Nico’s getting closer— breakthrough dose achieved! 12/19 AMPS 106

Deb & Wink said:
Nico is looking ok on the 2.5U dose for now. He got down to the blues today, with that 140 BG at +6. So don't be surprised if Nico's BG level is higher for the PM pre-shot. I still think you should hold the 2.5U dose, as long as Nico's BG is high enough.

Prozinc has a bit more flexibility in adjusting doses, than the depot type insulins like lantus and levemir do. So it's usually ok to shoot the next cycles dose, if you have only stalled the previous cycles dose for 1 hour.

For example, AM insulin shot was 1 hour later than normal, so the PM pre-shot test will be only 11 hours since the morning dose.

Does that make sense Em?
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Yes, that’s great— thank you! He did test PMPS at 379 so quite a bit higher. 2.5u were given just a few minutes ago. Will plan to hold as long as he isn’t too low, and ask for help if something seems amiss. Thank you for all your help!
 
@Deb & Wink @Chris & China (GA) @JanetNJ PMPS 77. Was hoping I’d actually get some quality sleep overnight.. stalling and will report back in 30 mins. Of I can push him up over 150 should I still try to give 2.5u??
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I don't have enough experience with ProZinc to encourage you to shoot the full dose at only 118. I was hoping since he went up about 20 points in the first 30 minute stall, he'd go up another 20 (or more) in the next 30 but now we're getting to the point where if you continue to stall, his numbers could start to drop again just because he hasn't been fed yet.

I think you should probably just give a token dose (like 1U?) just so he has some insulin on board.

This is for contemplation only @JanetNJ ,@Deb & Wink

I do not know if it's something that's ever been tried with ProZinc but we've done it with Lantus.....it's shooting 2 18 hour cycles.....so you'd go ahead and feed him now and then if he's high enough at +18, shoot then.....and then skip the AM shot completely and wait another 18 hours to shoot again (which puts you back at your usual shot time).

Example....usually shoot at 6am/6pm.....PMPS is too low so you wait until midnight (+18) to shoot. Then you skip the 6am shot and shoot at 6pm tomorrow (18 hours after the midnight shot) and you're back on time.
 
Chris & China (GA) said:
I don't have enough experience with ProZinc to encourage you to shoot the full dose at only 118. I was hoping since he went up about 20 points in the first 30 minute stall, he'd go up another 20 (or more) in the next 30 but now we're getting to the point where if you continue to stall, his numbers could start to drop again just because he hasn't been fed yet.

I think you should probably just give a token dose (like 1U?) just so he has some insulin on board.

This is for contemplation only @JanetNJ ,@Deb & Wink

I do not know if it's something that's ever been tried with ProZinc but we've done it with Lantus.....it's shooting 2 18 hour cycles.....so you'd go ahead and feed him now and then if he's high enough at +18, shoot then.....and then skip the AM shot completely and wait another 18 hours to shoot again (which puts you back at your usual shot time).

Example....usually shoot at 6am/6pm.....PMPS is too low so you wait until midnight (+18) to shoot. Then you skip the 6am shot and shoot at 6pm tomorrow (18 hours after the midnight shot) and you're back on time.
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Gotcha. Should I wait and see if Deb or Janet respond prior to giving even a token dose of 1.0u?

EDIT: 1.0u given at +13.5.
 
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@Deb & Wink @JanetNJ @Chris & China (GA) Nico is currently at 246 (+7.5), so I’m hopeful we will be a-ok to give 2.25u tonight. Just hopeful he doesn’t continue to drop, but we shall see. Wanted to let you know early enough in case he’s too low for a full dose this evening and some discussion needs to be had before all y’all head off to bed for the night (pacific time 7pm shoot for us here). Keep me posted. I’m off to a massage!
 
Emily Tuomey said:
Wanted to let you know early enough in case he’s too low for a full dose this evening and some discussion needs to be had before all y’all head off to bed for the night (pacific time 7pm shoot for us here).
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Ah, contingency planning. Both Janet and I are on the east coast. I think I have an earlier bedtime than Janet does.:)

Nico is working his way back down the dosing scale.

I don't think you have enough data to judge how Nico would do if you shot the full dose when he is in the low blue range. Yes, using MPM dosing method, you can still technically give your cat the full shot as long as the BG is >50 IF you are around to monitor and guide with food more intensively AND you know how low a particular dose takes him. When you don't have that capability for monitoring, than you need to more slowly work your way down to a lower and lower pre-shot in order to be giving the full dose, by striving for lower and lower pre-shots where you give Nico his full dose of insulin.

For now, I think you want him to be >150 at pre-shot to give him his full dose. As you gain more data on how Nico is doing on a particular dose, you can lower that guideline to 140, then 130, then lower.

It was much easier when Nico was really high, BG wise. Now, it takes a bit more thought to decide what you want to do. So now is the time to restudy those
Sticky PROZINC DOSING METHODS and make sure you know what to do if no one is able to get back to you in time. "Better too high for a cycle, than too low." Too low would be <50 mg/dL.

@Chris & China (GA) I've never seen anything like that 18 hour dosing used with Prozinc. Sure wish there were a few more experienced Prozinc people to weigh in on this idea. My 2 cents worth. Since Prozinc is NOT a depot insulin, there is no depot that drains if you skip the shot or give a greatly reduced dose. One cycle does have some impact on the next cycle, but not as strongly as lantus and TR would. Giving a token dose, a reduced dose for a cycle usually is sufficient if someone needs to stall and the BG has risen enough to give the insulin. If the BG levels are still not high enough to give insulin, then a skipped shot is still the recommendation.
 
The high number thus morning wa
Emily Tuomey said:
@Deb & Wink @JanetNJ @Chris & China (GA) Nico is currently at 246 (+7.5), so I’m hopeful we will be a-ok to give 2.25u tonight. Just hopeful he doesn’t continue to drop, but we shall see. Wanted to let you know early enough in case he’s too low for a full dose this evening and some discussion needs to be had before all y’all head off to bed for the night (pacific time 7pm shoot for us here). Keep me posted. I’m off to a massage!
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yeah I'd say he's good to go tonight for the 2.25
 
JanetNJ said:
The high number thus morning wa

yeah I'd say he's good to go tonight for the 2.25
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@Deb & Wink @Chris & China (GA)
I’m a little upset he’s back in the black tonight. Almost retested, but not sure I wanna continually put him through that. I’m sure it’s just part of his bounce, but still really bothers me to see. I knew he was gonna be high, just wasn’t prepared for quite that high. PMPS 516. 2.25u given. Eating well, lots of thirst. Bummed for him tonight. At least we will all get to sleep.
 
@JanetNJ @Chris & China (GA) @Deb & Wink Gonna work on getting a new thread going a bit later today— I’ll tag you all there and link this one. We had a great day yesterday, then this morning back to the higher 300s (AMPS 366)which I’m not enjoying seeing. We are going to take it easy today, lots of snuggles. Maybe that’ll help him. I’m also going to try switching him over to a FF pate diet after a lot of talk about how kitties are reading higher bg levels on Friskies (perhaps a recipe change with higher carbohydrate levels?) to see if maybe that will bring him down a hair too. Probably will start that Sunday when we are out of Friskies wet food. Okay, that’s the update. I’ll be back later!
 
Emily Tuomey said:
@JanetNJ @Chris & China (GA) @Deb & Wink Gonna work on getting a new thread going a bit later today— I’ll tag you all there and link this one. We had a great day yesterday, then this morning back to the higher 300s (AMPS 366)which I’m not enjoying seeing. We are going to take it easy today, lots of snuggles. Maybe that’ll help him. I’m also going to try switching him over to a FF pate diet after a lot of talk about how kitties are reading higher bg levels on Friskies (perhaps a recipe change with higher carbohydrate levels?) to see if maybe that will bring him down a hair too. Probably will start that Sunday when we are out of Friskies wet food. Okay, that’s the update. I’ll be back later!
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I'd liek to see the numbers come down just a little more. Can you do 2.75U? I'd like to see the nadir closer to 90-100.
 
JanetNJ said:
I'd liek to see the numbers come down just a little more. Can you do 2.75U? I'd like to see the nadir closer to 90-100.
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We can certainly try it— id like his numbers down more as well. Will start 2.75u tonight and monitor closer overnight (good thing about Fridays!). Sound good?? Which intervals should I test overnight?— I was thinking 4 or 5, 7 or 8. Let me know!
 
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