dosing advice cross posted Prozinc PMPS 132

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Ferndoc

Ferndoc

Member Since 2015
I'm in a 20 minute wait to see if Fern is rising. This morning he was at 376 and 305 at +6 so obviously a late nadir. I'm planning on giving either 1u or 1.5 if he is on the rise. The 132 is a human meter, I have decided to cross check either low or high numbers with the AT and it is 212. Thoughts.
 
Sue in GA gave me the advise of 1u on a rise. (Upon further refection I likely could have given 1.5 units as well.) I can't figure out if I'm happy or frustrated to have two lower numbers in 2 days. He seems to be either higher than I want or lower than I want. Come on kitten can't you do a nice slow downward slope. ;)
 
Ferndoc said:
Sue in GA gave me the advise of 1u on a rise. (Upon further refection I likely could have given 1.5 units as well.) I can't figure out if I'm happy or frustrated to have two lower numbers in 2 days. He seems to be either higher than I want or lower than I want. Come on kitten can't you do a nice slow downward slope. ;)
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let me share something that julie wrote that I saved...


I'm quoting Julie&Punkin here from another thread. Whatever you choose will be the right choice.
I'll check in the morning and see how things went!

ok, more about shooting lower numbers.

This is a particular passion of mine, although I didn't really "get" it until punkin had been treated for his acromegaly and his dose was dropping unpredictably, so I didn't personally shoot low. However, in the past several years since he's passed away, I've seen over and over that the way to get control of blood sugar is to shoot the full dose into normal numbers.

Now I don't think you were ready to do that yet today! You don't have enough information (data) on Mocha just yet. But the way to GET to that point is to get a variety of tests in.

Lantus and Levemir are really good at holding blood sugar flat. But they are not so good at bringing down high numbers. So you get those crazy drops when you shoot a high number - maybe 300 points or more even, after you've shot a really high number. Then inevitably, the numbers shoot right back up before long. Now you've got another super high number to shoot. Eventually, as you get to a good dose, you'll end up with a lower number at preshot. Might only be 175. Shooting that number, with the full dose, can lower your whole range of blood sugar. Now obviously, you can't do that when you're going to leave. But if you're home, your kitty is not sick and eating normally, you have plenty of strips and high carb food - then GRAB the opportunity as a chance to flatten out your cat's blood sugar.

The first time, just shoot something like a 150 or above. The next time you have the chance, try lowering the number to something like 120. Then try a 90. Even for those following SLGS, you can learn to shoot lower - it is in the sticky. Since you're following SLGS, that would be your lower no-shoot number.

The important thing is to work up to it so you have DATA that shows what YOUR cat will do as you shoot lower.

It also helps to look at spreadsheets of people who have done this. You're looking for green amps - then looking across the row to see the results. Then notice as the person continues shooting green preshots, how the spreadsheet often will turn all green, or all green/blue. Here are a few - these were both following Tight Reg, but the principle is the same:

Davidson - start at February when Shawna began to shoot green preshots
Vyktor - start at Feb 12, 2012 (Australian style dating on the ss 12/2/2012) when Serryn shot a 110. His really significant changes started about a month later in March when his ss went all green.

Both of these kitties went OTJ. Not every cat does, but looking at their spreadsheets can help you see what is likely to happen when you do work up to shooting low.

Furball - look beginning July 9, 2015 - Carla has been following SLGS with her. She's on an OTJ trial right now!

Here's a post that Libby wrote about a variety of topics - shooting a dropping number is on post 6.

You also want to read the SLGS sticky on handing low preshots - there is an initial section for those new to this, then there is a second section for once you have a little more experience. Usually the first time people will suggest that you stall to let the blood sugar rise and then shoot. Some people get stuck on stalling as a strategy and keep doing it over and over. Or they always reduce the dose when they have a lower preshot. These are good strategies to use initially to see what your cat will do, but there are other options in that sticky that can also be tried, with the goal to getting comfortable shooting lower numbers.

I like to give the example of golfing & mini-golf. Both involve clubs, a course and a ball, but other than that they have little in common. Shooting low and shooting a high number are much the same way. The results you get are not very similar when you shoot high versus shooting lower. Shooting low is like mini-golf. the ball doesn't move much and it stays flat. Shooting high numbers, like playing regular golf, actually has the potential for huge drops and then huge bounces from it - it goes far, it's harder to know where it's going to land, too. I think shooting higher numbers is actually riskier than shooting low.

The caution with all of this is to know your cat, work up to this, read lots, don't do it when you can't monitor, and ask for help if you want someone experienced to see if it's a good time to try it. Experienced members following Tight Reg will shoot most everything over 50 if everything is normal with their cat. Experienced members following SLGS will shoot most everything over 90. We encourage new members to ask for guidance for anything under 150 - but the sooner you get enough data that you can shoot lower numbers, the greater the possibility of remission for your cat. Shooting lower numbers (50-120) is the path to going off of insulin - honestly, i haven't seen it happen any other way. If it does, it's unusual and it would only be in a very newly diagnosed cat.

You also don't have to do this! There's nothing that says you need to - I'm just explaining how it can work in cats so you know you have this option, IF you want to try it. You always hold the syringe and the choice is always yours.

i do want to encourage you without pressuring you - there's no way to understand the intricacies of this Sugar Dance if people don't explain it. Others certainly explained it to me until I got it, too. When you understand how things work, it's easier to step forward into unknown territory.
 
Ferndoc said:
Sue in GA gave me the advise of 1u on a rise. (Upon further refection I likely could have given 1.5 units as well.) I can't figure out if I'm happy or frustrated to have two lower numbers in 2 days. He seems to be either higher than I want or lower than I want. Come on kitten can't you do a nice slow downward slope. ;)
Click to expand...
I just want to add-this is from lantus and levimer forum and it may be different with pro zinc as I do not think pro zinc is a depot insulin….
 
jayla said:
I just want to add-this is from lantus and levimer forum and it may be different with pro zinc as I do not think pro zinc is a depot insulin….
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I was going to say I'm not sure this is wise with Prozinc. Others who use Lantus mention not changing dose's while over on the Prozinc forum I have seen many more adjustments to dose based on PS numbers.
 
Ferndoc said:
I was going to say I'm not sure this is wise with Prozinc. Others who use Lantus mention not changing dose's while over on the Prozinc forum I have seen many more adjustments to dose.
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Yes I used pro zinc on a sliding scale--Im sorry I probably should have just waited for someone more experienced to respond--(lesson learned)
When I used pro zinc it lasted about 8 hours in my kitty with no depot I could detect-
 
That's the benefit of having an open, peer-reviewed board, Jayla. If any of us don't get it quite right other members can chime in with additional info. :)
 
Ferndoc said:
Sue in GA gave me the advise of 1u on a rise. (Upon further refection I likely could have given 1.5 units as well.) I can't figure out if I'm happy or frustrated to have two lower numbers in 2 days. He seems to be either higher than I want or lower than I want. Come on kitten can't you do a nice slow downward slope. ;)
Click to expand...
I know how you feel--At first I was so worried when my guy went to normal ranges and hypo--now I crave those greens!! But I did have to figure out his curve and how to manipulate it with food to slow it down from the sky diving!
 
jayla said:
When I used pro zinc it lasted about 8 hours in my kitty with no depot I could detect-
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All insulins will have a general mode of action but that doesn't guarantee a predictable response to any particular insulin.

Different cats respond differently to the same insulin. For example, Saoirse typically metabolizes insulin really quickly. When she was on Caninsulin she would go through most of the dose for a shortcut - sometimes she'd nadir at +2 :eek: and her BG would start rising fairly quickly from about +6 onwards. That said, she would also get a fairly significant bit of carryover from the crystalline portion of the Caninsulin dose but it was not sufficient to keep her in decent numbers; just enough to stop her numbers heading completely skywards. By way of comparison, Lucy's Squallie got a very long dose duration when he first started Caninsulin; it would keep his numbers down for 60% or more of the cycle (IIRC).

Home testing is invaluable in determining an individual given cat's pattern of response to a particular insulin.


Mogs
.
 
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Update, I might not have fur shot, he is holding steady +2 at 223 which kind of surprises me. Yesterday morning made me think it would possibly be up. I'll get a +4 before bed tonight. (Hopefully it will be steady to lower but not to panic land low)
 
jayla said:
I just want to add-this is from lantus and levimer forum and it may be different with pro zinc as I do not think pro zinc is a depot insulin….
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You're right, that advice is specific to Lantus and Levemir because of their depot, but it's also not for folks new to using depot insulins. If a person wanted to try shooting low, which is what you were quoting, they need to post in the Lantus/Lev insulin support group and get advice from experienced people there. Someone experienced could take a look at their spreadsheet and see if it's safe to do, or not. It's important to have enough data to see what's going on and determine that it's safe. It would be very dangerous for someone who hasn't been testing, or whose cat might have had too large of dose increases done, to shoot low. It's only safe to shoot low in the right circumstances. You really have to work up to it and get guidance from some experienced people.

Critter Mom said:
That's the benefit of having an open, peer-reviewed board, Jayla. If any of us don't get it quite right other members can chime in with additional info. :)
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Absolutely! And that's how we all learn, too.

I'll defer to experienced ProZinc users to help her with shooting. When I used it I didn't know anything and wasn't even testing. Fortunately, Punkin survived my ignorance! :)

Good call to tag some people to help, Jayla. Well done. :bighug:
 
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