Why does 1.5 does cause such a high preshot?

It looks like I need to raise the dose of insulin for my cat. I want to go to a 1.5 but whenever I iniate this slightly higher dose. I get very high preshots for some of the cycles. I tried 1.5 for about a week straight. Do you think I should try another week I did some readings with the 1.5 and I didn't see
any low numbers for bouncing, but is it possible that it went lower after hour 7 for a later nadir? when I do a little less
1.5 I don't get preshots as high?
Is this usual for such a slight dose increase. Is my cat sensitive at first to dose increase and then will acclimate. Should I press on and try it again for a week without changing and see what happens while getting some more

numbers? Is there a cumulative effect with Pro Zinc.

 

I'm not experienced enough to help with the dosing, but I do know that prozinc is not a depot insulin, its in at shot time, out by next, definitely not cumulative (I've seen duration quoted as 10-14 hours, my cat runs closer to ten I think)

eta: After looking more closely at your ss, I kind of get the feeling your kitty IS bouncing, hopefully a pro will be along soon to give you advice on how to proceed... (personally I think too much insulin)

 

Hi Catherine,
I understand your frustration from looking at Lovey's spreadsheet.

You are testing often during the PM cycle at the time that nadir should be happening, and no, you aren't seeing scary low numbers, so I get wondering "why would bouncing be happening?"

Yes, it is possible that nadir isn't happening when we would typically look for it to be happening, and maybe there are lower numbers early or late in the cycle that you aren't catching. But +6 is when it should be happening, and you can't test all day and night trying to find the elusive "low number".

Looking at just one cycle, and you can't draw conclusions from just one cycle... but the night of the 31st. You tested at +3, +5 and +7. And it looks like nadir happened either at +5, or maybe at +6 to me. And not scary low. But, if you consider that PMPS was close to 400, and nadir close to 200, that is a 200 point drop. And it is possible that a 200 point drop, even though the numbers didn't go really low, could cause a bounce. Maybe 200 is low enough to cause that. For now, but it won't always be that way. The more times Lovey sees blue numbers, the less bouncing will happen. And eventually, a 150 or a 100 won't cause a bounce either. (the other thing we all need to keep in mind is that these are "Alpha track" numbers, so while your spreadsheet says 200, on a human meter that might be a 160-170 or so.) And yeah, that might cause a bounce.

Thing is, there's very little you can do to stop bounces from happening, short of lowering the dose. And that can be counterproductive because it can cause you to just live in the higher numbers for most if not all of the day and night. So bounces are just something we have to deal with and live with until a cat stops doing them.

Bounces are "usual" unfortunately. I don't think I've seen a kitty who doesn't at some time bounce. But as far as a "slight dose increase" goes. No, .25u doesn't seem like much, but if you look at it in terms of "how big a percentage increase is it?" then it isn't so slight. Going from 1.25 to 1.50 is a 20% increase in dosage. If you were shooting 4u, and went up by .25u, that's a pretty insignificant percentage. But 20% is fairly significant.

As far as cumulative effect, do you mean does one dose build upon the prior shot? In that case, no. Once a dose of Prozinc wears off, it's gone from the system. There isn't a "depot" like with Lantus where there is more of a cumulative effect going on. Now, you could see "overlap", where a dose isn't quite worn off by 12 hours after a shot, and the next shot sort of starts working before the last dose is totally gone. But when that happens, what you'd normally see on the SS is a lower than anticipated preshot, followed by an earlier than normal drop in numbers after the 2nd shot is given. What you are seeing is a higher than anticipated 2nd preshot, which would seem to be either a bounce, or indicates that the shots aren't quite lasting 12 hours as if the insulin is worn off well before the time for the next shot.

I think that I would try to stay with 1.5u for a few days, and when you can, try to test around +6, and then after 3-4 more days at that dose, reevaluate?

 

Thanks, Bob. Last night I used the shy 1.5 (I got a 199 at 5 hours 30 minutes. Today's preshot was really high, 471.

 

I would try 1 3/4 units.

 

I'm with Carl. The insulin is giving you a very decent drop so I think he is bouncing. It is frustrating to see the high preshots but I think you have to consider midcycle numbers and preshot numbers both.

 

Thank you all for your timely input and feedback!

I appreciate all your responses and views to help my cat. I really appreciate your time and effort on this holiday weekend.


Thank you