Has anyone heard of 6-hour dosing with BCP PZI?

[Puddles' Person]

My cat recently (2 days ago) was started on BCP PZI (bovine) and while researching a link by Elizabeth Hodgkins, DVM and her PZI protocol, it stated that " PZI is insulin that can be dosed as early as +6 hours after the last shot when the rise in BG has been confirmed. In fact, at the start of TR, we recommend you try as much as you can to dose every +6 hours with a BG confirmed to be rising over 150, to get the overlap working for you as soon as possible."
I was surprised to read this but being a newbie, especially on this insulin, I wonder if anyone has heard of and/or tried +6 dosing (provided the BG is still high.) Thanks.

Molly and Donut

 

[BJM]

We prefer to stick to 12 hour dosing until testing shows it is necessary to shoot more often.

Check our protocol for ProZinc, which is similar to PZI, here and the older one for PZI here.

This may be safer to follow, as it is more consistent with major veterinary protocols.

 

[Sue and Oliver (GA)]

Since ProZinc generally has a nadir at 5-7 hours after the shot, I would not consider dosing at +6. We generally say that it could be dosed every 8 hours (three times in 24 hours) IF you have the data to show that insulin is needed that often. I would not start out thinking about dosing more often than every 12 hours.

We don't advocate the TR protocol unless and until the cat has not done well with the regular 12 hour cycle. Our protocol is more conservative and we feel, much safer.

 

[Puddles' Person]

Thanks so much, Sue and Oliver. 6-hour dosing sounded a little scary to me. There is so much conflicting information out there but safety is what really concerns me, especially just starting out as I am. Thanks so much.

Molly and Donut

 

[Puddles' Person]

BJM,
Thanks so much for your advice and the links to the protocols. I had never heard of the 6-hour dosing till I read that particular article but it sounded a little scary to me, especially in these early stages with Donut. Thanks so much for the links. I am going there right now and appreciate your help.

Molly and Donut

 

[BJM]

If you've ever looked at how bricks are laid, you'll notice a common pattern where each brick overlaps the one under it by half. This called a 'running bond' pattern. I think of dosing every 6 hours as dosing in a running bond pattern.

The protocol you mention tries to have more insulin start coming in when the previous dose is starting to expire, so the overall glucose control is very tightly limited in fluctuation. Without vigilent monitoring, however, you can run into problems very quickly. The nadir, or lowest glucose level is not a constant amount of time from the shot. It can vary with numerous factors such as food batches, changes in activity levels, changes in feeding patterns, stressors in the environment, and so on. If the overlap is too much, the cat may get into hypoglycemia which can be fatal. And it means you need tobe home to monitor the cat at a minimum of every 6 hours. That is very difficult on most folks schedules.