Need evening dose advice, BCP-PZI

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ursa68

ursa68

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Colby is a high dose, suspected acro cat. We've been slowly going up the insulin ladder with PZI. If you see his SS, you will see he has been flirting with some 300s recently, but was back up in the 400s last night. Tonight, his preshot is 211. That has NEVER happened! I even checked it twice. I upped his PZI dose this morning to 22U. That and the fact that he went to the vet this afternoon for some bloodwork are the only things out of the ordinary. Now I don't know what dose to give tonight. I went ahead and fed him and am waiting to check again after an hour. I'm scared to give a full 20+U dose tonight w/ a preshot that low. Any suggestions?

I'm reposting this to the general health forum.
 
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Just looked at your SS. Is he still dropping?? Looks like his numbers are dropping with no insulin.
 
Yup, just now checked again, he's at 172. This is strange. He's eating his evening snack now. I don't know what's going on. I'm going to continue to watch the rest of the evening just to see where this goes.
 
If it is IAA (insulin auto-antibodies) instead of acromegaly, you may have pushed through the antibodies.
I would not shoot a dropping number.
 
Cindy, what you're seeing yesterday is clearly a bounce. It appears you're close to the right dose, getting those nice blues, but you can imagine what his body was thinking of them OMG!!! That's why the bounce today. We don't recommend "shooting the bounce number" (no increases) - it is reactionary of their bodies. I think your 15u was a good choice... I prefer a reduction over a skip - even if just a small token dose of 25-50% of the regular dose. It may be that you see some additional wobble from the bounce, so don't be surprised if you don't see good numbers again, right away. But know that you're getting closer to where his body is starting to respond.
 
Thanks Lu-Anne! I sure hope to see more good numbers. I wish I could be home more to monitor him... I wouldn't cut back so much if I could be there to check him throughout the day.
 
@Grayson & Lu Out of curiosity, on the day where his PMPS was 211, and he continued to go down, what would you have shot? If you recall, that was the day I skipped the dose entirely.
 
I never had many "low" numbers on ProZinc... but like I've said before, 250 was my do not shoot number. I probably would have waited a little for a rise, then called it a night with a skip. The next dose I might have done a slight reduction (75% maybe).

I say this, but there were MANY MANY times when I first started seeing lower numbers on Lev that I did a 25% dose, then climbed back up slowly. A lot of those decisions were based on how much I needed to be able to function at work the next day, and/or how exhausted I was. I always tend to err on the side of caution, as I am the best caregiver when I'm coherent.

You had gone from 20u to 22u (a 10% increase), PLUS R the previous cycle. Some people see a residual from R for a couple cycles - with R, every cat responds differently. That combination probably is what got you to the blue. The red/black afterwards was clearly a bounce. So no surprises.

My only words of wisdom tonight would be to only adjust one variable at a time. Either the basal dose, or the bolus. You're getting close, so you will be doing more fine-tuning than a giant dose up the climbing ladder.
 
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