ProZinc Dosing for AM help needed ASAP

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Tanya&MK

Tanya&MK

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Hi!

My Kitty is newly Dx, and I have a PZI dosing question. I did not give a AM shot yesterday due to low AMPS. Last night was borderline (just over 200 PMPS)...and then he dropped to 59 at +3. I had never seen him below 100 so I panicked and gave him a little higher carb dry food.. Now this morning up to 568 because of the food I am almost 100% sure.

Should I give him the standard dose? He has not had a low to my knowledge but yesterday was close. Not sure with the recent eating if I should go back to the same dose. I have to leave for work in an hour just not sure what to do..

Thank you so much for your help! SS is updated below.
 
He is high this morning (probably a bounce from his greens last night) and might need your normal dose to come down. BUT if you have to leave, I'd be cautious and give less, maybe 1.5? Then, the next preshot that you get that is in more normal ranges, I would definitely reduce the dose to 1.5 or even 1.25.- especially if you can't test..

Have you seen the PZI protocol we put together? It is in blue in my signature.

Next time, try a little regular carb food first to see if he comes up. Then the gravy off the higher carb food, if it is still dropping.
 
He's shown you that at least for now, 2 units with a pre-shot of about 300 mg/dL is too much. You may want to consider developing a sliding scale where based on your test data, you can adjust the dose at pre-shot.

Possibly:
250 - 300: dose 1.5 units.
 
Thank you so much for the Info and replies!

I gave him 1.5 units at dosable shot, this morning AMPS 75, NS (see SS). But just checked him at +6 and he is up to 443? So confusing. He did eat 1 1/2 cans of food though. When you notice they are higher after skipping a shot, do you give insulin right away or wait until the time that you normally would again (mins 6-7am or pm) to restart?
 
The higher number is probably due partly to the food, maybe partly because the insulin just ran out and maybe because his pancreas helped a little and then got tired. If it doesn't mess up your schedule, you could give him some insulin now. I would check again and make sure the number is accurate first. It may be that you will have to wait 12 hours from this shot to give another, so make sure it doesn't mess up your schedule.
 
I had the same issue this morning, he was right at 200 so not sure what to do since I have to leave all day. I checked his BG 4 times 15 mins apart before feeding and did not see much (if any if dropped) rise in the number.

I really appreciate the protocol! The last thing I want is for him to go Hypo while I am at work.... hopefully sticking to the 1.25 dose for a few days will give me more of a PS number.

It's amazing how easy testing his ears is getting! That is so exciting for me! He and I are getting the hang of it (especially when I follow up with food). :razz:

Do you always check the PS number before feeding? My vet of course said to "always" shoot if he eats, but that does not account for insulin still wearing off from the night before or perhaps the low carb food starting to work with his pancreas.... I will be home working over the holiday for 2 weeks so will definitely do a curve test.
 
. Do you always check the PS number before feeding?
Click to expand...

It is best. If you get a 180, for example, and need to make sure the number is rising and closer to 200 before dosing, you need to have a number that is not inflated by food. If you have to stall, you want to be able to do that on an empty stomach. Once he is high enough to shoot, then he can eat while you are shooting with no problem.

I think I would reduce the dose further. You really want 2 shootable preshot numbers every cycle so he doesn't go from lows to highs in that 24 hour period. If 1.25 is giving you a unshootable preshot 12 hours later, then 1 unit might give you two shootable preshots. Skipping is safe, but not always ideal for getting and keeping him below that renal threshold (250) where his pancreas can heal. How about, even if you get a red tonight, shoot one unit and see where he is in the am.

When you are home to monitor, you might also lower your preshot number. We say 200 for new diabetics with no data, to keep them safe. You know how to test and if you are home to monitor and bring up any potential lower nadirs up with food, you could start shooting at 180 or so (after being sure he is rising, not still going lower and knowing you can monitor that cycle)

Kimmie was in the same place - having to skip shots. Here is her thread where we discussed the possibilities:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=129565
 
I agree with Sue. If you reduce to 1 unit, that might really help. Getting two shootable preshots is much preferable to getting one shootable PS and one skip. If your kitty can stay on more even numbers, he'll probably feel better too. :-D
 
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