Newbies to home testing & FDMB, using ProZinc

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Allie

Allie

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Hi everyone,
I'm Allie and my little fur baby is an 12yo domestic shorthair named Steve. Steve and I are so happy to have found you. We are hoping to make friends here and hope that we can learn from you! He was diagnosed in 2009. In spring of 2010, we moved from one of the humulins to ProZinc. We were shooting 4u twice a day without testing. And we were eating Science Diet d/m. Around Christmas, I noticed Steve's box having more clumps. I knew we'd have to go back to vet and get a new upped dose. So I headed to google and found out about using wet food and Tight regulation. I decided to eliminate dry food and attempt tight regulation using a sliding scale. On Jan 1st, we got rid of dry food (we reduced shooting 2u twice a day--until we could be sure carbs were out of his system). On Jan 11th, we started trying TR as recommended by another website. He hypo'd two nights ago (no symptoms but his BG was at 22 +3.5). We recovered with feeding maple syrup and some dry food (took 5 hours till i was sure he was in the clear).

Anyhow, now we have decided to proceed more cautiously and are looking for friends to tell us we are or aren't completely crazy along the way. We skipped the first dose post hypo and now are dozing 1u every 12hrs until we are sure we are normalized to that dose. So my question is, how have you guys proceeded with testing, curves, dosing after a hypo? If Steve were your baby, would you run a curve tomorrow or wait another day so we know carbs are gone? Would you run a curve with on 1U when you did it (I'm pretty sure he needs more than that, but don't know what that number is).

Thanks for any advice you can give or just general commiseration you can give. Stevie and I are scared but we are trying to 'remain calm and carry on'.

Cheers,
Allie and Steve
 
Welcome Allie! It is wonderful that you have done the research and started Steve on the right track with a good insulin, hometesting and wet lo carb food. And you have already survived a hypo :o

Every cat is different, so the numbers will tell you when the carbs from the hypo have worn off. What numbers are you seeing now? If I were you, I would do a curve tomorrow with the one unit and see what you get. It is a starting place. This whole dance is about data. The more numbers you have, the easier it is to predict how a given dose might affect him.

I would suggest that you get a spreadsheet going. We have this great google document - color coded - that makes it very easy to see history and patterns. And with your hypo, you especially need to have it so people can see at a glance what you are dealing with. Here are the instructions: Setting up a spreadsheet If you are computer savvy, it isn't hard. But if you need help, just send me a private message and I can help you set it up. (Lower left hand corner of my post - pm is private message)

Keep reading and asking questions. You are doing great!
 
Welcome Allie and Steve! What a scary episode you have had. Great that you are hometesting and know how to handle a hypo.1U is a safe place to start, even if it turns out to be too low. But what have his numbers been today? Eliminating all dry food probably caused his BG to go down a lot, so you probably needed to lower his insulin at that time. Getting more data is always helpful. If you give us more information about his numbers, we can be in a better position to make recommendations. If you feel up to it, it would be great if you could set up a spreadsheet. There is info about how to do this in the Tech forum (can find this on the main board)
http://www.felinediabetes.com/FDMB/view ... =6&t=18207. If this seems too complicated to do, just post here or in that forum asking for help, and there are people who will help you.
And keep posting and asking questions!
 
Welcome Allie...

I'm fairly new here, also. You've found a great place full of caring folks with lots of experience that will do every thing they can to help you and Steve.
 
Hello Judy, Sue & Beth (and your furbabies too!),
Prozinc was my vet's choice, but he also rx'd twice a day shooting with no home BG testing. I haven't researched other Insulins cause Prozinc is what we have to work with. I don't think my vet is going to change his mind on that and I'm not sure I trust the other vets around here (we are already on our second vet regarding treating Steve's FD). So, Steve and I are working the best with what we have and I think it will all will be well. It is our extreme wish to get him OTJ if at all possible. We know it will take work on our part, but we are ready for the challenge.

Anyway, It is so nice to have people to be a sounding board so Steve and I don't have to go this completely alone. I'm going to try to figure out the spreadsheet and start posting numbers up there, but in the meantime I'll try to explain here.

December 2010--dosing twice a day 4U, NO BG testing, eating Science Diet d/m, begin noticing telltale high urine output. Start Researching for treatment other options.

Jan 1, 2011
Replace food with gluten free, lo carb varieties of Fancy Feast wet food
Reduce dosing 2U twice a day.

Jan 11, 2011
Start trying to do TR as closely as we could based on Dr. Hodgkin's Protocol (dosing every six hours if BG was 150 or above using sliding scale to determine dose) .

This worked out great until :

1-19-2011
0530 +10.5  175  .5u
1130   +6.0  131
1300   +7.5  185  1u
1930   +6.5  214  2u
2300   +3.5    80

1-20-2011
0000  +4.5     22
0015  +4.75   35
0030  +5.0     35
0100  +5.5     31
0130  +6.0     42
0145  +6.25   40
0215  +7.5     84
0530  +10.0   312 Decided here to return to twice day shooting for now, but skipped first dose because I had to go to work and steve needed watching. Basically I was scared to do anything. I felt too high wouldn't kill him and he has no history of keto

1730  +22.0   407  2U
1830    +1.0   296

1-21-2011
Decided we needed to start over at 1U twice day instead of 2U...just to be safe
0530   +12.0  195   1U
1530 +10.0 273
1730 +12.0 284 1U

So here we are and we are proceeding with extreme caution. Steve will get dose 1U dose at 0530 (or as close as we can to 0530) tomorrow morning and we will work on a curve from there.

Thanks for being here!
Allie and Steve
 
I don't know if anyone here uses TR; there may be some who experimented with it. Most of us start low and go slow- one unit twice a day, watching the numbers. If you look at some of the spreadsheets, you can see that several people are giving less than 1/2 units adjusting doses as needed. That's one of the great things about PZI. It doesn't require waiting a week to change the dose; you can adjust as needed.

You have the basics down. Now you need to start fine tuning the dose. To do that, you need numbers. It is good to numbers around 6 hours after the shot. With PZI, that tends to be the lowest point in the cycle (nadir). So, in addition to the pre shot numbers, get some numbers around that 6 hour mark. And as soon as you can, do a curve. That is a day when you test every 2 hours during a 12 hour period. That will let you see how the insulin is working.
 
Sue,
I don't think I'll be attempting TR anymore, without support I'm afraid to continue trying it cause the hypo two nights ago scared me so bad. The board where they do TR didn't have an encouraging response to my questions on how to proceed, so I decided to try another avenue. So now I'm here at FDMB.

I like the SLGS approach you've described and I'm willing to try it. It seems like my approach of 1U twice a day for now fits with that approach so I'm thrilled for that.

We will do a curve tomorrow.

I do have few more questions:
1. I see people making reference to very tiny dose changes (.1 or .2 etc), what type of syringes are you all using? There is no way I could distinguish a .1U or .2U change in dose with my needles, I'd be lucky to do a .5U with real accuracy.
2. You mention that I won't have to wait a week to change dose using PZI. How long should I wait before changing dose? And Prozinc and PZI are the same thing or almost the same thing right?
3. Do you have a link explaining Start low and go Slow or is it just as simple as you explained?

Thanks,
Allie and Steve
 
Welcome.

Sounds like Sue might have some ideas for you to optimize your current routine. :smile:

If you get to the point to wanting to pursue the TR/TID below are my thoughts:

(information regarding off-board contact removed - mod)

If you do not find enough help here in PZI on the TR topic, I suggest you post in Health with a subject such as, "PZI TID TR help needed."

Use the word "PZI" and not "ProZinc" in the subject and it will likely get more attention. Many here have not tried TID or TR with ProZinc but they have a wealth of knowledge about using it with PZI. Though I have not done TID, personally I found that ProZinc is much like the old PZI Vet. So you might implore them to share with you their PZI knowledge.

I was eventually able to essentially achieve TR for short periods with just BID dosing, but that seems to be relatively rare. We were however not able to go OTJ.

(Link removed - mod)

I hope you stick around and we get to follow your progress. :smile:
 
Welcome Allie! you have found the right place!
Yes, my Payne and I were doing TR and I found the one size fits all approach doesn't work for us,
her numbers were all over the place and then we started re-bounding. Whereas you have been
battling low #'s, we were living in the high one's. BUT what I did learn from the experience is that
she responds really well to t.i.d. Even though her #'s have been high she is like a kitten again and
this morning spent her time chasing the puppy who is 10 mo's and 100 lbs. and then batting her
when she stopped :lol: was very funny!
(the puppy is part Great Dane but thinks she's a cat, another story)

You are doing great! you have already handled a lot! Somewhere on Dr. H's website it says that
the TR dosing schedule is not written in stone ..... well for me what's the point? Also I have
found that ProZinc seems to respond well with consistent doses, so I am back with a fixed dose
but doing it t.i.d.

We are all in the process of learning here and I truly believe had I not found this group of kind
and caring people, Payne would be dead. She had several rounds of DKA and had I not gotten
the information I got here, we would never have been able to work through it and she would not
be terrorizing the puppy today and tomorrow :)

So keep posting and the information will flow to keep you on the right track.
 
Allie said:
1. I see people making reference to very tiny dose changes (.1 or .2 etc), what type of syringes are you all using? There is no way I could distinguish a .1U or .2U change in dose with my needles, I'd be lucky to do a .5U with real accuracy.
Click to expand...
Many here use U100 syringes and do the conversion. You can read about this here:
http://www.felinediabetes.com/FDMB/view ... 19#p340819

Allie said:
2. You mention that I won't have to wait a week to change dose using PZI. How long should I wait before changing dose? And Prozinc and PZI are the same thing or almost the same thing right?
Click to expand...
The recommended wait period for a "fixed" BID dosing is somewhat increment specific. And it can vary depending on the "bean" [human]. So for larger increments one might want to wait a little longer - or for smaller increments one might want to go a little faster. Usually for doses between 1-2u the generally recommended increments to raise are .2u, then wait for up to 3 days and potentially up to 5 if one thinks they are seeing improvement at the end of 3. Sometimes it becomes very clear before a 3 day hold that a .2u increase is not cutting it and they might need to increase again.

However, one can change the dose every cycle [as in with "scale" dosing] with PZI but generally that is not the course for most beginners. It's possible that it can add too much variability to the dosing making it hard to determine what a given dose really did. Gathering data helps speed thing up.

When I started PZI Vet I knew I we needed less than 1u. I immediately went from dosing how my vet wanted to changing the dose every cycle. When we switched to ProZinc that approach did not work out so well in the beginning. So, I started at a lower dose and increase by .05u every 3 cycles [which is 5% is you think of it in a % kind of way]. So smaller but faster changes. But my approach is different than the norm - and maybe not better.

It really depends a lot on the kitty and bean to the best approach.

Allie said:
3. Do you have a link explaining Start low and go Slow or is it just as simple as you explained?
Click to expand...
This is the link to the SLGS approach:
http://binkyspage.tripod.com/SLGS.html
However, what beginners generally do here is a little riff on the basic ideas in that link as you can see from my answer to #2.

Keep in mind that there is no one size fits all here. And you are the one holding the syringe. So take the excellent ideas you get here and do what you think is best for your kitty.

When you have the time and you catch your breath :smile: there is a PZI Sticky that has a lot of good input for beginners [and the advanced] located here:
http://www.felinediabetes.com/FDMB/view ... p?p=340815
Newbies are very welcome here in PZI despite what it says. :smile:
 
Hi Allie and Steve! Welcome to fdmb. I think you've found a good safe haven. Let us know if you need anything explained, or if the jargon gets a little confusing. We were just discussing yesterday about how that can get a little intimidating. So, you dropped the dry food on 1-1-11, and reduced to 1u yesterday? I think I'd try to get a couple mid-day readings in today (around +4 and +6 maybe--meaning 4 and 6 hours after you give him his insulin). Then maybe try a curve tomorrow once you know he is settled in at this dose. I didn't notice it in a previous post, but if I missed it and I'm repeating someone I'm sorry--since we're all in different time zones we use "amps" and "pmps" to mean the blood glucose level just before the morning shot and evening shot (am/pm pre-shot). Then we use the
number of hours since that shot to list the rest of the tests.
Example: amps:300, 1u
+6:125 (6 hours after shot)
Pmps:345, 1u

U-100 syringes can be bought at walmart, but you have to really spell out what kind you need. I can email you a picture of the box info so you can show the pharmacist if you'd like. They are $12 for 100. The conversion is easy to do if you always keep your chart handy.

I hope you like it here!

Claudia and Charlie
 
Hi Allie and Steve! I wanted to say welcome. I had a cat named Steve when I was a kid - I love that cat, so that name brings back sweet memories. (My Steve was a girl.)

There's lots of great advice here. Take your time, read through it and the various other posts like the Newbie's Checklist when you have time, although it sounds like you've got a great handle on things already.
 
Wow you guys are a wealth of info! And so welcoming, I think Steve and I will be very happy here. This is exactly the kind thing I was looking for...people who understand these difficult decisions and who will let me know what worked for their kitty and what didn't.

Yes right now we are just using 1U every twelve hours (basically starting over after my failed TR attempt that resulted in hypo). We went to wet food on 1-Jan and started shooting 2U twice a day then (before Jan 1 we had been doing 4U twice day as rx'd by vet). The 2U worked well for 10 days. I didn't really test very often but his numbers were never under 120 and never over 250. Then the TR attempt. Now SLGS.

You have all given me a lot to think about. I will order the u100 needles from Hocks (LA won't let you buy them with out a prescription and that will require a visit too the vet and I'm not sure he's gonna be receptive). It will help me fine tune these dosing changes.

In the mean time, I will read over the links and all the advice you've given me, soak it up, mix it around, and decide the best course of action for little Steve. I am also populating our spreadsheet as much as possible. I did a BG curve today, but got pulled away so we are missing a little data. Still it's a start and we gotta start somewhere.
--allie and steve
 
It sounds like a solid plan. Ask if you have questions. There are lots of resources here that are sometimes hard to find because the site is so varied and big.

We will be eager to see your numbers when you get them. Staying in the 100 - 300 range during the cycle is very safe for newbies and not shooting when you get a preshot 200 or under is wise. You can always increase a dose the next cycle; you can't take the insulin out once you have shot. Fine tuning works best once you have data and understand how the insulin works in your cat.

Someone wise said this was not a sprint but a marathon. It takes a while - for you to figure out and for your kitty's body to adjust to.
 
LOL, Allie --- you're gonna do just fine here. And so is Steve. :-D You can ask a gazillion questions and dissent all you like. We welcome it.
 
I'm glad you found them useful -- but they are woefully out of date, now. I am too overwhelmed to keep them up, and companies are more and more secretive about the data. For my (non-diabetic) kitty, I'm pretty much into Fancy Feast and home-made food nowadays.

-- Janet
 
Oops!

Absolutely no disrespect to you Janet or Dr. Lisa, you are the goddess's of feline nutrition information and I bow to the hours and hours of work you put into putting together your food charts and information given to us so we don't have to do the work ourselves, as a matter of fact, Janet I hand out your list to anyone who seems remotely interested in a wet diet, Dr Lisa I've thought about grinding my own raw food from your recipies for a long time but last week when my vet called and said my best chance to get Harley off insulin would be to feed a raw diet he also told me about a small shop here that he found that grinds raw pet food daily so I went there and started switching the petting zoo over to raw last week. In the last 9 days Harley has only had 1 .2unit shot of insulin. :-D once they are completely switched to raw I will probably try making my own.

I don't get out of the PZI room much anymore these days so Gators home recipes and nutritional advise over the last 8 months came to mind first. I guess what I meant by resident nutritionist was here in PZI. :oops:
 
Thread has been split

All nonhealth posts have been moved to the Think Tank: viewtopic.php?f=22&t=35718&p=375199#p375199

Allie, welcome to FDMB. Like any large group, we have our low points despite efforts otherwise. I'm sorry your thread was hijacked. I was impressed, too, with your effort at mediation (which got moved to the Think Tank). Maybe you can become the official FDMB MEDIATOR and keep us all in line!

Best,
Rebecca
 
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