KristenP&Sam
Active Member
I feel very comfortable shooting 1.2 with a PMPS of 324. Anyone else agree? Disagree?
Sam - 1/5 PMPS 324
- Thread starter KristenP&Sam
- Start date
- Status
Gator & H (GA)
Very Active Member
1.2u looks good. I like the fact that there was a little drop in the PS values - at least you are not headed up which is good. Small consistent drops will eventually take you where you need to go.
The lower number at +2 than +6 indicates to me that this may not be enough though. The idea here is that with ProZinc and early nadir can indicate not enough insulin. As the dose is increased the nadir often starts to happen at later and more "appropriate" times. Also the shallow "delta" or change from PS to nadir indicates perhaps not enough insulin.
So I'm comfortable with you shooting 1.2 tonight - and you should be able to sleep very well shooting 1.2. But we may need to up your dose just a hair to like 1.3 perhaps or even 1.4u - we'll just have to keep an eye on things.
It seems thought you are really close on the dose. So 1.2 was a good choice.
I'm happy to see that, at least for now, you are able to maintain a somewhat level PS to PS and not have those very large deltas like you were having at the start of things. I'd like to chalk this up to your Sam just getting used to the insulin. There is a bit of an unwritten "rule" here that ProZinc seems to take a little while for the kitty to get used to it - perhaps in the range of 45 days. I hope this continues and the big delta days are part of history. This hopefully would also indicate that now you are getting appropriate duration of the insuiln and give hope that you may be able to continue with BID ProZinc - if you wish - and not have to try TID or another insulin. I'm keeping my fingers crossed.
Good work capturing the additional mid-cycles.
The lower number at +2 than +6 indicates to me that this may not be enough though. The idea here is that with ProZinc and early nadir can indicate not enough insulin. As the dose is increased the nadir often starts to happen at later and more "appropriate" times. Also the shallow "delta" or change from PS to nadir indicates perhaps not enough insulin.
So I'm comfortable with you shooting 1.2 tonight - and you should be able to sleep very well shooting 1.2. But we may need to up your dose just a hair to like 1.3 perhaps or even 1.4u - we'll just have to keep an eye on things.
It seems thought you are really close on the dose. So 1.2 was a good choice.
I'm happy to see that, at least for now, you are able to maintain a somewhat level PS to PS and not have those very large deltas like you were having at the start of things. I'd like to chalk this up to your Sam just getting used to the insulin. There is a bit of an unwritten "rule" here that ProZinc seems to take a little while for the kitty to get used to it - perhaps in the range of 45 days. I hope this continues and the big delta days are part of history. This hopefully would also indicate that now you are getting appropriate duration of the insuiln and give hope that you may be able to continue with BID ProZinc - if you wish - and not have to try TID or another insulin. I'm keeping my fingers crossed.
Good work capturing the additional mid-cycles.
KristenP&Sam
Active Member
Thanks for the input, Gator. I can't wait to see what the morning brings.
Gator & H (GA)
Very Active Member
I know it tough in the beginning and hypo incidents can be unsettling. But this whole thing can be very rewarding too - when you see their improvements or you have those little ah-ha moments and your confidence builds. So make sure to enjoy the rewards [even when they seem small] as you go along. 
KristenP&Sam
Active Member
You're 100% right about all of that!
Gator & H (GA)
Very Active Member
Another thought:
Since Sam was DKA IMHO would like to try to avoid numbers above 400 and would probably not wait long to try an increase [or give a slightly increased dose to bring him back down] if things start to approach 400 or above. Just my $0.02. I'm hopeful we can bring things down below 300 and maintain that [or close to that] as sort of your first goal. I'm keeping my fingers crossed that we can get there soon - we'll just have to see where things go.
Since Sam was DKA IMHO would like to try to avoid numbers above 400 and would probably not wait long to try an increase [or give a slightly increased dose to bring him back down] if things start to approach 400 or above. Just my $0.02. I'm hopeful we can bring things down below 300 and maintain that [or close to that] as sort of your first goal. I'm keeping my fingers crossed that we can get there soon - we'll just have to see where things go.
Joanna & Bix (GA)
Very Active Member
I would probably go to 1.4 in the morning if the PS isn't under 300. Although it can take a couple days to really see what a dose is doing, since this is a lowered dose, if anything I would expect the results to be lesser on day 2 than on day 1, as you are coming down off more insulin. When you are raising a dose, that's where I've seen increased impact from the dose on cycle 3 or 4, which is where you want to be sure to wait that long so you don't raise the dose on top of it gaining strength on it's own.
Not sure if that made sense :? but basically I'd say if you don't see a better PS or nadir in a cycle or 2, you can safely conclude this dose is too little, and there's no point (especially if you have a ketone history) in waiting longer. You saw a nice U-curve today, though too shallow, so I don't see any signs of wonkiness or anything to consider holding much longer at this dose if tonight doesn't prove any better than today did. Nice not to see any reds though, and yellows are still something to cheer about!!! I'm guessing you may end up needing something like 1.6, but we'll see what happens!!!
Not sure if that made sense :? but basically I'd say if you don't see a better PS or nadir in a cycle or 2, you can safely conclude this dose is too little, and there's no point (especially if you have a ketone history) in waiting longer. You saw a nice U-curve today, though too shallow, so I don't see any signs of wonkiness or anything to consider holding much longer at this dose if tonight doesn't prove any better than today did. Nice not to see any reds though, and yellows are still something to cheer about!!! I'm guessing you may end up needing something like 1.6, but we'll see what happens!!!
- Status