Confused about dosages, and tonight's shot

Hi everyone, after doing some reading and looking at spreadsheets here, I am a little confused about insulin dosing. Initially my vet said wanted to administer a set amount (3 units PZI twice daily), then when I started home testing and Shady's BG was up and down a lot, she sent me a scale (under 200- no insulin, 200-300: 1 u; 300-400: 2u, over 400: 3u). After I did a 12 hour curve and Shady's BG seemed to be dropping a little, she said to still follow the scale up to 2 units, but not to give over 2 units (wouldn't have needed to anyway because it has been going down).

My confusion and question is, most of the spreadsheets I have looked at here seem to administer the same amount of insulin regardless of BG reading. I think I have seen some that still give a unit of insulin even when the cat tested at 100 or even below PS! I am still giving insulin based on the scale and was wondering if there is any reason that most here seem to not use that method?

Second question, Shady's glucose readings have been dropping (maybe due to diet changes?), and several times lately he has been under 200 so I haven't given him a shot. But then the next reading is usually higher (upper 200s-300ish). Tonight he tested 176, so I gave him a half unit to see if maybe tomorrow morning he might be a little lower. Do you all think this was appropriate? I was a little nervous shooting when he was under 200, just getting a half unit I figured would be ok. Do you think shooting a small amount when he is at 150-200 would keep him more on an even keel and better regulated? Spreadsheet is attached with am/pm PS readings.

Also, any general opinions on the SS are welcome. He seems to be steadily decreasing, which I feel like is a good sign, but then he still has the occasional 300 reading. I would love for it to somehow go into remission or be diet controlled but I know that isn't always possible.

Thanks!

It looks like Shady is doing well. What would tell us more, and give you more information about what to shoot, are midcycle numbers. When you just look at preshot numbers, you can't tell if he went low mid cycle and is bouncing back up, or if he is flat the whole cycle and could use more insulin.

The .5 for 176 is probably fine, but I would plan to test a few times tonight to make sure he is not going too low. We generally tell new diabetics not to shoot under 200, but to wait 20 minutes without feeding and retest. Both to see if the number is nearer 200, and to make sure the number is rising, not falling.

Have you checked out the PZI forum? Everyone there uses or has used your insulin and can guide you on dosing. http://www.felinediabetes.com/FDMB/viewforum.php?f=24

Some people shoot lower numbers, but only after they have a lot of data (numbers) that give them confidence in how their kitty will react to a specific dose.

Also wanted to give you a document that has lots of info on PZI.http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=32799

There are 2 schools of thought about dosing PZI and two (or more) different kinds of cats who might benefit. If you check out the spreadsheets on the PZI forum, some people are using a sliding scale, but one with smaller dose gradients that yours. We tend to increase and decrease by .25 units or .5 units, not whole units. Some cats seem to do better getting the same dose for several cycles. Once you get some data on your cat, you may be able to tell which will benefit him most.

Thanks! I will check him in a bit but he seems to be ok and ate some. Sounds like I need to do more mid cycle testing. Poor thing, I feel bad poking him 2x/day anyway, and now maybe doing 3-4x/day! Thanks for the links. There is just so much information out there, it is really overwhelming. This board is really helpful though.

My confusion and question is, most of the spreadsheets I have looked at here seem to administer the same amount of insulin regardless of BG reading. I think I have seen some that still give a unit of insulin even when the cat tested at 100 or even below PS! I am still giving insulin based on the scale and was wondering if there is any reason that most here seem to not use that method?

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Simple answer. ECID. Every Cat is Different. Some cats respond well to a stable dose, while other cats respond well to a sliding scale. The "scale" is probably harder to figure out as far as where you place the "lines" between doses, and what the proper dose for each range of numbers is. I responded in your original post on the board that my cat was dosed this way from day one, so I understood why your vet did that with you and Shady.
It also enable you to dose below the "200 bg" line that we usually suggest that people not shoot below. Like tonight when you decided to shoot a small dose on the 176 reading. (I think that was a good choice, by the way!).

Do you think shooting a small amount when he is at 150-200 would keep him more on an even keel and better regulated? Spreadsheet is attached with am/pm PS readings.

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I think so, yes. The important thing, however, when you are shooting numbers below 200, is to keep a close eye on what his numbers do in the hours between shots. There is a lot less room for error, so you want to be able to get tests in the +3 to +7 hour range so that you can see if Shady is going lower than you would want him to go.

Carl

My vet advises me to not shoot at 150 or lower--that's using my Relion. I guess the reasoning is, on the Alpha Trak, that would be closer to 200.

Thanks everyone, Shady got down to 87 last night, which I guess isn't terribly low but was enough to make me nervous. That put him at 188 this morning, and if I was feeling experimental, I might've given him ~.25u, but he didn't eat much and I couldn't come home during the day to test so I didn't shoot. Tonight he was at 228, which is still pretty good numbers. Not sure what to make of it all still. I am thinking maybe go a little lower on dosages?

I am also thinking of phasing out the Wellness Core. Wondering if with his numbers already being improved, if that might bring him lower still and close to normal range??