Need advice on dose for tomorrow AM please...

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Lisa & Harry

Lisa & Harry

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Hi, Harry's PMPS tonight was 190. I waited 20 minutes and retested and got 188. I didn't give him his shot based on the Prozinc protocol. I fed him and had to run out for awhile tonight. Just got back and tested him. BG=537 at +4. Well, would have been +4 if I had given him his shot. I wasn't expecting it to be that high. Thought if it were still sort of low waiting to his morning shot would be fine. When I saw it that high I wasn't sure what to do, so I gave him 1 unit. Figured it was better than none, but probably not enough to do much unfortunately. I didn't want to mess up being able to give him his AM dose. But maybe I did. :( I'm worried about what I really should be doing now. Any advice would be great. Thanks!
 
Something to remember for the future "Better too high for a day than too low for a moment." This means, that barring ever having diabetic ketoacidosis, it might have been OK to just skip the shot, even if he was high, so you could resume your normal schedule in the morning.

Some analysis:
On 4/20, 2.5 units dropped the glucose roughly 100 mg/dL. This suggests that you might get about 50 mg/dL drop on 1.25 units. If you were able to monitor for a bit, it might have worked to shoot a reduced dose, on time, rather than skipping. PZI is flexible that way.

I would test tomorrow at the normal shot time to see what you get.
Then, if the glucose is still high, maybe shoot then, but calculate the dose cautiously based on the rough 50mg/dL drop per 1.25 units, because you are overlapping 2 doses and they won't add together predictably. And, by evening be back on schedule.

Continue getting mid-cycle tests whenever you can. That will help you see how much drop you get with given doses within given time frames and that will let you estimate what you might give at different pre-shots, letting you develop a sliding scale for dosing.

Does that make sense to you?
 
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Yes, this helps a lot! If his number is still really high, would you consider a normal dose? Or no matter what should I not even consider a full dose till tomorrow night?

One other thing? Any thoughts on the sudden low number tonight? That's a lower number than I usually see at his midpoint. Or are some days just off and that's all there is to it maybe?

Thanks so much for you help!
 
It's that darn Every Cat is Different thing (ECID). Some cats react immediately to a diet change and insulin. For some it takes several weeks for their body to adapt. Although more data in the future will give you a clearer picture, he may be a kitty that took awhile to adapt. Regardless, the lowering of levels and consequently insulin is a good sign. A little nerve wracking for you, but a good sign.
 
Sue and Oliver (GA) said:
It's that darn Every Cat is Different thing (ECID). Some cats react immediately to a diet change and insulin. For some it takes several weeks for their body to adapt. Although more data in the future will give you a clearer picture, he may be a kitty that took awhile to adapt. Regardless, the lowering of levels and consequently insulin is a good sign. A little nerve wracking for you, but a good sign.
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I sure hope things are headed the right direction. Harry had decent number tonight. It IS nerve wracking though. Thanks for the pep talk!
 
Lisa & Harry said:
I sure hope things are headed the right direction. Harry had decent number tonight. It IS nerve wracking though. Thanks for the pep talk!
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Thinking of you this morning, Lisa. Know the feeling well about it being nerve-wracking. It does get easier, though - just takes a little time.:bighug:
 
Hi Lisa - maybe the 500+ # was a bounce? Not sure, but it's terribly frustrating and scary - you did the right thing - you couldn't shoot a falling number Even after all the months, occasionally Murphy's prozinc will last 12=14 hrs, and I get the high pre shot #, and it still throws me way off. It will get better as you get more data -- and don't worry - many cats get these wonky #s occasionally You're doing just great - you have good instincts
 
Thank you both for the moral support! It's much appreciated. Harry was at 268 this morning which isn't too bad; for him anyway. And tonight, his PMPS was 127, so no shot. So curious to see what tomorrow morning will be. I'm hoping this is a trend and not just a fluke. Keeping my fingers crossed :)
 
Lisa, if he gives you a shootable AMPS #, I'd say you'll want to reduce that dose, as what this is telling you (one # shootable, the other not) is that 2.0 units is too much insulin for him.
 
I'm thinking that he may have dropped quite a bit at mid-cycle (daytime cycle) on 4/26; looks to me like he's been "bouncing" ever since ...
 
I'm thinking you might want to go back to 1.5U. 2 units is obviously too much, but we didn't really give 1.5U much of a chance (only 1 cycle) ... and I'd try holding that 1.5U dose for a few cycles (unless, of course you end up with another unshootable pre-shot #). And would be good for you to get at least some mid-cycle #s tomorrow to see how Harry's processing that dose through tomorrow's cycle.
 
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