Alex - ProZinc user - need dosing help

Alex had been on ProZinc since the middle of April. In most cases, he doesn't show a curve, he's flat. WIth recommendations from several of my ProZinc pros, at the beginning of July, we started over with the dosing at .6, held for 3 days, increased by .2, etc. We still don't really see very many differences between the doses.

Any ideas? Do I need to increase, decrease, hold the doses for longer?

P.S. I am seriously considering trying BCP's PZI insulin, but am having difficulty getting a prescription from by vet due to illness.

 

Hi -
It could be that the 0.6U dose is still too high. You aren't seeing any movement, which could be rebound. One thing you could do would be to take a few more readings sooner after the shot to see if there is any dip at all. Maybe the drop is too fast and you are catching rebound readings later. If there is no drop at all, that also suggests too high a dose. Alternatively, drop the dose even further for a couple of days and see what happens.
Jackie

 

I didn't see your response until after I had already shot this evening, but I did check at +2.

His PMPS was 189 and +2 was 241.

You think is indicates the dose is too high? Can you explain how you concluded that?

 

Where are you shooting? My vets tech initially showed me the rough, when I switched to around the arm and side there was a dramatic change in how Maisey responded to PZI.

 

I started out in the scruff of the neck, but Alex didn't like that. So now, I shoot kind of on the side.

 

Hi -
Part of my reasoning is just a general suspicion that if a cat's numbers don't make sense, then you have to consider whether the dose might be too high and be messing up their metabolism. I don't have as much experience with this as others on the Board, who can probably explain it much better, but if cats are used to having high BG, then they can react to large drops in BG as if they were experiencing hypoglycemia, even if their actual BG numbers don't get low enough to "officially" be hypoglycemia.

The thing that makes me suspect that the insulin dose may be too high is that you frequently see no change in the BG following a dose, and at other times you see a pretty quick drop. On 7/2, the AMPS was 221 and with a dose of 0.6, the +3 was higher at 349, followed by another steep drop to 146 at +6, followed by a big jump to 305 at +9. Then 7/3, the AMPS was again 221 and with the dose of 0.6, there was no change in the BG. This just strikes me as a lot of variability. Alex seems to be sometimes very reactive to this dose and other times, not reactive at all. If there isn't anything else going on, like not eating or something, it makes me suspect some sort of rebound.

In another example, on 6/28 the PMPS was 411 and with a dose of 1.4U, the +3 was 178 and Alex threw up twice. I had similar experience with my cat Argyle when I was giving her Humulin (a rapid insulin) when she was having ketone issues. In Argyle's case, she would vomit liquid or foamy stuff a couple of hours after eating, instead of vomiting food like they sometimes do right after eating if it's just because she ate too fast. I don't know if this was your experience with Alex. I read that when the body is reacting to the rapid BG drop, it can activate the autonomic nervous system and cause epinephrine release, which causes nausea, vomiting, hunger, etc, as well as kicking in the system which causes the liver to dump glucose and cause rebound hyperglycemia. Again, there are others on the Board who could explain it better.

In general, the PS readings have come down from the pink/red levels as you reduced from the 2.0U doses. It makes me wonder if you are headed in the right direction and just haven't gone far enough.

Although I have seen people (sorry - can't remember who) refer to the fact that you can also run into problems if you reduce the dose too quickly. Hopefully someone with more experience can chime in...

Jackie