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Theresatramondo

Theresatramondo

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Hi, Me and Tiffy are having trouble adjusting her insulin. Tiffy is on prozinc and I am attempting at a sliding scale. There is history on her spreadsheet. Her preshots are too high no matter what I do. I need help uploading the spreadsheet. Can you help deb?
 
okay, unbeknownst to me her ss is attached.
Please help with insulin amounts????? My heart is hurting. She seems okay, but had such a high Nadir today at 2.75, almost better when she was on 2.25 in am. :cry: :?
 
Hi and welcome to our PZI group.

Your spreadsheet is linked and I can see it fine.

I'll have to go over to health and read up on your background and history.

Are you testing for ketones? Are there any other health issues.
 
07/04 Tiffy +5 406 help

Hi, Tiffy just has a chronic URL and is on Azithromyocin. She is still coughing and sneezing, but not as much is nearing towards the end of the course. She will be at vet next week.
She is in pretty good health, and it is hard to get ketones off her, so No.
Also her ear is shot from curves. The doctor said test another spot, and I can't test more than amps, nadir, pmps and nadir. Too much on her little ear.
He will check her ear when he sees her.
I just need a sliding scale help with dosing. Based on tonight's pmps, I will raise or lower, but just as an aside, she sometimes lowers after nadir slightly, so she will either spike or lower into the 300s. so 500s or 300s. That is her path. I didn't feed her after + 3, and only a quarter of a can of evo as she needs to still gain, so she is getting approx. 1 can am and 1 can pm unless she is in the 100s, then I give her more, and she gets treats right after am and pm meal. just a little loving.

rb_icon
 
DRAFT Sliding Scale
Edits from those who have used sliding scales with ProZinc, please chime in!!!

So far, your spreadsheet shows
1.50 units of insulin drops as much as 100 mg/dL
2.00 units of insulin drops as much as 200 mg/dL
2.50 units of insulin drops as much as 200 mg/dL
2.75 units of insulin drops as much as 300 mg/dL

Maybe start with:
>550 - 3.50 units
>450 - 3.00 units
>350 - 2.50 units
>250 - 2.00 units

>150 - only if you are home to monitor, have stalled 30 minutes without feeding to make sure it is rising, AND she is not ill. Maybe 1.5 units to see how it goes.
 
Thanks a lot Beejay K. Got it this time, lol. I am so bad with initials :lol:
I will try this tonight.
The sore on her mouth went away. I think the l-lysine, which is good but not making me feel any better because I keep wondering if she has FHV.
 
Thanks a lot Beejay K. Got it this time, lol. I am so bad with initials :lol:
Click to expand...
Theresa, think you must have a mental block with B J M (not K)'s name. ohmygod_smile :lol: :lol: :lol: TT strikes again. :roll: :roll:

Nobody ever spells my first name right so Deb was the shortest I could make it and is easy to remember. Don't care, as long as you keep asking for help, it doesn't matter to me.
 
I havn't finished reading yet.

BJM your approach to a scale is much more scientific than mine has been and is worth trying. I usually start with a good dose on a given PS, weed out bounce numbers and analyze how the doses effected the cycles (should it have been higher or lower) etc.

The key to shooting a sliding scale is to stay one step ahead of it and try to anticipate what the next cycle might do, (are the numbers high because of a bounce that might wear off this cycle, then you might want to lower the dose) etc. Also when a step in the scale doesn't work then we can tweek that part of the scale higher or lower to fit better.

With all of the high black numbers I don't really see a good starting point for me. There were some nice cycles on the lower doses but that was a while ago.
 
Using this scale will require you to be very attentive to glucose tests around the nadir. So far, it looks like the nadir may be around +4 to +5 for the most part.

Because I'm guessing on the higher doses that you haven't shot yet, those are the ones I suggest you try when you are home to monitor, or can be awake until the probable nadir, or even stay up steering with food if the dose turns out to be a bit too much. And be sure you have some high carb and medium carb foods on hand, just in case. "Be prepared" is more than the Boy scouts' motto.

Fair warning: I view the dosing as a single subject research project. You have to find what works for your cat and for you. Sometimes, you may decide incorrectly and have to compensate; this is just more data to refine your approach ... and sometimes it can mean staying up a good deal of the night.
 
I think I like BJ's scale. The only dose I feel less than comfortable with is the 1.5u dose on the 150ish number. Until you shoot a number under 200 to see what happens when you start a cycle that low, I'd go with 1.0 units at the most. If your data shows that 1u is ok on a 200, and there's room at nadir to increase, that's what you could consider doing.
 
The key to shooting a sliding scale is to stay one step ahead of it and try to anticipate what the next cycle might do, (are the numbers high because of a bounce that might wear off this cycle, then you might want to lower the dose) etc.
Click to expand...

I agree completely with Robin. Using a sliding scale relies a great deal on instinct. And your ability to determine if a preshot number is high because there was a low nadir that caused a "bounce" or if it was a pretty flat cycle with no low number in the middle - in other words, the high number is "natural" rather than "caused" by a low.

As long as you can get preshot numbers and tests at nadir, a sliding scale is, in my opinion, the best way to go with Prozinc.
 
The really import thing is to be careful. If your gut says not to shoot, or to reduce, listen to it.

When you look at the spreadsheet, you'll see there is variable response to the same dose in the same starting range of numbers.

When in doubt, assume the biggest drop could happen and be conservative shooting until you have more data to see if there is some consistency.

As an additional safety measure, you might test 30 minutes to an hour before the pre-shot to make sure the glucose is rising.
 
BJM said:
The really import thing is to be careful. If your gut says not to shoot, or to reduce, listen to it.
Click to expand...

I so agree with the above statement. I have Simon on my own sliding scale and it is based more on my gut and what he has been doing most recently than on old number in my spread sheet. I also get to observe his food through out the day and also know if any of his numbers are influenced by his last munch session because I let him free feed.

Listen to your gut cause no one knows your cat better than you do. confused_cat Sometimes you are even right. Sometimes like me, you will panic and put up the 911 and ask the community for advice and of course that is alright too. nailbite_smile Just know that when you do it for a while, you will get a feel for what the right dose is. Will you always be right? Hell to the no. ;-) Cats change how they react to a dose daily it seems, but we make the best educated guess that we can and usually we do ok. Best to you both! :smile:
 
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