? Prozinc Dosing Inquiry

Mary Beth L

Mary Beth L

Member
Good evening. My cat, Tula is a 12 y/o F5 Savannah who was diagnosed with on 3/25/21. Immediately after getting this diagnosis, I switched her food from kibble to FF and Friskies Pate and later added YA and raw chicken/beef for snacks after joining FDMB.

She is underweight, around 9.5lbs and we have been struggling to find the right dose to manage her diabetes. After receiving the diagnosis, I changed her vet to a doctor who only sees cats and has been practicing for 17 years hoping to find someone who will work with us. She discouraged me against home testing stating is creates stress but I beg to differ. Tula comes to me to get tested and she purrs though out the process so no, doc, I won't stop home testing.

Every time I go up on her dose, it seems she gets worse and if I am reading the spreadsheet correctly, my data seems to indicate just that. I am at a loss and I feel like I am failing her.

Now I am posting here with hopes that someone can help me understand Prozinc, dosing and should I hold steady at the 1u/2x day dosage for now to see if things level out? If so, how long does it take to show improvement after dose has been increased?

Please help. Thank you.

https://docs.google.com/spreadsheets/d/13X08xdoLXw6Egg-QOMslO0MdAcyfh3UcqGMUn4fgcto/edit?usp=sharing
 
You're likely dealing with glucose toxicity, and she needs more insulin. But we recommend doing a curve before increasing, can you do one soon? We need to see how low she goes on this dose. Ideally you'd do one curve every 7 days or so and increase as needed.

It would also be nice to see more PM tests, cats often go lower at night, so when changing the dose want to be sure they're ok both day and night


There's another dosing method that allows you to increase more quickly but requires a lot more testing
 
What is glucose toxicity? I can do one today or tmrw. Just took her AM level and it’s up to 382. And I can try to get some late PM data. After I enter it on my SS, does it update on this thread? I’m curious about the other method. I can test almost anytime 5 days a week, excluding Mondays and Thursdays. New to this group. Thanks.
FrostD said:
You're likely dealing with glucose toxicity, and she needs more insulin. But we recommend doing a curve before increasing, can you do one soon? We need to see how low she goes on this dose. Ideally you'd do one curve every 7 days or so and increase as needed.

It would also be nice to see more PM tests, cats often go lower at night, so when changing the dose want to be sure they're ok both day and night


There's another dosing method that allows you to increase more quickly but requires a lot more testing
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Mary Beth L said:
What is glucose toxicity? I can do one today or tmrw. Just took her AM level and it’s up to 382. And I can try to get some late PM data. After I enter it on my SS, does it update on this thread? I’m curious about the other method. I can test almost anytime 5 days a week, excluding Mondays and Thursdays. New to this group. Thanks.
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Yep, the SS updates live for us!
Here is a post explaining glucose toxicity, but basically there's so much glucose in the system over time that it takes awhile for the insulin to "break through" and start lowering BG.

Here is another post explaining the dosing methods, the more aggressive one I mentioned is the Modified ProZinc Method towards the bottom. At minimum it requires testing around +3, +6, and +9 along with the preshots. Another difference between the two is reduction point - 90 vs 50. The 50 threshold can make some people really uncomfortable, and those lower numbers sometimes require testing hourly or more, and food intervention to keep them in a safe range. That said, those green numbers are where the pancreas is really healing, and often means a better chance of remission. So it's all what you're comfortable with.
 
Then I’m going for it. I feel comfortable 3 months into this journey. I’m tired of seeing her suffer. She is very thin and having problems with her hind legs. She’s been on 1U for 3 days and levels are getting worse and hardly a change at nadir. I just increased by 0.5 and will hold for at least 3 cycles as suggested on that incredibly helpful post about PZ. Thank you. I’ll be back soon.
 
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Mary Beth L said:
Then I’m going for it. I feel comfortable 3 months into this journey. I’m tired of seeing her suffer. She is very thin and having problems with her hind legs. She’s been on 1U for 3 days and levels are getting worse and hardly a change at nadir. I just increased by 0.5 and will hold for at least 3 cycles as suggested on that incredibly helpful post about PZ. Thank you. I’ll be back soon.
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I know how you feel!
I would follow the dosing sticky, it depends on the numbers you see. The minimum is to hold for 3 days before increasing if numbers are higher, then more towards 5 days as numbers get lower.
 
These numbers are very whacky and making me feel uncomfortable. AMPS 382, +3 255, +6 332 and +9 422. Is this normal?
Mary Beth L said:
Then I’m going for it. I feel comfortable 3 months into this journey. I’m tired of seeing her suffer. She’s been on 1U for 3 days and levels are getting worse and hardly a change at nadir. I just increased by 0.25. How long should I hold that dose there?
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FrostD said:
I know how you feel!
I would follow the dosing sticky, it depends on the numbers you see. The minimum is to hold for 3 days before increasing if numbers are higher, then more towards 5 days as numbers get lower.
Click to expand...
 
FrostD said:
Yes very normal!

Nadir was likely +4 or +5, so when you can may be helpful to get some of those to see.
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If I am reading my data correctly, I see a slight improvement as evidenced by lower pinks and reds than yesterday. Her nadir appears to be occurring around +3 and +4. I am going to stay the course for another cycle tmrw.

Assuming the nadir stays above 200 in the next 24 hours, would it be wise to increase by .5, total 2U and closely monitor the same as I have been.

I feel confident she’s going in the right direction but I’m looking for some reassurance. Thank you.
 
Mary Beth L said:
If I am reading my data correctly, I see a slight improvement as evidenced by lower pinks and reds than yesterday. Her nadir appears to be occurring around +3 and +4. I am going to stay the course for another cycle tmrw.

Assuming the nadir stays above 200 in the next 24 hours, would it be wise to increase by .5, total 2U and closely monitor the same as I have been.

I feel confident she’s going in the right direction but I’m looking for some reassurance. Thank you.
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I also want to mention is she underweight and thankfully she is eating. So I am feeding her 5-6x a day. She eats FF and Friskies Patè and in between meals, I am giving raw chicken and beef. This info might be necessary to know while I try MPM.
 
She can eat as much as she wants, as long as it's low carb!

Below 5U, increases are done in 0.25U increments. So if tomorrow goes like today, then on the morning if the 31st I would go to 1.75U.
 
FrostD said:
She can eat as much as she wants, as long as it's low carb!

Below 5U, increases are done in 0.25U increments. So if tomorrow goes like today, then on the morning if the 31st I would go to 1.75U.
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Thank you. Would you say there is a slight improvement?
 
Mary Beth L said:
Thank you. Would you say there is a slight improvement?
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Unfortunately, not really. Accounting for meter variance, you're seeing roughly the same numbers :/

I suspect you're dealing with glucose toxicity, so don't be surprised if you have to keep increasing before you start to see numbers come down. For most cats Ive seen here that's often around 3-5U, but they do usually come down in dose quickly once you break through the toxicity.
 
FrostD said:
She can eat as much as she wants, as long as it's low carb!

Below 5U, increases are done in 0.25U increments. So if tomorrow goes like today, then on the morning if the 31st I would go to 1.75U.
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Actually dose increases can be done in 0.5U increments if the nadirs are high, > 200 and using the MPM dosing method.
 
FrostD said:
Unfortunately, not really. Accounting for meter variance, you're seeing roughly the same numbers :/

I suspect you're dealing with glucose toxicity, so don't be surprised if you have to keep increasing before you start to see numbers come down. For most cats Ive seen here that's often around 3-5U, but they do usually come down in dose quickly once you break through the toxicity.
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I like the truth! Tula and I are going to keep on, keeping on
 
Hello I was just logging on to post an issue going on with my sugar boy. Tula seems like she's having the same sorts of issues. His clinical signs are getting worse and worse. He's become rabid with the water again and about 7 pounds we can't have him lose any more weight. Please advise. I'm doing a curve today!
 
ChristineS said:
Hello I was just logging on to post an issue going on with my sugar boy. Tula seems like she's having the same sorts of issues. His clinical signs are getting worse and worse. He's become rabid with the water again and about 7 pounds we can't have him lose any more weight. Please advise. I'm doing a curve today!
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Can you start your own separate post please and tag me?
 
Mary Beth L said:
+7 is 416, 1 hour after a big lunch. Is this normal? I apologize for the play by play posts but I want to make sure I’m still on the right path.
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That's a bounce - because she went from 355 down to 192 pretty quickly and her body isn't used to that, her liver "panicked" and dumped sugar into her body. Very normal! Frustrating but normal, will likely happen for awhile til she gets lower overall.

Normally a food bump from LC is around 50 points or less but ECID.
 
FrostD said:
That's a bounce - because she went from 355 down to 192 pretty quickly and her body isn't used to that, her liver "panicked" and dumped sugar into her body. Very normal! Frustrating but normal, will likely happen for awhile til she gets lower overall.

Normally a food bump from LC is around 50 points or less but ECID.
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LC and ECID?
 
Mary Beth L said:
Given the new black range data, does this indicate she has been experiencing glucose toxicity this whole time?
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It's a little bit hard to say, because she's had some low numbers here and there. So with the data you have it's possible she's just been bouncing for quite some time...it's common, and will eventually stop bouncing so high and for so long as she spends more time in lower numbers.

She sure did bounce high!! No chance she got some higher carb food?
 
FrostD said:
It's a little bit hard to say, because she's had some low numbers here and there. So with the data you have it's possible she's just been bouncing for quite some time...it's common, and will eventually stop bouncing so high and for so long as she spends more time in lower numbers.

She sure did bounce high!! No chance she got some higher carb food?
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Zero chance. My other baby, a foster fail, is on this roller coaster with us. She gets the same food minus the raw snacks bc she doesn’t like them.

“Spending more time in lower numbers,” means spending more time in the new low numbers since starting MPM?
 
Mary Beth L said:
Zero chance. My other baby, a foster fail, is on this roller coaster with us. She gets the same food minus the raw snacks bc she doesn’t like them.

“Spending more time in lower numbers,” means spending more time in the new low numbers since starting MPM?
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It's sort of relative for each cat and where they're at on the "journey". In this case Tula is used to 300s and 400s. So as she spends more time in yellows, her liver shouldn't freak out as much. Blues will probably make her bounce for awhile. But eventually her preshots will get down to yellows, and she'll spend more time in blues and won't bounce as much from them.

A cat that comes to mind is Susie. If you search for a post by "Summer and Susie", look at her spreadsheet in her signature. Up until this past week or so, she was bouncing and bouncing. Now her bounces are generally very short and her numbers are coming down.
 
FrostD said:
It's sort of relative for each cat and where they're at on the "journey". In this case Tula is used to 300s and 400s. So as she spends more time in yellows, her liver shouldn't freak out as much. Blues will probably make her bounce for awhile. But eventually her preshots will get down to yellows, and she'll spend more time in blues and won't bounce as much from them.

A cat that comes to mind is Susie. If you search for a post by "Summer and Susie", look at her spreadsheet in her signature. Up until this past week or so, she was bouncing and bouncing. Now her bounces are generally very short and her numbers are coming down.
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Ok. I will check them out. Tula is eating every time I feed her. She didn’t have ketones from her original dx. Gosh. Thank you so much for guiding me.
 
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