Change to Lantus? UPDATE: Back on Prozinc. Take him off before I leave on vacation? Pls help!!

Sudio3

Sudio3

Member
Hello!
So my cat Nudi started Prozinc in November 2018 went into remission July 2019 and went off insulin at that point and then at the end of December 2019 he went back on Prozinc. His numbers (morning & night before his dose) were always between 300’s-low 400’s whether the Prozinc dose was .5, .75, 1 or 2 units. So the numbers were always in the same range (high) no matter the dose. I assumed the insulin stopped working but then I had the Freestyle monitor put on him and that showed that on 2 units he was having a huge dip going from the 300’s down to the 70’s and then spiking back up to the 300’s- low 400’s during the day. So I lowered to 1.5 and there was still that big drop and spike. I then lowered to .75 but at this time the Freestyle came off but his morning and night numbers with the ear prick were in the 400’s on this dose and the vet was thinking it may still be doing the drop and spike so I lowered to .5 as I did get a day worth of data from the Freestyle on .5 and there was no drop and was pretty stable in the 200’s. So he has been on .5 with morning and night numbers still in the 300’s. I can’t seem to get him regulated into the 200’s. I stopped giving him any insulin today to see how he does without any Prozinc and to give his system a rest so that I could possibly try Lantus instead. I’m also getting another Freestyle put on him tomorrow. I have no idea if stopping the insulin is the right decision. I’m just reaching here as I don’t know what to do. He feels pretty sick when his numbers are in the 300’s.

* Note* Also I did not record the numbers the first time I had the Freestyle put on. I should have done this. Then I got the Freestyle put on a second time and it was faulty. So the one day in blue on the chart are the wrong numbers then the Freestyle broke completely. Tomorrow I will be getting another Freestyle put on.

Also, the day the Freestyle was giving the wrong readings Nudi didn’t get any insulin because it was showing his numbers were low so vet advised not to give insulin

My partner also gave him the wrong dose of .75 one day when he had been getting .5. So I’m sure this isn’t helping with his regulation.

Thank you so much!!
 
Hi. I am not super familiar with Prozinc. I mainly wanted to comment so that this might bump the conversation to the top of the pile so to speak. It did look like around 1/31 you started to make some progress on that dose and got some good numbers. That evening though, with a PMPS of 330 it looks like you didn't give any insulin either? With not giving the insulin now, and having his numbers in the 300s...I do think that can set things back a bit. Especially, if you say he doesn't seem to feel as well when he is in that range. Are you in the process now of getting the Lantus and just wondering if it is okay to start that after being on Prozinc?


I might also edit the post and add a question mark to the title so folks know you are still in need of clarification. You can click on the THREAD TOOLS and edit the title
 
We can help you with the Prozinc dosing.
But we need some BG test numbers on the spreadsheet.

Do you know how to home test the BG (blood glucose)?

It's a good idea to have either a pet meter or a human meter for backup. In case the CGM (continuous glucose monitor) you use has problems. And you have had problems.

Think of having a glucometer as an additional tool to help you manage Nudio's feline diabetes.

How is Nudio feeling?
 
I don't understand why you have stopped insulin when you are getting BG numbers in the 300s and 400s. This is dangerous and could lead to ketones developing in the blood/ urine.
You need to start insulin again AND you need to be testing the urine for ketones.
I would go out and buy a bottle of Ketostix from Walmart or a pharmacy as soon as you can. Collect a urine sample from Nudi and dip the test strip in and read against the colours on the bottle exactly 15 seconds later. Anything above a trace needs vet attention.
I can't stress enough how important it is that you do this test...and continue to do this test daily until Nudis BG levels improve.

Please let us know when you have restarted to insulin ( providing the BG is high enough to given insulin) and have done the ketone urine test. We are concerned..

Further down the track I would definitely look at swapping to Lantus.
 
Deb & Wink said:
We can help you with the Prozinc dosing.
But we need some BG test numbers on the spreadsheet.

Do you know how to home test the BG (blood glucose)?

It's a good idea to have either a pet meter or a human meter for backup. In case the CGM (continuous glucose monitor) you use has problems. And you have had problems.

Think of having a glucometer as an additional tool to help you manage Nudio's feline diabetes.

How is Nudio feeling?
Click to expand...
Yes we have the alpha trak 2 and have been using that. We have a new Freestyle on him and the numbers are usually a lot lower then then the alpha trak. So we’re not putting much stake in the Freestyle at this point. I have been logging his numbers in the spreadsheet. Is what I have enough? He is off insulin now and I just called my vet to prescribe Lantus for him as the Prozinc didn’t seem to be working. I honestly have no idea what to do but hoping the new insulin will help get him regulated? Thank you!!
 
Bron and Sheba (GA) said:
I don't understand why you have stopped insulin when you are getting BG numbers in the 300s and 400s. This is dangerous and could lead to ketones developing in the blood/ urine.
You need to start insulin again AND you need to be testing the urine for ketones.
I would go out and buy a bottle of Ketostix from Walmart or a pharmacy as soon as you can. Collect a urine sample from Nudi and dip the test strip in and read against the colours on the bottle exactly 15 seconds later. Anything above a trace needs vet attention.
I can't stress enough how important it is that you do this test...and continue to do this test daily until Nudis BG levels improve.

Please let us know when you have restarted to insulin ( providing the BG is high enough to given insulin) and have done the ketone urine test. We are concerned..

Further down the track I would definitely look at swapping to Lantus.
Click to expand...
Thank you. I stopped the insulin because the Prozinc didn’t seem to be working at all from what I could tell. I honestly didn’t know what to do to help him at this point (I’m in touch with the vet regularly and they have no idea either). I took him off the insulin to see if his numbers changed at all or if they stayed the same because again the Prozinc didn’t seem to be doing anything at all to bring his numbers down and when I went with a higher dose of Prozinc (the highest was 2 units) he was having huge drops into low blood sugar (60’s & 70’s) and then spiking back up to the low 400’s in a short amount of time, so the higher doses were not working either. Along with attempting to get information (ie is the Prozinc doing anything at all?) I was also thinking that detoxing him from the Prozinc and giving his body a rest from that insulin was a good idea before starting him on a new insulin, Lantus. I have know idea if this was the right thing to do. I’m on my own in this basically just doing the best I can in a situation where he seems to not be doing well and the Prozinc does not seem to be a help. I will take him to the vet tomorrow if they can fit him in hopefully to test for Keytones. I’ve done this many times before but thank you for the reminder to do again especially since his sugar has been so high for so long. It’s extremely hard for me to test for Keytones myself as he hates to pee inside and can hold it forever. Even though he is sick he still insists to pee outside. I have asked the vet to order the Lantus which I’m hoping will be available tomorrow or the next day the latest. Thank you for your help. I really appreciate it.
On another note: I have been having trouble testing Nudi with the Alphatrak and getting readings lately. my partner has much better luck then me but he is not always around. Nudi is also not thrilled about it getting done and loses his patience. I’m also working so not home all the time as I pet sit away from the house, I’m pregnant and have a toddler and now also my other cat is feeling sick so there is a lot going on but I will do my best to get his readings and keep giving him the best care I can. When I start him on Lantus should I start posting in that group instead? I will give an update on regarding the keytones as soon as I find out. Thank you.
 
Deb & Wink said:
We can help you with the Prozinc dosing.
But we need some BG test numbers on the spreadsheet.

Do you know how to home test the BG (blood glucose)?

It's a good idea to have either a pet meter or a human meter for backup. In case the CGM (continuous glucose monitor) you use has problems. And you have had problems.

Think of having a glucometer as an additional tool to help you manage Nudio's feline diabetes.

How is Nudio feeling?
Click to expand...
Deb & Wink said:
We can help you with the Prozinc dosing.
But we need some BG test numbers on the spreadsheet.

Do you know how to home test the BG (blood glucose)?

It's a good idea to have either a pet meter or a human meter for backup. In case the CGM (continuous glucose monitor) you use has problems. And you have had problems.

Think of having a glucometer as an additional tool to help you manage Nudio's feline diabetes.

How is Nudio feeling?
Click to expand...
Nudi is not feeling great. He never feels good once his BG hits the 300’s and having it be so high for so long he’s definitely not feeling good. My plan is to check for Keytones tomorrow at the vet and get the Lantus as soon as possible and try him on that. Thank you for your help. I appreciate it. I’m hoping this is the right thing to do. Thank you.
 
Good to hear back from you.
Yes get the ketones tested as soon as possible. It is important.
Ketones in the blood can be tested by using a meter like you test the blood glucose as well.
When you get the Lantus, post on the Lantus forum and we will help you get Nudi sorted.
Post and ask for the starting dose fir Nudi.
 
Bron and Sheba (GA) said:
Good to hear back from you.
Yes get the ketones tested as soon as possible. It is important.
Ketones in the blood can be tested by using a meter like you test the blood glucose as well.
When you get the Lantus, post on the Lantus forum and we will help you get Nudi sorted.
Post and ask for the starting dose fir Nudi.
Click to expand...
Ok thanks. I have an appointment today for this afternoon to test for Keytones with the vet. I will try and google the blood test meter that you mentioned for testing Keytones. That would be great. If you happen to know the name of it please send along. I called the vet this morning and they said they will call in the prescription this afternoon so I’m hoping to have the Lantus by tomorrow. Ok great I will post in the Lantus forum once we start. Thank you for your help. It’s truly appreciated.
 
Sudio3 said:
I will try and google the blood test meter that you mentioned for testing Keytones. That would be great. If you happen to know the name of it please send along.
Click to expand...
I have a Nova Max Plus blood ketone meter. There may be other blood ketone meters, but that’s the only one I’m familiar with. It’s definitely a lot pricier than the urine strips, but I had issues getting urine to test as well.
 
Amy and Socks said:
I have a Nova Max Plus blood ketone meter. There may be other blood ketone meters, but that’s the only one I’m familiar with. It’s definitely a lot pricier than the urine strips, but I had issues getting urine to test as well.
Click to expand...
Ok thank you so much. I will check this out. It will be so nice to be able to check him myself!
 
Just for the record, you don't need to "detox" the cat by withdrawing Prozinc before starting Lantus. People who switch do Prozinc one cycle, Lantus the next.
Sudio3 said:
Thank you. I stopped the insulin because the Prozinc didn’t seem to be working at all from what I could tell. I honestly didn’t know what to do to help him at this point (I’m in touch with the vet regularly and they have no idea either). I took him off the insulin to see if his numbers changed at all or if they stayed the same because again the Prozinc didn’t seem to be doing anything at all to bring his numbers down and when I went with a higher dose of Prozinc (the highest was 2 units) he was having huge drops into low blood sugar (60’s & 70’s) and then spiking back up to the low 400’s in a short amount of time, so the higher doses were not working either.
Click to expand...
Don't be surprised if you see the same behaviour with Lantus. Nudi is not used to low numbers yet, and as a result his body is compensating by dumping sugars (what we call bouncing) and resulting in those higher numbers. It is very common for new diabetics to start high, drop, then go high again in the same cycle. Only once their body spends more time in normal numbers and gets used to it, will they stop bouncing as much.

One other note, dosing decisions with Lantus are based on how low it takes the cat. Those lows are typically in the middle of the cycle, so you will need to learn to look for those nadirs in both the AM and PM cycles. In the PM a test before bed will help you determine whether he is going lower that cycle. Or maybe your partner can help with those tests.

One other note, the Freestyle Libre is a human meter, which typically shows lower numbers than the pet meters like the AT. However, our dosing methods are written using human meters so they are numbers we are used to.
 
Wendy&Neko said:
Just for the record, you don't need to "detox" the cat by withdrawing Prozinc before starting Lantus. People who switch do Prozinc one cycle, Lantus the next.

Don't be surprised if you see the same behaviour with Lantus. Nudi is not used to low numbers yet, and as a result his body is compensating by dumping sugars (what we call bouncing) and resulting in those higher numbers. It is very common for new diabetics to start high, drop, then go high again in the same cycle. Only once their body spends more time in normal numbers and gets used to it, will they stop bouncing as much.

One other note, dosing decisions with Lantus are based on how low it takes the cat. Those lows are typically in the middle of the cycle, so you will need to learn to look for those nadirs in both the AM and PM cycles. In the PM a test before bed will help you determine whether he is going lower that cycle. Or maybe your partner can help with those tests.

One other note, the Freestyle Libre is a human meter, which typically shows lower numbers than the pet meters like the AT. However, our dosing methods are written using human meters so they are numbers we are used to.
Click to expand...
Ok thank you. So Nudi did not have Keytones. His numbers have also been in the 200’s recently (high 200’s) but I still thought this was weird as it’s been in mid 300’s-low 400’s steadily for a while. It made me think that maybe I shouldn’t give him the insulin? But regardless I am picking up his insulin (Lantus) tomorrow. So, since his numbers may bounce on Lantus as well would it just make sense to keep him on the Prozinc and see if he balances out? I will need to buy a human meter for the Lantus and figure out how to use it and also it just seems confusing and like a lot to deal with. I will do my best to do whatever I need to do for him but I really don’t have a lot of time and I’m frankly nervous about starting him on the new insulin but also want to give him the care he needs. I would go with the slow and steady approach starting him on Lantus. I need to re-read that sticky again. It may be hard for me to take his sugar 4-5 times a day in the beginning so this is a concern for me. I’ll keep learning/reading/asking questions and I’m sure things will get more clear.

Thank you for letting me know there is no waiting period between starting a new insulin and also that the Freestyle is showing human numbers so that most likely was the difference in readings.

Thank you! I appreciate all the help!
 
Si am cat mom said:
Hi. I am not super familiar with Prozinc. I mainly wanted to comment so that this might bump the conversation to the top of the pile so to speak. It did look like around 1/31 you started to make some progress on that dose and got some good numbers. That evening though, with a PMPS of 330 it looks like you didn't give any insulin either? With not giving the insulin now, and having his numbers in the 300s...I do think that can set things back a bit. Especially, if you say he doesn't seem to feel as well when he is in that range. Are you in the process now of getting the Lantus and just wondering if it is okay to start that after being on Prozinc?


I might also edit the post and add a question mark to the title so folks know you are still in need of clarification. You can click on the THREAD TOOLS and edit the title
Click to expand...
Thank you for your message I somehow missed it!! I appreciate your feedback and thanks for bumping the post. Yes I will be picking up the Lantus tomorrow I’m working on figuring it all out and I’m hoping to start him on it soon! Thank you!!
 
If you already have the Alphatrak pet meter and can afford the cost of the strips. You can keep using it.

The people on the lantus forum may be more used to human meter readings, but they should see your signature data that indicates the Alphatrak being used and you have it noted on your SS.

It's up to you which meter to use. Pet or human.
 
Deb & Wink said:
If you already have the Alphatrak pet meter and can afford the cost of the strips. You can keep using it.

The people on the lantus forum may be more used to human meter readings, but they should see your signature data that indicates the Alphatrak being used and you have it noted on your SS.

It's up to you which meter to use. Pet or human.
Click to expand...
Ok thank you. Appreciate your help.
 
So I put Nudi back on .5 of Prozinc on 02/20/20 and his numbers are still so high it seems even higher then when he was off Prozinc because at least he had some numbers in the yellow when he was off? I’m leaving for a week tomorrow night and I put him back on Prozinc because it was recommended that I at least put him on some kind of insulin because his numbers were so high even though the Prozinc didn’t seem to be working previously. I’m in the process of switching him to Lantus but didn’t want to start him on that right before I’m going away for a week as the pet sitter could not be regular with his dosing she would be an hour late a few times and it my understanding that Prozinc tolerates that better and honestly Lantus seems a little more confusing and high maintenance while I’m trying to get him regulated. I wouldn’t be around to test him regularly. My question is, I’m wondering if I should take him off Prozinc again for the week I’m gone and then start him on Lantus when I’m back because his numbers are so high on Prozinc anyway and there will be no one to test him when I’m gone. And I’m having trouble finding someone to give him his insulin for two mornings so he would miss two doses. Thank you!! I look forward to hearing from you!
 
Sudio3 said:
My question is, I’m wondering if I should take him off Prozinc again for the week I’m gone and then start him on Lantus when I’m back because his numbers are so high on Prozinc anyway and there will be no one to test him when I’m gone. And I’m having trouble finding someone to give him his insulin for two mornings so he would miss two doses.
Click to expand...
Choices.
1. Vacation dose. Reduce the dose to half of what you currently give. So that would be 0.25U of Prozinc.
Pros: Cat sitter not testing. Less likely for Nudi to have low BG levels on a lower dose of insulin. Hypoglycemia less likely. Cat still getting SOME insulin. Cat may not eat as well while owner is away.
Cons: Ketone risk. Due to not enough insulin.

2. Current full dose.
Pros: Cat is getting SOME insulin.
Cons: Cats do not always eat as well when their owners are gone. Greater risk of hypoglycemia in that case.
0.5u dose may be too high. Not much mid-cycle data to base a judgement on. Only pre-shot tests.
Cat sitter not testing. No way to tell if BG levels fall too low.

3. No insulin while you are gone.
Pros: No risk of hypoglycemia since cat will not be receiving insulin.
Cons: Ketones develop and lead to a full blown DKA (diabetic ketoacidosis) incident.

There are risks, there are always risks with whatever decision you make. You make the choice you think would be best for YOU and NUDI. This is a very tough decision for you to make. But you are the one that knows your cat best and needs to make that judgement call.
 
So I also just found out from a neighbor that there is another neighbor that leaves dry food out for stray cats and my neighbor thinks she has seen Nudi going over that direction so he could be getting dry food that she leaves out! Uh! But this could be why he has been so hard to regulate?
 
Sudio3 said:
So I also just found out from a neighbor that there is another neighbor that leaves dry food out for stray cats and my neighbor thinks she has seen Nudi going over that direction so he could be getting dry food that she leaves out! Uh! But this could be why he has been so hard to regulate?
Click to expand...
Yup. That could be a good reason that Nudi eating some dry food will keep his BG levels higher. Time to think about talking to the neighbor or making Nudi a strictly indoor cat.
 
Hi Sudio3, I simply wanted to make you aware of this. I realize you are away on vacation. But this is very good information for you to read when you have time.

All the "Sticky" or pinned posts in the Prozinc forum have been updated and there are a couple of new ones.

Highly recommend that everyone using Prozinc or helping those using Prozinc read them thoroughly.

I'll be doing that myself. Been expecting this for some time. Came about a week before I thought it would.
Thanks Marje, and Robert, and especially Djamila for the Modified Prozinc Method. You folks are FANTASTIC!
 
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