Am I just being impatient???

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Annemarie/Tigger(GA)

Annemarie/Tigger(GA)

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Hi everyone, how long Does it take to see a change in BG numbers after you up the dose? Maybe I'm just being impatient, but I've up'd Frazzles dose from 1u to 1.2 and I figured I would see almost an instant change. Am I wrong? I spoke with my vet and she wanted me to up him to 2 units, is that too much to fast? What does everyone think??

Thanks guys!
Annemarie
 
I know we sound like a broken record, but you are missing the most important part of the picture when you don't have nadir (midcycle) numbers. If he is flat midcycle, then you increase. If he goes low midcycle, then no. If you can't get nadirs during the day, set the alarm for 6 hours after the night shot.

No, I would not increase by more than .25 - .5 at the most. But I wouldn't change the dose at all without at least one nadir number.
 
You.may need to wait at least 3 days (with Cass at least a week) to see any effect. Like Sue said, you don't want to increase too fast.
 
I haven't come across in my readings about the nadir number, so no broken record sounds here. It's not possible for me to wake up during the night and take a reading so I'll have to do it during the weekend. How many nadir numbers do I need? Do I need to track them everyday? If so, I won't be able to. How much does feeding before the mid cycle shot affect the number? Im at work during the week but on the weekends he does eat small meals during the day.

Thanks
 
A few cycles with preshots plus nadirs will give us a lot of info to work with. The food just becomes part of the info. The only time you need to limit food is 2 hours before the preshots. You want a preshot number that is not food influenced.

If the numbers show us that smaller more frequent meals help, you could consider an automatic feeder for feeding during the week.
 
Annemarie/Tigger said:
I haven't come across in my readings about the nadir number, so no broken record sounds here. It's not possible for me to wake up during the night and take a reading so I'll have to do it during the weekend. How many nadir numbers do I need? Do I need to track them everyday? If so, I won't be able to. How much does feeding before the mid cycle shot affect the number? Im at work during the week but on the weekends he does eat small meals during the day.

Thanks
Click to expand...

There are a minimum of three times you should test each day.
Before am shot, before pm shot, and just before you go to bed.

The first two tests are to be sure it's safe to give a shot, and the last test is to be sure your cat's numbers have not gone too low as many cats go lower at nite.
I would not worry about setting an alarm to get up in the middle of the nite for testing; you can wait until a day off or the weekend to do some curves. When you have time, testing ever 2 hours between shots will give you an idea how the insulin is working, and start to show you where YOUR cat's nadir is located, general vicinity as nadirs don't stay put. After a few curves, you will have an idea how your cat is doing on insulin and when you see the lowest numbers.

People work or are away during the week so nobody can do testing during those times. Just test when you can, but be sure to get the above 3 tests done each day. Missing a test before a shot could be dangerous as you may be giving insulin when your cat is already very low..... not a safe idea.
 
I disagree with Gayle (Blue). (This board is based on peer review. We don't always agree on strategy.)

You wanted to know whether you need to increase the dose. The only way to get that information is to see how the insulin is working, and the number that will be the best indicator of that is the nadir - somewhere around 6 hours after the shot. With ProZinc, the three numbers that give us the best information are the two preshots and the midcycle number. Even one midcycle number will help us figure out what range of numbers he is getting with the insulin.

Get those numbers when you can. If it isn't until the weekend, then that is when you'll get them. He is not in awful numbers so we can wait. I would not suggest a curve, which is testing every 2 hours during the day. I would just suggest the preshots and a midcycle number or two. Then we can help with a dose strategy.
 
You asked about tracking nadirs daily.... since you don't know your cat's nadir, the best way to locate it is by random testing at different times along cycles, not by getting only the +6. Get some +3s, some +4s, some +5s.... they are all data.

I was not able to get daytime +6 numbers from Monday to Friday as my work was over 1hr away from home, so there was no way I could come home, test, and get back to work without taking over 2hrs for lunch.... my boss would not have put up with daily 2hr lunches.
I was able to get a nitetime +4 or +5, a bedtime test on weeknites. Sometimes, I was home in time to get a +11 before dinner, and I often would get a +2 in the evening. I never once set an alarm to get a +6 and it would not have mattered because one of my cats had a +5 nadir or earlier, and the other had a +11 nadir.
Not that many cats have a +6 nadir; many are earlier, and a handful are quite late.

On the weekends, I would do curves on Sat and Sun, testing every 2 hours or so and into the evening until bed time.

So a minimum of 3 tests per day during the week, with curves on the weekends were more than sufficient for me to identify my cats' nadirs.

While I did not use any P insulins, it has been shown that Lantus and Levemir are longer lasting with nadirs further along than the P insulins, so a bedtime BG test would be sufficient during the week for your cat on PZI.

I will not comment on your dosing as I have not used this insulin.

Gayle
 
I agree with Sue. If you need to figure out if the dose needs to be adjusted, you need to know the preshot numbers and the nadir number. A lot of people think that Prozinc is dosed based solely on the preshot numbers, but that isn't correct. You have to know the highs and the lows of a cycle to find out if the dose it too high, too low, or just right.
Unlike Lantus or Levemir, where the dose is based on the nadir number, and you would be shooting lower preshot numbers than you would with Prozinc, you can't shoot insulin on preshot numbers that low (100 or even less) with Prozinc. The "L" insulins are longer lasting, and just work differently than Prozinc does. IMHO, Prozinc is easier to "understand", but the "L's" are easier to use, because the protocol gives you great guidelines and steps for you to follow.

While an "on the way to bed" or "on the way out the door" test is a good idea (because it can tell you in advance if a cycle is going to include lower numbers in the middle), if you go to bed two hours after a shot, it isn't going to tell you much, because the insulin is just starting to reach the "onset" point where it just starts to affect the BGs. With Prozinc, a test 3 or 4 hours after the shot can give you a sneak preview of what's in store this cycle.

What can you do as far as testing? Everybody has a life they need to live outside of treating a diabetic cat. Do you work all day during the week, making mid-cycle tests on weekdays impossible? Tell us what your "life" schedule is, and we can help you come up with a test schedule that works for you.

Carl
 
That's for the responses everyone, I really do appreciate it. I do work during the day, I'm out of the house at 7 and don't get home till 6. I work 5 days a week, Monday through Friday. And I work 1-2 Saturdays a month.

I'm still confused though...he still has high numbers all across the board, so wouldn't I want to increase his dose. It's not good for him to stay in the 300 range right?
 
While it does look like the numbers are high, there's too many "blanks" to know for sure. At first glance, yes, it looks like you could increase. The issue is, by how much? You can't tell that easily. If you can, on the weekend, get some tests, day or nighttime, in the 5-7 hours after the shots range. If you know the "lows" and the "highs", then it is easier to figure out how much of an increase would be safe.

Carl
 
Probably, but the only way to know that an increase is needed is to see how the insulin is working. And that takes midcycle numbers.

For example, if he is going down to 50 midcycle and then bouncing back up to the 300s, an increase could be dangerous. If he is flat through the cycle and in the 200s at midcycle, then an increase would be good. If he would be higher at midcycle than preshot, it could be an inverse curve which might require a dose decrease.

You hold the syringe and you can give more insulin if you want to. But we are reluctant to give you advice to do so without having more information.

Will you be home this weekend and be able to get some midcycle numbers? If not, if he were my cat, I would bite the bullet and wake up and get a midcycle number at night. Then you'll have the info you need.
 
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