Elmo on Prozinc..What do u think

Hi,

Elmo has been on Prozinc for about a week now, pretty much did a curve on him today...

He has mostly been on one but I have sometimes been giving him 1.5 so I do not even think the curve I did today is really that accurate.

My plan was to leave him on 1.5 unless he goes low.

I was also wondering if this is ok to give one unit one day, 1.5 another or should I just be giving one amount so he settles?

Any advise is appreciated.

I test his ketones weekly.

I am trying to do the start low go slow but I get ancy that his numbers are kinda all over.

He eats friskies canned only 3 times a day, one feeding am dose, one pm dose then again at bedtime 10-11pm or so.

Thanks :mrgreen:

 

Hey there,

I'll try to answer the best I can.

Good news is you did get a bit of a curve today on 5/9 - so you are probably close to a good dose. However it appears 1.5 *may* not be enough insulin [by just a hair maybe]. But you may want to move to using U100 syringes [which I assume you have already since you were using U100 insulin before] with the conversion chart. VERY IMPORTANT to use the conversion chart in the sticky at the top of this forum - and if you have any questions to ask before dosing and maybe even practice with water a few times. Anyway this will help you dosing be more consistent - but read the warning and use the CONVERSION CHART.

A couple things:
1) I just saw you are now using ProZinc which is U40. Are you using the U100 syringes with this? If you are then you can make dosing changes in .2U changes with the conversion table linked in the sticky in the top of this forum. So you could up to say 1.6 for right now. If you are using the U40 syringes then do they have a half unit markings?

2) If you could put together your profile as instructed in the tech support forum that would help us help you best by giving us a more complete picture of what is going on.

3) Not sure if I've given you the free feeding lecture or not ;-) , but free feeding is best if Elmo is not overweight or overweight prone [and then timed feeders are a good way to help approximate free feeding]. I put water into H's food so it does not get crusty. Your 3 feeding may end up being free feeding, I don't know.

PZI is very flexible, some cats do best when the doses are help for several cycles to let it settle and others like mine does OK when the dose is changed ever cycle [this is sometimes called "sliding scale" or I call it "variable dosing strategy." However, while you are starting out the best seems to be to let the dose settle for a few cycles at least. I hear you about getting antsy but diabetes is a marathon and not a sprint. If you skip over the right dose you could loose even more time dealing with a rebound situation [or worse]. As you progress, and you get to a point where the numbers are dropping you will probably want to adjust the dose down by just a hair, say .2u [if you are using the U100 syringes] and you start to get PSs that border or cross your no shoot level. I found that with ProZinc H kind of had to be taught to do variable dosing, it seemed may that his little body had to get use to it, but once it settled into that style then things were OK.

I do like how Elmo dropped into the mid 200's for the AMPS on 5/8. I'd say you guys are doing pretty darned awesome for the fact you only been on ProZinc a week.

I hope I'm answering all your questions, don't hesitate to ask more or for clarification. This seem a little slow in here recently - I'm hoping others will be along eventually.

What is your current no shoot number?

 

Hi,

Thanks for answering, I think I have talked to you before.

I am currently using U40 syringes and I am eyeballing one and a half units since there is no line for half on the syringe.

I do also have U100 syringes and I have conversion chart but have not been using U100 syringes.

I am am experienced vet tech so I can do the conversion easily but get confused with what dosage etc.

I thought that I did have a profile for Elmo?? I will have to check tomorrow and see..

I give them canned at about 7am, 5pm and then again at 10-11pm so this is a free feeding as its gonna get with 8 cats.. I give 2 cans 7am, 2 cans 5pm and 3 at 11pm.

So based on his spread sheet and curve do u think I should up him to 1.6 or 1.8 or should I just continue with the 1.5 for another week??

 

Hey there, sorry I do not know [or remember your name]. Seems there's been a few through here in the past week or two and I'm sorry my brain is a little mushy when it comes to the old short term memory [clever paradox intended ].

Shweet! We need more pros/old-hands like you in here! Practicing with water can help and if you have any questions make sure to ask BEFORE dosing. Make sure to PRINT out that chart and post it to where it is obvious [I have mine magnet-ed to my fridge].

If you have the profile then just link to it in your signature like you have the SS.

Understood. "Closest approximate" is the key.

Well my direct thoughts are that I think you should get down to business with the U100 syringes which will help you make more consistent doses. Of course you should only do this if you feel comfortable with it but that is my option [the option of some random dude in a cat forum ]. If it were me, then I would try the 1.6 for few cycles. You might have been getting some action with 1.5 but today's curve was a little shallow and your are guesstimating doses right now. Make sure you have your no shoot [the PS level at which you will not give insulin] level set. This level is usually 200 for beginners and as you get more data and confidence then that number will drop to perhaps 150 [H's is about 90 at this point]. If you hit your NS level then [depending on your nadir] you may want want to reduce the dose down just a hair maybe like .1 or .2u. The thing is that PZI is not like some other insulins and really doesn't take that long to settle. Especially if you are testing a lot then you should be able to predict how that dose is doing. If you are testing less then it might take a little longer to predict how a dose is doing or exactly what it is doing. As I said the GREAT news is that you are getting a regular looking curve - though just a little shallow at this point maybe. So that is my $0.02 - I hope I answers your questions for the moment?

BTW, this might be getting the cart before the horse but if you want to read about some more advanced dosing techniques you can search this forum for "VDS" or "Variable dosing strategy" just to give you an idea of strategies beyond SLGS. This is usually more advanced than beginner level but it might give you an idea of the flexibility of PZI and maybe something down the road for you to explore. Again, if you have any questions please ask.

Things seem slow in here in PZI for the moment, I hope others will be along to give their own $0.02.

 

ok now giving him 1.6 in u100 syringe so we shall see.

I tested him at plus 4 just to see and he had dropped over 100 points, that was surprising condsidering he has not dropped much recently.

will wait atleast a week to 10 days then do a curve.

thanks

 

You don't need to wait 10 days. Pretty much after 3 cycles they are used to the dose change. Max I would wait would be 6 cycles [3 days]. If your schedule doesn't permit it then that's another story... But if you don't get anywhere where with the 1.6 then I would bump up by .1 or .2u after a few cycles. And you are doing a good job getting those mid-cycle numbers. :smile: I like making smaller more frequent changes - that's just my thing.

Good work on getting the U100s going. I think you will find that they will make things a lot easier for you ultimately. Certainly you can trust the consistency of the dose increments more.