Question about Prozing protocol

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prairiecat

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I am posting I do believe in the correct place for Prozinc concerns. My furbaby Tiny is doing well but I have some concerns about timing his shots. First of all, at nadir he was very low, around 40, and at 12 hours he was closer to 100 than 200. After decreasing his dose I still have good numbers at nadir (77) but at 12 hours I am a tad under 200. I waited and gave him his shot at 15 hours as his BG was above 200. This is where I am confused. Is the 12 hour schedule set in stone? Should I hold the injection and just give at the next scheduled time? When I held it for the 12 hours he was above 300. I have experience with human diabetics, but not kitties! :? Thank you for the help.
 
Welcome! Yes, this is a good place to post about ProZinc, especially for dosing questions. We are a small forum so you may not get an immediate answer. If you have an emergency, post on Health where there are more eyes.

Could you set up a spreadsheet? It really helps you and us see patterns of numbers and dosing, and is very helpful when you talk to your vet. Here are the directions:

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

It's a little tricky, so if you need help, just ask.

It may be helpful for you to look at the other posts on this forum and check out their spreadsheets. although every cat is unique, you can see how other cats are reacting to doses.

It is hard to tell from your description of the two cycles what is going on with Tiny. The insulin is definitely working as he is dropping at nadir. It is possible that he drops lower before or after that midcycle number you have gotten and then is bouncing back up for the preshot. Or maybe his preshots just are a little higher. What might help is to get a curve - that is, get tests every couple of hours over a cycle (say at +3 to see when he starts moving down, and +5 and +7 to see if you definitely have the lowest spot and then around +8/9 to see when he heads back up). Then you'd have a real picture of what is happening.

One of the nicest things about ProZinc is that you can vary things. So, for example, if you find that his pmps is higher than his amps, you could shoot at +11 for the evening shot and +13 for the am shot. Or you might give hima little more at pmps and a little less at amps. But first, you need the curve to show you exactly what is happening.

Just for reference: we generally consider a cat regulated if they are in the mid200s at preshot and in double digits at nadir (but not below 40 which is approaching hypo territory). So it sounds like Tiny is in that range. If they range from 40 - 120 OFF INSULIN FOR 2 weeks, we consider them in remission.

Congrats on getting testing down! That is often the hardest part of this sugar dance. Now to fine-tune the dose.

What is Tiny eating and getting for treats?
 
Thank you Sue and Oliver for the quick reply :-) The spreadsheet has begun and will post in a few days when I have some numbers to work with. Nice to know the flexibility of Prozinc. For food he is getting Fancy Feast wet food and only the classic varieties. I also choose the fish flavors as they are highest in protein. My other fur kid eats dry and wet and the dry is available, but fortunately Tiny only eats it if there is no wet available and he has a hungry moment. I have only seen him munching on dry 2-3 times in the past several weeks. As for treats, he does not care for any of them. His treat is his "nippers" (catnip), which he loves. He has been 24 hours without insulin as of now and his BG was 128 (bedtime) when I just checked. 12 hours earlier it was 88. It is coming up slowly. The morning may be very high. We will see . This is most interesting as earlier in the week when he missed a shot one evening when I had to be away his BG climbed to 383. Looking forward to the trends I see on the spreadsheet in a few day. Again, thanks for all the advice and help. I hope I am not too confusing when I tell my tale here :-)
 
Hi and welcome aboard!!
Sounds like you are already on the right track and doing a great job!!
Just one idea - if you are still feeding dry then check out Young Again brand. Its only available to me by Internet but it is low in carbs and I use it while I'm on vacation otherwise the wet is best for all diabetic or not.
Terri & CL
 
Thank you. Have ordered the young again dry food. Hope he likes it! Question about the spread sheet. This is difficult if I do not dose every 12 hours. Need a column for time along with date. :-( Seems as if he is on a 15 hr schedule. I am wondering; Is my goal to reduce dose till he falls into a more routine schedule? I will get a good curve going this week and then I hope the light will come on! :-) Thank you again for all the help.
 
If he is not high enough to shoot every 12 hours, then you may need to reduce the dose. It is hard to know about seeing a spreadsheet (I can set one up for you - check your private messages. On the top of the page: "1 new message"). If you are waiting for 15 hours for one shot, is the next one then 9 hours after that one? If so, he may be bouncing. You can vary the shots like +13/11 but 15/9 is not going to work.

Please let me help you get your numbers in a spreadsheet. Then we can help you figure this out. Even a few midcycle numbers will help, if you can't get a curve in.
 
You may find this helpful as you work on setting up the spreadsheet.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
 
Thank you. I do have the spreadsheet that is on the website here. Looks to be the same. Just wish there was a column for the time. I will add that I guess. Tiny's BG has been under 100 for the past 24 hours. I wonder what is going on here. I am afraid he will have a super high bounce by morning. We will see. Will post spread sheet at end of the week or sooner. He is getting tired of the "pokes" this evening. :YMSIGH:
 
Under 100 is wonderful! We consider a cat in remission if they range from 40-120 for 2 weeks, without insulin, with the majority of the time in double digits.

If he climbs around 200, you can give him a small dose. We have ways to give a drop!
 
Hi,
prairiecat said:
[Re spreadsheet]...Just wish there was a column for the time.
Click to expand...
Unless you want that for your own purposes there is no need to add a column for the time.
There are members from quite a few different time zones here. So, when other folks look at your spreadsheet they don't need to know the actual time you gave a shot or did blood tests; they will just want to know how many hours since a shot you did the blood tests. And each column on the SS represents an hour.

Eliz
 
Hey Eliz, thanks for the reply. I will post a spreadsheet this evening at least what I have so far. He was 407 this morning. That was 33 hrs since his last dose. Gave him his 2.25 this morning and 4 hrs later we are at 38. My guess is I need to lower the dose and maybe the numbers will even out so I can shoot more regularly and see what happens. (hopefully, the reductions continue). He is hungry, acting OK, and eating and has been this low before. Appears to me he is becoming quite insulin sensitive if there is such a thing, or hopefully his little body is helping out! I think I told you I am a nurse so I understand the human thing, just have to learn the feline thing! :-) BTW, I have never shot less than 10-12 hrs apart, that I do know. I will continue to monitor this low and see how it climbs and see when we reach 200 again. I may have to check him in the night, I will see. Do you ever shoot below 200? I did in the very beginning when I was learning and did not know. At 12 hrs if he was 170, I gave him his dose. He started on 2 units, went up to 3 units and now down to 2.25 and I believe has earned another dose reduction.
Now, I have told you lots of history, ideas, and happenings. I hope you are not totally confused confused_cat . I have to go out for a few hours this evening. I will post my spreadsheet so far before I go so you can see what is going on. Thanks again for all the help, you are a jewel ! :YMHUG:

Prairiecat (Claudia)
 

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38 is very low for a +4 number. Please take give him some higher carb food (a little of the gravy off high carb food works well) and retest in 30 minutes. You don't want him to drop any lower and with2 hours until nadir, that is a real possibility.

You definitely need to reduce the dose.
 
It won't let us see it. First, go to the left hand side of your spreadsheet and choose Share. Then Share with Anyone with the Link

Then go to the right hand side and choose File, Publish to the Web, Start Publishing. The url that comes up in the box is the one you need to copy and then paste into your signature. Be sure to get rid of the one in there, put the new one in and Submit.

Is he doing okay? I was worried with your early 38. He is bound to bounce tonight. Please reduce the dose anyway.
 
I am hoping I did it correctly this time. I have only one terst strip left for the morning. He is doing great. I will get more tomorrow. Store is 80 mi away <Groan......> Anxious to see his level in the morning. In the beginning I was not testing and just shooting! YIKES! Now I am afraid to shoot without testing. Shall I go down to 2 or 1.75? I am thinking to try the 1.75. Check out the SS and see what u think. I will post his morning number for you. Nite for now, and thanks again for all u do!
 
The spreadsheet works great! I would normally agree with 1.75, but I'll watch for your am number. The one issue is your shortage of strips. You won't be able to see how the cycle is going early on or midcycle without strips.

Maybe stockpile extra strips when you get some today? Eighty miles is a long way to go if he is low and you are worried and you have only a few strips left. With him going low each cycle, I'd want to stay on top of the numbers and yes, definitely not shoot without testing first.
 
If you're in the US, check out our shopping link for ADW, which tends to have decent prices on testing supplies and ships them to you. With a bit of estimation, you can order a regular shipment so that 80 mile drive is irrelevant.
 
Number is 342 this morning. I have to be gone today so I will not be here to monitor him. I am going to go down to 1.75 for this shot and will check as soon as I get home which will be +8. That was my first batch of strips when I bought the meter. I will stockpile from now on ! :-)
 
I think that is a good dose. The amps is probably a bounce from the 36 (or lower) yesterday. The goal is two shots a day, 12 hours apart, on safe preshots. Hopefully a dose reduction will get you there.

Anytime you are worried he might drop while you are gone, it is good if you can leave out some food for him. (if he is a scarfer, spread it around on a plate and/or add water to it.). Most cats will eat if they feel themselves dropping too low.
 
It may be that you need to lower the dose even more. Can't know for sure, but an 86 at +8 could mean a number in the 40s at +5-7. And he may bounce for pmps or may be too low to shoot. If he is in the 200s, I think I'd try 1.5 and get a before bed test. If he is higher, that is a harder call. If he did go low and bounced, the lower dose would be safest. But you don't really know how low he might have dropped or if he stayed in nice nadir ranges like the 60s/70s.

I think I'd go with the idea that you can always raise the dose if needed next cycle, but you can't get the insulin out of the cat once you dose. That is, reduce again.
 
Hi, I am keeping the spreadsheet up to date. He is getting closer to needing a dose @ 12 hours. I am wondering about lowering the dose a bit more. Wish i had more marks on that syringe. The 100U isn't much better. Any ideas? Seems strange to me how low he stays then shoots up really fast. Gonna check him now @ 2:00am which will be +13 hrs, then I must get some shut eye. Thanks again.
 
Yes, I'd definitely lower the dose. One thing you could do is go down to one unit and then go back up in .2 increments. That is much easier (and safer) to do than try to decide how much to reduce.

Are you using 1/2 unit 100U syringes with the conversion chart? If so, it should be pretty easy to see increments like .2 and .4. If you are using U40 Prozinc (there is a form that is U100. It should say on your bottle of insulin.) then you have to use the conversion chart) Now I am wondering what kind of insulin you are using (U40 or U100) and if you are sure using the correct syringes for it?

Here is the conversion chart:

Conversion chart

And a thread on the U100 syringes that make the smaller dosing easier:

viewtopic.php?f=24&t=64269&hilit=U100+needles

The reason he drops low and then bounces back up is that his body senses a number that is lower than it is used to. It panics and releases extra glucose to combat the low number. Those extra sugars make his blood glucose levels rise more than expected. So he "bounces" up to a number that is higher than usual.

What will help is to gradually get him into lower numbers. The easiest way to do that is to start low (maybe at that one unit) and slowly increase as your testing indicates.
 
Dropping to 1 unit and going up is a great idea. Helps you make sure you don't miss the right dose somehow. :-D
 
I am keeping a SS for Tiny and would like some input. I have him down to 1 unit and am wondering if a dose reduction is warranted. Note the super high number occurred when he got into his brother's dry food. My fault. He usually stays under 200 for longer than 12 hours. I am using U40 prozinc and yes I have correct syringes. (the U100's I have are not half units) I am an RN so I do have experience with humans :-) but this fur kid diabetes is a bit different and I am trying to learn. What my question is; Am I aiming for the correct dose so he will be in range and need a shot every 12 hours? His dose is certainly lower than when this all began. ( Right now poor baby has an ear infection so I am testing him less often. ) Thanks for the help :-)
 
Tiny is looking great. I think you have a couple choices. You can lower your no shoot number to 150-180 and shoot a smaller dose. Without the U100s, the best way might be to draw up a dose of colored water you are confident seeing on the syringe (like .5?). then let out drops, counting, til it is gone. Once you know how many drops are in .5, then you can give (for example). 3 drops by pulling up .5 and letting out drops, save 3.

You can chase the number - shooting later than +12 when he reaches your target number. Then wait again till he reaches your target number. It means you will be shooting off the 12/12 schedule, probably quite a bit later, but you catch him before he gets higher.

Both ways require pretty careful monitoring so you could wait till his infection clears. He might also drop lower after the infection clears - sometimes that raises their numbers.
 
Hey There, Thank you for the response. You said it just right with the "chasing the number" comment. That is exactly what I am doing. I think I will see if a definite pattern emerges over the next several days and then reduce the dose if that appears to be an option to try. Yes, this sugar dance is challenging to say the least!
 
Assistance please on SS

Hello,
Tiny continues on Prozinc but has not reached shot levels for several days now. Am I correct to just continue testing BG q12h ? I was planning on reducing his dose with his next shot as he was lasting 30-36 hrs before reaching shot level. But, to my dismay or delight (not sure what is going on) he has not reached shot levels since. Is remission on the horizon? ( I am afraid to be too optimistic) Opinions from you knowledgeable beans please :-)please. BTW, what sclae has anyone found to be best for weighing our little furkids? His weight is a concern of course.
 
He is looking really good! We consider a cat in remission if they range from 40-120 for 2 weeks, off insulin. So it looks like you are 2 days in. I'd continue to test in the am/pm. Small frequent meals also often help the pancreas heal.

I used my home scale which I knew was pretty accurate. I'd get on with him and then without him, subtracting my weight.
 
terriy said:
Hi and welcome aboard!!
Sounds like you are already on the right track and doing a great job!!
Just one idea - if you are still feeding dry then check out Young Again brand. Its only available to me by Internet but it is low in carbs and I use it while I'm on vacation otherwise the wet is best for all diabetic or not.
Terri & CL
Click to expand...
Thank you for the info about "Young Again." I was so worried over the summer going away over weekends, and what to do while I was gone, that my husband actually stayed home over some of the weekends and LAbor Day weekend so I could go up and close up my camper for the season (since I am the 1 who knows what goes where etc... and he is not working and I work full-time, so I deserve to get away! :-D ) If I had known about that food I would have felt better leaving, cause I have 3 kitties, and couldn't leave wet food out cause they would eat it all at once. I thought about getting the automatic feeder, but didn't know how I could keep the other 2 fatties away from it! I am going to try to order some of this to keep on hand! It's been a very long difficult summer cause of my kitty!!! (But I just love him so much! :smile: ) Betsey
 
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