Late Nadir?

Discussion in 'Prozinc / PZI' started by AbyResq, Jan 20, 2018.

  1. AbyResq

    AbyResq Member

    Joined:
    Feb 28, 2016
    ECID and Sweet Pea is definitely different than the last 3 cats I had on Prozinc. For the last 3 daytime cycles his PMPS numbers have looked like his nadir. Way too low to shoot. I ran a full curve today. I've been feeding him at shot time and around +4. I think I'm going to add another meal around +8 to see if it brings his glucose up for the next cycle. Would you adjust his dose too?
     
  2. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    I think I'd go with the +8 snack first (or maybe even +9) and see if that works to make the PMPS's more comfortably shootable.

    Another option would be to lower the AM dose so you get less duration.

    And a third option (so many choices with Prozinc!) would be to give a small dose on the PM cycle and then monitor. Those AMPS's are high enough that he may actually be able to take some insulin on lower numbers and be okay with it.

    I would suggest getting a +2, +3, etc. tonight and see at what point the insulin wears off. Getting an idea of his duration will help figure out the next step.
     
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  3. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Wondering if Sweet Pea might be going low during some PM cycles on the somewhat higher doses and bouncing up to AMPS as a consequence? (See 16 Jan PM cycle - BG still falling at +5.)

    (Just chuckin' ideas out here.)


    Mogs
    .
     
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  4. AbyResq

    AbyResq Member

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    Feb 28, 2016
    All ideas are welcome. Most of his PM cycles after 1/16 were at reduced doses because the AM cycles surfed along.

    At +14 he's 156. I don't know enough about him to shoot at that number. If he's >180 by +15 I think I will try 1.2 for tonight. 1 didn't hold him when I tried that the other night. He's enjoying all of the extra meals.
     
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  5. Sarah Smith

    Sarah Smith Member

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    Apr 20, 2016
    :bighug: Wish I had some advice!
     
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  6. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Since onset with Prozinc is usually +2 or slightly after that (of course ECID and all), if you had given the dose at shot time it would be grabbing onto the 156. I'm guessing that would be okay, but I certainly understand the caution. So if you shoot at +3/+15, the insulin will be grabbing a number that is approx two hours later than that, which should be a nice safe number.

    This makes me wonder if another option for managing the late nadir might be to shoot on a 13/11 dosing cycle. Again, there are a lot of ways to approach this with prozinc, so it just depends on what sounds best to you, and what level of monitoring/intervention you want to try.
     
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  7. AbyResq

    AbyResq Member

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    Feb 28, 2016
    I can't be a risk taker overnight right now. I still don't have tons of energy from dealing with the flu. I have no issues testing, a lot, but I don't want to risk sleeping through a hypo. A 13/11 dosing cycle might be a good option for him, hmmmmm.
     
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  8. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    I can totally understand that. I find it nearly impossible to wake up during the night, so I'm with you on not wanting to risk middle-of-the-night hypos. And also, I think we have plenty of other things to try that don't involve a high level of risk at this point. We can start gambling more later if the snack and the 13/11 don't fix the problem. If we can figure out a way to give a PM dose, I think those AMPS numbers will start looking much better.
     
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  9. AbyResq

    AbyResq Member

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    Feb 28, 2016
    +15 - 151

    We may end up skipping again tonight. I will give him one more test at +16.
     
  10. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Make sure you get the sleep you need though. If you need to skip tonight it will be okay. You've got a good plan for tomorrow to try to get him back on two shots.
     
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