Another quiz question

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Sue and Oliver (GA)

Sue and Oliver (GA)

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Okay, this one is on dosing.

New member. Started on 3 units of ProZinc.

First day
amps 280 3 units
pmps 350 3 units

3rd day
amps 218 3 units
+8 70
pmps 172 0 units

4th day
amps 200 How much insulin?

Clearly a dose reduction is needed. How much and why?
 
First day is probably a bouce; third day obviously ran long. I'd reduce to at least 1u, possibly .5 given the long run & low number after 24 hours. Need to check for ketones with the substantial decrease. If there's a justification for the high starting dose besides dosing on weight rhat can make a difference on whether to go with .5 or 1u.
 
The newbie should be encouraged to drop the dose to 1.0 unit to start. More frequent mid-cycle tests should be run to determine how low kitty is going, before any kind of dose change is recommended. I would encourage using 250 as a "no shoot" number when starting out.
 
Reduce dose to .5u, with no shoot number of (200). Checking for ketones? If not, do it! :smile: May be some bouncing going on, some cycles running too long. ProZinc is best given two shots/day. Mid-cycle tests would be helpful. And a SS :-D
 
I'll take a shot at this one too.

Obviously the 3u was too high to start and gave a long cycle on day 1. Can't tell what happened on day 1, other than the PMPS was higher, but not "bouncy high".
Data for day #2 is missing, but I'm assuming 3u continued. AMPS on day 3 almost too low to shoot, and I would have advised a reduction that morning. The cycle gave a nice green in the middle, so it didn't go "too deep", but went too long, making a shot that night not possible.
No insulin for 24 hours? And a nice low yellow AMPS on day 4.

Wouldn't want to continue 3u with that record, but not sure if I would drop all the way to 1u as the new "normal".
I would probably recommend 1u on a PS between 200 and 300, and then advise 1.5u or 2u if over 300. I would try to get green nadirs because the one on day 3 didn't seem to cause a bounce to me. I'd try to maintain momentum because with this limited amount of data, I think "OTJ" is a good possibility in the not too distant future.
If that were to continue, I would lower the "no shoot" line to 150 with a small dose like .5u

Carl
 
Long duration on day 3, looks like dosage is too high.
Reduce dosage to 1.25 2x a day and hold for several cycles to see if it allows kitty to have shootable numbers for both AM and PM and stop bounces.
Recommend no shoot number at 200< until newbie gathers more data.
 
Did we pass?? nailbite_smile nailbite_smile

Do you grade on a curve?? nailbite_smile nailbite_smile

Do we get extra credit for attempting the question?? :-D :-D
 
I would say you all passed, but remember I am not an expert. :-D

The interesting thing for me (and I hope everyone) is that while several answers offer different doses, all are viable options. None harm the cat. All offer options for monitoring and possibly changing in the future if the cat is too low or too high. All take in consideration the previous doses and reactions. Some are more cautious and offer a lower dose (I often find myself writing, "I tend to be cautious" when giving advice); some suggest less of a drop but still within a safe range.

The correct answer is that there is no right answer. No one of us can be sure what any of the changes in dose would do, other than not put the cat in danger. If we use the speadsheet history and give a safe option and urge monitoring and a no shoot number, the rest is up to the cat. :mrgreen: We've helped someone who doesn't understand how the data helps yet. And it is clearly something all of you can do. I think the scariest thing for a newbie is to put a request for dose advice out there and not get any response.
 
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