PZI expiration + need advise asap! Reading = 600+!

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rubyshoes

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My 10 year old, Zilly, was diagnosed almost 3 months ago. The vet who diagnosed him, as it turns out after almost $800 in fees, never had diagnosed a diabetic cat before. Most of what I've learned about this illness and advice for treatment has been here, so let me first thank you for being here.

I have run out of money and cannot afford to take him to the vet anymore. I started home testing a month ago and I'm at my wits end. He is not regulating at all and I fear the worst.

Could it be that his insulin has expired? The bottle of PZI states 9/2012 as the expiration, but I've also heard that it expires after a month of receiving it from the pharmacist. Does anyone know which is true? I cannot afford another $135 if the bottle I have is still good. I don't know how to tell. :?:

Additionally, I don't know where to go from here regarding the amount he's being given. I've tried to do a "curve test" but don't really understand how to interpret since every time I test him it is different (re: the same time of each day). His lowest test had been 385 (!) and now he's over 600 (!!!!). He gets twice daily injections after feeding (EVO, he won't eat wet food unless I syringe feed). He started at 1 unit twice daily and he's up to 2.5 units twice daily but it doesn't seem to make a difference.

Now, he lays next to his water bowl, drinks all day and has started urinating on all the rugs. I love him dearly, but don't know how much more I can take. If anyone has any insight as to what I need to do, or could do please share. :?: :?: :?: Thank you for taking the time to read this post.
 
Ok - take a deep breath --- and let it out.

Congrats for learning how to test blood sugar at home - that will help a lot.

PZI does last a good long time if handled gently and refrigerated with no freezing. Is it PZI from BCP or ProZinc? (these are slightly different)

Lantus can have a much shorter "life", officially a month, so maybe that is what you've heard.

With dry food, it is possible that your kitty needs a bit more insulin to feel better and reduce the peeing -- but we need to study your Blood Sugar records to see, ok?

We recommend testing blood sugar before every injection and then sometimes during the day. We call the before shot tests AMPS and PMPS for morning pre-shot and evening pre-shot. (we don't post actual times because we live all over the world and it gets too confusing with 18 different time zones and people all having different shot times anyway)

We recommend creating a Google spreadsheet to type in your blood sugar test data for sharing with us --- there are instructions posted on how to do that.

While it can be frustrating getting this information set up for us, it helps us give you SAFE advice that will help your kitty -- it can be dangerous to give advice without having enough information, and we are not vets (except for one or two...). We have diabetic cats and care about helping others.
 
Hi,
It sounds like both you and Zilly are having a pretty rough time of it. It is great that you posted about it, because everyone here loves a challenge, and loves to help!
Can you answer just a couple questions?

Do you give Zilly his shots 12 hours apart?
Do you test him just before giving him his food and his insulin?
Those are the two most important tests of BG that you need to do.
One other test, about 6 hours later will also be a great benefit.
If you can tell us what his numbers are/were before his AM and PM shots for the past few days, we might be able to make some sense out of his numbers. And if from this point onward, you can test him in between his AM and PM dose once around the mid-point, then we can see what the dose of insulin is doing or not doing for Zilly.

Later, we can talk about "curves" and testing several times a day. And we can talk about how to get him on a good wet-food low-carb diet. You said you are feeding him dry EVO, correct? Can you tell us which variety? EVO does make some lower carb dry foods, so it may be the best he can get at least until we convince him that the canned food tastes better!

He keeps drinking and peeing because his BG is still more or less non-controlled. We can help you get it under control, and it will make Zilly feel like doing something besides laying around the water bowl and peeing all over the house. I know you're overwhelmed and confused. So is Zilly. We want to help both of you!

Carl in SC
 
Some people succesfully use a bottle of pzi until it runs out. Try not to shake or drop it. If the insulin looks the same (slightly cloudy but with no clear "floaty" bits it's probably fine.

Hang in there! Testing is the hard part (okay, patience is really the hard part) but with patience we can help you both feel better.
 
ProZinc is supposed to be good until expiration date if refrigerated and handled gently with no shaking. There has been some discussion amongst PZI users if it possibly loses some of its strength when the bottle gets low. Some people think it does, by their cats reaction and others don't, so that is just an opinion. The official statement by the manufacturer of ProZinc is it is supposed to be good until expiration date. I assume PZI insulin is the same concerning expiration date, but I am not familiar with it.
If the insulin has not changed color or does not have crystals floating in or been left out in high temperatures for a long period of time, it should be good.
I am not one to give advice, my cat is hard to regulate and has a non conventional shooting schedule, but there are many people over in the PZI group on the board that are very experienced with ProZinc and PZI that can help you figure out whether your cat needs more or less insulin and can help you set up a spreadsheet so we can see what may be going on with your kitty.
Stop in to the PZI group and someone will help you. PZI is not as active as Health or some of the other insulin groups, but someone is always on in the mornings and evenings and will answer quickly.
Hope to see you there.
Angela
 
Many thanks to all of you for your kindness and taking the time to provide such helpful advice. I'm starting to feel like maybe with your help I can get Zilly regulated. @-)

I will now attempt to answer the questions posed and hopefully provide enough information to find the next step.

The insulin is in a box as I understand it should be kept out of the light. The BOX says that it is PZI, but the bottle reads "ProZinc". (I'm not sure if that helps.) After observing the bottle closely, I believe that the insulin is in fact okay. There are no crystals or particles floating. It has been kept refrigerated, never frozen and never shaken.

I was mistaken on the name of the food that he is eating: it is Innova, Cat & Kitten. (I tried the EVO dry previously and he was not interested). I understand that I should not change his food anymore until he is regulated, as I've read that changing that while adjusting the insulin provides inaccurate results.

His injection schedule has been in 12 hour intervals (am and pm), after feeding (the vet said he should have food in his stomach). When I check his BG it is done before he eats or has had an injection. The past three days I have checked it, the (Relion) meter reads "Hi" which is translated to "over 600" according to the guide. His poor little ears are taking a beating. That being said, over the next three days I will check it am, pm as well as a mid-point interval reading and share the results. I will do my best to provide the information in a spreadsheet.

Again, thank you all so very much. Stay tuned for results! :YMHUG:
 
Good it sounds like everything should be okay with the insulin!

About the food and the insulin. Sometimes, people change the diet before even starting with insulin. In my case, it was 3 or 4 days from the time Bob was diagnosed until I got the insulin in the mail. So I changed his diet, removing all dry food in that time frame. The benefit to that was that the diet change had a positive impact on his BG prior to insulin treatments, so I was able to start at a low dose because his numbers were lower.

We caution people that the change to low carb food can drop BG sometimes up to 100 points by itself. Most times, a vet will prescribe a dose while kitty is still eating "junk food", and when the diet change drops the numbers, the dose can then be "too high". So once insulin treatments have started, we tell people to transition to a good diet while keeping an eye on the test results, so that the dose can be cut back if the numbers indicate that it should be.

If you were to change Ziily's diet now to all low-carb wet food, we'd advise that you also pay attention to see if his numbers drop significantly, and then possibly reduce his dose accordingly.

Right now, with numbers in the 600s, we need to figure out why, and how to bring them down. That's why testing and posting your numbers will be a great help to you, to zilly, and to everyone trying to help out.

The injection schedule is perfect. It should be every 12 hours. And the sequence you are doing things in is also correct. Test first, then feed, then give him his shot. You need to test before the food has an effect on his BG, and you need to make sure he eats, so that it is safe to shoot him. You want the insulin going into a system that has a "full belly".

One suggestion - just to make sure the meter is working right. Test yourself. Poke your finger tip and test your blood. Assuming you aren't a diabetic, your number should be less than 100, maybe in the 70s or 80s. If that's what you get, then the meter is okay. If not, let us know right away.

Last thing for now. I sent a "PM" to you earlier, but not sure you realized that or know how to know when someone sends you a message. At the top of the screen on the left hand side, there's a link to "user control panel". There should be a message saying (1 new message) next to it. If so, (or maybe there's more than one), if you click on it, it will take you to your PM inbox, where you can reply or send PMs much like sending IMs or emails.

Keep us up to date, and somehow we'll all figure out what you can do to make Zilly feel better soon!

Carl in SC
 
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