Considering switching Taffy to ProZinc

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Taffysmama

Taffysmama

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Can I get some feedback on ProZinc, please? What to expect/know/consider...

Since Dx I have been under the impression that Prozinc is more "old school" & that Lantus is the "new" way of treating feline diabetes. But, I have been reading a little from Dr. Hodgkins (who used to be my vet before Taffy, sure wish she was around here still) who seems to prefer ProZinc. Of course, the info was written several years ago by now.

Because Taffy was not a regularly dry fed cat (other than occasional unauthorized kibbles) at Dx, it seems that diet change has not made a significant difference for him in his BG. Maybe a depot insulin like Lantus is not the right insulin for Taffy?

Seems like I see more switching from ProZinc to Lantus or Levemir than vice versa. Does anyone ever switch from Lantus to ProZinc? Maybe if I did TR with more frequent injections of ProZinc, I could get his pancreas to behave!

Taffy seems to feel lousy lately. Low energy. Eating okay, but I think I poop problems have him down.
 
When was the last time Taffy had full blood panel, urinalysis, teeth checked and physical exam? It could be the pancreatitis and the use of the inhaler that is keeping her bouncy.

Can't speak to switching, Gizmo has been on Lantus only.

:bighug: hugs, I know the frustration. I was in tears earlier this week. Better now, but yeah, this disease takes its toll on us beans.
 
I don't know anyting about ProZinc, but TR is written to be used with Lantus. I don't think it will work with ProZinc. I hope you can figure something out that helps flatten Taffy out. :bighug::bighug::bighug:
 
What are you looking to change/achieve with a change in insulin? I have seen the odd person switch yo Prozinc to get more schedule flexibility.

If you are looking for better regulation, I would try Levemir first.
 
TR doesn't work with Prozinc since it's an in-and-out insulin. You would still only do BID injections every 12 hours though. It does have an hour flexibility if needed but still prefers consistency. I came from Prozinc land :)! @Kris & Teasel has switched from Lantus to Prozinc and back to Lantus. She's the only one I know immediately that could give more insight. Hope Taffy starts feeling better :bighug:
 
LizzieInTexas said:
When was the last time Taffy had full blood panel, urinalysis, teeth checked and physical exam?
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Not too long ago. May 6. All looked good.

I just want better control. The sleep deprivation is killing me! Lantus seems unpredictable with Taffy.

Sorry for your distress this week...I'm sure we all have been there!
 
carfurby said:
I don't know anyting about ProZinc, but TR is written to be used with Lantus. I don't think it will work with ProZinc. I hope you can figure something out that helps flatten Taffy out. :bighug::bighug::bighug:
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Dr. Hodgkin's talks about TR with Prozinc. Probably not the same "rules" but just mainly meaning frequent blood checks and aggressive/right insulin dosing.
 
Wendy&Neko said:
What are you looking to change/achieve with a change in insulin? I have seen the odd person switch yo Prozinc to get more schedule flexibility.

If you are looking for better regulation, I would try Levemir first.
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I'm looking for better regulating, better control. Taffy seems to not really have consistent nadirs. He starts to head down and goes down they both cycles, sometimes. I was thinking that in/out would be better than depot for kitty like him. I want to get his pancreas in healing numbers more regularly.
 
Taffysmama said:
Since Dx I have been under the impression that Prozinc is more "old school" & that Lantus is the "new" way of treating feline diabetes.
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Actually, the use of ProZinc is newer than Lantus use in cats. The original PZI Dr. Hodgkins promoted on her website is no longer available in the US.. and hasn't been for several years.
Taffysmama said:
Does anyone ever switch from Lantus to ProZinc?
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Rarely.
Diabetic Cat Help, one of the groups that split off of Dr. H's original group (after Dr. H left the group) makes an interesting statement about ProZinc (one which I happen to agree after observing ProZinc use on the FDMB), "We have not seen the success with this insulin that we have seen with the bovine based PZIs. It is also more expensive than the other PZIs, starting at $120 for a 10ml vial of U40, and is often more than that, depending on the vet's mark-up."
Taffysmama said:
Maybe if I did TR with more frequent injections of ProZinc, I could get his pancreas to behave!
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Not sure if you're aware both Lantus and Levemir can be dosed TID if necessary. It's usually not a schedule we recommend unless absolutely necessary because it's a grueling schedule at best... no matter what insulin is used.
Taffysmama said:
... but I think I poop problems have him down.
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Poop problems will get anyone down... human or feline... no matter which insulin is used.
carfurby said:
don't know anyting about ProZinc, but TR is written to be used with Lantus.
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There are different TR Protocols out there that can be used with almost any insulin.
Yong said:
TR doesn't work with Prozinc since it's an in-and-out insulin. You would still only do BID injections every 12 hours though. It does have an hour flexibility if needed but still prefers consistency.
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ProZinc users on the FDMB are simply not aware of methods that are and have been used successfully on other websites. One can shoot on various predetermined schedules as well as on a sliding scale. Dosing does not have to be BID and doses don't have to be consistent... because it is an in and out insulin.

Several different methods of TR with the P insulins (prior to when ProZinc came out) were very common on the FDMB as well as elsewhere. PZI users practiced TR before Lantus was even introduced and still do on other websites today. :)
Wendy&Neko said:
If you are looking for better regulation, I would try Levemir first.
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I agree. In fact after closely observing insulin use with cats for 11 years now, if I were Queen of the Universe, Levemir would be my first choice for cats. That's not to say some cats will do better than others, but overall I think Levemir affords more flexibility and the possibility of a flatter curve. JMO.
Taffysmama said:
This is what I am reading. Like I said, Dr. H was my vet with previous cat (who had kidney failure, not FD) and I do trust that she is very knowledgeable about this. However, I think this was written several years ago, so maybe it is out-dated?
http://www.yourdiabeticcat.com/protocol.html
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Yes, that's Dr. H's original website. She's no longer there. A very interesting fellow who rules with an iron fist was running that message board. I haven't been over there in a long time so I don't know the current status of the group. A couple of groups have split off of that group (with Dr. H's blessing) and they are carrying on her legacy.


Just my thoughts...



 
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I am following her protocol. Maverick was on Prozinc with every 6 hr dosing when blood sugar was proven to rise above 150. It was tedious and exhausting. He is now on Lantus and R initially given every 10hrs. He is now going 24hrs between shots and rarely goes over 200.
 
Mom2Maverick said:
I am following her protocol. Maverick was on Prozinc with every 6 hr dosing when blood sugar was proven to rise above 150. It was tedious and exhausting. He is now on Lantus and R initially given every 10hrs. He is now going 24hrs between shots and rarely goes over 200.
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An example of a method successfully used elsewhere with Lantus... (although on a tougher schedule than 12/12).
 
Jill & Alex (GA) said:
Just my thoughts...
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Thanks! Just what I was looking for! Lots of info and informed opinions! So, the U100 Prozinc is not available now...what is available is different, how? Pork, bovine, ...so confused. Why is the one Dr. H used no longer available?

So you think a cat like Taffy - older, was not on kibble diet at Rx, using low doses of steroid inhaler - might do better on Levemir? What sorry of cases do better on this insulin. I read that it has later nadir, but what else should I know?
 
Mom2Maverick said:
I am following her protocol. Maverick was on Prozinc with every 6 hr dosing when blood sugar was proven to rise above 150. It was tedious and exhausting. He is now on Lantus and R initially given every 10hrs. He is now going 24hrs between shots and rarely goes over 200.
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This sounds very confusing! How did you figure it all out? I don't think I have any vets in my area who are well versed enough in the various insulins and methods to closely assist me with this. But I feel like I could do better by Taffy, just not sure how.
 
Taffysmama said:
So, the U100 Prozinc is not available now...what is available is different, how? Pork, bovine, ...so confused. Why is the one Dr. H used no longer available?
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PZI and ProZinc are not synonymous. They're different. The different types of P insulins are explained here: http://www.diabeticcathelp.com/COK/InsulinScales.htm and here: http://www.felinediabetes.com/pzi.htm.

The reason the original PZI was discontinued was because manufacturers could no longer get bovine (beef) used in the making of PZI in the US so they had to find a replacement. That's when ProZinc was born.
 
Taffysmama said:
So you think a cat like Taffy - older, was not on kibble diet at Rx, using low doses of steroid inhaler - might do better on Levemir? What sorry of cases do better on this insulin. I read that it has later nadir, but what else should I know?
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Generally speaking, I think Levemir works better for diabetic kitties than other insulins. The onset of Levemir is usually around +4, but as with everything else, may be different for different cats. Nadirs are later. Can be anywhere from +6 to the next shot time. One of the things I loved about it was there seemed to be more predictability. Also, the later onset is helpful when shooting R at shot time. The R wears off just as the Lev onsets which helps pull down/flatten the entire curve.
 
Jill & Alex (GA) said:
Generally speaking, I think Levemir works better for diabetic kitties than other insulins. The onset of Levemir is usually around +4, but as with everything else, may be different for different cats. Nadirs are later. Can be anywhere from +6 to the next shot time. One of the things I loved about it was there seemed to be more predictability. Also, the later onset is helpful when shooting R at shot time. The R wears off just as the Lev onsets which helps pull down/flatten the entire curve.
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What is R? More predictability is what I'm looking for!
 
I've seen most kitties get flatter with Levemir but of course not all. If you do switch, please post for a starting dose advise. Typically the Levemir dose is started at 70% of the current Lantus dose but also depends on what the cat is currently doing on that dose of Lantus at the time of switch. @Osha switched from Lantus to Levemir just 2 weeks ago and is a dramatic difference in flatness. Otherwise I don't have much to add. Levemir was better for my Doodles but with all his other issues including IAA he's not a good example.
 
Taffysmama said:
What is R?
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R is short for Novolin R and Humulin R insulins. Novolin and Humulin are simply brand names. R refers to "regular" insulin. R is a fast acting insulin which begins to work shortly after injection and peaks in about an hour or two. ECID. Duration is usually around 4 hours total, but occasionally, we see the duration of R to be close to 5 - 6 hours. Initially the caregiver will run an hourly curve to determine how their cat responds to R.

R is often used by vets when treating DKA, sometimes used by caregivers of high dose cats, sometimes used by caregivers of ketone prone cats (usually when ketones are present), sometimes by caregiver's of extremely bouncy kitties, sometimes with very sick kitties who are experiencing high flat numbers. On rare occasions I've seen R used with kitties experiencing a lack of duration.

R can be an awesome tool, but when not used properly it can quickly become dangerous. This is why we always recommend supervision by a member who has R experience... at least in the beginning or until the caregiver becomes comfortable with it's use.
 
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LizzieInTexas said:
How would you shoot if working traditional hours? I work 7a-3:30p. I currently shoot @ 4:30.
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To determine a specific time you'd really have to accumulate a little Lev data to figure out what's best. Although, after taking a peek at your ss, I don't know that I'd switch to Lev. Gizmo is responding very well to Lantus. If I were in your shoes I think I would try to prop up the lows with food. The curve would become flatter in a little higher range which in turn, would allow you to raise the dose in order to pull the entire curve down. Propping the numbers up with food would keep Gizmo from bottoming out. In other words, I'd tweak what I was doing before thinking about switching. If that didn't work, then I'd consider switching to another insulin. You're too close with Lantus to abandon it at this point.

Just my thoughts...
 
Thanks, all. This was a helpful discussion. I don't know if Taffy is a good candidate to try Levemir and/or other, or not. He has never had DKA, just been hard to regulate. But my schedule has not been consistent, either. Unfortunately, my schedule will continue to be changing, as I don't work a regular 8-5 type. Of course, I would discuss any changes with vet and would need to get any new Rxs from vet and right now civvie Baby is next in line for vet budgeted $$$ with his dental needed. Pretty sure my vet won't know the best dosing protocols that I can find here, but I would still need to have a visit to get new insulin. My biggest frustration is that I feel even when I do +2 checks and test a lot, I can never be sure what his numbers are going to do. So I either stay up half the night, or give too much food snacks. Currently we have been at 1.75 units for a long while. If I increase, I am pretty sure he will go low and need a reduction within 1-3 cycles. And I am always afraid that I won't be around to catch the drop. Just don't know where to go from here.
 
Jill & Alex (GA) said:
To determine a specific time you'd really have to accumulate a little Lev data to figure out what's best. Although, after taking a peek at your ss, I don't know that I'd switch to Lev. Gizmo is responding very well to Lantus. If I were in your shoes I think I would try to prop up the lows with food. The curve would become flatter in a little higher range which in turn, would allow you to raise the dose in order to pull the entire curve down. Propping the numbers up with food would keep Gizmo from bottoming out. In other words, I'd tweak what I was doing before thinking about switching. If that didn't work, then I'd consider switching to another insulin. You're too close with Lantus to abandon it at this point.

Just my thoughts...
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It was more of a general question. I am not considering switching at this time. Thanks for the input/advise. :bighug:
 
Taffysmama said:
Taffy seems to feel lousy lately. Low energy. Eating okay, but I think I poop problems have him down.
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What kind of poop problem? Marvin was feeling lousy earlier this year, his poop was hard as rocks, as he isn't moving around enough. The vet told me to buy him Lax-a-day from the pharmacy, he gets 1/4 tsp in the morning. this is the one she recommended because it is mild. I saw the change in him immediately when his poop became normal. Can't believe I am talking about poop. So if that is the cause for Taffy, you may want to try that.
 
Marvin's Mom - Nat said:
What kind of poop problem?
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That's my problem, I'm never sure! I "think" he has some hard poopies holding things up, so I give small doses of lactulose for several days. This has worked in the past and after a few days he gets it out. But I am never sure that is what is going on. If I give too much then we have opposite problem. I have tried Miralax (same as what you use) but no great results. Being a long hair, he and I both hate when things get soft or runny!!
 
Taffysmama said:
That's my problem, I'm never sure! I "think" he has some hard poopies holding things up, so I give small doses of lactulose for several days. This has worked in the past and after a few days he gets it out. But I am never sure that is what is going on. If I give too much then we have opposite problem. I have tried Miralax (same as what you use) but no great results. Being a long hair, he and I both hate when things get soft or runny!!
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I use the one I have every day, that may be the difference. That maybe the difference, I was giving him 1/2 tsp and it was softer than what I would like so reduced to 1/4 tsp and it's been normal since. It's been about 3 months. He may need something stronger, from the vet if it is stuck, and than something mild daily.
 
Taffysmama said:
That's my problem, I'm never sure! I "think" he has some hard poopies holding things up, so I give small doses of lactulose for several days. This has worked in the past and after a few days he gets it out. But I am never sure that is what is going on. If I give too much then we have opposite problem. I have tried Miralax (same as what you use) but no great results. Being a long hair, he and I both hate when things get soft or runny!!
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Aauuuggghh, I am dealing with the same issue. My poor boy hasn't gone in 2 days. Part might be from stress of the vet visit yesterday but I can tell he is miserable. I use Miralax in his food. A scant 1/8 teaspoon split between 3 snacks/meals both AM & PM cycles. I may need to give him a bit more if no results overnight but, like you, don't want to go too far and have the opposite problem.
 
Jill & Alex (GA) said:
other words, I'd tweak what I was doing before thinking about switching. If that didn't work, then I'd consider switching to another insulin. You're too close with Lantus to abandon it at this point.
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I agree with Jill, you are getting some nice higher greens with Lantus and to tweak the cycle using food with a little more insulin could get him into overall lower numbers.

As far as the poops, I was reading on Dr. Pierson's site that with raw food, their poops are smaller and dryer ( I did not know that about the dryer part) but you do want to have him going daily.
 
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Taffysmama said:
when I do +2 checks and test a lot, I can never be sure what his numbers are going to do
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Usually if the +2 is the same as the Preshot ]number or lower, it could likely be an active cycle. If you can't be around or up very long, that is where propping with food would be really helpful. If ever you need help, just post with a question mark and someone should be around to assist you if you to help guide you with the carb choice and amount if your aren't sure. That is the trick part with "knowing thy cat" I always put the carb % in the cell with the lower number and amount fed so that I could look back and see what boosted Bubba up and how fast it did the job.
 
Taffysmama said:
I don't know if Taffy is a good candidate to try Levemir and/or other, or not.
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I think it's up to you and your schedule. I made the switch for none of the conventional reasons. Neko was always diving at night and bouncing during the day on Lantus. For months on end. I tried everything else I could think of to try to switch it up. Turns out the switch to Lev helped with that, but the main bonus was the better predictability/flatness which helped me to get longer stretches of sleep between tests at night.

The main thing to consider before switching is the later onset and nadir. Neko's Lev onset was around +5, so most nights I would not get a test after onset before going to bed. But if her before bed was fairly flat or not much up from preshot, I set an alarm. Her nadirs were more often +9-12, which was great, since I was home for preshot time. For some people, the average +4 onset and +8 nadir times don't fit with their schedule. That can be the biggest drawbacks of the switch. For me it was a bonus cause I am often up at+9 overnight to row and would test before heading out.

The +2 test never did much for me on Lantus either. ECID, though it works for a lot of them.
 
Wendy&Neko said:
Neko was always diving at night and bouncing during the day on Lantus.
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That sounds like Taffy.
Wendy&Neko said:
better predictability/flatness which helped me to get longer stretches of sleep between tests at night.
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...that's what I am needing! The sleep deprivation is killing me and I feel like I have given up on TR and stay at same dose so I don't worry so much during days when I'm gone, etc. & if I don't wake up to test in middle of night.

So, for example, what times did you shoot and later test times?

Sounds like it may be worth trying for Taffy. Biggest bummer would be cost...I just got a new pen of Lantus recently & currently get them for zero $$ with the Lantus discount card! Also, new insulin might require another vet visit and we just went in June to get Lantus Rx refilled. Maybe my vet would Rx Levemir without another check up, I'll have to ask. How does it run, cost-wise?
 
Taffysmama said:
So, for example, what times did you shoot and later test times?
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I kept preshot time the same as on Lantus, it suited my schedule. Neko didn't like to be predictable, so I had to play it by ear a bit for test times. What worked for her might not work for Taffy. I always liked the +9 or thereabouts, cause it told me if she was rising or still dropping at preshot. Occasionally she would nadir as late as +15. Based on if she was on her way up or down and her numbers, I could either wait until +7 for a test, or have to test earlier. At night I always got a before bed test, which told me if I needed a +6 or 7 overnight. If I was going to be away for the afternoon test, I would get an earlier one to tell me if I needed more carbs in the autofeeder.
 
Oh, man @Wendy&Neko that sounds confusing! I'm sure I would get used to it eventually.

Thank you all for all of the info and this is something I need to consider in the future perhaps.

But I have decided to get Taffy a dental first and see if it makes a difference. I just discovered last night that he has some inflamed gums and some pretty bad tartar/plaque. Last I and vet had looked, it was not so bad at all. He has a "tight" mouth, I don't know how else to describe it...it is very hard to get a look. Now both Taffy and civvie Baby are on deck for dentals. This is going to be expensive!
 
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