uses or has used your insulin.

I can't get your spreadsheet to come up. (I could yesterday so I would suggest going back to your original and going through the Procedure for sharing and posting again. If you need help, just ask) Until then, can you share what numbers you got around that nadir (+6) number?

Tell me if I am wrong, but I think I remember that you were dealing with quite a few variables including a food change and his not eating, and that earlier you had some nice numbers on low doses?
 
Re: Dosing advice needed

Our general rule of thumb is to hold a dose for a least 3 days before you make changes, unless he goes dangerously low. Some cats (like my Cassie) do better if you wait at least a week before making changes. I'd advise holding the dose for a couple more days. You're actually getting halfway decent numbers on the 1.25u--in fact I suspect you may need to reduce soon, rather than increase.

(I did get your SS to open.)
 
Re: Dosing advice needed

It did open for me this time. I'm with Lisa; you have seen some varying numbers on varying doses. Yesterday was a little high all round, but you weren't sure about how much went in. I would stay with the 1.25 a few more cycles and get a nadir whenever you can. (Some people have to get one just before bed at night, but it really helps you see where the cycle is headed.) You got a nice amps this morning; I would be curious how low he went overnight.

Patience is the key. Once you know what his patterns are ( where exactly is the nadir/ does he go lower during the day versus the night or vice-versa/what role is feeding playing depending on what and when fed) we like to see you play it safe. It is so much better to raise the dose based on numbers over time than to raise it and have it be too much insulin and then deal with a low number.
 
Re: Dosing advice needed

If you want, post here daily. (Early morning or evening is when most people are on) so we get to know Tiger and his patterns.
 
Re: Dosing advice needed

Not bad. We consider a cat regulated if they run in the low 200s at preshot and the 100s at nadir. He is almost there. It would be nice if the nadir drops a little - into a range below 100 but above 40, but for this early in the game, it's not bad at all. Every cat is different, but there are some that take a week or two to really react to the insulin with the best numbers for a specific dose.

You are both doing great. Food is good; he's eating; testing is working. Just sit back and breathe. Get midcycle numbers whenever you can. The only numbers to be cautious of are if you get a number under 200 at preshot and if you see numbers in the 40-50 range. If the preshot under 200 happens, wait 20 minutes without feeding (ignore his gnawing on your leg :mrgreen: ) and retest. You want to make sure the number is rising, not falling, and that it goes over 200. (Once you have a lot of data, you can consider shooting in the 200 range, but I wouldn't yet. ) If you see a number below 50, feed some regular food. If you see a 40, come on here and ask for guidance. If no one is around here, go on health and ask.
 
Re: Dosing advice needed

Hi and Welcome to our PZI group.

Your dose of 1.25 is looking good so far.

You've gotten great advise.

I look forward to getting to know you both.
 
Re: Dosing advice needed

ok, I skrewed up. Tigers PMS was 174 and I fed him and was getting ready to give shot when I remembered that under 200 I shouldn't give shot. I came back on here and saw where Sue and Oliver said to test and if preshot is below 200 wait 20 minutes and retest before feeding. Since I already fed what do I need to do? Should I go off of the 1.25 and give maybe .5 or none at all.
 
Re: Dosing advice needed

Since you have so little data, I would skip. He will likely be high in the am since he has been 24 hours since the last shot but don't react with more insulin. The 1.25 was okay; if you won't be around to monitor, you could even go down to one unit.

If you had retested in 20 minutes, you probably could have shot. Next time you'll know exactly what to do.

This period is all about gathering data and keeping him safe while you figure out the dose that works. You are doing fine.
 
Tiger was doing good with his numbers and we were starting to lower the dose. Now he is back in the 300's and this morning I went back up to 1 unit. Can someone look at his chart and tell me if I am doing the dose correctly. He is on Prozinc 2x. He is eating good and no ketones.
 
Has anything else changed? Food? Stress? It is odd that it looked like one unit was too much, as you got low preshot numbers. .75 doesn't seem to be doing much though. Wonder if he is still reacting to lower numbers on that one unit? Can you get some more midcycle numbers today? That might help us see if he is going low and bouncing, although it doesn't look that way. I think I would stick with the .75 a few more cycles to see if he goes down.
 
No, nothing has changed. The boiled chicken at night wouldn't do it, do you think? I just boil the chicken in water, with no seasoning. I use the broth to mix with his food, but I have been doing this all the time.
 
No, the boiled chicken should be fine. Maybe he is just being a cat..... :mrgreen: If the numbers don't improve on .75, then you could a little more, but maybe not the one unit yet? Do you have the U100 needles? .8 would be a possibility with them.

It doesn't seem like such a tiny bit of insulin should change the numbers. But in some cats, they seem to. Take a look at Cassie's spreadsheet (bookworm) Lisa has moved between one unit, .8 and .6 and it makes a big difference. The other thing that Cassie does is to take awhile to settle into a dose; maybe Tiger is the same way?
 
I am using the u40 that I buy from the vet. Where can I get the u100. The vet told me you have to convert them, and I don't know how to do this. I have been drawing just under the 1 with the top of the plunger black touching the 1 mark on the u40 for the .75u. When I would draw for the 1unit I would have the bottom of the black on the plunger at the 1 mark. I hope that makes sense.
 
Here is a thread on the U100 needles - where and what to buy. You don't have to buy them from the vet. Depending on the state you live in, you may or may not need a prescription.

U100 needles

Here is the conversion chart. It must be used. Lots of members put it right on the fridge so they can remind themselves every time they give a shot.

Conversion chart
 
Thank you, I am going Wednesday to get u100 needles. Maybe this will help do exact doses instead of guessing when I dose below 1unit.
 
Make sure they give you the syringes with the half-unit markings. Tell them you want to see them before you buy them. People have said they specified 1/2 unit marks, only to open them at home and find they weren't the right ones. A lot of places won't do returns on diabetic supplies.
Carl
 
I've been following your posts but usually can't open your ss on my phone.

I know you've heard ECID (Every Cat Is Different), but based on what I've seen with Cass, there are a couple of things I'd recommend:

1) pick a dose and stick with it for a week. Some people do well with sliding scales, but I've had the best experience with holding a dose (some say at least 3 days, Cass does better with at least a week. I'd try 0.8u if you get the u100s.

2) try to get a mid-cycle number as close to +6 as possible in each cycle. It looked like 1u was too much because you had several cycles that ran long. I'm wondering if the "normal" cycles on 1u involved bounces. It's hard to tell without a number near nadir. If you can't do +6, get one right before you walk out the door (I get a +4 in the mornings during the week, but a +6 at night).

Feel free to check out Cass's SS, but be aware he's a strange boy. We're in the process of working out way back down in dose--he had badly infected teeth and is about 3 weeks past a major dental. We've been at this for almost 17 months and we're still trying to figure things out.
 
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