? Question about preshot with low numbers in Modified Prozinc Method

Hello group! Lately we are seeing that our Sharess has days in which it takes longer and longer to reach numbers higher than 200 in the preshots, so we usually delay the shots until she reaches these numbers. Are we doing wrong? Is it safe to shot her with numbers very close to 200? We are following the modified prozinc method but it does not specify what the safe limit number is to take the shot.

Maybe I'm silly but I have only found a small guide on the SLGS method, but not on the modified method. Can I aply the SLGS guide bellow to the modified method too?

Below 150 mg/dl (8.3 mmol/L), don't give insulin.
Between 150 and 200 (8.3-11.1 mmol/L), you have three options:

a.) give nothing
b.) give a token dose (10-25% of the usual dose)
c.) feed as usual, test in a couple of hours, and make a decision based on that value

Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.

 

Greetings, Vicky!
What kind of meter are you using? Your signature and spreadsheet says one thing, but your spreadsheet is completely filled in, which makes me think you are using a Continuous Glucose Monitor (Libre.)

 

Here is an excerpt from the MPM dosing guidelines. As it says, the goal is to be able to shoot lower preshot numbers. The under 200 rule is a guideline to help mew people who do not have a lot of data on their cat’s spreadsheet. I do not think that you need to be stalling all the time to wait until she is above 200. Are you feeding during this time? I cannot tell from the spreadsheet what here original AMPS/PMPS are before the yellow numbers that are on the spreadsheet — so I don’t know what her first AMPS/PMPS are before the stalling. Most people will put both the first test number in the cell and also the numbers after the stalling. What kind of blue numbers are you seeing?

 

Oops: here’s the excerpt:
How to handle a low pre-shot number:

• Sometimes your kitty will surprise you with a lower than normal PS number (but above 50). When that happens you have four choices:
  • Skip the dose: If the number is below 200, and your kitty is newly diagnosed(less than three months), your best option is to skip unless your kitty has ketones or is post-DKA (see below) and you should post here or in the Health Forum for help.
  • As you gain more experience and data, your goal is to gradually learn to shoot lower and lower numbers (never below 50). You can use other options below as you are learning to shoot below 200. Ultimately, with data, experience, and knowing your cat, you should be able to shoot PSs above 50 provided you are available and able to monitor.
    • If your cat has been diabetic for awhile and the PS is much lower than normal, you may still need to skip if you have to leave the house for many hours and can’t monitor, but in general we don’t recommend skipping if your cat has a good body of data, so see the other options.
  • Stall: Do not feed your kitty but wait 30 minutes and test again. (Note: we generally stall without feeding because food will falsely cause the BG to rise. It’s important to not shoot a food spike
  • If after stalling the number is rising into safer ranges, you can then give the full-dose shot. You can stall as long as you need to (in 30 minute increments), but keep in mind that the next shot needs to be 12 hours later, so be mindful of your new shot time. If it’s getting too late, try the next option.
  • Reduce the dose: How much to reduce can be a tough decision. Some of it will depend on how well you know your cat, how confident you are in testing, if you’ll be around to monitor, etc. This is a good time to ask for advice. If no one is around and it’s your first time, reduce the dose by 50%. If you have been at this awhile and know your cat’s reactions well, you can do a smaller reduction. If your cat is below 150, do not give a dose at all unless you can get regular BG tests throughout the cycle.
  • Give the regular dose: this is recommended if you are able to monitor closely and/or if your cat is a long-term diabetic (more than a year) and you have a lot of data to know it’s safe. Long-term diabetics with solid data can often safely shoot below 150 (and should if possible to do so safely).

 

Hello @Suzanne & Darcy!

Thank you so much for your answer. Indeed, we have a meter but now we also are using Freestyle Libre and I forgot to change it in the spreadsheet. I have already modified it. Thanks for highlighting it!

When we write down the AMPS/PMPS numbers it is exactly at the time of the shot. If we have to move the hours due to low numbers, we write it down by putting the number followed by an @ + the number of hours that we have gone past the previous preshot. For example, on 12/17/2023 you can see that at +11 there are (162, 217@+12, 236@+13), this is because we had to shot 3 hours later (the 2 additional hours after +11 plus one more hour noted in the preshoot). I hope it's clear.

Thank you very much for the excerpt. I'm going to start applying it. We did it once a long time ago, and her numbers went down very quickly and went up very quickly, so we weren't sure if it was safe, but it's been a year since she was diagnosed with diabetes and we monitor her curves continuously with the sensor, plus we are almost always at home with her. I'll let you know how it goes. Thank you very much, I don't know what we would do without your advice. This is what I wrote in my facebook a few days ago and I truly mean it!

https://www.facebook.com/Zhashia/po...yGAb7WGt7ecEScor9aXnYXT9MUucwn3Q3CXyhBwibYiul

 

Not to steal into your thread :0 but are the guidelines numbers for human or pet readers?

 

As far as I know pet readers and human readers are more or less the same in terns of numbers except for the fact that pet readers are more expensive in general, but maybe someone more experienced can answer your question

 

That is so sweet (what you wrote on Facebook!). I love that. I have the same collar for one of my cats (the one with the moon and stars on it). He needed it this past summer.

 

I’m not sure I understand the question. Vicky uses a Libre sensor that is calibrated for humans and so will give numbers similar to a human meter (although there are some differences and I have noticed in some cats/sensors that they read lower in the low numbers.

 

Or do you mean the guidelines in the Modified ProZinc method? The ones I excerpted above for Vicky? Those guidelines (and all of the guidelines on this Board) are based on numbers obtained with a human meter.

 

Hi Vicky. I was just checking in. Have you been able to shoot any lower preshot (under 200) yet? Many of her AMPS look on the higher side, but she gets a lot of nice numbers in the middle of the cycles.

 

Hi @Suzanne & Darcy!!

Merry christmas! Sorry for not responding sooner, but these are complicated dates, plus I was singing in a concert with my singing academy that organized a student concert last Thursday and Friday and I haven't stopped rehearsing and preparing everything
You cant see the resoult here ^_^

Thanks a lot for your kind words. I really meaned every single word I wrote in Facebook!! Awww what a coincidence that we have the same collar. I bought that cone because every time we change the sensor it is impossible to put the shirt on her immediately and we have to wait 1-3 days, since she is allergic to the sensor and her skin gets very irritated. This collar is way nicer and flexible than the plastic regular ones and she likes it a lot.

At the moment we haven't been able to shot her with numbers below 200 because she has a cold and the numbers are a bit random, but one day we managed to shot her at 205 and it went very well. I'll let you know how it goes when she stops sneezing and her numbers return to normal

Again thanks a lot for worring about my baby and merry merry Christmas!!!