Prozinc dosing help please! Still pretty new here

Discussion in 'Prozinc / PZI' started by Sara-Jane, Mar 25, 2024.

  1. Sara-Jane

    Sara-Jane Member

    Joined:
    Jan 16, 2024
    Hello!
    Ok so my little Evie has been on Prozinc for 4 months now. I’m hoping to get some support re doseage . I never know if I’m giving correct amount.. I feel it’s not enough some days (hardly even get a curve) however she’s dipped very low on one unit and once again on .75 units .. I’m trying to reassess frequently as I know she is newly diagnosed! I’m also afraid to increase unless I’m home and can monitor for the day as during the week I’m gone long hours . I’m always worried about her having a hypo.. I’m kinda of a wuss ! I do have timed feeders out during day. She gets many small snacks frequently. Eats FF pate and boiled chicken, some tiki cat shreds. But I want the best for her . I’m using the slow method for Prozinc. Anything below 5 I believe merits a reduction. I did just increase her again back to 0.75. I also never know what to do when she’s only 11 or 12? If I’m leaving all day I’m afraid to give a full dose ! Any advise I would really appreciate! Thank you!
    https://docs.google.com/spreadsheets/d/1Um6bHwTUUj9hHGUtCusUT7eWdfnuRb12UsYrtZ27OkY/edit
     
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  2. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Let me look over her spreadsheet and then reply. Welcome to the ProZinc forum.
     
  3. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Can you tell me when she’s dropped very low? I’m not seeing it on her spreadsheet. I see a couple of dark greens that are safe greens.
     
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  4. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    It is true that if she drops below 90 on the SLGS method she earns a reduction. This is not always in the best interest of the cat, however, so sometimes we need to modify that a bit. A lot depends on the cat and the caregiver’s schedule and situation. But for now, we will stick with the basics until we see how she does. You’ve done a great job of taking care of her so far. I wish you had come to this forum sooner.

    I totally understand the fear of having her drop too low while you are away. That is not unreasonable. Do you have to leave right after you give her the insulin? I don’t see any tests at +2 on the week days so I’m assuming you leave before that.

    I have a few questions about why she only received.25 units of insulin on certain days/nights when her preshot number was low.

    For now, hold the .75 unit dose for 7 days and then run a curve on the weekend where we can try to catch a lot of information about her onset, nadir and duration. You actually are really lucky because she’s a pretty regular kitty. I don’t see a lot of bouncing or diving so that is very good.
     
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  5. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    When exactly does she get her snacks from the automatic feeders? At what hours in the cycle?
     
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  6. Sara-Jane

    Sara-Jane Member

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    Jan 16, 2024
    Ohhhh thank you I’m so appreciative for all your help!! The time she dropped to 3.8 I believe was an evening when she was on 0.75 units. According to the slow method that I was trying to follow, I thought that merited a reduction? Anything below 5 makes me very uncomfortable TBH. At 3.8 it was the middle of the night, I was exhausted, and I worked the next day. It seemed she was still dropping so I gave her a large amount of FF pate plus just a few high carb kibbles and waited for it to turn around so I could go back to bed…

    yes I can rarely catch anything past +3 hours when I’m working or in the night. It’s midnight at that time for me and I go to bed after that. I test on Sundays and Mondays on my days off as frequently as I can! (If you look I did a ton of testing yesterday and today).

    I leave a timed feeder out for her during the days I’m at work. I feed her at either +2 or +3 usually a snack size of FF, then I leave for work, then I have feeder go off at usually +5 and then again around +7 too with again snack size portions of FF pate usually. She does not always eat it I will say. It doesn’t have a bell or anything to sound it and she sometimes sleeps right through the whole day and doesn’t touch it. She’s motivated by me when I alert her it’s snack time and feed her myself. So I worry about her when I’m gone…

    like I said I’m a wuss! When she is only 11 or 12 my vet said I could either give .5 or .25 of a unit . I’ve literally been winging this ! I’m so afraid when she’s 11 to give her too much insulin and then leave during the day??? (I’m in canada so mmol/l is our metric)

    i do agree she’s pretty regular. Almost always yellows is where she sits . It’s just different nadirs at different times and it scares me!!
    Thank you SO much I need all the help I can get haha!
     
  7. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    You are most welcome. If you are using a human meter, which I believe the Freestyle Lite is, then your “take action” number is 50 (2.7) and not 68 (3.8). Now that just means to keep a close eye on them and test in 20-30 minutes. Usually it can be managed with low or medium carb, but if the cat doesn’t come up in numbers then higher carbs are necessary. I’m just saying that, in an of itself, 68 is not a bad number. 68 is a great and a safe number. But you have to consider how early it is in the cycle and how much time there is to your cat’s typical nadir. I also know what it’s like when it’s nighttime and you need to sleep.

    And yes, when following SLGS we first use 90 (5) as a reduction point. But using 90 as a reduction point does not mean that 90 is a dangerous number. It is not. It’s just a number to try to keep the cats safe for new people, or people who aren’t able to test enough to do the Modified ProZinc Method. Normal cat numbers are between 50-120. Non diabetic cats even spend time in the 40s, but of course they are able to regulate their own blood glucose. So we don’t like to see a cat who is receiving insulin to go below 50 for safety.
     
  8. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    How about you run a curve testing at +2, 4, 6, 8, 10 and PMPS.
     
  9. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    I think if Evie drops low she will become hungry. If you have a fasting preshot number below 200, you could try a .5 dose at this point. If it happens on a day you are home, I would suggest you shoot the full amount and test frequently to log the numbers and intervene with food/carbs as necessary. As long as you are able to test, you are in control and can keep her safe.
     
  10. Sara-Jane

    Sara-Jane Member

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    Jan 16, 2024
    Ok great thank you! I am confident to do full doses if I’m home but when she’s low I will be afraid to do too much when I have to go to work. I’m trying to get as many curve numbers as I can. My poor girl is so tired of being poked but I know it’s important. Is it true for me to assume that if she isn’t getting an accurate/high enough dose more regularly then it’s harder on her body, increases overal numbers, and definitly reduces chance of remission? I know I need to have more guts. I just couldn’t live with myself if something happened to her while I was away at work! Her mid day numbers since I’ve gone back up to 0.75 in the last two days have looked pretty good to me! Keeping my fingers crossed they stay that way!
     
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  11. Sara-Jane

    Sara-Jane Member

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    Jan 16, 2024
    I am also curious.. at what number do I skip insulin? I’ve always been told 10mmol/L or less then skip! Thank you
     
  12. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    The goal is to be able to gradually shoot lower numbers. You have never shot anything under 200 it looks like so we don’t have data to know how she would respond. Hopefully, she will oblige us by giving us a lower preshots day on a Sunday or a Monday when you’re home so that you can shoot and carefully monitor the cycle. You work Tuesday through Saturday?

    I would not recommend skipping the shot but giving a token dose of maybe .25 units. I see that on February 9 you shot .25 units when she had a preshot of 203. She seemed to do fine that day. If she had dropped too low during the cycle you would expect to see have seen a very high PMPS.
     
  13. Sara-Jane

    Sara-Jane Member

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    Jan 16, 2024
    Ok I see, thank you! Yes I work Tuesday-Saturdays ..
     
  14. Sara-Jane

    Sara-Jane Member

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    Jan 16, 2024
    Hi Suzanne! I did a detailed curve on Evie this weekend was hoping for your advise . Pretty bad in my opinion .. hardly a curve at all. Is it time for another dose increase? I am always so surprised how one week she will decrease into good numbers then another week hardly at all.. i havent changed a thing in her routine. Thank you in advance!
     
  15. Sara-Jane

    Sara-Jane Member

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    Jan 16, 2024
  16. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    It was better yesterday though! I will be right back.
     
  17. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I do agree. You should increase to 1 unit.
     
  18. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    And I just wanted to say… please don’t be downcast. She’s really not doing badly at all. You are seeing some blue numbers on a small dose, and I really believe she’s going to be in even better numbers soon. You are doing great!
     
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  19. Sara-Jane

    Sara-Jane Member

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    Jan 16, 2024
    Great thank you! She hasn’t been at 1unit since she started back in December and we had some wonky numbers then.. I will try to adjust the dose next week when I’m home to monitor. Thank you so much
     
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