6/16 Alexia's Blue - AMPS 304, PMPS 179 - 1 unit prozinc

Wow, it's been a while since I wrote a real condo.

I'm getting Blue this afternoon for two weeks, and wanted to get eyes looking at his SS and guidance as needed on how to handle him.

As the data is lacking (I'll work on improving it) and she wants to continue with prozinc, I'm thinking that I will shoot 1 unit tonight.

I'm open to input here - please note, he is on prozinc not lantus - so, I'm learning here too. LL is my home and there are enough beans here who are familiar, I'm hoping to get help from you all.

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

Hey Hillary!!

I'm not familiar with Prozinc, but do know there's former users in here, whether their experience was good or bad, hope u get some insight.
I would suggest thou - for more eyes, cross post in the PZI and health forums too, its a little quieter there, but hopefully this will get you some extra eyes.

and of course you're always welcome in LL! :YMHUG:
Now - get your meter lock and loaded :lol: and test away!

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

Geez, Hillary. I haven't a clue how Prozinc works and I believe there's a substantial difference compared to Lantus. I would hate to give you misinformation or suggest something that would have negative repercussions for Alexia. Have you thought about posting on Health or the PZI forum?

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

I will cross post on those boards as well. Thanks

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

Off the top of my head, the only cats I can think of in LL who have previously used Prozinc are Connor (GA) and Jazzy.

What I learned from trying to help Donna/Connor with Prozinc is that it’s so new that I don’t know if anyone has figured out how to work it. The manufacturer makes it sound like it’s more similar to Lantus, but it’s not. I tried to use it like Lantus, that didn’t work. I had Carolyn helping me use it like PZI and that didn’t work. Connor bounced like crazy and I could never tell whether to increase the dose or decrease it. The only thing that worked for Connor was switching to Lantus. That is only MY experience, and surely there is somebody somewhere who has learned the tricks of Prozinc, but I couldn't figure it out for Connor (Jazzy doesn't count, because nobody was tracking her data at the time she was on Prozinc).

Connor's SS: http://spreadsheets.google.com/pub?key= ... utput=html

He did end up needing a higher dose of Lantus to get a breakthrough, but on Prozinc we couldn't increase the dose enough to overcome the bounces, because he was dropping too low/too fast and setting up even more bounces. Then we did a rebound check that didn't work. Lantus leveled him out, so we could increase the dose to get to his breakthrough.

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

took a quick look at Blue's ss. I think the approach I would take for the next few days would be to hold the 1 unit and test as much as you can. Onset looks pretty early, I would try to figure out when that is as well as when nadir is. Seems like 1 unit *might* be too much coming off of yellow preshots, but it's hard to say yet. There are some fast, early drops.

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

This is so kind of you to take care of Blue for 2 weeks! I know nuthin' bout no Prozinc, but just wanted to say how cool it is that you are helping Alexia with Blue.

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

Please post on the PZI forum. There are a few there that are more familiar with ProZinc than the old PZI. I know they are similar, but they're not exactly the same. Joanna & Bix, Hope & Ariel, and Nancy & Cody that just switched to Lantus are all experienced over there.

You are very sweet to take care of Blue. Alexia is very lucky to have you nearby.

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

oh, I forgot that Nancy/Cody used Prozinc, good!

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

Hillary,
You are amazing!

I've never felt comfortable giving dosing advice. We were otj almost immediately after we started hometesting. But I will try to help a little. I'm sure there are a few who can help like Joanna, Sarah, Lori, Kelly, and Donna (I might not have listed all, sorry)

I know when I have had to board my kitties, they don't eat as well. This would be my concern combined with such limited data. There are already a few nice blues, and a no shoot last night! What are you using as a no-shoot number? I would think 150 could be a good number (perhaps with a token dose if you're around to test afterwards)

A couple things to remind everyone of regarding the differences between PZI and Lantus:
There is little or no shed buildup, and we typically shoot based on the ps, not the nadir. I'm sure you already know this, just wanted to remind anyone posting ;-)

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

I crossposted on health and pzi - figure the more beans I can have look and help me the better.

My plan was to stick with 1 unit, get some evening tests in and then more on weekend, when I'll be home and build up some data and hopefully beans to guide.

No I didn't know this. See that's a huge difference already. I think she used 200 as her level, and that's her comfort level, me, I can handle drops and greens, so I like the 150 as my target.

OK, cool, I can do this, I can do this, I can do this - yes I will keep telling myself this. nailbite_smile

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

Oh boy Hillary that's dangerous posting here for Prozinc :lol:

I know very little about PZ never used it, but basically it works like Vetsulin and others Humalin N etc. just has a slightly longer duration

Vetsulin lasts about 8 hours maximum and PZ can last 10 hours or slightly more (almost never has overlap).

doses should be adjusted (but not radically or to frequently) based upon Preshot values and nadirs. To establish a scale for dosing you need to figure out the reaction of your own cat. Basicially the higher the preshot the higher your dose will be and your goal is to get a nadir in the optimal BG range (50-100) I think nadir often occurs around the +6 with PZ but can vary from cat to cat. A caution is when you have high PS and have missed a possibly low nadir (<50) which could cause a bounce accounting for the high PS in which case you would be inclined to increase the dose however the correct move is to decrease slightly. Same rule for decreases applies a nadir lower than 50 means decrease and decrease if the PS is lower than you are accustomed to until you determine a higher dose is safe on a lower PS. Due to the longer action (compared to Vetsulin) PZ won't have an overlap like Lantus but it will (hopefully) have an overall progrssive lowering of the BG and tendency towards a flatter curve.

The longer duration means that when you shoot say 1 unit on a PS of 300 and you acheive a nadir at +6 of 80 mg/dl (this indicates a good dose) it may take several days on this dose before you get these result so you should try to maintain a steady dose for few days to "let it settle" the duration of the insulin is about 10 hours so the BG should slowly rise until that time the remaining 2 hours until PS it may rise somewhat quicker and higher (you should avoid food completely at this time anyway) but eventually it will not reach the previous level of PS (300's) and may well come out with 250. You would (providing you can test and observe the cat) continue giving 1U potentially arriving at a nadir below 50 which would earn you a decrease at the next cycle (someone can advise what increments you should use .25U or less or more?) I know PZ is a U40 does that make a difference? anyway even if the BG doesn't go below 50 on that dose it could allow a surf around say 70's and an even milder rise between +10 and PS giving you an ever decreasing Preshot value eventually you have a Preshot that is to low to comfortably shoot the 1U so you would go ahead and make a small decrease. And if this "ideal" pattern progresses you can imagine that eventually OTJ is going to occur. Does this make any sense ohmygod_smile

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

Oh man, I read it, now printed it, and will try to absorb this.

I think I am understanding, that I need to shoot consistent doses for now 1 unit - get in PS always, try to test for nadir to see how he drops, then if 50 or less, lower the dose, otherwise maintain 1 unit, until we get a 50 or less.

ohmygod_smile ohmygod_smile ohmygod_smile

As complicated as lantus is, at least it makes more sense - I'm going to read this on my way and make sure I get what you're telling me.

And for those PZI users - I'm cross posting on both boards and I've asked for help and guidance. I will take the help from whomever has knowledge and can offer the guidance.

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

I don't have any experience with PZ I do understand it somewhat theoretically. Looked at your SS, are these all your testing results and doses or are some from Alexia? How much are you able to test (away for work etc.)? I think the 1U should bring you some results once there was a nice 110 at +3 so I would think it probably went lower by +6 (maybe even a nice green) which would indicate the dose was fine on a PS in the 200-300 range. I did have a spreadsheet for curves back on Caninsulin that actually calculated the ratio between BG changes per unit of insulin (basically the potentcy of each unit) so you can see that 1U has the ability to lower the BG by about 100 mg/dl (this is not always consistant everyday) but is a general assumption. Because there is no overlap or extended duration of insulin action the dose you give is only going to act on the PS you currently have and has no effect into the next cycle. On a low PS like 100 it would be impossible to give 1U because you can't lower the BG 100 pts! You would need to give a reduced dose (but you would need to be able to monitor). Alternatively if after several cycles on 1U you are still getting higher PS and haven't captured a reasonable nadir (wildly guessing <150) you should try increasing the dose a bit to get the BG down.

There are lots of sliding scales and "cut off" points that people using PZ follow I'm not so familiar with all of it, but for starters I would stick to a basic plan of attempting to get a few hours each cycle where BG remains in the healing (under the kidney limit) range and establish some data on how PZ works for Blue.

Another reason I like Lantus and levemir it's more predictable (even in light of ECID) and there is a standardized protocol that works well in most cases. PZ has had a good outcome for many though so it definatly has it's place.

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

Thanks monique I am on my way. Home with him now and will give him a little time to settle in and test

The ss so far iS all alexia. And I will build. Up the data in evening and wknd. What yopu write makes sense and I will start with 1 unit and try to get nadir tests in to see how low he can go. With the change of address and all I won't be surprised if he is higher than norm.

 

Re: 6/16 Alexia's Blue - AMPS 304 - 1 unit prozinc

Good afternoon!

Monique, thanx for carefully explaining everything...your posts were the best explanations I've read in a while about how a not-newbie should handle PZI! I only had time this am to do a quick blurb about the major diffs betw the insulins.

Hillary, the other thing I wanted to post, but didn't have time to do this morning was about the food issue.

You mentioned not being surprised if Blue's #'s are high from stress, but I wouldn't be surprised if he went low. When C was dx last fall, I took him to the vet's for a curve (I know, didn't know any better then) His curve was in the low 100's the whole day. Even though he's always been a big eater, stress makes him not want to eat. He ate less than half his normal breakfast at the vets, so his bgs were much lower than normal (at least, I think).
Then again, this past weekend, he wouldn't eat. I was drooler sitting for my sis, and he was very stressed from the hyper pup invading his territory. I had to sit with him in the bathroom (his fave place) and still only got him to eat a few tbs. He went a whole day w/o eating nearly anything. And this is from a big piggy who'll eat anything and everything! I checked his bgs immediately following a stressful moment with the drooler---he was at a low-end for him 66.
Just wanted put this out there; Blue might throw you a curve ball! A no shoot of 150 sounds very reasonable given all your experience. I wouldn't be surprised if Blue earns a reduction soon looking at the blues on his ss. Then again, he might spike on you----its all just a crap shoot!

I am curious to hear how his pmps is tonight. Good luck!

 

Oh boy, he is so angry. He finally went into the carrier and I used his mommy shirt to block and try to calm him, while I tested. Took a few tries to get the test, but he tested good.

Then trying to figure out how to shoot, just shoot or tent and and shoot, what will he allow.

Well I sorta tented and shot, and he yelled and hit at the same time, so his fur was a bit wet, not sure how much of that 1 unit got in and how much got on.

Sigh - going out for a couple hours, will see how he is and attempt a mid-cycle test or not, if he's really angry still.

 

Shoot the scruff it's the easiest on a strange cat(or any cat). Tent it , stick your finger in the center to pick a place to shoot and direct the needle toward that part of the tent. You should feel it go through the skin so you know you haven't shot a fur shot. Don't pull it right out after injecting. Sit with it for 2 seconds(so you know the insulin went in) then slowly pull out and you should feel the needle come out of the skin as well. That worked for me when i was unsure.

 

Caryl,

That's all well and good but he has teeth, and he moves pretty fast. So, it was hard to get blood, tried several times and well just trying to inject was a challenge in itself.

I'll try scruff next time and see if that may be easier.

 

Good Luck. Sounds like a challenge. Tuffy was on PZI for about 3 months. I think it stung when injected because she always smacked me when I withdrew the syringe. Is there a reason they did not switch to Lantus? I missed that decision from her initial post.

 

hillary, i don't think it's a good idea to post a prozinc kitty's condo on lantus. it's potentially too confusing, and not really safe to have nonusers posting dosing advice. really caution against it. i'd worry about Blue.

the more elaborate advice you've gotten comes from a lantus user's point of view and doesn't apply to PZI/prozinc. remember, the curve is not as flat as we'd see with lantus/lev so such tight regulation at the outset may set him up for hypos/bigger BG swings. just treat this as a newcomer would, and don't aim for tight regulation.

same general principle applies when talking a new insulin, tho. probably need to hold a conservative dose for a few days til you get a better idea via spot checks of how it's working for blue. adjust downward as needed if you're seeing too big drops. guessing the goal here isn't immediate regulation, just keeping blue in a safe holding pattern til alexia gets him back. it may take 7-10 days to get more predictable info about how blue handles prozinc, anyway.

i'd be happy to help you with Blue on the health forum if you want to post there. PM me here or on facebook if you'd like me to look at any threads you start on health.