Pre-shot test numbers and adjusting the dose depending on the number

[applecove]

Is there a page with info about this?

For example, if a cat is on 2 units of ProZinc twice a day and his AMPS or PMPS number is, say, 250, should he be given his full 2 units of ProZinc? Or should he be given less?

Or if his pre-shot number is less than 200...let's say 185...should he be given his full dose of 2 units or should he be given less (1.5 units?, 1 unit?)

I guess what I'm asking is, is there some kind of chart that says something like this:

if the cat's pre-shot number is between 300-400, give him his full dose
if it's between 200-300, give him his full dose (or less?)
if it's between 100-200, give him his full dose (or less?)

 

[Rachel]

There's not a chart like that. I get why that could be helpful, but honestly, that really depends on the cat. Some cats do great at full doses on lower numbers...some cats require less. There are so many factors to consider, including length of time on insulin, what the cat has done before, if DKA has ever happened to the cat, what they are eating, etc. There's just no way to come up with a chart like that for all cats.

What we do have is the following excerpt from the Protocol sticky:

"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.

If the cat is high and flat during the entire cycle, the dose could be raised by 0.5 units, as long as monitoring if possible."

So basically, it depends on the preshot and the nadir. In general, if the cat is in the 250ish range, and dropping enough at nadir, you can adjust a small amount...if not dropping enough, you can adjust a larger amount. But we don't have much for what to do in lower numbers because honestly...it really depends on SO MUCH else. Djamila, for example, might not change her dose at all based on lower numbers. She's been doing this for years, and at this point she knows Sam so well that she has a pretty good idea of what he will do. He also has other health issues that she has to consider when dosing. Other cats will always go too low if given a full dose on a lower number.

You get an instinct for these things in relation to your cat over time.

 

[Kris & Teasel]

Excellent reply from Rachel. It really does take time - and BG data on your SS - to learn what to do in these situations. Add to that the fact that some cats respond one way on one occasion and differently on another. My cat is like that. You actually learn a lot about the nuances of dosing your own cat if you use ProZinc because we really do understand that ECID (Every Cat Is Different).

The L insulins (Lantus and Levemir) have two sets of dosing guidelines that are quite specific about how to dose in various scenarios and some people are able to follow them to a T. They like having specific instructions on what to do and if kitty cooperates it can work very well. Others follow them for a time until they learn their kitty's patterns and decide that they need to deviate from those guidelines for a variety of reasons.