Way to break a bounce Rom!!

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Sue484

Sue484

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Good grief Rom!! What are you doing to me?

I tested at AMPS and he was 4.1 (74). So I stalled for 45 minutes and he was 5.6 (101) I fed him then as I was getting late for work. I meant to test and inject before leaving but forgot!! (Bad Mum). I got my other half to test straight away and he was 10.8 (194) so he gave 1 unit. Hope I did the right thing.
 
+3 he is 14.8 (266). I'm still getting to grips with this insulin and it's not really making sense in my brain. From what I was reading yesterday, ProZinc is a delayed acting insulin. How long after shooting is onset usually?
 
Sue484 said:
+3 he is 14.8 (266). I'm still getting to grips with this insulin and it's not really making sense in my brain. From what I was reading yesterday, ProZinc is a delayed acting insulin. How long after shooting is onset usually?
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Some cats will show a definite response by +2 or +3 but others might not. Teasel doesn't usually show a lowering until +4 or beyond. I don't know why other than a food spike but I'd expect that to be over after +2. It is what it is. ProZinc should be slower in onset than Caninsulin and I know you have experience with that in Rom. I'd chalk it up to you still being on the ProZinc learning curve and Rom still being in the different insulin adjustment phase.
 
Rom never had an immediate reaction on Caninsulin. He was mostly +3 or later. Maybe he is an even later starter on ProZinc. Unless he in on a bounce, I hope to do a curve on Saturday. I just can't wrap my head around how you can dose a sliding scale achieve (hopefully) regulation. Lantus makes perfect sense to me. Maybe that is why Frankie is regulated and not Rom!!
 
I can't dose on a sliding scale with Teasel because he's far too reactive and is a vigorous bouncer. He also becomes "dose complacent" - mildly insulin resistant after a few cycles. Paradoxical, I know, but I have to hold a dose for a couple of cycles at least to reduce bouncing. Unless he surprises me with a low PS, I keep the same dose for AM and PM and I only do increases in the AM when I can monitor through the day. I have to look at mid cycle numbers over a few days to decide on where to go next with dosing. If he ever becomes a bit more regular in his responses, I might try sliding scale dosing but I'm not holding my breath.

BTW, our experience with lantus at the beginning didn't work out well. He was still bouncy and then really got stuck up high because of the duration of the insulin and need to hold a dose longer before changing. It's possible I could have made it work eventually but his very expensive bout of DKA in March made me want to try something else.
 
@Kris & Teasel I'm not doing a sliding scale at the moment, but I just cant see how it would work. Rom nadirs late it seems on ProZinc, so I need to get used to his new patterns. Out of interest, what would you call a low PS? Then what do you do - halve the dose and go back to normal for the next shot? I know ECID but just to get an idea.
 
Sue484 said:
@Kris & Teasel I'm not doing a sliding scale at the moment, but I just cant see how it would work. Rom nadirs late it seems on ProZinc, so I need to get used to his new patterns. Out of interest, what would you call a low PS? Then what do you do - halve the dose and go back to normal for the next shot? I know ECID but just to get an idea.
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At this point my too low to shoot number is anything under about 10 mmol/L. If I had a 9.8 + I would likely give the same dose and monitor carefully. If it's in the region of 8, I'll use the stall and retest technique. That usually works. I've stalled up to an hour (successfully) in the past. On 10/18, he surprised me with an AMPS of 6.8 and I knew stalling wouldn't take him up near 10 in any reasonable time frame so I skipped the shot and lowered the PM dose a bit. I'm still learning how to deal with this. I think next time I'd opt to give a token dose (1 u?) instead of a no shot because I have more data to go on. I'd wait to see the next PS before deciding on that dose.
 
From your post elsewhere:
"With Lantus, they say shoot low to stay low. I started seeing progress with Frankie when I started shooting the full dose into lower numbers and not doing chicken shots. As long as you know his nadir on a dose when he breaks a bounce, in theory it should be ok. But I can't see your spreadsheet at the minute, so I am only commenting my experiences. Also what helped with Frankie was not reacting with an immediate reduction to a number below 68 (I use Alpha Trak). I know he doesn't hold reductions well, so I decided on a three strike rule. If in doubt, I went with my gut."

This approach, maybe modified a bit, might work with ProZinc as well. Being a bit braver when you can monitor and you have enough data to go on and avoiding chicken shots when possible might give a better response. Something to try later?
 
I have been wondering the same thing, but whenever he throws me a low PS it is normally a weekday when I am at work!! I was emailing a vet at the RVC dealing with the remission clinic and she said anything over 10 to shoot the full dose and between 7.5 and 10 half dose if after eating they are not above 10. I'm not sure I'm comfortable with that though.
 
Sue484 said:
I have been wondering the same thing, but whenever he throws me a low PS it is normally a weekday when I am at work!! I was emailing a vet at the RVC dealing with the remission clinic and she said anything over 10 to shoot the full dose and between 7.5 and 10 half dose if after eating they are not above 10. I'm not sure I'm comfortable with that though.
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At least the RVC vet and I agree on 10 as the borderline. Her advice to give a half dose if between 7.5 and 10 might be OK and is somewhat in line with what I'm getting at when I talk about being braver.

FYI - Just did +4 on Teasel and got 17.5 when I had a nice 11.9 as AMPS. I'm using Freestyle Lite strips in my AT meter and they give about 7% higher BG number.
 
Rom seems to handling the insulin the same as Cappuccino, what I can see for her is a low preshot then a rise in response to food and starts to fall around +5 with a late nadir, sometimes even at the time of the next shot. I am able to shoot anything more than 7.5 at pre-shot because of this. If you can get a curve done it will help to know how low you can safely shoot.
 
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