First Curve Complete! Need Advice On What To Do Next?

Alright! I just finished up with Tootsies first curve. Now I need some advice on what we should do from here. Just as a reminder, our vet started him out on 2units of Prozinc twice a day. I've read repeatedly that you shouldn't ever start that high and someone mentioned maybe he should start on a lower dose and see how he does? Because his perfect dosage could of been missed? These are the times I need the most help because it all confuses me right now. So I need your expert opinions on what we should do next. I appreciate all your help so far. Thank you!

 

Good job! I don't think, based on your numbers, that 2 u is too high. I would increase to 2.25 u tomorrow AM. Hold that dose AM and PM for 3 or 4 cycles and increase to 2.5 u if you don't see lower yellows and maybe some blues.

You'll have to eyeball that 2.25 u dose. Do your syringes have half unit marks on them? If not, do your best to estimate 2.25 u and aim for consistency dose to dose rather than absolute accuracy. It can help to draw up that dose in coloured water as a visual reference.

 

I agree with Kris that 2u isn't too high, given the numbers you're seeing. I think you can go to 2.25 a Kris suggested, as long as you increase again in three cycles. Or you could even do a 0.5u increase if you are feeling comfortable testing and Tootsie is tolerating it well. When a cat is above 200 at nadir, the protocol suggests the slightly larger increases, but only if you can monitor.

It appears that you somehow have the old version of the spreadsheet. How in the world did that happen?!?! Anyway, on your spreadsheet it indicates that 40 is the start of hypo. We now use 50 as the reference number for that as an extra margin for safety. I just want to make sure you're aware of that since your spreadsheet won't cue you. Also, when reading around here, we often refer to "lime green" as a reference to a hypo number. Since your spreadsheet will give you lime green on anything under 100, please know that your lime greens will be a good thing (as long as they stay above 50).

 

Thank you for the replys. I am apart of a feline diabetes support group on Facebook as well and one of the admins set my spreadsheet up for me. We have decided to increase to 2.4units starting tomorrow morning. We were going to do 2.5units but we are going to use the U100 syringes with the conversion chart and 2.4units was the closest we could get for the conversion. Ive made a note on my spreadsheet that we would be using the U100 syringes at the U40 dosage. I am totally comfortable monitoring and testing him now but with me switching the dosage tomorrow how often do you think I should check? I'm always told before each shot, so AM and PM and then again at least 3 hours after PM shot. I should be able to get in a few tests tomorrow if needed but with it being Saturday we do have some errands that need to be done tomorrow.

 

I'm glad you caught that, Djamila.

 

This is the basic routine we recommend:

1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
3. do extra tests on days off to fill in the response picture
4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
5. post here for advice whenever you're confused or unsure of what to do.