I'm a newbie again!

[Rob & Harley (GA)]

Hello,

My 14 year old Harley was originally dx 7/9/09, I found this board within a few days. I did some reading but mostly did alot of freaking out and asking questions instead of reading.

We started on Vetsulin. I took the advise here and changed his diet, started home testing, etc. He was on and off of the Vetsulin within 3 weeks until June 2nd this year. I had to go out of town for my job, my cat sitter backed out at the last minute so I had to board him at the clinic. He was so stressed that he stopped eating & pooing but he never stopped hiding. They called me on Friday, June 5th and told me that he wasn't doing well and they tested his bg and he was 450ish. I cancelled the rest of my trip, got in the car and drove straight home and picked him up on Saturday.

I firmly believed that it would be transient from stress. I started him on Lantus, made an appointment with a new Vet and started a condo in LL.

Because of my job I’m not home to test and shoot on a tight schedule, the stress was getting the best of me and we switched to Prozinc.

It has been a crazy 5 weeks and obviously it isn’t transient.

That is my tale of woe. I’m a newbie again. I was never very experienced at it the first time around and I have a ton of new questions about his SS and why he is bouncing all over the place.

Any advise and help is greatly appreciated in advance.

Peace,
Robin

 

[Nancy and Cody]

Hi Robin,
welcome to PZI! Were looking forward to seeing you post whenever you can and folks will surely try to help. A good place to start is the stickies. It can give you some good info on onset, duration, nadir.

I tried studying your ss and noticed you were dosing under 1u. Do you use u100 syringes with the conversion chart? If not, it really helps get accurate microdosing. You already have the u 100 syringes for Lantus. The conversion chart is available if you search it (sorry dont have the link)

I'm pretty sure you know this but low carb wet food only, no dry treats or food at all. Also a timed feeder can be useful to spread out your feedings while you might be away.

Prozinc is a good insulin, durable, stable and flexible. Hope it works well for you guys. Try to be patient. Many have noticed that their results improve after about 4-6 weeks Hopefully your kitty will be even quicker...

 

[Laurie and Mr Tinkles]

Hi Robin! I'm sorry that Harley is back on the juice, but I wouldn't give up hope that this is transient. The curve you did yesterday looks good! I know he bounced back up again this morning, but that is because of the reduced dose you shot last night. I see some yellow ps#s, and that's good, he seems to be responding quickly to the ProZinc.

Some general advice from my experience: When you increase the dose, I suggest you increase by no more than 0.25u at a time, and hold the dose for 5 days before you evaluate it. Small dose adjustments often give you big effects. It often takes several cycles for the dose to settle, and the numbers don't always show the true effect until then. Be patient, take your time.

Are you using u40 syringes? If so, I would suggest using u100 syringes with the conversion chart. http://www.felinediabetes.com/insulin-conversions.htm It will make it easier to make small (0.1-0.2u) dose adjustments. The 1.0u dose looks like it is giving him a pretty good drop, I would hold it a few more days because it looks like the dose is almost perfect from the curve you did. The bouncing that you are seeing is pretty typical of the adjustment period. It can be a little frustrating, but hopefully it'll settle down sooner rather than later.

 

[Joanna & Bix (GA)]

Welcome! Sorry you had to come back though. :cry:

You switched to ProZinc on 7/4, did I get that right? I would add a line in your SS that goes all the way across & says "Started ProZinc" or something, just for clarity for anyone looking at the SS who might not realize there were 2 different insulins.

The curve on 7/11 actually looks quite good. The lowering to 0.8u that night is what I would have done too, and from the next morning's PS it looks like he would have tolerated the full dose on the lower PS. If it were me, I would probably go ahead and raise to 1.25u.

If you are worried about him going too low, a spot test around +2, +3, or +4 (depending on your level of concern) is a nice check. Many PZI cats seem to get their biggest drop somewhere between +2 and +5. Bix used to drop the most between +3 & +4.5 or so, then it would slow down to a nadir around +6.5 (nadir time can really vary a lot though - looks like +7 for the moment from your curve, but it can move around some so that could change).

If a +4 or so is above 100 or so then there's probably no worry. If you saw a # like that at +2 or +3 you would want to feed some, and continue spot checks to make sure things don't go too low. A lot of times though they will kind of plateau, so a lower # at +2 on PZI is not nearly as scary as a lower # at +2 on Vetsulin. You still want to feed LC and test every 30 minutes to be on the safe side (and give HC if you have a truly scary #), and in every case I have seen, that manages it well and keeps them in a nice ride of good #s.

As for hypo fears, one thing that really has helped me is free-feeding. Bix will eat if his BG starts to go low - I have (by accident) overshot before by a moderate amount, and he will just eat a lot to balance the insulin. Especially with low doses like this, I don't think hypo is a big risk for Harley, and if you know food is available for him (I found out here that it's ok to leave the canned food out for hours), then you can feel more comfortable that his natural instinct to eat to fend of low BGs should keep him protected.

We started on Vetsulin as well before switching to PZI (I have never used Lantus). With PZI you often don't get as dramatic a drop as with Vetsulin, and their bodies I think tend to balance out the insulin a bit more a times, so you don't see as much drop sometimes without raising the dose. It took me a while too to lose the Vetsulin mindset (I was terrified of hypos too when I got here).

Hope some of that helps, and just ask whatever questions you have!!!

 

[Rob & Harley (GA)]

Thank you guys, it all helps.

He is free fed with Friskies Low Carb Wet canned between 7 & 8% carbs (and he knows to eat when he goes low), I'm looking into lower carb foods. I was feeding FF to him and trying to switch the civies to wet with the Friskies and he switched himself to the Friskies, at least he would eat it.

Yes he started Prozinc on 7/4. I will add the switch to Prozinc to my ss tomorrow, I must have missed that when I updated his ss.

I am using u100 syringes with the conversion chart. The u40 needles that the vet gave me hurt him with every shot.

I was afraid to shoot the 167 with a full 1 unit dose so I reduced to .8, but if that is what caused the bounce I'll need to be braver. The Vetsulin mindset is hard to shake.

I'm not home during the day to get +2, +3, etc. The best I can do is to run home at lunch time and get a +5 or +6, and I don't know until that day, at lunch time, if I can to it or not.

Thank you for your responses. I really need your help.

Peace,
Robin

 

[housecats4]

Hi just wanted to send prayers and Angels to help ...stay brave it only takes that one time I did it so can anyone :mrgreen: :lol: LOL Kath

 

[Blue]

For the tests at +2 thru +5, you can do like many others and catch those tests when you are home, on weekends or on days off. Most days, I could get those tests only on the weekends when not working.

 

[Angela & Blackie & 3 Others]

Welcome!

Blackie started out on Vetsulin in the beginning, too. We found out that the Vetsulin was recalled, and the company wasn't making it anymore. She was started on ProZinc May 12th, and I'm still trying to get her regulated. Slow process, but don't give up. Start low, go slow (I think that's what they say; if that's the wrong saying, please correct me).

I also use the U-100 syringes, and have used the conversion chart. Makes giving shots so much easier, and 1/2 the time (depending on where I insert the needle), Blackie doesn't feel it.

You're doing well.

 

[Joanna & Bix (GA)]

I was afraid to shoot the 167 with a full 1 unit dose so I reduced to .8, but if that is what caused the bounce I'll need to be braver. The Vetsulin mindset is hard to shake.

Actually I agree with your choice - even though they often still need the full dose when the PS is a lot lower, unless you have something like ketones you are dealing with, IMO it makes sense to reduce by a little to be sure it's safe. Could be that I still have some Vetsulin mindset myself but in any case that's what I would have done. Usually reducing by a lot backfires (like cutting the dose back as far as 1/2 unit), but dropping by 0.2 to me is a smart move. The higher PS the next day suggests that you could have shot the 1u, so next time you can shoot that with some confidence that it's safe to do so.

Some cats seem to have done really well on Walmart's Special Kitty. Bix has IBD so unfortunately I'm really limited in what I can feed him, but you might find with some experimenting that some foods work better for him than others. Of course if he switched himself to Friskies, it could be a sign that's his food of choice!

Don't stress about the spot tests - I didn't mean you have to get them, just that if you are feeling worried about hypo, if you see a +2 or +3 of something like 190, then you know there's most likely very little to worry about.