Dandy...On ProZinc...For Now...Then Lantus

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theruss

theruss

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Hi all,

This will be a double-post, both here and in the Lantus forums. I had a previous post in the general health forum, but once I got my act together with home testing, someone kindly suggested I create a new one here in hopes of getting expertly fine-tuned advice on Dandy's situation. This board has been wonderful!

Dandy is a 7 year old, 16lb puss. He was put on the juice (ProZinc) exactly a year ago.

Prior to this past week:
- No Home Testing, only monthly BG checks at the vet
- 6u BID ProZinc (started at 1u and moved up to 6u over 6 months or so)
- 3 oz Purina DM wet food at shot times.
- 1/2 cup Purina DM dry food to eat whenever (while I am at work / sleeping)

Starting this past week:
- Home testing as much as I can, certainly AMPS, PMPS, and a read at lunch time. In the midst of a weekend-long BG curve.
- 1.5u BID ProZinc (due to dropping dry food...better safe than sorry)
- 3oz Purina DM (or equivalent low carb wet food) at shot times
- 1.5oz Purina DM (or equivalent low carb wet food) at lunch and as a late evening snack.
- Misc. low carb treats for being a brave boy when I'm poking at his ears like a vampire.
- Tested for Ketones a couple times late in the week. Negative.

The intention here is both to get used to home testing, and switch over to Lantus (for procurement and financial reasons). The vet was totally cool with us switching over to Lantus (in fact, he admitted Dandy was the only patient he had on ProZinc), and suggested 2u BID (based on the 6u ProZinc that was being administered). It was also suggested to me on the board that 6u may have been too much, and since I dropped dry food, maybe even more so, so I'm afraid that a 2u starting dose of Lantus may now be too much.

That being said, I've taken a 'better safe than sorry' approach this week. I've dropped the dose to 1.5u (ProZinc), and have just been taking BG readings as frequently as possible. The numbers don't seem crazy high, but they're also not at 'normal' levels. You can look at my SS, but be aware that the first few reads were using the FreeStyle Lite meter, which I'm told could have been reading a bit low. I've since switched to a ReliOn Confrm (which is great because the strips are way cheaper :)).

I guess at this point, I'm just looking for some advice on go-forward strategy. Should I just go ahead and make the switch to Lantus at a lower dose and monitor closely? Or, do I stay on ProZinc for a little longer until I'm sure he's 'stablized' from the diet change, then switch?

Any advice would be greatly appreciated...but when you do respond, please whisper...Dandy's napping right next to the computer...

Thanks!

Russ & Dandy
 
Hiya and welcome to the FDMB Family, Russ and Dandy! cat_pet_icon

Sounds like you're off to a wonderful "re-start" with getting rid of the dry food and becoming aware of how carbs effect our sugar babies. :smile: Sometimes even a few pieces of crunchy goodness can soar BG readings through the roof for those sensitive. :o It's possible getting Dandy on a less than 10% carb diet could drop his BGs lower, too.

And congratulations for joining the vampire club! That is a feat all it's own, isn't it? :lol:

Poopy just read the part about Dandy taking a nap and is now demanding his, with lovings from momma bean first, so off we go. See ya later! :YMPEACE:
 
Since you have the Prozinc, I think I'd stick with it until we can figure out a good dose. When you switch, the dose will be based on a % of his current dose of Prozinc. If you switch now, you might be "in the dark" more or less for a Lantus dose that makes sense at the beginning.

I agree that 6u was too much especially with the change in diet. And it's good that you have the meter issue settled so at least you can trust the numbers you are getting.

I also agree with your assessment of the numbers for the past few days. Not terrible, but higher than you want them to be. While 6u may have been too high, I'm thinking you might have to climb the ladder a little bit to find a dose that starts improving the numbers and making the curves look better. Even the 1.5 doesn't look sufficient at this time.

Going forward - (and this is just how I think it can be done, and I encourage opposing opinions)-
Stick with a dose for at least two days (4 cycles).
Look for a curve that shows you at least a 50% drop in BG from PS to nadir.
If you don't see one, and you can be around to test between say +4 and +8, kick it up .5u
If you do see a 50% drop, stick with the dose for at least another day or two.
If you don't get any green numbers at that time, increase by .25, and continue to monitor.

This is more aggressive than most people would be comfortable with, and you are the one holding the needle and dealing with the numbers, so it's always your call, Russ.
But I'm thinking you might have to go up to maybe 3u before you see great results. I had to go up to 4u with Bob, and then it only took another 3-4 weeks climbing down the ladder pretty fast before he went OTJ. From day one up until that 4u bid dose, all the advice came from my vet (I wan't a member here yet). The decreases in dose, I learned here just from reading a bunch. Sort of happy I found this place, because I probably would have kept going up like you did and may have had some scary days and nights, or Bob might not be sitting on my foot right now sleeping while my toes go numb. :smile:
Carl
 
Hey Carl,

Thanks, as always, for the thoughtful advice. The plan you're talking about is definitely the plan I had been leaning toward the last 2 days or so (which is why I bumped up to 1.5u from 1u after a couple days), just not as nicely spelled out. I figured I already had him on 6u BID for 6 months, so stepping up a little more aggressively, as described, wouldn't be any worse than that, especially if my numbers indicated that he isn't anywhere close to hypo levels at any time. Getting the BG numbers this weekend has given me a little more confidence that I would at least be making an informed decision. Thanks home testing!

For the weekend curve I've been working on, it doesn't really look like the current dose of ProZinc is really having an effect (unless I'm not looking at it right). It appears that the Preshot and nadir (well, where I would expect the nadir) numbers are about the same, except a couple hours after food, which read higher. The percent drop is an interesting concept. I wasn't even thinking about it in terms of percentage, but it would be interesting to look at it that way.

I have a good amount of ProZinc left to 'play with' before having to re-order, especially at these BIDs (as opposed to 6u!). Obviously, I would like to switch over to Lantus before that, but if I don't, it's not the end of the world. I'll hang around the same dose for tonight, and see if anyone else has an additional suggestions. I know I need to be cognizant of too high a dose giving me bad numbers, but from what I've read, I don't think that's what's going on here...feel free to chime in on that, though! :).

DooDoo is napping again, and his feet are twitching...better use this opportunity to slip out and grab some additional test strips. I wasted a king's ransom in test strips this week, but I think I finally got the hang of it.

R
 
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