Prozinc and AlphaTrak question

[Blzlovr]

I've been giving Cleo 1 unit of Prozinc twice daily after eating (Fancy Feast classic) for 3 months and she seems to be doing good. She is normal weight, she had a insulin check-up at the vet today and they said she was 426 mg/dl and told me to increase to 3 units twice daily. I checked her with the Alpha Trak right after on code 37 and it said she was 255, I then checked her non-diabetic brother and it said 54. So now I'm confused. She has been throwing up a little in the mornings before eating and maybe due to low or high blood sugar? Thank you for any advice. Sherril

 

[JanetNJ]

Woah, a jump from 1 u to 3 u is too much! It should go from 1 unit to no more than 1.5 units. That's a dangerous increase all at once. Here's a link to dosing ProZinc https://www.felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/


This is the spreadsheet template we use. You will see most of us have a link in our signatures below to our spreadsheets. They are super helpful for tracking numbers and make it easier to give affice. https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Are you feeding several meals a day or just two big meals? If it's just two meals then there may be stomach acid build up. It's better to feed several small meals a day.
It's impossible to tell you if the throwing up is from her numbers. I'm really glad to hear your are testing at home. Do you have a log you can share?

 

[Blzlovr]

Thank you for the links, I'm switching to 3 meals a day and 1.5 units twice daily. I need to figure out why the Alphatrak numbers are so off from the vet's numbers. I have been keeping a paper log in the Alphatrak booklet but if the numbers are so wrong I need to figure out why. I'll be contacting AlphaTrak customer support next.

 

[Oscar and Carrie]

Thank you for the links, I'm switching to 3 meals a day and 1.5 units twice daily. I need to figure out why the Alphatrak numbers are so off from the vet's numbers. I have been keeping a paper log in the Alphatrak booklet but if the numbers are so wrong I need to figure out why. I'll be contacting AlphaTrak customer support next.

It's very common for BG numbers to be elevated at the vet due to the stress your cat will be feeling being in an unfamiliar environment, so it's unlikely there's anything wrong with your monitor.

Definitely second Janet - if you get a spreadsheet set up it can help other members to advise on dosage etc. and you can share it with your vet so they can evaluate based on home readings which shouldn't be influenced by stress levels.

 

[Pabs&Ro]

Stress at the vet often elevates BG levels. Are you using the alphatrak test trips?

 

[Blzlovr]

Yes using AlphaTrak strips, and I tested her non-diabetic brother and his number was 54? Shouldn't he be in the 90-110 range for normal? I don't believe she gets stressed out at the vet and I tested her about 30 minutes after the vet tested her.

 

[Pabs&Ro]

That does seem odd. I thought alphatrak was more accurate in the lower ranges. Pabay is always in the higher ranges and it fluctuates a lot. I changed to centrivet which is calibrated for cats. I am much happier with it and it's cheaper. The readings don't fluctuate, they are steadier and I have a better picture of what is going on.

 

[Deb & Wink]

Non-diabetic cats or very well regulated cats, or cats tightly regulated, or cats in diabetic remission (diet controlled) can have BG levels in the 40 to 100 range.

My non-diabetic cats would often test in the 40-60 mg/dL range. So those readings on your Alphatrak are not odd at all.

 

[Blzlovr]

Thank you! Was worried about Ramsey's low number. Cleo has another glucose check at the vet tomorrow I hope she is back to normal. Changing her to 3 meals a day has helped with the throwing up issue.

 

[Pabs&Ro]

you could give the vet your alphatrak so he can do a test with his meter (or blood) and you meter and see if there is a difference.

 

[Deb & Wink]

Changing her to 3 meals a day has helped with the throwing up issue.

You might want to consider splitting up the food into 4 meals a day. The bulk of the meal to be fed at pre-shot test time. Then a small snack later in the cycle, not much beyond +5 or +6.

One of my civies (civilian or non-diabetic) cats would eat too fast, and then vomit up her food. If I split her meal up into smaller portions, with the main portion first thing, then the smaller second portion a bit later, she did not vomit. When a cat eats too fast it's sometimes called "scarf and barf".

I fed 2 breakfasts and 2 dinners which kept her happy. Well, along with a small mid-day snack and another snack right before my bedtime.

 

[Blzlovr]

Cleo only throws up in the early morning and it's not food, it's white and foamy and not that much. Cleo's vet visit at 4:30 pm today showed her BG at 443 mg/dl and he also tested her with my AlphaTrak meter and it was 438 mg/dl. I questioned the vet tech about the difference in the testing numbers last week with their meter and my meter and she said that maybe they gave her something to bring her glucose down and she would check the chart but she didn't see anything in the chart. That would explain it though. The vet wanted to keep her to do a curve but I said I would do it myself and then he suggested fructosamine testing and that came back at 380 umo/L. So now I'm going to test her before every shot and keep a record of it in the spreadsheet that I created today. Just have to figure out how to update it. Thank you every one for your help.

 

[Deb & Wink]

So now I'm going to test her before every shot and keep a record of it in the spreadsheet that I created today. Just have to figure out how to update it.

You have to sign into your google account, in order to update the SS. The link you have here, in your User Id Signature is view only and can't be used for updating.

Curves at home will be more reliable, since your cat is not stressed out like they would be at the vet clinic.

Cleo's vet visit at 4:30 pm today showed her BG at 443 mg/dl and he also tested her with my AlphaTrak meter and it was 438 mg/dl.

How many hours was that since you gave Cleo Insulin? Saying 4:30 PM doesn't mean much to us, since we all live in different time zones.

 

[Blzlovr]

4:30 pm Pacific (Southern California)

 

[Deb & Wink]

4:30 pm Pacific (Southern California)

Sorry, that still doesn't help.
No idea when you gave Cleo her insulin. Every one gives their cat insulin at a different time, depending on their schedule and life responsibilities.

Because we all live in different time zones, when we express times, we do it in the number of hours since the dose of insulin was given.
So 1 hour after insulin is +1, 2 hours after is +2, 3 hours after is +3, etc.
AMPS is the morning (AM) pre-shot test. PMPS is the evening (PM) pre-shot test.

So how many hours was it between when you gave Cleo insulin and when the vet did those tests? +4? +8? +10? Something different?
However many hours it was, that is where you would enter the test at the vet on the SS.

More information on the SS is here: >>>>>
Sticky HOW TO USE THE SPREADSHEET

 

[Blzlovr]

Still trying to figure out the spreadsheet, so I get that AMPS is the AM pre-shot test and PMPS is the PM pre-shot test, and the columns after are the number of hours before the shot was given. So my normal day is to test at 8:00 am, feed at 8:15 am, shot at 8:30 am, feed at 1:00 pm, test at 6:00 pm, feed at 6:15 pm, shot at 6:30 pm. The spreadsheet would show test numbers, units given, and then AMPS hours would be +14 and PMPS would be +10, am I doing it wrong? I thought I was supposed to give her shots right after eating?

 

[Deb & Wink]

and the columns after are the number of hours before the shot was given.

The columns, with the +x numbers, are the hours AFTER the shot is given. Not before.

then AMPS hours would be +14 and PMPS would be +10

Why are the shots of insulin being given so far apart? Every 12 hours is the standard dosing interval.

I thought I was supposed to give her shots right after eating?

Yes, but the test, feed, shoot routine can happen in a much shorter time frame. No need to wait so long between your pre-shot test and the dose. Or between the pre-shot test and giving your cat food. As short as you can make it, 5-10 minutes is plenty. As long as your cat has a good appetite, there is no reason to wait until they have finished eating before you give your cat the insulin shot.

Prozinc is not a very fast acting insulin. Not like Vetsulin (Caninsulin) or NPH type insulins where you would want to have the food on board (in your cat's stomach) some time before you give them the insulin shot. Prozinc takes about 2-3 hours to onset (start working) for most cats.

 

[Blzlovr]

I'm confused about the spreadsheet, I give her the shot a few minutes after she eats, so I would put her test results in the +1 box? And I haven't been dosing every 12 hours, I've been giving her shot after she eats in the morning at 8:00 am and after she eats at 6:00 pm, maybe that is why she is throwing up in the early morning because too long between doses. I was told to dose with food so should wait until 8:00 pm to feed her and give her 2nd dose? Thank you so much for your help.

 

[Deb & Wink]

The pre-shot test goes in the AMPS column if done in the morning, and in the PMPS column if done in the evening.

If you test Cleo 1 hour after you give her the insulin shot, that BG number would go in the +1 column.
If you test Cleo 2 hours after you give her the insulin shot, that BG number would go in the +2 column.
If you test Cleo 4 hours after you give her the insulin shot, that BG number would go in the +4 column.

The doses of insulin should be given 12 hours apart. Or as close to that as you can do.

I was told to dose with food so should wait until 8:00 pm to feed her and give her 2nd dose?

Yes, wait until 12 hours from the first shot to give the second shot.
So if that means 8 pm your time for the evening shot, then wait to feed her then and then give the shot of insulin ASAP.

We like to see the pre-shot test done when there has been no food given for 2 hours before that test. Any other tests you do during the 12 hour dosing cycle, we expect there to be some food influence. No food for 2 hours before, so you are not shooting insulin into a BG number that is inflated by the food. Made higher by the food.

You can feed your cat multiple meals a day. You do not need to limit those feedings to only feeding right before the insulin shot.
Many of us split the food into several meals a day, wtih 4 meals being very common. Feed the bulk of the food before the insulin, then smaller snacks after that.
Try not to feed after about +6. That is because the insulin is "used up" by then and feeding in the last half of the 12 hour cycle usually leads to the BG numbers going up too far.