Question about numbers with switching insulin

Ducote was switched today from Vetsulin to Prozinc. His AMPS was 480. I tested him two hours later and he is 518?? This is the first time I have had a number go higher two hours after giving insulin. He did eat with his dose this morning.
- Since Prozinc is supposed to take a little longer to kick in, am I just seeing the result of his morning meal and it is going to come down a little later in the day?
- Am I just used to the fast drop from Vetsulin?
- Is this normal for Prozinc?
- Does it take their bodies time to adjust to a different insulin?
- Could it be a bounce from good numbers yesterday?
I am going to take more tests today and see what the trend is with his numbers today and at what point he comes down. Why does this condition have to be so confusing One step forward and 300 back

 

Its going to be ok Heather. I wouldnt be surprised with any number that might come up after an insulin change. Give it time and wait for more replies sure to come.

 

Two more hours have passed and he is up 4 points (AMPS 480, +2 518, +4 522) It is kind of like his body is not even recognizing that I gave him insulin this morning. And it is now time for his mid-day Fancy Feast so the numbers are probably going to shoot up from here

 

Heather worry about that when you get there. Ya nevah know!

 

I did a curve today since it was his first day on the new insulin and I plan to do another in a few weeks. I AM COMPLETELY CONFUSED WITH TODAY'S NUMBERS! They make absolutely no sense at all

 

Hang in there Heather help is coming. @Deb & Wink

 

Since Prozinc is supposed to take a little longer to kick in, am I just seeing the result of his morning meal and it is going to come down a little later in the day? YES, it should. But Ducote has his own ideas. Remember about meter variance. Numbers that are within 15-20% of each other are basically the same number. So all those BG tests today were all within that 15% and can be considered to be the same number.
- Am I just used to the fast drop from Vetsulin? YES Prozinc usually onsets about 2 hours after the shot. Vetsulin in about 1 hour.
- Is this normal for Prozinc? YES
- Does it take their bodies time to adjust to a different insulin? YES
- Could it be a bounce from good numbers yesterday? YES Those blues were excellent, but Ducote's body is not used to such low numbers so tries to protect itself by dumping sugars and hormones into the bloodstream to bring those BG levels back up.

One other idea. It could have been a fur shot.
Are you using the U40 syringes? And double checked the amount? Could you please attach a picture of an empty syringe, with the plunger at the spot where you measured the dose?

What Prozinc will give Ducote, is longer duration, 10-14 hours, instead of the 8-10 hour duration that is usual with Vetsulin.

Patience little grasshopper. It's not going to happen the first day.

You had also dropped the Vetsulin dose down to 3.5U from 4.5U, because your sister was looking after Ducote. You may need to go back to the 4U of insulin, now that you are using Prozinc. The switch is usually done on a 1 for 1 basis. In other words, you take the dose of the prior insulin into consideration and usually need to give an equivalent dose.

You need to get at least one more test in, during the PM cycle. A "before bed" test is one that many people are able to do.

 

Thank you! Your message was super helpful! Patience is something that I am lacking lately lol! I am just looking forward to any sort of a pattern and it is not happening I know that we will get there but why can't I just snap my fingers and fast forward

I am pretty confident that I am giving the right dose and that they are not fur shots. I was a nurse before I was a teacher so I am very familiar with different types of syringes and dosing techniques. Ducote is a long haired cat so I also made it a habit to always give him a little rub after his shot to feel for any wetness just in case. I am hoping that his numbers were just due to either a bounce or a change of insulin and tomorrow will be a better day

I figured since my sister gave him the 3.5 of Vetsulin for eight days that it might be harmful to skip back up to 4.5 so I was going to do 3.5 for 3 cycles and then go up by .5 every 3 cycles if I do not see any improvement (I also stuck to the 3.5 because of the good day on that dose yesterday). Should I have just gone back up right away?

I did get a +2.5 after his PMPS and it went down from 498 to 400 so maybe tomorrow will look better than today.....one can only hope

 

272 this morning

 

HA!

Dont get too use to that...LOL...They have a mind of their own.

Its good to see you smile.
j

 

98!! A green!! Ands I am home so I don't have to sabotage him!!

 

!!!!!!!!

 

Green, green, green!! Yay for Ducote!!!

Expecting to see a bounce for Ducote at PMPS, but I'd be VERY happy if he proved me wrong.

 

I was so excited about his current number that I didn't even think about PMPS! His PMPS is in 3 hours. If he is not up to 200 by then, do I hold his dose? Give him a smaller amount?

 

Stall. If Ducote's number is not between 150 and 200 at PMPS, don't feed, test again in 20 minutes and hopefully it's a rising (20% +) number. You can stall for up to 1 hour with Prozinc, and still keep to your usual shot time for the next cycle. If you are able to test about 30 minutes before PMPS, that will tell you if the PMPS pre-shot tests is a rising number when you do get around to PMPS test time.

If the pre-shot is falling, you might give Ducote at least a token dose(10-25% of the normal dose), to keep his BG levels on track, and keep his BG's from going sky high. UNLESS the pre-shot is <99, then I think you skip the shot.
As long as Ducote doesn't have ketones, the skipped shot should be ok.

Even though Ducote has been on another insulin, I'm treating this like he is pretty new to getting insulin. He is, only being diagnosed 5 weeks ago. Not totally new, but new enough to getting ANY type of insulin. Normally, we would use 150 as the break point, the decision threshold to skip the shot.

 

I tested him 2 hours after the 98 and got 120 (and that was one hour ago). It looks like he is on the rise. So if he is above 150, I should give him the current dose of 3.5u?

 

ONLY if you can stay up and monitor him.
If he were my cat, I'd want to see him at 190 or better at pre-shot before giving the full dose. 150-200 is kind of the "gray area" as to how much Prozinc to shoot, when it's only been a very few cycles on this insulin. It's why we suggest you stall without feeding and make sure the BG is a rising number before making your decision on the dose.

We don't really know how Ducote will react to getting his Prozinc dose yet, when he is that low (150) at pre-shot. It's only been a couple of cycles where he has been on this different insulin.

If he was at 98 at +8 today, he likely dropped lower between the +4 and the +8 tests. No way to know for sure if he did. But I think you should reduce his dose to no more than 3.25U and maybe even down to 3U for now. Being a bit more cautious right now, with the insulin dose, until you have more test data on how he reacts to the Prozinc, will be a good idea.

Ducote seems to have a bit of a pattern, with both Vetsulin and now that he is on the Prozinc, of dropping down to the greens and low blues when he starts out in the yellows at pre-shot. No idea how low he will go if he is in the blues at pre-shot. Knowing that reaction will take more test data, to find that out, when it happens with a blue pre-shot (100-199 mg/dL).

 

Thanks! I just got a PMPS of 231 so I feel a bit better about his dose. I did take your advice to go down a bit because I don't know if he possibly went under 90 today. I gave him 3.25 instead of the 3.5u.

Now that you say it, I can see the pattern of how his numbers fall when he starts on yellow. He hasn't had too many days where he started on yellow (and he normally picks an inconvenient day ) so I am normally too stressed on these days to actually take notice of anything. He picked a good day today and I was able to appreciate his numbers for the first time . I hope that he makes a habit out of these numbers and I am able to learn more about what to do when he is in this range (I have become too accustomed to the black numbers!)

 

With the Prozinc, Ducote SHOULD get better duration and not bounce to those black numbers every time at pre-shots. That's not to say he won't have a black BG number ever again, but he should certainly have fewer and fewer. He'd look good in blue. Blue and orange are complimentary colors.