Zulu - dosing help needed

Discussion in 'Prozinc / PZI' started by ZulusMom, Oct 11, 2017.

  1. ZulusMom

    ZulusMom Member

    Joined:
    Aug 31, 2017
    I'm at a loss. I switched Zulu over from a high carb diet to low carb about two weeks ago. Before I made the switch I lowered his dosage a little to offset any drops from the diet change. Instead of seeing drops in his pre-shot numbers, though, they've gotten higher. I started increasing his dose to compensate, then realized maybe he was getting too much insulin(?). I dropped him down to 1 unit 2x per day but his pre-shot numbers are still higher than they were before the switch. I'm not sure if I should go higher or lower, and I know I don't have enough data (we had a lot of trouble getting home-testing down, and still not perfect). My husband will be home to get a mid-cycle number, but we won't be able to run a full curve until the weekend.

    The link to his spreadsheet is below - I apologize, since his dosing and testing is all over the place and there isn't really a lot to go on. I'm considering dropping his dose to 0.5 units and seeing if that helps, but his pre-shot numbers are freaking me out.

    https://docs.google.com/spreadsheet...2fkiUi8UOp2pHWt_n96wbpyoRkgxXCvaetvoj/pubhtml
     
  2. ZulusMom

    ZulusMom Member

    Joined:
    Aug 31, 2017
    His AMPS +5 was 262, so a drop of 109
     
  3. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    Welcome Zulu's Mum!
    First thing I notice is the jumping around with doses. With newer diagnosed kitties, this can cause some wonkiness. His testing doesn't seem all over the place and I know you guys are still working on your routine :bighug:. The most important tests are AMPS and PMPS with him not having eaten for at least 2 hours prior to this time so the BG isn't food influenced ;).

    Has Zulu ever been hospitalized for DKA? We want to make sure he isn't prone to ketones so you don't hold a lower dose and leave him in higher numbers too long. You might want to test weekly just to be safe :). From the consistent PS tests, I think he'll be an average dose kitty but I could be very wrong. If you and your DH (dear hubby) work full time, then you'll aim to get AMPS, PMPS, and a before bed test (usually between +2 and +4 for evening cycle) during the work week. On weekends, you'll want to grab some extra mid cycles during the day.

    I don't think you need to drop back down as low as 0.5U as his PS numbers don't indicate the 1.0U is too high. So my thoughts are to:
    • Keep at your testing and aim to get the 3 minimum tests during the work week; extras on weekends.
    • Let us know if your keeping the 12/12 hour schedule, his feeding schedule, any other health concerns we should know about.
    • Hold a consistent dose of 0.8U (compromising between 0.5U and 1.0u) for no more than 6 cycles/3 days.
    • Confirm you are using U-100 syringes with a conversion chart for Prozinc (u-40 insulin). And do they have half unit markings.
    • After 6 cycles, increase by 0.2U.
    • Always keep track of how Zulu is feeling :).
    Increases only approved if his numbers are permitting. If he takes a nice drop, then of course we'll re-evaluate your game plan :smuggrin:. Most kitties on Prozinc nadir between +5 and +7. They also tend to run lower overnight for an idiopathic reason :cat:. Feel free to ask us any questions or if I've posted something confusing :D.

    Looking forward to helping you and Zulu :bighug::bighug::bighug:
     
  4. ZulusMom

    ZulusMom Member

    Joined:
    Aug 31, 2017
    Thank you Yong! I really hope you're right, and Zulu will be an average case!

    The dose jumping is on me. I get antsy seeing high numbers and then a bit trigger happy with the dose changes. DH is a lot more patient, so we've agreed to make dose change decisions together from now on.

    No history of DKA (thank goodness!), I have tested him for ketones a couple of times, but not recently so I'll make sure to check the next time I catch him in the litter box. He's actually really good about that; if anything he just gives me a weird look and continues his business.

    We are keeping the 12/12 hour schedule. As for feeding, he gets we food with his injections and we free feed YA Zero Mature during the day. We tried wet food in a timed feeder for when we were at work but he wouldn't eat out of it very often. Even with the YA food left out, he usually barely eats anything during the day between his AM and PM shots.

    Yes to the U-100 syringes with the conversion chart.

    Thanks again for the advice!
     
  5. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    I think keeping the dose consistent and moving up slowly will really help. We find that it works better...it seems like changing the dose based on the number SHOULD work, but except in rare cases, we find that it doesn't usually. Not really sure why, but consistency seems to be the key for a lot of our kitties!
     
    Yong likes this.
  6. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    Consistency works better with insulin as well since it is a hormone, not a medicine :). Feel free to ask us any questions :bighug:
     

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