Changing to ProZinc - what to expect

Sarahand Jeffery

Sarahand Jeffery

New Member
Hi there
Jeffery was diagnosed as type 1 in October and has been on Caninsulin since. We got to a point where his fructosamine showed a near perfect number but he then had a hypo event in the middle of the night. Long story short, on the advice of this forum I asked the vet to look into ProZinc as members said that it was less harsh and less likely to cause hypo as it doesn’t drop so hard.
It took a few weeks to move this forward as my vet knew nothing about ProZinc so I had to pay for them to consult an expert.
Here I am ready to start with ProZinc tomorrow morning on 1 unit, with a Freestyle Libre attached to monitor him and give the vet the numbers after 5 days to look at his next dose.
Since he went hypo I have become used to keeping a very close eye on Jeffery’s numbers between 4 and 6 hours for nadir, to make sure it isn’t too low (had another couple close calls, despite smaller doses).
My reading tells me nadir varies on PZ so would love to know the general consensus of when it is for owners, and any other info from people who have transitioned from Caninsulin to PZ.
Thank you!

Extra info: Jeffery is FIV+ and has IBD, with the only food his stomach settles on being high fibre, and high carb. We have tried diabetic friendly and other wet foods and it was disastrous so on his Royal Canine Satiety Dry he will stay.
 
Hello Sarah, and welcome to the ProZinc forum! I understand about the food. Have you tried the Hill’s Z/D hydrolyzed protein food before? It’s for IBD. I have an FIV+ cat who also has IBD (biopsy confirmed) and it’s been recommended for him — although I haven’t tried it yet because I was hoping not to have him eat that stuff.

Anyway, about the ProZinc, you will find it’s a much better insulin for cats. Caninsulin (as the name implies) is an okay insulin for dogs but doesn’t work well with a cat’s metabolism at all. Somehow I wish we could get vets to stop prescribing it for cats. They’re so uninformed on feline diabetes (beyond diagnosis at least- many are clueless) and it’s amazing to think that vets are still prescribing Vetsulin/Caninsulin when the veterinary profession has said they do not recommend it for cats. I am also amazed that you had to pay for your vet to consult with an “expert.” You just paid for your vet’s Continuing Education. That should have been on him/her to pay. All they had to do was a little internet research of their professional publications to find out. Anyway, I just feel sorry that you and Jeffrey have been through all this …. most especially a hypo. Was it a symptomatic hypoglycemic event or just a really low number (it’s not the same thing.)

What is his current dose of Caninsulin? Is he staying in safe numbers on that dose at this point?
I would really be happy to help you. We need to first get you set up with a spreadsheet so you can input your Libre information there. This will be really important so we can know how to safely adjust his dose, as needed.

Here’s the link for how to create a spreadsheet.
https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

As far as nadirs go, it varies a lot by cat. Somehow cats on ProZinc will nadir at +4. A lot will nadir at about +6. We can use food to slow them down a bit because we do not want steep drops in BG that can cause a bounce. A cat’s nadir can vary. Many times in the beginning they tend to nadir earlier and, as they make progress toward regulation, the nadir gradually get later (more toward +6.)

We should talk about his feeding schedule as that’s really important. You won’t need to feed him early and wait half an hour or so before giving the shot anymore. ProZinc will onset at approximately +2 (two hours after the shot) so, unlike Caninsulin, the procedure is to test BG, feed and shoot right away. You can shoot while they’re eating if that works.
Oh, we need you to get your signature set up as well with all the basic information. see my signature at the bottom of this post. It is usually the cat’s name, age, date of diagnosis, type of insulin, which dosing method you will be following (it will be SLGS for you in the beginning), type of glucose meter you are using, type of food being fed, and concurrent health conditions (the FIV and IBD) as well as any medication they are taking. It also is helpful if you put your time zone on there (EST for example) if it will fit.
We can talk about a lot of stuff and should… but I have thrown enough at you for the time being. Thanks for taking such good care of Jeffrey and being his advocate with the vet to get him onto a better insulin. I can tell you love him a lot!
 
Thank you for the warm welcome
I’ll take a look at the signature and spreadsheet tomorrow when I am on my computer rather than my phone.

Vet said he can’t have steroids unfortunately, which the vet said would usually be their go to, because they are immunosuppressants and he is immunocompromised by his FIV. Did you find the same?

It isn’t the first time I have had to pay for expert advice, the last being for his IBD symptoms and how to deal with it when it is with FIV. There wasn’t actually an answer to it, and it is £150 a time! But yes I do love him and so of course I pay it.

His hypo event was unfortunately symptomatic, I woke up in the middle of the night (miraculously) and he was staggering all over the place, confused and drunk. It was horrible. I think
It happened because I tried to move him to diabetic biscuits - I should have known better - and it had upset his tum. Any change of food brings back weeks of bloody diarrhoea and going outside his tray. I don’t think he was therefore absorbing nutrients normally. Only yesterday after a month did I get a normal poo from him.

He has been on 4.5 units of caninsulin. His numbers are all over the place. Because his stomach has been bad this last month his appetite has not yet returned so he has had some partial doses. Sometimes he drops low even on a half dose, other times it doesn’t touch him. What others have said u Caninsulin hitting hard and fast I have definitely found to be true - a couple of times he will start around 22mmol, drop to around 15 and then an hour later it’ll be nearing the 2.7 stage! It has left me very nervous to give full doses and I hope PZI is a calmer experience for us

Re. the feeding, there’s no way for me to be sure he will eat it all if he starts eating, so I guess I will still need to wait until he gets it all down? He’s a funny one when he has a flare up
 
Yes, you want to make sure he has a little food in him at breakfast time, but if he eats during those first two hours of the cycle ( after some initial breakfast) that will help prevent steep drops as well. It depends upon his eating patterns. That is incredibly scary about his hypo!

My FIV+ boy was on steroids Dexamethasone at a low dose every other day before the IBD diagnosis. It was for skin issues that were very severe. We had no choice— either he tore himself up and was miserable with itching or we had to use the lowest dose possible of the steroid to control the itching. Since his IBD diagnosis in September of last year, he has been on Prednisolone and is doing well — although I have had some difficulty with tapering his dose down (he will start vomiting again). He is currently on 5 mg Pred per day that I hope to reduce in another month. It’s definitely not something you want to give an FIV cat unless you have no choice, because it will suppress the immune system to some degree. His intestinal inflammation was pretty severe and so we felt we had no choice. I do my best to keep him well with some supplements, and I worry. He isn’t diabetic though. If you are able to control Jeffrey’s symptoms with food, then that is good. Prednisolone, in addition to high carb food, would raise his blood glucose even more.
 
With ProZinc, you may initially need to give partial doses at times if you have a preshot BG reading that is lower than you have experience/data shooting. As you gather data on his spreadsheet, we will have a guide to help make dosing decisions. It’s good to be consistent, but first you have to know how he handles the dose. I am really hoping this will help him!
 
Sounds like you’ve had quite the journey with your FIV baby too. I keep telling myself I can only do my best - and if he dies then there is nothing more I could do. He is an ex stray and he certainly would be long gone if he was still on the streets.
Doesn’t always help me in those emotional times of worry though…
I’m sorry to see on your spreadsheet that you lost beautiful Darcy ❤️ Was it diabetes related in the end?
 
My poor boy had Acromegaly, which is a pituitary tumor that causes excess growth hormone to be produced. The excess growth hormone makes the cat extremely insulin resistant (that is why we were up over 40 units at one point.). It also destroys other organs in the body. In Darcy’s case, the growth hormone trashed his kidneys and that is what actually killed him. He was getting really great blood glucose readings - we had that under control- but we couldn’t stop the kidney damage. It was too late. He was a very sweet boy and I was lucky to have him.

My FIV boy was dumped on the streets too (he’s not a feral cat, he’s very tame). I took care of him and his lady friend for a year or so outdoors at a place where they were living. I finally could not take the stress anymore of worrying about them constantly after they were shot by someone. And then there was the fighting to defend territory which resulted in further injuries and the FIV.
 
Just write down somewhere the BG numbers for Jeffrey tomorrow preshot and any other times you can scan the Libre. +2 and +4 and +6 would be good, but I don’t know what your schedule is like tomorrow (or any other day!):)
 
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