Mary Dosing thoughts?

Discussion in 'Prozinc / PZI' started by Sarah Smith, Jan 16, 2018.

  1. Sarah Smith

    Sarah Smith Member

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    Morning all!

    I am trying to figure out a dose for Mary this morning, I've already started off poorly with her. I did not do a PM dose last night, The vet starting her at the clinic messed up all the timing and she was 104 at +8.5. 2 hours before AMPS she was 231. I did have to give her some food, syringe fed 10ml of RC recovery. she is on her IV right now, so trying to get a gameplan for insulin. Vet started on 1u, which dropped her from 512 to 138 at +6. I will not be home to test, and mom wont learn how to do it.... I figure 1u will probably be too much, but was hoping for some input.

    Thanks!
     
  2. Sarah Smith

    Sarah Smith Member

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    AMPS is 262, but is food influenced.... i k ow she needs something but Im scared to give any.....
     
  3. Djamila

    Djamila Well-Known Member

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    It may be too late, but I think 0.5u would be safe. You don't really want her to have no insulin when she's fighting ketones.
     
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  4. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I hope this isn't too late. She absolutely needs insulin after her positive ketones test. I think 0.5 u would be OK.
     
  5. Rachel

    Rachel Well-Known Member

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    Did you manage to give her any insulin, Sarah?
     
  6. Sarah Smith

    Sarah Smith Member

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    Sorry, will explain in a bit, no insulin this morning, PMPS is 373, it is an hour after I had scheduled to do her PM.... going to do .5u, I only have full unit syringes.... she is still not eating on her own, syringe fed her 10ml of RC recovery
     
  7. Critter Mom

    Critter Mom Well-Known Member

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    Does she have any anti-nausea medicinal support in place yet, Sarah? And is she pooping OK?


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  8. Sarah Smith

    Sarah Smith Member

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    Pooping yes, she was given something at the vet, but Im not sure its helping. Honestly just walked in the door, scooped her up, tested/fed posted. Will .5 be too much u think? just found some U-100's for smaller dosing
     
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  9. Kris & Teasel

    Kris & Teasel Well-Known Member

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    So - no insulin last night or this AM, correct? You'll have to eyeball the 0.5 u dose as carefully as you can. It's possible she might end up needing 0.75 u so if you can find some U40 syringes with half unit marks they'll help. I think they can be ordered from adwdiabetes.com.
     
  10. Critter Mom

    Critter Mom Well-Known Member

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    May I enquire as to the brand and model name of the syringes you're using for feeding, Sarah and also where you get them (a link would be great if you have one).

    A Swedish member needs to assist feed her kitty for the foreseeable future and she's being charged > USD$ 7 a pop for a 10ml syringe. (Feeding via mouth, not tube.) I'd welcome any suggestions or advice you can offer.


    Mogs
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  11. Sarah Smith

    Sarah Smith Member

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    Dont have the u100 conversion anymore anyway....
     
  12. Critter Mom

    Critter Mom Well-Known Member

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    I suggest keeping a close eye on frequency and consistency of bowel movements. The last thing you need is constipation and worsening nausea going on on top of everything else.


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  13. Critter Mom

    Critter Mom Well-Known Member

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  14. Sarah Smith

    Sarah Smith Member

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    Thanks Mogs! Shes in her crate getting her evening IV, need to go out and feed my community cats, will be back in about 15 to clear up the day and update everyone....
     
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  15. Kris & Teasel

    Kris & Teasel Well-Known Member

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  16. Sarah Smith

    Sarah Smith Member

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    Thanks to you as well Kris! Mogs, sorry I cant help much with the syringes, The brand is Nipro and they are 11ml. My vet gave them to me, I need a few more and will inquire with her tomorrow. I wound up erring on the side of caution and giving her on the low side of .5, I dont have half unit syringes and did not have the U-100 conversion until after I shot.... She was 373 PMPS, is 372 at .5. I was running late tonight, had to go feed the feral colony I care for behimd my old house. I did not make it to them yesterday with Mary's vet visit and the weather is so cold right now I was scared not to get them some food. Forgot yesterday that there will be 3 days a week I will probably have to shoot PM doses a little late due to this. Monday, Wed and Friday...
     
  17. Critter Mom

    Critter Mom Well-Known Member

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    Sarah, thanks for the info and for offering to check with your vet. Mucho appreciated. :)


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  18. Sarah Smith

    Sarah Smith Member

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    Wanted to clear the air about this morning, then its time to feed Me and my other furry family. Too many mouths around here! Have mine, 3 outside not quite feral (I can work them to a point) and 14 in a colony behind the house I moved from this summer I wish I could relocate here....
    I know I should have given a dose this morning but I did not feel safe doing it. My mom does not know how to test, I am trying to get her to at least let me show her, she may be coming around slowly. With her on antibiotics, not eating not having any history of how she'd react to any dose except a 400 pt drop at +6 the day before. Also my strips were expired and I had no HC food in the house..... I just didnt feel safe with the whole situation. I just hope I made the right call!
     
  19. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You were caught between a rock and a hard place ... Have you been able to get urine ketone test strips?
     
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  20. Sarah Smith

    Sarah Smith Member

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    Bought some new Ketone strips and test strips today Kris :) Now to catch her in the act! I have a homemade litterbox in the crate with her, hoping the fluids will make her go, they did last night. She looks so frail right now its scarey.... I need to update my profile pic, I still have Cooter up there, but have to find a good one for it. trying to remember, 2 hrs PS is when to start watching correct? she actually went up to 398 at +1.5, and I do need to get some more food into her shortly....

    Edit: She just dropped to 314 at +2, so away we go!
     
    Last edited: Jan 16, 2018
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  21. Kris & Teasel

    Kris & Teasel Well-Known Member

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    ProZinc’s onset is about 2 to 3 hours after the shot and the nadir is about 5 to 7 hours after.
     
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  22. Rachel

    Rachel Well-Known Member

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    You have to do what you feel i s right. That's a tough spot to be in...know that we aren't going to judge you here, Sarah! We just worry about all our kitties here and when we don't hear an update, we tend to question what's going on! Please do let us know once you get a ketone test...I'm hoping that her ketones have come down!
     
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  23. Sarah Smith

    Sarah Smith Member

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    Thanks Rachel :) I had forgot my phone yesterday morning so couldnt read/post anything all day, Glad yesterday is done! AMPS was 332, syringe fed her 10ml of RC recovery and gave her 1u. I have not been able to get a ketone test, and am dropping her at the vets this morning. I'm hoping the can get a test and give her something for neausea and appetite.
     
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  24. Djamila

    Djamila Well-Known Member

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    Sending healing vines to Mary today! :bighug:
     
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  25. Sarah Smith

    Sarah Smith Member

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    No ketones detected in multiple tests today at vet! +10 of 170 at vets as well. on our way home with different fluids and some meds
     
  26. Critter Mom

    Critter Mom Well-Known Member

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    We like this sort of news, Sarah! :cat:


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  27. Critter Mom

    Critter Mom Well-Known Member

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    BTW, which meds did you get to help with Mary's appetite problems?


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  28. Sarah Smith

    Sarah Smith Member

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    Ok, pretty much settled now so can type for a few while I eat. Doc wants to drop Mary down to .5 BID for now. I dont have any half unit syringes, so did .4 with a U100 (1u as marked on the U100 syringe). Came home with mirtazapine, which I had, but wasnt sure it was actually good, it was from awhile back. Also got some Metoclopramide, which I've never used before, and feedback is most appreciated! Her potassium is still pretty low, Vet thinks this is making Mary neauseas (I cant spell!). changed her fluids from Plasma-lyte A 200mls a day to 9% Saline with Potassium added 150ml a day. She is also still on the clavamox, and has been sniffling a little since last night. She does look better today though, was bright eyed when I picked her up, so I know we arent out of the woods, but feeling better about her situation!
     
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  29. Djamila

    Djamila Well-Known Member

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    So great to hear that she is bright eyed and ketone free!!! I can't help with the meds, but I'm sure Mogs will be along soon! @Critter Mom
     
  30. Critter Mom

    Critter Mom Well-Known Member

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    Will chime in on the nausea side of things on the morrow. Sleep meds on board and about to pass out.


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  31. Sarah Smith

    Sarah Smith Member

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    Thanks Mogs! Have a good night :cat:
     
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  32. Sarah Smith

    Sarah Smith Member

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    Mogs,
    Sorry I didnt get this info for you yesterday, its been a LOONG WEEK! Got another syringe for feeding today so i could get a look at the package. They are leur slip tips, small for getting in little mouths. Foind 100 for $17 on amazon.
    https://www.amazon.com/gp/aw/d/B01J..._SY340_QL65&keywords=nipro 10ml syringe&psc=1
     

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  33. Critter Mom

    Critter Mom Well-Known Member

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    @Sarah Smith - Thank you! You're a star!! :bighug:

    Great to see a pic of Mary! She has a lovely little face. :cat:


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  34. Sarah Smith

    Sarah Smith Member

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    @Critter Mom Just wanted to tag you so you didnt miss the above post. I can only imagine how hectic your alert box is! Forfot to tag you on it the first time :cat:
     
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  35. Kris & Teasel

    Kris & Teasel Well-Known Member

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    She's a very cute girl! :) How is she doing today? If you have a minute it would be helpful if you updates your SS.
     
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  36. Sarah Smith

    Sarah Smith Member

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    Found a good pic from a few months ago, before we moved. She always has the quirkiest looks! I will work on the spreadsheet this evening Kris, will try to get her numbers from the vet, they've had her during the day almost all week.
     
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  37. Critter Mom

    Critter Mom Well-Known Member

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    I think Mary has an adorable little face. Her avatar always catches my eye. :)


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  38. Sarah Smith

    Sarah Smith Member

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    Wanted to give a update and take a minute to thank everyone who has been helping us through the beginning of this!
    Mary is slowly coming back to her normal self. Yesterday and today she has been much perkier, talking to me more, wandering around the house, and is drinking a bit today. She absolutely would not sit still for her afternoon fluids, so we did half and will rotate in another short session to make up the difference. She is still getting 150ml of Saline with potassium a day through the weekend. Her labs looked alot better yesterday, though her electrolytes are still a bit out of balance. I added yesterdays labs to her spreadsheet, Mondays are there as well if anyone wants a glance. Wish I knew more about interpreting them, I rely on the red (high) and green (low) color codes on the printout.
    Now for the part I am a not proud of.... her numbers. Thursday is bare... she was staying in the 100's all day at the vet Thursday (still need to get the numbers) and the vet was thinking maybe sge osnt diabetic, but with her bloodwork so out of wack and some sort of infection it threw her glucose way up. She asked me not to give Mary any insulin Thursday night or Friday morning. I opted to go with that... by the time she got to the vet Friday she was high again. All the numbers from yesterday except AM +10 are vet numbers. Once again she was in the mid 100's all day. Vet suggested she may only need 1 dose a day. She was still mid 100's come PM time, so I decided to give the one dose theory a try. This morning she was 456.... I will not be doing either of these again! I did .5 units, which did not bring her down to the 100's, but looks like we will have a number that is not scarey to give .5 too this evening. Here is Mary sitting on the cat tree a little while ago, she is definately feeling better, and hopefully I have had my stupid decisions quota filled the last few days and we can get her feeling normal again!
     

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  39. Critter Mom

    Critter Mom Well-Known Member

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    Love the pic! Mary looks like a real 'old soul'. (((Mary))) :cat:

    It's very good to hear that she's starting to feel better.


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  40. Sarah Smith

    Sarah Smith Member

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    She ate!! Well, kind of :) She licked off a bit of some Sheba whitefish and tuna Pate. its not enough to help pre insulin though. shes at 228 PMPS, thinking .2 will be better based on Thursday mornings numbers which were close to the same...
     
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  41. Critter Mom

    Critter Mom Well-Known Member

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    I'm glad to hear that Mary ate a little for you. :)

    Unfortunately I can't comment on the dosing side of things (never used Prozinc).


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  42. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I suggest you try 0.2 u and get a +2 test to see where she's headed. In the early days of data gathering almost every dose is an experiment. At some point it would be good to find a moderate dose that you can give both AM and PM for a few days in a row to see if she'll settle. Too much dose hopping can increase the ups and downs in her BG readings.
     
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  43. AbyResq

    AbyResq Member

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    I'm glad she's starting to eat, Sarah.
     
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  44. Sarah Smith

    Sarah Smith Member

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    I'm hoping to settle in at .2 AM and PM. I screwed up this week with the PM misses, which raised her AM's, needing the .5's. hoping the dose tonight will keep her AM at a decent number tomorrow that we can dose at .2 again..... but lets see if the numbers cooperate tonight :cat:
    Edit: Forgot to mention, Negative Ketone strip!
     
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  45. Rachel

    Rachel Well-Known Member

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    I’m glad she ate some! I think your plan is a good one. :)
     
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  46. Sarah Smith

    Sarah Smith Member

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    Yay! The eating was not a fluke! She has now eaten 4 small amounts of pate :cat: This is awesome since my biggest worry was low BG and her not eating :facepalm:
     
  47. AbyResq

    AbyResq Member

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    Happy dance for Mary eating! :D What a relief for you.
     
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  48. Kris & Teasel

    Kris & Teasel Well-Known Member

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    One of our general recommendations for ProZinc dosing is to keep a dose for three cycles to evaluate it. If it doesn't seem to be quite high enough, raise it a little bit after three cycles. If you think Mary has recovered enough of her appetite and the numbers this cycle and next permit, you could try 0.4 u tomorrow AM. We want to keep ketones at bay. Are you dosing the ProZinc with U100 syringes and the conversion chart?
     
    Last edited: Jan 21, 2018
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  49. Critter Mom

    Critter Mom Well-Known Member

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    Pardon the drooler intrusion, but ...

    [​IMG]

    Woot! :woot:


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  50. Sarah Smith

    Sarah Smith Member

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    Yep, using U100's and the chart. Slight snag with raising... Shes at 100 +4 with no appetite... have gravy and a syringe if it comes down to it, just trying not to panic too early and sabotage this cycle. will be checking again in 15min at +4.5
     
  51. Djamila

    Djamila Well-Known Member

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    From the 105 and the 100, it looks like she's surfing. Remember she is safe until 50, so no need to panic. Just keep posting the results you get and we'll keep an eye on her with you. :bighug:
     
  52. Sarah Smith

    Sarah Smith Member

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    Now I'm confused... I took no intervention and got a 312. Checked twice more to be sure and got 329 and 328 from both ears..... I know the samples on the 105 and 100 were a little lean, could that have caused low numbers?
     
  53. Djamila

    Djamila Well-Known Member

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    I suppose wonky tests are possible, but it seems unlikely that you'd get a 105 and a 100 and have both of those be errors. Although going from 100 to 329 without carbs in a half hour seems a little unlikely too. Oh cats....:cat: Assuming all of the tests are accurate, and assuming she didn't sneak out and have an ice cream sundae between the 100 and 329, the next options are either short duration since the dose was too small - it just ran out. Or a bounce either because she hasn't been down that low before, or because of the frequent dose changes.

    Don't worry about it too much at this point. Grab another test a little later in the cycle if you can today, and go ahead with dose increases as Kris suggested, and just keep an eye on things.
     
  54. Sarah Smith

    Sarah Smith Member

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    Chickened out on the dose increase, she is just not eating enough yet that I feel comfortable I could steer her if she started diving. She was off food for just about a week, and her stomach must have shrunk a bit. Good news is she did eat a little at PMPS. She is only managing to down about a quarter of the sheba perfect portions at a sitting, which are 1.3oz I believe. PMPS was 266, so we should get down in the blues this evening.
     
  55. Rachel

    Rachel Well-Known Member

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    Hoping that she starts eating more soon!
     
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  56. AbyResq

    AbyResq Member

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    Come on Mary, you can do it.
     
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