Need dosing advice

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Haylee&Tigger, Jun 24, 2020.

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  1. Haylee&Tigger

    Haylee&Tigger Member

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    Jun 9, 2020
    Tigger has held his .25 dose for about a week now after reducing from .5 and his spreadsheet looks wacky! I honestly feel like he did better on the .5 dose even though his numbers went pretty low. It’s just confusing with all the mixed info about what is hypo and what isn’t.

    Besides that, at this point I’d be fine tuning and increasing by smaller increments at a time which is almost impossible for me to measure on the syringes I have without half markings. Should I increase back to .5 or slowly from where he currently is, so by like .10?
     
  2. Sarah&Soph

    Sarah&Soph Member

    Joined:
    Jun 18, 2019
    The term “hypo” can be a little confusing at first. Because of the way Prozinc works, unless you are very experienced and know your cat we like to keep their BG above 90 when using this insulin. However your cat is not technically in any “danger” until they drop below 50 on a human meter. On this board the term “hypo” is usually only used if your cat is actually showing symptoms. If not, then it’s just referred to as being in low numbers. So a cat can be in the 40s and still not be hypo, its just in low numbers that you definitely need to bump up.

    If after 7 days Tigger is still in pinks and yellows I think you would be okay to bump back up to 0.5. Some kitties have a strong initial reaction to insulin but it doesn’t always last. Sometimes newly diagnosed cats can have crazy looking spreadsheets like Tigger does now. It can take their body time to used to being on insulin :cat:

    What is your feeding schedule for Tigger like? One thing you can try to do is if you notice a big drop in his BG, you can feed a small snack to slow this down. My cat spent most of her time on Vetsulin which is a similar but more harsh insulin. She would always have a very big drop at +2 which was the onset for her, so I would feed her at this time to slow it down, that way I didn’t “force” her to earn a reduction and would keep her nadir in a good healing range
     
  3. Shelley & Jess

    Shelley & Jess Member

    Joined:
    Jan 23, 2020
    Tiggers numbers weren't too low. As Sarah&Soph said he fell below 90 - the point where you take a reduction when following Prozinc SLGS dosing method.


    I remember running around the house in a frantic tizzy when Jess hit her first blues - all excited, freaked out and worried at the same time!

    Maybe this will help - from the Sticky How to treat HYPOS & what are considered low numbers & very low numbers that need bumping up:

    VERY LOW NUMBERS – WITHOUT SYMPTOMS

    Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a very low number (under 40 mg/dL or 1.9 – 2.2 mmol/L) administer a teaspoon of corn syrup, liquid glucose, pancake syrup or honey, or INSTA-GLUCOSE and follow with food until the blood glucose numbers rise to acceptable levels. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If using liquid glucose, dilute with water for a thinner consistency.

    LOW NUMBERS – WITHOUT SYMPTOMS
    Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a low number (40 – 60mg/dL or 2.2 – 3.3mmol/L) give food or treats until the blood glucose numbers rise to an acceptable level. If the cat refuses to eat even his/her favorite foods, you can syringe feed or administer a small amount of syrup.


    If you follow the Prozinc Dosing Method and keep testing at the times you already do you'll keep Tigger safe. Those early cycle tests can give you a heads up which way the BG is headed and give you time to intervene if needed. Have you stumbled across the +2 information written by Deb & Wink and Chris & China yet?
     
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  4. Haylee&Tigger

    Haylee&Tigger Member

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    Jun 9, 2020
    So if Tigger happens to fall below 90 again, would I reduce his dose immediately again?

    +2 information? I’m not sure. I might have. I’ve read quite a lot on here I guess some of it I needed to reread.
     
    jt and trouble (GA) likes this.
  5. Shelley & Jess

    Shelley & Jess Member

    Joined:
    Jan 23, 2020
    You got it! From the Prozinc Dosing Sticky when following SLGS:

    "Anytime the BG drops below 90 mg/dL, reduce the dose by 0.25u at the next shot."

    The +2 is one of my favourites:

    First part is specific to lantus, written by Chris & China. Second part is more specific to Prozinc, written by Deb & Wink.

    With Lantus from Chris&China


    The +2 is like an "early warning" for most cats!
    If the +2 is about the same as the PS, it's usually a pretty normal cycle...dropping down to nadir and then rising back up again.
    If the +2 is higher than the PS, that usually signals a bounce, and those are the cycles when you can usually take a break from testing.
    If the +2 is lower than the PS, that's your "Early warning" that kitty might be going much lower later in the cycle so it's important to plan on getting another test or two (or 6) in.

    It doesn’t work every time or with every cat. But it does hold true most of the time, so keep this in mind for next time.

    With Prozinc by Deb & Wink

    More than a number range, think of the percentage of the drop at +2, that may tell you if your cat is going to drop much lower. Think of that +2 as being an indicator of what direction the BG levels may be headed.
    With Prozinc, if you see a 40%, 50% or greater drop, between the pre-shot and that +2, that's a serious heads up warning.
    If you see a 20-25%, 30% drop, not quite so worrisome. But still be cautious.

    Your cat drops 2 color ranges between pre-shot and the +2, pull out your hypo kit and plan on staying up to test.
    Your cat drops 2 color ranges between pre-shot and the nadir, that is to be expected. But you don't want the drop to be much more than 50% between pre-shot and nadir with Prozinc.
    Cats tend to bounce high if the drop is 50% or more from pre-shot to nadir.
    So you steer those mid-cycles with food, to slow down the steep drop and stop the bounces from being too high.

    It's a balancing act.

    The +2 is like an "early warning" for most cats!
    If the +2 is about the same as the PS, it's usually a pretty normal cycle...dropping down to nadir and then rising back up again. (About the same means taking meter variance, that 15% variance that hand held glucometers are allowed to have into account)
    If the +2 is higher than the PS, that usually signals a bounce, and those are the cycles when you can usually take a break from testing.
    If the +2 is lower than the PS, that's your "Early warning" that kitty might be going much lower later in the cycle so it's important to plan on getting another test or two (or 6) in.

    It doesn’t work every time or with every cat. But it does hold true most of the time, so keep this in mind for next time.

    It also kind of depends on what BG pre-shot your cat started out the cycle with. Lower than normal, keep a closer eye on the cycle. Lower than you are used to shooting, a number you may not have given insulin before, keep a closer eye on the cycle. Stalled and number rose some, but you did a reduced shot, maybe another test or 2 to see how much the number is rising.

    It makes a big difference if your cat starts the cycle in the pink 300-399 mg/dL range (16.6 - 22.16 mmol/L) then if they are in the blue 150 mg/dL range ( 8.3 mmol/L).
     
  6. Juls and Billy

    Juls and Billy Member

    Joined:
    Dec 28, 2019
    You did the dosing protocol correctly when you dropped the dose after his dip under 90.

    I do see that his numbers are holding pretty steady, and we aren't seeing any blues or greens yet.

    Maybe consider doing a "fat" .25 for a few days. Instead of going back up to .5, try drawing .25 and then drawing up just a tiny bit above that mark. If you try it, note it in Tigger's spreadsheet as "F .25" for the dose. Tigger may need just a bit more insulin at the moment, but this is worth trying before you go back to .5, I think. The exact amount of the F .25 isn't that important, you just want to be as consistent as you can.
     
  7. Haylee&Tigger

    Haylee&Tigger Member

    Joined:
    Jun 9, 2020
    In regards to his feeding schedule, I feed him twice a day. Once at 9AM and once at 9PM.

    Thank you all for your helpful opinions! :D I think I’m going to try the “fat .25” first for the next 3-5 days, then if nothing else bump him to .5
     
  8. Sarah&Soph

    Sarah&Soph Member

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    Jun 18, 2019
    If feeding twice a day works for you and Tigger that’s perfectly fine to do, but you can feed more often if you wish. Some cats do better with multiple meals throughout the day as it can help support their pancreas more. It can also help slow big drops, like I mentioned earlier as well.

    Good luck with the new dose :cat:
     
  9. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    I would go back to 0.5.
     
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