Prozinc experiment, possibly on the way to trying Levemir

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Squeakycats

Squeakycats

Member Since 2017
Hello, everyone! My kitty was well-regulated for a few years on Lantus (even going into remission a couple of times), but he hasn't been doing so well for the last couple of years. It seems impossible to get him into good numbers for most of the day without him randomly becoming hypoglycemic on a semi-regular (yet unpredictable...) basis. We've tried to rule out everything that might be causing problems--he has no untreated dental problems, no infections, no active pancreatitis, nothing else that shows up on an exam or bloodwork. We tried him on once-a-day (morning) dosing just to see if that might work; it didn't (we avoided the hypos and got nice daytime numbers, but his numbers shot up tremendously overnight, as you might expect).

His vet thought it might be time to experiment with a new insulin, so we've just started ProZinc. We'll give it a good thorough try, but I'm wondering what might be next if it doesn't go well. I have read some posts here where people say that their kitties do wonderfully on Levemir but not Lantus, and I'm wondering if any of those folks could tell me more. If you switched from Lantus to Levemir, why was that? What changes did you notice? How does Levemir seem to work better for your kitty? I'd greatly appreciate any input!

PS I don't have a current spreadsheet posted for my kitty. I may get one up there and start asking for more detailed advice soon, but right now, I'm just hoping to learn more about the Lantus vs. Levemir thing.
 
Thanks, Deb! I have been reading the Prozinc material here, and while it's very clear, it also seems like Prozinc works quite differently from Lantus, so I am sure I would benefit from advice. I'll try to get his spreadsheet tidied up ASAP! It would be great if it works for him; I'd like to get the poor little guy feeling better again.
 
Even SS tab with the most recent time frame, since you started the Prozinc would be helpful. Doesn't have to be months worth of data.

You can add a new tab to your existing workbook. No need to create an entirely new one.

Directions are here.
**2020 Spreadsheets--PLEASE READ **

Unfortunately, Marje is out right now. There is one other person (not me) that can fix spreadsheets if you need a hand.
 
I started on Lantus since Livemir was not available in USA. I switched one of my cats to Levemir since he was a high-dose (acromegaly) and Levemir was supposed to sting like Lantus stings. I really did not notice a difference even though literature at that time said Levemir was a little more potent. The link to that literature is now dead. I then switched my other cats to Levemir once Lantus was used up to only have to use one insulin. Some time later I got a good deal on a vial of Lantus and switched all but my high-dose cat back to Lantus and not no significant difference. One the Lantus was used up I switch those cats back to Levemir and noticed no significant difference. Overall I think Levemir resulted in a lower overall BG with a more level, lower curve.
 
I switched Neko to Levemir because I was tired of the bouncing during the day and going low at night. it got tiring fast! She was also a “higher dose” cat, though on about 1.5 units when I switched. The first time her dose was higher she was on Lantus, second time on Lev. I think she did feel Lantus sting. We have had several people switch just for that reason. One person had to stop insulin until she got Lev. It was that bad, :(

It’s ECID on how cats react on Levemir. I think the majority flatten out, but some don’t so no guarantees. For me personally, I got more sleep at night. Neko was flatter so I got longer naps between tests. Eventually she became a flatter Lev cat. Note that it can take a few months for them to learn how to use the new hormone/insulin.

Seconding Deb, spreadsheet please. Even the last couple weeks of data is a good start.
 
Thanks, everyone--and hi, Wendy! You were such a huge help to me back in the earlier part of the Lantus journey. My kitty doesn't seem to be bothered by any stinging, fortunately--the problem was similar to what you described with Neko. The dose he needed to get decent numbers during the day would lead to major bouncing at night; I was routinely up 3 or 4 times a night responding to him waking me because he was going too low and needed to eat. At the vet's suggestion, before switching to Prozinc, we went ahead and tried some unorthodox Lantus "experiments"--adjusting the evening dose instead of using the same dose morning and evening (I know the nadir is what matters more than the shot-time number, but what the heck, seemed worth a try), and then when that wasn't going well, giving the Lantus just once a day. With the latter approach, his daytime numbers didn't include any big ol' drops, but by morning they were awful, so I was ready to move on to the Prozinc experiment, but there was chaos at the vet's office (one of them had surgery and the other was going crazy trying to cover for her), so there was a delay in getting a plan together for that. While we waited, I performed yet another little experiment by raising his dose higher than it's pretty much ever been (around 1-1.5u was typical for him for most of his time on Lantus). We were starting to get some interesting results there, but when the arrangements for the Prozinc came through, we decided to go ahead and move on--since we'd been using the Lantus without real success for a long time and the vet and I both had high hopes that the Prozinc might do the trick.

So here we are just a few days into Prozinc-land. The vet wasn't sure whether to start him on 1.4u or 1.2u. I was inclined to start lower, figuring we could always raise it (a la SLGS), but based on his weight the vet thought 1.4 was more appropriate, so we did that. But when we got what looked like a possible bounce during the first cycle (from 106 to 412 over the course of a couple of hours, without eating), I dropped back to the lower one. He had a horrible number this morning; all I can guess is that my husband, who almost never handles the "cat stuff," messed up somehow last night and fed the wrong food or gave a furshot (I left a filled syringe).

I am not known for having an extensive wardrobe of patience pants--the one pair I have is usually in the wash--so I know I am about to receive a virtual smackdown for changing things too frequently. I have earned it and will try to endure and change my evil ways. It's just so hard for me to see him uncomfortable and feel like there must be *something* that we could do--some change we could make--that would get us on the "right" path, so things could settle down for him and for overly-anxious me. But maybe there is no such path, and he's just an all-over-the-map kind of kitty (he's always been "bouncy," for sure). Or maybe there's just no way to quickly stumble onto it. Anyway--the recent spreadsheet is here, and I greatly appreciate all tips: https://tinyurl.com/tgyoe6k Sorry about the pet meter--I used a Relion one for years but the vet really, really wanted me to use the AT while we are trying to figure out what works best. The gray lines mark places where we made some kind of switch--the switch to Prozinc was just a few days ago.
 
No worries.

We all want to get our cats feeling well.
Squeakycats said:
I am not known for having an extensive wardrobe of patience pants--the one pair I have is usually in the wash--so I know I am about to receive a virtual smackdown for changing things too frequently. I have earned it and will try to endure and change my evil ways.
Click to expand...
Nope, not gonna happen, no smacking allowed here. Not into violence.

We'll still work with you, and get you a couple of extra pairs of patience pants along the way. Plenty to share. Need to know your favorite color first.

With the tinyurl link, we won't be able to see the updates you do to the SS. Plus, you will have to add it to your post every time.

That is why it's better to update and add a tab to the existing SS.

Or you could add a second link in your Signature. But that new link should be for all data you gather. Please don't be switching back and forth between spreadsheets for 1 meter versus the other.

Also, changing signature and heading on the SS to indicate current insulin is a tiny thing, but a big help.
You might make a note that you are using U100 syringes for dosing the U40 insulin, but recording the dose amounts on the SS in the U40 amounts. People do it both ways. Ran into one of those situations (giving U40 insulin, record U100 syringe amount on the SS) this week. Need to know which way you do it.

I prefer seeing the U40 insulin amount. Don't need to see the amount of insulin on the SS in U100 syringe measurements. If that is what you are doing. Using the conversion chart for U40 to U100 syringes.
 
Oh, I'm sorry, I didn't realize the tinyurl wasn't a permanent thing! I'll put stuff in the signature and fill it out fully, and I'll try to move the Lantus stuff into a separate tab from the Prozinc. That should make it less of a mess! I'm definitely trying to record the U40 amount, despite using the U100 syringes and conversion chart to administer it, since I have a bazillion U100 syringes around. Thank you for non-smacking and patience pants donations--any color will do! Edited to add: I think I'll just pull everything out of the signature until I get that done, to avoid increasing confusion. Should be able to work on it in the next few hours.
 
Yes, spreadsheet is working, though looks like old data is gone now. Old data could be kept in a different tab on the same spreadsheet.

As with Lantus, those night time spot checks before bed are still recommended. Looks like a really big drop yesterday morning (or last night) caused today's bounce.
 
Misha looks rather good on the 1.2U of Prozinc.
He already got down into the blue range numbers.
Using U100 syringes with a U40 insulin works quite well.
Love when people are able to do that.

Thanks for the SS update, and noting at the top that you are using the U100 syringes but recording the dose in the U40 amounts.

Echoing Wendy's reminder to get PM cycle tests. If you aren't testing at night, you are missing half your data as Sienne and Gabby (GA) would say.

Patience shorts, blue with a touch of yellow. To match Misha's mid-cycle numbers.
Shorts, because we had a heat wave of 65 F (18 C) today in coastal Massachusetts.
Liquid_Force_Wmns_Drop_Shorts-2T.jpg
 

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Those are some classy shorts! OK--so I'll start getting night tests for the Prozinc (and not just depend on him to wake me up if he's going low!). I'm encouraged to hear that you think it's good for him to be getting blue numbers at this point! And maybe I can do a second link for his older spreadsheets, which were with the Relion meter. Thanks, y'all! I'm sure I'll be bugging you again soon ;)
 
Hahaha! Excellent lions!

Any thoughts about last night's numbers? I know I need to get more, but it's interesting that he seems to have just dropped a little before heading back up--so maybe there wasn't a bounce after all? Could he need to be on the slightly higher dose (1.4 u instead of 1.2)? Too soon to say? He's pretty symptomatic, unfortunately--eating ravenously, drinking and peeing a ton, looking scruffy because he's not grooming enough...in that regard, he was better on the Lantus even when his numbers weren't consistently where we wanted them (he wasn't eating/drinking excessively).
 
Squeakycats said:
Could he need to be on the slightly higher dose (1.4 u instead of 1.2)? Too soon to say?
Click to expand...
Too soon to say. You can't rush it, or you'll wind up in the same situation your were before with the Lantus.

Patience young grasshopper. (I'm dating myself, with that old "Kung Fu" clip from a 1970's show.)

I'm still at the beginning of learning wisdom. Expect to be there for the rest of my life.
 
Good morning, friends! Misha's numbers look crappy to me, but I have stopped myself from trying a dose increase, thanks to your gift of those very fashionable patience pants. His vet's initial instructions were to go for 7-10 days, do a curve, and report in. I am guessing the vet will say we should go to 1.4u, but of course I can't know for sure, and they're not open over the weekend. He won't care if I adjust it myself, though; I think I do more monitoring than 90% of his patients, and he knows I understand what hypos are and how to handle them.

What would you do? Do I need to go ahead with a full curve to be sure I'm not missing a nadir, then decide based on that, using one of the Prozinc protocols? I see that SLGS recommends a lower starting dose for most cats, but I would think Misha would fall under the rule that "If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration." I see that he had 3 numbers under 150 (101, 106, 148) during his first few days on the Prozinc, all between +3 and +6, and the protocol says "If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose."

BUT!!!!! The protocol uses numbers from human meters. Based on experience, I would expect each of the numbers in that general range to be around 20-30 points lower on a human meter--the AlphaTrak always reads higher, though that difference is less dramatic in the lower range than the higher range. I would expect some of these 500-ish numbers he's been hitting with the AlphaTrak to be more like 400's on my Relion meter. (I know there's no direct comparison, though my husband, a literal rocket scientist, insists he can makes me some kind of translation-from-human-to-pet-meter chart using magical calculus if I give him enough numbers...I did use both meters for a while to get that sort of data and just need to round it up and hand it over to him.) But I guess the colors in the chart have already been adjusted...so maybe it makes more sense to say that he's gotten a few "blue numbers" but few yellows, no greens, lots of pinks and reds, and a few blacks.

I see that the more aggressive modified protocol says "If nadirs are 50-100 [which would be greens], hold the dose for additional cycles. If the nadirs start to rise, then increase the dose by 0.25u. If nadirs stay in green numbers (50-99), continue to hold the dose." He's not getting anything green, and spot checks suggest his mid-cycle numbers are rising over what they were the first few days. This protocol says to hold doses for 6-10 cycles (3-5 days) during the initial adjustment to the insulin, then begin to adjust after only 3-6 cycles.

Anyway--what do I need to do to determine whether it's time to increase the dose a little? Do I need to start using a human meter again? If so, I guess I'd use it in addition to the AlphaTrak, since the vet *really* wants the AlphaTrak numbers, and he does--to his great credit--actually review numbers I send and comment on patterns, etc. (he will love the spreadsheet). I hate how expensive the strips are, and he and my other kitty (who may have early-stage CKD--the vets disagree about this) have been breaking the bank lately with medications and vet visits, but I know I need to suck things up right now to have the best hope of getting him stable in the long run.

HELP! And THANKS!
 
I think your idea to get a full curve before any changes has merit. You do want to make sure you catch that nadir. Yes, a dose increase may be warranted, but there's no rush.

Honestly, I bullied my vet into accepting our readings on a human meter. But as you have both, why not use the human meter for day to day, and when you get a curve, use both. Human meter for you, pet meter just for the vet to understand the curve numbers better. You can warn the vet that your spreadsheet is done with a human meter.
 
Curve first. 7 to 10 days on this dose. It can take time for a cats body to adjust to a new insulin.

Squeakycats said:
I see that the more aggressive modified protocol says "If nadirs are 50-100 [which would be greens], hold the dose for additional cycles.
Click to expand...
The MPM (modified Prozinc Method) is basically TR for Prozinc. With a few modifications specific to an in-and-out insulin.

Squeakycats said:
Anyway--what do I need to do to determine whether it's time to increase the dose a little?
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You need another pair of patience pants. Even if you decide to follow the MPM more aggressive protocol method, you need to wait at least 1 or 2 more 12 hour cycles before increasing.

He's bouncing off that low of 101 on 3/2/20. HARD. You need to give the bounce time to clear before you decide to keep the dose or increase. Patience.

The higher the bounce, the bigger and faster the drop. 476 to 101 in 3 hours is one heck of a drop. 375 points. 125 points an hour. Misha is bouncing from that, intensely right now. His body was trying to protect him, by dumping glucose and hormones into his body, to bring him back up to a safer level.

Uncontrolled drops = big bounces. You may want to try "feeding the curve" to stop the drops from being too steep and/or fast. Steering the numbers. Providing small snacks at certain points during the day.

Or if you are home to monitor, you can steer the BG numbers more closely. Takes more monitoring. You'll really want to get a human meter if you decide to go that route. Contour Next one is very accurate, high ratings from Consumer Reports and human diabetes websites. 32 to 37 cents per test strip. (I just costed it out for someone else)

Do you feed Misha around +1.5 to +2? Other times?

You don't take the dose back up, if the bounce is starting to clear. That will simply make him bounce again and more intensely.
Squeakycats said:
What would you do? Do I need to go ahead with a full curve to be sure I'm not missing a nadir, then decide based on that, using one of the Prozinc protocols? I see that SLGS recommends a lower starting dose for most cats, but I would think Misha would fall under the rule that "If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration."
Click to expand...
Hold the dose. At least 1 more and possibly 2 more cycles. Then a curve. Then maybe an increase if it's warranted.

Yes, Misha does fall under the "if cat previously on another insulin" rule. But you were overdosing him on the Lantus anyway.

AND the Lantus depot has to totally drain first, so that "depot" under the skin is accentuating the bounces and drops these first few days on Prozinc and giving you even wilder BG readings. It can take several full days to drain the depot, usually a minimum of 3 days or 6 cycles. Sometimes a few cycles more.

You went directly from using Lantus to using Prozinc and it's a "darn" good thing your vet started Misha at that low 1.2 U dose of Prozinc. (Ok, I'm scolding you a bit here. I fully admit it.)

Squeakycats said:
(I know there's no direct comparison, though my husband, a literal rocket scientist, insists he can makes me some kind of translation-from-human-to-pet-meter chart using magical calculus if I give him enough numbers...I did use both meters for a while to get that sort of data and just need to round it up and hand it over to him.)
Click to expand...

Member BJM did that "rocket scientist" comparison years ago, back in 2013, with a few of us providing the numbers for her chart. Not officially sanctioned though, so don't think I should share it. The so much % solution, Sherlock Holmes. (It was more than that %.) Can't find the spreadsheet anyway.:(

Time to take up yoga? or meditation? or mindfulness breathing? connect with nature? tell us to go fly a kite off Mohegan Bluffs?
https://theconversation.com/why-we-are-hard-wired-to-worry-and-what-we-can-do-to-calm-down-127674
 
pink panther pants.jpg


p.s. you don't need separate spreadsheets for different insulins.
 

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Ah, ok, I didn't realize it could take THAT long for a bounce to clear--I always assumed they'd clear within a day or two. Oh my. Poor little guy. Sounds like the best thing might be for me to NOT hang around all day watching and poking him, at least for a few days. I'm freelancing right now so I work at home, which is great in terms of being available but maybe not so great in terms of feeling like I should always be DOING SOMETHING RIGHT NOW!!! Going hiking usually makes me more sane; I should do some more of that, perhaps. I will carefully read the article! I have actually been through a whole mindfulness-based stress reduction class three times (liked it so much the first time that I did it twice more), and it was very helpful when I was going through cancer treatment, in terms of not living in a constant state of freaking out--I've gotten really slack since then. We moved recently, and the area we're in now (Northern New Mexico) is beautiful, so getting outside more probably really would be good.

Feeding: he has his freeze-dried raw food available pretty much all the time in case he needs a snack, and I usually offer him canned food at shot times, right after testing (he usually eats maybe 1/3 of a small can). It's all very low carb. Left to his own devices, he mostly eats at night, and I think it's largely snacking--go for a bite, snooze a while, go for a bit more, etc. If he runs out of food, he makes sure I get up and get him some more. I know free feeding is controversial and can make it hard to get accurate curves, but it makes me less anxious to know that he *can* eat if he's feeling really hungry, and he has never been one to eat a ton at once, even when he was a kitten--he's just kind of a nibbler (unlike my other kitty, who will gorge until she barfs and then immediately want more to eat, if she's allowed to do it her own way...I have a special feeding box for him that she can't get to).

He does respond well and rapidly to medium-carb or high-carb food--it's always been easy to pull him up if he goes too low. So I could try dispensing some medium-carb food routinely at around +2 if that would be helpful--I might have to wake him up to get him to eat, but it's enough of a treat that he'd probably do it. I don't know that this is something I'll always and forever be able to do as just part of his routine, so I don't know if I want to become dependent on it, and I don't want to screw up the data--but maybe this is something that would help him stabilize? Hmm. (I know he would say "Yes, this is the best idea ever!!! Give me the gravy food!" if he were participating in this conversation.)

The vet actually wanted me to do 1.4u, based on his weight, but I think the vet would've approved of dropping to 1.2. Do you think I need to back off even more?

I do have a human meter--it's what I always used until I started working with this vet. This guy is the former president of the Winn Feline Foundation, a total cat research fanatic, and also very caring and curious; I feel really lucky to have him as a resource, which is why I was willing to consent to using the pet meter. No other vet has been able to persuade me :p The trouble is that after all these years using the human meter, those numbers are stuck in my head--so seeing a number like 500 makes me totally lose my mind, when I guess it's not as bad on the AlphaTrak (still bad...but maybe not AS bad). He was very sick when he was first diagnosed--he had lost a bunch of weight and wouldn't eat (thought we were going to have to do a feeding tube)--and yet his number was only something like 380, so I guess that's also in my mind when I see the higher numbers and have the impulse to change things too soon.

So what I'm taking away from my little self-directed therapy session here is that I'll do the following:

1. Get a grip
2. Give him a couple more days on the current dose (to clear the bounce), then do a full curve and consult with y'all (and perhaps the vet as well) about next steps based on that data--maybe a curve on Sunday?
3. Give him just a tiny smidge of a higher-carb food (maybe around 7-10%) at around +2 to slow the drop a little
4. Return to using the human meter most of the time, knowing that this will probably necessitate using *both* meters on curve days (since I'll want numbers for the human meter chart as well as pet meter numbers for the vet); also get the husband to do his numerical thing and experiment see whether it's good enough to predict one meter's number based on the other's. This will also mean having two spreadsheets, I guess. (I know I don't strictly speaking have to have different ones for the different insulins, but it helps me to separate them visually somehow; I don't want to get confused about what 1.2 on Prozinc means vs. what something similar like 1.5 on Lantus means.)
5. Put on pink patience pants while washing yellow ones. Consider buying even more patience pants! Heck, I probably need an entire patience outfit.

Please scold me without hesitation! Misha is the sweetest, smartest, most tolerant and affectionate kitty ever, and what I want most is just to get him feeling better and get him onto a smoother path. He doesn't deserve to suffer from my anxiety and/or ignorance, and reminders of that are very helpful and motivational! Thank you so much for taking the time to help me through this Prozinc adventure--be assured that even if we have to go back to Lantus or on to Levemir in the future, I will apply what I'm learning (like that it can take so long for a bounce to clear...good grief...I truly didn't know).
 
You're doing great. Deb is giving you excellent advice and you are collecting a wardrobe full of patience pants. We get it. We do. It's so hard not to turn into a complete kitty helicopter parent with all this going on. Just keep reminding yourself that in the case of feline diabetes, rushing the treatment does nothing but cause further problems. This really is a case of slow and steady wins the race. We just get impatient because we want our sweet sugar cats to get better right now! But I bet you anything that Misha is already feeling better than before he started treatment. Pay attention to his behavior, and signs he's feeling better right now. Focus on today rather than the end of the journey.
 
1. Yes. grip
2. Yes. time to clear bounce
3. Yes. food at +2

No on the gravy food at +2. You only need to give him some of his regular low carb food then, to slow the drop.
Medium carb food is actually 10-15 percent or so.
High carb food is 16 % and up.
4. Yes, human meter
5. More for the patience outfit. Jacket to go with the pink patience pants sent earlier. :p

Pink motorcycle jacket small.jpg
Boots next? Already have all this stuff on my computer, only have to upload it. Although I don't think the boots would fit over the top of the pink panther slippers in the last pair of patience pants.

Squeakycats said:
I'm freelancing right now so I work at home, which is great in terms of being available but maybe not so great in terms of feeling like I should always be DOING SOMETHING RIGHT NOW!!! Going hiking usually makes me more sane; I should do some more of that, perhaps.
Click to expand...
Feeling the need to "do something right now" is all too common. We want our pets to get better, feel well, be happy all the time. We want to do our best for them.

We hope that with your new vet and our assistance, Misha will get there. Happy cat = happy owner. Trite but true.

Think of anything we say here as something you can and should pass by your vet. After all, we are laypeople. Still lots of experience with feline diabetes, but we can miss things.

Northern New Mexico is beautiful. Haven't been in New Mexico for years, but have been around many places in the state - birding trips, family vacations, exploring.
 

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Quick visual assessment you can do for Misha. Appetite and the 5 P's, - purring, preening, playing, pooping, peeing. All good, then you know things are getting better. If there are 1 or more of these areas that are still having issues, then you know you have more work cut out for you. Sometimes, too frequently, we focus on the BG numbers too much and need to ask how the cat is feeling. You too.

I realize that you said Misha is more symptomatic on the Prozinc. Hopefully that will improve soon too.

Time to go take a hike.
 
Yes, behavior-wise, he was mostly doing ok on the Lantus. There were a few days where he wasn't grooming himself or spent the day hiding under the bed, but for the most part, he was ok--he was just getting crappy numbers (both at home and when the vet did fructosamine tests). He is now drinking and peeing too much and seems to have a bit less energy. But we'll see how things progress! Thank you for this helpful reminder to look at the big picture.
 
Curve underway here, but I'm thinking it's time to go up to 1.4 u tomorrow morning if nothing interesting happens tonight (I'll try to get a reading around +4). Sound ok? I don't want to forfeit my beautiful pants!

Other than being ravenous, drinking too much, and not liking to get poked every few hours, he seems to be hanging in there all right. Hope everyone is having a good weekend!
 
Oh my gosh, what is he doing? :eek: Decided to start the 1.4u last night because I knew I'd be able to check him frequently, and it seemed like things went fine--got a nice blue number at +6. I was able to check at +6 today, and he was at 308, so it didn't seem like anything particular was happening--but tonight at shot time, he was in the light green (56 on the first measurement, 52 on the second one--this is on an AlphaTrak meter still). I swear I didn't go give him a shot in the middle of the day or something, and I'm being very careful with measuring the doses! I gave the morning shot in the flank rather than the scruff (I alternate, but the scruff is usually easier); could that matter somehow?!? I can't think what else could be different. Obviously I'm skipping his shot tonight and going back down to 1.2 tomorrow, until I can reach the vet, I guess. (And I've fed him some medium carb food and will check him again soon, etc.)

How is this happening with an "in-and-out" insulin? What is up with this kitty?
 
Giving the insulin in places other than the scruff can mean the insulin is absorbed more quickly. I’d stick to places other than the scruff.
Any number under 68 on the alphatrak is a take action number so glad you have some higher carb food. Did you test again? Sometimes if the low number is at Preshot, you only need to give some low carb food to bring the BG up, as it is at the end of the cycle and the insulin is wearing off. Data collection will tell you what carbs work best in that situation.

I was another one who swapped from Lantus to Lev. I loved Lev. I found the onset later... around +3 and the nadir later as well which usually meant the curves were flatter except when Sheba bounced which she loved to do. She also seemed more settled and calmer on the Levemir
 
OK, I'll try to do the flank consistently if he'll let me. I fed him some medium carb food at shot time, then again about 20 minutes later, and he's now back up at 79--of course I'll keep checking and feeding until he seems to be in the clear (this is not our first pajama party, alas). Fortunately he's always good about eating his special "treat" food when I need him to! This poor little guy, just bouncing all over the place. I swear I am measuring super-carefully and repeatedly, storing the insulin as directed, etc. This is such a puzzle. I'll be very curious to see what the vet says.

That's awesome that Sheba did so well on the Levemir! Thank you for leaving her spreadsheet up--it's so nice to open one and see all those pretty blues and greens. She was a gorgeous cat!
 
I did the scruff or below the shoulder blades for 5 years with no issues. Neko didn't like being poked in the flank, I reserved that for fluids days.

Small request, could you either start a new thread or change the title? The discussion seems to have wandered from "From Lantus to Levemir".
 
Yes, it sure has--sorry! I'll change the title for now, but should I be moving this to the Prozinc thread?[ Edited: sorry, I mean Prozinc forum]
 
Squeakycats said:
I gave the morning shot in the flank rather than the scruff (I alternate, but the scruff is usually easier); could that matter somehow?!? I can't think what else could be different.
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Location, location, location. As true for insulin shots for your cat as it is for buying a home.

Prozinc ISG (Insulin Support Group ) would be good for the new thread.
 
I'll jump on over there. Last night's incident didn't get any less weird as time went on--I was up feeding him decent-sized portions of medium/high-carb food (a kind that has always worked great in the past for him) and he just kept staying low--and even this morning, after having been fed all night and not getting a shot last night, he was at 366 (not great, but the lowest AMPS he's ever had on Prozinc). I decreased his morning dose a lot (went from 1.4 to .8) and am awaiting a message from his vet.
 
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