Not sure about dose.

Discussion in 'Prozinc / PZI' started by Donna J, Mar 30, 2022.

  1. Donna J

    Donna J New Member

    May 1, 2021
    Any input would be welcome on Baby's numbers....he is still on ProZinc but his dose is changing almost daily because his numbers are all over the place. I thought he was starting to give lower numbers but he still goes high even after having a good day. I'm at a loss as to what to do and I'm guessing at what dose to give now.
  2. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    May 10, 2013
    It can help to crosspost over in the main health forum if you're not getting replies here fast enough.

    ProZinc usually does better if it's kept on a consistent dose instead of dosing based on the Pre-shot but ECID.

    It looks like he's been on ProZinc for almost a year and without getting very good results. I'd suggest trying a different insulin at this point. Not every insulin works well in every cat. If it were my cat, I'd ask my vet about switching to Glargine (Lantus, Basaglar, Semglee) and see if it works better for Baby
  3. Donna J

    Donna J New Member

    May 1, 2021
    I'm on my last bottle of ProZinc with 0 refills. I wanted to use it up before spending money on a new insulin but I agree about trying a new insulin. I was trying to keep it around 2/2.5 units but because he is up and down so often it seems I'm constantly adjusting. He has a good day here and there so I thought his pancreas was starting to work better. Tonight I kept the dose at 1.75 because I just wasn't sure if I should have gone back to 2 since he got 1.75 this morning. I hate to keep changing but I don't know what else to do, besides trying a new insulin. I feel like I can't shoot 2.5 units when he tests at say 190 or lower.
  4. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    May 10, 2013
    On the SLGS dosing method (and the amount of data you have on Baby), you should bring down the number you're willing to shoot the scheduled dose. At first the "stall point" is 200 but as you gain more experience and data, you want to start bring that down. Even on SLGS, you can gradually work down to shooting the scheduled dose at a PS over 90.

    From the SLGS dosing method: (red highlights are mine)
    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.

    We usually don't suggest or recommend shooting a preshot number less than 90 mg/dL when following the SLGS Method. Remember that with SLGS, generally speaking, your goal is to achieve flat numbers that are greater than 90 mg/dL. However, let experience, data collected, knowledge of your cat, and availability to monitor help in making the best decisions for your cat.
  5. Donna J

    Donna J New Member

    May 1, 2021
    I do write everything down in a notebook so I have easy access to where he was previously and what I shot at, and I found he usually goes lower at night so there's no telling what number I'll get in the morning. I'll try to keep it as steady as I can until I can switch him over to one of the other insulins. I think he may do better on a depot insulin. I just wasn't sure if I was doing something wrong. Thanks for commenting!
    Chris & China (GA) likes this.

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