Phoebe's Rebound pt.14

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Eric, I'm a little concerned about shooting 2.5u this morning after that lime green last night. As Sharon said, I think Phoebe needs a reduced dose. Right now it looks like you're dosing kind of like Vetsulin with a broad sliding scale. Prozinc is an in-and-out insulin, so there is some flexibility on dosing, but the protocol recommends a more consistent approach to the dose with only small changes that are closely monitored. The 473 this morning was a bounce number, not a "real" 473. I wonder if Phoebe wouldn't get some more consistent numbers with a lower and more consistent dose?

This is an excerpt from the protocol:
Changing the dose will depend on both the pre shot levels and the nadir (lowest point of the cycle, usually 5-7 hours after the shot.)

When adjusting the dose, it is wise to check with your vet and with forum members for guidance. In general, the following guidelines can be used. Be cognizant of the over riding principle for ProZinc/PZI : Every Cat is Different (ECID)

If the cat is in the 250+ range at pre shot and does not drop 50% or more for nadir, a small adjustment could be considered, if monitoring is possible. A small adjustment is likely to be 0.25 units per shot.

If the cat is in the 250+ range(or higher) at pre shot and drops below 50% at nadir, bouncing is a possibility.

Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, releases glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". (Adapted from the Lantus sticky by Jill)

If bouncing is suspected, any increases in dose should be tiny and monitored carefully.

Doses are best held at least 3 cycles, unless the nadir is too low. In that case, it should be adjusted down. NOTE: A cycle is 12 hours. So, when we say 3 cycles, we mean (3) 12 hour cycles.
Phoebe's PMPS is 513 what do you recommend for a shot?
 
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