Mason - prozinc dosing

Status
Not open for further replies.
248 AMPS, sticking with 1.5u and can check at lunch easily. Had upset stomach at +11 too. Hadn't had issues with the food prior but the dog was sick two days before so maybe pet flu or something?
 
Last edited:
The yellow says the bouncing has stopped (until next time) so you should get a good idea of what 1.5 u can do today. Hard to say about the tummy upset. Could they both have gotten into something they shouldn't have?
 
Dog i think just ate too fast but then he didn't eat much for last two feedings so who knows. Rat terrier so very temperamental. Cat i don't think so. Only thing I could see out was bowl that had ice cream in the sink and rinsed out. Shouldn't have been enough in that water to do anything. Just seems odd to throw up that much after 11 hours from eating. Then of course the smaller rat terrier ate it up before my wife could clean it up *gag*.
 
christobevii3 said:
Dog i think just ate too fast but then he didn't eat much for last two feedings so who knows. Rat terrier so very temperamental. Cat i don't think so. Only thing I could see out was bowl that had ice cream in the sink and rinsed out. Shouldn't have been enough in that water to do anything. Just seems odd to throw up that much after 11 hours from eating. Then of course the smaller rat terrier ate it up before my wife could clean it up *gag*.
Click to expand...
If Mason's stomach was empty at +11 stomach acidity can irritate and cause clear, foamy vomit. People whose cats have a chronic problem with that will use human Pepcid or similar to help. I don't know enough to advise on its use.
 
I'm sometimes the dissenting opinion, so take this with a grain of salt, but if it was Sam, I would try the 1.75 again. You got a long cycle from it, but only once. If you wanted to try it again, just make sure it's a cycle you can monitor in case I'm wrong :).
 
I'm new to this, but I thought it's bad to keep changing the dosage so often, and especially not more than half units.
 
srk3cats said:
I'm new to this, but I thought it's bad to keep changing the dosage so often, and especially not more than half units.
Click to expand...

At the beginning of Mason's spreadsheet, where you see the 4u and 3u, those were from the vet. Vets often prescribe too much insulin because they base the numbers on in-office BG tests which are stress-inflated, or the fructosamine tests which show an average, but not the actual impact of a dose.

The drop down to 1.5 units was the beginning of using the procotol here. The increase to 1.75 was a small increase based on the pre-shot and nadir numbers that christobevii3 was getting. The reduction back to 1.5 was based on the AM cycle on 4/6 which showed the insulin lasting too long during that cycle. When it lasts too long like that, it sometimes means too much insulin, so we recommended reducing the dose.

christobevii3 is able to make dose changes as often as 3-6 cycles because he is monitoring closely at home - getting consistent pre-shot tests before every dose, and getting frequent mid-cycle tests so we can clearly see the impact of each dose.

I hope that all makes sense. If not, please feel free to ask for clarification.
 
I tend to agree here...it looks like 1.5 has been given a good run now and when you get a chance, going back up might help. But I would make sure you can monitor..
 
Djamila said:
At the beginning of Mason's spreadsheet, where you see the 4u and 3u, those were from the vet. Vets often prescribe too much insulin because they base the numbers on in-office BG tests which are stress-inflated, or the fructosamine tests which show an average, but not the actual impact of a dose.

The drop down to 1.5 units was the beginning of using the procotol here. The increase to 1.75 was a small increase based on the pre-shot and nadir numbers that christobevii3 was getting. The reduction back to 1.5 was based on the AM cycle on 4/6 which showed the insulin lasting too long during that cycle. When it lasts too long like that, it sometimes means too much insulin, so we recommended reducing the dose.

christobevii3 is able to make dose changes as often as 3-6 cycles because he is monitoring closely at home - getting consistent pre-shot tests before every dose, and getting frequent mid-cycle tests so we can clearly see the impact of each dose.

I hope that all makes sense. If not, please feel free to ask for clarification.
Click to expand...
Yes, when Chloe was first diagnosed, she was put on 2 units. The first curve was done a couple weeks later at the vet. I have the scores somewhere. The highest number was in the 500's and I was told that the numbers were very high and the vet was worried, so she increased the dose to 2.5 units. Chloe hasn't been at such a high dose since I found this forum.
 
385 at +6. Definitely looking at 1.75u for tonight. Looks like a 1.5u dose keeps things averaged around 380 with a few anomalies like the 248 AMPS or the mid 400 areas.
 
363 PMPS so went to 1.75u. Definitely a predictable reading though with dosage. My alphatrak strips got delayed in shipping and down to two more. So will save for tomorrows AMPS and PMPS unless I can get some at the vet tomorrow or delivery updates for tomorrow instead of thursday. Hadn't got ketone strips yet.
 
Got the new strips in before leaving for work from lunch. First group were batch 7 and these are batch 38 for cats. Reading of 421 with the new batch so maybe just an oddball reading earlier.
 
354 PMPS with new strips. Still relatively in the 380 + or - range even with higher does. I'll test the +2 and +4 tonight. Would be feeling a lot better if I was averaging around 300 like the couple of good days earlier on.
 
I know this is a strange question to ask when you're getting such high numbers, but do you know how to steer a hypo? Do you have a hypo kit?

The reason I'm asking is that I'm thinking you should raise the dose tomorrow evening (since you can monitor more in the evening than you can during the day). And then continue to raise the dose every 3-4 cycles (only on cycles you can monitor!) until you start to get some mid-cycle drops. Right now your cycles are upside down which usually indicates that the dose is too low.

So back to the first question: when you start to raise the dose, there is always the possibility that Mason will react and drop lower, so I want to make sure you're prepared and confident about that before we start messing with things too much.
 
It is easy to monitor on Friday evening thru Sunday evening. Weekdays I can do pre shot, lunch, pre shot, and 4 hours until bed.

I'm not sure if I have a hypo kit...I've seen references to having honey in case it drops or a high carb food (feral cat outside has dry food). Let me search and see what I need.

Also, rechecked him since I actually checked 20 minutes earlier than feeding. 464 now. I went upto 2u. Guess food stress when his numbers are high and a little more hungry makes him impatient.
 
Last edited:
Here are the links to the hypo information: http://www.felinediabetes.com/FDMB/threads/hypo-links-be-prepared-just-in-case.48385/

And just to clarify, I do think that holding a dose for three cycles is important to avoid getting weird numbers -- that's why I recommended going up tomorrow instead of tonight. That being said, I think Mason is safe from going up tonight -- it's just that raising quickly without giving enough time for the dose to settle can sometimes causes wonky cycles that make us all scratch our heads and doubt the next step.
 
Understood. I figured up tonight since he had spent some time at 1.75u and saw good numbers one cycle but not now. Also, it would give us enough cycles to plan something for friday evening or saturday.
 
I really do think Mason's fine with the dose tonight...just wanted to clarify for future dose changes. :)

Also, setting him up for the weekend cycles makes a lot of sense, so well done!
 
422 at +4 so not movement really so far. A single visit reference due to the local vets not knowing much about cat diabetes had them write me a prescription for lantus. How long would you stick with prozinc after we go through dose raising before considering it? Could it also be more related to psychological obsession with food? Maybe look at getting a timed feeder with a cold pack to feed mid day or twice during the day?
 
The how-long-to-stick-with-it question is really hard to answer at this point. I think it depends on response once he gets to a dose that gives some better curves. If he gets drops into the greens, and those show some consistency, then you could stick with it. If he just can't sustain those and the PS numbers don't budge, then I'd say switch. Fingers crossed he responds well to this though!

I'm a fan of several meals or free-feeding, so I vote yes on the feeder. It could be psychological, but at the numbers you're seeing, I'm more inclined to say it's because he can't get the nutrients he needs out of the food right now and he really does need more food than he would if he had regulated BG.
 
Ok, I'll look at ordering the feeder for him. I could always feed a can at lunch but not everyday without the feeder. His initial issue with eating was obsessing about dry food so the behavior is there and todays test 30 minutes before feeding and at feeding showed that large difference. Also, am asking since I will probably need to get another bottle of prozinc in a few weeks is all. I guess I can order that and give it another bottle and see.

Any thoughts on that oeverpaw meter? Strips look significantly cheaper if the accuracy is ok. May end up getting that. Strips look like they take more blood but shouldn't be too big of an issue. 150 strips for everpaw at the same cost as 100 for the alphatrak
 
I've only ever used a human meter, so I don't really know what to suggest about that. All I can say is my strips cost way less than either of those! :)

To be honest, if I was ordering new insulin, I would probably go ahead and get Lantus. Prozinc works great for a lot of cats, but I like the logic of Lantus. I imagine that the longer a kitty spends in healthy numbers, the better they'll feel, and the depot insulins keep their numbers more consistent instead of the smile curves that we get on prozinc. If you look at Sam's numbers right now, he doesn't have much of a curve - so I think he's doing well on prozinc. But I guess if it was me, I'd use the prozinc while you have it, but if you don't see some good responses by the time you need to re-order....then maybe switch at that point?

If you do decide to switch though, the Lantus protocols are written for human meters only, so you might consider switching meters to a human one instead of the Everpaw anyway. Then you can just use the AT2 to give numbers to your vet (if s/he requires them for a new prescription).
 
Yes, I'll take anything at this point. He seems happy but I know he can do better. He is growing some hair back on his hind legs too that had been bald on the insides.

430 at +2. I want to see if anything improves then next week take the numbers to the vet and see if I should continue with prozinc or lantus on next refill.
 
If you increase tomorrow night, you could probably (assuming no surprising numbers pop up) increase to 2.5 on Sunday morning, and have Sunday AM/PM to monitor a bit and make sure he's safe before going back to work on Monday.

Of course if he suddenly starts dropping or bouncing, all bets are off! ;) I'm just a little worried about him being up in the pinks and reds for too long and would love to see him get some better numbers. It is good to hear that he's seeming happy though!
 
540 first test at +4 and was so bewildered I tested again and got 488. Any thoughts? Not really sure what to think here besides prozinc may not be ideal for him (he's calm as can be laying on shoes right now) and with slight dose increase going up higher than the previous 1.75 with lower numbers. I did feed a can midday so possibly high food bounce? I'll try to replicate feeding a can with Lilly to share at lunch.

When he was on vetsulin I did not test we saw a weird response. He would not be excessively urinating for a week on a dosage raise and then regress back to same as before.

His behavior, uriniation, and fur though says he is doing better. Just BG says no.
 
Hmmm....any chance it was a fur shot? And you are feeding fancy feast classic pates? or a different type? Any pets in the house eating a different food that he might have gotten into?

It's likely just an unfortunate cycle, but figured it was worth looking around in case there was another cause....
 
The dogs and cats are separated for feeding and nothing but fancy feast classic fed. I gave the shot about 10 minutes after feeding (forgot). I think we can just say fur shot then to be safe for now too? I really was careful to be sure it was in though.
 
As frustrating as it is to do a fur shot, when you get numbers like this, you almost hope it was that and not just that the insulin isn't working!

Another way to look at it though is that you've actually had similar cycles before. On 5/8 AM cycle, he went up 128 points, 5/8 PM cycle, he went up 93 points, 5/10 AM was up 92 points...so this cycle he went up somewhere between 64 and 116 points, depending on which reading is closer to correct. So this time it looks extra ugly because it hit a black number, but in terms of relative response, it's not far out of line with what you've already seen.
 
Status
Not open for further replies.
Back
Top