Coming off N, starting ProZinc

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kds0200

kds0200

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Hi everyone! I've read the sticky posts in this forum (and a few days ago introduced myself in the main health forum) but wanted to ask a few specific questions.

Bailey just visited a new vet; the vet who diagnosed him on 9/28 put him on N and insisted he stay on Royal Canin diabetic food, no matter what, and then turned extremely unhelpful so I wanted a second opinion. The new vet, Dr. B, decided to put Bailey on ProZinc because that's what he's had the most experience with (even though I asked about Lantus). He also wanted to stay with Royal Canin diabetic but eventually said I could do what I wanted on diet, once it became clear that I was doing my research and trying to make informed decisions about what was best for MY cat. So Bailey will be switching from Royal Canin to Fancy Feast Classics for wet food, with just a little dry to munch on in between feedings (and we're switching to Young Again Zero Carb dry just as soon as our order arrives!).

So question 1: Bailey's been on 3 to 4 units of N for the past five days, so Dr. B said to start him out on 3 units of ProZinc. Is this good dosing advice or should I start low and go slow since it's a new type of insulin?

Dr. B also seemed to think I could stop doing home testing for a while (when I brought out my book with test results from the last couple of weeks, he just kind of gave me a look like, "Oh, how cute, you're testing and worrying for no good reason at all") but I'm inclined to keep up with the testing. I probably won't do another full curve for a couple of weeks but I'd still like to know where his numbers are at, especially since Bailey has been so good about letting me test him (his SS is in my signature).

Which leads me to question 2: Any thoughts on continued home testing?

Thanks as always to everyone who posts on FDMB and shares their knowledge and experiences. I was upset when Bailey was first diagnosed but finding this place has helped immensely!
 
Hi Kellie and Bailey! Welcome to PZI! We're a smaller forum, mostly busy in mornings and evenings. If you ever have an emergency I'd suggest cross posying in the main forum since there are more eyes there.

ProZinc is a good insulin. I might suggest starting at 1 or 2 units. That way you don't start too high since that could cause a hypo. Someone else will probably be along soon to give some advice about this too. I'm not entirely sure what dose though I would start low personally.

I strongly encourage home testing especially since you're changing food. Lower carb food can drop your cats BG over 100 points. I advocate home testing before changing foods. You want to make sure you are testing before each shot, at nadir whenever possible, and maybe before bed to see where he's heading at night.

Remember that your vet doesn't make the final decision. This is your cat. My vet constantly told me to change food and I constantly ignored her. She was great otherwise but I did what was best for my cat.

Let us know how we can help. You're not alone! We're here to help!
 
Hi Kellie,

Welcome! I posted on your Health thread and am glad to see you here. I'm with Rachel. You can always start at one unit, get some numbers and increase after 3 cycles if he is too high. It is so much easier to increase based on your data rather than try to figure out how much or little to reduce. If you decide to reduce to one unit, I'd get ketone tests in also. (always a good idea when lowering a dose)

And yes, testing is vital - especially when making changes like insulin and food. With ProZinc, you want that preshot number and a midcycle number to help you figure out how the dose is working. It really isn't dosed much differently than N. You have the flexibility of changing the dose, giving different doses am and pm and dosing earlier or later. The difference is that ProZinc isn't harsh. The nadir should be in that +5-7 range and it should slowly rise to +12.

Since you read the stickies, you probably saw the Protocol. If not, it's in my signature.
 
Thanks, Rachel and Sue! I read the Protocol sticky first thing after coming home from the vet and am very glad for the info in it. I guess since I'm still new to all this I'm sort of balancing things out in my brain. When the vet give me information (especially when it sometimes contradicts things I've read about feline diabetes) my head starts to feel like it's doing loop-de-loops and I just need to take a step back and sort it all out. I totally agree about taking what I know about MY cat and doing what is best for him. I've had Bailey for seven years so I've pretty much got him figured out by now ;-) This is just changing our routine up a bit.

Will definitely continue testing and start low on the ProZinc tonight and tomorrow. I'll update his SS and keep track of where he's at.

Thanks again!!
 
Welcome, Kellie! You are among a great group of people here. Sue and Rachel are invaluable. And so is home testing. Ben would have been a dead kitty five days into his sugar dance if it wasn't for home testing. And as Sue has told me before, even if you don't like the numbers you are getting they are valuable data points. Just keep it up.
 
Home testing is a safety thing,
- to make sure it is safe to shoot, based on the collected data showing response to dose at various starting levels
- to check the nadir for dose effectiveness, between +5 to +7 for ProZinc, though typically towards the shorter end of time
- - the nadir should remain safely above 50 mg/dL to avoid hypoglycemia
- to monitor home intervention for slightly low numbers (if the cat is seizing, have someone drive while you give glucose/Karo).
- to monitor high numbers to evaluate likelihood of diabetic ketoacidosis, in combination with urine or blood ketone testing. DKA is a medical emergency.
 
BJM - your timing is excellent. I just got home from work and tested Bailey at +6, he was at 129, which, as you can see on his SS, is the lowest he's been since this adventure started! Am very pleased with this small victory and will continue to test throughout the afternoon and pre shot, of course. Today is the first day he's had only Fancy Feast classic chicken, none of the Royal Canin diabetic dry stuff. He seems to stay full on the wet food better now so isn't begging if his dry bowl stays empty. I just can't believe how much two different vets were pushing me to keep him on RC dry. So glad for this message board and for trusting my own instincts!

Thanks everyone! I'm enjoying the small victories when they come and hoping to see more soon. It's all a lot of work, and I'm sure he'll have fluctuations in his numbers still, this early in the game, but it's totally worth it.
 
Welcome Kellie!
You have gotten great advice and I won't duplicate it. I just wanted to say hi :-D

And point out one good reason to keep testing--- Changing the diet should have a huge effect on Bailey's numbers and you may even need to decrease!

Jen
 
Hey, Jen, thanks for the welcome! And yes, testing is key and I'm definitely keeping up with it, even though Bailey's patience with all of this - testing and shots - is wearing a bit thin.... He was a little terror when I went to give him his insulin tonight. After the first syringe ended up in the carpet, the second finally found its mark, but what a brat he was! haha

There was a big spike between his +8 and PMPS tonight, from 161 to 512. He'd gone all day with just wet food (Fancy Feast classic chicken) but around 5:30pm he started begging and wouldn't quit so I gave him just 1/6 a cup of Royal Canin diabetic dry (the stuff two different vets have pushed me to keep him on exclusively) to hold him over until his next can of food at 7pm.

So next time I think he'll get a little canned food early. No more dry. I have some Young Again Zero Carb on order that should be here on Tuesday and I'm curious to try that since he loves his munchies. But I wonder too, could today just be a weird "bounce" (I think that's what I've seen it called). I was still glad to finally see some blue numbers on his SS, either way. I'm planning to do a curve on Monday (want to give his little paw a break from the lancets tomorrow and only do pre shot tests) and see where he's at with this new diet and the ProZinc.
 
Could be both. That blue is lower than he has seen so definitely could be a bounce. And the dry food can also bring it up. I like your idea of no more dry ever. You might try adding warm water to the wet. Sometimes they like that and it helps keep them hydrated and it makes them feel fuller.

But a blue! Hurray!!!!
 
What a lovely blue number you had! Do I see that you're doung a curve tomorrow? I'll be at work (alas!) but will try to check it out after I get off. Looking forward to seeing where the numbers go.

Pro tip: if he's being a terror for shots, give while he eats. I used to do that for Gypsy and she hardly noticed! You may already know that but thought is throw it out in case.
 
Hi Kellie..Welcome and good luck!My kitty is on prozinc two weeks now and responding very well and even gained a pound back.
 
Thanks for the welcome, Joyce! And your kitty's numbers are looking great! So glad to see that. Very encouraging.

And Rachel, yes I was glad to see the blue numbers and glad (but also a bit mystified) to see a green number today! He's had only wet food since 7pm yesterday (Fancy Feast Classic chicken). I'm completely eliminating the Royal Canin diabetic dry and looking forward to seeing what his PMPS number is tonight. Will keep updating the SS and definitely do a curve tomorrow. Should be interesting to see how this plays out. Would love to get him regulated on diet alone and OTJ but I know it's a process and I'm trying not to get my hopes up too high just because of a few nice numbers. Could just be the nadir? (am I using that word correctly? still learning all the terminology!) Bailey certainly enjoys all the canned food (which he used to only get every other day).

Regarding the shots, this morning he was also acting like a little brat about it. Fortunately my family is nearby and my stepdad (who occasionally has to give himself insulin shots) came by and gave the shot while I held Bailey. I'd tried to give it while he was eating before but he's gotten wise to it and now whenever I start to pinch his skin up, even just the slightest bit, he takes off like a flash. So he likes his new diet but not enough to be that distracted by it. Sometimes I think my smart boy might be too smart for his own good! haha

EDIT: quick question while I'm at it: when I test his PMPS, on the off chance that his number is still below 200 (which I doubt it will be) do I scale the PM insulin shot WAY back or do I not give insulin at all?
 
Isn't green a lovely color? :-D My guess is that he will bounce - that is a huge drop. I think I might be tempted to try a little less tonight, even if he is high. It might give you a lower amps tomorrow to work with, if the bounce is shallower.

If you get a 200 or below and don't have enough data to predict what his numbers might do, try stalling. Wait 20 minutes, without feeding (which would raise the numbers on its own) and retest. You want to be sure the number is tising, not falling, and closer to that 200. And probably reduce a smidge from the earlier dose, as it gave you an unshootable preshot.
 
Back up again for the PMPS (357). Initially thought I'd do 2 units of ProZinc but looking back at the data decided to go with 1.75. Would rather do a lower dose of insulin in case he bounces low again overnight when I'm not testing. Still planning to do a curve tomorrow. Curious to see how his AMPS is!

Thanks again, all! Bailey and I couldn't do this without your wonderful help :-)
 
You're doing a great job Kellie - kudos on the testing!

Welcome to the group and ask plenty of questions. We've all been in your shoes! And remember, even if he's been on other insulin, it may take a little while to acclimate to the ProZinc. As hard as it is, try to be patient. He will come around!

Keep up the good work!

Lu-Ann
 
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