First Post. Switching from ProZinc to Lantus/Levemir?

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theruss

theruss

Member Since 2012
First off, I want to thank everyone for their expertise and support. I have been lurking in the shadows here for about a year, and the information from this board has been a tremendous help. Thank you!



'Diabetes' Dandy got diagnosed last July after increased drinking and urination, and then glucose tests. The vet in Buffalo, NY prescribed him ProZinc. We started him at 1 unit, 2x a day, but over the course of a few months, made it up to 6u, 2x a day. Since the diagnosis, we've moved to Central PA. I can't seem to find ProZinc locally anywhere, meaning I need to order it online, and pay for overnight FedEx. Very expensive (~$130 + $20 shipping per 10ml)... This was manageable at 2 units a day, but at 12 units a day, (and possibly more since he's still having bad days), yikes...

My question to you folks is, do you think it'd be okay to inquire about switching him to Lantus or Levemir, which by all read accounts has potential to be equally effective, cheaper, and locally available? Has anyone found themselves in this situation? Perhaps you could share some insight?

He is on a pretty strict feeding plan / schedule (One can of Purina DM wet food a day, and about 2/3 cup dry DM food) now. As for the drinking and urination, he's got his good days and bad days...but even the bad days are much better than before he was on the ProZinc. I had been doing frequent at-home testing, but haven't been recently. I will probably start back up again shortly.

If I decide to make the switch, obviously I would need to follow veterinary instructions and some of the posts I've seen about reducing the starting dose.

Just to make sure I'm giving all the details, Dandy is a 7-8 year old domestic short hair tabby cat. He lost a tail and half a tooth before we met, so he's used up at least a couple of lives, but has plenty left. He's energetic, vocal, and affectionate (to the point of annoying sometimes). When he was at his most sausage-y, he was 17lbs, but though diet, exercise, and 'betes, he's hovering around 14. Aside from those details, he's appears to be in perfect health.

He's got an older brother, Rhubarb, who still lives in Buffalo, and who he sees at least once a month.



Any thoughts? Thanks again,

Russ
 

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theruss said:
'Diabetes' Dandy got diagnosed last July after increased drinking and urination, and then glucose tests. The vet in Buffalo, NY prescribed him ProZinc. We started him at 1 unit, 2x a day, but over the course of a few months, made it up to 6u, 2x a day. Since the diagnosis, we've moved to Central PA. I can't seem to find ProZinc locally anywhere, meaning I need to order it online, and pay for overnight FedEx. Very expensive (~$130 + $20 shipping per 10ml)... This was manageable at 2 units a day, but at 12 units a day, (and possibly more since he's still having bad days), yikes...

My question to you folks is, do you think it'd be okay to inquire about switching him to Lantus or Levemir, which by all read accounts has potential to be equally effective, cheaper, and locally available? Has anyone found themselves in this situation? Perhaps you could share some insight?
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What a beautiful kitty Dandy is!

Since you are shooting at such a high number I would suggest Levemir- mainly because some humans say that Lantus stings at high doses. Either route you go you should get the solar pens (lantus) or flex pens (levemir)- they are 3ml pens and come in a 5 pack. I would shop around for the cheapest rate as most pharmacies do not sell individual pens. BUT- it is better in the lone run to get the pens as the vial, while less amount (10ml I think) and cheaper, could become contaminated and you would have to chuck the whole thing- if a pen did that it would just be the smaller amount.

How did you arrive at the 12u? Was there some condition or infection that indicates such a large dose? My Sneakers has Acromegaly and is a high dose cat- she currently gets 12u BID and a pen lasts less than a month. If you haven't had Dandy tested for either Acro or IAA it might be something to talk over with your vet. Otherwise the dose might be too high for her and the few numbers you are seeing are really bounces and rebounds from the high dose. But there is something else that you need to take into account:

He is on a pretty strict feeding plan / schedule (One can of Purina DM wet food a day, and about 2/3 cup dry DM food) now. As for the drinking and urination, he's got his good days and bad days...but even the bad days are much better than before he was on the ProZinc. I had been doing frequent at-home testing, but haven't been recently. I will probably start back up again shortly.
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Two things- dry food and not home-testing- at 12 BID :shock: :shock: :o . The dry food could be one reason Dandy is needing such a high dose (unless you had him tested for acro and IAA) and to not test when you can is like standing outside in a thunderstorm with a lightening rod and saying "I dare you!"

The canned food, while not the best, is at least in a barely okay carb level but the dry food most certainly is not- I just read a post from Carl about that in another thread. I would switch to all canned and both Binky's list and Hobo's list has the nutritional information that can help you- staying under 10% carb is good, under 5% carbs is better.

You didn't say when you gave the food- only twice a day? Snacks given? You might can loosen up on the feeding schedule to something every two/three hours during the day- most human diabetics have several small meals throughout the day because it helps their bg levels to remain calmer rather than dramatic ups and downs. Most people on the board also do this for their diabetic cats as well. My Sneakers gets an ounce of food every two hours in a feeder. If you are worried about the wet becoming stale- freeze it. It thaws slowly so Dandy could have his snack in two to three hours, or you can get a feeder that lets the cat eat on schedule.

Just to make sure I'm giving all the details, Dandy is a 7-8 year old domestic short hair tabby cat. He lost a tail and half a tooth before we met, so he's used up at least a couple of lives, but has plenty left. He's energetic, vocal, and affectionate (to the point of annoying sometimes). When he was at his most sausage-y, he was 17lbs, but though diet, exercise, and 'betes, he's hovering around 14. Aside from those details, he's appears to be in perfect health.

He's got an older brother, Rhubarb, who still lives in Buffalo, and who he sees at least once a month.



Any thoughts? Thanks again,

Russ
Click to expand...

Russ is quite the handsome devil too ;-) !

Good luck on all the advice.

heather
 
Hi Russ,
Glad to see you finally posted. I only used compounded PZI, which was only available by mail, so I can't help much with sourcing of Prozinc. I thought it was something you got directly from the vet, but I never bought it! I know that a couple of people who post in PZI have been able to find some at Costco if there is one of those anywhere close by.
Lantus or Levemir would be available at a local pharmacy. Cost wise, I believe that if you buy it by the pens (rather than vials), it is more cost effective. It would cost you more up front, but the price per dose in the long run would be cheaper. You would need a prescription called in, of course. Either is a great insulin for cats, and a few people have recently switched from Prozinc to one of the "Ls" with decent results. I would definitely discuss it with your vet. Most vets seem to have a preference, but many will work with their patients that wish to make a change.

At 6u BID, I'm thinking that is the highest current dose of Prozinc on the board, and I am wondering if Dandy has ever been tested for a high-dose condition like Acromegaly, or for IAA? What sort of BG numbers have you been seeing lately? We're really big on regular home testing here, most definitely before every shot, but you probably know that from reading here over the past year :smile:

One thing working against you is the dry food, and if you can ditch that, you might see a lowering of his numbers overall.
http://www.catinfo.org/?link=felinediabetes

I'm sure users of Lantus/Levemir will be able to give you more info on the cost, and tips on how to save $$$ on those.

Carl
 
On the food/carbs issue.
Purina DM dry is listed as 13% calories from carbs. Under 10% is recommended, and under 7% is even better. As far as dry food goes, it is one of the lowest, but if you look at that link, you'll see why dry food is bad for any cat, and worse for diabetics.
The DM canned food is better, and low enough in carbs. The biggest thing against it is that it only comes in one flavor, and some cats will decide they just don't like it any more. Plus the ingredients are no better than most grocery store variety brands, so the cost is illogical. Basically, you are paying for the "name", but you aren't getting good value for your dollar. Think of Friskees Pates or FF classics as the "generic" form of that 'script food!

Carl
 
Wow! I look away for a second, and here we are with a bunch of awesome replies and information!!

Heather, while I accept your compliment, I believe you meant Rhubarb is a handsome devil :). Yes, he is quite distinguished, despite the giant "So your cat is old!" folder he got at his last vet visit :).

To add some details: I feed Dandy the DM wet food twice a day 12 hours apart, 1/2 can at a time (they are the bigger 5.5oz cans), right before shots. I convince myself he really wants the shots...and is waking me up because he wants a shot (of course, it's not for the food).

I leave him 1/3-2/3 cups of dry DM during the day in this cool little feeder called Stimulo (http://www.amazon.com/Stimulo-Feeding-S ... ds=stimulo). Makes him have to work to get food, and he can't just sit there and chow down. Works great for his brother too, who has a sensitive stomach, and prior to Stimulo, would often add unwanted calories to Dandy's meals, if you catch my drift. No snacks, except the very occasional frosted mini wheat if I'm not paying close enough attention to my bowl or floor...

The 6u, 2x a day was attained gradually over time, until his levels were somewhat stable and at least down in the 200s. They started around 450, pre-treatment. There wasn't any known condition...just a lot of glucosey pee in the litter box.

Things I took away from all the comments so far (thanks again, so much!):

1. Try to dump dry food all together. They used to be free-range grazers, but I've gotten them off that over the last year. Heather recommended putting wet food in a feeder. Is there a particular brand/model of feeder that you recommend for this? I had a dry food auto feeder, but found that the lowest amount dispensed way too much...the stimulo seems to be working much better there. Hence my suspicion of auto feeders...

2. Home test. Home test. Home test. Yep, I was paying attention :). If I want a happy, healthy, kitty, and informed help on the board, I must home test! Message received.

3. Have Dandy tested for Acromegaly and IAA. We're going to the vet this afternoon, so I'll be sure to ask about that. I'll also get a BG read. Good to know 12u a day is very high. I'm thinking my vet would have had me bump it up another notch if I didn't say anything to the contrary...I don't think they have much experience with ProZinc.

4. Switching to Lantus or Levemir is worth a shot (pun intended, love puns!). Go for the pens. Luckily enough, I've got family in the medical/pharmacy biz, so I think I can get them close to cost. With ProZinc, I do not have that avenue available to me, because it's not people medicine :(.

5. Stop emptying my poor pockets for 'rich people's' prescription food. Get the 'generic' ground horse hooves :). He has yet to show disinterest in any food I've put in front of him hehe, so done and done.

I'll let you know how fat-fat does at the vet today, in hopes that it may be helpful to others with similar situations. I may even post some pictures of his nub'n :) (gotta trim it first so it's presentable).

Thanks again,
Russ
 
If your cat is very carb sensitive, you may be causing the high insulin needs with both the wet and dry food, especially the dry. One of my cats was very carb sensitive, and if she got just a small mouthful of maybe 3 or 4 pieces of dry food, her BG would soar and would stay high for hours.
You can get a PetSafe 5-compartment auto feeder, one that many people are using, and put low carb wet food in the sections.
For diabetics, it's better for their BG to be feeding several small meals/snacks throughout the day, as food causes spikes in the numbers.
The dose you are giving is quite high, and would likely cause suspicions of an insulin resistance problem, but first you need to remove all dry food from the diabetic's diet... wait at least a week to be sure the dry food is out of the cat's system; it can take up to 3days for all to pass out of the system.

I would definitely switch to Levemir as it is a longer lasting insulin than the current one you are giving, and it's a much gentler insulin with curves quite flat when compared to other insulins. As for cost, I think you have passed the point where Prozinc is now more expensive for you.

From the sounds of things, your cat is on the large size, still not regulated, and at a fairly high dose. You may want to keep in mind testing for acro and also IAA later, if the food changes do not bring down his dose needs. You will want to feed a bit more until you cat is regulated as cats' body are not capable of extracting all that is needed from food. One of my cats was up to 24oz/day until she was regulated and came down to around 6oz/day or so. My other cat was up to 30oz/day and got down to about 10-12oz/day. By feeding too little to a diabetic, you are starving the cat as it can't get the nutrients.

Testing is very important when giving insulin and at a dose of 6u BID, you want to be sure you give insulin only when needed.
If you have some old test numbers on a spreadsheet, you can post the link to the data and it will help others to help you.
You can just pick up where you left off by posting your test numbers right onto the same sheet.... you can just put a note on a blank line to explain the reason you stopped testing. For the insulin switch, you would do well to post on the PZI/ProZinc forum and ask those who have switched for the % of the switch. It could be somewhere between 1/2 to 2/3 unit total, so shots would be somewhere between 3units to 4.5units / BID.
 
Russ: You gave me some good laughs today with your post (generic ground horse hooves!!!)! Don't be lurking in the shadows and don't forget to home test (home test, home test). We need all the laughs we can get here! Best to Dandy and Rhubarb!
 
Alright...I took that that fatty dum-dum to the vet. The doctor was definitely on board with everything I asked about / brought up. If there's one thing dating a doctor/surgeon has taught me, it's not to begin a conversation or point by saying, "but I read on the internet that...". You can't win that way...I did good, and he heard me (us) out :)

We decided on 2units, 2x a day of Lantus to start with (vs the 6units,2x a day). That's the one he was most comfortable with / had the most experience with (and is probably the easiest / cheapest for me to get). The idea was to go a little less than half of the ProZinc. He'd rather Dandy have somewhat elevated blood sugar than way too low. I thought that was a good strategy based on my reading and everyone's advice.

We decided to hold off on the tests for Acromegaly and IAA until after we give the Lantus / food change a chance to do its thing. The ProZinc did have results (brought down the sugars from around 450 to around 250), and Dandy's otherwise healthy...so he didn't think the test was necessary at this time. We will definitely revisit if it seems prudent.

I'll re-start at-home testing tonight, and keep a log (although I imagine it will be high due to the stress of leaving the house. I take him out very often...you think eventually he'd get used it...but then again, you'd think he'd stop meowing around hour 5 on monthly trips to Buffalo...that's why man invented earplugs and the genre of metal). I have a nice BG monitor app for the iphone I was using before...I can aggregate later and post.

I'm going to lose the dry food and add at least another meal of wet food at lunch time, and work on getting the recommended auto feeder. I'll use up the rest of the wet DM, and then look at a more price / carb appropriate replacement. I certainly appreciate all the advice there!

Thanks everybody that donated their time! I'll send updates, and if I learn anything cool, I'll be sure to share! This is absolutely the best resource on the web for the cat sugars. Dandy will be so happy that they won't have to take one of his legs!

R
 
Russ, great update!

The biggest difference between Prozinc and Lantus is that dosing with Lantus is more dependent upon the nadir numbers, and more strict about shot timing being 12 hours apart. So if you can finagle your schedule to allow you to test at least three times a day (Once before each shot and try to catch one nadir) it'll help determine if the dose is appropriate. Sometime in the first few days, it would be very helpful to get a curve where you can test every two or three hours during one cycle so you can see a pattern to his numbers.

If the 6u dose of Prozinc was appropriate (which I have no clue whether it was or not), then the 2u starting dose of Lantus may be a little low. But I think it's a safe place to start, and if it isn't enough, that will be evident after a few days on the new insulin. Don't expect lightning quick results from changing. It'll take a few cycles for the Lantus to "take" as it is a depot style insulin.

If you need something to read, go to the Lantus TR forum and check out all the sticky threads. One to read for sure is the one about proper handling and storage. With Prozinc, it is normal to roll the vial prior to filling a syringe. With Lantus, that is a no-no. It is more delicate and shaking, rolling, stirring etc is not good for it. Treat it like it's nitroglycerin! In the fridge, keep it someplace besides on the door. It also might be more difficult to see in the syringe, because it's clear instead of cloudy-ish like Prozinc. Oh, they should have given you different syringes too, as Lantus is a U100 insulin, and Prozinc is a U40. They should have orange caps instead of red ones.

Keep us posted and fire away with any questions that come up.

Carl
 
I am glad you are waiting to have the acro/IAA tests done because why spend money if it turns out that your cat is very carb sensitive and when you remove the dry food, you see a drop in insulin needs.
There was once a cat on around 20u a day of humulin, then changed to all wet food.... that cat's dose dropped to around 1u twice a day. The dry food can make a huge difference for some cats.

Good luck with the insulin change. Be sure to read the info about the new insulin in the Lantus or Levemir forums on this site because there is a difference between them and your current insulin.
 
Carl and Gayle,

Thanks so much for the additional information and support!

I knew about the syringe difference (and stylish choice of orange instead of red), but did not know about the rolling. Great advice...because I would have probably rolled it around like an ape, then wondered why it was ineffective.

I picked up the Lantus last night in cartridge form, as recommended. I'll shop around a little more for subsequent doses, but hopefully this'll last me for a while. It's definitely still less (barely) per ml than the ProZinc, and the needles are OTC and cheaper as well. It's certainly far less of a hassle to get.

The plan is to start the Lantus on Saturday or Sunday so that I can watch him closely and get reads every couple of hours.

Dry food is totally out as of yesterday. The go-forward plan is to read,feed, and shoot at 6am and 6pm. Luckily, I work 2 miles (well...3.5 for summer due to construction) from my house, so this will give me an excuse to bike home and back during lunch time for an additional read and feed for the forseeable future. Dandypuss might even help me keep the human sugars away!

Unfortunately, I still haven't tested BG. I went to do it last night, and voila! Battery's dead (told you it had been a while)! I need to get a replacement this afternoon...

I'll definitely check out the Lantus forum for additional information. I mean, I'll be working...okay, I'll look if I need a break hehe.

Thanks again,
R
 

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Great going on the change!

I, too, use the petsafe5- it has 5 bowls and turns around on the base. Electronic- uses D bats- but easy to program so you can actually split meals into breakfast, mid morning, mid afternoon and when I get home to shoot again :lol: . Then I do evening meals when I am home. If you look on my SS at the far right, with all those little c's- that is my food diary I am keeping for her. Then again, Dandy probably wouldn't need as much once he gets regulated.

Waiting on the acro/IAA tests is great until you see what kind of levels Dandy has on the dry- here is HOPING he drops units (fingers crossed!)

With the change and drop- pick up ketosticks from the pharmacy to keep an eye out for those pesky little buggers. They show up with too little insulin and with Lantus and Lev the mysterious 'shed' has to build a few days so bear in mind that Dandy's #'s might initially be high until he starts getting the full dose of insulin each cycle. Sneakers did get some insulin from the start but it took 3 days for her ketones to drop to trace showing that she was getting enough insulin (and a week for them to disappear). Did I explain that right?

Yay! For change. Lets hope it goes.

And thanks for the clarification of the units :-D Since I do dose 12u BID (and I KNOW that's high) I was worried on a kitty that might not have needed it. 6u BID is high but not as bad :lol: .
 
How does the PetSafe 5 do with wet food? Does it get all gross toward the end of the day, or do you freeze the food?

For now I went with the CatMate C20 (http://www.amazon.com/Ani-Mate-Inc-Cat- ... ds=catmate). It seemed like a good fit, since I can typically feed breakfast, lunch, and dinner. I was also intrigued by the space provided for an ice pack...

If that doesn't work out, I'll be sure to check out the PetSafe 5.

Thanks again,

Russ
 
I have the CatMate with 5 spots and ice packs. It works well, but you generally can't get the times of opening closer than 4,5 or 6 hours apart. That is fine, cats don't need to eat food all day long.
 
The petsafe5 rotating food dish comes off for cleaning- that gets done every night :lol:

The only food I really put in there now is the frozen ice cubes of the raw chicken diet that I make her along with another cube of water because it adds moisture. I used to put in regular canned with the chicken when she was eating a lot more and I don't recall it being too messy. Add an ice cube and it will stay fresher longer and you don't get those little dried stuck- on pieces.

Some people put down aluminum foil and just pick it up and toss it at the end of the day.
 
Hi all,

Thanks for the followup on feeders!

I was able to get batteries for my Glucometer (Freestyle Lite). Gave Dandy 6 units of ProZinc at 6am, followed by 1/2 Can Purina DM. Walked home and fed him another 1/2 Can Purina DM around 1:00pm. I just pulled a read at 5:00pm of 186. It's been a while...getting that blood is tricky :).

That's on the high side of normal, correct? and lower than we had been pulling a few months back at the vet (which was around 260-280 after a 12 hr fast)...probably partially stress related...

Should I give him his usual 6 unit shot at 6pm, or should I hold off and just test levels every couple hours?

Additional note...yesterday AM was his first day without dry food. Today is his second day without dry food.

Additional, additional note...I decided not to start the Lantus until Saturday so that I can be home to monitor his levels.

Any thoughts would be appreciated.

Thanks,
Russ
 
186 is on the low side of what we consider a safe preshot number for new diabetics. (And he qualifies because of the new diet change) The suggestion is anytime you get under 200, wait 20 minutes without feeding and retest. You want the number is be up closer to 200 and you want to make sure it is a rising number, not a falling one.

I am not sure about the dose; let's see what others say. You definitely need to reduce - the preshot number under 200 shows you the dose lasted a long time (ProZinc usually has a smile cycle - preshot, down to nadir, back up to preshot) which suggests the dose is too high.

With the food change already making a difference (and that can continue to lower the numbers for several more days) I would err on the side of caution. Let us know if you will be around and be able to test and how often. That will help us think about the dose.
 
I would stall without food till you see 200, then shoot no more than 1u.
i think your days of shooting six units are over.
Carl
 
Such a quick response! Thanks guys!!

I tested again at 6:30 (took me a while to get blood...I think he's on to me). Read 200, but that was after 15 minutes or so of futzin' and pokin'.

I just fed him 1/2 can of DM, but only administered one unit of ProZinc to be safe. Any opinions on when I should try to test again? 2-3 hours?

Also, any small low carb treats I can feed him to keep him busy while I poke at him? Thinking about drawing a small X on the ear with a sharpee.... (not really).

In response to the question, I'm around all night and can test whenever...but back to work around 6am tomorrow morning. The only limit is his patience and my aim...

Thanks again,

Russ
 
Normally the food creates a higher number in the first hour or so. Getting a +2 or 3 would be good. The important times are definitely 5-6 hours after the shot and maybe 9. Should give you a decent picture.

Are you using the Freestyle Light? With butterfly strips or not? Some people have had issues with that meter reading low, particularly at higher numbers - especially with the butterfly strips. You might search the site for freestyle meter and see what you find.

My guys loved Bonito Flakes and Pure Bites, both low carb.
 
Hi Sue,

Thanks for the recommends. I am using the Freestyle Light with the butterfly strips. I'll check out the posts. I'm planning on switching to one of the Relions, but I figured it'd be a shame to waste the strips I already have...It would be interesting to pick up the Relion and check out the difference on the same draw...maybe I'll do that tomorrow.

I saw some folks recommend the Wellness jerky treats, which I think I can buy in the store...I'll give those a try first (fish flakes! yuck [for me, tasty for him]!).

And I'll attempt another draw in a couple hours.

I just gave him a thorough wrassle. Gotta get that exercise in for the day.

R
 
Purebites, i think, has a freeze dried shrmp treat, and they taste ok....I had to try them!
And Petsmarts sells tubs of freeze dried salmon and chicken treats made by Beefeater....I haven't sampled those but my cats inhale them. All are zero carbs I believe.

Carl
 
Purebites did the trick! Made it much easier to distract him enough to get some more blood. I assume we'll get better at this. I'll continue to wish for some sort of faucet or tap though...For anyone having problems getting blood, you're not alone...I feel for you, especially if you have an uncooperative puss. Luckily mine is pretty cooperative.

The Wellness Pure Delights Jerky were NOT a hit. I think he ate one piece, but only after I put a few PureBites on top of it. It was the Turkey & Salmon flavor (pink package). I bought every flavor of Purebites, but the Turkey is what I gave him.

Pulled a 186 again (hoping it's coincidence, and not my Glucometer playing tricks on me...we'll find out tomorrow after I buy the Relion) at 10:30pm (PMPS + 4 hrs) after a 1 unit dose of ProZinc.

I probably won't get another read before bed, but I'll do an AM read. If he's still around the same level pre-shot time (and the pee in the box looks okay), I'll probably stick with 1 unit of ProZinc (instead of the 6 units I had been dosing prior to this evening).

Hoping he is carb sensitive or that he was over-dosed, and he's not as bad off as I thought...

Thanks again for all the advice. Yous guys are the best!!

R
 
FreeStyle meters are not a good choice at all.... it has been found that these meters, with the new butterfly technology strips does not give true readings, and you can find several examples of the FS meters not registering over 299, and when several meters are compared, the FS meter fails miserably.
Get a Relion meter as its strips are the most economical.
Your cat could be suffering in much higher numbers but your FS meter is telling you that the numbers are not bad at all.

Do a search on this board and you will find plenty of proof that the FS meters are not good and should not be trusted.
 
Thanks Gayle.

That's the plan for today. I swear when I originally bought this thing it got good reviews, maybe pre-butterfly strip, but what are you going to do? Seems a shame to waste the rest of the strips...those things were not cheap. Maybe I can make a collage or something...

DooDoo posted an AMPS read of 186 again this morning (6 hours after his midnight snack of 1/4 can DM)...which is the third time I've gotten that particular number, so I'm absolutely suspicious. I thought it might be because I was having trouble getting a lot of blood, but this time I accidentally went all the way through Mr. Ear, so there was plenty of blood to test :(. I'm going to try and test the Relion and Freestyle in Tandem on the next read, just for funsies.

Water level and pee in the box look like that of a normal cat (for now), so I administered 1u of ProZinc to be safe, since I'll be at work all day.

I'll be testing again around noon or so, hopefully with the new reader.

As a refresh, I had been administering 6u of Prozinc BID for at least 6 months until last night, when I dialed it down to 1u. Also, we've started day 3 of no dry food.

Thanks,
Russ
 
Seems a shame to waste the rest of the strips...those things were not cheap. Maybe I can make a collage or something...

At least you haven't lost your sense of humor. :mrgreen:

Yes, the same number over again is suspicious. We'll be glad to see what the ReliOn gives you.
 
It's good to hear you will be using a trustworthy meter for testing, and keep in mind that the differences were noticed if the cat have higher BG numbers.... if the cat were truly in the 200s, maybe the FS will register correctly?

As you have reduced the dose a great deal along with switching to all wet food, please be sure to test for ketones often because if your cat is ketone prone, the insulin reduction if not needed could contribute to ketones and problems are not just at higher BG numbers...

Hopefully with a good meter and a good form of food, you may get some decent BG numbers and have no need for switching insulin.
I much prefer Levemir, but if the changes you have made turn out to get you some great BG numbers for your cat, I would say maybe stay put if you have not already purchased the new insulin? If you do find that the higher dose is needed, then I guess it would be a good idea to switch for cost as well as getting gentle curves.
 
Thanks for the information, Gayle.

Guess I'll be going back to Walmart and/or a drug store over lunch to pick up some ketone test strips...My fault for not reading up on that in depth before I went this morning for the new meter.

How often and for how long do you think I need to test? In other words, if it comes up negative, when do I know if I'm in the clear for a while? And then how often do I check back in? I just read the FAQ on Ketones. I assume he's in the "BG is in the 200s, but is eating less category (not by choice, but because I made him stop eating dry food)", which is why I'm testing him...

Thinking an acetone smell to his breath might actually be an improvement, but I'm guessing the other symptoms would probably be a bad time. At least he doesn't have smelly AND hot breath, like his brother.

We had been testing his urine at the vet, but did not this time around because we were going to switch insulins anyway. So, to get the urine, I just hold the strip under him and squeeze him? (That's not a real question :)).

Ohhh...and I did purchase the new insulin, but have not opened it yet. I've got almost an entire vile of ProZinc left (just popped the top yesterday), so there's no rush to switch over either, especially if we're getting good numbers. Not to get my hopes up, but 2u of ProZinc BID would not warrant a switch like 12u did. I could deal with the price and hassle to get if a vile lasted that long, and seemed to be effective.

Thanks all. I'll post pre-lunch numbers this afternoon.
R
 
Continuing to enjoy your sense of humor (the ear tap is actually a great idea....LOL!...wish I had one) and can't wait to see the testing strip collage. LOL!
 
Thinking an acetone smell to his breath might actually be an improvement, but I'm guessing the other symptoms would probably be a bad time. At least he doesn't have smelly AND hot breath, like his brother.
Click to expand...

Has he had a dental exam recently? You're right, the other symptoms? Definite bad times. I've smelled that acetone smell, and I'll never forget it. It went away after 3 nights in ER care. But those three days were pretty dicey.

We had been testing his urine at the vet, but did not this time around because we were going to switch insulins anyway. So, to get the urine, I just hold the strip under him and squeeze him? (That's not a real question :))
Click to expand...
LOL, maybe not a serious question, but some people who have had difficulty catching kitty peeing probably thought about trying it. Some cats, like Bob, are very private litter box cats. I found it impossible to catch him in the act, and ended up having to buy a blood ketone meter to check him for ketones. Normally, if you catch him in time, you can just hold the stick in the stream. If that doesn't work, you can get dozens of tips on how to get a successful urine ketone test.

Carl
 
Hey Carl,

I had his teeth examined on Tuesday. He does have a broken tooth (since we adopted him, 5 years or so ago), that will probably eventually need out, but the gums around it aren't inflamed or discolored, and the tooth itself doesn't seem to be bothering. The breath comment was just a joke...fishy.....:).

Worst case scenario on the ketostix is put a plastic bag into the litter box. He's not terribly shy about staring at me while he pees..must have learned that in kitty prison. I was able to pick them up on my way home.

I tried to take pre-lunch numbers, but failed. I couldn't seem to get enough blood onto the new meter (ReliOn Confirm) before he got all riled up. Now he wants to play-attack me (which can get rough), and that does not lend itself to careful aiming. I'll have to try again later, like PMPS time... :( Hoping I will get better aim, and he will get better at bleeding.

Sorry for no numbers update.

Russ
 
He will get better about bleeding. The more you test, the easier they bleed. I did find with Bob that his left ear bled better for some reason. Probably because that's the one I poked the most, since it was the easier one to access given our test routine.

Plastic bag under the top layer of litter will work, as will saran wrap. Some people use a different box with aquarium gravel in it since it won't absorb the pee. Then you can rinse the gravel and reuse it next time.

Carl
 
AHA! Snuck up behind him and got the Ketone test straight from the source before returning to work. Negative!

PS - I highly recommend Omega Paw's rolling litter box. Changed my life (although I had to take the top off to snag the sample).

R
 
Got it! I think I had better luck using the lancet pen. I was freehanding with the lancet before. I'm very excited because I left my house earlier very frustrated that I couldn't get a good blood draw. I am victorious!

On the same draw (yep! good draw!):

ReliOn pulled a 208.

FreeStyle Lite pulled a 185.

So, it appears that the FreeStyle is pulling low, at least in comparison...although, I guess it's tough to say which one is correct? Except of course, I trust my heroes on the board, so I'll go with the ReliOn number.

This was a PMPS read, so I continued with 1u of ProZinc at the regular time.

Reminder: The schedule for the last 2-3 days has been 6am/6pm feeding of 1/2 can DM and shots, 12pm lunch of 1/4 can DM, 12am snack-y poo of 1/4 can of DM. Purebites as distraction from getting ear pricked. We are approaching the end of day 3 with dry food removed. No Ketones detected as of this afternoon.

He seems perfectly happy, playful, hungry (always and forever), and pee/water seem to be traveling at normal rates.

I'll take another read tonight in a few hours before bedtime. After that, I'm not really sure what the go forward plan is...

I'm set up to keep going with ProZinc for at least a month without needing a refill...I'm also ready (supplies and vet blessing wise) to switch to Lantus...

Super thanks to everyone who has followed this long and winding thread. You've been a lot of help. I feel like I'm basically starting over from scratch here (but with a little more knowledge)...just trying to do it right this time.

Russ & Dandy
 

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Nice number! Interesting that is in the same range as your earlier ones. And that isn't a big variance between the two meters- my understanding is that sometimes the false readings are often at the higher ranges with the freestyle meters.

So going forward - watch the 200 preshots and make sure they are rising before you shoot. Get that midcycle number so you can see how low the insulin takes him. A regulated cat is generally in the 200 range at preshot and in the 100s or lower at nadir. You don't want him in the 40s at nadir - that is getting too low. A low nadir and/or a long cycle can mean a decrease in dose is needed.


You are doing great!
 
Good evening / morning?

Fell asleep at like 8:30pm, so I didn't get an evening read. Now I'm up super early though.

I got a read at 3:15am or so (PMPS + 9) of 244 on the ReliOn. It took me a few minutes to get a good poke, and I gave him some purebites 3 minutes or so before I could get the blood...so it may not have been an accurate representation. Gave 1/4 can of DM as a late night snack post read.

Eventually the purebites will be a reward AFTER getting the blood...but that's not really the way Dandy's mind works. He doesn't understand rewards for behavior, for his brain is the size of a peanut and/or sunflower seed. The sad thing is, out of the two, he's the smarter one. Dandy is the smart one...annoying to travel with (Where am I? Where are we going? Are you going to put me in a bag and throw me off a bridge?), and the schemer, while Rhubarb is the big, dumb, sweet one, that will sit in the front seat with you on trips. Guess which one I got stuck traveling with? :)

Anyway, I got myself with the lancet this time and read a 34 on the ReliOn and 85 on the FreeStyle...so I think I might need a snack :). Tried retesting myself on the ReliOn to see if it was a bad read, but man, I have trouble getting enough blood on the strip, or on the right part of the strip. Say what you want about the FreeStyle, but their strips definitely suck the blood in better...

More testing at AMPS time. (around 6am), then more cross-meter reading...

R
 
Hi Russ! Was trying to review your spreadsheet but it appears to be locked from outside view. You may have to change the "visibility" option to allow others to view, or maybe it's the "sharing" option that needs changed (not the expert on this!!). I was just curious, and like to view others spreadsheets -- try to learn how various doses of insulin affect BG levels in individual kitties (ok...I'm just nosy!). If it is not your intent to share the spreadsheet, that is cool too; but just pointing it out so you are aware.
 
Hi Melanie,

I was intending to share. Sorry about that! I think I fixed it, although there's not much data yet. Nose away :)

Read a 235 at AMPS this morning (no treats). It was about a hour later than normal, and 4 hours and change after the last test.

I administered 1u of ProZinc (down from 6u a couple days ago) after feeding 1/2 can DM for breffist.

Thinking I'll keep him on the ProZinc at 1u at least until next weekend (unless BG levels get crazy), so I can continue to test prior to the potential switch. Might give me a good idea of the important times to home test moving forward...Does that sounds okay? Other recommendations?

Thanks!
Russ
 
He is looking fine, Russ. Please get some midcycle numbers so you can see how low the insulin takes him.

If you can and want to, you could do a curve this weekend. It is generally a test every two hours during the day (lots of treats required). It will show you when the onset is, whether and when food after the am shot raises his numbers, how long before the numbers start to rise again after nadir (or how long he "surfs". - as we call it). Good information for you to have.

If he likes the DM, continue to feed it. But if you want to try a lower carb food, it might impact his numbers downward. (just stay away from fish more than twice a week or so). Purina and your vet should accept any unopened cans. I just said my cat wouldn't eat it. Many cats tire of the taste as it is mainly liver.
 
Thanks, Sue! Great advice!

I'm going to try and sneak home a little early for lunch today to grab an AMPS+4. I will also try and do a curve on Saturday (iffy on a full curve, but I can probably check some of the midcycle numbers at least) and Sunday (definitely).

He's fine with the DM, but I had actually planned on not buying any more due to the hassle of going to the vet and cost. I've probably only got 6 or so cans left, which I'll just use. What does lil Ollie like to munch on? Dandy's never refused any type of wet food, so the sky's the limit. I'll search around on the board later to see what folks are using, but if you have a recommend, feel free to post!

I've seen the food lists floating around out there. Awesome resource, but a little overwhelming...just like selection of food...there are so many out there. It would also be super sweet if I could get it into a sortable version (sort by carbs :))...maybe I'll work on that sometime soon and share...

PS - My finger hurts...I'm apparently harder to get blood from than Dandy. I figure if I was going to put him through it, I should do the same to myself...but I had to do it a bunch of times until I got anything. Reminds me of the last time I gave blood. I was told I had 'deep veins', which I just figured was another way of saying I was 'not without heft'.

R
 
I was overwhelmed by the selection at first, Russ. I printed off Janet and Binky's list and spent a ridiculous amount of time in the canned food aisles at PetSmart. Once they decided they would eat Fancy Feast, I got those - the classic ones, not the sliced or gravy. It is not the premium food - Merrick and Wellness have "better" ingredients - but when you figure cats would be perfectly happy eating a mouse, I decided they didn't need cranberries and premium cuts. It's an economic and personal choice...
 
After about 10 minutes futzing around trying to get some blood, I finally got enough to read. He wasn't upset about me trying to get blood, but he was on alert and playing around and scratching his chin with the lancet pen and flashlight. Not sure if this would have any effect.

AMPS + 5: 285

This is the highest read since I've been home testing this time around.

I administered 1/4 can of DM for lunch after that read. Did not give any more insulin. Sound okay?

Also, I used a flashlight this time for vein location. I noticed that where I previously poked had left some sort of bruising that I can only see with the flashlight behind his ear. If the vein is a river, the spots I'm talking about are like a lake. Is that normal?

In other news, I cannot get this blasted ReliOn to read MY blood! the blood just sits there on top of the strip (not that I can get that much..guitar playing and sausage-fingeredness have given me tough fingers apparently). I'm about to go Klingon style on my hand so I can verify the cat's read!

Qua'plah!

R
 
Hi Russ! I too had trouble at first with the Relion test strip (I use the Relion Micro). At first I slopped a big droplet onto the bottom of the strip -- and it did absolutely nothing; just sat there laughing at me. I have come to the conclusion that the Relion likes to sip the blood on its own and refuses to play any other way (at least my unit). So I hold the bottom of the test strip at almost a 45 degree angle to the drop - with the base angled gently toward the drop (you could say the base was just kissing the drop)... and it starts to sip just fine. For some reason, the smaller drops work better than the bigger ones. I had no success holding the strip parallel to the drop (horizontally) and globbing it on. Not sure if any of this will work for you, but throwing it out just in case.
 
Hey Melanie,

That sounds about right. I've been getting blood from the inside of the ear mostly, which just happens to be at the angle you describe, which it probably why it reads for him, but not for me. I can tell we faced the same problem when you described it as: "it did absolutely nothing; just sat there laughing at me." I spent a good 30 seconds yelling at it, "COME ON!! READ IT, YOU BASTARD!!!".

The other thing I just read about on here is that are different gauges of lancets. I currently have the OneTouch ones that are super thin. That might be another reason for my blood troubles. I was reading that a smaller gauge (bigger lancet) might work a little bit better at first to train the ear to bleed. I'll pick up another box of thicker ones after work and see how I fare.

Thanks,
R
 
Yep, I am using the 28 gauge and they help a great deal. It has taken almost a month for Ninja's left ear to "learn how to bleed." It is a slow learner. I'm not sure I know exactly what that phrase means (learns how to bleed), except that some of the senior posters say the ear develops additional capillaries (?) once it gets stuck often enough -- maybe a self defense mechanism; kind of like a person who gets held up at gunpoint over and over -- they learn to surrender the goods faster each time. LOL!! Ninja's right ear, I don't know... I don't think there is any blood in it. Try as I might, nothing ever comes out of that one except hair.
 
HA! Ninja's ears seem as stubborn as Dandy's.

After 20 minutes of pleading and wrasslin' (he's not getting angry,but he is putting up mild resistance), I managed to get some blood for PMPS, which read 380 (ouch!). Highest by far since I've been checking.

Again, treats were given a few minutes before I actually got the blood, so this might be skewed. I need to trust myself more and hold off on the treats. I also can't be certain enough got into the meter for an accurate read...but that's just me being in denial.

I administered 1.25u (1.5u plus a little bit of air) of ProZinc and 1/2 can of wet DM. I will try and check again in 2 hours or so. Unless I can realize the secret of testing between now and Sunday, I may have to hold off on the curve until Dandy and I get better acclimated to testing. At the very least, I will continue with the AMPS and PMPS, and trying to get a few mid cycle numbers.

Got some 28 gauge pokers and managed to get blood from myself using the method discussed a few posts ago. Read a 112, which is probably normal because I ate dinner about 20 minutes ago.

Thanks again,
Russ
 
Hmmm...just read 313 at PMPS +2.5...so lower, but not near 'normal'. We took a nap, and it was easier to take blood while he was still sleepy. Can't wait to get the little ball of blood like you see in pictures, vs milking the tiny little speckle...

Are you guys poking the inside of the ear, or the outside of the ear?

And lastly, if I do a BG curve, do I do it over the course of a 12 hour fast (breffist and shot, no lunch)? Or do I feed as usual?

Off to not think about diabetes for a little while...(not really...off to buy some rice and a kid sock for ear warmings...). At least I can leave the mess of blood spots and diabetes equipment that has become my desk for a while...

R
 
I never tried poking the inside of the ear. I know people who have kitties with black ears have said they have better luck using the inside surface.

When you do a curve, everything stays the same except for the number of times you test (every 2 or 3 hours). Food, meal timing should stay the same so the curve is representative of a normal routine day.
Take a break, we all need them!

Carl
 
Thanks, Carl.

Dandy does have dark ears and mild tuftage (if I might make up a word), so I have had better luck so far with poking the insides. I'll just keep trying both ways to see what works best.

Also, I took a look at your spreadsheet. Very inspiring...in two months it looks like you've gotten your sugarpuss's BG down from the 500s to normal, acceptable ranges. Great job!

R
 
Hey Russ.

That isn't actually "my SS". I created if for another person who is treating their kitty with Lantus, and then I set it so that they could update it. Those numbers do look really nice though. I just wish I could convince them to get regular mid-cycle tests, because I think that cat might be close to losing the urge for insulin...

I never actually did a SS for Bob. I used to record his numbers on paper and fax them to the vet every 10-14 days. By the time I started posting here, Bob was almost OTJ, so I never bothered doing one for him. I, however, would have also been urged to get some mid-cycle tests, because I didn't do nearly enough of them either. I tested before each and every shot, but many days that was all I did. Now I know better...

Bob was on PZI for about 10 weeks last year, and next week will be our "1 year OTJ" landmark.

Carl
 
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