Switching from vetsulin to prozinc

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Lisa and Smoky

Member Since 2016
I'm switching smoky to prozinc from vetsulin. He has been taking that since Sept 6 and has shown little improvement. His vet suggested trying prozinc and then maybe Lantus later on if prozinc doesn't work. Does anyone have any pointers for me? I have read the stickies already. My vet wanted to go from 3 units of vetsulin to 3 units of prozinc. Isn't that too high of a starting dose for him?
 
I'm switching smoky to prozinc from vetsulin. He has been taking that since Sept 6 and has shown little improvement. His vet suggested trying prozinc and then maybe Lantus later on if prozinc doesn't work. Does anyone have any pointers for me? I have read the stickies already. My vet wanted to go from 3 units of vetsulin to 3 units of prozinc. Isn't that too high of a starting dose for him?
I assume you're referring to your regular vet and not the cat vet you consulted? You'll find ProZinc to be quite similar to Vetsulin in many ways. ProZinc tends to be slower in onset than Vetsulin and can be a bit longer in duration for some kitties. Like Vetsulin, it's in and out in a cycle and there's some flexibility around dosing times if you need that occasionally. I believe it's quite a bit more expensive than Vetsulin though.

If it was my cat, I'd reduce the dose to start until you have an idea (through ++ testing) of how Smoky responds to ProZinc. I wouldn't start at more than 2 u twice a day and I'd start on a day when I was home to monitor frequently. Others might have a different opinion.
 
You are right, I was talking about his old vet who wants to start him on a higher dose. You are also correct about the vet at cat clinic wanting to try smoky on a dose of prozinc and test him four times in an 8 hour period to see how he does. The prozinc should be ready to pick up by tomorrow. I an not working on thanksgiving day so could monitor him that day. I don't know if I should wait until Nov 28 to start him on the prozinc, he is going to the vet that day for bloodwork,urinalysis, spec fPL test for pancreatitis, and fructosamine test.
 
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If he were mine, I would also give a little less to start and start on a day I could monitor. If the lower dose is not enough, you can increase after a few cycles. I agree that the protocol for both insulins are similar and it shouldn't be too difficult change for either you or Smokey.
 
You are right, I was talking about his old vet who wants to start him on a higher dose. You are also correct about the vet at cat clinic wanting to try smoky on a dose of prozinc and test him four times in an 8 hour period to see how he does. The prozinc should be ready to pick up by tomorrow. I an not working on thanksgiving day so could monitor him that day. I don't know if I should wait until Nov 28 to start him on the prozinc, he is going to the vet that day for bloodwork,urinalysis, spec fPL test for pancreatitis, and fructosamine test.
Is he seeing your regular vet or the cat vet on Nov. 28? I'm asking because I thought your regular vet wasn't going to do those tests. They're a good idea though.

I say start the ProZinc as soon as you get it. That way, you'll have something to report to the vet at the Nov. 28 appointment.
 
He is seeing the vet at the cats only clinic. His regular vet actually charges more and doesn't think he needs all those tests done. The one thing I don't like about the vet at the cat clinic is that she is very much against using a human meter. I could not even show her my SS since it was done using a human meter. @Critter Mom sent me a file to print and show her about using human meters. I just hope she will read it and not just ignore it. She has a very " pushy " personality but is well versed in treating feline issues.
 
He is seeing the vet at the cats only clinic. His regular vet actually charges more and doesn't think he needs all those tests done. The one thing I don't like about the vet at the cat clinic is that she is very much against using a human meter. I could not even show her my SS since it was done using a human meter. @Critter Mom sent me a file to print and show her about using human meters. I just hope she will read it and not just ignore it. She has a very " pushy " personality but is well versed in treating feline issues.
Overall, Lisa, you'll probably feel better about taking Smoky to the cat vet and his diabetes will get more informed treatment. Her "pushy" personality is the down side but just smile and nod in agreement and say to yourself, "I'm doing this to get the best for Smoky." Someone suggested a while ago that you get an AlphaTrak pet meter and a vial of strips and use it when the new vet wants you to do a curve at home for her. The rest of the time you can keep doing what you're doing with your ReliOn meter.
 
I'm hoping that will work with the pet meter and she doesn't want to see how his spreadsheet looks the rest of the time. She is likely to want me to bring him in for weekly curves if she finds out about the " human" meter I'm using.o_O at $80 a week that's not an option for me.:nailbiting:
 
I'm hoping that will work with the pet meter and she doesn't want to see how his spreadsheet looks the rest of the time. She is likely to want me to bring him in for weekly curves if she finds out about the " human" meter I'm using.o_O at $80 a week that's not an option for me.:nailbiting:[/QUOTE

Once she has you on her routine, she'll probably want you to do a curve at home periodically. There's no reason for her to want to do a curve in clinic every week from now on. You could certainly be very up front and say your finances don't allow that. You can use the pet meter for at home curves. Don't even bother showing her the SS - that's for you to know how he's doing.

Once she has you on her routine, she'll probably want you to do a curve at home periodically. There's no reason for her to want to do a curve in clinic every week from now on. You could certainly be very up front and say your finances don't allow that. You can use the pet meter for at home curves. Don't even bother showing her the SS - that's for you to know how he's doing.
 
I think what she wanted to do was a curve each week for four weeks and then go to curves done at home. You are right though, I don't have the budget for curves done at cat clinic. What is the best place to buy AT2 meter? I read on here once that the Freestyle Light test strips can be used for that meter. Do you need certain lancets for the AT2 meter, I'm assuming the ones for my relion micro won't fit it.
 
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What is the best place to buy AT2 meter?
I bought mine at my vet clinic. I'm not sure if you can buy them elsewhere.
I read on here once that the Freestyle Light test strips can be used for that meter.
Yes. I use FS strips in my AT meter. I do a few comparison tests (AT strip and FS strip) on the same drop of blood to get an idea of how the readings differ. So far my FS strips read 4% - 7% higher in my AT meter than AT strips do.
Do you need certain lancets for the AT2 meter
No need to use AT lancets - more expensive for no reason. You can use your ReliOn lancets in their holder to prick Smoky's ear.
 
Quick question for you all. I picked up the prozinc from the vet tonight. He prescribed 2 units twice a day. I increased smokys dose of vetsulin from 2.5 last night to three units this morning. His AMPS was at 388. His PMPS tonight was reading hi on relion meter so it was over 600. What the heck happened???

Also, should I start Smoky out on the 2 units of prozinc or try 1 unit instead? I can monitor him tonight and all day tomorrow. Does he need to eat before his shot, have food " on board"? I also got him Denamarin to take, a liver supplement.
 
I guess I will just give him one unit of prozinc and monitor him tonight.
Hi Lisa,

Just saw this now. No harm in starting him at a low dose of ProZinc. If tonight goes OK you could try 2 u in the morning. It should be OK because you've been at 2.5 - 3 u with Vetsulin. You might as well do it on a day you can test frequently. Yes, he should eat before his shot but it doesn't need to be a full meal because ProZinc doesn't hit quickly.
 
Thanks, my vet said if I was worried since I can't watch him the full 12 hours after pm shot to give him one unit tonight. I have to update SS to reflect his BG and insulin change.
 
Smoky only ate twice today, morning- 5 oz and night- 6 oz. I wanted to try it and see how it affects his BG along with starting him on prozinc. Boy, is that a big price difference: Vetsulin: $40, Prozinc: $120:facepalm:

I also ordered an Alpha Trak starter kit to compare results on occasion with my Relion meter. Also, to do a curve once a week to make the new vet at cats only clinic happy. I couldn't afford to use it all the time though.
 
Smoky only ate twice today, morning- 5 oz and night- 6 oz. I wanted to try it and see how it affects his BG along with starting him on prozinc. Boy, is that a big price difference: Vetsulin: $40, Prozinc: $120:facepalm:

I also ordered an Alpha Trak starter kit to compare results on occasion with my Relion meter. Also, to do a curve once a week to make the new vet at cats only clinic happy. I couldn't afford to use it all the time though.
Yes, ProZinc is like liquid gold in cost! Good idea to have the AlphaTrak for your new vet but for sure use your ReliOn in between. The AT strips plus the ProZinc is very hard on a person's wallet.
 
How long does prozinc take to start working? Smokys numbers are still high. How long should I keep him on the same dose?
 
How long does prozinc take to start working? Smokys numbers are still high. How long should I keep him on the same dose?
I think the numbers are telling you that 2 u isn't a high enough dose. You could try 2.25 u tomorrow morning and stay at that dose for a couple of cycles. You'll likely end up in the same dose range as you were in with Vetsulin and, from there, need to make careful increases to get him down into better numbers.
 
He only had two injections of 2 units so far, Thurs am and pm. I thought you were supposed to keep the same dose for three cycles. Is it safe to increase his dose after only 24 hours? I would agree that the two units is really not doing that much for him. I can tell the difference between vetsulin and prozinc, he had big drops and then bounced high on the vetsulin. His numbers on prozinc drop a little bit but I don't see the diving and bouncing common with vetsulin.
 
He only had two injections of 2 units so far, Thurs am and pm. I thought you were supposed to keep the same dose for three cycles. Is it safe to increase his dose after only 24 hours? I would agree that the two units is really not doing that much for him. I can tell the difference between vetsulin and prozinc, he had big drops and then bounced high on the vetsulin. His numbers on prozinc drop a little bit but I don't see the diving and bouncing common with vetsulin.
The general recommendation is to hold a dose for three cycles. Sometimes we deviate from that once we have more experience with kitty's response to the insulin. You could give 2 u for a third cycle if you're more comfortable with that. I suggested trying 2.25 u this AM because of your previous experience with dosing Vetsulin.

As you accumulate data over time using ProZinc you'll get a much better picture of Smoky's response to it. He might still throw some weird numbers but don't think the insulin isn't working properly. Kitties who aren't regulated don't always read the FD rule book. :)
 
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I checked your SS and see that you gave 2.25 u this AM. That's just fine. Things will take a couple of days to settle.
 
Yes, I would go up - probably a little faster than the normal protocol. Since Vetsulin and ProZinc aren't terribly different in the way they are dosed and how they work, he may need the same level to start that he was on with Vetsulin. But always better safe than sorry, so starting a little lower was wise. I just wouldn't stay there long.
 
I decided to give him the 2.25U in am since his BG was still high, @ 525 and then see what his PMPS is tonight. I usually hold a dose for three days. He hasn't been diving or bouncing yet so thought I would try a slightly higher dose.
 
Smokys PMPS was 383, I think maybe another dose of 2.25 units might be OK for him. Did he drop too much from this morning? I know when he was on the vetsulin his BG would dive and then he would bounce high.
 
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Smokys PMPS was 383, I think maybe another dose of 2.25 units might be OK for him. Did he drop too much from this morning? I know when he was on the vetsulin his BG would dive and then he would bounce high.
I'd try 2.25 u again tonight. This morning's number was from too low a dose. Raising his dose this AM caused the drop - to be expected and it doesn't look extreme to me. Bouncing is a possibility even with ProZinc so don't be alarmed if it happens. Over time you'll learn to work with/around it or maybe it'll be much less of a problem for Smoky.
 
OK so smokys PMPS was 592, he seems to be doing the same thing as when he was on the vetsulin. I can't seem to get his numbers to drop much even on a little higher of a dose, 2 units to 2.5
 
I don't know if I should raise his dose after 3 cycles of the 2.25 or not? I'm getting very frustrated and want to just cry right now.:oops: plus smoky always seems to be hungry even when he eats 12 oz of wet food a day
 
I don't know if I should raise his dose after 3 cycles of the 2.25 or not? I'm getting very frustrated and want to just cry right now.:oops: plus smoky always seems to be hungry even when he eats 12 oz of wet food a day
Yes, you could try 2.5 u tomorrow morning. He's had 4 cycles of 2.25 u and the numbers say it's not enough. Don't stay too long at an ineffective dose if there's insulin resistance possibly complicating things. His UTI put him in high numbers for quite a while and resistance could well be at the heart of his failure to budge. Slow, careful increases are the way to get over that.

Please take some deep breaths, Lisa. You're very stressed from what you've been through with Smoky. You need to give ProZinc time - it's a good insulin but it's not a magic bullet.
 
OK I just hate seeing him being so sick for a few months now. I'm trying hard not to rush the process. I am home tomorrow and Monday plus he has his bloodwork, urinalysis, and other tests on Monday. I'll wait and see what the results are from that. Sorry if I'm going into panic mode a little, I'm a bit sleep deprived.o_O
 
OK I just hate seeing him being so sick for a few months now. I'm trying hard not to rush the process. I am home tomorrow and Monday plus he has his bloodwork, urinalysis, and other tests on Monday. I'll wait and see what the results are from that. Sorry if I'm going into panic mode a little, I'm a bit sleep deprived.o_O
Lack of sleep makes it really hard to stay calm and function properly. I'm sure you feel as though you're on high alert after all you've been through with your boy. It's best to proceed with a mindset that you'll give ProZinc time, carefully make whatever dosing changes are needed, track all the data, do curves at home when you can and not overreact to strange numbers or runs of strange numbers.
 
I see you gave 2.5 u this AM. I'd give it 3 cycles or so then go up to 2.75 u if you don't see a response. I suspect there's insulin resistance affecting his numbers so you don't want to linger at ineffective dose levels. Sometimes we can get trapped into thinking that if the dose needs to go up we're failing somehow or that the disease is worsening. Not so - kitty needs the dose he needs at that point in time according to the whole bunch of physiological factors that are in play. Always remember that for many cats, the best dose is a moving target.
 
Agree. It may take awhile for him to adjust to the insulin and the dose will likely need tweaking. You are doing the very best job you can to help him, keep him safe and give him a wonderful quality of life. Remember that he doesn't know he is sick - he knows he is getting great food and snacks and lots of attention.
 
Smokys AMPS was 548 and he was at 555 at +4.5 hours. Could that mean the dose is still not enough? I don't think he would hit his nadir that soon and be going back up already? What are the best meds for nausea and pain relief? I want to ask his new vet at cat clinic about getting some for him. He has Metoclopramide for nausea but it doesn't help at all.

I was really exhausted, (slept 4 hours), so went back to bed and got another 3 hours of sleep. Thanks for all the encouragement and great advice.:) I'm trying to learn as much as I can about FD, it's a lot of info.:bookworm:
 
Metoclopramide affects gut motility. Others on here can recommend different antinausea meds to ask about if you post separately with this question on the main forum. Maybe Smoky's nausea has another cause. Maybe the high BG contributes t it. Hard to say. Yes, I'd say that his numbers are telling you his dose isn't high enough. Keep raising it cautiously.

FD is overwhelming to say the least and there is a lot too learn. Take it slow and you'll get there. It'll boost your confidence once you have more knowledge and experience. There's nothing worse than feeling helpless ...
 
OK so I took smoky to the vet at cat clinic for his bloodwork and other tests. The vet becomes annoyed if I ask questions about smokys proposed treatment plan. She can't adjust his insulin unless I bring him in there for a curve and pay $80 each time. The only other option is for me to do a curve at home and then do a phone consult with her. I have to use an AT2 meter so I bought a starter kit. I also will get charged $40 for this "phone" consult just to read her a bunch of numbers so she can then "interpret" them for me. Does anyone else think this is crazy? I have told her numerous times that I have a limited income and can't do that. Sorry, I was just venting a little.:mad:
 
Yes, I think it is crazy. A vet, well versed in Fd realizes that vet curves are less accurate than home ones because of vet stress and it's likelihood to artificially raise levels. And $40 certainly sounds excess for a consult.

Do you like this vet? Do you have other choices in your city? If I were you, I'd call around and ask about other vet's experience with Fd. Have they had many patients with FD? What is their treatment plan? Has it been successful? Are they supportive of at home testing? You can also post your town on Health and ask if anyone knows of a FD vet in town.

Have you picked up the AlphaTrak already? Can you refuse it? Many vets use and accept human meter and of course, they are much less expensive.

To me, this sounds like the beginning of a long battle, when it should be a collaboration between vet and patient. She is working for you, after all. You are the customer.
 
Good advice from Sue. You want a vet who knows cats and is up-to-date but you sure don't want to have to fight for what you need or can afford. Grrr!
 
I don't like this vet, there is one experienced with FD three miles from me. I am just waiting for the test results from vet at cat clinic. I will have to go down there and ask to talk to one of their vets. The staff at cat clinic are not very friendly and seem quite impersonal. I get the feeling she will not adjust his insulin w/o my doing things her way.

I did pick up my alpha track starter kit from post office this morning. A very good friend of mine gave me the money to buy it. She also gave me a box of 50 freestyle light test strips.:) Smokys old vet did phone consults with me at no cost. I will have to remember to ask about that when talking to other vets.
 
Smoky PMPS was 599. He had 2.75 units in am. too much maybe? same dose for tonight? not sure now.
I suggest the same dose for tonight and maybe again tomorrow AM if AMPS is in this range. I think you'll need small increases (0.25 u) every 3 cycles or so until you get some action. It's likely that he has insulin resistance right now after being high from the UTI and whatever else might show on his blood work.
 
I don't like this vet, there is one experienced with FD three miles from me. I am just waiting for the test results from vet at cat clinic. I will have to go down there and ask to talk to one of their vets. The staff at cat clinic are not very friendly and seem quite impersonal. I get the feeling she will not adjust his insulin w/o my doing things her way.

I did pick up my alpha track starter kit from post office this morning. A very good friend of mine gave me the money to buy it. She also gave me a box of 50 freestyle light test strips.:) Smokys old vet did phone consults with me at no cost. I will have to remember to ask about that when talking to other vets.

Your next vet might be keen on the AT meter for at home curves so it's good to have around. That's a good gift from a kind friend. The Freestyle Lite strips work well in that meter.
 
You know, I mentioned that to the vet at cat clinic. I'm talking about how his old vet told me to slowly increase in .25 increments for 3-4 cycles at a time. I did give him the 2.75 tonight and will wait to see what his BG is in am before dosing.
She looked at me like I had two heads.o_O
I will do a curve with the AT2 meter on Sunday. How can you tell how to dose based on the numbers this meter uses?
 
You know, I mentioned that to the vet at cat clinic. I'm talking about how his old vet told me to slowly increase in .25 increments for 3-4 cycles at a time. I did give him the 2.75 tonight and will wait to see what his BG is in am before dosing.
She looked at me like I had two heads.o_O
I will do a curve with the AT2 meter on Sunday. How can you tell how to dose based on the numbers this meter uses?
Generally the AT meter reads higher than a human meter does but the difference depends on whether the BG is low or high. We can help you with that when you do a curve with the AT meter.
 
Thank you! I was getting confused just reading the user manual for that meter.
The most important difference with the AT meter is that you have to set the correct cat code number foe each vial of AT strips you use. Many will have the same code number and there aren't a lot of different codes. The manual tells you how to set the code.
 
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