? Change dose?

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Peppersmom72

Peppersmom72

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I've switched Pepper to Prozinc and because it is a low dose, her BG numbers are through the roof.
When can I change her dose?
 
Why did you go down to one unit when you switched? Usually you switch insulins at a comparable dose - just a bit lower, but not all the way back to one unit. At first glance I would say to increase right now, but I'm wondering if there is more to the story that I need to know before I say for sure? And we can also talk about how much to increase.
 
Djamila said:
Why did you go down to one unit when you switched? Usually you switch insulins at a comparable dose - just a bit lower, but not all the way back to one unit. At first glance I would say to increase right now, but I'm wondering if there is more to the story that I need to know before I say for sure? And we can also talk about how much to increase.
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The vet said to start at 2. When I asked on here if that was correct, I was advised to start at 1.
 
Was that out on the Main Health forum? I'll see if I can find the thread - I'd like to see why that was recommended....
 
Sorry that took so long. You have a lot of threads out there! :)

Here it is: http://www.felinediabetes.com/FDMB/threads/need-some-help-please.188593/

I'm guessing from reading through the threads that the one unit was suggested out of caution because it sounds like you're gone for long hours during the day and are somewhat limited in how much you can test. Is that correct?

In general yes, increasing by a full unit is too much too fast. Though there are times when we recommend it when it's still early like this and the starting dose is just too low. I'm going to tag @Kris & Teasel to weigh in on this since it looks like she's been following your history through a number of your threads and I have only skimmed a bit.
 
I can only test AMPS, PMPS and up to +6 after pm insulin. I work an hour and a half away from home. Evenings and weekends is where I do majority of her testing.
 
Peppersmom72 said:
Ok, thank you. Yes, I've posted alot. I had a lot of questions and this seems the best place to get answers. Everyone is so helpful.
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This is a great place, and I'm glad you're posting and asking questions! This is such a great community! I've been on here for a couple of years and still ask questions and seek out other opinions when I'm making decisions. It's a wonderful, caring, smart group of people!
 
Peppersmom72 said:
I can only test AMPS, PMPS and up to +6 after pm insulin. I work an hour and a half away from home. Evenings and weekends is where I do majority of her testing.
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Oh wow, that's a long commute! I'm guessing that's why it was recommended to start a little lower - just to make sure Pepper is safe. I do think I'd like to see you increase sooner rather than waiting the full week (that's what is usually recommended on the initial dose), but again, let's see what Kris says since she has more history with you.

Are you around this weekend? If Kris hasn't had a chance to check-in before the morning dose, I'd say go ahead and stick with the one unit in the morning, and then tomorrow is Friday evening so if you're around for the weekend, we can maybe make an adjustment then.
 
I will definitely be around this weekend. I can also check my email periodically during the day to see what she responds with. Thank you so much for your help.
 
Yep, looks like you're due for an increase! I agree with Djamila...if you do it when you're home to keep an eye on her, it'll be best. I'd do the increase tonight (Friday night) and that way you can keep an eye on things. :) Unless Kris suggest otherwise...she's been following you I see.

Also, welcome! Ask us any questions you have...we're happy you're here and happy to help!
 
If you prefer the u100's, they can be used with prozinc if you use the conversion chart:

http://www.felinediabetes.com/insulin-conversions.htm

If you decide to go that route, be very careful and play around a bit first to make absolutely certain that you understand how to do the conversion. I use the u100's so I can make more precise changes in dose and not have to guess so much for the in between doses.
 
Just seeing this now - needed an early night last night. :) I've reread the previous thread discussing Pepper's inappetance, etc. The 1 u starting dose was suggested because advice givers were being cautious. I like Djamila's suggestion to raise the dose tonight and monitor more on the weekend. You'll be going up a full unit to 2 u which is closer to her required dosing range. Some cats have an initial bigger reaction to a new dose so I'd test her at +2 tonight to see if she's dropping more quickly than usual.

Keep posting here - small forum and your posts will be seen quickly (usually!).
 
Kris & Teasel said:
Just seeing this now - needed an early night last night. :) I've reread the previous thread discussing Pepper's inappetance, etc. The 1 u starting dose was suggested because advice givers were being cautious. I like Djamila's suggestion
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Ah! I missed that there was a history of inappetance too! Thanks so much, @Kris & Teasel! I figured there must be a reason for starting that low. Is that resolved now?

Do you feel okay about a full unit increase in this case, or do you think a 0.5u would be better? It's still early enough that Pepper hasn't really adjusted to the one unit which makes me think the big increase might not be too bad - coupled with peppersmom72 (I'm sorry, I dont' think I know your name....?) being able to monitor this weekend if she gets bouncy. But since this is a bit unconventional I just want to confirm I'm not crazy for thinking we should do a vet-sized increase instead of a protocol-sized increase.
 
@Kris & Teasel
Yes! You are correct. That is why I was asking if a dose increase was appropriate to do now only a few days in. She needs it. I didn't want to just do it, if it was too soon. She will get 2u this evening for her pm shot, if that's correct?
 
Djamila said:
Ah! I missed that there was a history of inappetance too! Thanks so much, @Kris & Teasel! I figured there must be a reason for starting that low. Is that resolved now?



Do you feel okay about a full unit increase in this case, or do you think a 0.5u would be better? It's still early enough that Pepper hasn't really adjusted to the one unit which makes me think the big increase might not be too bad - coupled with peppersmom72 (I'm sorry, I dont' think I know your name....?) being able to monitor this weekend if she gets bouncy. But since this is a bit unconventional I just want to confirm I'm not crazy for thinking we should do a vet-sized increase instead of a protocol-sized increase.
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My name is Missy. Pepper's appetite has been pretty good.
 
Djamila said:
If you prefer the u100's, they can be used with prozinc if you use the conversion chart:

http://www.felinediabetes.com/insulin-conversions.htm

If you decide to go that route, be very careful and play around a bit first to make absolutely certain that you understand how to do the conversion. I use the u100's so I can make more precise changes in dose and not have to guess so much for the in between doses.
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I'm not comfortable with the conversion. I'll stick to using the u-40 syringes. Pepper doesn't seem to mind. She's the boss. Lol
 
Just doing some thinking out loud here: increasing to 2 u tonight is doable. If you feel more comfortable going to 1.5 u tonight that's reasonable too. How do you feel about it, Missy? You've said Pepper is eating well right now.
 
If Prozinc is safer than Novulin N then I'm ok with the increase to 2u. Her appetite seems good right now, but that can change in a blink of an eye.
 
Peppersmom72 said:
If Prozinc is safer than Novulin N then I'm ok with the increase to 2u. Her appetite seems good right now, but that can change in a blink of an eye.
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Yes, ProZinc is a gentler insulin with a slower onset in general. Try 2u tonight and get that PM dose +2 test. You'll need a little time to see her particular reactions to ProZinc. :) Do you have appetite meds on hand in case she decides she won't eat? Many people with kitties who are like this have a supply at home all the time. Would your vet agree?
 
@Kris & Teasel ,
Ok. I will do the 2u tonight and do a +2 test. When does Prozinc "usually" get it's lowest? I noticed Novolin got to it's lowest around +5.

Yes, I have appetite meds on hand that the vet gave me, if needed.
 
Pepper hardly ever eats during the night.
I leave food out for her, but she doesn't touch it.

Is that going to cause a problem with Prozinc?
 
Peppersmom72 said:
Pepper hardly ever eats during the night.
I leave food out for her, but she doesn't touch it.

Is that going to cause a problem with Prozinc?
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No, it shouldn't. If you can, set an alarm for a mid cycle test (in the +5 to +7 range) tonight and Saturday night. That data can help you see what she does on the dose overnight. I can't leave food out either because Teasel's sister would eat it and she's on a hypoallergenic diet.
 
It doesn't look like Kris is online right now (unless she's hiding ;)). Going up at +2 isn't uncommon. BG will rise after eating, and then start falling when the insulin kicks in. Onset for Prozinc is generally around +2, so the +2 test will often (especially earlier on or when the dose isn't high enough yet) show a rise, the +3 will hopefully start to show the beginning of the drop.
 
Djamila said:
It doesn't look like Kris is online right now (unless she's hiding ;)). Going up at +2 isn't uncommon. BG will rise after eating, and then start falling when the insulin kicks in. Onset for Prozinc is generally around +2, so the +2 test will often (especially earlier on or when the dose isn't high enough yet) show a rise, the +3 will hopefully start to show the beginning of the drop.
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Should I test again at +3 or wait until +6?
 
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