Need help understanding

[Dragonfly229]

I am confused on a few points about insulin in general and Pro-Zinc in particular. Hopefully someone can help me.

It is my understanding that Pro-Zinc has an approximate 12 hour duration, and that it takes a while after injection to begin working and then to reach it's optimum level, roughly 5-7 hours. With that said . . .
Why is there so much worry about giving insulin at the right time with a BG under 200? As you can see from Linus' spreadsheet last night, the minute the insulin wore off he rocketed up over 400. If I had shot at the right time when his BG was 185, I could have avoided this and possibly kept him in better numbers. Since the insulin does not kick in drastically immediately, why is there fear that it will drive the BG down? As soon as the last dose wears off, the new one is there to keep him on track.

I can see not shooting under a lower number, say 125-140, and definitely checking to be sure that a lower number is rising and not falling before shooting, but I feel like I've lost ground by not supporting his lower numbers with more insulin, but instead letting him shoot high and then starting over. With the desired curve it seems like the right thing is to give more insulin as the old insulin wears off, to keep the highs and lows regulated and the BG level more stable.

So what am I missing?

 

[Catannc]

Can't answer on the insulin, but have been reminded repeatedly myself that meters have a 20% variance/error which would mean 186 would be considered the same as 200. Maybe somebody could give a tip on what to do when you see 175-225 readings preshot, test again in a few minutes?

 

[Sue and Oliver (GA)]

In general, we tell new diabetics not to shoot under 200 because they don't have the data to know how the cat is responding to the insulin. So we err on the side of caution. His daytime cycles have looked better lately. I think what is missing with Linus is enough data to know what to do. I know you never have a consistent schedule but any data is better than none. Maybe this week you could get a test every time you are around - going out the door, coming in the door, before bed, when you wake up at night (if you are old enough to have that problem :mrgreen: )

After you have an idea of how he responds, you can shoot earlier. You need to be sure he is headed up and not down. The reason you need to be careful is that if you are shooting off the 12/12 schedule, it is easy to lose track of how long it has been between shots. It gets complicated. That's why most people use it - it requires less thought and monitoring. It is safer. For example, you wouldn't want to shoot a pmps at +10 and then an amps at +10 because you would be shooting then 8 hours between shots. There can be some overlap with PZI with some cats and that does enter the picture. And cats throw curve balls - suddenly going down at +10 when they were seemingly headed up. Shooting off schedule isn't something that would be easy to do on a consistent basis without quite a bit of additional monitoring.

We have one member who shoots 10/14 because her cat consistently is low at amps and higher at pmps.

We have several people shooting three times a day, every 8 hours. If that would fit your schedule better, you could send a pm to kse (Kim) who has been doing it a long time. The important thing is to be sure you are shooting a rising number and monitor carefully and often. I am not sure that would be an option for you.

I hope I haven't just confused the issue. It wouldn't hurt to shoot early every once in a while if Linus is clearly headed up. You just need to watch it on your next cycle.

The other part of this puzzle is food. Are you feeding him small infrequent meals so his pancreas is supporting day and night?

PZI is one of the only insulins when you can shoot off a 12/12 schedule as it is the only one without a shed (which does give a lot of overlap), otherwise you could consider another insulin.

Hopefully others will have other ideas for you.

 

[Dragonfly229]

I feel like I'm staying pretty close to a 12/12 schedule. I'll slide early or late sometimes by 30-45 minutes, to try to flex for upcoming schedule changes, but mostly we've been at about 8:30am and pm. And I've always had a number in the 300's or 400's, so it hasn't been an issue until now.

I'm feeding about 4 times a day, 1/2 of a 6 oz can each time, or a whole 3 oz can in the evenings. You'll see that on the spreadsheet as .5TD or .5PP, etc. I've been trying to see if any particular food affects his BG dramatically, but so far it's pretty random.

 

[Sue and Oliver (GA)]

You got in trouble last night because you had a low pmps and were going to need to shoot much earlier this am so you skipped, is that right? If so, that cycle and this one will probably just be squirrelly and you can start new tonight.

30-45 minutes shouldn't be an issue as long as you think about it the next cycle and see if things changed.

 

[Dragonfly229]

I was trying to shoot at 8:00pm so my son could shoot at 7:15 this morning. Instead, we ended up skipping because I couldn't shoot any later and still get a shot in this morning. So I gave the shot at 5:00 am instead of 7:15.