Learning the ins and outs of PZI dosing

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Caroline17

Caroline17

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hello! I've chatted with some of you on other forums and am so impressed by how much everyone cares as well as how much knowledge you all have!

Now, on to my question. I've got Vonn's spreadsheet in my signature. Currently he's prescribed 4.5 units of PZI twice daily. This morning his BG was 136. This evening it's 181. I don't want to go the whole 4.5 units. My gut is telling me 2 units but I'm still learning this. Thoughts?
 
good job getting the spreadsheet going! I think it's a VERY GOOD CALL to reduce. I have a feeling he's been needing a reduction for some time. 181 is actually pretty low. I'm inclined to say not more than 1 and then monitor what his level is at +5 or 6.

those high 500's a few days ago are almost surly a BOUNCE from going way too low when you shot 4 when he was just 289.

Honestly, and I'll let other people with more PZI experience way in on this... I would do 1 tonight and then see what it is tomorrow... and if it's in the 200's kind of "start over" at a low dose of 1 or 1.5 for a few days. He's got lots of crazy bouncing numbers... no doubt it's making him feel kinda crappy. we have to get those numbers more regulated.

I had to copy and paste your spreadsheet address... can you instead make it a clickable hyperlink?
 
JanetNJ said:
good job getting the spreadsheet going! I think it's a VERY GOOD CALL to reduce. I have a feeling he's been needing a reduction for some time. 181 is actually pretty low. I'm inclined to say not more than 1 and then monitor what his level is at +5 or 6.

those high 500's a few days ago are almost surly a BOUNCE from going way too low when you shot 4 when he was just 289.

Honestly, and I'll let other people with more PZI experience way in on this... I would do 1 tonight and then see what it is tomorrow... and if it's in the 200's kind of "start over" at a low dose of 1 or 1.5 for a few days. He's got lots of crazy bouncing numbers... no doubt it's making him feel kinda crappy. we have to get those numbers more regulated.

I had to copy and paste your spreadsheet address... can you instead make it a clickable hyperlink?
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I was not a good mom when it came to testing. Those almost 600 BG levels were last year when we had to hit the e vet for super high levels. Today was the first time I've tested since December
 
I would agree with Janet that 1u would be the best approach for tonight since we don't have a ton of data to work with right now. Don't feel like you weren't a good mom. We all do the best we can with this! Congratulations on getting the tests the past couple of days!

Here is a quick video that will show you how to link your spreadsheet (good job making it!). Let me know if you need any help with getting it linked.

 
Actually I might take that back about 1u. Do you have time to wait a bit before you dose him? It might be better to get some other eyes on this. If he had 136 this morning, and 181 tonight, I'm not sure I would feel comfortable recommending any dose. I'd like to see a few other folks weigh in first.
 
Caroline17 said:
I was not a good mom when it came to testing. Those almost 600 BG levels were last year when we had to hit the e vet for super high levels. Today was the first time I've tested since December
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Oooh. I see. I didn't look closely at the dates. I still think start from scratch. Von may have been giving you behavior problems because he's going too LOW. I'M SO GLAD you've started testing again.
 
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Caroline17 said:
I was not a good mom when it came to testing. Those almost 600 BG levels were last year when we had to hit the e vet for super high levels. Today was the first time I've tested since December
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Those super high numbers look like they were a bounce. He should have been reduced then.
 
Whew! Am I glad you're testing again! Those preshot numbers are lovely but very low for giving insulin. Heaven only knows how low he went mid cycle. I can't view your spreadsheet so I can only go by those two numbers and what you've said about highs. How about giving him 0.5 u this evening and test at + 2 to see where he's heading? That's a very small dose but still a little insulin. It might have to go up in 0.25 u increments but this can be a baseline reference dose.
 
Rachel said:
Hey there! Have you given any insulin yet?

@Kris & Teasel if you copy her SS link and then paste it into a browser window, it's viewable. :)
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I looked at it and I see an AMPS of 163, not 136, and a zero for dose both last night and this AM. Am I correct in thinking the blue 163 this AM was after a no shot green last night? And now there's another blue PS in spite of no insulin since yesterday AM?? Could you please verify this?
 
Oh! I definitely didn't notice that either...I thought that was last night. :rolleyes:

Okay, yeah with that info, I'm with Kris on the dose.
 
Spreadsheet is linked, updated and cleaned up a bit to clear up the confusion. The wacky numbers were all 2016 and the spot where there was no PMPS was a time when I didn't test. Trying to get this coordinated with my husband has been interesting to say the least. He doesn't feel comfortable testing, just shooting. I have now taken over both feedings so I can reliably test.

I ended up giving 1 unit last night. This morning he was at 194 so I stuck with the 1 unit.
 
Great job, Caroline! Every cat is different (you'll hear that a lot here), but my cat would much rather be tested than shot. He doesn't exactly love either part, but he's less bothered by the testing than he is by the injection. Hopefully as your hubby sees the process a bit more, he'll grow in comfort with it. You're getting some nice pre-shot numbers. If there's any way you can, either today or this evening, it might be helpful to try to get a test sometime between +4 and +6 to see where his numbers go during the cycle, and make sure this is a safe dose for Vonn.
 
Djamila said:
Great job, Caroline! Every cat is different (you'll hear that a lot here), but my cat would much rather be tested than shot. He doesn't exactly love either part, but he's less bothered by the testing than he is by the injection. Hopefully as your hubby sees the process a bit more, he'll grow in comfort with it. You're getting some nice pre-shot numbers. If there's any way you can, either today or this evening, it might be helpful to try to get a test sometime between +4 and +6 to see where his numbers go during the cycle, and make sure this is a safe dose for Vonn.
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Hubs isn't cool with needles at all. It's all I can do to get him to shoot insulin! Vonn is definitely the opposite of your cat. He can't stand getting a prick for a test, but isn't phased by his shots. I meant to grab a test later in the evening last night... I've set up a reminder in my phone so I don't forget tonight!
 
Lol...my sister is the same way about needles. She was over the other night and couldn't even watch when I needed to test Sam.

On another topic, based on the numbers you've had the past couple of days, I'm guessing that his previous dose was way too high for him, and his "eat your appendages" thing was because he may have been dropping into hypo territory and trying to get food to bring his BG back up. Hopefully now that you've lowered his dose (and may well lower even more in the next few days), he will settle down and be less ravenous. I'm so so glad you've been able to test and make some changes for him. Fingers crossed this was all he needed to settle back down.
 
Djamila said:
Lol...my sister is the same way about needles. She was over the other night and couldn't even watch when I needed to test Sam.

On another topic, based on the numbers you've had the past couple of days, I'm guessing that his previous dose was way too high for him, and his "eat your appendages" thing was because he may have been dropping into hypo territory and trying to get food to bring his BG back up. Hopefully now that you've lowered his dose (and may well lower even more in the next few days), he will settle down and be less ravenous. I'm so so glad you've been able to test and make some changes for him. Fingers crossed this was all he needed to settle back down.
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Seeing his numbers this low has given me sooooo much hope. I am really hoping that our issues developed because he was getting too low. He seemed much happier last night and this morning. He was still being a pest heading to the kitchen but once there he waited patiently for his food. Fingers, arms, legs, eyes, EVERYTHING is crossed!
 
Great job with the SS! That makes it much easier to read. :)

I think it's almost surely that the numbers were too low. Those mid cycle numbers will help you see if you need to reduce the dose or if it's good where it's at! I think the testing is really going to help you get him to a good place where he stops trying to eat you!
 
I've been reading over all the threads for info and to help me see what everyone does to treat their cats. Could someone do a short explanation for me as to why the poster was advised to shoot when the numbers were below 200? I'm curious because I thought we were not supposed to give insulin at all if there were such low numbers. Thanks
 
Lillie said:
I've been reading over all the threads for info and to help me see what everyone does to treat their cats. Could someone do a short explanation for me as to why the poster was advised to shoot when the numbers were below 200? I'm curious because I thought we were not supposed to give insulin at all if there were such low numbers. Thanks
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The rule that says no insulin if BG is below 200 is aimed at newly diagnosed diabetics and their inexperienced owners. Once you've been at it a while, have a lot of BG data on your SS and understand your kitty's responses you can bend the rule in a variety of ways. These include:
  • dropping your no shot number lower
  • Stalling without food for 20 minutes or so, retesting and giving insulin if BG is rising
  • Giving a reduced dose.
All these techniques require the judgment that lots of experience gives you.
 
I believe don't shoot below 200 is for newer members until you get enough data to see how kitty responds. Vet's normally tell people this too, partially as a safety precaution.

Cross posted with Kris, she said it much better lol :)
 
Quick update on Vonnegut. I'm doing a quick curve today at 3+ and 6+. He was at 191 this morning so I opted to skip his shot. I'm glad I did! His 3+ is 120. I've definitely been pushing him far too low. I'm checking in with his vet tomorrow and will let everyone know what she says.
 
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