I don't think the insulin is WORKING

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123joan

123joan

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I upped Lucy's dose from .8 to 1 unit about five cycles ago. Her BG doesn't seem to ever go down. I'm worried. Maybe I handled the ProZinc too harshly? My vet told me to swirl it, which I imagined as a figure 8, which I have been doing, but it's not a rolling maneuver, like I just saw demonstrated on a ProZinc video on youtube featuring Dr. Mike.

Talk about obsessing! Now I'm worried that the ProZinc is damaged. Am I crazy?

Is there something else I should be doing? Should I take her to the vet? She is eating fine, and purring, lays around all the time but that's her mode.

Shouldn't I be seeing a nadir somewhere?

Or should I be patient and wait a few more cycles?

:(
 
After stewing over this all night, I realize the insulin must be working SOME, as her BG levels would rise quite a bit after she eats. Right? I still don't see that she has much of a curve if one at all.

AMPS 333
1 unit
 
It's working, because there is some drop in the middle, just not much. I don't know if it's a case of too much insulin or too little. You dropped quite abruptly from 1.2 to 0.8 a while back, so I'm not really sure how to read what's going on. I'm having to increase myself--Cass has gone from 0.6 up to 1.0u in the last couple weeks and I'm afraid I may need to go up again soon (yesterday was nice, but today he's back in the mid 300's).

I'm not really sure what advice to give you. I've always had the best success with holding a dose for at least a week (two is better if the numbers are just "iffy") before I make changes. I would say hold for a few more days to see what happens, unless your numbers go over 400 again.

Hopefully someone else will chime in soon.
 
I'm with Lisa, Joan. I would hold the dose awhile - maybe till you can get a curve? It does look like she is pretty flat, but you only have that one number to gauge it with. I wonder if she is lower before or after that mid number? After a curve, you will have the info to see if increasing is a good idea.

There are really only two ways to know if ProZinc isn't working - either the numbers get wonky or you see floaties. A curve should eliminate one of those factors?
 
I'll be able to do a curve Saturday or Sunday. Won't be able to test tomorrow mid cycle at all. So glad to have FDMB for support, thank you ALL.
 
Just because I tend to be more agressive than some others, I'll throw my 2 cents out there...

ECID, and Cass is a great example of that credo. Lisa has learned by doing this for a while, that it takes sometimes a week or more for him to settle into a dose change. Other cats can show immediate results. Not sure yet what Lucy thinks.

So, I'm not one to "hold a dose" if I don't see results in two or three days.

The other big difference in my thinking is "dose adjustment increments". I think (just MY opinion), that the dose adjustment needs to be big enough to be "different", so the smallest increase or decrease I tend to advise is .25u at a time. I think that .1 increments don't tell you much, and that differences in BG when you only adjust by .1u can be explained just as easily by meter variance or any number of variables that go on inside or outside kitty's body on a day to day basis than on the actual dose adjustment.

My basic theory is that a dose, any dose, should give you at least a 50% drop from AMPS or PMPS to nadir. If not, then the dose is most likely too low. That's easy to say, because I'm not the one with the 200 AMPS worried that the nadir might be 50 or below if the dose is too high. But if you can "be there to watch", and you are confident that you can manage low numbers with food/karo etc if/when low numbers appear out of nowhere, then I think you can be more aggressive.

It all comes down to the caregiver's level of comfort regarding testing and low numbers. Not saying anyone should think like I do.

Carl
 
I can find maybe three instances where her BG has dropped 50% from AMPS or PMPS to nadir, the most recent being 9/11. I can't recognize any sort of pattern for her, so how can I come up with a plan or theory?

This morning her number was lower, for a change
AMPS +232, where did that come from? I continued the same dose.

If I wanted to increase dose by .25 unit, how would I measure that on the the U-100 syringe? The doses go in increments of .2 units.

I don't feel as if I'm learning anything about Lucy's patterns. Except that they don't look like I WANT then to look!

Curve planned for this weekend.
 
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