Crackerton...new to PZI..starting micro dose tonight...hoping we can get it.

I have 3 years experience with and acro cat, PZI and a sliding scale...but it was LONG ago. Started Crackerton on lantus...he is on such micro doses the shed is majorly screwing him up. .25 unit is too much once the shed is full and 1 drop is not enough. He had major dental issues that now fixed may be having him close to remission. He has horrible neuropathy. I am starting a dose of .2 unit by using a u100 syringe. I will eventually need help with a sliding scale...so happy to be rid of the shed! Any advice appreciated....the bouncing happened every time his shed got full...poor guy.

 

Hi Jen and welcome. It looks like you were moving the dose around quite a bit on Lantus which can make it hard to see the benefit of the shed/depot. If you're more comfortable with Prozinc though, it's a great insulin too.

My advice for you at this point would just be to collect some data now that Crackerton is on Prozinc and once he's had some time to adjust we can figure out next steps.

 

Well on 0.2 unit he was 164 AMPS so I was not about to shoot and go to work and not be able to monitor. That was more than a 200 point drop between the preshots. His plus 8 was 369..
With Lantus I moved around doses because every time the shed got full on 0.25 units he bounced way high...it was too much insulin. When at only a drop it wasn’t enough.
I am thinking first part of sliding scale is regular dose 0.2 unit. If preshot under 200 0.1 unit...after that I only have drops to deal with. This micro doses are a pain!
What do you think? He does not tolerate being in the greens well...he immediately bounces. We have to take him slow...

 

That AMPS was maybe still being affected by the Lantus since I believe the depot takes a few cycles to clear. I agree with @Djamila, collect more data. Try to stick with a consistent dose for a few cycles so he has a chance to even out and get through the bouncing.. unless of course he drops into hypo range.

 

I started typing a big analysis of what you were seeing on Lantus, but then realized that going back into history isn't going to help you at this point since you aren't using Lantus anymore anyway. So let's just move forward with getting Crackerton adjusted to his new insulin.

Bouncing is just a part of the process for many cats. if they never move through the bounce they'll never get to better numbers. You can't reduce the dose every time he hits a green if you want him to improve. We'll be happy to help you get this all sorted as you move forward.
For now, just give him a few days at a steady dose and collect data, then we can see what needs to happen from there.

 

Well I lowered the dose by half with a amps of 207...@+8 he is 356...I think this is a bounce. I can not monitor til +8. There is no way for me to predict a hypo. Tomorrow morning I can monitor some as I have leeway with work on Fridays. What is your opinion on the +8 today?

 

My opinion is that its really important for you to get some +4 to +7 numbers tomorrow if you can to see what he's really doing... to try to catch the nadir. My guess would be that the +8 today was caused by too little insulin, but without enough data its hard to know for sure. Either way, pick a dose you are comfortable with and stick with it for at least 3-4 cycles. Consistency is what will get him through the bouncing. If the nadirs after 3-4 cycles are still too high, then you know its safe to increase. Base your dose increases/decreases on the nadirs, not the bounces.

Good luck!

 

I agree that this looks like a bounce after a decent AMPS. Maybe keep the 0.1 u dose until the weekend and do a full curve then? I, personally, like keeping a dose consistent AM and PM unless a low number tells you to reduce. Changing dose according to PS can work once the kitty is more settled at/near a good dose range. Until then it can cause quite erratic numbers in bouncy boys like Crackerton.

Have you been giving B12 to help with his neuropathy? How is he feeling overall?

 

He is an enormous love bug...all over me...super gregarious...eating tons...he hates bg tests and insulin...he is a fighter...
He is taking zobaline which is the methylcobalamine (spelling) version of b12 which is more absorbable...his neuropathy MAY be improving but I see him all the time..hard to tell...he is either getting more coordinated or it is getting better...at first he walked like a slippery seal...not getting anywhere fast...now he has forward motion quite quickly...his carpal neuropathy is very bad...vet is afraid he will need fusion eventually...

 

PMPS 405 did 0.2 unit...will do curve part tonight and some tomorrow...barring super low number will shoot the same tomorrow....
BTW...I am recording the actual dose but using u100 syringes it is drawing to the .5...which number should I be reporting? It is confusing to keep them straight....

 

Record actual dose.

 

I agree with @SpotsMom - I don't think this is a bounce, I think it's a high number from insufficient insulin. Getting tests in earlier in the cycle will help to know for sure. It's possible there is a low number hiding in there that we just can't see, but my hunch is that he just didn't get enough insulin to hold his numbers down.