? 7/23 just a ProZinc visitor with a question

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Beenie (GA)

Beenie (GA)

Member Since 2017
Hi everyone!
So my Beenie is a high doser and I'm following the ProZinc protocol trying to breakthrough this resistance. What exactly is the benefit for a high dose kitty to be on Lantus/Levemir? Do these insulins help get you to the breakthrough dose faster? I've read once you are at 6.o U or higher Levemir is the better choice due to Lantus stinging at high doses, is that true?

Would love some LL eyes on my Beenie's SS for some feedback. Yesterday was a good day and we had a nice stretch of yellows. I was so excited I set my alarm to catch a blue at +8 last night but didn't. What made me scratch my head was this mornings AMPS number.

I just picked up a new vial of ProZinc yesterday and will use it but would consider an insulin switch next vial if someone could educate me as to why LL might be better.

Thank you!!!!:cat:
 
Beenie said:
I've read once you are at 6.o U or higher Levemir is the better choice due to Lantus stinging at high doses, is that true?
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A number of high dose cats have been switched from Lantus to Levemir for that reason, but Chino is at 12.5 units and has never shown any discomfort, so I've stuck with Lantus. Another reason people switch is that some cats respond better to Levemir (flatter cycles, later nadirs).

I don't have any experience with ProZinc so I can't answer the other questions but there are people here who've switched from it.
 
Adrian and Chino said:
A number of high dose cats have been switched from Lantus to Levemir for that reason, but Chino is at 12.5 units and has never shown any discomfort, so I've stuck with Lantus. Another reason people switch is that some cats respond better to Levemir (flatter cycles, later nadirs).

I don't have any experience with ProZinc so I can't answer the other questions but there are people here who've switched from it.
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Thank you!
 
Not all insulins work well for all cats, so generally, if you've been on one insulin for 4-6 months and it's not seeming to do much, we suggest trying a different one.

Lantus/Levemir are "depot" insulins so they work in a different way than ProZinc which is an "in/out" insulin. A depot insulin releases slowly and usually has some "carry-over" from one shot to the next, where the in/out insulins don't.

Usually, if we see a cat on ANY insulin that's over 6U (and has been increased in a sane way and tested enough to know what's going on), we suggest having them tested for acromegaly and IAA to see if that's why they're such big gulpers.....there are also some treatments for acromegaly that might reduce the insulin dose. (if positive for acro, there are also other health issues it's important to know about).

Will Beenie do better on Lantus/Levemir? Possibly!!....I'd say it's worth trying though!
 
@Wendy&Neko and @julie & punkin (ga) have had cats with acromegaly and have worked closely with many of the members here on managing their high dose cats. @Sandy and Black Kitty has an enormous amount of experience with IAA (insulin resistance).

Levemir is not acidic and is often preferred over Lantus once a cat is on a large dose, especially if the kitty starts to flinch with Lantus. At low doses, this doesn't seem to be a problem.

I've not spent time on the ProZinc board so I don't know if many people with high dose kitties have used ProZinc. Wendy or Julie may know. Theoretically, it shouldn't matter, at least with insulin resistance.

You may want to consider getting Beanie tested to determine if a high dose condition is present. Your vet will need to get a blood sample and send it to the vet lab at Michigan State University. There is information on the High Dose Forum about getting the testing done.
 
We have a couple of currently active members with high dose cats who switched from Prozinc. @StephG switched to Lantus and @Sharon14 switched to Levemir. I think Levemir has a slightly longer duration and would recommend it over Lantus for that reason. Neko was on Lantus first and I didn't think it stung here, but she would occasionally walk away from the shot. On Levemir, she purred during the shot. :cool: Her cycles were also flatter and more predictable, hence I got more sleep and tested less too. Many high dose caregivers use fasting acting R as a bolus insulin, and Lev cycles make it easier to add R as a tool.

As far as The L insulins vs Prozinc, I think the benefits are the duration of insulin, and the experience we have here with high dose kitties and the L insulins, which means we have developed some techniques for fast tracking dosing to get you quicker to a good dose. Plus there is just more knowledge of high dose conditions here. And one really cool thing, kitty Marvin is on a cabergoline trial, a medicine that the Royal Veterinary College is testing for acromegaly in cats. Marvin has gone from 8 units to one drop of insulin in 5 weeks. :cool::cool:
 
And how could I forget Wes @saltycat :banghead::banghead: :oops: His Jack switched to Lev and was a good example of the antibodies (IAA) being confused at first by the insulin switch.
 
Chuck is on 16 units twice a day now. He gets longer control in each cycle and bounces aren't as high on lantus. I haven't noticed any discomfort with the shot. Well once he flinched but I can't say that was from the poke or insulin. I warm his shot between my fingers for a minute or two before shooting just so it's not so cold going into his body.
I haven't tested for high dose conditions but with the trial drug mentioned above we might get it done sooner.
Chuck is doing better on lantus and seems to be getting back to his usual personality quirks...
We are very happy with the switch.
 
It is also MUCH cheaper. I was paying $110 ish per prozinc vial with 400 units. Only lasted a month! You can get 1500 units (with all 5 pen together) for about $160-170 ish from Mark's.
At higher doses this end up being a big money saver.
 
Chris & China said:
Not all insulins work well for all cats, so generally, if you've been on one insulin for 4-6 months and it's not seeming to do much, we suggest trying a different one.

Lantus/Levemir are "depot" insulins so they work in a different way than ProZinc which is an "in/out" insulin. A depot insulin releases slowly and usually has some "carry-over" from one shot to the next, where the in/out insulins don't.

Usually, if we see a cat on ANY insulin that's over 6U (and has been increased in a sane way and tested enough to know what's going on), we suggest having them tested for acromegaly and IAA to see if that's why they're such big gulpers.....there are also some treatments for acromegaly that might reduce the insulin dose. (if positive for acro, there are also other health issues it's important to know about).

Will Beenie do better on Lantus/Levemir? Possibly!!....I'd say it's worth trying though!
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Thanks Chris & China! I'll consider a different insulin if we don't make any progress. Beenie surprised me with her +6 number today so we shall see ;) She is certainly keeping this very interesting.

I already have contemplated testing for Acro and IAA but will wait it out a month or so before we pull the trigger on that. I already sent the MSU forms to my vet and he agrees we'll wait another 4-6 weeks. If she break trough before that great, if not we'll dig deeper. :cat:
 
Sienne and Gabby (GA) said:
@Wendy&Neko and @julie & punkin (ga) have had cats with acromegaly and have worked closely with many of the members here on managing their high dose cats. @Sandy and Black Kitty has an enormous amount of experience with IAA (insulin resistance).

Levemir is not acidic and is often preferred over Lantus once a cat is on a large dose, especially if the kitty starts to flinch with Lantus. At low doses, this doesn't seem to be a problem.

I've not spent time on the ProZinc board so I don't know if many people with high dose kitties have used ProZinc. Wendy or Julie may know. Theoretically, it shouldn't matter, at least with insulin resistance.

You may want to consider getting Beanie tested to determine if a high dose condition is present. Your vet will need to get a blood sample and send it to the vet lab at Michigan State University. There is information on the High Dose Forum about getting the testing done.
Click to expand...
Yes, thank you Sienne and Gabby. I have read and read on line at least in humans when it comes to insulin resistance the type of insulin really doesn't matter. I guess I was hoping for someone to shed some light on why it seems the high dose kitties I see on here end in LL land. I see so many SS's on the ProZinc forum that are on such tiny doses. That is the norm and I feel we are the exceptions (big gulpers). In the end Beenie just may be that and that alone, a high doser with no underlying reason.

I guess the next step is to give it a little more time than the Acro/IAA testing will be the next step. Depending on the results dosing may change.

Thank you again for you feedback !!:)
 
Keep in mind the Royal Veterinary College research that found one in four diabetic cats has acromegaly. They found an average dose of 7 units and some as low as 1 unit. It's not so much about the dose, you just give a cat however much insulin they need, but rather managing side effects if a cat has acromegaly. Knowledge is power and helps you help Beenie.
 
Wendy&Neko said:
We have a couple of currently active members with high dose cats who switched from Prozinc. @StephG switched to Lantus and @Sharon14 switched to Levemir. I think Levemir has a slightly longer duration and would recommend it over Lantus for that reason. Neko was on Lantus first and I didn't think it stung here, but she would occasionally walk away from the shot. On Levemir, she purred during the shot. :cool: Her cycles were also flatter and more predictable, hence I got more sleep and tested less too. Many high dose caregivers use fasting acting R as a bolus insulin, and Lev cycles make it easier to add R as a tool.

As far as The L insulins vs Prozinc, I think the benefits are the duration of insulin, and the experience we have here with high dose kitties and the L insulins, which means we have developed some techniques for fast tracking dosing to get you quicker to a good dose. Plus there is just more knowledge of high dose conditions here. And one really cool thing, kitty Marvin is on a cabergoline trial, a medicine that the Royal Veterinary College is testing for acromegaly in cats. Marvin has gone from 8 units to one drop of insulin in 5 weeks. :cool::cool:
Click to expand...
Wow and hooray for Marvin! That's amazing! Thank you Wendy & Neko. So the L's get you there faster (the good dose). Ok then that's kind of what I was hoping to hear. I can't toss the $$ I just spent on the new Prozinc vial but if there isn't a marked improvement as we end that vial I'm thinking LL is where Beenie might need to be. I'm counting the hours to PMPS to see what surprise she has in store tonight.

Thanks :bighug:
 
StephG said:
It is also MUCH cheaper. I was paying $110 ish per prozinc vial with 400 units. Only lasted a month! You can get 1500 units (with all 5 pen together) for about $160-170 ish from Mark's.
At higher doses this end up being a big money saver.
Click to expand...
Thanks Steph! The only difference I see on Chuck's and most others SS is the bouncing. Beenie just seems so "stuck" and never ventures off to blues or greens. We had one blue but that was it. Most other SS I look it is where I see the bouncing phenomenon. A big drop to a lime or forest green and *BAM* a pink, red, or even black. And then it takes time for the kitty to "settle". I can see that now but certainly not when we started this journey. Good tip on the price point and something to consider when I'll be needing insulin more frequently. Acro/IAA testing will be our next step. Thanks so much for the feedback ;)
 
Wendy&Neko said:
Keep in mind the Royal Veterinary College research that found one in four diabetic cats has acromegaly. They found an average dose of 7 units and some as low as 1 unit. It's not so much about the dose, you just give a cat however much insulin they need, but rather managing side effects if a cat has acromegaly. Knowledge is power and helps you help Beenie.
Click to expand...
I know I've read the statistic and I'm baffled that more kitties aren't tested. A 1 in 4 chance is pretty steep. I haven't seen any clinical signs of Acro in her which is why I haven't moved faster on it. I truly have sent the forms from MSU's website to my vet so I'm so ready to move on testing. I want to give it several more weeks before we do. I try to look at the big picture, Beenie was just diagnosed in May so it hasn't been that long and we've seen improvement. I just don't see the same movement throughout the day in her numbers like most and the fact she is up to 8.6 U and counting is what worries/confuses me.

Thanks for the info!!:cat:
 
Beenie said:
someone to shed some light on why it seems the high dose kitties I see on here end in LL land.
Click to expand...
It's because Lantus and Levemir both have a longer duration in a cat's body than ProZinc has. People are trying everything they can to control a high doser's blood sugar, and so switching to the longest-possible lasting insulin is one of those things.

We started and stayed with Lantus, because Punkin didn't seem bothered by it. If I were doing it over again, however, I would switch to levemir. I've seen some good successes with cats moving to Lev.

Best of luck to you!!
 
julie & punkin (ga) said:
It's because Lantus and Levemir both have a longer duration in a cat's body than ProZinc has. People are trying everything they can to control a high doser's blood sugar, and so switching to the longest-possible lasting insulin is one of those things.

We started and stayed with Lantus, because Punkin didn't seem bothered by it. If I were doing it over again, however, I would switch to levemir. I've seen some good successes with cats moving to Lev.

Best of luck to you!!
Click to expand...
Thank you !
 
It looks like you got some great info so far. I fully understand the "stuck" numbers. I went through the same thing with Jack. If you look at the beginning of his 2016 spreadsheet you can see where we were "stuck" when using prozinc. When I first switched him to Levemir he had some greens due to his IAA. He then got stuck again until we found that breakthrough dose that finally got him into some better numbers. I made the switch to Levemir before getting the IAA/Acro tests done.

I agree that the Lev is more cost effective, for me it was less then half the cost of prozinc. Ordering from Marks marine pharmacy is much cheaper then a local pharmacy here in the US. It's also nice using less volume in a high dose cat since it is a more concentrated insulin(100u per ml versus prozinc's 40u per ml).
 
saltycat said:
It looks like you got some great info so far. I fully understand the "stuck" numbers. I went through the same thing with Jack. If you look at the beginning of his 2016 spreadsheet you can see where we were "stuck" when using prozinc. When I first switched him to Levemir he had some greens due to his IAA. He then got stuck again until we found that breakthrough dose that finally got him into some better numbers. I made the switch to Levemir before getting the IAA/Acro tests done.

I agree that the Lev is more cost effective, for me it was less then half the cost of prozinc. Ordering from Marks marine pharmacy is much cheaper then a local pharmacy here in the US. It's also nice using less volume in a high dose cat since it is a more concentrated insulin(100u per ml versus prozinc's 40u per ml).
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Thanks Wes! If cost wasn't an issue would you have switched from ProZinc? The reason I ask is if ProZinc is an in/out insulin wouldn't that be good when you get into the lime greens? I guess I still need to educate myself more on the depot insulins. I've read the stickies but I worry that if you get a kitty cleared from a low number there is still the "depot" left. How long do you need to monitor before you're out of the danger zone?
I guess the longer lasting is better to get the numbers down but when they go too low is what scares me. We haven't had any low numbers yet. I know they're scary for all when it first happens but I'm petrified that it will happen when I'm not home.
Anyhoo, the other thing is I'm torn with getting the testing done now or later. What do you think based on her dose and the timeline of it all?

Thanks!!!:)
 
What is the advantage of knowing later what you are dealing with? Beenie is well over six units now. Knowing what you are dealing with might change your dosing strategy to get her into good numbers sooner.

We have "tricks" for interrupting the action of the depot in larger doses if kitty goes too low. Specifically, shooting a greatly reduced dose for the cycle following will help drain the depot. And it really is ECID how each cat handles lower numbers. Neko was quite carb sensitive and it didn't take much work to get her up over 50. I didn't even need particularly high carb HC most of the time, though I did bring out the corn syrup for under 40. OTOH, some caregivers need to have HC that is over 20% carbs. Do you have an autofeeder for Beenie? I found Neko became almost predictable on Lev, and would put HC in the feeder if there was any doubt what she would do while I was out. She was food motivated, no problem getting her to eat from the feeder. :p
 
Wendy&Neko said:
What is the advantage of knowing later what you are dealing with? Beenie is well over six units now. Knowing what you are dealing with might change your dosing strategy to get her into good numbers sooner.

We have "tricks" for interrupting the action of the depot in larger doses if kitty goes too low. Specifically, shooting a greatly reduced dose for the cycle following will help drain the depot. And it really is ECID how each cat handles lower numbers. Neko was quite carb sensitive and it didn't take much work to get her up over 50. I didn't even need particularly high carb HC most of the time, though I did bring out the corn syrup for under 40. OTOH, some caregivers need to have HC that is over 20% carbs. Do you have an autofeeder for Beenie? I found Neko became almost predictable on Lev, and would put HC in the feeder if there was any doubt what she would do while I was out. She was food motivated, no problem getting her to eat from the feeder. :p
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All great info!!! Thank you. Beenie has an automatic feeder and is soooo food motivated. Has always been a foodie. My other civies, if up to them they would eat slow and take a break, go back for more later. Grazers I guess.
So your explanation on the depot and greatly reduced dose the following cycle makes sense to me. If going out and in doubt leave a MC or HC carb for mid day feedings. I'm a little taken back by all of it, in shock a little. I just got used to this whole new lifestlye, learned to test, give injections, get a crash course on feline diet, feline health, and was ready for the sugar dance. This big gulper aspect with the possibility of another chronic disease like Acromegaly is a lot to sink in especially under three months in. I guess I was delaying the testing because I'm scared to know so thank you for the kick in the tush. No reason to wait, not at this dose. Knowledge is power and so is early detection.

Thank you, thank you :bighug::bighug:
 
I started on prozinc simply because that is what the vet recommended. The main reason I switched was the prozinc just didn't seem to be working and we were getting into higher doses. I think Chris mentioned above that some cats respond better to different insulins as well. As I read more on the forums here, I liked the idea of a depot insulin that lasted longer and had a flatter curve then an insulin like prozinc.

The lower cost was nice but not the main reason for switching. It also seemed like there were more cats on Lantus/Lev then prozinc. The Lantus and levemir section of the boards here also seemed more active.

There are lots of members here who work during the day and cannot be home to test. Learning your cats patterns and testing before work/bed can help you see a drop coming and like Wendy mentioned there are lots of tricks to deal with them.

While not necessary the Acro/IAA tests do help and can help in determining a strategy for dosing. I've found out over time the IAA can make things unpredictable at times. Knowing what I was dealing with helped.

I think we were all overwhelmed at first, don't feel bad at all. There is so much information here that even my vet refers to them as my diabetes specialists ! Hang in there and keep reading, it definitely gets easier as time goes on.
 
saltycat said:
I started on prozinc simply because that is what the vet recommended. The main reason I switched was the prozinc just didn't seem to be working and we were getting into higher doses. I think Chris mentioned above that some cats respond better to different insulins as well. As I read more on the forums here, I liked the idea of a depot insulin that lasted longer and had a flatter curve then an insulin like prozinc.

The lower cost was nice but not the main reason for switching. It also seemed like there were more cats on Lantus/Lev then prozinc. The Lantus and levemir section of the boards here also seemed more active.

There are lots of members here who work during the day and cannot be home to test. Learning your cats patterns and testing before work/bed can help you see a drop coming and like Wendy mentioned there are lots of tricks to deal with them.

While not necessary the Acro/IAA tests do help and can help in determining a strategy for dosing. I've found out over time the IAA can make things unpredictable at times. Knowing what I was dealing with helped.

I think we were all overwhelmed at first, don't feel bad at all. There is so much information here that even my vet refers to them as my diabetes specialists ! Hang in there and keep reading, it definitely gets easier as time goes on.
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Thank you
 
If definitely is overwhelming at first. When I started there was just one other acromom on board. Julie saved my sanity. It didn't help that I soon knew more about acromegaly than the vet. :rolleyes: Feel free to lean on us. :bighug:
 
Thank you. I had already emailed my vet the two forms from MSU for the testing. He basically felt it was too soon to go that route (probably not knowing the ins and outs). Tomorrow I call and tell them its the route we are going! Thanks Wendy :cat:
 
Spoke to my vet's office today about testing and they are ordering the "kits" (or mailers) from MSU as they've sent samples in the past and feel its the best way to send. I will post once I know results. This will take a little time as the kit has to come in, make the appointment to get the blood drawn, and off to MSU.

Thanks again for the encouragement. :bighug:
 
Beenie said:
I'm blown away at Marvin's numbers. That is so exciting and only two weeks in on cabergoline did you see results. How is Marvin feeling? Do you see a tremendous difference? I would imagine so.
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Sorry for the late response, I was on the road this morning and just got back home. Marvin is doing better, just getting his numbers in a lower range is helping. He has severe neuropathy so I am hoping that his legs will start to heal now. His personality is more like it used to be, and he is getting around a bit more even with the neuropathy. Of course he is drinking less, peeing less, and using his litter all the time now. His appetite is less sometimes, but that's ok, he's was a big boy :) It's only been just over a month, will be interesting to see how he does over time and if any adjustments will be required.
 
Marvin's Mom - Nat said:
Sorry for the late response, I was on the road this morning and just got back home. Marvin is doing better, just getting his numbers in a lower range is helping. He has severe neuropathy so I am hoping that his legs will start to heal now. His personality is more like it used to be, and he is getting around a bit more even with the neuropathy. Of course he is drinking less, peeing less, and using his litter all the time now. His appetite is less sometimes, but that's ok, he's was a big boy :) It's only been just over a month, will be interesting to see how he does over time and if any adjustments will be required.
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:bighug:Well Marvin's number are getting to a better place faster than his body can get too. Its a good thing. All those healing blues and greens will do Marvin all the good in the world!!! So happy for you
Do you think the Zobaline is helping? Not sure when you started but I just started with Beenie a few days ago. She wasn't walking on her hocks but the she would only walk a few steps then stop and lay. She goes further now but nowhere near what she used to do. Hoping this supplement will assist in the healing process :)
 
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