ANOTHER UPDATE: Advice? new vet & switching to Prozinc....

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Hi there,

I've been "lurking" on the PZI board for awhile due to the fact that Motska is using the last of her Vetsulin and we will need to switch insulins soon (I don't want to go to Lantus or Lev, because there are frequently times when I can't shoot on a 12/12 schedule -- it may be 11/13 or more, especially if I'm able to find a second job). I have also finally made the decision to start over with a new vet.

The reason for the vet switch is basically that I keep running into some of the same issues as others who have vets that aren't willing to learn or update their knowledge about FD. He still instists that I shouldn't be hometesting unless I use the expensive glucomter that I must buy from him. And when I kennel Motska there, they just "shoot blind." They do not have any means to test her BG other than by doing a blood draw from a vein in her leg, so even if I was willing to pay $25 x twice per day for them to test her, they would absolutely tear up her veins (and frankly, I think they would just refuse to do it, because of the damage to her veins). Everyone is friendly there and they like Motska (even though she's always grouchy with them), but also show a lack of interest in reading any information I bring them. (I say "they", but it's actually a 1-vet practice with several vet assistants.) Like many of your kitties, Motska would have crossed the bridge a long time ago if it were not for the advice and caring of the folks on this board. I cannot possibly express enough gratitude for the fact that I still have my babygirl.

So after making a few phone calls, I've found a new vet (a feline-only practice) that encourages hometesting, and when you kennel at their facility, they will test before giving a shot! (I have two roommates, both of whom are incredibly irresponsible, so I won't EVER ask them to take care of her, and any of my other friends who would be willing to watch her, have dogs -- hence the need for a place to kennel her.)

I've compiled a list of questions that the new vet's office answered over the phone. So my main question is this: How do I/we know what dosage of Prozinc to use? Motska is currently on just .1 unit of Vetsulin (sometimes .2 if she's a bit higher than usual). Since they're both U-40 insulins, I'm thinking I should start at .1u of ProZinc. Does this sound like a good idea? I'd rather err on the side of caution, since I work outside the home, and if she hypos, I won't be here to catch it during the day, and I'd probably be asleep if it happened at night. I am home on weekends to do a curve as necessary.

Also, I'm 99% sure that Motska will need to have a dental. Should I wait until after the dental to make the switch to ProZinc?

And any other suggestions you may have to offer will be welcome. My appointment isn't until next Saturday.

Thanks!

Kris
 
Re: Advice? new vet & switching to Prozinc....

Hi Kris,
Welcome to PZI!. Sounds like a good plan to switch vets---can't believe they shoot blind. A dental sounds like a good idea, and starting low sounds good too. Always better to be safe. Maybe you should wait till after the dental to switch, unless there is a reason to do it sooner--so you don't have to deal with too many things at once. Looking forward to more postings from you.
 
Re: Advice? new vet & switching to Prozinc....

Your spreadsheet is confusing (not the sheet, just what happened) In January she brought herself down from the 100s with no shots at all. Now it looks like she is running in the mid 200s. Wonder if that is just the inconsistency of the Vetsulin or if she has an infection with her teeth. I think I would consider having the dental done first in case that would bring her numbers down into a normal range.

Trying to start an insulin when you have numbers in that lower range will be tricky. One element to consider that if the Vetsulin is just not working well and she is running in the 200s with an inefficient insulin, what will happen when she gets on one that is works better more consistently. I hope you can start on a weekend when you have time to do a lot of testing. I agree that you could start very conservatively in your .1 and .2 range and see what happens. The nice thing about PZI is that you can quickly adjust the dose up if it is not working.

It sounds like you have found a much better vet. I can't imagine that a vet would say they will just shoot blind because they can't do a bg reading.

Welcome to the forum, Kris. We are a small group but friendly and kind with each other. Most of us are only on in the am and pm, but some of us check in during the day.
 
Re: Advice? new vet & switching to Prozinc....

Welcome Kris & Motska,

Good for you for home testing, it is the only way for you to know if it is safe to give Motska insulin. I hope you have better luck with the new vet. My vet forbade me from home testing but since I didn't listen to her and got a Walmart Relion Micro meter and tested, my Harley is still here with me.

Have you heard that Vetsulin has had some potency problems and has all but been abandoned? Maybe you could get your vet to switch it to Prozinc right away for free since it looks like your micro doses have been working really well until a week ago or so. I would start at the same small doses like .1 when you start Prozinc just in case the Vetsulin isn't working and the Prozinc does.

If Motska needs a dental I would get it now before the insulin switch, infections in the teeth could be what is giving her the high bg's. Harley had a dental a few weeks ago, the vet suggested I switch to a raw diet soon after and he is trying his best to come off of insulin, we are almost there.

Again, welcome to our little group.

Robin
 
Re: Advice? new vet & switching to Prozinc....

Hi and welcome! I'm glad you found a vet with a better understanding of fd. That really helps! I've got no advice that the others haven't already given, but just want to wish you lots of luck in your switch of vet and insulin!
 
Re: Advice? new vet & switching to Prozinc....

Thanks for the replies everyone!

Judy -- I can't believe that they shoot blind, either. Last summer when I went to Michigan for a family reunion, I had them shooting .5u BID for her dose, and spent the entire week obsessing over whether or not they would even notice it if she started into a hypo. Thankfully(?) her numbers were a bit higher back then, so there was less of a chance she would hypo. But now, considering how her numbers are now, and how she reacts to the Vetsulin, I know she would not survive a week in their "care."

Sue -- I agree that the inconsistency might be due to her teeth -- maybe not, but we'll find out either way! From what I can see of her teeth (she has never liked it when I try to get a look), she has quite a bit of tartar built up, and it has been almost three years since her last cleaning, so that would make sense. If you were to go back and see her numbers from October, she looked like her pancreas was really trying to kick in back then also, but it pooped out again. I'm hoping that a clean, healthy mouth will help give her some consistency with her BG numbers. And yes, I plan to start the ProZinc when I'm going to be home the entire weekend, so I can do spot-checks throughout the day (both Saturday and Sunday).

Robin -- My old vet did tell me a long time ago about the halt in production of Vetsulin, but since she was doing pretty well on the Vetsulin, we decided to keep going with it until we couldn't get it anymore (or until we saw that it wasn't working well for her). He did have some other diabetic animals under treatment that had already made the switch because they weren't responding well to Vetsulin, but he and the owners were making that decision on a case-by-case basis. And I'm glad to hear that you (and everyone else, it seems) agree that she should have the dental done first, and then switch insulins. I thought that was what I should do , but I wanted to check in with those of you who have more experience with this sort of thing!

Charliemeow -- thanks for the welcome!

Thanks again for the welcome and the advice! I guess I already knew what I should do, but I think I needed to feel more confident in my decision. I'd rather ask a question and be told that I am absolutely wrong, than take an unnecessary chance with Motska's health. She's 16 years old, and I'd like to keep her healthy as long as I can! (And if I can figure it out, I'm going to try again to get her picture up here.)
 
Re: Advice? new vet & switching to Prozinc....

sue and oliver are usually great at helping people with tech stuff. Or try posting in the tech forum = lots of helpful people. love to see your picture!
 
Re: Advice? new vet & switching to Prozinc....

Well, we have good news and bad news....

The good news is that I LOVE this new vet's office. They are fairly up-to-date on current FD treatments, and on their website, they even have a link to FD.com!!! They spent a good 45 minutes with me and Motska, and were very interested in hearing what I had to say! They are 1/2 hour away from anywhere I usually go, but it's absolutely worth it! They were surprised to hear that she's 16 years old -- apparently she looks much younger (can I say that she gets it from me?).

The bad news is that when they checked her teeth, they were able to get a good look at her back teeth (which I have not been able to do) and not only does she need a dental, but she also definitely needs one tooth pulled. She may need more pulled, but they won't know for sure until they do the radiographs just prior to doing her dental and then when they get into the cleaning -- they'll want to check for any abscesses and resorption (sp?). But that one tooth that definitely needs to come out -- is half blackened. When I saw that, it broke my heart -- I feel like a bad mommy for letting my baby's teeth rot! Yes, it's my fault that I don't brush her teeth. I am also angry that my old vet didn't recommend a dental for her a year ago, when she was in for last year's exam and shots! (It has been almost three years since she's had a cleaning.) If she had a dental last year, maybe she wouldn't have a rotting tooth!

The good news is that I actually trust these folks (which I kinda didn't with the old vet). And they will be monitoring her closely -- including checking her BG levels while she's under. They printed out an estimate for me, and made sure to estimate on the high side -- just in case they have to pull out a few more teeth, and the price is doable, thanks to my tax return. Annnnddd, if we get her bad teeth out, then her BG will likely be a bit more stable (but I'm afraid to even get my hopes up about the possibilty of going OTJ).

Her procedure will be done on Tuesday the 22nd.... Crossing my fingers until then!

Thanks for your help, everyone!
 
Re: UPDATE: Advice? new vet & switching to Prozinc....

So glad to hear you like the new vet. I think having a vet you can trust is a piece of heaven! And with the teeth taken care of, your need for insulin may really drop! Paws crossed.
 
Re: UPDATE: Advice? new vet & switching to Prozinc....

This sounds like very promising news. Teeth problems can really mess up bg levels, so you could be looking at a completely different picture after the dental.

If you need some reassurance about the dental, post over on Health. Lots of diabetic kitties have had dental procedures and done very well.

Sounds like you got a great vet!
 
Re: UPDATE: Advice? new vet & switching to Prozinc....

Good news on the new vet. Lucky girl to take after her mama bean and look so young.

A dental can improve her health in many ways.

We'll be thinking about you on Tuesday. Please keep us updated.
 
Re: UPDATE: Advice? new vet & switching to Prozinc....

Guilty of bad-tooth-mom here too :oops: brushing is NOT appealing!!!

If you don't already have a game plan, I'd get some advice on doses for before and after the dental - I'd check on Health & ask your vet too. I don't recall exactly what the scoop is, but I think maybe the anesthesia can lower BGs (?), something or other at least, so the advice is generally to shoot on the lite side. And also of course if you have to take away food before going in you probably don't want to shoot full doses.

Good luck with everything!
 
Re: UPDATE: Advice? new vet & switching to Prozinc....

Just wanted to say hi. I'm new to the PZI forum too and new to FD. This forum has been amazing and patient in answering all my newbie questions. Will be very interested to hear how the dental goes for Motska. My kitty, Max, needs one too, but I have held off until I could get Max more stable with the diabetes.
 
Re: UPDATE: Advice? new vet & switching to Prozinc....

That is just awesome news about how tuned in your new vet is. And while the dental might seem like bad news, truth is after it's done, it may really change your insulin needs, so ultimately, it could be a good thing.
 
Re: ANOTHER UPDATE: Advice? new vet & switching to Prozinc..

Motska had her dental today and needed SIX teeth pulled. :sad: Two incisors, two premolars, and two molars. One tooth actually broke while they were scraping the tartar off of it, and most of the others had severe problems with the gumline receeding. She's a little loopy from the pain meds (Torbutrol) and she's also on liquid Clindamycin, but otherwise seems to be doing okay, considering how much she had done today. We go in for her follow-up on Saturday.

Thank you again to everyone for your advice, thoughts, and prayers!

Also, if anyone has any advice regarding how to make it easier to give liquid Clindamycin, I'm all ears -- she is really fighting me on it. The vet warned me that it might happen, since it tastes really bad....
 
Re: ANOTHER UPDATE: Advice? new vet & switching to Prozinc..

I'm so glad everything went well, she will really start to feel better soon. Watch her bg's, they tend do go low after anestesia and not need as much insulin.

As for the liquid pain meds, ask for Bupe instead (sorry I don't remember the full name), it's injectable and you already know how to do that.
 
Re: ANOTHER UPDATE: Advice? new vet & switching to Prozinc..

I think the Clindamycin is an A/B right? I had a loopy cat who didn't mind it, lucked out on that one, but yeah, they are supposed to hate it basically. I don't have any tips but if you don't get any here you might try on Health. Maybe someone has a trick. I'd just try to get it as far back as you can, I think they taste it less that way, but obviously that is easier said than done.

Hope she is feeling better soon! Bet you are glad you got the dental done! It is always a (bad) surprise in my experience what all they find in there when they really look. :(

p.s. she is gorgeous!!!! I'm a sucker for a calico :-D
 
Re: ANOTHER UPDATE: Advice? new vet & switching to Prozinc..

This morning the meds went a little easier.

She has her full appetite already, so I tested her BG an hour before her normal AMPS and she was at 259. So I crushed her Torbutrol (pain meds) and mixed it in with 1 tsp of food and gave her the next hour to eat it and let it take effect. Then at her normal AMPS time and she was at 266, so I fed her the rest of her food and gave her insulin, and then gave her the Clindamycin (A/B). It went a little easier, because of Joanna's suggestion to try to get it as far back in her mouth as I could, and because she was sufficiently loopy from the Torburtol that she didn't fight me nearly as much. I won't be able to get back in there to try and get Bupe instead -- at least not until her re-check on Saturday. So if we're still having problems with the Clindamycin, I'll have to just keep trying to administer it until then.

And thanks for the compliment, Joanna -- I'll pass the message along to her (naturally, I talk to her on a regular basis, and of course I think she's gorgeous as well) -- I just wish she wasn't so grouchy with other people. She's a momma's girl all the way.... If she's in a good mood, once in a while, sometimes she lets other people handle her. Maybe. (From what I'm told, this isn't uncommon in Callies/Torties.)
 
Re: ANOTHER UPDATE: Advice? new vet & switching to Prozinc..

What's the saying? "half sweet, half crazy" I think :lol:

that's very smart to get her loopy before the nasty meds, great idea!!!
 
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