Questions about Dose on ProZinc

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Nan & Amber (GA) said:
I don't "do" prozinc dosing as a rule, but in this case, since Carlos dropped below 68 on an AT2, I think he's earned a reduction under any dosing method, right?

I believe I once had a conversation with Deb where (if I remember correctly), she indicated that the reduction is taken from whatever dose produced the low, which means down 0.25U to 2.0U(prozinc folks, please correct me if I'm wrong-- I could definitely be misremembering :().
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Hi Nan that's what the Sticky says, just don't want her to have another day like today with him dropping too low/again
 
Nan & Amber (GA) said:
Oh good, Elizabeth is here to clear this up!!!! I will retreat back into the shadows on this one...
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No come back, we need to figure this out!! :P

My instinct would be to drop to 2u as well but I thought I saw that you put the lower pre-shot into account and don't base off of it ... perhaps that was for Lantus?? @Deb & Wink help us figure this out? XD
 
errrrgggghhhhh.... Honestly, I feel like the prozinc discussion is outside whatever expertise I might have, but I can say something about lantus:

Panic said:
I thought I saw that you put the lower pre-shot into account and don't base off of it ... perhaps that was for Lantus??
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With Lantus, you always have to take the depot into account. So, if you were dosing at 2.75U for a week and got a low off of a BCS, you would (usually) ignore the BCS and assume that "the depot done it" and reduce off of the 2.75U that built the depot.

My understanding with Prozinc (such as it is) is that, while there's some carryover between shots, it's not nearly as big a factor as the Lantus depot, so you focus more on the shot that produced the low than previous shots.

Plus, there's the fact that @Danidahl had to fight those low numbers for a while...
 
Hello everyone! I am so sorry I just saw these. His pre-shot number was 597 so we shot the 2.75 dose. We did 2.5 dose for over a week and his numbers were still really high. He only went to the 2.75 on Monday, going to take a reading in a little bit to make sure he isnt shooting down but with such a high preshot number I am not super worried about a hypo. I really appreciate your help. Today was horrible and I am exhausted. And I confirmed with my vet twice that they wanted me to shoot for anything over 30 because it went against everything I had previously read. The conversation went from her telling me not to test, me saying I would be testing no matter what, and her saying if I continue to test she wants me to shoot anything over 30 and doesnt want to get panicked voicemails from me and to just shoot as she has prescribed. I am looking into a new vet but for now I am just trying to get his dose right myself (and with the help of all of you wonderful people). I will lower him back to 2.5 in the morning and try it for a few days to see how it goes because I really don't want him to have another day like today. Hope everyone has a good night!!
 
My recommendation would be to drop the dose to 2U. That is based on Carlos dropping too low on the 2.25U dose this AM. He's bouncing sky high now at PMPS, but that is to be expected after the lows this AM. BLACKS = BOUNCING in almost every instance. RED BG ranges mean the same, a bounce.

Nan & Amber (GA) said:
I don't "do" prozinc dosing as a rule, but in this case, since Carlos dropped below 68 on an AT2, I think he's earned a reduction under any dosing method, right?

I believe I once had a conversation with Deb where (if I remember correctly), she indicated that the reduction is taken from whatever dose produced the low, which means down 0.25U to 2.0U(prozinc folks, please correct me if I'm wrong-- I could definitely be misremembering :().
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You're correct Nan. Reduction needs to be taken based on the current cycle insulin dose for Prozinc.
Yes, the reduction was "earned" since Carlos dropped below 68 on the alphatrak (that is like 50 on a human meter). The exception would be if the member has a LOT of test data and knows how their cat reacts to the different carb levels of food. That is not the case with Dani and her Carlos. She is too new to this "sugardance" to make those kinds of choices to keep the dose higher when her cat dropped so low today.

Personally, I think Carlos is being overdosed, and is dropping too low at night. Need some tests during the PM cycle to show us what is happening then.

Dani, as you can see there are varying opinions and suggestions on what the dose should be for your cat Carlos. This happens sometimes, and ultimately you hold the needle and need to make the decisions on how much insulin to give your cat Carlos.

We really want to try to find an insulin dose that you can give the same amount both AM and PM cycles for several days. Plus, let's see how fast Carlos clears this bounce.
 
Thank you Deb. I will probably feel more comfortable lowering his dose for a bit, especially after today. Why do you think he is dropping low at night? Do cats drop lower at night than they do during they day? For his dose reduction, do I always take it at .25? Or Should I go lower?
 
Danidahl said:
Thank you Deb. I will probably feel more comfortable lowering his dose for a bit, especially after today. Why do you think he is dropping low at night? Do cats drop lower at night than they do during they day? For his dose reduction, do I always take it at .25? Or Should I go lower?
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Cats just usually drop lower at night, I can't tell you why
We usually decrease or increase by 0.25 units
 
Danidahl said:
Why do you think he is dropping low at night? Do cats drop lower at night than they do during they day?
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Many cats are more active at night, and more activity burns up more glucose, so they drop to lower BG levels.
I'm also seeing lots of reds and black BG ranges on the SS, which to me says the dose is too high, and is taking him too low sometime during the cycle. When is the question.

The way to find out the answer to that question, is to do some testing. A good test to get is the "before bed" test, around +2 to +3. And maybe set an alarm to get a test around +5 or +6. Yes, I know, OUCH on your beauty sleep but testing can't be avoided at night, or you only have half the picture of what is going on.

Danidahl said:
For his dose reduction, do I always take it at .25? Or Should I go lower?
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Dose reductions at this particular dose are in 0.25U increments. Only if your cat is more than 1 year since diagnosis, the the guidelines are different. If the nadirs are >200, than larger dose increases are needed.

Dani, would you start a new thread please, and link this one in at the top? When threads get too long, it gets hard to follow them. Plus it makes the database behind the scenes slower to work. Thanks.
 
Danidahl said:
And I confirmed with my vet twice that they wanted me to shoot for anything over 30 because it went against everything I had previously read. The conversation went from her telling me not to test, me saying I would be testing no matter what, and her saying if I continue to test she wants me to shoot anything over 30 ...
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One word: horrifying.

... and doesnt want to get panicked voicemails from me and to just shoot as she has prescribed.
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Ever get the feeling someone's in the wrong line of work?

The treatment approach she advocates could result in panicked calls alright.

I am looking into a new vet
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Don't walk, RUN!


Mogs
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Thanks Mogs! I felt very similar and am really upset with the vet. She is the third one I have gone to and got really annoyed when I said I was testing and showed her my spread sheet. She said I was taking it too seriously and that I just needed to trust that she knew what she was doing. The only good thing that came from the visit is she wrote me a prescription for ProZinc so that I could move away from the Vetsulin. I just moved to the area right before Carlos got diagnosed and am finding a lot of the vets near me are pretty terrible when it comes to cat diabetes. I got a few recommendations from the fb group for vets that are around an hour away and am hoping one of them ends up working out
 
Danidahl said:
She said I was taking it too seriously and that I just needed to trust that she knew what she was doing.
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To which the appropriate reply would be:

"Excuse me, but I take treating my cat with a potentially lethal medication very seriously indeed, and I'd rather trust what my cat's blood glucose is doing, thank you very much (especially when you're telling me it's OK to give insulin to an already hypoglycaemic cat!)."

I wish you every success with your vet hunting, Danielle.


Mogs
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