Prozinc advice needed: Another day, a hundred more questions. :)

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Re-rest to confirm the result.

Yes, intervening is a good idea.

Have you got Karo/honey/other syrup?
Have you got high carb food?

Feed 1-2 teaspoons of high carb food, or low carb food plus a few drops of syrup on it.
In 20-30 minutes, re-test the glucose.
If still low, repeat the feeding.

Repeat as needed to get 3 rising numbers and past the nadir.
 
Not sure of the carbage on this ProPlan wet wood that I had laying around but she just ate two spoonfuls with a couple of drops of honey.. Will retest at 130am. She wasn't happy about being woken up for that, though. :)

Is going from 246 to 48 at +5 a cause for concern? Should she continuously be monitored now?
 
I would re-test to confirm that the meter reading was somewhat accurate.

With Prozinc, once you establish the amount of drop with a given pre-shot range and dose, you can develop a custom sliding scale where you adjust the dose based on the pre-shot and your knowledge of how the ProZinc works in your cat.
 
She needs to be monitored until you know for sure she is rising and will stay above 50. I'd post your AMPS in the morning for dosage advice and plan on no shot if under 200. If over 200, you probably need to drop to 0.5 units.
 
It takes about 20-30 minutes for high carb syrup or gravy to hit.

I might repeat the following again, since Thaiger continues to drop.

Feed 1-2 teaspoons of high carb food, or low carb food plus a few drops of syrup on it.
In 20-30 minutes, re-test the glucose.
If still low, repeat the feeding.
 
Has anyone ever told you that when you go to the High Carb foods (the Fancy Feast Gravy Lovers) what you should do is pop open the can and then take the lid and smash it down onto the food and squeeze the "gravy" out (into a little bowl or something).....the gravy is where the carbs are. We don't want to feed the "meat part" too because we don't want to fill them up so that they're not willing to eat again if necessary

So when we say "a teaspoon or 2 of HC food", what we really mean is the gravy part (and most cats go CRAZY for it)

We want them to be willing to continue to eat IF we need them to eat later in case their BG goes too low again
 
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That can be normal after feeding high carb. I'd still get one or 2 more tests to make sure she's still rising. High carb can spike the blood sugar but might not keep it up necessarily.
 
It may wear off fast as it was fueled by gravy and honey.
At this point, give a couple teaspoons of low carb food to help sustain it without elevation.
Re-check in 20-30 min.


Ps Really, I am in bed and about to sign off! Not that I'm OCD or anything!
 
That's great!! Now no more food and retest in 30 minutes...if she's still about the same, retest in another 30...but if at the next test she's continued to climb, you can wait for 1 more test an hour later and if that's good, call it a night!

However, if her next test shows her dropping again, but still above 50, give her some of her low carb food and the "2 hour clock" would start over

Once they're "UP" to a safe place, you want to test for 2 hours after without food to make sure they can stay up on their own before going to bed
 
Little bit of conflicting info there - to food or not to food? :) We are now at +6 and at 77. Leave her alone and test again in 15? Give her food? She's really getting fed up with the ear pricks, poor thing. :(
 
If you feed low carb now it might sustain her numbers but at the same time you want to make sure she'll be hungry enough to eat some high carb food if she starts to drop again. So it could go either way.
 
that's basically the same number....I'd leave her and just retest in 20-30 minutes (77 and 80 are pretty much the same number)....THEN if she's still "surfing" (in those same general numbers) I'd test again after 30...and if still doing OK, get 1 more test an hour later
 
Basically, you want to keep feeding them until they get into the high 70's or above....then you stop feeding, but continue testing at 30 minute intervals for 2 more times....if they're still holding their own or climbing, test 1 more time an hour later (so you have 3 tests in those 2 hours after the last food)

BUT, if they drop (and by more than just a couple points), and you have to feed again, as long as they're above 50, always start with the Low carb food...a teaspoon or so and then the 2 hour "clock" for testing starts over
 
Katie

Can I just double check the AT in your title doesn't relate to an alphatrak does it? You mean at +5 don't you? Just wanted to double check as it isn't mentioned which meter you use in your signature.
 
phlika29 said:
Katie

Can I just double check the AT in your title doesn't relate to an alphatrak does it? You mean at +5 don't you? Just wanted to double check as it isn't mentioned which meter you use in your signature.
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Yes - at +5 hours! I'm using a Relion Confirm - i'll add it to my sig now.
 
It may be worth mentioning that since today is the first day of insulin, she still has Iams dry food down for grazing (not a low carb food) and then is on Friskies Pates for wet food. Vet told me to do the food change slowly so i've managed to get her on solely low carb wet food but still have the dry food down which she isn't eating much of, but it's still there.
 
Katie it looks like you've got some great helpers here so I am going to *try* and get some sleep. You're doing great and I'll check in on this thread when I get up!
 
@phlika29 I have to leave....can you keep an eye out for her for awhile?

Also, @manxcat419 is was online and she's had quite a few nights like this lately and has pretty much learned the ropes

My general feeling is she's past the point of being too worried, but does need to go ahead and do those checks to just make sure she's able to stay above 50 without food for at least 2 hours before going to bed.
 
So here is what we're looking at so far:
PMPS was 246. At +2, we were at 198. At +5, went down to 48.
Did some high carb food and honey for two rounds - no food since +5.15... went to 47 at +5.30, 80 at +5.45, 77 at +6 and now 98 at +6.30..
 
That's a good number but you should hold out for a test which is 2 hours after no food to check it doesn't drop again. Sorry
Chris & China said:
My general feeling is she's past the point of being too worried, but does need to go ahead and do those checks to just make sure she's able to stay above 50 without food for at least 2 hours before going to bed.
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I assume that will be the 3 am one?

It looks like she will get herself a reduction In dose tomorrow.
http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/
 
I think I can rest easier now because I think you're out of the woods but another test in an hour would probably be best. Great job Katie!
 
yeah - 20 more minutes will be the 2 hour with no food mark. I can hold out until then. Do I need to get up again and check before the AM shot time?

246 was a really low starting point for her - I haven't seen numbers under 400 in a while.. Is it safe to guess that if she is still around that 250 mark, i should only give ~.5u (i say ~.5 because i have u40 syringes so would be eyeballing it). If she's back in the 400's she should get the full 1u, right?
 
Yes @phlika29 a dose reduction for sure! @Thaiger & Katie personally I would shoot 0.5 units for anything over 200. One unit might be okay with a preshot of 400 but it would require the same intense monitoring like you've done tonight. I think I'd go with 0.5 and work you're way back up if need be.
 
I gave the pm shot at 8pm and am planning on giving the am shot at 8am... However - I have something that I absolutely cannot get out of tomorrow night and won't be home until around 11pm to give her the pm shot... And then I need her back on an 815am, 815 pm schedule because of work.. So my thinking is (please correct me if i'm wrong):

PM shot today (2/6 actually) was given at 8pm
Hold off on AM shot (2/7) until 11am and give .5 instead of 1u
PM shot at 11pm (2/7) and give .5
Check BG at 8am on (2/8) and if >200, give .5 (this would only be 9 hours since the last shot) - trying to figure out how to get her back on the 8am and 8pm schedule..
 
Hi Katie,

Gosh, this has been something of a 'baptism by fire' for you.
But you did great! :)

Do you have syringes with half-unit markings? If not, it would be good to get some of those. Or, it is possible to use U100 (instead of U40) syringes and use a conversion cart. This can be helpful if if there is a need to measure smaller doses.

Eliz
 
Again I have no experience of prozinc but it isn't a deposit insulin is it?

You could start a new thread over on the forum and see what other users do.

How about give the morning 0.5 dose at 9.30 am and then give the evening dose at 11 pm. That way you split the difference in time so you are 1hr 30 late with each dose. Or maybe it is better just to be late for the evening dose? You know to always check the preshot glucose don't you?
 
If it's close-ish to 200 I might stall and shoot if rising without food. I think 170ish and under I don't think I would even bother stalling and just forego the shot. I don't really want to give dosing advice since since you just started insulin and we don't have a lot of data on different doses yet. I might be tempted to just shoot at 8am and forego the 8pm shot altogether to stay on the 8/8 schedule but maybe someone with more experience could agree or disagree.
 
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