unable to regulate BG

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Pat

Member Since 2013
My cat BeeGee was put on 3cc of Prozinc x2 the vet was not having me test and she almost died. I told him I would test B4 injecting. I find her 7AM BG is high 250 to 330 so give 3cc of insulin
7PM test and BG ranges 101 to 66 so no insulin. Vet said reduce insulin to 1cc. That was 3 days ago BG stays in the 275 to 330 range. I cannot tell if I am on the right track or not. We are new to all this she was diagnosed 4 months ago . Grateful for any help
 
Welcome Pat and BeeGee! :YMHUG:

Great job on getting the testing started! 3u is a really high starting dose, so it's good that you've dropped it back to 1u. We have this handy spreadsheet that we all use to help us track the numbers we're getting and to see a pattern. This will let us know when we find the Goldilocks dose: if the dose is too high, too low, or just right.

For more information on PZI/ProZinc and how the dosing works, you can check out the unofficial PZI/ProZinc Protocol.

What foods are you currently feeding BeeGee?
 
Thanks for the reply, am feeding Wellness and EVO, she doesn't care for either so have to mix them with Skippies Pate
 
It will help us (and you) to figure out how the insulin is working if you would get a few midcycle numbers.

The preshot number is vital to be sure the dose you are planning to give is safe . (we do suggest that new diabetics not shoot under 200 but wait 30 minutes and retest, without feeding. You want to make sure the number is rising and over 200).

The midcycle numbers (somewhere 5-7 hours after the shot) tells you how the insulin is working - how low it takes her. Then you can figure out if your dose is just right, too low (her midcycle numbers are flat or high) or too high (she dips low midcycle - under 50)
 
For more information on PZI/ProZinc and how the dosing works, you can check out the unofficial PZI/ProZinc Protocol.
Click to expand...

I don't know that "unofficial" is a great word for describing the protocol that Kay linked you to. No, it's isn't published in a medical journal. It's based on observations by people who have used Prozinc or PZI over the years that Sue has been here (which a lot more years than I have been around).

There is a protocol which has been published in medical journals for Lantus/Levemir, but I wouldn't call it "Official". And the TR protocol used "here" on FDMB is not exactly the same as the original protocol based on the R/R study. It has also been modified based on years of people using it and posting here on our board.

That said...

What Sue said above is great advice. If you can manage to get some tests around 5-7 hours after the shot, that will let you know how effective the 3u dose is. If you are seeing a pattern where you get numbers high enough to shoot in the AM, but too low to shoot in the PM, it could be that the dose is a little too high. Or (after you have the data to know for sure), you might be able to shoot different doses AM and PM, or adjust the dose amount based on the numbers you get at AMPS or PMPS. The key, no matter what insulin you are using, is collecting the data that reveals how it works on your kitty. Because every cat is different, and they each react to insulin differently.

Carl
 
Carl & Bob (GA) said:
I don't know that "unofficial" is a great word for describing the protocol that Kay linked you to. No, it's isn't published in a medical journal. It's based on observations by people who have used Prozinc or PZI over the years that Sue has been here (which a lot more years than I have been around).

There is a protocol which has been published in medical journals for Lantus/Levemir, but I wouldn't call it "Official". And the TR protocol used "here" on FDMB is not exactly the same as the original protocol based on the R/R study. It has also been modified based on years of people using it and posting here on our board.
Click to expand...

Thanks for clarifying, Carl! I wasn't really sure what terminology to use and in no way meant to diminish the quality of work and the amount of time that was put into creating it. ;-)
 
You'd posted twice, and I'd answered on the other post. I've moved it over here and deleted it from the other, duplicate post.

Pat said:
My cat BeeGee was put on 3cc of Prozinc x2 the vet was not having me test and she almost died. I told him I would test B4 injecting. I find her 7AM BG is high 250 to 330 so give 3cc of insulin
7PM test and BG ranges 101 to 66 so no insulin. Vet said reduce insulin to 1cc. That was 3 days ago BG stays in the 275 to 330 range. ...
Click to expand...

Good for you for testing; that is critical to keep your cat safe.

I think you mean UNITS of insulin, not CCs. Each CC (aka milliliter or mL) of ProZinc has 40 units of insulin in it and that would be a huge syringe-full.

The pre-shot number is often in the 200-300s with Prozinc; perfectly normal and expected. The dose is generally adjusted based on the nadir, the lowest point between shots. The pre-shot numbers help you decide if it is safe to give the shot, but the nadir tells you if the dose is right. For ProZinc, that means testing around +5 to +6 hours after the shot. Some folks do this on a day off or a weekend, some folks set an alarm and test in the middle of the night to check the nadir.

*****************************​
Perhaps you will find the following useful.

The difference in using a pet-specific meter vs a human meter (aside from the very high cost of the former) is mostly a matter of scale (though not exactly 1:1). Think of it as reading temperature in Celsius vs Fahrenheit. Both are correct. If you have the reference values for each, you can interpret them.

So, here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]
 
Thanks for all your help, on 1 1/2 units twice a day and totally on Wellness cat food twice a day . Last five days AM 203 PM 275
AM 330 PM 252
AM 268 PM 285
AM 191 PM 362
AM 232 PM370
Will do a curve after Christmas, house full of people much stress for cat and me. Merry Christmas all
 
Hey there

Thanks for getting these numbers! however, although pre shot tests are mandatory for keeping your cat safe - they don't tell us a lot about how a dose is working since the pre shot time is when the insulin has worn off. You really need mid cycle tests when the insulin is at its maximum action to tell you how well it is working..

I usually recommend 3-4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

Wendy
 
Bee Gees BG very strange starting 12-22
AM 235 gave 11/2 units PM 215 gave 11/2 units
AM 201 gave 11/2 units PM 89 gave 0
AM 159 gave 0 PM 261 gave 1 1/2 units
AM 81 gave 0 PM 150 gave 0
AM 122 gave 0 PM 133 gave 0
AM 244 gave 1 unit noon 84 PM 213 gave 1 1/2 units
AM 200 gave 1 1/2 units noon 54 (gave her food)
I found the Prozinc protocol and started following it the 25th that would be the day of the 81 BG level, will continue testing
 
It looks like maybe her pancreas is helping out sometimes (when you get a double digit preshot and it continues in that range through the next cycle.) or she is just getting too much insulin and it's lasting longer than one cycle.

If you could set up a spreadsheet and then post on the PZI forum, we could follow her and give advice. I would reduce the dose at this point - maybe .5 or one unit on those 200 preshots and see if you get two shootable preshots instead of a low pmps after that 1.5 dose.
 
I so appreciate all the help, I am 80 years old and sorry to say the download of the spreadsheet is beyond my computer skills.
 
Step by step instructions for the spreadsheet.

Don't let the word 'spreadsheet' faze you. Its laid out like a checkerboard with columns for the date, the insulin, and any tests you get. There's a column for making notes on anything that might alter the glucose readings.

Each row is for one day.
You start at the left and enter the date.
Next you enter the pre-shot test value and the insulin dose you gave.
When you get any extra tests between shots, you put them in the column that indicates how many hours it has been since the shot.
Ex, a test 2 hours after the shot goes in the +2 column.
 
Here is BeeGee's spreadsheet. (We are still working on getting it in Pat's signature)

BeeGee's SS

Pat, the one unit worked well today. The 70 is a very nice nadir. It may be that the food and the insulin are starting to work together and that he will continue to need less insulin. And he might also bounce tonight. (That's when the body senses number that is lower than it is used to and it releases extra glucose) But regardless, I would stay with the one unit for awhile,unless you get a midcycle number under 50 or a preshot under 200.
 
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