Dosage advice

hi. Have been withPzi since the beginning of January with 1u 2x a day. Haven’t seen a decrease in pretest bgs but I do see lowerblue numbers for longer. I try to test as often as I can with schedule permitting. Today I did a first curve, stopping now due to apptmts but I will update the spreadsheet wit her pm test later. My cat is vastly underweight at 6.03 lbs. she has been on Insulin since last July and losing weight every since. She has had ups and downs with nausea and eating habits so I don’t care when she eats if she’s hungry I never take food away even the minute before a bg test. It’s just out of the question. If she doesn’t get her diabetes under control my fear is starving to death. She’s not processing the nutrients. The Vet did bloodwork early December and while the thyroid values were high, they were not alarming but maybe for her, it is an issue even if they are slightly elevated. My Vet was concerned about treatment bc she didn’t want to make her hypothyroid as I guess the paste medicine has to be given in small amounts due to the potency of it. I have not perused That further bc she had boughts of nausea and wasn’t eating for a couple of days so I was preoccupied. I thought it was pancreatitis but her values were super duper low in the blood work in dec and The Vet said it would be unlikely they would skyrocket in just a month...my goal is to do another round of bloodwork for updates with pancreas and thyroid testing if they have such a thing... until then trying to get her bg under control. The curve i did today was interesting as at her lowest it was 213 and she is usually in the blues. She was eating small a lot today but I’m not sure that has a lot to do with it as the other blues on her ss are under the same circumstances.
I am thinking to increase to 1.25 for next week and I will do a curve next weekend. She randomly had a hypo episode last week so I am worried about dosage but I do think she can afford to go up .25. I will take her bg a few times tomorrow and in the evening to monitor but going back to work (teacher) won’t be able to during the day until next Saturday but I will take
Pm value before bedtime. How does anyone feel about this dosage? I am not seeing the decrease in Am Pm preshot values like i said before and I heard PZI was supposed to help with this? Here is the curve from today until now.

Heard her eating within 4oclock hr
5:00 444
7:00 373
Ate around 9
900 337
10:45 212
Ate
12:00 204
Ate 1:30
1:45 247

Not as good aa some of the other days but on Vetsulin it was out of her system by now and she was in the 300s by noon.
I read the stickies for PZI. Does anyone else agree to raise to 1.25?
Aso - I had a low Pm number and didn’t know what to do that day bc with Vetsulin I would have just waited and decreased the dose. I asked in other forums bc they r busier and one member agreed with me when I wanted to give .25 at 8pm to keep her numbers low at night. It didn’t affect the AM number at all. What is the best way to deal with low numbers under but close to 200 on PZI? Thanks

 

Hi! I do think your kitty needs an increase...bumping to 1.25 (and monitoring) would be good. Then I'd stick with that consistently for several cycles to see if that helps bring Abby down. Generally speaking, when you get a number under 200 we say to stall without feeding for 15 to 20 minutes and re-test...that usually brings them up some and if she was close to 200 (like that night she got 162) she might be high enough then to shoot! If you can't do that, or she doesn't rise, we'd post here and suggest getting some eyes on it. We are a busier forum at night and in the morning. What time zone are you in and when do you shoot? We can usually get someone around to check in on you if we know what time you'll be around.

 

I’m eastern time zone, CT. I SHOOT AT 5am and 5pm.

 

I second Rachel's advice!

 

The regular amount? That’s what I’m not clear on. If a bg for her is near or into 400 and she goes down 200-250pts on 1u how will she not have a hypo if I shoot now 1.25 at 200? Just trying to wrap my head around how insulin is processed in the body.

 

The way forward is to work at building up your BG data base on your SS:

• Stay at 1 u for several cycles and aim to get more data in the +5 to +7 area or at least before bed every day.
• Try to remove all food in a 2 hour window before your preshot test. This is key: you need to know the BG without food influence to determine if a dose will be safe. She can eat freely at all other times.
• If she has a lower PS you can stall for 20 minutes without feeding, retest and if her BG is going up, give a full dose. This can be repeated up to 3 times, a total of one hour's stalling. You can also give a reduced dose, maybe 50% of normal.
• Post here as often as needed for help.

Your curve data for today shows that the insulin is working, the nadir is about 50% of the PS number which is what we look for but you need more data with non food-influenced PS tests. The response to insulin can be erratic in many cats so dropping 200 points to nadir on one dose doesn't mean that'll happen on another dose. It's variable and that's why learning your kitty's patterns by BG testing is so important.