Need advice please!

Discussion in 'Prozinc / PZI' started by Adam Flowers, Jan 25, 2018.

  1. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Can someone please look at Mogee's SS and give me some advice. Please!

    His PMPS and AMPS were super high last night and this morning. I thought maybe it was because his dose is getting to high and he is either dropping too low or is dropping to much to fast, so I reduced his dose.

    Now he is 283 @ +7 today which is really high. I think I should have stayed with the 3 units but the pastcouple of weeks he has had two days where hedropped really low and it bugs me being at work during the day wondering if he is low so it is hard for me to give the 3 units.

    Any advice??

    Thanks guys!
     
    Last edited: Jan 29, 2018
  2. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I gave my two cents on your other thread in the main health forum.
     
    Adam Flowers likes this.
  3. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    I just found the thread in Main. I agree with Kris' recommendation. Hope Mogee comes back down soon!
     
    Adam Flowers likes this.
  4. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Thanks again guys! Moving up to 3.25 starting this weekend!

    Have a great weekend!
     
    Rachel, Djamila and Kris & Teasel like this.
  5. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Alrighty guys. So this morning I increased Mogee's dose to 3.25 units as we discussed. He is having a great day thus far. I just tested him @ +5 and he is 76.

    Is that too far of a drop from an AMPS of 322? I guess now my big concern is tomorrow I will not be able to test him until my lunch break from work at about +7.5. Worried he may drop lower when I am not here. Just stinks as when I give the 3 units, he doesn't drop nearly as far.
     

    Attached Files:

  6. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    That's a really beautiful number! He's about at nadir, so most likely, he will remain safe. Why not keep an eye on things today and let's see what happens...it's nerve-wracking, but as long as he doesn't drop lower and is in the same range, this dose seems to be giving him a good cycle. It's possible he'll bounce too and remain high and flat tomorrow...hard to know. I'd wait until we see what the rest of this cycle brings before we think about tomorrow.
     
    Adam Flowers likes this.
  7. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    67 @ +6.
     
    Sarah Smith likes this.
  8. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Yes. I am not worried about a hypo today. Just more concerned if he dropped this low on the initial dose change, how low will he go tomorrow if I'm not here. It's just so crazy how 3 units doesn't out him below 100 but .25 more puts him near the low low mark.
     
  9. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Nice numbers! It's a large BG difference from AMPS to nadir but he's not a big bouncer so you should be OK. Are you using an automated feeder? If so you could have it timed to open a bit before nadir while you're away at work. It would be nice to see more of what this 3.25 u dose can do.
     
    Rachel likes this.
  10. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Nice job, Mogee! I agree with Kris and Rachel - so far he's been a pretty steady kitty, so see what happens tonight, but I'd guess he'll be fine. A fairly typical pattern is to have a great initial response, and then settle out a little higher on a dose, so my bet is that the cycles after this will stay safe.

    Unless of course he goes long tonight and you end up with a lower-than-normal PMPS...then it might get a little trickier ;)
     
    Rachel likes this.
  11. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    I think you might be fine with 3.25 again tomorrow. As Kris says, an auto feeder could help. But it looks like Mogee stayed safe today, so if you get something similar tomorrow, you should be fine. If I recall you shoot at 5 AM EST? That's 4 AM my time...I'm not usually up that early, but I am usually on around 4:40 my time (5:40 your time). Could be earlier depending...I'll try to check in as soon as I feed my little ones tomorrow, but will probably be past your shot time.
     
  12. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Went ahead with the 3.25 this morning, even though I was scared to, given Mogee was only 262 AMPS.

    I could only make it until 9:30 at work this morning until I just had to come home to make sure he was okay. He was 232 @ +4? Which is the highest he's been at that time all year. And after that great AM yesterday, Mogee didn't go low at all last night either. It will be interesting to see what the 3.25 does tonight with a PS of 283.

    Is there a reason his numbers would appear flat or higher than normal after that nice AM yeaterday? I know I need to just ride it out.

    As always, any advice is appreciated. We are so grateful for all of you.
     
    Last edited: Jan 29, 2018
  13. Sarah Smith

    Sarah Smith Member

    Joined:
    Apr 20, 2016
    Not a bounce, just a flat cycle from the lows yesterday maybe?? Just a random guess on my part, someone who really knows will be along shortly I'm sure :)
     
  14. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Alas, it's just the bounce cycle:
    1. Mogee goes lower than normal
    2. Mogee goes high and flat
    3. Mogee starts responding again (or gets stuck and you have to increase the dose again)

    The high flat part can last up to six cycles. So tonight is cycle 3. Some kitties only get stuck for a couple of cycles, some get stuck for all six, and some just get stuck. Then you do another increase to get them unstuck and moving again. I would give him another day to see if he gets back to work. This part is really hard. Waiting is no fun. There isn't really a way to speed it along though since his last responsive cycle took him to 67. But there isn't any need to worry about the high flats. They are just part of the process. This is the part where we usually tell people they have to get out their "patience pants"...:)
     
    Yong, Critter Mom, Rachel and 3 others like this.
  15. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Thank you for all the information and advice. As I thought, something I will just have to ride out. He seems fine and happy. I will keep you guys updated on how he does so that you are able to help me decide what to do with his dose!

    Appreciate the help!!
     
    Critter Mom, Djamila and Sarah Smith like this.
  16. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Definitely high and flat again.

    PMPS 283
    +3 303
     
  17. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Yuck. Come on, Mogee! You can do better than this!!!
     
    Adam Flowers likes this.
  18. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Just hoping there's not another underlying issue. First time since diagnosis he has been this high @ +3. I know I need to put on my patience pants but worry overwhelms me.

    Even when he's hit those low numbers in the past, never has he stayed high for this long.
     
  19. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    So.. Mogee got down to about the mid 200s last night and today got in the mid 100s on the 3.25 units..

    I just went to test him for him PMPS and it was 81?!?!

    I tested again to make sure, 92?

    Obviously I stall and don't inject. How long do I wait to test again to see if he goes up at all (usually shoot if over 180)?

    How long do I wait before I can feed him?
     
  20. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Don’t feed. You can test again in 20-30 minutes. You don’t want to feed until we see if he’s rising on his own.
     
    Adam Flowers likes this.
  21. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Yes, I remembered to withhold the food this time!
     
    Critter Mom likes this.
  22. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Okay, I stalled and 25 minutes later he was 94. Do I stall again?
     
  23. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Does this mean he needs a reduced dose as Well? Is the 3.25 units too much? Obviously I'm not injecting a 94, but how did he get this low when he was 163 @ +5?

    He's a hungry boy. When can I feed?
     
  24. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    It's a long cycle - the insulin hasn't worn off yet. I hate to have you skip tonight, but I also don't want you to starve him when it doesn't look like he's going up in any hurry. Go ahead and feed.
     
    Adam Flowers likes this.
  25. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    How long past regular shot time are you at this point? @Kris & Teasel are you around? I'm still at work....
     
  26. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    He usually gets his injection at 5:45 cst. We are 45 minutes past...going to test again in 5 minutes
     
  27. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    I've still stalled with the food.
     
  28. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Shoot - it doesn't look like Kris is around. Don't give up on shooting yet. You may be able to shoot a little late tonight if the food gets him going. I'm heading into a meeting and am going to keep my fingers crossed that Kris, @Rachel or @StephG login soon and can walk you through figuring out a possible dose for a little later.

    Basically you wait for the food to raise the BG, and then give a reduced dose a little off schedule. The reduced dose will be better than nothing, but still wear off before morning, so you should be able to shoot near to your regular time in the morning. I'll be back in about an hour, maybe a little less if I get lucky and we are efficient ;-)

    So assuming this next test isn't a 200 (which seems unlikely), go ahead and feed, and I'll keep my fingers crossed someone logs in to walk you through the next part. If not, I'll be back as soon as I can, but really, it's okay to feed him now. I know how tough it can be to make them wait!
     
  29. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    @Djamila you rock!

    Just tested again. 94, which is 55 minutes after he is supposed to get his injection.

    I am going to feed and then I have to run and get more strips!

    Based on what I read on the Prozinc stickies, I should test him again @ +2 and we can go from there?

    Thanks again. Just let me know how long I should wait to test and post again. You're the best!
     
  30. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Just seeing this now. You can try what Djamila described: feed him, retest 30-45 minutes after food and give a small dose so he's not sky high in the morning. Post as soon as you have that test and we can decide on the reduced dose.
     
    Adam Flowers likes this.
  31. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    How long can your schedule be off?
     
  32. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Hi Chris,
    You have about an hour's leeway with ProZinc before you have to adjust the dose. If it's longer than that you can get back on schedule using increments. Also the low-ish PMPS, feed test a short while after food and give reduced dose is something that can be done with this insulin.
     
  33. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Not too sure what you mean by that...
     
  34. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Chris might be referring to dosing later this evening and how that will impact what you can do if your AM dose time is set by needing to leave for work. ProZinc has a little more flexibility in dosing than Lantus which is what Chris used.
     
    Adam Flowers likes this.
  35. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    Sorry just saw this! I see Kris is here, and gave the exact advice I would! Feed, retest in 45 or so, and shoot token dose. I won't be here probably when you get that number...Kris will you still be able to be around?
     
  36. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    I will test at 730 cdt and post. You guys are so great.
     
  37. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Yes, I'll be here to check in.
     
    Rachel likes this.
  38. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    128, 45 minutes after eating a can of FF. He gets two cans, sometimes two and a half a night.
     
  39. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Mogee gets tested, fed, and given insulin at 5:45 am CDT. All within about 5 minutes.

    I do not leave for work until 7:00...

    I can get up earlier, as I have an alarm set for 4 am to take his food away..
     
  40. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Hooray! I'm so glad you guys got the tag. I felt awful abandoning Adam like that!

    Whoa - Mogee is in no hurry to shake off that AM dose, is he? And you were worried he wasn't responding enough yesterday! ;)

    So you're about two hours past regular time now, right? Which means +14 (if I've counted that right). Prozinc rarely lasts past +14, so he's gotta rise soon. How's he doing with the extra tests? I'm inclined to say give it another 30 minutes and test again as I'm not super comfortable having you shoot on a 128. Let's see what Kris says.... I do want to be mindful that we are right on the edge of the latest you could shoot in the morning before walking out the door.
     
    Adam Flowers likes this.
  41. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    We are exactly 12 minutes until +2. So yeah, about +14 since AM dose.
     
  42. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    I know. I was so worried yesterday. Crazy how this all works.

    I will test again in 30 minutes and post it at 8 pm cdt.

    Thanks again!!!
     
  43. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    OK. His evening shot would be almost 2 hours late, right? So - given that factor and also that his BG is only 128 I was going to suggest 1 u. I like Djamila's idea of waiting another 30 minutes but my feeling is he won't be a lot higher.
     
  44. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    You're probably right, but it has to wear off sometime! I feel good with the 1u as well. And that puts your shot time at 8pm, which means you can definitely shoot at 7am (numbers willing), but can most likely shoot at regular time since I can't imagine one unit won't have worn off in plenty of time.
     
    Kris & Teasel likes this.
  45. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    The Tag Team has spoken! ;)
     
  46. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    You guys are great. Still waiting to get that 8pm reading.

    I trust you guys but it does worry me to shoot low, given I have never done it before. But it also worries how high he may be if he gets none at all.

    Just another new step in this process.
     
    Sarah Smith likes this.
  47. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    Yes....when you stall, what you can do and when you can do it also depends on your shooting schedule. Luckily with ProZinc you have a little more flexibility with time, but it's important that we know how much flexibility you have
     
    Adam Flowers likes this.
  48. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Good to know! I posted my AM availability above.
     
  49. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    As for PM dose availability. I cannot give insulin before 5:45, as I do not get off work until 5:30 CDT.
     
  50. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Alright guys.

    184 two hours and 15 minutes after insulin should have been given..
     
  51. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Should I go ahead with the 1 unit?
     
  52. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Or what happens if I give nothing?
     
  53. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    I think the 1U dose will be fine tonight

    Hopefully he'll give you a shootable number in the morning, but if he doesn't, skipping isn't the end of the world....they always get back on track at some point.

    Might remind him.....No worky for the hoomin=No foody for the kitty!!
     
  54. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Alright, was really hoping to have a no shot night but want what's best for Mogee.

    1 unit it is. Appreciate ALL the help everyone!!
     
    Djamila likes this.
  55. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Obviously dose in AM is dependent upon testing but...

    What is protocol now that I just gave 1 unit @ +2?

    Do I go about things as I normally would in the morning?
     
  56. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Was his PS low because his dose is too high?
     
  57. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    I don't think his dose is too high yet....although I might think it is in another day or so. One wonky cycle isn't enough to reduce the dose just yet, but if he does this again, we'll need to lower it. Sometimes the place the injection is given makes a difference in how it is used an absorbed, so once in awhile you'll get a high cycle or a weird cycle and there isn't anything wrong other than the insulin just got in an odd place that day. So a couple of wonky cycle and we look at other causes.

    As for the morning, I would test him maybe 30 minutes later than normal - so +10.5 from tonight's shot. If he gives you a typical AMPS, then you can go ahead and shoot early. If he's too low, then you'll need to stall and try again at +11.
     
  58. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Disclaimer: For anyone who is lurking or might read this in the future -- we can be this aggressive with the feeding before the shot trick, dosing, and flexing the shooting times because Mogee is on a bigger dose and leaving him without insulin support could send his numbers sky high. If he was only on 1u normally, we would have just had Adam skip tonight. The big dose means that his pancreas is needing a lot of support, and abandoning it for 12 hours with no exogeneous insulin could be bad news.
     
  59. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Chris, thanks for helping out tonight! What does that mean though? I haven't seen it before...
     
  60. Adam Flowers

    Adam Flowers Member

    Joined:
    Sep 23, 2017
    Okay. Sounds good. Thank you for telling me how to work the AM cycle.

    Just tested @ +1, 257. So he's up there. Glad I gave him something.

    And once again, thank you for your time tonight and advice @Djamila, @Chris & China, @Kris & Teasel, and @Rachel.

    So grateful for all of you!
     
    Critter Mom, Rachel and Djamila like this.
  61. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Oh geez! I get it now. Sorry for being slow on that....
     
    Chris & China likes this.
  62. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    Probably because I just made it up....LOL
     

Share This Page