Mickey update 6/27

Bg is 453 with only FF chicken today. The isulin is defiantely Prozinc. No insulin today. Good idea to wait a few days to see what we have. Waiting for him to pee so I can test for ketones.....We will see what tomorrow brings. Thanks all!!!

 

Peggy, when you get a chance, maybe the folks here can help figure out good time to give shots, with the shift changes it's going to be confusing.

I'm hoping the BGs come down quickly now that the dry food has been taken up.

 

Can anyone suggest times for shots? weird schedule

I work 5 6a-2p shifts then one day off....5 2p-10p and one day off the next night I go in at 10p-6a for 5 days with 2 days off....trying to figure out a schedule...rrg. I can't do consistant 12-12 shots ever. I could possibly pay a vet tech to come over? That may have to happen. Thanks!!

 

I don't know ProZinc, but I'm betting the folks here do and can help you work out a schedule that hopefully won't involve hiring a vet tech.

 

Hopefully Jennifer! ((hug))

 

Oh boy, that's a fun schedule! What a challenge!

Well the good news is that you can definitely have a more flexible schedule with Prozinc. You could do 5am-5pm and then on your day off, shoot a lower dose one cycle and move the schedule back to 1am-1pm, then on your next day off do the same thing and move the schedule to 9am-9pm. You can, before you get to optimal dose, just shoot 2 hours early for 2 cycles, but it may be less disruptive to just undershoot one cycle. You should try it both ways and see which works better for you.

Some general info on Prozinc from my experience: It takes 45 days for the cat to get used to Prozinc. Maybe a little less, but it seems like that's the general time frame. Until then, you may see the nadir move around, the numbers may bounce around unpredictably. You need to be patient. When you adjust dose, do not increase by more than 0.25u at a time, and let the dose settle for 5 days before you evaluate the need for another adjustment unless you see a low nadir (<50) or unshootable ps#s. Start low, go slow...even more so with PZ, you want to make small, infrequent dose adjustments. It isn't unusual to see a dramatic change when you adjust the dose by 0.1u....yes, really! It also often takes a few cycles to see the effect of the dose adjustment, so you have to give it time to settle, particularly when increasing (hence the 5 days). Prozinc has a 10-14 hour duration (according to my vet) and if the dose is high, you will see longer duration (more overlap). The nadir is generally between +5-+8, when it is later than that, it usually means the dose is too high.

 

Just wanted to chime in to say that there are times when you want to be more aggressive with it, for instance if you have ketones present, or high #s that just aren't budging. Although I haven't used ProZinc specifically, my understanding (and what I've observed here) is that it works very similarly to the other PZIs.

My view on PZI in general is to move in either 0.25 or 0.5 increments depending on the #s you are seeing, your cat's response, etc. Similarly on the # of days to settle, I've seen opinions in the past of 2-3 days, 3-5 days, 1 week, and variations in-between. I think there is a fair amount of ECID in terms of your cats needs. If your cat is not super-sick you can go slower, but there are other times when you need to be more aggressive with it.

The main point of SLGS (start low go slow) IMO is to avoid 1) accidental hypos when overlap kicks in, and 2) rebound. Both of those I think can be managed even when using a more aggressive dosing strategy. For instance if you look at people shooting as-needed and going for TR, that is a radically different strategy that SLGS, and certainly it works very well for some cats. I don't know if it's been proven yet with ProZinc, I think some around here have done that but I forget exactly.

I think Laurie's advice is excellent advice for many cats , just wanted to mention that there are some situations where other approaches are needed, and also other approaches that are possible that may also produce good results. It may turn out that ProZ is less flexible than other PZIs (I hope not!!!), but one of the virtues of PZI has been that you can vary things quite a bit and still get good results.

Peggy your schedule makes my head swim! :lol: I can't get my mind around it enough to offer any useful suggestions, but it should be manageable, as Laurie said you will probably have to do some experimenting & data collecting to see what works best. The earlier you shoot the more overlap you will get with the prior shot, so you generally want to reduce the dose a little bit on an early shot, and increase a bit on a late shot (often a +11 won't show much difference from a +12, but something like a +9 can give you a dramatically better response than the same amount of insulin on a +12). With PZI you always want to shoot on a rising BG, so though many of us skip a rising # test if shooting at +12, if you shoot at something like +9 you would want to get two tests maybe 15 minutes or so apart to be sure he is past nadir and his BG is headed back up.

If you don't see much better #s in a day or so, I would consider going ahead and starting on 1u BID (or 0.5 if you are more comfortable with that). When I switched Bix's food his #s came down really fast, but he was already on insulin so that helped. Often when they are in higher #s they need some help to come down from there. Hopefully though you will see better #s soon!!!!

 

I agree with just about everything Laurie except for the 5 day thing. It is more like 3 cycles [1.5 days] and delaying anymore can delay regulation. I do agree with small changes [no more than .2u] but personally I also think waiting more than 3 cycles is counter productive. But that is just me. For Peggy, you might get some conflicting advice here but the bottom line is that PZI is very flexible and there are many strategies that work for many folks. However, IMHO in the initial stages it is important to get thing rolling and not delay for 5 days before changing doses. So my advice is to make .2u max changes every 3 cycles or less.