Need dosing advice after +2 BG of 64

Discussion in 'Prozinc / PZI' started by Barbara, Sep 4, 2020.

  1. Barbara

    Barbara Well-Known Member

    Joined:
    Apr 10, 2011
    Petunia had a dental yesterday so the day was shot....we were gone for 13 hours! She didn't loose any teeth. AMPS was a little surprise since she was higher last night but I guess when I think about that she was probably still stressed from the trip. The +2 was a total shock...I had to go to work so DH was in charge, things did not go exactly how they should have. Thankfully she was fine but it took some HC FF to get her going in the right direction. Now I have no idea what to shoot tonight??
     
  2. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    A dental can make a huge difference.
    According to the dosing methods (SGLS), Petunia (and you after yesterday) have earned a reduction to 0.25 units.
    Let's see what the Prozinc Pros have to say. You've got time.
     
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  3. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Wow to Petunia! Yes, that's a reduction by 0.25u :)
     
  4. Barbara

    Barbara Well-Known Member

    Joined:
    Apr 10, 2011
    I'm a little hesitant due to PMPS being 188....should I go ahead with .25
     
  5. Panic

    Panic Well-Known Member

    Joined:
    Apr 10, 2019
    Can you stall feeding 20 minutes and see if she goes up?
     
  6. Barbara

    Barbara Well-Known Member

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    Apr 10, 2011
    Ugh....already fed her
     
  7. Barbara

    Barbara Well-Known Member

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    Apr 10, 2011
    Ok, so this might not be the best thing to do but it's my mother's 81st birthday & they are waiting for me to have cake. I will check back here in an hour or so but for now I'm not giving her anything
     
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  8. Barbara

    Barbara Well-Known Member

    Joined:
    Apr 10, 2011
    Well I & only ended up being gone an hr tested at +13 & she was 202 she ate after PMPS ended up giving her .25
     
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  9. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Wish your mother a Happy Birthday from all of us.

    Get a +1 and a +2 (especially) if you can. See which way the wind is blowing.
     
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  10. Barbara

    Barbara Well-Known Member

    Joined:
    Apr 10, 2011
    +2 175

    So if she's under 200 in the am should I stick with .25?
     
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  11. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    I'll leave that up to Prozinc users to answer.
     
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  12. Panic

    Panic Well-Known Member

    Joined:
    Apr 10, 2019
    Well since she hit 61 today she actually earned a reduction to 0.25u.

    If she's under 200 tomorrow try to stall. Below 150 skip, between 150-200 you can skip or give a token dose - 10-25% of full dose. That's 0.025 to 0.065u. That'd be like a drop I guess? I've never given that small of a dose before.

    How to handle a lower than normal preshot number when following SLGS:

    Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
    Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
    A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
    • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
    • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
      • a.) give nothing
      • b.) give a token dose (10-25% of the usual dose)
      • c.) feed as usual, test in a couple of hours, and make a decision based on that value
    • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
    • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
    • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
    Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin once you have data and understand your cat’s cycles. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.

    With experience, you may find that lowering these thresholds may work well for your cat. When you have reached that stage, the following guidelines are suggested for Prozinc users following the Start Low Go Slow approach:

    If the preshot number is far below usual preshot numbers:
    • Do you need to stay on schedule? Then skip the shot.
    • Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
    • Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.
    If the preshot number is near kitty's usual preshot numbers:

    Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot.
     
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