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Jennybags123!

Jennybags123!

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Hello, my cat Calvin was diagnosed with diabetes on November first. We have been trying Novolin with little to now no success keeping him in the normal BG range. I researched for information here, and it was recommended that we try a different insulin. I contacted my vet and he said we could try PZI. I asked him if I had to use the u40 syringes( because I have a ton of u100s) and he said I should use the u40s. I think he thinks I would mess up the dosage if I convert to the u100s. My question, though, is his recommended dose, 2 units, twice a day. Is PZI stronger than Novolin? I'm concerned it might be too much for Calvin? We have been giving 2 units of the Novolin and had really no success. Calvin is staying in the 300s to 400s most of the time. The lowest he's gotten lately is in the 200s. He usually eats enough at meals to get his shots. He is still on dry food as I'm nervous to switch too many things at once. If anyone has any thoughts I would appreciate the advice. I'm not starting the PZI until tomorrow or Sunday when I can be home all day to monitor his numbers. Thanks!
 
Hello and Welcome to the ProZinc forum! I help a lot of people with ProZinc and their kitties, and I would love to help you. I can’t advise too much on dosage because I would need a spreadsheet with blood glucose (BG) tests from the Novolin to see what was going on. Novolin is a very short acting insulin that will not lower a cat’s BG for too many hours- perhaps 4 hours. Have you been recording your tests on Calvin? Could you start a spreadsheet and put in as much data as you can? What kind of glucometer are you using? What is Calvin eating? You should start giving him a main meal at shot time and then small meals/snacks at +2 and +4 and (two and four hours after his shot). With ProZinc, you want to feed multiple small meals through the early portion of the cycle (before nadir, which is the lowest point in the cycle.)
 
Here’s a sticky note with a lot of helpful information. I don’t want to overwhelm you, but you can look it over and ask questions as they arise. I will be here to guide you and will have a lot of questions for you, too (I hope you won’t mind.)

As for syringes, we can use U-100 syringes with ProZinc as long as we use the conversion chart for dosing. I can help you with that if you would like to try.
 
Oh, and finally, you are correct that we don’t want to change too many things at one time. We should change either the insulin or the food to low carb. Switching to low carb food can make a big difference in the cat’s BG numbers so you need to be able to test frequently during the switch. Low carb food will make it much easier to get Calvin into better BG numbers.
 
Thank you so much! I will try to make the spreadsheet this weekend. I am hoping to start him on the PZI tomorrow, as I will be home all day to monitor him. We use a Libre 3 sensor. He has rarely been in the normal zone while on Novolin. He is eating Purina DM dry food, he won't eat the wet version DM. I have tried Fancy Feast classic pate, he loved it, but he has only had it once, I wanted to see if he would even like it. I will keep him on the DM for now and transition him down the road. He usually eats again around 11 or noon, but he's not always hungry then. Feeding has been challenging, if he doesn't eat at mid day then he us starving by like 4pm and we have to try to hold him off so that he is hungry and will eat at shot time. We usually end up having to give him a tiny bit just to get him through. I would like to use the u100s as I have so many. I understand the chart but depending on the dose, it may be challenging to get it exact if for example, we want to give 1 unit, which would be 2.5 on the u100. My u100s only have unit marks, no half marks. Sorry this was so long! I so appreciate your help! My vet just seems so blasé and not too forthcoming with answers to my questions. Thank you so much for thus Forum and community!
 
Oh wow. That isn’t going to be easy (maybe not even possible) to get an accurate dose with no half unit markings on your syringes. It could be problematic.
 
Jennybags123! said:
He usually eats again around 11 or noon, but he's not always hungry then. Feeding has been challenging, if he doesn't eat at mid day then he us starving by like 4pm and we have to try to hold him off so that he is hungry and will eat at shot time. We usually end up having to give him a tiny bit just to get him through
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Again… what is your time zone and shot time? When you say 11 o’clock I can’t know how many hours after his shot time that is. That’s why we talk in terms of +1, +2, etc. that tells us how many hours after the shot was given. Anyway, if he’s really freaking out for food, then give him a small amount of the Fancy Feast classic pates or other low carb food that will not impact his blood glucose too much— this could be a way of gradually introducing the lower carb food while he still eats the dry DM (which you eventually will need to do - slowly.) The main thing to remember is to not feed anything for two hours before shot time because otherwise the AMPS/PMPS tests (the tests you will take before the morning and evening shot times) may be inflated by food (higher BG due to food) so you may not know if it os safe to shoot the full dose.
 
And since you use a Libre sensor, you should be able to fill in the spreadsheet almost completely. Do you have the capability to get Libre information remotely on your phone? (It’s possible) or do you scan it? You can scan it each hour when you are home. One thing to be warned about regarding the Libre is that it tends to give excessively low BG readings in the lower numbers (below 100 and lower the closer you get to 50.). We have had many members here alarmed and panicked by the Libre indicating hypoglycemia when it really wasn’t the case. It really would be beneficial if you could get a human glucometer to use as a backup — to be used when the Libre indicates that he’s too low.
 
Jennybags123! said:
! My vet just seems so blasé and not too forthcoming with answers to my questions.
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I am concerned about this, but not surprised. Vets don’t receive much training at all in Feline Diabetes. and the information is generally more applicable to dogs and outdated. As long as you can do your own thing with the ProZinc, with our help, all will be well.
 
Suzanne & Darcy said:
Again… what is your time zone and shot time? When you say 11 o’clock I can’t know how many hours after his shot time that is. That’s why we talk in terms of +1, +2, etc. that tells us how many hours after the shot was given. Anyway, if he’s really freaking out for food, then give him a small amount of the Fancy Feast classic pates or other low carb food that will not impact his blood glucose too much— this could be a way of gradually introducing the lower carb food while he still eats the dry DM (which you eventually will need to do - slowly.) The main thing to remember is to not feed anything for two hours before shot time because otherwise the AMPS/PMPS tests (the tests you will take before the morning and evening shot times) may be inflated by food (higher BG due to food) so you may not know if it os safe to shoot the full dose.
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We give him his shot at 6:45-7 am EST, depending on how he is eating. Sometimes he will eat at 11 am or noon, but most days he's not interested until 3:30 or later. We offer him food at 6:30 so that he can have his shot, sometimes it takes him a while to eat, he will eat a little and walk away. We have to keep offering it to him and encouraging him to finish it. I scan him when I am home. I'm working on the ss, but after I put all of the information in, after saving it, it didn't upload to my signature page, not sure what I did wrong. I also didn't find a place on the ss to record food intake or type of food. Should I just make notes somewhere? I appreciate all of the information you are sharing, it is so helpful and I am very thankful!
 
Jennybags123! said:
ating. Sometimes he will eat at 11 am or noon, but most days he's not interested until 3:30 or later. We offer him food at 6:30 so that he can have his s
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So 11 a.m. would be +4. That’s a little late for the first snack. I would feed him a little less breakfast to make sure he’s hungry again at 9 a.m. (and again I would make it the FF Pate which he seems to like so far.) 9 a.m. would be +2 and that is a really good time to give a snack since +2 is the typical time for ProZinc to onset (start lowering BG). A snack could be 1-2 teaspoons. Then I would see if I could get him to eat again at +4 (11 a.m.). After those morning snacks he may not be so frantic at 3:30 but if he is, it would still be okay, if you must, to give another 1-2 tsp of the Fancy Feast. Normally I don’t recommend feeding after nadir, but in the beginning we sometimes need to make allowances and gradually work our way to doing things differently. Calvin has already been through a lot and we need to keep him happy if we can!
 
Hey you forgot your spreadsheet set up! Well done. We usually record food intake (what was fed and at what + hour it was given) all the way over to the right in the remarks section.
 
With ProZinc, there doesn’t have to be a long time given between testing, feeding, and shooting. Usually you can test, feed and shoot within a few minutes. I would just make sure he eats a little bit and then shoot because, as I said above, the insulin doesn’t typically onset until about +2 (which would be a good time to start scanning the Libre)
 
So just to make sure I understand, it's ok to shoot even if he only eats a little? I've been trying to make sure he eats about 2 TBSP because the vet said I shouldn't shoot without him having enough food in his system.
 
Jennybags123! said:
So just to make sure I understand, it's ok to shoot even if he only eats a little? I've been trying to make sure he eats about 2 TBSP because the vet said I shouldn't shoot without him having enough food in his system.
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If he were on the Novolin, you would want to make sure he eats a larger meal, but with the ProZinc it’s okay for him to eat a little less at shot time and then make sure he gets the planned snacks or grazes/finishes up his food in the next two hours. Then hopefully he would eat a teaspoon or two at +4.
 
Ok thanks. Last night he was very hungry, ate dinner, had his shot, wanted more food, ate a couple more TBSPs before bed. I am concerned, his BG has been high (above 400), since yesterday at 3:00, which is +8 hours after 1st dose, 1 unit PZI. It has stayed high. I last checked at 10 am EST, still above 400. I don't understand what is happening. I even wondered if the sensor is malfunctioning.
 
He’s probably just bouncing. Let me take a look at the SS — no wait… I cannot look at his SS because it is not up to date. I see only up to December 11. Please update the spreadsheet and try to keep it updated as much as possible. Let me know and I will take a look and comment.
 
Thank you. I have updated the ss. He us acting fine except for biting me last night, that means he wants more food, so I gave him a little DM at bedtime. 11 pm.
 
Are you testing for ketones. I hate seeing all that red.
Why dis you drop his dose down from 2 to one units. He is not doing as well on 1 unit at all.
 
I'm not testing for ketones. I've read about it some but I don't see how I can really do that. I started him at 1 unit because I was worried the ProZinc might be stronger than the Novolin? I asked the vet but he never gave me an answer. He is eating the dry DM, I was concerned about changing his diet as well as his insulin at the same time.
 
One unit is not enough it is apparent. When switching from one insulin to another, we take into account the previous dose and the nadirs that the cat was getting on that dose. Since you are not changing the food right now (which would lower BG) and that is okay for now— you should increase the dose — probably to 1.5 units. Your nadirs are quite high. As for ketones, when the cat is in high numbers it can be dangerous if they are producing ketones. You can test them with keto stix available from a Walmart or drug store (no Rx needed.). Those are placed in the cat’s urine stream while they are in the litter box. Alternatively, you can purchase a blood ketone meter which is used like a regular handheld glucose meter. I bought a Nova Max Plus blood ketone meter after my boy went into DKA and nearly died. He spent a week in Emergency Care.
 
Now if you would like to do the food change over to low carb, you could do that and keep the dose at 1 unit while you change to low carb food. His numbers will come down with LC food.
 
Thanks for the information. I have started Calvin on 2 units. He's eating a little better and aside from last night, when I inexplicably did a fur shot, he has been acting like he feels ok. Last night he was jonesing for food, nothing would satisfy him, which is the behavior that I notice when his BG is too high. He had his 2 units this am and he's acting like he feels pretty good. When do you think I should start transitioning him off the DM? I'm giving him the wet food between meals for now. If his BG isn't regulating in the next week or so I was thinking I could try easing him into the fully wet diet. Lmk what you think. I plan on trying to check his urine for ketones. Not sure how well that is going to work, lol, but I will try! I'm going to get his new sensor this weekend. I am going to try removing the old one and applying the new one myself so that I don't have to stress him again by taking him to the vet. Wish me luck! I will save that stress for important and necessary visits. That's the update, thanks again for your help! I don't know what I would be doing without this forum!
 
Hi. He is doing well on 2 units. You even have seen some blue, which is good. Be sure to get a +2 tonight and another test after that if you can. Do not increase above 2 units at this point, even if he looks to be high — because it looks like he is bouncing a bit from the numbers that he’s not used to. Then he comes down. You can gradually mix in more and more of the LC wet food as long as you are able to get frequent tests. He probably will need reductions in insulin. We don’t want him dropping too low.
 
Oh, about the sensor, are you a member of the Facebook group for Libre sensors? There’s a group for helping people put on their own Libre sensors. As a backup, do you have a handheld human glucometer like a ReliOn meter (sold at Walmart?). It’s important to be able to check low numbers when the Libre is telling you it’s too low (or if it conks out.) Our members find that the Libre reads abnormally low when the numbers get down below 100/75 and it can be really alarming at times.
 
Suzanne & Darcy said:
Oh, about the sensor, are you a member of the Facebook group for Libre sensors? There’s a group for helping people put on their own Libre sensors. As a backup, do you have a handheld human glucometer like a ReliOn meter (sold at Walmart?). It’s important to be able to check low numbers when the Libre is telling you it’s too low (or if it conks out.) Our members find that the Libre reads abnormally low when the numbers get down below 100/75 and it can be really alarming at times.
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I will check out the Libre2 Facebook group. I will have to check out the ReliOn as well. He did drop a bit after he had the Fancy Feast for his pm meal last night but he rebounded quickly. Thank you for your help!
 
Looks like last night he was eating low carb FF food. Is this correct? He hit green, so I would like to know what the difference was between last night and his usual food intake or anything else that was different. It’s good to see! :)
 
Yes! He ate a full can of Fancy Feast for his evening meal, no DM. Then, when he hit 83 I got a little nervous, so I gave him a tsp of DM because I was afraid he was dropping too low. He then came back up a little. Trying to figure out when and how to switch him over safely to the low carb. Nervous also because he is so changeable in what he wants from day to day. Right now he is very interested in the FF so I think I could switch him over without a problem, but he does get bored very quickly. I have two flavors of the FF right now. I wonder if I should just start with one meal a day of FF? And see how he responds?
 
Hi, just updated everything. I changed his sensor without any trouble. Had a lot of trouble removing the old sensor's glue!! So mad that they used super glue on him!! It finally came off but his skin is super irritated. I have put some healing balm on the sore spot. His numbers seem to be improving, I have been giving him FF for his snacks.
 
Oh, poor boy with the super glue! What kind of adhesive did you use for the new sensor?

You had a lovely string of blue today! You’re making progress.
 
Hi, yes I think we are getting somewhere. I found a skin "tacky" glue wipe, not sure if it will really hold, but I refuse to use anything that isn't easily removable. The redness is starting to go away thank goodness, poor boy it looked so painful. I will keep the ss up to date and hopefully we can keep making progress.
 
Well this morning I tried feeding just Fancy Feast at am shot time as well as some snacks throughout the morning and Calvin started dropping low, so I gave him DM as well as a drop of honey and he gradually came up. I guess he can't eat the FF exclusively yet at least not while he's on 2 units of ProZinc. I thought since his numbers seemed above the optimal zone for the majority of the time he might be able to regulate somewhat with the low carb food but I guess not. This is so confusing to me. Not sure how to proceed. Should I just keep feeding a mix of DM and FF, stay on 2 units and see what happens? I know it hasn't been very long yet but I keep hoping to see some progress.
 
Wow. That is an absolutely gorgeous cycle! What a beautiful run in greens! He really was surfing in green today! That is amazing progress. Really you should be pleased. In addition, I feel sure that if you had tested with a handheld glucometer, the numbers would have been somewhat higher. More in next post…
 
It would be really helpful if you could put in the notes about what you fed (like when you gave the honey, for example) the hour that you gave it (+3, +4, +4.5 for example.). We can’t look at the spreadsheet numbers and tell what was 2:30, etc.

Now, having said that. He was never in any danger during this cycle. His lowest number was 55. We want cats on insulin to stay at 50 and above. Don’t give honey or high carb food unless he drops below 50 (here’s where a backup meter is helpful to check the Libre’s accuracy.) I do completely understand your alarm though at seeing these lower numbers for the first time. Most of us get addicted to greens because those are the normal, healthy numbers for a cat and we want our cat’s pancreas to have an opportunity to heal. But greens can be scary when it’s all so new. Unless the cat is really being overdosed, a little low carb wet food can be used to steer the BG numbers and help the cat to stay in green without knocking them up into blue and without shortening the duration of the insulin.
 
Since Calvin is still eating some dry food, you will need to follow the SLGS protocol, however. With SLGS, the reduction point is 90. That does not mean that a number of 50 and above is dangerous. It just means that the goal for SLGS is to keep the BG numbers between 90 and 150. With the Modified ProZinc Method (MPM) our target BG is between 50 and 120. Since dry food can sometimes make the BG numbers a bit unpredictable, cats eating even a small amount of dry should follow SLGS. Since he dropped below 90 today, Calvin has earned a reduction down to 1.75 units. So his new dose going forward would be 1.75 units until he either needs and increase or earns and reduction.
 
He should have had a low carb snack (teaspoon) at +2 today (I don’t know if he did) and if he dropped into green the next hour (as he did) a little more (teaspoon) then at +3 as well. After that you can just feed as needed if his numbers in the green seem to warrant it. It sounds like you may have done this?

Anyway, good job taking care of him today. He’s very lucky to have you! Be sure to take that reduction down to 1.75 units. :)
 
Hi, I just found your reply so I haven't implemented any of your suggestions yet. I'm reading and rereading all of this, trying to make sure I understand. So my goal right now is to keep him between 90 and 150? I am still giving him the dry DM as he doesn't always want the wet FF, sometimes he won't eat it. I need to check the conversion chart for the proper dose for 1.75 units. If I can covert for the u100 syringes, as that is what I have right now, I will start him on that dose in the morning. Thanks so much! I am hoping I can get him where he needs to be. Ttys!
 
I can't seem to find 1.75 on the conversion chart? Can you let me know how much that would equate to on a u100 syringe? If I need to I can get the u40 syringes from my vet. Thanks! I will also update the ss so you can see when I gave honey, etc.
 
We need to get you set up with a signature. In ot you would put that you are using u-100 syringes with the conversion chart.
I didn’t recall that you are using U-100s. So I have a question, if you are using the U-100s and are giving 2 units, you are drawing the u-100 syringe to the 5 unit mark, correct? You are right that there is no 1.75 unit conversion. The closest you can do is 1.8 and that would be fine. You draw the U-100 syringe to the 4.5 mark and that equates to 1.8 units of ProZinc. That will be fine.
 
Jennybags123! said:
So my goal right now is to keep him between 90 and 150? I am still giving him the dry DM as he doesn't always want the wet FF, sometimes he won't eat it. I need to check the conversion chart for the proper dose for 1.75 u
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The goal BG for those following the SLGS dosing method is to keep the cat’s nadirs between 90 and 150. It would be good if we can keep them there all the time, but sometimes they’re going to be higher- especially at the beginning and end of a cycle. Some cats will level out and stay fairly even. We can customize the reduction point a little bit if we need to, but with dry food in play we won’t change it too much.
 
Ok thanks for the clarification. Yes, I am drawing to the 5 mark on the u100s. I will start Calvin on 1.8 tomorrow morning.(4.5) on the u100. Thanks again!
 
It will actually be 1.8. So just write 1.8 in the units column. Okay. Talk to you later. :bighug:
EDIT: I see you’re already prepared and have written in the 1.8. Perfect!
 
Hi, Calvin hasn't had much of an appetite today, so I think that may be why his numbers went low? He really did not want the FF this morning and only ate a TBSP of dry DM. I'm hoping he will eat normally this evening at shot time. He did dip low once, 54 on the Libre. I haven't received my Relion yet, I ordered one online. I gave Calvin the 1.8 units this morning. That's the latest! I appreciate any insights or information that you think may be helpful. TTYL.
 
??? Help!! Hi, Calvin's pre shot number is 253, much lower than his usual 400+. Should I give him his 1.8 units? He has only eaten about a tsp or 2 of the Fancy Feast. I'm afraid the insulin will send him too low!?
 
I ended up delaying his shot by 2 hrs. I waited for his BG to get to 340 and then gave him a reduced dose, 1.5 units. His eating was so off today. He finally ate 2TBSP DM at +3 after his pm shot. His numbers still dropped rapidly after the reduction in dose. I will see where he is at in the morning.
 
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