Pip - Dx 11-19-2025 Prozinc dosage and weird drops

SarahJeanne said:
Good morning friendly people and cats :)

So the good news is Pip seems out of the red on his preshots... the bad news is I got my first fur shot this morning so I hope he got a lol bit of his dose.

Happy Thanksgiving to all the American members :)

Have a great day!
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He’s so cute! My Pip is currently running around the house like crazy (morning playtime) and meowing for breakfast.
 
It definitely wasnt a complete fur shot cause his numbers were in the yellows yesterday :)

So... I got a pretty aggressive email from my vet yesterday... here is it translated to english:

Hi Sarah

Thanks for the information, I understand the numbers better now, but it's rare for someone to do glucose tests at night. For now, it drops to 13.6 or 14 mmol/L 4-6 hours post-injection, which is a good response. Normal glucose is 3.3 to 6.6 mmol/L. I don't like it when it drops below 7 mmol/L during the day, and I accept that its lowest is sometimes 10 mmol/L.
We're still far from the target range, however, I would advise giving 2 units every 12 hours and doing a glucose curve at time 0 (before the morning injection), 4 and 6, and 8 hours post-injection in one week.
I have a lot of clinical experience with diabetics and different types of insulin, and I also follow the manufacturer's recommendations. But if you prefer to have online veterinary care... are the vets on the site you're consulting really vets? I thought I saw that they were cat owners.
One thing is certain: it's best if only one vet follows the diabetic cat at the beginning of treatment; otherwise, if two people give different information, it won't work.
If you're more comfortable increasing by 0.5 units at a time, that's fine as long as the cat is doing well, because there's a higher risk of ketoacidosis and polyneuropathy, and it will require much more monitoring. After each increase, you need to do a curve 7-10 days later.

Hoping to help you with Pip.

I am a bit speachless... higher risks of ketoacidosis?
Her need to put down the advice I am receiving because it is given by cat owners really makes me sad.

She insists on doing a clinic curve 7 days after each dosage raise even if I am doing curves at home...

I'm seriously just trying to do right by Pip and I dont even know what to reply :(
 
Hey Sarah, I totally get the frustration there and sorry you’re dealing with that :confused:. I think that’s why a lot of us just stopped engaging with our vets regarding the details of FD management. It’s not their fault, this is a complicated disease and they have so much else to handle and know as a veterinarian…

I wouldn’t write back anymore, personally. And if they gave me a problem about that decision I’d find a new vet (I’ve done this, but understand there are challenges sometimes). But if I were to respond, I would emphasize that yes, none of us here are vets, but, a human doctor put together the information here all based on actual FD research papers and published guidelines. With hundreds if not thousands of cats achieving remission…

The advice they gave might work, but is risky and doesn’t line up with what’s been going on on this forum for 30 years.

So all that to say, I’m not trying to put down your vet. I’m sure they’re great at a lot of things and we need our vets. Just not necessarily for every FD intricacy IMO.
 
Tim & Pookey said:
Hey Sarah, I totally get the frustration there and sorry you’re dealing with that :confused:. I think that’s why a lot of us just stopped engaging with our vets regarding the details of FD management. It’s not their fault, this is a complicated disease and they have so much else to handle and know as a veterinarian…

I wouldn’t write back anymore, personally. And if they gave me a problem about that decision I’d find a new vet (I’ve done this, but understand there are challenges sometimes). But if I were to respond, I would emphasize that yes, none of us here are vets, but, a human doctor put together the information here all based on actual FD research papers and published guidelines. With hundreds if not thousands of cats achieving remission…

The advice they gave might work, but is risky and doesn’t line up with what’s been going on on this forum for 30 years.

So all that to say, I’m not trying to put down your vet. I’m sure they’re great at a lot of things and we need our vets. Just not necessarily for every FD intricacy IMO.
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Thank you Tim!

Good morning and I hope you and Pookey are doing well today 😊

I gave her access to a spreadsheet I made just for her where I will put my curve today at +4 +6 +8 like she wants and I will wait till Monday to decide if I reply or not.

She is treating my Tiny man and I need to bring her a stool sample wednesday to make sure his treatment worked so maybe I will wait to talk to her in person...

I will just ask her to trust me in handling the diabetes and agree to bring Pip in for weigh ins and checkups when she wants to see him... I hope we can find a compromise

For now Pip got his morning shot and we're going to go back to bed a bit 😴

Have a wonderful day!
 
Well, your vet probably just knows what they learned in school, and has kept doing that. There are lots of vets like that. They are otherwise good vets, just as Tim mentioned.

But here is where you'll find the expertise, the lived experience of following these protocols.

As a funny anecdote, when I first started here with my first diabetic cat, I told the veterinarians at the Rive-Sud hospital about the Roomp & Rand protocol, the one for tight regulation on Lantus. They started phoning me to get details, how we set up our spreadsheets, what do they mean, etc.

Turns out the vets contacted the press here, and had an article published about their amazing new treatment for feline diabetes. So we often teach the vets.

With the vet I recommended, again, he's no diabetes expert. Those are here. But he won't try to tell you that you need to do in-clinic curves (which are expensive, stressful, and don't give an accurate snapshot, which our spreadsheet does). He doesn't know about best foods for diabetics. You'll get lots of info here. But he will respect you following what we're doing here, because he knows me, Luciole, and that we're being helped here.
 
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You know, I read this message this morning and I have been thinking about it ever since. I am sorry that your vet is making things so difficult for you. That is quite aggressive as you say (threatening really since she is in a position of power.) I often think that people share too much information with their vets about the day to day management of their cat’s feline diabetes. Oftentimes it’s better to not show them your spreadsheet, but to just provide individual day curve data, when requested. It really depends upon the kind of person your vet is. I am just really sorry this has added another level of complexity to your journey with Pip’s diabetes.

The mention of DKA is probably just referring to Pip being in high numbers — or saying that if he is in high numbers his risk of DKA is greater. You can test him for ketones yourself at home with either urine strips or a blood ketone meter. I do remember having a hard time getting my vet to accept the readings from my blood ketone meter— simply because she was not familiar with them. She questioned their accuracy, but I had done the research on them so I knew they were accurate (and I just needed to know when my boy’s ketones were high.) Fortunately, she didn’t care how much I tested him. She knows me well enough to know that I research and read about everything and also that I would test him at home anyway no matter what. She could see that I would not let him hypo, so she was happy to let me keep him in normal cat BG numbers as much as possible. Normal cat BG numbers are between about 50-120, by the way. If you have a civvie at home (non-diabetic cat) you can test him/her and see what I mean.
 
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