New to ProZinc With Low Numbers

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barbie330

Member Since 2012
My 19yr old, Dottie, was diagnosed a little over two weeks ago. She was put on Humalin N and was on a roller coaster of BG's. Found a new vet and started 1 unit of ProZinc 2x day on Wednesday. Last night and Wed night the meter read Low after 4 hours. No hypo symptoms just low & low numbers (20's) Brought her up to safe BG's both times with a little high carb wet & Karo. I reduced her to .5 units today and at 2 hrs she was 76 and 2 hrs later 46 instead of low reading.
I'm still not sure when to feed her in regards to her shots and this new insulin. Was I right to lower her dosage?
Thank you.
 
Me again...

Well done, you, for learning to hometest so fast! But just as well you did otherwise you'd not have picked up those low numbers. And you knew what to do to bring her BG up as well. Top job!

This looks like it may still be too much insulin. What was her BG before you gave the shot?

Have you removed dry food from her diet recently..?
Or it may be that she hypo'd and is super-sensitive to insulin at the moment... Or it may be that she needs just tiny doses... Or even no insulin by looking at those numbers...

We need more info from you...

In the absence of any other info please see this from the 'FAQ's'

"Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?


A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines. Below 150 mg/dl (8.3 mmol/L), don't give insulin. Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value. Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise. In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine. Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher..."
 
Thank you for helping. I'm new to this.
Her pre shot number was 264. I tested her every two hrs after her shot and her numbers were: 264 175 46 82.
Since her diagnosis, two weeks ago, she's only been on low carb wet food. I'm still learning all of this and now with her new insulin I'm starting all over. The when to dose is very helpful. I learned quickly that 1 unit's too much for her. I'm just not sure when to feed her in relation to PZI (nothing helped with the Humali N). She's 19 and I want to do the best for her.
 
You can somewhat manipulate the numbers with food. Today at least, her lowest number was 4 hours after the shot, correct? So you might offer a low carb snack around that time. Lots of us feed smaller frequent meals using an automatic feeder or freezing the food and letting it thaw.

I am wondering if you reduce the dose if her cycle will be longer, with the lowest number coming nearer the +6 time frame.

You can shoot smaller doses with U100 needles and a conversion chart. (ProZinc is a U40 insulin so the conversion is necessary. Lots of people give doses in the .2 - .3 range especially when they are weaning the cat off insulin.

Here's the conversion chart:
http://www.felinediabetes.com/insulin-conversions-printer.htm
 
The conversion chart is a huge help since I have over a hundred U100 syringes. I tested her at her 12 hr dose and she was at 170. I choose not to shoot below 200 feed a little wait 2 hrs and test her again. I'm thinking of going lower than .5 units because of the lower number of 46. Thanks for advising that. This site is a blessing.
Update: After 2 hrs with food down to 146.
 
The lowering of the number after eating is great news. It means her pancreas is working a little! I would continue to monitor, not shoot under 200 and get some more data. Once you have more information on how she is doing number wise, you can consider mini dosing to get her into the blues and greens - if she isn't already doing that on her own. Mini dosing is giving tiny amounts when she is in the 150 range, but only when you can monitor carefully and only when you have enough data to give you an idea of how low even a tiny amount might take her.

Another thing you can try is to give the small frequent meals to help support that pancreas and lower the carb count of the food (if possible) For instance, if you are giving 6% carbs, can you find a food she will eat that is 2 -4%? (Staying away from seafood more than a few times a week.) Even lowering the carb count by a small amount can bring down the numbers, in some cats.
 
She eats only the lower carb Fancy Feast classics. I'm not sure of what's 2-4%. I only gave her .25 units today (.5 units yesterday) and am testing her every 2 hours.
 
Hi, you're doing a really good job. Dottie is one seriously lucky cat to have you in her life! :thumbup

BTW. What's your name? Do we call you 'Barbie'?
 
Hi Barbie!

With all that's going on we haven't really had a chance to actually say 'hello' to you or to welcome you to FDMB yet, so, 'welcome aboard!' :YMHUG:

I know how stressful this all is at the beginning (and so does everyone else here!) But you really are doing a brilliant job. And I'm British, so you can probably take everything I say as an understatement! ;-)
 
Thank you so glad to have found this board. It's a process but I'm learning. Especially since her BG's are lowering after 6 hrs since her dose of .25. Just gave her some high carb wet to boost her a bit. Do I lower her dose for her next shot?
 
How low did she go on .25? Did you get some midcycle numbers? 40s and below are the time to break out the higher carb food. Higher than that, you can feed a little of the regular carb food to see if it brings her up.

It helps if you can give us an idea of the numbers this way:

amps # .25 units (the number in the am before you feed her = #)
+6 # ( or how ever many hours it has been since the shot - +4 or +7, whatever it is)
pmps # (the number in the pm before she is fed) Insulin amount (if given)

While this is scary, it is excellent news! The diet has made a big difference and it may be that she won't need to be on insulin long!
 
I started her on .25 units on 9/29. On 9/28 I gave her .5 units and her BGbwas reading low on the meter. That was reduced from 1 unit to start from 9/26 after 2 other low readings on 9/27 & 27. On 9/28 she only had .5 units for over 24 hrs of BG's between 175-198. I test her every 2-4 hrs. Am I doing something wrong? Let me know if you need more info.
Today:
The pre shot BG was 322 at 9:41 am
10:03 am .25 units
2:13 pm BG was 54
4:17 pm BG was 37 fed high carb food
4:42 pm BG was 60
 
Okay, I think I have your numbers right on this spreadsheet:

Dottie's SS

So if I understand you skipped the shot last night and she was at 322 this am. Right? I was wondering as the 322 seemed a little high, but once you consider the skipped shot (so she had been 24 hours since the last shot) it makes more sense.

I am thinking the .25 is still too much insulin. If you are using the conversion chart and the U100 needles, how about waiting for a preshot over 200 and then trying .1 (I know it is tiny amount) I think you could consider quitting the insulin for awhile, except the 322 this am shows she does need a little. (If she had been below 200 this am, quitting would certainly be an option.)

Just for reference: We say a cat is regulated when they are in the 200s at preshot and in double digits at midcycle (but above 40) We say a cat is in remission if they range from 40 -120 off insulin.

Confusing, I know. You are doing a great job! It is hard enough to figure this stuff out when your kitty is in safer numbers in the beginning. It is very hard when you are trying to figure it out and dealing with low numbers!
 
Thank you soooooo much. At the 12 hour mark, if she's not at 200 no insulin. How long after do I test again and see? Until she's over 200 or just wait til it's time for her am shot? I have a lot of u 100's. Where on the syringe would .1 be? Again, thank you.
 
If you want the spreadsheet, send me a private message. (pm button on the bottom left hand side of my post)

What number is she at +12? If she is close to 200, you can wait 20 minutes without feeding and try again. If she is still low, then you probably will need to skip again unless you have a flexible schedule. if you can shoot at will, you could just watch tonight and when she is +200 (and two hours from a possible food bump) shot .1 If you skip, even if she is in the 300 range tomorrow morning, try that .1
 
I never used the U100s and the conversion chart, so I hunted for another post that might explain it. See if this helps:

It is also time to go and get some u-100 needles, if this current trend keeps up you will need smaller doses and it sucks trying to do it on the u40s. Conversion factor for Prozinc to be used with these needles is x2.5, so if you need to shoot .4u it will line up exactly with the 1u line on the u100 syringes, .2u will be exactly 0.5u on them. Makes it so much easier. Here is the conversion chart, print it out and keep it on the fridge and always check and double check your doses.

http://www.felinediabetes.com/insulin-conversions.htm

For the needles, open the box and check that there are 1/2unit markings on them to the left of the whole units. The pharmacy doesn't seem to know the difference between the 1/2 u and 1u needles: Relion U100s; 3/10 mL; 31 g.; 8mm needles from WalMart. Model #81131-0311-79 . They are just under $13 for 100 syringes, cheaper then the vet and so much easier. For small doses to make it easier to get the right amount without all the back and forth with the plunger, draw slightly more insulin than you need then rotate the plunger clockwise, this will press out the insulin one drop at a time until you hit your mark.
 
I have the ReliOn Walmart syringes (3/10mlcc 8mm 31 gauge) as well as the ReliOn prime meter. Very good prices :-D. So .1 units will be above the 1/2 unit mark on the u100 if unread the chart correctly? I just tested her and her BG is 152 @ 7:00pm. Going to give her low carb dinner and test her again in 1 hr. It'll be 12 hrs at 10:03 pm.
 
Many, many thanks. Hopefully, she won't need any @ 10' but we'll see. I'm sure I'll have more questions and thank all of you for your excellent help. Until then, have a wonderful evening.
 
Hi Barbie,

Sue sent me a message and asked me to take a look. It's incredible that Dottie is getting that much of a response from such a teeny dose of Prozinc!

If you are using the conversion chart and U100 syringes, then .1u would be equal to .25u on a U100 syringe. Here's a picture of what that should look like:
025unit-1.jpg


If you can see that, your eyes are in great shape! In theory, you could give even less than that, but it won't be easy to see, or to be really consistent with. But with the drops in numbers you are seeing (from 257 to 46 on .1u), it almost looks like Dottie is close to not needing insulin, period.

Carl
 
Thank you for the syringe pic and the checking her numbers. What a big help. She's so far (knock on wood) she's only needed the .1 every 24 hrs. Everyone here has been a tremendous help. Dottie and I thank you.
 
Took at peek at Dottie's spreadsheet this am. Great news that food brings down the number, not the other way around. :-D It means the pancreas is working a little.
 
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