Adjusting doses on your own

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Fluffy Face

Fluffy Face

Member Since 2016
It's ill-advised, but I've taken to adjusting doses on my own a bit. I posted before that I had increased Serena's dose to 2 units, following guidelines my boyfriend's vet gave him for his cat (no shoot under 200, 1 unit 200-300, 2 units if above 300). Got paranoid about her going hypo while I'm at work, so I brought it back to 1 unit. After getting a mid-cycle reading that I was unhappy with, I increased the dose to 1.5. Numbers are still all over the place. It's hardly been more than a week, so I probably shouldn't be adjusting her dose so much...

Any thoughts on the numbers and doses so far?
 
I don't use ProZinc so I can't really help much, but I notice that you don't really have a lot of information on her SS and that makes it difficult for anyone to help answer dose questions. Is there any way you could maybe get in a few mid-cycle tests from time to time? Her AMPS and PMPS numbers are high, but there's no way to tell where they've gone during the cycle, and whether, maybe, she's dropping low and then bouncing, or whether she's staying higher all through the cycle. :)
 
Hiya,

Long story short, I think your insulin dose is too high and needs to be reduced.

You are seeing low numbers late in the insulin cycle. There aren't many mid-cycle test numbers, so we don't actually know if Serena has dropped even lower than her preshot numbers at some point during the cycle.

Two (of several) reasons to lower the dose:
1) If you regularly get preshot numbers that are too low to shoot.
That can indicate that the dose is too high. Reducing the dose may even out the numbers and enable you to give shots twice a day.
2) Numbers that are too low.
That '64' is considered in hypoglycemic range on an Alphatrak meter. Therefore, the dose is definitely too high.

I think Serena is dropping too low (and at least one point she's dropped into hypoglycemic range) and is subsequently 'bouncing' into higher numbers as a response. When a cat's blood glucose drops too low the liver can release stored glucose to raise the level. It can also release counter-regulatory hormones, the purpose of which is to try to keep the blood glucose high for a time.

I'd strongly suggest that you reduce the dose and get some mid-cycle numbers every day if possible to see how low Serena's blood glucose is dropping on the reduced dose. If you can't get tests routinely during the day then do try to get some tests during the evening. A 'before bed' test is routine for many of us... ;)

I have to say though that I think you're doing a brilliant job considering how long you've been doing this! You've learned to test, and you've set up a spreadsheet to record the data already. Well done! :bighug:

Eliz
 
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I notice Serena had a reading of 64 last night at PMPS. While that is not a hypo unless Serena was showing symptoms of hypoglycemia, it is a warning for the potential of a hypo on your pet meter. Anything below 68 requires intervention and monitoring. According to IDEXX labs the normal BG range is 72 to 175.

When you get a reading 68 or below, it is important to feed the cat and retest again every 20-30 minutes until you get at least two readings above 68 and holding. The high reading of 428 this morning was likely due to that low number last night. It's called bouncing and happens because the cat's body panics at the low number and pumps out hormones that cause a surge of glucagon which in turn raises BG.

I would urge you to monitor closely today and only give 1.5u if and when you can get some mid cycle tests in to see how low that dose is taking . That low reading so late in the cycle, suggests Serena may have been even lower earlier during the day cycle yesterday and could possibly have had a symptomatic hypo event.

You might want to include that your question is concerning ProZinc in your Title to get some folks experienced with that insulin to weigh in but with that low reading yesterday, I would strongly recommend you get some advice before making dose changes recommended for another cat and that you get more mid cycle tests. The dose should be based on how low it takes Serena NOT on how high the reading is pre-shot. The pre-shot number simply tells you whether it is safe to give insulin but it doesn't determine dose.
 
Thank you all. I was having the same feeling about the dose perhaps being too high, causing those low and then high #'s. I work during the day Monday-Friday, so I can't get readings during the week, and then the weekends are filled with who knows what. But I can certainly set aside some time one of these Saturdays or Sundays to get more mid-cycle #'s.

She was indeed not showing any hypo symptoms with that low number...
 
I understand the concern about her dropping lower. I could likely get a couple tests in the evening.
 
There are a lot of people that use a sliding scale with Prozinc, but that is after starting at lower doses and seeing how well your kitty will respond, once her body has becoming "climatized" to having external insulin added in. You cannot use someone else's sliding scale since Fluffy may react much differently to the Prozinc than your boyfriend's kitty. The rule is start low go slow and get as much data as you can before deciding on any dosing changes.
 
This is the time to be patient, sliding scales are possible but you need adequate data first and you have been at this no time at all (I know it feels like a long time already - we have all been there). My spreadsheet has a warning on it because it is looking like an explosion in a paint factory for reasons yet to be determined, and I am adjusting doses to try to find the optimum dose currently. Fluffy needs to clear the bounce and then you need a curve to determine how low the dose takes her and the timing of that low point, once you know this then you are in a better position to know what to do with her numbers. Slow and steady is the way. I don't use Prozinc so can't give dosing advice, those who do are better placed to help with that.
 
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