How soon can I increase the dose using ProZinc?

[Anne & Hyde (GA)]

Hyde was diagnosed last Monday 5/18 with a BG of 425 at the vet. She was not showing any symptoms prior to diagnosis.

We had a diabetic 10 years ago using Humulin U and our protocol was to start with a low dose for a few weeks, then do a full curve and up the dose and repeat until we got good numbers. She finally settled out around 4 u.

Hyde is on ProZinc starting at 1u 2x daily. Her PS numbers are consistently over 500. With this different insulin, how long before we can increase the dose? I have read the protocol thread in the ProZinc forum but I was confused as to how long a cycle was. Details are in her SS in the signature.

She is eating wet food twice a day (not a large serving because she will over eat and puke). There is dry food out all day because they are used to free feeding and because of health issues with her brother.

Suggestions?

Anne & Hyde

 

[Elizabeth and Bertie]

I have read the protocol thread in the ProZinc forum but I was confused as to how long a cycle was.

Hi Anne,

A 'cycle' is the duration of one insulin shot. So, each day, on a 12 hourly shooting schedule there are 2 cycles.

Info from the Prozinc protocol:
"Starting Doses
The recommended starting dose for ProZinc or BCP PZI is .5 units or one unit twice daily. It is suggested that if the initial numbers are high, doses can be changed every three cycles, increasing by .5 at a time. If the initial numbers are in the 200-300 range at preshot and midcycle (nadir) numbers are not too low (not 50 and under), increases can be made .25 units at a time. During this early period, especially if wet low carb food is replacing higher carb dry, monitoring is very important. Insulin plus a diet change can result in sudden low numbers or in a gradual lowering of numbers overall, depending on the cat. "

However, high numbers don't always mean that more insulin is needed....
Although most of your data shows very high numbers that may not be the whole picture.
That +3 of 23o on the pm cycle of 21st May shows quite a steep drop. And Hyde quite possibly had a few hours to go until the peak of the cycle (lowest number). So, I wonder if his blood glucose got too low for his comfort zone and then triggered a 'bounce' back up to high numbers. It is possible. And it may be that this has happened on other days also.

So.... To be on the safe side, before considering an increase I would suggest some more tests to see what is happening during the cycle. It's important to find out how low this current dose is dropping Hyde before increasing.
Are you up for a few more tests...?

I'm going to tag Sue for you as she has a lot of Prozinc experience @Sue and Oliver (GA)

And are you checking Hyde's pee for ketones? At those numbers it would be wise. You can get Ketodiastix/Ketostix (or equivalent) from a pharmacy. Crumpling plastic food wrap in the litter tray is a good way to catch a sample; you only need a tiny amount. Anything above a trace reading for ketones is a reason for a vet visit.

Eliz

 

[Elizabeth and Bertie]

She is eating wet food twice a day (not a large serving because she will over eat and puke). There is dry food out all day because they are used to free feeding and because of health issues with her brother.

Hi again, Anne,

What dry food are you leaving out?
And what health issues does Hyde's brother have?

Eliz

 

[Sue and Oliver (GA)]

Hi Anne and Hyde,

I'm with Elizabeth, it would be nice to see some mid cycle numbers so you have a clear idea of what is happening. And the dry food carb count is important. If he has access to dry food that is high carb, his numbers may be much higher than they would be on the same dose if he ate only low carb. If you must feed dry, can you get his brother on a lower carb food? Could you leave wet low carb out for them to graze on and then feed his brother at scheduled times when you can make sure they are eating separately?

 

[Rachel]

Hi Anne and Hyde!!! I just wanted to chime in that I leave out wet low carb food for my kitties. They've always free fed, and when Gypsy was diagnosed, I couldn't for the life of me get them to eat all the food at meals. They'd all eat some, but they prefer to come back to it over and over, eating just a little each time. Adding some water to the food can help keep it from drying out. Alternatively, you could get a timed feeder that would open at 2 hour intervals or something so they had access to more wet food throughout the day, but only to some of it at a time, so they don't scarf it all up. I'm not sure if either option will work with Hyde's brother, but I wanted to let you know that leaving out wet low carb food isn't a problem.

Is Hyde's brother named Jekyll by chance? I just have to ask...

 

[Anne & Hyde (GA)]

Yes - Hyde does have a brother Jekyll. We don't know what is wrong with him. He went from being a fat boy to only 10 lbs (always thought he would become our second diabetic - not his sister!). His blood work came back completely normal. They will be 14 next week and the thought of putting an old cat through anything as traumatic as surgery or chemo is out. He is on steroids to perk him up. All 4 cats get some wet food twice a day and dry mix of Iams hair ball (it was the lowest carb and easiest available food 10 years ago when we had our first diabetic - Alex) and Friskies (2:1). Oscar (9 years old) gets nutso when the dry bowl is near empty and starts beating up on the other cats until we put more dry food in the bowl. I think we are stuck with having dry food out all the time. I don't think with the way the younger 2 eat, that any wet food would last long. Also, Hyde has proven on many occasions, that she will eat enough to make her throw up.

Not testing for ketones (luckily never needed to in the previous diabetic) - not sure how to tell if I am testing pee from the right cat? DH and I are out of the house most days.

Hyde is not a fan of having her ears tested but will get more spot checks. When should ProZinc peak?

Is there a list of low carb dry foods on the internet?

Anne & Hyde

 

[BJM]

Low carb dry foods in the US are slim pickings ... no pun intended.
Evo Cat and Kitten
Stella and Chewey's freeze dried (doesn't crunch)
Young Again 0 Carb (internet only, pricey, allegedly they eat less so cost is supposed to be comparable).

See my signature link Secondary Monitoring Tools for urine testing tips. Cats often eliminate within 20-30 minutes of eating, so you'd want to observe him in order to get a fresh sample.