? Changing from Levemir to Prozinc ????

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Tuxedo Mom

Tuxedo Mom

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Because my kitty has early stage Cushing's I am considering changing from Levemir to Prozinc, basically because I could use a sliding scale for dosing. Since my Tuxie has no predictable numbers (due to the Cushing's) I would like to be able to shoot the numbers I see at preshot.

Can anyone give me any advise on changing over to Prozinc from Levemir. I would really like to be able to continue using the U100 syringes and I know there is a conversion table for doing so.

What dose would I start at ( preferably on the U100 syringes) if I am currently dosing at 4.5 units Levemir X 2?

How would I determine what sort of sliding scale I should use?

I have read the protocol for Prozinc, but am still unsure when the increase or when to reduce (I am using the Alpha Trak2 pet meter) ?


After 13 months of using Lantus/Levemir I am really scared to enter unfamiliar territory. I have lots of Levemir left so it is not a problem of "have to do now", but I really think considering Tuxie's conditions that trying Prozinc may work out better for him AND me.

Thanks for any input!
 
Hi Mary Ann,

We don't often get people switching in this direction, but we'll do our best to help. I can see how a sliding scale might help.

Here is the conversion chart:

http://www.felinediabetes.com/insulin-conversions.htm

I would be only guessing about the switch dose. The nice thing is that you can raise the dose in 3 cycles by 0.5 if he is sitting in high ranges. So maybe decrease by one unit - on the cycle where you can monitor carefully?

The differences I see is that ProZinc really is based on the idea that every cat is different, and that what a dose does for one cat on a given number may be completely different than what it does for another. So there is no set protocol - no "if you get this, shoot this". The dose is based on the preshot being safe to shoot (we do not advocate shooting a low ranges like the L insulins. Some people shoot at 150 and maybe under - if they have data and can monitor and are giving tiny doses) and the nadir being in safe ranges and past data of that cat getting a dose in that range and the results. So, it is trickier to decide on a dose until you get data and feel comfortable interpreting it. Hopefully that is where we can help.

The other difference is its adaptability. You can shoot early or late. Some people shoot an 11/13 cycle if the preshots are unequal. People have shot every 8 hours, after they collect enough data to know that the insulin isn't lasting longer than 8 hours. And you can develop a sliding scale, especially adapted to your cat's numbers - shooting different doses for lower ranges and higher ones.
 
Welcome Mary Ann and Tuxie to the Prozinc Forum. I bet it is really scary to try a different insulin but it looks like you are very familiar with the whole process and it should be a pretty easy transition to you. Sue gave you some good information. The only thing that I would add that with Prozinc, you need to know, of course, the preshot number and the nadir to determine the dose. When you get enough data, you will be able to come up with a sliding scale. You have been doing a great job of collecting data and will know very quickly what Tuxie's nadir is with Prozinc. Just holler if you need assistance and let us know when you are going to start with Prozinc.
 
Thank you for the responses. I love the Levemir....however with Tuxie's early Cushing's diagnosis it reealy changes the rules. From my understanding Prozinc is a 10 + hour duration with no depot, which allows for adjusting the PS amounts accordingly to the PS=readings. Since Tuxie has early Cushing's his numbers do not follow any rhyme nor reason. so the TR and SLGL protocols do not work well with him. I still have several months worth of Levemir left and I am doing as much readings as possible about using Prozinc. The really sad thing is when I took Tuxie to the vet for his UTI and asked what the costs were for Prozinc she had not even heard of of it before....and she is a good vet ..licensed since 1975. I really like her but every time I take Tuxie there I feel like I am teaching her more than I am paying for. :(

This may seem a really strange question but has anyone done a part Levemir/part Prozinc to srart with...such as AM Levemir and PM Prozinc?? Maybe I am way off base but I don't know what the easiest way to do a transition from Levemir to Prozinc would be. I though after 14 months of treating a DM cat I would be confident, but right now I am scared out of my mind about switching.
 
Tuxedo Mom said:
.....
This may seem a really strange question but has anyone done a part Levemir/part Prozinc to srart with...such as AM Levemir and PM Prozinc?? Maybe I am way off base but I don't know what the easiest way to do a transition from Levemir to Prozinc would be. I though after 14 months of treating a DM cat I would be confident, but right now I am scared out of my mind about switching.
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Hi Mary Ann! I think you're wanting to shoot what you see for that cycle rather than depending on insulin already in the body?? I don't think a combination of Levemir and Prozinc will give you what you're looking for -you'd still be dealing with a depot of Lev but depleting it by 24 hours, Prozinc wouldn't add anything to the depot so it would stay wonky. When KT got so sick and both Lantus first and Lev were driving him up and down too much AND I couldn't depend on him being able to eat at any given time, I needed the same thing. I changed him to NPH. At that time, people suggested I wait 1-2 days between stopping Lev and starting the N then shoot at 1 unit. I'm NOT saying that's how you should approach this, I'm just sharing my experience. We didn't have much time to really evaluate as I lost him within another couple of weeks....

HUGS!
 
Lyresea thank you for your input...I did not realize that Squeaky had crossed the bridge. The names may change but the love remains....forever...:bighug:


I guess I am really scarde about changing to a different insulin. With Cushing's it is a a lot like Acro...where there is tumour on the pituitary gland. Sometimes it is "working" and sometime it is "switched off". Since there is really no pattern to the dosing IMHO it makes more sense to dose accordingly to the pre-shots and taking the nadir into account. I have been in contact with the 3 poeple whose kitties had Cushing's and it is a whole new ball game from type 1 or type 2 diabetes.
 
Tuxedo Mom said:
Lyresea thank you for your input...I did not realize that Squeaky had crossed the bridge. The names may change but the love remains....forever...:bighug:

I guess I am really scarde about changing to a different insulin. With Cushing's it is a a lot like Acro...where there is tumour on the pituitary gland. Sometimes it is "working" and sometime it is "switched off". Since there is really no pattern to the dosing IMHO it makes more sense to dose accordingly to the pre-shots and taking the nadir into account. I have been in contact with the 3 poeple whose kitties had Cushing's and it is a whole new ball game from type 1 or type 2 diabetes.
Click to expand...

KT, my first diabetic, crossed in 2014. We adopted Dakota in 2013 already diabetic for 4 years - he's now 15 years old with kidney disease but he's still plodding along on Levemir.

I think you're making a good decision by going this route - this gives you a lot more flexibility to give him what he needs when he needs it.
 
Hi Mary Ann! I don't really have any advice to add as I've only ever used the ProZinc...but I wanted to welcome you to our little forum and let you know that we'll be here to help you figure it all out!
 
Thank you all for your help and encouragement. I am going to do more researching on Prozinc and the dosings before I make the final decision. I still have almost 4 full penfills of Levemir ( 1 open and 3 unopened) so I have lots of time. It is good until April 2017, so I can have it as a backup if the Prozinc doesn't work out. The open penfill will last me about 1 month so that will be the time I make the decision.

How long should a 10 ml vial be good for? I read the product information file on the manufacturer's website and couldn't see an expiry time frame.
 
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