ProZinc dose question?

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Megan and Bernie

Megan and Bernie

Member Since 2020
Hi, all!

I upped Bernie’s dose last week from 1u to 1.25u, and thought maybe she was just adjusting, but her numbers have been consistently higher. Any ideas? Does she need to be increased again? Or decreased? I haven’t caught any lows, but I can’t wrap my mind around how a higher dose led to higher BGLs?? I feel like her dose needs to be bumped up again, but am worried her BGLs will continue creeping up with a higher dose. Please help this confused mamabean.

(Side note: I won’t be home for the length of the day until Friday, so that’s the earliest I can increase her dose and be able to monitor her.)

Thanks!
 
Megan and Bernie said:
Hi, all!

I upped Bernie’s dose last week from 1u to 1.25u, and thought maybe she was just adjusting, but her numbers have been consistently higher. Any ideas? Does she need to be increased again? Or decreased? I haven’t caught any lows, but I can’t wrap my mind around how a higher dose led to higher BGLs?? I feel like her dose needs to be bumped up again, but am worried her BGLs will continue creeping up with a higher dose. Please help this confused mamabean.

(Side note: I won’t be home for the length of the day until Friday, so that’s the earliest I can increase her dose and be able to monitor her.)

Thanks!
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I'd try 1.5
 
The reds are bouncing.

Insulin dose adjustments for insulins, including Prozinc, are based on the nadir or lowest number in the cycle.
Megan and Bernie said:
I haven’t caught any lows,
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Yes, you have "caught" some nadirs (lows). But those nadirs or low readings are only down in the yellow BG ranges.

The pre-shot tests are the last BG numbers to decrease. There is still a lot of room to increase the dose for Bernie. No,, I'm not seeing any particular change in the overall BG levels since you increased. Bernie is still mostly in the Yellow 200-299 range in the middle of the cycle. Those are the numbers you should give more "weight", not the pre-shot numbers.

So as Janet said, it's time to increase the dose to 1.5U
 
Deb & Wink said:
The reds are bouncing.

Insulin dose adjustments for insulins, including Prozinc, are based on the nadir or lowest number in the cycle.

Yes, you have "caught" some nadirs (lows). But those nadirs or low readings are only down in the yellow BG ranges.

The pre-shot tests are the last BG numbers to decrease. There is still a lot of room to increase the dose for Bernie. No,, I'm not seeing any particular change in the overall BG levels since you increased. Bernie is still mostly in the Yellow 200-299 range in the middle of the cycle. Those are the numbers you should give more "weight", not the pre-shot numbers.

So as Janet said, it's time to increase the dose to 1.5U
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Ooh, ok that makes sense. I’ll up her Friday when I can stay home and monitor her. Why is she bouncing if her nadirs are still high in the 200s?
Sorry for all the questions, this is so confusing for me.
 
Megan and Bernie said:
Why is she bouncing if her nadirs are still high in the 200s?
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Copied the following from the lantus forum, but the description of bouncing is accurate across all the insulins.

Bouncing - 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, release glucagon, 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". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

So Bernie's body is not used to those numbers in the 200's. So when that happens, a self protective mechanism kicks in to bring those "perceived" lows back to a higher BG level her body considers "safe." As her body adjusts to the lower numbers, the bouncing "clears" the cat's system.

Until the next time of a "perceived" low BG level. Then the cat will bounce again. Some cats bounce all the way to remission. Some cats bounce so high, the BG level simply appears as "HI" on the meter.

One way to "control" a bounce, a bounce caused by a too rapid drop in BG levels, is to give your cat some small "snack" sized meals. 1 to 2 teaspoons is usually enough. Feeding at +2 and maybe +4 can be helpful. Timed feeders are great for doing these little snacks, when you are away at work.

Or you can freeze small portions of food and leave them out to defrost in a dish when you leave for work.

p.s. Keep asking questions. It's how we all learn.
 
Hang on. I'm not on late at night, or early in the morning much in these days of upended life due to covid. Be right back.

Ok, looked at your girl Bernie's SS and she definitely has room for an increase. Her nadirs are > 150, so time to bump the dose up to 1.75U. From the new Sticky PROZINC DOSING METHODS

"If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit"

I don't see that the bounces are taking her too high or too low either. Bump the dose. Starting with the PM cycle.
 
Deb & Wink said:
Hang on. I'm not on late at night, or early in the morning much in these days of upended life due to covid. Be right back.

Ok, looked at your girl Bernie's SS and she definitely has room for an increase. Her nadirs are > 150, so time to bump the dose up to 1.75U. From the new Sticky PROZINC DOSING METHODS

"If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit"

I don't see that the bounces are taking her too high or too low either. Bump the dose. Starting with the PM cycle.
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Thank you so much! Will do! Stay healthy :)
 
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