Prozinc issues

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nookie088

Member Since 2014
My cat was recently diagnosed. The vet started him out on 2 units of Prozinc twice a day. I quickly found out was too much; I did a glucose curve and he bottomed out at 66.

Over the last couple of days I have changed his diet over to a wet and low carb dry mixture. His feeding time are 7 AM and 7PM. His injection times are 7:30 AM and 7:30 PM; he is now getting .5 units of Prozinc.

Now the problem, I still can't get him regulated. I am unable to check his BG during the day. I do however check it before each injection and at 10:30 PM every night.

4/13/14 7:30 PM - 550
4/13/14 10:30 PM - 240

4/14/14 7:00 AM - 503
4/14/14 7:00 PM - 420
4/14/14 10:30 PM - 403
- he got sick and threw up several times overnight
4/15/14 7:00 AM - 593

Is he getting to much or not enough insulin? The vet wrote script for Novolin N. He thinks the insulin maybe working to well and driving his BG to low and then he is rebounding.
 
I think it certainly could be that he is dropping low midcycle and bouncing back up! Especially if you have made a food change. The only way to be sure is to get readings then. Many working people set the alarm and get up 5-7 hours after the pm shot and test to see what is happening. The other time that might give you a hint (but doesn't always hold true) is to get a test before going to sleep. Sometimes the +3 number shows a fast downward trend if the dose is high.

I would not switch to N. especially if you are not around during the day. In many cats,that insulin is fast acting, taking the cat low down early in the cycle and then bouncing back up around 8 hours after the shot, not lasting as long as ProZinc. You would need to be able to monitor more, not less, with N.

Can you plan to do a curve the next day you have off? Get a test every 2-3 hours between the am/pm shot. That should give you a good picture of how the insulin is working throughout the cycle and whether he is experiencing lows and highs. The sooner the better. If he is dropping low midcycle, you run the risk of his hypoing while you are gone. Be sure to leave food out so he could try to bring himself up.
 
The BG values are showing a decrease, I would increase the dose to 3/4 or even to 1 unit twice daily. I would not change insulin
 
Sue and Oliver (GA) said:
I think it certainly could be that he is dropping low midcycle and bouncing back up! Especially if you have made a food change. The only way to be sure is to get readings then. Many working people set the alarm and get up 5-7 hours after the pm shot and test to see what is happening. The other time that might give you a hint (but doesn't always hold true) is to get a test before going to sleep. Sometimes the +3 number shows a fast downward trend if the dose is high.

I would not switch to N. especially if you are not around during the day. In many cats,that insulin is fast acting, taking the cat low down early in the cycle and then bouncing back up around 8 hours after the shot, not lasting as long as ProZinc. You would need to be able to monitor more, not less, with N.

Can you plan to do a curve the next day you have off? Get a test every 2-3 hours between the am/pm shot. That should give you a good picture of how the insulin is working throughout the cycle and whether he is experiencing lows and highs. The sooner the better. If he is dropping low midcycle, you run the risk of his hypoing while you are gone. Be sure to leave food out so he could try to bring himself up.
Click to expand...

I am going to set my alarm to get up at 1:30 tonight to test him. I plan on doing a curve on Friday while I'm off. The vet gave me a script for glipizide last Friday and said to give him a half pill with every meal. He said the glipizide would slow the effect of the insulin. It did but a little too well. He only dropped maybe 50 points 6 hours after his injection(1 unit of ProZinc on his old high carb cat food). I stopped giving him the pill and changed his food to wet & low carb dry mixture. I'll post his BG from tonight tomorrow AM.
 
Sue and Oliver (GA) said:
I think it certainly could be that he is dropping low midcycle and bouncing back up!
Click to expand...

Hello, and welcome to FDMB!

I absolutely agree with Sue that your kitty could be dropping low and bouncing up.

If we look at those numbers for the 14th April his preshot BG was 550(30.5), and just 3 hours later it was 240(13.3). And if we consider that the insulin might not have started to take effect until maybe an hour (or more) after the shot then your kitty's BG could have dropped 310(17) points in 2 hours. The speed of that drop alone would be quite likely to cause a 'bounce'.
But if we consider that he might have continued to drop at a similar rate for a further couple of hours then it's quite possible that he got into hypoglycemic numbers (unless he bounced before that point).

Do you know when your kitty usually has the lowest number of the cycle (nadir)?
And what glucose meter are you using?

With my own cat I find that getting tests two and three hours after a shot is a good indicator of how much he is likely to drop. And it may be that you can identify a time early on in your own cat's insulin cycle that gives you similarly useful info.

I know it's a bit of a pain to get up in the night to test, but, given the data you've given in your post, it's very important.

It's useful to put together a 'hypo kit' for times when numbers are low. And, as a minimum, it should include a high carb food (in gravy if possible) and a source of sugar such as syrup/glucose/karo. I'll find the link to the hypo info and post it here shortly. You may never need to use it, but it is as well to be prepared.

What is your kitty's name? And would you like to share your name with us?

Eliz
 
Great that you are planning to get an overnight midcycle and eventually a curve. That information will be very helpful.

I would not use glipizide on its own and especially not with insulin. It is thought to tax the pancreas instead of letting it heal like insulin does. Using it with insulin with an unregulated cat with possibly volatile drops could be very dangerous.

Here is our ProZinc protocol. It may be helpful.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=109077
 
Elizabeth and Bertie said:
Do you know when your kitty usually has the lowest number of the cycle (nadir)?
And what glucose meter are you using?

What is your kitty's name? And would you like to share your name with us?

Eliz
Click to expand...

I did a curve when he was on his high carb dry food about 2 weekends(2 units of Prozinc) ago and he hit 60 five hours in; I gave him some honey right away. At 6 hours he was at 88 and the rebound to around 600 at 12 hours. So I am guessing his lowest point will be at hour 5 or 6.
I am using a ReliOn Confirm meter. Got if from Walmart pretty cheap.

His name is Jay and my name is Paul.
 
A nadir of 60 mg/dL on a human glucometer does not require intervention; its a beautiful number. Here's our pet-specific reference numbers for human glucometer readings.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


* * * * * * * * * * * * * * *​
Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
Hello Paul,

I hope you got back to sleep OK after getting up to test Jay last night.

Here are links to 2 pages of info about hypo and about handling low test numbers. It might be that you never need to use this information, but I strongly recommend having a good read through (and maybe even printing it out for reference: it can be handy to have around in an emergency). If you do find yourself facing very low BG numbers it's extremely helpful and reassuring to have read some info beforehand.
viewtopic.php?f=28&t=15887
viewtopic.php?f=28&t=61799

Do ask any and all questions you want to. We're here to help.
 
Well the wife and I got up at 1:30 to test Jay. First off his BG at 7PM was 545. He ate at 7PM also. I gave him 1/2 a unit of Prozinc at 7:30PM. At 1:30AM his BG was 499. At 7AM this morning his BG was 398. His nadir must be at hour 7 or 8. So we will get up at 2:30 tonight to test. Also at 7:30AM this morning I gave him 3/4 a unit of Prozinc. Will post tomorrow AM with the results. Thank you everyone for your advice.
 
It's great you are getting some numbers. The more data, the better you can determine the best dose.

We use a great Google document - a color coded spreadsheet - that easily shows the history of dosing and numbers. And you can attach it to your signature so when you want some immediate advice, we can see what has been going on. If you check other people's post, you will see it attached. Here are the directions:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

It's a little tricky so ask for help if you need it.
 
With ProZinc, I find the nadir can be earlier than +6.
When I tried it for Spitzer, it was around +5; he had some other medical problems.
For Gracie, she seems to nadir about +5.5 hours after the shot.
 
Barb & Mr. Frog said:
Just curious about the food, you mention a low carb dry /wet food mixture, which dry food, and is the wet low carb?
Click to expand...

Friskies classic pate and Evo dry. Much better than the Meow Mix I was giving him. Looking to try the Friskies flaked as it has higher protien, lower fat and the same amount of carbs as the classic pate.

Update from last night. At 7PM his BG was 458, gave him 3/4 unit of Prozinc at 7:30PM. At 2:30AM his BG was 381. At 7AM this morning his BG was 539. I increased his dosage to 1 1/4 units. Going to get up at 2:30 tonight to test and will do a glucose curve on Friday.
 
Hi -

Just chiming in to concur with Sue & Eliz. I would be reluctant to use Glipizide while using insulin and not being home to keep an eye out. I think of it like this - we only have control over 2, maybe 3 things with our kitties: insulin injected, food offered, and maybe exercise, depending on the kitty. So many other variables that they control. When I make a change, I want to do one thing at a time. If it's food, or a dose change... I want to know what is triggering the result, without question.

The other thing I would offer is my experience on bringing up a low number. I've used Karo Syrup (honey works too) rubbed on the gums or poured on the food. I've also used Fancy Feast (FF) gravy foods. First time, I saw a low number, I gave him a can of gravy - think he jumped 100 points in 20 minutes! YIKES!!! Now I do a spoonful of gravy FF w/ 1/4 or 1/2 can FF Classics. I also recheck within 30-60 min, as sometimes the food OR the Karo can bring them up, but then they drop back down.

Kudos for you for catching the low. Happy to offer up other suggestions/ideas if I can.

Lu-Ann
 
Hello. Welcome to FDMB. I have been reading your thread and have been following your kitty's progress. My cat, Merlin is also on Prozinc. I found that his nadir is typically at +5 too. I think it takes a while to get regulated. We are still not there but that is my goal too. I found that I wanted to try things (maybe too fast and too much) in order to get those good numbers but in reality, there is a lot of trial (and sometimes errors on my part) before we make one small improvement. Just wanted to reiterate, to take things slowly...the whole process and procedures will get better for your kitty and you.

Also, just wanted to share my experience regarding wet food. Merlin was totally on dry forever (he is 16 years old) even after he was diagnosed. It wasn't till five months after his diagnosis when I found this site and I made the change from dry to wet. His dry food was the really good stuff too, Earthborn. Anyway, it took me about 10 days to transition but once I was totally on wet, low carb food, I saw a huge difference. I am not so sure the change was in the BG numbers but definitely in the amounts of insulin I was giving him. I was giving him 3U and sometimes 4U two times a day. Once he was 100% on wet food, his insulin intake decreased drastically. I went from 3U to 1U. It was so exciting and think of all the money I was saving too!

As I am sure that you have already figured out, this is the place to be. Great people with lots of expertise is willing to help us newbies. I was looking at your spreadsheet and noticed the comment on the top right cell of you feeding 30 minutes prior to injection. Wasn't sure when you were testing but I learned here that it is better to not feed them two hours prior to your AMPS and PMPS test. That gives you a better reading for you in order to make a decision on how much insulin you should give. Then after I get the BG number is when I feed (and I give Merlin his shot while he is eating).

Anyway, hang in there...you are doing great with your testing.
 
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