When to dose help?

Discussion in 'Prozinc / PZI' started by Tillie and Valentino, Dec 27, 2020.

  1. Tillie and Valentino

    Tillie and Valentino Member

    Joined:
    Nov 25, 2020
    Hello,

    I'm having a predicament I've never run into with Valentino. His numbers were very Normal this morning when I checked before food 150- and 180 after eating. They're usually over 340. I'm waiting to give his dose (4 units Prozinc) and now it is 45 minutes past when he should have had it. Any suggestions? Should I wait until a certain point, or give him smaller dose? He has a tendency to have big drops from his higher morning numbers. Any help from the pros would be appreciated. Of course, it's Sunday so I can't call his vet. @Diane Tyler's Mom – any thoughts?
     
    Last edited: Dec 27, 2020
  2. Pookie

    Pookie Member

    Joined:
    Oct 10, 2020
    Hi Tillie. Not only is it Sunday, but it's the last day of a holiday weekend when so many are probably traveling!

    I can't give dosing advice, but one of the things I value most about this forum is the guidelines provided for each type of insulin. I know that can rely on them to help me if there's no one online. I've copied this from PROZINC DOSING METHODS

    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.​

    Hope that helps.

    Enid
     
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  3. Tillie and Valentino

    Tillie and Valentino Member

    Joined:
    Nov 25, 2020
    Thank you so much, Enid! I really appreciate it. That helps a lot. I will check it again and then see.
     
    Last edited: Dec 27, 2020
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  4. Tillie and Valentino

    Tillie and Valentino Member

    Joined:
    Nov 25, 2020
    So, it's still just 178 and 1.5 hours past his shot time. I think I'll give .25 dose for this morning and that way he'll have some insulin in him, and then see how high he goes tonight.
     
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  5. Pookie

    Pookie Member

    Joined:
    Oct 10, 2020
    I think I did the same thing when I was confronted with a low PS. I've read here a billion times, "better a day too high than an instant too low."

    E
     
  6. Tillie and Valentino

    Tillie and Valentino Member

    Joined:
    Nov 25, 2020
    Right! It's good to remember that! Since he has acromegaly, his numbers may be dependent on whether the growth hormone is surging or not. They keep you on your toes!
     
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  7. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Looks like you fou d his breakthrough dose and are seeing the numbers come down now.
     
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  8. Tillie and Valentino

    Tillie and Valentino Member

    Joined:
    Nov 25, 2020
    hi @JanetNJ ... thanks for helping with this. I really appreciate it. Just curious what you mean by "breakthrough dose" and what that would mean?
     
  9. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    When there's some insulin some and the dose starts climbing there's often a ceiling that's but where the dose will suddenly start coming down.
     

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