A question about the reducing 0.25 unit when BG below 90

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Liang & Nathan

Liang & Nathan

Member Since 2020
Hello everyone,

I have read the post of "prozinc dosing method" a few times and still have a question about the reducing 0.25 unit when BG is below 90.

So If I get a number <90, I need to decrease the dose by 0.25 unit.

How long should this reduced dose hold? Just one time? or 3 days? or 1 week?

If I give the cat the reduced dose and then on the same day I get another number <90, should I reduce another 0.25 unit again?

I am very grateful for many kind and warmhearted advices I received from my previous postings. You are really really helpful.


http://www.felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/

It says "
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit"
 
Hi---

I'm really not familiar at all with the Prozinc dosing methods, but I'll do my best here.

What we do with Lantus SLGS is to hold each new dose for a week, unless there's another drop under 90. In that case, there's an immediate 0.25U reduction, and the 1-week clock starts over.

My reading of the text above is that it's very similar/identical to the Lantus SLGS method text so this interpretation should hold, but if a Prozinc users contradicts this interpretation, go with them!
 
Nan & Amber (GA) said:
Hi---

I'm really not familiar at all with the Prozinc dosing methods, but I'll do my best here.

What we do with Lantus SLGS is to hold each new dose for a week, unless there's another drop under 90. In that case, there's an immediate 0.25U reduction, and the 1-week clock starts over.

My reading of the text above is that it's very similar/identical to the Lantus SLGS method text so this interpretation should hold, but if a Prozinc users contradicts this interpretation, go with them!
Click to expand...
Sorry Nan maybe you can tag Deb. Yours is the only tag that works for me :(
 
Liang & Nathan said:
How long should this reduced dose hold? Just one time? or 3 days? or 1 week?
Click to expand...
Until the BG levels tell you otherwise. This is NOT a one time reduction. or for 3 days. Or for 1 week. The reduction holds until you are not seeing good response from the dose reduction. It depends on YOUR cat's reaction to the reduction.

Liang & Nathan said:
If I give the cat the reduced dose and then on the same day I get another number <90, should I reduce another 0.25 unit again?
Click to expand...
Maybe, maybe not. Usually not, if you get another BG number in the same cycle that is <90. Maybe if you get another BG number that is <90 in a different cycle (AM vs PM). Or spanning a 24 hour cycle from PM one day to AM the next day.

For example, in the AMPS cycle, if you get a 88 at +3 and then a 84 at +6 in the same cycle, that is only ONE dose reduction.
If you get a PM cycle of a BG 77 at +2 in the PM cycle, and dropped to 43 at +4, that would be a second dose reduction and some serious testing and food support to bring your cat out of the low 40's and back to a safe level. UNLESS ( and there are always exceptions) you know your cat does not hold reductions well, then you hold off on the reduction.

Unless your cat has a history of ketones or DKA, then you try to stay steadier in the dose, and never skip a shot.

There is NO insulin depot to take into account, when using Prozinc. So I don't think that back to back dose reductions are called for in the Prozinc dosing protocol. Not 100% sure on that. You can always take a second reduction, then increase the dose again if the reduction fails to hold the numbers lower. But you have to wait out any bounce from the lower numbers, just like you have to do with the depot type insulins.
 
Deb & Wink said:
Until the BG levels tell you otherwise. This is NOT a one time reduction. or for 3 days. Or for 1 week. The reduction holds until you are not seeing good response from the dose reduction. It depends on YOUR cat's reaction to the reduction.


Maybe, maybe not. Usually not, if you get another BG number in the same cycle that is <90. Maybe if you get another BG number that is <90 in a different cycle (AM vs PM). Or spanning a 24 hour cycle from PM one day to AM the next day.

For example, in the AMPS cycle, if you get a 88 at +3 and then a 84 at +6 in the same cycle, that is only ONE dose reduction.
If you get a PM cycle of a BG 77 at +2 in the PM cycle, and dropped to 43 at +4, that would be a second dose reduction and some serious testing and food support to bring your cat out of the low 40's and back to a safe level. UNLESS ( and there are always exceptions) you know your cat does not hold reductions well, then you hold off on the reduction.

Unless your cat has a history of ketones or DKA, then you try to stay steadier in the dose, and never skip a shot.

There is NO insulin depot to take into account, when using Prozinc. So I don't think that back to back dose reductions are called for in the Prozinc dosing protocol. Not 100% sure on that. You can always take a second reduction, then increase the dose again if the reduction fails to hold the numbers lower. But you have to wait out any bounce from the lower numbers, just like you have to do with the depot type insulins.
Click to expand...

Thank you very much. I really appreciate your reply. Very very helpful.
 
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