The Switch to Prozinc

Status
Not open for further replies.
Susan and Timmy

Susan and Timmy

Active Member
Timmy is 11 years old and was dx in December 2016. We have been on the main board posting and getting help, thank you, @Kris & Teasel. He has been on Vetsulin at varying doses throughout that time. The extreme rising and dropping leaves him feeling really rough. He is very bouncy, which just makes matters worse trying to get his numbers lower. There have been a few times during our journey so far where he acts like his old self, before FD, but these are few and far between. Of course I want remission, but more so right now, I want him to start feeling better and acting more like Timmy more often. So fingers crossed...Prozinc here we come!!!!

I am going to start the Prozinc in the morning at 1 unit. :nailbiting:
 
Susan and Timmy said:
Timmy is 11 years old and was dx in December 2016. We have been on the main board posting and getting help, thank you, @Kris & Teasel. He has been on Vetsulin at varying doses throughout that time. The extreme rising and dropping leaves him feeling really rough. He is very bouncy, which just makes matters worse trying to get his numbers lower. There have been a few times during our journey so far where he acts like his old self, before FD, but these are few and far between. Of course I want remission, but more so right now, I want him to start feeling better and acting more like Timmy more often. So fingers crossed...Prozinc here we come!!!!

I am going to start the Prozinc in the morning at 1 unit. :nailbiting:
Click to expand...
Welcome, Susan! This is a nice friendly group that you've joined with some experienced advisors to help you and Timmy.
 
Hi Susan, and welcome! Fingers crossed that Timmy will find the ride a little smoother over here in prozinc-land!
 
Thank you for the welcome. :) I just gave him his last dose of Vetsulin, so we are ready to begin in the morning. I'll admit I do feel uneasy not having the data to rely on with dosing, but baby steps getting that built back up with the Prozinc.
 
Yep, 1 unit is what I would give too! You'll get the data, and until then (and after then too!), you have the support of this group!
 
First day on Prozinc 1 unit. I'm freaking out a bit about his numbers today. His amps was 384 and he has steadily gone up every 2 hours. Now at +6 he is 504. His dose was not a fur shot, I'm sure of it. Is this normal?
 
Susan and Timmy said:
First day on Prozinc 1 unit. I'm freaking out a bit about his numbers today. His amps was 384 and he has steadily gone up every 2 hours. Now at +6 he is 504. His dose was not a fur shot, I'm sure of it. Is this normal?
Click to expand...
Could just be due to the significant dose reduction and/or a new insulin. Two more 1 u doses and then increase. You could even increase next dose but it might be good to have this baseline data.
 
Ick. I'm so sorry you're getting those numbers! It just indicates that one unit is too low, which I think makes sense considering the previous dose on vetsulin. That being said, you're starting in the right place....you just don't want to hang out at that dose for very long. It's a process to get ramped up to an effective dose without missing something good along the way.
 
I agree with Kris that you can probably going fairly quickly through some of these low doses, but I would say to keep one unit tonight just so you have an AM and a PM cycle at the same dose. It will help to see if Timmy reacts differently during the different cycles. But I think you could up it in the morning.
 
Okay. Thank you. I am worried about ketones now. I'm going to stalk him to get a urine check today. I sure do hate these high numbers. My knee jerk reaction is to increase the dose tonight, but I don't know this insulin and how Timmy is going to react, so I will give the 1 unit again tonight and see how he does. He is hiding in my closet right now, which makes me feel horrible, but it is a process. Going back to the ketones for a second, I don't have any first hand knowledge, but keeping in mind ECID, could he develop them just from being high for this short time?
 
Susan and Timmy said:
Okay. Thank you. I am worried about ketones now. I'm going to stalk him to get a urine check today. I sure do hate these high numbers. My knee jerk reaction is to increase the dose tonight, but I don't know this insulin and how Timmy is going to react, so I will give the 1 unit again tonight and see how he does. He is hiding in my closet right now, which makes me feel horrible, but it is a process. Going back to the ketones for a second, I don't have any first hand knowledge, but keeping in mind ECID, could he develop them just from being high for this short time?
Click to expand...
If he's eating well, is well hydrated and has no infection or inflammation going on he should be OK. Ketone testing is still a good idea.
 
He shouldn't develop ketones just from being high for a short time. He could, but it is usually the trifecta: not enough insulin, not eating, and an infection. Just test for ketones but don't worry about them too much.
 
Susan, I just saw the note on your spreadsheet, and I think you made the right decision. His numbers were really high today.

Prozinc does better on consistent dosing -- it's flexible, but not as flexible as vetsulin -- but if it was my kitty, I wouldn't want to see those mid-cycle numbers for too long either. You have a strong history of monitoring, so I would even say to go ahead and move to 1.5 tomorrow, but then really really hold that dose for a few cycles before the next move. If you keep going with that rate of change (every cycle) it will make Timmy start bouncing around and that doesn't feel any better than a few high cycles. So if you decide to go with 1.5 in the morning, please hold that for a few cycles after that to give his body time to adjust.

My limited understanding of vetsulin is that the response to the insulin is direct: what you dose in a cycle, responds in that cycle. With Prozinc we find that it can take a few cycles to really see how the cat will respond - sometimes it will seem like no response for the first few cycles, and then it starts to work. Other times there will be a response in the first cycle after a change, then a few flat cycles, and then some consistent drops for the nadir. That's why we recommend holding for 3-6 cycles because depending on the cat, it can take that long to really see whether a cycle is working or not.

Does that make sense at all? I'm not sure I explained that in any way that will make sense....:):):)
 
Djamila said:
Susan, I just saw the note on your spreadsheet, and I think you made the right decision. His numbers were really high today.

Prozinc does better on consistent dosing -- it's flexible, but not as flexible as vetsulin -- but if it was my kitty, I wouldn't want to see those mid-cycle numbers for too long either. You have a strong history of monitoring, so I would even say to go ahead and move to 1.5 tomorrow, but then really really hold that dose for a few cycles before the next move. If you keep going with that rate of change (every cycle) it will make Timmy start bouncing around and that doesn't feel any better than a few high cycles. So if you decide to go with 1.5 in the morning, please hold that for a few cycles after that to give his body time to adjust.

My limited understanding of vetsulin is that the response to the insulin is direct: what you dose in a cycle, responds in that cycle. With Prozinc we find that it can take a few cycles to really see how the cat will respond - sometimes it will seem like no response for the first few cycles, and then it starts to work. Other times there will be a response in the first cycle after a change, then a few flat cycles, and then some consistent drops for the nadir. That's why we recommend holding for 3-6 cycles because depending on the cat, it can take that long to really see whether a cycle is working or not.

Does that make sense at all? I'm not sure I explained that in any way that will make sense....:):):)
Click to expand...
Yes, it does make sense. You explained it well. In all honesty I was actually thinking of 1.5 units for his a.m. dose depending on his numbers, but I wouldn't increase that much, that fast, without posting. I need to get those numbers down a bit so I can see what he is going to do at a dose and get a good feel for how the Prozinc works with him. I was a bit discouraged tonight with his numbers today and your response came at the perfect time. Thank you so much. :)
 
I have been getting good data over the past two days. It may sound stupid, but I have been graphing it out to see the "gentle smile" curve, and I have seen it, just not in the lower numbers. His numbers increase and decrease so much gentler, I am so pleased. I will increase to 1.75, but I would like to do that with his a.m. dose. It will give me 4 cycles at 1.5 units so I will have that data and it wont be increasing the dose at night. If you think it would be better for Timmy for me to just increase it tonight, I will do that. Thank you so very much for the guidance. :)
 
Susan and Timmy said:
I have been getting good data over the past two days. It may sound stupid, but I have been graphing it out to see the "gentle smile" curve, and I have seen it, just not in the lower numbers. His numbers increase and decrease so much gentler, I am so pleased. I will increase to 1.75, but I would like to do that with his a.m. dose. It will give me 4 cycles at 1.5 units so I will have that data and it wont be increasing the dose at night. If you think it would be better for Timmy for me to just increase it tonight, I will do that. Thank you so very much for the guidance. :)
Click to expand...
I'm a fan of increasing in the AM too, Susan. That'll be fine. I think making a graph is a great idea!
 
Djamila said:
Oh! I hadn't looked at your spreadsheet yet! Look at those yellows!!!!!! Hooray!
Click to expand...
I know! I was so happy to see those yellows!!! It lets me know we're on the right track. We just need to keep this up and slowly get into some blues. I took a look at Sam's spreadsheet and it is beautiful with those blues and greens. Hopefully Timmy will get there too, but for now I am thrilled with with his yellows today. :)
 
Djamila said:
You may already know this from your time on vetsulin, but tonight's high flat cycle is totally normal. That often happens after a kitty hits a new low number. Try not to let it discourage you from the great cycle this morning!
Click to expand...
Timmy didn't have many flat cycles on Vetsulin, his numbers looked more like a heartbeat monitor, so these flat numbers are new to me. His numbers are kind of flat today as well and it doesn't look like we will hit yellows today. Does that mean we are still not at a high enough dose, or do we need to hold the dose while his body adjusts?
 
It means both of those things: hold the dose for three cycles to give him time to adjust, and also you are still at too low of a dose. Based on his vetsulin numbers, I think you still have a few increases to go before you start to get really good cycles. But if you just jump up to the high doses, he'll bounce around for a good while and that's hard on their little bodies. That's one of the reasons why we do the slow rise in doses, even though we know it's too low at this point - it's just gentler on them. You might get some better action tonight, or it might take a few more cycles. Depending on the cat, it's usually 3-6 cycles to see what the dose will really do. However, since the numbers are still as high as they are, three cycles is enough before you do the next increase. As you see lower nadir numbers, you'll need to slow that down a bit. So right now we just look at each increase, and then decide when to move on. So sort of a day by day decision.

So right now, I would say keep the 1.75 tonight and tomorrow morning, and then move to 2.0 tomorrow evening. However, if you prefer to do the increases during AM cycles, that's fine too. Just plan to increase for the Monday AM cycle instead.

And as always, if he starts dropping more than 50% from PS to nadir, then hold off on the increase and keep the dose a few extra cycles.
 
Djamila said:
It means both of those things: hold the dose for three cycles to give him time to adjust, and also you are still at too low of a dose. Based on his vetsulin numbers, I think you still have a few increases to go before you start to get really good cycles. But if you just jump up to the high doses, he'll bounce around for a good while and that's hard on their little bodies. That's one of the reasons why we do the slow rise in doses, even though we know it's too low at this point - it's just gentler on them. You might get some better action tonight, or it might take a few more cycles. Depending on the cat, it's usually 3-6 cycles to see what the dose will really do. However, since the numbers are still as high as they are, three cycles is enough before you do the next increase. As you see lower nadir numbers, you'll need to slow that down a bit. So right now we just look at each increase, and then decide when to move on. So sort of a day by day decision.

So right now, I would say keep the 1.75 tonight and tomorrow morning, and then move to 2.0 tomorrow evening. However, if you prefer to do the increases during AM cycles, that's fine too. Just plan to increase for the Monday AM cycle instead.

And as always, if he starts dropping more than 50% from PS to nadir, then hold off on the increase and keep the dose a few extra cycles.
Click to expand...
Okay. That makes sense. I will keep gathering info at this dose and see about increasing with the Monday AM dose. Thank you.:D
 
Kris & Teasel said:
The Monday AM increase is a good plan. You'll get there. :)
Click to expand...
Slow and steady. I am getting used to the Prozinc. I still expect those huge drops that I had with the Vetsulin. His am and pm numbers are closer together, which is also surprising me. Over the last two days, even though he is at higher numbers, he is hanging out with the family more. Not a bad start if I do say so myself. :)
 
I'm so excited for you and Timmie. Keep up the good work Susan:bighug: it's so great to see he's getting into some yellow numbers. He will be surfing in those blue waters before you know it.
 
Well now! Isn't that a nice little curve!

Brace yourself though -- that's the lowest he's been on prozinc, so you can pretty much bet on a bounce for the PMPS, or if not a bounce number, then at least a flat cycle tonight. It's so great to see that lovely drop for nadir today though!
 
Susan and Timmy said:
Timmy didn't have many flat cycles on Vetsulin, his numbers looked more like a heartbeat monitor, so these flat numbers are new to me.
Click to expand...
Susan and Timmy said:
Slow and steady. I am getting used to the Prozinc. I still expect those huge drops that I had with the Vetsulin. His am and pm numbers are closer together, which is also surprising me.
Click to expand...
I feel this. My cat also had huge and sudden drops on Caninsulin/Vetsulin. She'd often drop more than 100 points lower within the span of an hour or two, only to shoot back up at +5, often just as dramatically. I'm still getting over some very real anxiety about lower than usual pre-shots because of this, though ProZinc is so different. Her cylces have been higher/flatter lately too. I am really grateful for these forums because after coming from Caninsulin, I don't think I'd know what to do with these numbers!

Just wanted to say you're definitely not alone in that experience. You got some good results though! Hope it keeps up for you and Timmy.
 
Notice I hedged and said bounce or high flat cycle. ;)

And Susan, I saw your note on the spreadsheet, I think it's fine if you want to hold this dose a bit longer and give him some time to settle out at this dose.
 
Djamila said:
Notice I hedged and said bounce or high flat cycle. ;)

And Susan, I saw your note on the spreadsheet, I think it's fine if you want to hold this dose a bit longer and give him some time to settle out at this dose.
Click to expand...
We had a good run of numbers today. :) You were right in calling that bounce, but I was so hoping he wouldn't. Hopefully it won't last too long. ;) So I will go ahead and hold the 1.75 units for another two cycles just so I can get a feel of how the numbers are going to go.
 
Nah, 401 is in line with your regular numbers, so not particularly bouncy. We'll have to wait until +4 to see if he's flat tonight, but you have a little drop already, so I might be wrong about both predictions. Sometimes it's so so good to be wrong! :D
 
Status
Not open for further replies.
Back
Top