Advice on skipping dose, what's too low to shoot?

[Kim3803]

I just want to hear a few different opinions on this so I can be better prepared next time.
Jax is on Prozinc Currently up to 6.25U 2x/day.
He is very new to blues and last night for his PMPS he was 97 first time in the green. I was in total shock and decided to skip the dose after quickly reading through the prozinc dosing guide. I know I could of or should of stalled and tested again in 30-60 min.
This morning he was 402 which I figured that would happen. I do have a few questions.
-Since skipping the dose and him rising that high, is that going to mess him up to the point of regressing?
-If this happens again where it is a low pre shot number, even if stalled, do you shoot or not? Do you give a partial? if so, how do you calculate how much of a partial?
I know these are complicated questions since every cat is different and has different circumstances.
Any opinions/advice is great appreciated.

 

[Librarianista]

I don’t have any answers to your questions, but I would have probably done the same thing in your situation.

I’m on a different insulin, but the first time I did a fur shot, I was worried about what her results might be, but she eventually came back down. I do not think one skipped shot is going to mess up any progress for more than a few days.

 

[Kim3803]

I don’t have any answers to your questions, but I would have probably done the same thing in your situation.

I’m on a different insulin, but the first time I did a fur shot, I was worried about what her results might be, but she eventually came back down. I do not think one skipped shot is going to mess up any progress for more than a few days.

Thank you so much, I appreciate it.

 

[Sienne and Gabby (GA)]

Prozinc's very different than Lantus (which is what Chloe's caregiver's use). Prozinc doesn't rely on a depot for it's action.

The data that you collect today will give you good information and help to inform your decision making the next time. In fact, your pre-shot (402) is history by your +2 (258). I suspect that Jax will be back in blue numbers this cycle.

The challenge is that you will need to consider where your comfort level is with shooting lower numbers. Seeing that first green pre-shot is always a surprise! If you'd posted last night, other than suggesting stalling, it would have been helpful to see when Jax's numbers began to rise. Again, this is good information so you have some idea as to whether it's safe to shoot. At this point, all we know is that by +3, numbers jumped up considerably. It also helps to remember that Prozinc onset isn't immediate. You see relatively flat numbers from pre-shot to +2. This tells you that feeding your cat is propping the numbers up and that onset of the new dose is after +2. This gives you a cushion for shooting a lower number. (Today is a bit different given yesterday's skipped shot.)

As for shooting a reduced dose, there's no hard and fast rule. I would have likely suggested reducing by 0.5 to 1.0u.

Given that Jax is on a dose that's over 6.0u, has anyone suggesting getting him tested for a high dose condition?

 

[Kim3803]

Prozinc's very different than Lantus (which is what Chloe's caregiver's use). Prozinc doesn't rely on a depot for it's action.

The data that you collect today will give you good information and help to inform your decision making the next time. In fact, your pre-shot (402) is history by your +2 (258). I suspect that Jax will be back in blue numbers this cycle.

The challenge is that you will need to consider where your comfort level is with shooting lower numbers. Seeing that first green pre-shot is always a surprise! If you'd posted last night, other than suggesting stalling, it would have been helpful to see when Jax's numbers began to rise. Again, this is good information so you have some idea as to whether it's safe to shoot. At this point, all we know is that by +3, numbers jumped up considerably. It also helps to remember that Prozinc onset isn't immediate. You see relatively flat numbers from pre-shot to +2. This tells you that feeding your cat is propping the numbers up and that onset of the new dose is after +2. This gives you a cushion for shooting a lower number. (Today is a bit different given yesterday's skipped shot.)

As for shooting a reduced dose, there's no hard and fast rule. I would have likely suggested reducing by 0.5 to 1.0u.

Given that Jax is on a dose that's over 6.0u, has anyone suggesting getting him tested for a high dose condition?

Ok thank you for the information. This is still kinda new and confusing for me. I went with skipping the dose when I seen the ProZinc dosing guide said to skip 150 or lower at pre shot. I wasn't comfortable enough or knew if I should of or how much partial I could give.
Jax is just about 4 months in now and he's just starting to stay in the yellows and some blues. My vet has been extremely unsupportive with no help and wrong information so I have been learning and asking questions on here since the diagnosis. I have heard of the testing for high dose but since he is still kinda new to this I didn't really look into it yet. I know that yes 6 units can be a lot but I always hear they need what they need and other cats are on much higher doses. Again I know every cat is different.

 

[Sienne and Gabby (GA)]

It's absolutely true that a cat needs what they need when it comes to insulin. However, we've found it helpful that once a cat is at 6.0u, getting the cat tested for acromegaly and insulin resistance can help to inform your dosing.

I'm tagging @Wendy&Neko who can help give you more guidance regarding high dose issues.

 

[Kim3803]

It's absolutely true that a cat needs what they need when it comes to insulin. However, we've found it helpful that once a cat is at 6.0u, getting the cat tested for acromegaly and insulin resistance can help to inform your dosing.

I'm tagging @Wendy&Neko who can help give you more guidance regarding high dose issues.

Thank you, I appreciate it.

 

[Wendy&Neko]

Hello from me. My girl got up to 8.75 units, and had two conditions that can (but not necessarily) mean that a cat needs a higher dose than the majority. Those conditions were acromegaly, a benign pituitary tumour that sends out excess growth hormone, and IAA or insulin auto antibodies. You can think of it a bit like an allergy to the injected insulin. The antibodies bind to the insulin, making in unavailable for the body to use. Studies have shown that 1 in 4 or 5 cats has acromegaly. There are other conditions that also cause to need more insulin, like pancreatitis, hyperthyroidism, heart conditions, but tyically those cats don't need over 6 units. Which is why we suggest getting tests for those conditions at 6 units in dose. The vet can draw the blood and send it to Michigan State University for both tests. More details on the conditions are in this forum: Acromegaly / IAA / Cushings Cats

 

[Kim3803]

Hello from me. My girl got up to 8.75 units, and had two conditions that can (but not necessarily) mean that a cat needs a higher dose than the majority. Those conditions were acromegaly, a benign pituitary tumour that sends out excess growth hormone, and IAA or insulin auto antibodies. You can think of it a bit like an allergy to the injected insulin. The antibodies bind to the insulin, making in unavailable for the body to use. Studies have shown that 1 in 4 or 5 cats has acromegaly. There are other conditions that also cause to need more insulin, like pancreatitis, hyperthyroidism, heart conditions, but tyically those cats don't need over 6 units. Which is why we suggest getting tests for those conditions at 6 units in dose. The vet can draw the blood and send it to Michigan State University for both tests. More details on the conditions are in this forum: Acromegaly / IAA / Cushings Cats

Thank you for this information, I appreciate it.