Redd 10/15 - NEW just switched from Lantus

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Ellen & Redd

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Hello PZI people! I'm Ellen and my cat Redd just switched from Lantus to Pro Zinc yesterday. I feel like I am starting all over again and could use some PZI guidance. I'm busy reading through all the info on this board but Redd is a tough case so I thought I'd reach out now rather than later. He was up to a whopping 8.5 units on Lantus which prompted my vet to suggest we try a different insulin. Any advice you can give me to get through the first few days would be great, especially if any of you have switched from Lantus. Thanks!

Quick Background: Redd eats Wellness Core chicken wet food. He weighs 13 pounds and is 15 years old. He has multiple health issues - severe pancreatitis flare ups, IBD flare ups, high blood pressure, cardiomyopathy. He is medicated during flare ups for the first two issues (buprenex & flagyl) and daily for the second two issues (atenolol & amlodipine). He tested negative for Acromegaly and Cushings. He just started getting B12 injections for neuropathy.

My vet has started Redd on 3 units of Pro Zinc which I know is huge, but his numbers are really high. See our spreadsheet attached. Vet told me the Pro Zinc nadir is between +7 - +10 and to test then (also preshots) but I am going to do more frequent testing starting today. I have 2 more days before the vet will consider raising his dose. His current state is typical for high BG - way too much drinking, peeing and eating with little moving and grumpy attitude. I hate to see him like this and hope something kicks in soon.

10/14 (Day 1)
AMPS = HI (>599)
+7 = 403
+10 = 392
PMPS = 449
+4 = 326
+9 = 356

10/15 (Day 2)
AMPS = 511
+2 = HI (>599)

Thank you!
 
Welcome Ellen and Redd,

Yes, Redd is a complex kitty. All the medications and the pancreatitis can really impact his blood glucose levels. I can't disagree with starting at 3 units with his previous numbers, but it does eliminate the trail period at lower doses that could help lessen the rebound possibilities. I would suggest when and if you increase, increase by .5 units not a whole unit.

Have you seen the PZI document? It might give you some insights: viewtopic.php?f=24&t=32799

I am wondering about the Wellness for the pancreatitis. We have a couple people who deal with that who may be able to help you with diet suggestions. Here are some articles also:


http://www.felinediabetes.com/phorum5/r ... ?8,1259368]
http://www.marvistavet.com/html/body_pa ... line_.html
 
Thank you for the suggestions! I am slowly working my way through all the links on the PZI info page. It is a lot to absorb, especially as I try to figure out which parts are different from what I already learned for Lantus. I appreciate your suggestion on foods too. It has been 6 months since we switched to Wellness Core from a higher carb grain-free wet food so it is probably about time to do a review of the options for lower fat food. I just have to be careful as the food has to be grain-free and I can't try a bunch of different ones to see what he likes as that can cause an IBD flare up. Frequent pooping is not fun to add to the frequent peeing situation. I embarassed to admit we already have four litter boxes for one cat in an effort to cut down on out-of-box peeing.

Thanks again!
Ellen
 
ProZinc is dosed very differently than Lantus as there is generally no overlap. We generally think when it's done, it's done. I think it is easier to go from Lantus to PZI than the other way around, though.

Yes, the PZI document has pretty much everything. I would suggest printing off the parts you want and letting it help you get to sleep at night.....It is definitely not a one shot read.

Whatever works as far as peeing and pooping goes......

The nice thing is that you seem to be getting a curve - it is just a high curve. Are you sure testing for ketones on a regular basis?

And FYI, we are a much smaller forum than Lantus or Health. People tend to be on in the earlier am and pm, so if you need dosing help, post and give us a while to reply.
 
Welcome! Just to let you know that numerous people have found nadirs on ProZinc to be rather variable (maybe from anywhere +5 to +11?), especially at the start. Assume you are testing for ketones? Please ask anything, we like to be helpful!
 
Actually, the nadir can vary quite a bit; it's usally around +6 but can be earlier or later (Cass's is.about +5). You may want.to get some earlier numbers just in case.

One big difference-unlike Lantus, prozinc doesn't form a shed; once it wears off, it's gone.
 
Welcome Ellen and Redd!

I too have a very complicated 16 year old cat, Kitty. We experienced very high numbers, that resembled Redds....we eventually ended up on 4 to 4.5 units of PZI and even dosed as high as 5 units. We now dose PZI tid (3.5 units) and have had great results.

My Kitty, also has Ptitis and has flare ups from time to time.

What dose of Lantus did you intitially start at? What increments did you increase by when increasing the Lantus.

Trust me, it took me 6 months, but between tid and sub q fluids, Kitty is now in much better numbers. Prozinc is very flexible and we will figure out a regiment to help Redd!

Glad you are in PZI! It is a great insulin....for complicated kitties. Also, great to see the Acro test was negative.

Kim and Kitty
 
What a welcoming group you all are! Thank you!

I thought the vet seemed off on the nadir. I am doing a full curve today to see where we fall. I am glad to learn that I no longer have to deal with the dreaded Lantus shed and overlap. The delay after a dose change or fur shot was frustrating. I like "when it's done, it's done" a lot better.

I have not been testing ketones BUT (don't yell at me please) I will start that tomorrow. Awhile back, my vet told me not to bother as we've never had dehydration or loss of appetite problems or ketones in office urine samples. I'd feel better knowing for sure though since he is going to have higher than usual BG until we get him on the right dose so I'll get the sticks tonight. Wish me luck on that! I hope my cat doesn't mind company while he pees.

Kim - Glad to see another rainbow colored chart and congrats on your good numbers TID. I like the idea of having TID as an option now. To answer your Q, Redd was first diagnosed in April and we started on 1 unit of Lantus. My vet initially insisted on a really slow increase schedule so it took six months of .5 increases to get up to 8.5 units. Also, each pancreatitis flare up not only delayed increases but seemed to erase any improvement we had made. I have a stash of buprenex and my vet gave the ok for a low daily dose if I want to try it but I am going to wait on that until I see what the new insulin does on it's own. Too many drug changes at one time make my head spin as you never know what is causing what.

Thanks in advance for the support! I'm feeling optimistic about our switch now.
 
Hi Ellen, and welcome to the group!
I havent had a time to check out Redd's SS but will soon,
just wanted to give you a quick welcome!

I have also switched my Shakes from Lantus to PZI and he is doing so much better on PZI!!
hopefully you will have the same results

Denise and Shakes
 
Hi Ellen:
Just wanted to stick my head in and say hi and welcome! I’m know I’m a little late to the party here.
I hope ProZync will work better for Redd. It’ll take a little getting used to, but this group is very helpful and knowledgable.
You are in good hands :-D
 
Hi Ellen, and a big welcome to you and Redd!

I have not been testing ketones BUT (don't yell at me please) I will start that tomorrow
Click to expand...
.

Not sure, but I think "yelling" is prohibited in PZI! At least I've never seen it here. You'll find this to be a very tight-knit group, lots of support, and good senses of humor. About the only "complaint" I have is that everybody except me and one or two others are huge fans of wine. Sometimes I feel like such an outsider for preferring beer. :lol:

I understand the high doses given the high numbers. Some folks here get incredible results from tiny doses, while others (like Kim's Kitty) drink the stuff like water wine. My sugarcat, Bob, was up to 4u BID at his peak. We are a small group, but it is very obvious when you look at the daily threads that we prove the ECID concept.

You must learn, if you don't already do so, that "voting" is extremely important to us. See the recent "cookbook cover cat" and "OLM Catnip Cottage" voting campaigns for examples.

Like someone else already mentioned, the forum is most active early AM and at night. We do have regular members across the country though, and if you don't see anyone online, don't hesitate to PM somebody. Sometimes we're just in another forum. A few of us frequent "Health" especially to greet new board members.

I think that what you will find most attractive with PZI is that is seems (at least the way I understand Lantus) to be much more flexible. It is not as strict as far as 12 hours, there's a little leeway there. It is also easier to see what an adjustment to a dose does, because you don't have the "shed" - so the small increases or decreases show results sooner. If I understand it, the nadir is the basis for lantus dosing. With PZI, it's a combination of the preshots and the nadir. FWIW, when Bob was on the juice, his nadir tending to happen between +4 and +5.

Oh, one thing I was wanting to ask. With all the additional conditions and treatments you've had to do with Redd, were sub-q fluids a part of the routine at some point? A few of us have a lot of experience with those....

So, welcome to the group!

Carl
 
Hi Ellen & Redd,
I'm a high-dose mamabean who switched from PZI to Levemir. My Charlie is acro, though. Glad to hear that your sweet Redd tested negative for that. With such high doses, though, I'm wondering if IAA (insulin autoimmune antibodies) could be the cause. Was he tested for that at the same time? The PZI bunch is a great group of people who helped me greatly before our switch-- you are in good hands here. My main reason for switching before we got the positive acro result was money. PZI was getting too pricey for me at such a high dose. I hope you get this all figured out :-D

Claudia & Charlie
 
Hello Elleen and Redd :YMHUG:


welcome to the FDMB Family :smile: I don't feel I can give advise but just wanted to say welcome ! I to have a kitty who is hard to figure out cat_pet_icon , but with all of our family here we are never alone !! and they are such a big help and comfort :YMHUG: so welcome again from me and callie

oh Carl I like wine but I also like beer with green olive !! yum ( just have not had either in a long time )
 
YES!!! If you don't like yelling....you will love PZI...we don't yell about anything except beer vs. wine and sometimes, Barbara gets upset about the dreaded 150s!

Welcome once again....I was also wondering about the IAA test.....even if he is insulin resistant, and I am certain my Kitty is, even though we didn't have the test done.....you can shoot through the resistance. So, don't let the "words" scare you.
 
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