? Dosing Advice Prozinc 1

I'm not convinced that 3u was really too much. Sometimes there's just a weird cycle like that low PS (although I haven't read the earlier posts on Main, so maybe it is :)). However, since the data is new, and he hasn't been a diabetic for very long, and everything has been so inconsistent and wonky the past few days, here is what I propose: We just hit reset and start over.

What are your weeks like? Are you away from the house for work? Are you mostly at home? Depending on how much you're around and can monitor will determine the plan going forward.
 
I'm thinking for today, you give 1u. Both this morning and tonight. Then assuming the data is high, we start the increases. Nice and slow and methodical until we get to something that gives better numbers.
 
I agree with Djamila. We've basically spent the last several cycles reacting instead of trying to proactively figure out how to get Bear into good, steady numbers. I hate to see him jumping up and down like he has been. I think it's time to try to get him where he needs to be following a methodical approach. This is partly my fault because I've been just reacting with Bear and haven't taken the time to really sit down and figure out where to go from here in the future.

What do you think of Djamila's suggestion? I like it a lot. It will allow you to move Bear up instead of guessing how far to decrease him if he hits a weird PS. It will also give you really good data at different doses so that if you DO get a weird PS at some point, we'll have a better idea of what to do for it.
 
I'm not convinced that 3u was really too much. Sometimes there's just a weird cycle like that low PS (although I haven't read the earlier posts on Main, so maybe it is :)). However, since the data is new, and he hasn't been a diabetic for very long, and everything has been so inconsistent and wonky the past few days, here is what I propose: We just hit reset and start over.

What are your weeks like? Are you away from the house for work? Are you mostly at home? Depending on how much you're around and can monitor will determine the plan going forward.

I am my Mother's caregiver, she has Cardiovascular Severe Dementia, which means majority of the time I am home she can't be left unattended. My schedule is ridiculous and at times very upside down. My mother has taken a turn for the worst as she is fighting a antibiotic bacteria which is in her wounds on her leg. In the next few weeks we are looking at many tests, and different specialists, possibly hospitalization with IV Antibiotics.

My husband can help on weekends and evenings but he can't stay up late, after 10PM.
 
Lora, I'm here too (got up with a cold so skipping my planned outing:blackeye:). Well he is certainly giving us a range of readings. I have to wonder if he came back down last night at some point given he didn't soar to the red range after two missed shots in a row. I'm still convinced 3 units was too much but it's possible 0.5 isn't enough.

I see Djamila has suggested 1u and Rachel agrees. So do I. We have been reacting (but then again, I'm not sure Bear gave us much choice given the drops he was dishing out! :banghead:
 
@Rachel, not your fault at all! I absolutely think you did the right thing considering what you were seeing. The NS's were right since there isn't much data. Sometimes a kitty has to have a few days like that before we see enough to get a sense of next steps. And my hunch is that Bear is going to be a bit of a bouncer which will make this one heavier on the "art" side of the dosing.
 
Linda, I understand how it looks like that, and in the end, he hopefully won't get back up to 3u since he's off kibble now, but it's important to remember that Prozinc doesn't behave quite like the insulins you're used to. It does give weird cycles on occasion and it's important not to react to each cycle as it's own thing, but to consider them within the larger patterns.

All the way through section A, 3u wasn't too much.
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Then 24 hours after his last kibble, we see a weird cycle. Now that could have been a wonky test strip since he was almost 300 just a few hours before, and two hours later he was nearly to 400. Or it could have been a legit number based on the body recalibrating to the reduction in carbs, or it could have been simply an anomoly. Either way, it's set off some days of randomness that we need to correct now. Prozinc doesn't do well with inconsistent dosing, so we need to get back on track and try to get this poor little Bear stabilized so he isn't bouncing hither and yon like this.
 
His appetite sucks. Wet is a no go. So I gave him Chicken Treats with testing and more for his insulin- 11 total = around 33 calories.
 
Lora, is that normal for Bear? Does he usually eat his wet food well? And when you say you gave chicken treats...do you mean he just got some treats for breakfast and isn't eating anything else?
 
He definitely feels like yuck. As I was petting trying to stimulate his appetite he moved away with small tail swishes.
 
Do you have ketone test strips at home? If not, can you go to the pharmacy and pick some up? They are about $15 and you test by sticking a test strip in some urine as he pees (we can share some tricks on how to do that).
 
Lora, is that normal for Bear? Does he usually eat his wet food well? And when you say you gave chicken treats...do you mean he just got some treats for breakfast and isn't eating anything else?
He has been eating wet well but somedays not and that is why I resorted to Kibble on the 26th and am logging/weighing all his food before and after he eats.
 
Do you have ketone test strips at home? If not, can you go to the pharmacy and pick some up? They are about $15 and you test by sticking a test strip in some urine as he pees (we can share some tricks on how to do that).

Yes Linda also said this. I will get some today.
 
Here are a few things that sometimes help a kitty that isn't loving the wet food:

https://www.chewy.com/purina-pro-plan-veterinary-diets/dp/49853 This is sold as a probiotic, but it's relatively useless in that regard. However it's an amazing flavor enhancer that many cats go crazy over. You sprinkle just a little from a packet on top of the food and they'll gobble it up. So one packet can last like a week.

https://www.amazon.com/Kaneso-Tokuy...pID=51XK5uUQxWL&preST=_SY300_QL70_&dpSrc=srch Bonito flakes. You can buy this is pet-specific packaging for three times as much. Or you can buy this. :)

Grocery store options: Cheap dried parmesan cheese - you know, the stuff in the green canister (or whatever brand you have at your store). Nutritional yeast or brewer's yeast. That is different than bread yeast, so make sure you get the right kind. It' soften sold in the bulk food section which is nice because you can buy just a little until you know if your cat likes it. Mine go nuts for the nutritional yeast. Tuna water. Find tuna that is packed in water and pour a little of the water on top. Be careful though because this can also adding a lot of extra sodium, so I wouldn't use this more than rare occasions.

And I would still encourage you to test for ketones while his numbers are this high.
 
Do you have ketone test strips at home? If not, can you go to the pharmacy and pick some up? They are about $15 and you test by sticking a test strip in some urine as he pees (we can share some tricks on how to do that).

I am also weighing him but am not too sure on the accuracy of my scale. A baby scale will be here Tues. His weight is fluctuating quite a bit. Yesterday it was 16.4, .4 is tenths. a few days before 15.6
 
Yes, I'd encourage a ketone test as soon as you can manage it today. You want to stay on top of things just in case, as ketones are much easier to treat if caught early.
 
How to test for ketones:

You need to put the strip into fresh urine, and then carefully time it and compare it to the color key in good light. The timing is important as the strip will continue to darken. Dark is bad. So you want to look at it right at 15 seconds or 30 seconds or whatever your brand says for the most accurate results. The good light is important because the shades of color aren't super dramatic so you need to be able to see it well.

To catch urine: If you have a cat with no modesty like mine, you just go in and stick the strip behind him while he pees. Sam actually lifts his butt for me to make it easier. If your cat is more modest, but will still let you in the room, some people use a long handled spoon to catch the pee. Then they just label that spoon as the cat pee spoon and don't use it in the kitchen anymore o_O. If your cat is sneaky about their habits, you can take some plastic wrap and wrinkle it up and stick it in his favorite corners of he litter box. Then a little pee gets caught in the wrinkles and you can test from there. You still need to be vigilant in noticing he's using the litter box though to try to catch him before he covers the whole thing in litter.
 
@Djamilla I realize ProZinc doesn't work like the insulins I used with my girl but I have used it in the past albeit briefly. You, Rachel and Kris definitely know the nuances of ProZinc far better than I do :). I can see your rationale about the 3 units and admit I interpreted his numbers a little differently and probably did so with other insulin "glasses" on to some degree. We all agree that the bouncing is a problem and really muddying the picture and that we need to find a more consistent dose for Bear. I for one am glad I can learn more from all of you.

Given Bear is not eating well right now (he was fussy yesterday too if memory serves), I wonder whether he is just being stubborn or if he has something else going on that is contributing to the rollercoaster numbers. Definitely think testing for ketones would be a good idea.
 
:rolleyes:Yeah but I am in a brain fog right now and forgot to go look. Apparently need more :coffee::coffee::coffee::coffee:. :woot:

Love your detailed accounting of Bear's intake. Just a thought and for my pea brain....when you are documenting food it would help to indicate PS (pre-shot) or +1, +2 etc instead of actual times. We are in different time zones so using the same "details" as the readings would make it easier for us all to put the full picture together at any given time. :)
 
Do you have ketone test strips at home? If not, can you go to the pharmacy and pick some up? They are about $15 and you test by sticking a test strip in some urine as he pees (we can share some tricks on how to do that).
Yes, I'd encourage a ketone test as soon as you can manage it today. You want to stay on top of things just in case, as ketones are much easier to treat if caught early.
:rolleyes:Yeah but I am in a brain fog right now and forgot to go look. Apparently need more :coffee::coffee::coffee::coffee:. :woot:

Love your detailed accounting of Bear's intake. Just a thought and for my pea brain....when you are documenting food it would help to indicate PS (pre-shot) or +1, +2 etc instead of actual times. We are in different time zones so using the same "details" as the readings would make it easier for us all to put the full picture together at any given time. :)

I will make sure to have those +'s. A lot of the times I am not feeding Bear right after testings so I can only put the time I fed but I will add more details.

So at this point in our time spent corresponding I know you don't have a pea brain, lol.

Depending on stress levels my brain jumps off the train track multiple times sometimes in a very short period of time. Sorry about your cold and missing your train show. :)
 
Do you have ketone test strips at home? If not, can you go to the pharmacy and pick some up? They are about $15 and you test by sticking a test strip in some urine as he pees (we can share some tricks on how to do that).

@Rachel @Djamila @MrWorfMen's Mom
Ok, we have Ketone Strips and are set up for testing.

I don't know if you read the Thread Unstable Diabetic Cat, but I'm wondering if that Blood Panel at the Vet's tested Ketones specifically? I remember the Vet going over Kidney function and Liver and that he said everything on the Blood Panel was all good except Blood Glucose.

I guess I need to request copies of Bear's medical records from the Vets.
 
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Ketones would not be part of a regular blood panel. Some vets might test for them once a diagnosis of diabetes was assumed but I think that would be rare unless the cat was seriously dehydrated, not eating and very lethargic along with a high BG at the diagnostic visit. If the vet didn't mention ketones as something to watch for, they likely didn't check it.

Good luck with the ketone testing. If the strips should prove to be a problem with Bear, there are meters you can get to test ketones in the blood. The strips for them are more expensive but it can be easier with a shy/litter fussy cat.
 
Ketones would not be part of a regular blood panel. Some vets might test for them once a diagnosis of diabetes was assumed but I think that would be rare unless the cat was seriously dehydrated, not eating and very lethargic along with a high BG at the diagnostic visit. If the vet didn't mention ketones as something to watch for, they likely didn't check it.

Good luck with the ketone testing. If the strips should prove to be a problem with Bear, there are meters you can get to test ketones in the blood. The strips for them are more expensive but it can be easier with a shy/litter fussy cat.

Bear is an 80, which is considered large. One below the highest. So nurse Linda what is the protocol for this?
 
Ketones would not be part of a regular blood panel. Some vets might test for them once a diagnosis of diabetes was assumed but I think that would be rare unless the cat was seriously dehydrated, not eating and very lethargic along with a high BG at the diagnostic visit. If the vet didn't mention ketones as something to watch for, they likely didn't check it.

Good luck with the ketone testing. If the strips should prove to be a problem with Bear, there are meters you can get to test ketones in the blood. The strips for them are more expensive but it can be easier with a shy/litter fussy cat.

@MrWorfMen's Mom @Rachel @Djamila

HELP! Bear's ketones are 80. In the large on the graph for Relion Ketone Test Strips. This is one below the highest which was 160. Just tested Bear's BG it is at 288.
 
Lora, are the strips ketone only or glucose & Ketones? I have never heard of ketones strips giving you a number. The ones I am familiar with are a colour graph and you have to read the strip within so many seconds and compare its to the colours on the strip vial. Anything over a trace is considered reason for a vet consultation.
 
Lora, are the strips ketone only or glucose & Ketones? I have never heard of ketones strips giving you a number. The ones I am familiar with are a colour graph and you have to read the strip within so many seconds and compare its to the colours on the strip vial. Anything over a trace is considered reason for a vet consultation.

Just Ketones and the graph has colors to compare in 15 seconds.
 
Lora, are the strips ketone only or glucose & Ketones? I have never heard of ketones strips giving you a number. The ones I am familiar with are a colour graph and you have to read the strip within so many seconds and compare its to the colours on the strip vial. Anything over a trace is considered reason for a vet consultation.

Bear's color is one color block away from the highest. His color has an 80 and shows large. The highest is also in Large and has a 160.
 
Lora, are the strips ketone only or glucose & Ketones? I have never heard of ketones strips giving you a number. The ones I am familiar with are a colour graph and you have to read the strip within so many seconds and compare its to the colours on the strip vial. Anything over a trace is considered reason for a vet consultation.

So this constitutes emergency Vet?
 
OK I just looked up the strips. Now I understand. Sorry Canadian here!

I think you need to contact your vet or take Bear to the nearest ER. High ketones can turn into ketoacidiosis which is not only very dangerous but also very expensive to treat.
 
Definitely not something to mess around with. If your vet is not open today, ER is the best option. They will probably put him on IV to flush his system of ketones and give him some medication to help his appetite along with regulating his BG. :(
 
OK I just looked up the strips. Now I understand. Sorry Canadian here!

I think you need to contact your vet or take Bear to the nearest ER. High ketones can turn into ketoacidiosis which is not only very dangerous but also very expensive to treat.
I have called his vet and left message on emergency line. It said if no one calls in 15 minutes to contact 2 other optional places.
 
Lora, I would call the optional places unless your vet is open today or you know they will come in to deal with an emergency case. I don't want to panic you, but the sooner you get Bear to the vet, the better. It's likely they will keep him overnight or even a few days to get him stabilized.
 
Lora, I would call the optional places unless your vet is open today or you know they will come in to deal with an emergency case. I don't want to panic you, but the sooner you get Bear to the vet, the better. It's likely they will keep him overnight or even a few days to get him stabilized.
On our way. TTYL.
 
Oh no! I'm so sorry Lora. I was away this afternoon. I see you're on the way to the ER...please check in tonight when you can and let us know how things are.
 
Oh Lora! Sending you and Bear so much love. We have a funny expression we use around here - we say we're sending "healing vines". It's kind of like prayers or good energy, or positive vibes, or whatever you believe in. Please know that there are tons and tons of healing vines heading your way. And please keep us posted as soon as you know something. We all worry about every cat on here as if it is our own.
 
@MrWorfMen's Mom @Rachel @Djamila @Crista & Ming @Kris & Teasel

Great News! Bear is home after getting subcutaneous fluids, (IV fluids under the skin). He is not out of the woods yet, by far. I met a great DVM who is well educated on high protein, low carb diet for felines. She was side line working at this clinic this weekend but has her own practice also.

I told her I was home monitoring and she asked if Bear's BG had been really high. I told her no, and after a series of other questions I told her about Dr Pierson's article and how it led me to this group. I had asked her earlier if she wanted to see Bear's SS and she didn't seem too interested. After she had asked multiple questions and we talked about the success rate of high protein, low carb diet I could see her interest was peaked so I gave her my phone with Bear's SS on it.

She said, 'Wow, you are serious!" She took some time and looked at his figures. She told me the SS gave her the evidence to back up what I had said about his BG. I told her and pointed out what Djamilia had said about Bear's recent bounces as a possible occurrence and the upper readings being more the norm. She nodded her head as in agreement and looked at me in amazement and said so the group is overseen by Drs. I said no just people with a lot of experience and knowledge.

i talked about how another person thought Bear's pancreas is possibly sputtering on and off during these bounces and about skipping a dose when Bear was so off schedule so there wouldn't be an overlap, plus the multiple advice to test Bear's ketones. I can tell you the info and things you guys have talked about with me impressed this Dr a lot.

She said she thinks when Bear had his 517 BG was when his liver dumped the ketones and she pointed to my remarks and said here were he was vomiting also leads me to that.

His blood panel and urine test again was good except (urine-Ketones), and his BG went up to 423 which she associated to stress at the clinic. His white blood count was slightly elevated but she said it wasn't due to infection but I think she said to the ketones maybe?

She gave me options and explained what they entailed, including overnight stay with IV fluids and regulating insulin or subcutaneous fluids and go home with a follow up with his regular Vet and if I felt comfortable with giving Bear the fluids myself I could ask explain to my Vet that I had been shown how to do that there at the clinic and if he said no I could always (and she smoothed out her scrub so I could see her name) find this Dr and where she works at during the day.

I asked her, "How dire is it with ketone levels like Bear's because I had heard even a trace amount was an emergency?" She replied she had seen a cat with much lower levels die within a few hours but usually patients with high ketone levels have and have had for a while unmonitored testing and extremely high BG numbers.

So a tech showed me how to administer fluids and I will be going to get an IV bag from an amazing Dr. tomorrow!!!

YOU GUYS ARE AMAZING AND IF BEAR MAKES IT, IT IS DUE TO YOU!

((Now I need some advice Bear's PMPS is 328, are we looking at a repeat of 1 Unit?)))) :) XOXO
 
YAY!!!! I'm so glad Bear is okay and you spoke to a nice doctor :) I'll leave the real work to the experienced on the forum. I'm just here to say I'm so happy to hear the good news!
 
Oh Lora I am so very very relieved. :)I have been kicking myself all evening for not mentioning the ketone testing sooner. Glad you found a vet that was willing to listen and appreciate the hard work you've invested in his wellbeing. Some don't and actually tell people to stop testing so much!:banghead::arghh:

Anyway, I think it's important to get some insulin into Bear but I need to think about this for a minute and have a few questions. I don't see anyone else on right now. You've had a heck of a day/night and I'm sure you are in need of sleep.

Has Bear eaten since you got home? Will he eat something even if you have to give him his beloved kibble? Whether he will eat or not and your need for rest have to be considered here.
 
Oh Lora I am so very very relieved. :)I have been kicking myself all evening for not mentioning the ketone testing sooner. Glad you found a vet that was willing to listen and appreciate the hard work you've invested in his wellbeing. Some don't and actually tell people to stop testing so much!:banghead::arghh:

Anyway, I think it's important to get some insulin into Bear but I need to think about this for a minute and have a few questions. I don't see anyone else on right now. You've had a heck of a day/night and I'm sure you are in need of sleep.

Has Bear eaten since you got home? Will he eat something even if you have to give him his beloved kibble? Whether he will eat or not and your need for rest have to be considered here.

We just feed him 1 tuna. He had Chicken Treats with his testing of course.
 
Oh Lora I am so very very relieved. :)I have been kicking myself all evening for not mentioning the ketone testing sooner. Glad you found a vet that was willing to listen and appreciate the hard work you've invested in his wellbeing. Some don't and actually tell people to stop testing so much!:banghead::arghh:

Anyway, I think it's important to get some insulin into Bear but I need to think about this for a minute and have a few questions. I don't see anyone else on right now. You've had a heck of a day/night and I'm sure you are in need of sleep.

Has Bear eaten since you got home? Will he eat something even if you have to give him his beloved kibble? Whether he will eat or not and your need for rest have to be considered here.

Sorry 1 ounce which is about a half a can.
 
Oh Lora I am so very very relieved. :)I have been kicking myself all evening for not mentioning the ketone testing sooner. Glad you found a vet that was willing to listen and appreciate the hard work you've invested in his wellbeing. Some don't and actually tell people to stop testing so much!:banghead::arghh:

Anyway, I think it's important to get some insulin into Bear but I need to think about this for a minute and have a few questions. I don't see anyone else on right now. You've had a heck of a day/night and I'm sure you are in need of sleep.

Has Bear eaten since you got home? Will he eat something even if you have to give him his beloved kibble? Whether he will eat or not and your need for rest have to be considered here.

I am doing pretty good. I do believe things happen for a reason. I'm not sure of your belief but I believe God really had a hand in this. :) I still have adrenaline and I don't feel tired yet.
 
Oh that adrenal rush will drift off and you will suddenly be drained no doubt.

If that's Fancy Feast cans they are 3.3 oz. If it's Friskies, aren't the cans more like 5oz? I was just looking to see how much he had been eating and for his weight, it doesn't sound like he's eating enough and that may be contributing to the issue.

I'd be inclined to give him 1 unit with testing at +3 along with a snack and another test sometime in the middle of the night (say +6 or +7) and again leave food out for him....something you know he will eat. That would keep your dosing consistent from this morning.
 
Oh Lora I am so very very relieved. :)I have been kicking myself all evening for not mentioning the ketone testing sooner. Glad you found a vet that was willing to listen and appreciate the hard work you've invested in his wellbeing. Some don't and actually tell people to stop testing so much!:banghead::arghh:

Anyway, I think it's important to get some insulin into Bear but I need to think about this for a minute and have a few questions. I don't see anyone else on right now. You've had a heck of a day/night and I'm sure you are in need of sleep.

Has Bear eaten since you got home? Will he eat something even if you have to give him his beloved kibble? Whether he will eat or not and your need for rest have to be considered here.

Good grief, 1 ounce is 1/4 a can. I guess my brain is showing that I'm tired.
 
Friskies 5 ounces. So 1 Unit now, at +3 testing and snack, then test at +6 or+7 and leave some food out. The Dr was impressed by his BG numbers with Bear being recently food transitioned.
 
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