10/17 AMBG 124, no shot 37+17.33; 39 17.5; 46 +18

Jose here
Jack's most recent condo

Just switched Jack from Lantus to PZI after a 4 day moratorium on Insulin because his numbers were all over the place. He got his first dose last night, 1u.
He received no insulin this morning as we did not feel comfortable giving him another shot with a AMBG of 124, not knowing how the PZI affects him. It's now afternoon and he was checked at 1 and was in the 60s. I gave him some fancy feast, which usually sends him back out of a dip with lantus, and have been checking every 20 minutes or so and he is STILL going down, most recent spot check was 40.

I'll check him again right after posting, but I'm getting nervous about this. Should I be making plans to take him to the emergency vet? Is it time for some corn syrup or kibble?

 

Re: 10/17 AMBG 124, no shot 37+17.33; 39 17.5

ok, so he seems to be hovering in the 37-47 range for the past hour. I'm going to keep keeping a very close eye on him. Whole cat--only a bit of lethargy and annoyance at me for poking him so much, but otherwise no symptoms. If in the next half hour he hasn't started going up, going to give him some more fancy feast, if he drops any more, or becomes symptomatic then the corn syrup is coming out.

 

Re: 10/17 AMBG 124, no shot 37+17.33; 39 17.5

Hi Jose,

Wow great numbers. Prozinc is not as long lasting as Lantus and does not have a shed. If he was off insulin for 4 days and has had his last 1 unit shot last night my guess is that his pancreas is working and taking his job back.

Good job not giving him any insulin this morning.

At this point I doubt he has any insulin left in his system so I would feed that 40 bg a little wet low carb food and test again.

A cat will not hypo with no any insulin in his system.

Don't panic, you just havn't see normal numbers for a while.

Keep us updated.

Robin

 

Re: 10/17 AMBG 124, no shot 37+17.33; 39 17.5

I see you're feeding raw, do you know what the carb's are? Do you have any higher carb foods in the house?

If you pull out the corn syrup you are going to send him really high and will rollercoaster for a little while trying to get him stable again.

I would feed something a little higher in carbs than he is getting now. That will bring his bg's up more gently and not overdo it.

I just switched Harley's food from 4% carbs to 6-7% carbs and his bg's shot from the 160's to high 200's, I switched him back to 4% and he is back in the 160's, crazy huh.

 

Re: 10/17 AMBG 124, no shot 37+17.33; 39 17.5

thanks robin--it's hard not to panic when things have been so all over the place. I'm gonna give him some more LC--he's definitely very lethargic right now, and he's been eating today...
Is it possible that the PZI is just very slow acting with him? I think i read somewhere that some people end up shooting PZI just once daily?

we've been feeding him primal raw, not sure what the carbs are--I think it's on the higher end of raw because it has some veggies in it.

Ok, so no corn syrup for now. Will try to figure out the actual carb-content. For the few days with no insulin and eating 1 oz primal 4 times daily he was hovering in the 300s, hard to believe that he's where he is now without any insulin in his system.

 

ok, he seem's to be nudging back up slowly. I'm gonna hold off on giving him more food at the moment--he has a history of rollercoasters, and if we continue just having a slow steady climb, then that would be great. I'll check him again in about 20 minutes unless something in his behaviour changes.

 

From everything I've seen, Prozinc can last anywhere from 10 to 14 hours and then it's out of their system.

There is an insulin new in the UK that says it lasts 36 hours but that insulin isn't sold in the US.

Most cats new to Prozinc get a pretty fast onset between 2 to 3 hours and the nadir moves around some until they get used to the insulin. Then they get rising numbers the first 2 hours, with onset at +3 or +4 and the nadir settles in somewhere between +4 to +7.

How long has be been eating raw? If it's new maybe the raw has dropped his bg's down to normal. If that's the case I'm going to try it.

I know it's hard to not panic. I still panic at times. Take a deep breath.

 

he's been eating raw for well over a month now. In fact, it was after a transition from raw to kibble (Orijen's I think) that coincided with a new cat joining the household that he became symptomatic and was diagnosed.

Deep breath taken, and duly noted. What made me most nervous was that even after eating his numbers continued going down. He seems to have hit a plateau for now. He's in limp rag-doll mode which is not his typical chatty obnoxious self, but I'm not worried anymore. Would this seem to warrant a reduction in his dose when he get's his next one? I wish that we'd been awake and testing him last night to see what his #s were doing when the PZI was 'active'

 

With PZI alot of us seem to move to some sort of sliding scale once we have enough data to support the change, we shoot the numbers (ps's) and watch the nadir to make adjustments. Which I think is the opposite of Lantus. We do not shoot low numbers like Lantus does either.

I would not shoot another 1 unit unless he spikes really high again. But we won't let him go really high again, Ok?

You know, if he went from raw to kibble with the added stress of a new roommate at dx he may not be a true diabetic. Although once a diabetic always a diabetic, but with the switch back to raw, some time to get used to his new roomie and the help from the insulin during that stressfull time he may be becoming diet controlled.

I would watch his bg's, if they start creeping up you can decide at what # you would start shooting again, like 180 to 200. I would go with a .2u and see what that does for him. If it's not enough go to .4u, etc. But we'll have to wait and see, his bg's will tell us what he needs.

 

thanks for the dosing guidelines as well, that would have been my next question ;-)
other that yourdiabeticcat.com which seems to have dosing guidelines that are way too high for Jack-o, is there somewhere we can look to get some general ideas if a dose adjustment seems appropriate?
You mentioned never shooting low #s--what is too low to shoot?

 

For someone new to Prozinc the no shoot number is 200. When you have some data on how the Prozinc is working in his system (when onset is, when nadir is, how much of a drop you can expect) you can lower your no shoot # to 180, etc.

Your spreadsheet is your dosing guideline. Every Cat is Different. Sliding scales are custom made to every cat and their situation.

1 unit last night on a 282 is reasonable, but whatever he did with that dose was not typical today, so I would not shoot 1 unit again. He may very well have gone too low last night and is recovering today.

Prozinc can give big results on very small adjustments. With Harley I was getting pretty good results with 1.2 units but it wasn't quite enough so I went to 1.4 units and he almost hypoed, at +2.5 he looked a little shaky so I tested him and got a 41, his nadir is between +4 & +6 (talk about panicking) so I fed him 8% carb wet food and brought him up, then kept an eye on him the rest of the day.

There was a member not too long ago, Mom to Missy, I don't think she ever shot more than a half a unit. They went off insulin about a month ago.

 

cool, thanks for answering my questions so thoroughly

 

No problem. Knowledge is power.

Come back and ask any questions you have. Someone around here will probably know a little something about it.

The PZI forum doesn't always get alot of traffic. If you have an emergency and no one is in PZI to answer right away go over and post in Health, there are always people on the Health board to help you right away, even if they don't know Prozinc.

 

Welcome to PZI land, JacksDads. Wow. He had a pretty wild ride last night/today.
I have nothing to add to Robin's comments, just wanted to say hello.
:smile:

 

ok, all the other kitties are jealous of you guys :lol: time will tell if 1 shot of PZI was all he needed?!? that will look really awesome on our PZI success stats!!!

Bix sometimes gets 24 hours out of PZI, but he has a sputtering pancreas so I think that's why. If he's running high, he will be zipping back up by +13 or +14, if not sooner.

My guess would be Jack's #s have been all over the place lately due to a sputtering pancreas - good reason, though I'm sure it makes dosing confusing. The nice thing about PZI is that you can vary things as much as you need to in terms of shot timing & doses, so you may find it easier to work with given variable #s.

I would set a no-shoot, like Robin said, of maybe 180 or 200, and try giving a small dose (maybe 1/2 what you gave?) if he gets above those #s. If you can get a +4 and/or a +6 after a shot, that's good data for PZI, as many cats seem to nadir somewhere in that zone.

Also if he starts running a bit higher, but not too high, like 140 or 160 maybe, you can try feeding a small meal and see if that prompts his pancreas to bring the #s down by itself. If not, that's when you'd want to start considering giving a small dose.

That's great Mom to Missy went OTJ! I have been wondering. Did we ever have a party? drinking09

 

just looked at the #s looks like he's jumped up again - I'd give something less than 1u - if it were me I'd probably try 0.5, but probably you can try anything in there that feels right to you, it's pretty much data gathering right now...

 

so, for better or worse, Yoshi and I decided that the best thing to do given that he was even higher today at PMPS than he was yesterday that it was better to stick with the 1u and continue getting some good information. I don't have to be up early tomorrow, so I can check on him a few times during the night and see what he does in the 12 hours after the dose rather than in the 2nd cycle. It would have been really useful I think to know what he did last night.

It seems to me also, that what y'all are suggesting is that rather than sticking to a strict 12hr schedule, we should figure out the smallest dose that will send him back into the ideal range when he starts creeping up to the 200s, even if that is before +12? Am I understanding correctly?

 

welcome!
I don't have time to add much but the typical action curve is described in a PZI post near the top of this forum. You should definitely find it and read it. Onset is usually +2, nadir +4 to +7, but ECID obviously. but it might help you know when to start testing.

 

Ok, he zoomed up instead of creaping up but good for you for not giving karo syrup and artifically inflating his numbers, nerves of steel, that's huge. Now you know that his P is sputtering,

It's all about data gathering now.

Regulation is what we are all shooting for, OTJ is a bonus. I try to keep Harley under bg's of 200 to protect his other organs (kidneys, liver, etc)

Some people do shoot three times a day if your life schedule can handle it. Mine can't. But if you can handle it we can work with it.

 

I would wait til +12 since things are so new on PZI. I actually said whatever I said thinking you might need a booster sometime well past +12, so as-needed, but with +12 being the short end of the timing. Technically you can shoot PZI if you have a rising # past nadir, but until you have more data I would stick with 12/12 (or longer if not shootable at a +12). It only makes sense to me to shoot early if you know you don't have 10-12 hour duration on PZI.

 

Just wanted to say hi and welcome.

 

Hi Yoshi and Jose!

Oscar started out on Prozinc (we are now in lantus land), but it is a great insulin for a kitty who needs to be on a insulin as needed basis especially!

You are getting quite a drop on 1u, which may be what is triggering the liver to dump sugar into the system in an effort to protect itself (which is what is giving you those really high numbers right after the low ones). I personally would recommend going down to 0.5u (if using u40 syringes) or 0.8u (if using u100 syringes and the conversion chart) and hope that the dose reduction will start to even the numbers out a little bit more.

I know Oscar loves to give me spuddering pancreas surprises, but nothing like what Jack is giving you! Best of luck to you guys with prozinc!

 

Hi Jacks Dads,
Are you still here?? Just checked out your ss. Looks like Jacks been giving you some pretty green amps.
Hope you come back soon to say hello.
Marcy