Dosing advice for ProZinc - how many units before switch to another insulin?

[Anne & Hyde (GA)]

Hyde was dx in May 2015. Since then we have been testing and increasing her units gradually. She is currently getting 4u twice a day.

Doing a curve today and not getting great numbers (ignore the curve numbers from Thursday - they were really out of whack - think something was wrong with the shot). We are still in the process of switching everybody to Evo Cat and Kitten (at a 50-50 mix of new and old) and are feeding 2 meals a day of low carb wet.

Given the fact that her numbers are so high and she is getting a pretty high dose already, do you think that I should insist on a different type of insulin from the vet? She is only 9 lbs - will increasing to 5 units (a 1u increase) possibly get her into the good numbers?

 

[Sue and Oliver (GA)]

Those numbers are really high. It looks like you increased slowly so too much insulin doesn't seem to be an issue.. I don't know about the Evo; do you know how many carbs it has?

Couple things:

I would definitely starting getting regular ketone tests with numbers this high. You use the ketone urine strips that humans use and stick them in her urine stream. If this is not possible, we have other ways.

It is possible she is a high dose kitty. Here are some of the possible conditions. You might see if any of the symptoms sound familiar.

http://www.felinediabetes.com/FDMB/...-other-high-dose-conditions-what-we-know.375/

Some of the links on the above thread are not good. It is not a forum that is active but I hope you can gleam some information.

It is possible that another insulin would work better. In case she is a high dose kitty, I'd suggest Levemir. It is thought to sting less at higher doses.

 

[BJM]

You may have a duration issue, too. Tests in the +10 and +11 period will help show if it is wearing off by then.

You have been increasing by 0.5 units at a time, and given the mid-cycle tests being so high. that was appropriate.

I would definitely consider Levemir. If you're near Canada, get yourself a passport and drive up on a mini-vacation day to get some over the counter. In the USA, you'll need a prescription and to order online from Canada (much less expensive) you'll need the Rx sent there. Thesre are a couple of Canadian pharmaciesfolks have used successfully - Mark's and 77Canada.

Meanwhile, as a stop gap, you could try adding just a tiny, tiny dose of Regular insulin (0.5 of Humulin or Novolin R). It is very harsh, but can bring down the glucose enough that the ProZinc can handle keeping it down. In some states, you can get R by just asking the pharmacist. It does require U-100 syringes. If you decide to do this, please let us know so we can coach you through it.

 

[Anne & Hyde (GA)]

Well, the +10 number is HI. Not near Canada but sister-in-law is - maybe I will recruit her to make a trip.

The Evo dry food is listed as 7% calories from carbohydrate.

Humulin R anecdote-
Had first hypo on Humulin R with our previous diabetic (Alex). Vet walked in the exam room, shot the cat and when I asked with what, he had given her 8u of Humulin R. I was up all night with her - had just started home testing. Found a new vet the next morning.

 

[BJM]

OMG. Glad you fired that former vet!
And that is why I said a tiny amount to see how it works. One of the high dose conditions is insulin auto-antibodies (IAA) . When you get up around 6 units of insulin, we strongly recommend getting the tests done.

 

[Rachel]

The vet did WHAT???? I would lose my mind.

A tiny dose shouldn't cause that problem.