Jimmy 6/25 amps 359

Hello everyone, Jimmy's ps#'s seem to be lower last couple days, but sometimes he is not having much of a curve. We haven't changed any of his food/feed times. We have been using the Relion Micro this week which reads anywhere from 60-90 lower than the Alphatrac. On the SS, R=Relion and A=Alphatrac. I increased his dose from 2.50 to 2.75 this morning. Usually we have done a .50 increase, but that didn't seem right in my mind this time.

 

Hi Angela! I took a quick look back at your previous posts to see which insulin you are using...ProZinc, correct? The first thing I would say is that your feeling is correct, you should not increase by more than 0.25u at a time with ProZinc. With this insulin, small changes often give you big effects, so you want to go with baby steps when changing dose.

I see by your SS that you have held the 2.5u dose for several days before increasing again. That is great, and I would continue to do that. It can take several days for the dose to settle. However, I would not have increased from the 2.5u dose. Sometimes when your cat is used to running high all of the time, when they start to get some lower numbers, the liver panics and dumps sugar to prevent hypo, even when the numbers are not that low. When that happens, you see a zoom upwards and a high ps#. That's what I am thinking may be happening. You did get some lower ps#s and then some higher. If you could do a full curve, we could get a better picture of exactly what is happening throughout the cycle. I would go back to the 2.5u for a few cycles and then run a full curve when you are able to.

Another thought is that you may have overshot your mark. He may need an even lower dose. You sort of jumped from 1.25u up to 2.5u without holding the dose for enough time to settle at any dose, and some of the dose increases were 0.5u. I'm not being critical of you, I'm just observing the dosing and thinking that your dose may be somewhere in between there. ProZinc is a quirky insulin, it doesn't like variation in dosing much, in my experience. I jumped around like that, changing dose every couple of days and it didn't work well. I finally decided to stick with a dose for 5 days before increasing, assuming the data supported an increase at that point.

Another thing to keep in mind is that ProZinc can be very frustrating in it's inconsistency during the first 45 days of treatment. It looks like you are still about 10 days or so from that mark, so hopefully things will start to settle down soon!

ETA: Please keep posting daily threads here on his progress so more eyes can be on him! It really helps when you can get thoughts from other PZI users. :smile:

 

Hi Angela, nice to see you around!!! It makes sense to me that you moved in 0.5u increments when the #s were really far from what you want, then moved to 0.25 when it looks like you are getting closer to a good dose. That is my understanding of what is recommended with PZI, though I haven't used ProZinc so it could be different than the other PZIs in that respect.

It looks to me in general like he is doing better on the higher doses, PSs are improving and you are seeing a reasonable U-curve most of the time. I'd tend to agree with you that he needs more insulin. Sometimes when they get in higher #s they get used to it, and end up needing more insulin to get back into decent #s. (insulin resistance?) With Bix I found I had to shoot higher doses til his liver got trained and the #s started to come down on their own.

 

Hi Angela,

It's great to see you posting! I agree that Jimmy is still not where he needs to be with the insulin, and it was good to move up to 2.75. Hold that 4-5 days and see where your'e at.

The reason the AT and Relion meter are different, is that one is programmed for human blood, one for animal blood. The thing you are looking for if the relative trend of numbers within one meter. I would use the Relion because the strips are less expensive, until the day when you get really low and need some "animal data" then pull out the AT. And beware of trusting every number you get. Whenever I get an odd number, I will retest right away.

While you are still struggling with high numbers, are you also being careful with carb levels, dry food accidents , and only LC treats like freeze dried chix or fish? The littlest thing, like stealing off the counter, or morsels off the floor can mess you up. Seemed like he did well on the cowboy cookout.

"Liver training" is the hardest part. They get used to high numbers and bounce when they go down to numbers they haven't seen for awhile. I tried for months going really slow with this, gradually bringing him down, but now am being more aggressive. I've been told to expect to see a week of some bouncing before his liver stops freaking over the lower numbers. There must be a middle ground, pushing, without getting huge swings back up. I think thats why you hold 5 days. You need to judge your increases based on preshot, but more important to me is how low they go midcycle.