From 400 to 40 and back

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Steph

Steph

Member Since 2013
I've attached a spreadsheet. Numbers were still too high on 3.5 2X day Prozinc. (We switched a month ago from Lantus.) Now at 4, they are crazy low, as right now. (I just gave syrup.) As you can see, I did not shoot at all the other night after a low number at night, only to awaken to 400s.

My vet thinks something "else" is going on here. I need to fix this, and it is not for lack of trying.
The sheet is a bit of a mess because of a wonky meter that is now in the garbage, and Confirm is set and doing nicely.

Your thoughts? Pancreatic damage?
 
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Might it just be that he hit 'that dose' that's going to start bringing him back down? I don't know anything about ProZinc apart from in theory as I've never used it, but if 4 is too much and 3.5 not enough, is there any way you could measure 3.75 to see if that keeps him somewhere in between?

And yes, your ss is working fine now :)
 
He just measured 437 and I shot 4 again. I will temper tomorrow, per your suggestion. There has to be some "center" here. Thanks!
 
It's the only thing that looks like it would make sense - the 4 units didn't take long to drop him low after you increased the dose. It has to be worth a try at a dose in between to see what he can do with that. Good luck tomorrow! :)
 
I think he is bouncing around. If he were mine, I would shoot less for lower and for higher preshots, and try to get a nadir each cycle to see how the dose is working.

For example on 3/24, he got 4 units on 182 and the insulin lasted more than 12 hours, giving you an unshootable pmps. So that dose seemed too high. The next morning he was really high, not unexpected after 24 hours since the last shot. On 3/26, it looks like 4 units is too high even for 300, as he had a nadir under 50. How about 3/3.5 for pre shots over 300 and 2.5 for pre shots in the 200s and 1.5/2 for pre shots under 200. (With ProZinc, we urge those new to the insulin not to shoot under 180/200, but to stall 20 minutes, without feeding and retest. You want to make sure he is rising so as not to shoot a falling number.). My thinking with the lower dosing is that, if you give less and it doesn't take him low enough, then it is easy to raise the dose a smidge. If you give too much, then you have to deal with low nadirs and pre shots too low to shot and it is harder to decide how much to safely reduce.

He is definitely responding to the insulin. I think you just need to tweak the dose. You could post on the PZI forum and get daily advice on your dose choices, if you want.
http://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/


Also, have you seen the protocol we put together for ProZinc?
http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/
 
Hi Sue. Thanks for this. You made words fit a rather untenable situation. No, I didn't see the protocol, but I will study it this weekend, and revisit your notes. I didn't expect this one to be so challenging, but I am determined to master this. Back to you soon.

My ? is: Will I ever be able to just shoot and not test so much? Be on a schedule? Or am I dreaming?

I also thought it was important to stay with/maintain a dose? (Or was that Lantus?) That's what I've been trying to do, believe it or not...
 
Well, I would always suggest testing before each shot, just because you can't be sure when they will throw you a curve and be lower than normal. It is nice to have a nadir every few cycles so you can see how your dose is doing.

Some cats prefer a steady dose with ProZinc; some cats do well on a sliding scale. It depends on the cat (doesn't it always:D). Even with a steady dose, you have to expect different results shooting the same dose into a 400 versus a 200. ProZinc is an in and out insulin so you don't get the longer flatter cycle that you do with Lantus. You shoot and can tell how that dose worked that cycle. But with ProZinc, you can adjust faster. The insulin is more adaptable. If it works better for the cat, you can shoot different doses am/pm. It isn't a big deal if you have to shoot a little earlier or later; the 12/12 schedule is a little looser.

One thing that might also be helpful is to look at the PZI forum remission thread - (it's at the top of the forum)and see what different cats' path to remission looked like. ProZinc is absolutely an insulin that follows the idea "every cat is different". That makes it easier to work with in some ways and harder to work with in others.:mad:
 
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