9/25 Squamee AMPS 280 A dosing question

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judy and squamee(GA)

judy and squamee(GA)

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AMPS 280 .4u
+2 184
+4 214
I will continue testing, but I guess this means that her nadir is before 4? It may have been a skinny dose, I was struggling with the syringe markings (pretty sure I have it right now). If she goes way up by tonight, I am wondering how to proceed. I could go up to .6. Or is it better to stay at one dose for awhile?
 
Hi Judy,

With Prozinc it is usually best to stick with a dose for awhile to let it settle and let her body adjust to the insulin. But since you're just starting you could go to .6u instead. Whatever dose you decide on I would stick with it for at least 3 to 5 days so we can see a picture develope of how she's doing.

Usually you will see the bg rise for the first two hours so you got a pretty steep drop right away. Are you going to get a +6 and on?
 
The usual advice is to hold it at least 3 cycles. I think 3 DAYS or 6 cycles is the max. The recommendation for holding doses has steadily gotten longer and longer for some reason which IMHO potentially draws out the regulation process longer than necessary.

PZI is so flexible. If you want you can change the dose every shot - variable dosing. You are lucky that you know 1U is a dose that you kitty really responds to. So you can chose which strategy you want. I think that since you are trying to ensure the numbers do not go too low you may want to adopt a variable dosing strategy. Rather than going against your intuition and holding a dose that may take you kitty into low numbers you do not feel comfortable with. Maybe others here will feel different?
 
+6 282BG I am hoping it doesn't skyrocket by tonight. I am feeling inclined to go to .6. Or maybe I will wait till tomorrow morning, as I will be around during the day. It's curious, mostly she wasn't this high even when she was on no insulin at all.
Also, I remain puzzled by her behavior---she seems more comfortable as the insulin wears off. I know someone suggested that may be her getting used to the insulin---I guess a few more days will make it clearer.
 
It's interesting that she had an early drop then stayed the same from +6 to +12.

It does take time for them to adjust back to the lower numbers again.
 
Looks like you are getting back in the swing of things Judy. There are a few other former OTJers around lately and I know from what they've said it's an adjustment to get back to it. And Squamee went OTJ so fast too, I don't know you had long enough to really have a comfort level with some of it, but hopefully it'll feel natural soon.

I cringed when I just read (a few days posts ago - I'm just getting caught up) your vet started you on 1u :shock: cuz I remember how dramatic Squamee could respond to the insulin. Thankfully looks like it all went well (didn't they start you on 3u or something last time around? wow, weird to think back on THAT!) and you are on a more conservative dose for starters. No need to stay up all night with the hypo kit handy again, I remember one or two of those you had last year, yikes! Of course she may end up needing 1u, but just in general terms I'd be cautious in the 1st few days as her body adjusts to the insulin, before considering going back to that dose.
 
PMPS+12 283BG .4U
+2 202
+3.25 220

This means the nadir is between 2 and 3 hours? DOes that mean the insulin duration is likely to be short? Less than 12 hours?

Hi Joanna! Nice to hear from you. Yes, I did start at 3U last time around. Shocking, no? And almost immediately had 2 all nighters with you. At the time I didn't even realize how very low she went!
 
Nadir is the lowest point of the curve.
http://petdiabetes.wikia.com/wiki/Nadir

The duration is normally less than 12 hours - like about 10 hours.

Of course, Joanna has done a great job explaining these terms in the PZI Sticky and I would refer you to that too.

+2 might be the lowest point of this curve [but the 'normal' peak hours 4-8 are not known currently in this curve]. And +2 was the lowest recorded on your last .4 dose too. Ultimately these curves may have little to do with a curve once you give this insulin for a while and kitty gets used to it. BUT this is good data you are getting. You can kind of go along here and see what this does does as this approximate PS or maybe what % drop you can expect from a given dose. Meanwhile you are also gaining confidence.

It seems the common thought with ProZinc is to give it up to 45 days to kind of settle out. So you may see some moving around of things during that time.

Also, your feeding schedule may impact the curves. I am a proponent of free-feeding [for non-obese or obese-prone cats]. Normal cats should eat 10-20 small meals per day [according to SACN 4th ed - still need to look this up in 5th ed.] and free feeding helps approximate this. Free feeding also help to minimize the effect of food on the curve.

I would also make sure to note that you CAN dose an 'odd number' dose like .5u or .7u which would just be between the appropriate lines. So if you wanted to up the dose you could conceivably do that in .1u increments and not just .2u increments. With the small doses you are giving a smaller dosing change might be warranted. I certainly had better success with small dosing changes [sometimes even "0.05"u changes] - especially when we started ProZinc. "Smaller more frequent dosing changes" - that's something I like to pontificate about. :-D
 
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