7/26 Harley AMPS 368, PMPS 348, +3 183

High this morning.

 

Re: 7/26 Harley AMPS 368

Wishing for good #'s for you today, Rob & Harley.

 

Re: 7/26 Harley AMPS 368

Robin you probably already shot but i'd have brought out the big guns and shot your 1.2 at that.
sorry i usually don't come on till 9 or 9:30 pacific so kind of late now for those 2 cents.

 

Re: 7/26 Harley AMPS 368

Ah, the suspense, LOL!!! Hope today goes great, on whatever dose he got!

I would have shot 1.3, or maybe a one-time skinny 1.4 or regular 1.4 to compensate for the loss of momentum, and then would drop the dose back to 1.3 if the PS improved (or probably 1.2 on a really good PS around 150). I noticed you actually do have data on a 1.2 that you shot a few days ago at something around 170, and it kept the #s flattish, so sorry whatever I said in the last thread, I missed that you do already have some data to support shooting at those #s. Last night's +3 though was pretty good, yay!!! Bix got that sometimes if I lowered the dose a lot on a low PS - the 1st few hours of the cycle would be pretty good (presumably some overlap left from the last shot), but then he would be much higher by +12 (and long before).

Anyhow, it's all good! You will find the balance I am sure of keeping him in good #s, it just takes some trial & error to get there. Hope you are hanging in there ok & not getting too frustrated with the variability in his #s. It looks really good to me overall - he is seeing a fair amount of good #s, and that's what's most important for pancreas healing.

 

Re: 7/26 Harley AMPS 368

No suspense. Since I had to stay up until 11pm to get the +3 I spent the time going over his ss from the first time around when he came otj, trying to remember what I did when I did it and why. It was all kind of a blur back then with alot going on all at one time.

So I wanted to try something and only shot a .5u this morning to see what would happen. His numbers +11 was 329 so it's not as bad as I thought it would be.

I've made so many mistakes this time I don't think that I gave any one thing a chance to work so I want to start over with the right thinking and the right dosing.

Lori, why would you have shot a 1.2? Just curious.

What would you guys shoot tonight on a 300ish tonigh? I honestly feel that 1.4 is too much. If you don't think so please tell me why. I'm still trying to wrap my head around all this.

I shoot in an hour.

Thanks,
Robin

 

Re: 7/26 Harley AMPS 368

I'm no expert by any means, however, if you don't want to shoot a 1.4, and 1.2 isn't giving you enough information, how about between that... if it's at all possible? Would that be a 0.5 unit increase after the 1.2...?

Since you're on ProZinc, 1.4 isn't all that much at all.

Just a thought.

 

Re: 7/26 Harley AMPS 368

Taking a quick glance of your SS, you had him on 1.4 before, and he gave you good #'s. May happen again. I wish you luck for those good #'s again.

 

Re: 7/26 Harley AMPS 368

Thanks Angela, the 1.2 was getting good #'s. I'm going to do a little more reading on the Prozinc website.

 

Re: 7/26 Harley AMPS 368

Robin it's like I said shoot the #. High # shoot the higher dose, Low # shoot a lower dose.
I thought your high was 1.2 but whatever it is...shoot the #.
If he's 300 tonight i'd shoot the 1.2.
Now a question for you.
Why did you shoot .5 into 368?
What was the thought behind that?

 

Re: 7/26 Harley AMPS 368

Ok, so I'm completely new to this party, but why are you shooting a sliding scale? I'm just curious because we found that the sliding scale with ProZinc caused us lots of trouble. ECID and if Harley is a sliding scale kinda cat, no worries, but I figured I'd ask.

 

Re: 7/26 Harley AMPS 368, PMPS

I wanted to try the old school way of thinking on this. Things have changed so much in the last year on this board. I had better luck on the old way.

So Prozinc is very different than Vetsulin but very similar. I'm just trying to figure it out.

 

I agree 1.4 is too much, but I think it may still be useful on a high PS to bring the #s down. I'd probably try a skinny 1.4 though in that case. It's possible that if you stick with 1.3 for a few cycles that may prove to be enough, but the 1.2 and the fat 1.2 haven't looked to me to be enough. The 1.3 wasn't looking to be enough, but sometimes they will do better on cycle 4, so I wouldn't say for sure that 1.3 won't work.

Her #s make a fair amount of sense to me and I feel clear on what I would do in your shoes (of course I might be wrong!), but you need to do what feels right to you. That's what I did with Bix, and although I made a lot of mistakes and put him in high #s a lot more than I probably needed to, it was what I had to do for my own sanity, and thankfully he was pretty forgiving. That's how you learn, trying things and gathering data, so if your dosing decision doesn't work out one time, you try again next time and do better.

For those reading, I'm not sure Robin means to be using a sliding scale - I've been advising her to experiment with doses in-between 1.2 & 1.4 to try to find the sweet spot. To me, 1.2 looks to be too little & 1.4 too much, but with the trials she did on 1.2F and 1.3, they didn't see to be working well. So that's where the 1.4 came back in, to break back down through the #s, but it still looks to me to be too much for an ongoing dose.

We switched from Vetsulin to PZI, and I struggled for a while too getting used to the differences. I think the biggest things that I had to get used to are to look at PZI in terms of both the current shot and the shot before (a 1.3 following a 1.4 will probably give you better #s than a 1.3 following a 1.2 - I've been calling that overlap, or momentum), and to see that the drops aren't a given.

My experience with Vetsulin was that you could set your clock by the amount of drop you would get off a certain dose. With PZI, it's a toss-up whether you will see that drop, or not much of anything. From what I have seen with PZI, for some cats there is a sweet spot with the dose - a hair too low and it's like shooting water, a hair too high and you're scrambling for the hypo kit (ok, not THAT extreme hopefully!). I found that really frustrating. From what I can tell you can't aim for a "safe" nadir like 100 and have much hope of achieving that. Bix was all 250 nadir, or 50, with little middle ground. I think it has something to do with their body utilizing the insulin well if it's the right dose (maybe with pancreas being able to kick in at the same time to give better #s? not sure about that), but I'm not really sure, it's just what I've seen.

Robin, don't beat yourself up. There is no right answer - PZI is so flexible it's more a variety of approaches, any of which can be successful if they work for a given cat. She has seen some really good #s, so you know she is responding well, it's just a matter of finding the groove.

 

Thanks Joanna,

I think some of the mistakes I've made were out of panic to try to get a handle on this. And you are right about setting your watch by the timing and drop you got from Vetsulin, if you saw a change from that you knew something else was going on.

Prozinc doses seem to be a moving target. You never know what to expect from one day to the next.

I'm not opposed to a sliding scale, it makes sense to me not to shoot a higher dose on a lower number. If someone can explain to me why that doesn't work with Prozinc I'd appreciate it.

 

Ok, here's my two cents, for what it's worth.

I'm with Hope. When you change the dose with ProZinc, the first few cycles often don't reflect the change. You need to dose consistently, don't try to dose based on preshot number. It's more like Lantus, watch the nadir. If you get a low preshot (like that 168 you had), you *might* want to lower the dose slightly, but not much, that means that you are at a pretty good dose. Wait a half hour, test again and shoot if above your no shoot. If you can't wait for the # to rise, you might have to shoot a lower or token dose, don't judge by the next few cycles because you have to let it settle again. After a token dose, go back to a slightly lower dose than before, and let it settle. When I say slightly, I mean 0.05-0.1u.

Feel free to look at Tinkles' SS....the beginning is a little confusing, I tried TR for a few days, so there is some weird dosing a few weeks in, but I experimented, and you'll see what worked the best for us. When I got a low ps#, I would wait and feed and shoot a little later, normal dose or very slightly lower (new) dose....and then hold that dose. I often went against advice to change the dose more frequently, and it worked very well for us.

Every time you change the dose, even by a tiny amount, you start the settling process over, so you can't judge by the next few cycles. With the way you have been dosing, you can't tell anything about any dose. The numbers just bounce around with no clear pattern. This is what is so frustrating about ProZinc. Patience, you need to have patience and let the dose settle.

Do what you want, that's my experience. IMO, ProZinc is not like other PZIs....similar in many ways, but there are differences....particularly in the beginning. After Harley adjusts to it, you will be able to be more flexible, changing doses more often, but in the beginning, you need to be consistent. Dose hopping will only confuse and frustrate you.

Good luck!

 

Thanks for the explination Laurie. I'll take another look at Tinkles ss.

I feel comfortable with the 1 unit right now so we'll see where that takes us.

 

I know it's frustrating, hang in there. We bounced all over the place, it was very difficult to figure it out, but once we got around the 45 day mark, things improved a LOT. I'm hoping you'll have an easier time than we did, but either way, it WILL get better!