New to ProZinc...Dosing Question...Confused By Vet

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WenDawg

WenDawg

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Hi everyone. My cat has recently been diagnosed with diabetes and I just picked him up an hour ago from the vet with a bottle of ProZinc (U40). He received his first dose today at the vet's office and they kept him all day to run a curve. They were waiting for me to completely switch his diet to low carb before starting the insulin.

From everything that I've read on this amazing board, everyone seems to be dosing twice a day. The instructions I was given was to dose once a day. Does this sound correct? :?: They are starting him out on 2 units once a day. It just seems odd to me to only dose once a day when everyone else is dosing twice. I have a monitor, so I am able to test him as frequently as needed. While I don't have a spreadsheet set up within Google documents yet, his numbers consistently run in the mid 300's (without insulin).

I also questioned them because the vet said I didn't need to worry about a 'no shot' cut off point. But, from what I've read on here, a newly diagnosed diabetic cat should not receive a shot if preshot numbers are below 200. Basically, she was saying don't worry about the preshot number, just give him the insulin every day. That sounded a bit odd to me as well.

Thank you in advance!
 
You have good instincts! You are right, ProZinc is used twice daily as it rarely lasts more than 12 hours. So, shooting once a day means the insulin works for the first twelve hours and then, without insuIn, the blood glucose levels jump up. So it's a little bit like a roller coaster. . You can see this by testing for 24 hours - seeing when he drops and starts back up. I would divide the dose, give one unit every 12 hours

We generally suggest new diabetics not shoot under 200, until they have enough data to know how the insulin is likely to work for that number. Always better safe than sorry! You can stall, waiting 20 minutes without feeding and retests. If the number is 200+, then shoot but maybe a smidge less.

I'd check out our protocol and other people's thread and spreadsheets.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=109077
 
Hi and welcome aboard. You found the right place to be!! You will find many here who can help with any and all questions that you may have.
Wishing you the best!
Terri & Chicken Little
 
Welcome and WOW...good thing you did some homework prior to your kitty coming home from the vet. After you read the ProZinc protocol, I would suggest getting your spreadsheet set up as soon as possible. In the meantime, write down all your testing data so you can backfill once you get your spreadsheet going.
 
Thanks for the information and support. I really appreciate it as it appears that I'm going to either have to be very proactive with my vet or switch to a new vet that has more knowledge in this area. I've posted my spreadsheet and will probably need some input on dosing, etc in a few days once I get more data entered as it's clear that I can't really rely on my vet for this :sad:
 
So I would give it maybe 3 cycles, see how and where the lowest point is. If he is not dropping 50% or so after 3 cycles, then you could increase by .25. Three more cycles and see how that dose looks. It's a process, increasing slowly and safely, based on the data you have.

For reference - we generally consider a cat regulated if they are in the mid- lower 200s at preshot and in double digits at nadir, but not below 40, which is approaching hypo territory. So that is the first goal. Once he is in regulated numbers and you have data to guide you, you get a little more aggressive with dosing.

You might post a thread on Health, specifically with your city and state to see if anyone is nearby and knows a Fd friendly vet.
 
If you like your vet then you will just have to teach your vet all you learn about diabetes in cats. My vet is a good guy but he was not very knowledgeable when it came to diabetes and cats. He even had a cat that had diabetes and lost it due to hypo from not testing before shooting. I liked him and his staff a lot and did not want to change vets so I just had to train him to be the vet I needed him to be!! You can do the same if you want to keep him! If they wont work with you then certainly I would change vets. You need someone on your team!
 
Thank you for all of the info! I actually contacted my vet today about me swinging by and getting U100 syringes to possibly increase by 0.25 as suggested above (he only gave me U40). That caused another discussion. I told them that I have the conversion chart (thanks to this awesome board :-D ) and that I understood the difference in measuring between the two. The tech said that the doctor would have to get back to me about this...which he didn't. This just seems like an uphill battle every step of the way :sad:
 
It looks like Abernathy is still running high after three cycles. You could consider upping the dose, on a cycle you can monitor - to 1.25 (you'll have to eyeball it until you get the U100s) or 1.5
 
Sue and Oliver (GA) said:
It looks like Abernathy is still running high after three cycles. You could consider upping the dose, on a cycle you can monitor - to 1.25 (you'll have to eyeball it until you get the U100s) or 1.5
Click to expand...

Thank you! I am going to do that tomorrow when I will be around all day.

I do have a couple of questions...
--his BG numbers are running higher now that he is on insulin compared to when he was first diagnosed and I was just monitoring while switching his diet. Before insulin he was always in the mid to low 300s, but now I'm getting numbers in the 400's. Is this normal? Is it his body's way of adjusting?

--he is more of a free feeder and I am wondering if I should pull up his food after breakfasat when doing BG curves? Will the free feeding interfere with his numbers while I am still trying to figure out his dosage?

Thanks again to everyone for your input. I appreciate it.
 
I don't know why he seems to be higher. It might be that you need to increase, or decrease. Unfortunately the only way to do this is choose a dose, to collect numbers and then, when you have enough to see a pattern, react. I think I would try more insulin and see what happens. We want to see a smile pattern in his cycle: starting at a number in the am, dropping slowly during the day and then rising slowly up to the same range as the morning. He is not showing us that yet. If you increase and his numbers rise instead of dropping, then we'd think maybe he needs less insulin instead of more. But with a new diabetic and not much data, as long as you can monitor with changes, I'd go with a little more insulin.

I would continue feeding the usual way when you are doing your curve. You want to have a "normal" cycle to compare to each time, food included. The only time you want to withhold food is 2 hours before the pretests morning and evening, so that number is true and not food influenced.

It would be a good idea to add ketone testing to your regime. You use the regular ketone strips that humans use. If he will let you, stick it into his urine stream when he uses the litter box. If not, we have other ways :mrgreen: Anytime you are getting higher numbers, it is good to be on top of possible ketones.
 
Great info!! Thank you.

I'll work on upping the dose and collecting more data to try and see what's going on.

What's interesting is that he's acting like he is feeling better with these higher numbers compared to previous lower numbers. Strange :?
 
The 1.5 (now 1.6) is looking better. Like the blue and yellow, although they probably made him bounce some. I'd stick with 1.6 for a few cycles and see how things look.
 
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