Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need advis

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alicia.1771

alicia.1771

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If anyone is around any advise is very much appreciated...I am at a lost here.

Newly diagnosed on 7/16/11, vet started 2.0 Unit ProZinc BID on 7/19/11 then was told to drop to 1.5U BID on 7/22/11. Beau was eating well up until Sunday 7/24/11 when I need to start coaxing him to eat. Yesterday PMPS was 144 and won't eat so I skipped insulin. This morning was AMPS was 374, I thought about dropping the dose but I'm so new to this disease I didn't want to mess anything up so I gave 1.5U. Now at +6 his BG is 65 and only ate 1/4 can FFC. I am worried because I need to go back to work in about 15min, will he be ok until I come back in 4.5 hours??? I will try to feed him a little more before I go.

If his PMPS # are still low, I should skip the insulin again, right? Help....

I tried to link the SS in my signature to show his BG for the past few days, hopefully it's working.
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

65 is not a hypo number yet and theoretically you should be right around nadir on this insulin although it can differ a little from one cat to another. can you test him again right before you have to leave, to see if it's up or down at all from the 65?

and post?

skipping shots leads to the teeter totter of high low high low. if the pmps is too low for a shot, that's typically a sign that the dose is too high. if it happens very many times, i'd probably suggest reducing the dose a bit more, maybe down to 1 unit, and trying that.
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

Ditto to Cindy's comments....retest and post and if you continue to have unshootable numbers at +12, then I would reduce to 1 unit.
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

Thank you all who have responded, it makes me feel I'm not on a sinking boat by myself.

ok, got him to eat a little bit more, but still total < 1/2 can. BG is at 74 now so I feel a little better. But I'm still confused about what to do when PS is < 200. I know there are a few options but I'm so new at this I really don't know what to do. For example, last night his PMPS is 144 at 7:30pm, not eating, I got him to eat about 3/4 cans FFC + few kibbles (only way he'll eat now) over the course of 2 hours and his BG went up to 175 at 8:30pm then 287 at 10:30pm. So was skipping the shot not the wisest choice? Would a reduced shot be a better choice and can I still do so at such a later time after his scheduled PM shot?

Also, is feeding him dry kibble better than him not eating? My vet gave me some Nutri-Cal, should I try to use that if he's not eating well?

Thanks again for all your input, I've to go back to work now but will be checking the board periodically. Any advise on his PM shot would be very much appreciated.
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

I posted this on the PZI board to get you some help.

You have an interesting situation with feeding dry and still hitting nadirs in the 60s-----so, I would prefer someone else advise you. But I will keep an eye out to be sure you are not alone at pmps.
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

I wouldn't use the nutrical since that is packed with sugars and carbs. If it takes a piece of kibble or two to get him to eat his plate, then that is fine.

Regarding the missed shot last night - by one hour after normal shot time you definitely had a rising number, I would have advocated shooting a reduced dose at that point (1u at the 175 number).

The nadir (lowest point) today was a beautiful number really. If you can estimate it - try going down to 1.25u for tonight's dose if you have a shootable preshot number. Right now what you are seeing is the body starting to work with the insulin. It is wonderful that this is happening so quickly for you guys! A lot of us in PZI call this "momentum" and this could be the beginning of a string of dose decreases. (momentum = when you all of a sudden see long duration and get preshot numbers that are not shootable) You don't want to back down too quickly, but you also don't want to hold it when it is dangerous.

Please post when you have the preshot number for tonight and we'll help guide you along! Feel free to either post here or over in the PZI/Prozinc insulin support group section cat_pet_icon
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

Thank you all for the your advise. I will be sure to post his PMPS # once I get home because I have a feeling it may be < 180 again.

Question and possible scenario for tonight:
1) do most of you test before or after eating? I generally test him first, then feed him, then 30 min later give his shots when his numbers were in the 250-400 zone.
2) if his PMPS is < 180 and not eating well, do I give a reduced dose at PM shot time or monitor and give a reduced dose later (and how late can that be)? I really want to keep him on a good schedule to not mess up his insulin response.
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

Wow...you sound like me!

One thing you might try if he continues to not eat the FF. Switch do a different canned food. Kit ate his FF for 3 days with no problem and no kibble. Then all of a sudden, REFUSED to eat it at all. I switched to a different canned food (out of desperation) and bam! He started eating again. Just a suggestion, every cat is different :)

And yes, him eating the dry is better than him not eating at all. I've had to ween Kit off of his dry. Today is his first day with no dry! Just sprinkle less and less on top of his food every day. His BG will rise quicker and higher if he is eating the kibble. So as you ween him off, you may have to adjust the dose. Sorry I can't help you on the dosing, I'm new to this myself!

I think most people probably, test, feed, shoot.
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

Always test before feeding.
I always fed then shot within minutes. You don't have to wait to make sure his bg is going up. The food will make his number rise before the insulin kicks in. PZI is a slow acting insulin. It will eventually catch up. My routine is test, feed, shoot all within 15 minutes.
Carl
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

alicia.1771 said:
Question and possible scenario for tonight:
1) do most of you test before or after eating? I generally test him first, then feed him, then 30 min later give his shots when his numbers were in the 250-400 zone.
2) if his PMPS is < 180 and not eating well, do I give a reduced dose at PM shot time or monitor and give a reduced dose later (and how late can that be)? I really want to keep him on a good schedule to not mess up his insulin response.
Click to expand...

1. Most of us test > fed > shoot all within like 15 min. No need to wait 30 min to give insulin with prozinc

2. If his pmps is above 150 and is a rising number, you can give a reduced dose. In this case 0.75 to 1u and monitor for the evening. The specific dose depends on the specific number you get tonight.
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

ok, just tested him, his PMPS is 138. Going to feed him now and will post shortly how much he ate.

Any suggestion on PM dosing???

EDIT: his appetite is better tonight, ate 3/4 cans of FFC and the remaining 1/4 with a few kibbles. His PM shot should be at 7:30pm, should I go ahead a give a reduced dose (say 0.75U or 1.0U) or test again at 8:00pm before deciding on dosage???
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

Can you go ahead and retest now to see how much of a rising number you have? Have you fed yet?
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

He is at 198 now, 45 min after eating 1 can FFC + few kibbles. So I guess it's ok to give him ProZinc, just not sure the dosage. Given his low #'s at +6 and PMPS, is it reasonable to give him a reduced dosage? Should I do 0.75U or 1.0U instead of his normal 1.5U?
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

I personally would go with 0.75u just to be safe. Tomorrow morning, depending on the number, you can try 1u or 1.25u.

Next time this happens you want to try to not fed just yet. Food will always make them rise and you want to be able to tell if the insulin is wearing off and giving a natural rise before you give food and insulin. :-D
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

Hi Alicia!
I was going to answer in pzi but this is fine .... you now have a shoot number but with his recent drops I would go down to 0.75u .... you are doing really well in so short a time!

Are you checking for ketones? It would be a good idea to start because it can be a big part of keeping him healthy. Good job!

Nancy and Payne
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

Thank you Kelly and Nancy for your dosage suggestion! I gave him 0.75U tonight (rough estimate as I only have U40 syringes, will be ordering some U100 so I can do smaller dosing). Since I gave his PM shot almost 45 min past his regular schedule, do I need to adjust his AM shot time?

Kelly - I generally test him around 7pm then feed (I have to hand feed him or he walks away after a few licks and sometimes it can take up to 20 min for him to finish his food) and give his shot at 7:30pm. So if next time this happens, I should not feed and retest around 8pm? What would be the steps if:
1) the #'s don't change much and remain < 150? --> feed and skip dose?
2) the #'s are increasing but still < 150? --> feed and give reduced dose?
3) the #'s are increasing and > 150 but < 200? --> feed and give regular dose?

Nancy - yes! I was just reading about testing Ketones and stopped by Walmart on my way home from work to get some additional supplies (Karo syrup and alternative canned food). I knew I forgot to look for something (the Ketone strips!) but I have been so sleep deprived lately I couldn't remember what I was supposed to buy and it was getting close to his PMPS time so I left. Thank you for your suggestion and I will be sure to get the strips soon. Do they sell these at Walmart? Any specific kind?
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

They sell the urine ketone strips anywhere they sell insulin supplies, any brand works fine.

You don't shoot under 150, that is your constant cut off #. If it's early enough you can wait an hour, re-test and make a decision on that # but no insulin <150. If it is between 150-200 reduce your dose by what the # is.Closer to 150 I would shoot 25% of the dose .... closer to 200 I would shoot 50% of the dose.

When I get off schedule I usually adjust by 30 min. at a time .... we do that on the week-end when we want to sleep in later. If you had no choice, you could do one hour but usually only once in 24 hr.

Also remember once he gets his shot, you have 4 hours to get food in him .... so the timing is not bang/bang! If you need to feed some, feed more a little later, that works.

You are doing great! Remember to breathe .......
 
Re: Newly Diagnosed on 1.5U ProZinc, 6+ today is 65 - need a

1) the #'s don't change much and remain < 150? --> feed and skip dose?

Wait another 30 min to test before feeding. Once you are 2 hours past normal shot time and you are still at or below 150, then I'd skip the shot. You can delay more than that and shoot once you have a shootable number if you are able to adjust the next shot appropriately.

2) the #'s are increasing but still < 150? --> feed and give reduced dose?

Depends on how close to 150 you are. If you are increasing and your second number is say 140, definitely wait to feed and test again in 30 min. You will more than likely have a shootable number at that point. Give a reduced dose if the number is between 150 and 200. Give the regular dose at a number above 200.

3) the #'s are increasing and > 150 but < 200? --> feed and give regular dose?

If the number is between 150 and 200 give a slightly reduced dose. If greater than 200, give the regular dose. Once this happens a couple of times, you will learn the patterns of your cat and can adjust your doses accordingly.
 
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