River on ProZinc

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Kym&Jason

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Hi there. My name is Kym. River is my 15 yr old companion. I am giving river his first dose of insulin today after being otj for 18months. It has been so long since I did this last and I am getting back up to speed. We are using Prozinc this time instead of Lantus so I would love advice/support, as I am not familiar with this insulin and have forgotten so much. We were able to finally able to regulate River after 1 month of following TR(tight regulation and frequent testing). The hospital and vet could not regulate him (get his bg under 300) even after spending over 3 weeks total in the hospital. That almost devastated me.

I am back on board and was wondering who else is dosing more frequently than 2x a day if the numbers indicate doing so. I would love to know who's chart to look at and who the Prozinc experts are to follow. This tight regulation worked well for River in the past and at the moment I have extra time to monitor frequently.

Thank you, Thank you!

Kym
 
Hi Kym!

Cass and I dose tid but we're new and still trying to figure out a dose (and switch food, mr. picky). Kim & Kitty (kse) also dose tid amd help us out a lot. I think there may be someone else, but I don't remember who (sorry!).

We went to tid because Cass nadirs at +4 and then skyrockets. He'd end up higher than he started, despite a decent drop. We haven't found the right dose yet but his ps #s are dropping. Keep in mind he's still on dry food for the moment.

I tried to look at your ss over in health, but it was too hard to see on my phone (& not linked here). I'll try to take a look at work tomorrow with a bigger screen and see if I can make any comments.
 
Hi and welcome back, sorry you have to come back, Harley and I had to come back too.

Nancy and Payne are the other ones dosing tid.

Come back as often as you can, we are a small but friendly group.
 
HI!

I have a complicated hard to regulate 16 year old cat, Kitty! I dose TID, but I am not as aggresive as some. Kitty has seen much better numbers since starting TID...we have been on TID for over 2 months.

Welcome to our group!

Kim and Kitty
 
Re: River on ProZinc- advice for dosing at +8

Thanks Kim & Kitty, Rob & Harley, Cass & friend! Thank you for making me feel welcome. Sorry for all of the questions, trying to get a schedule and plan in place quickly that is safe but efficient.

River 441 at +0- gave 1u Prozinc.
+2 478
I am testing again at +6 and +8.

If bg is rising at +8 and we stay above 200, is it ok to dose 1u again at +8 or SHOULD I wait later? We had success earlier with dosing smaller amounts more frequently but that was with Lantus. I am now and Prozinc and unsure of the difference. I know that Lantus is longer lasting and what I did the day before would affect the following day, need advise with Prozinc as I have read it acts quicker.

Chart is now attached below.

Thanks for your advice.

Kym
 
Re: River on ProZinc- advice for dosing at +8

Thanks Kim & Kitty, Rob & Harley, Cass & friend! Thank you for making me feel welcome. Sorry for all of the questions, trying to get a schedule and plan in place quickly that is safe but efficient.

River 441 at +0- gave 1u Prozinc.
+2 478
I am testing again at +6 and +8.

If bg is rising at +8 and we stay above 200, is it ok to dose 1u again at +8 or SHOULD I wait later? We had success earlier with dosing smaller amounts more frequently but that was with Lantus. I am now and Prozinc and unsure of the difference. I know that Lantus is longer lasting and what I did the day before would affect the following day, need advise with Prozinc as I have read it acts quicker.

Chart is now attached below.

Thanks for your advice.

Kym
 
Welcome Kym,
I have a very complex kitty who has been doing t.i.d. for quite awhile .... but she is a high dose cat, 12u a day. ProZinc is a very forgiving insulin and is very gentle and works well with t.i.d.

If your going to do t.i.d.you would dose every 8 hours on a rising # .... I would be looking for River's nadir, my Payne has a real early one, some have late.

I think with Lantus once you build up the shed, it acts just as quick as pzi.

Ask questions and welcome.

Nancy and Payne
(who likes more people on t.i.d. :)
 
Thanks Nancy-

I came across this from my first bout with diabetes. http://www.yourdiabeticcat.com/protocol.html Is this the chart that you use? I am trying to understand people's charts and see what is working and what is not.

Blood Glucose PZI mg/dl Units of Insulin to Inject
151-170 .5
171-185 1
186-200 1.5
201-220 2
221-250 2.5
251-290 3
291-350 3.5
351-410 4

I want to start conservative to see how River reacts, based on this chart we are very conservative with the 1u since his bg is above 400. If I am available to give ProZinc insulin at +6 and the numbers are rising and we are above 200 from my research it appears that it would be beneficial (though I get less sleep)

Kym
 
Some cats don't respond well to changing the dose with every shot and my Payne is one of them. We tried TR and she bounced and bounced, what she likes is consistency. I have found that if I stay around 12u a day, it works better for us.

The problem with shooting a +6 without knowing when his nadir is .... pzi normal nadir is +6 and if you dump more insulin on top of a nadir, I have found that to be a problem. I know you have used TR before and if River didn't bounce, then once you have more data, it is possible to shoot at +6 if you have a rising #. I would get more data first myself, you have plenty of time to become aggressive.

I would stay at 1u for a short time to collect data, what dose was he on with L and why are you using pzi and not back to L?

And yes, Dr. Hodgkins site is the TR place BUT I would do some more reading, she has been? disputed by many and many of her theories questioned, like a cat can't hypo on TR or have ketones .... not true! but her chart is reasonable if your cat can keep changing doses.

Nancy and Payne
(better known as the ketone queen!)
 
If you're thinking of going TID, you need to get some mid-cycle tests between +4 and +8 a couple of times to figure out where his nadir (lowest point in the cycle) is. Most of us stick with a dose at least 3 days and don't use a sliding scale. When you first start out, it's better to hold a dose for a least a week and let the cat get used to it. From the limited information you have on your chart (I know, just starting) I can't tell if you're a candidate for TID or not.

Hang in there!
 
River-ProZinc- bg number thoughts?

Hi! I did TR before dosing river as need (when bg was above 151 and rising and after +10 for lentos) I am now using prozinc. Does anyone here do a similar of program and having success? Basically it would be only dosing 3-4x daily if river needed it. I went to ydr but it does not seem active with people at the moment and I desperately need the community support. You guys have been great!

I want to figure out a program and stick with it. River was very challenging to regulate on Lantus but was otj in less than 4 months on the tr program after my vet thought he was a lost cause. I need to create a ss that works with his schedule. This is what I have so far. I would love thoughts, suggestions, things to consider. I have been rereading all the notes here but helpful to bounce off ideas or have someone point out where to look.

Thanks again!

Kym
Rivers info:
otj since 5/4/09- relapsed 9/26/11
location: seattle pst
15 year male
weight 10.8 pounds (down from 12.5)
FF 9oz day (chicken, turkey giblets, seafood from list) ate ff w/gravy accidentally for over a week when i was out of town and relapsed.
Prozinc U-40

using 1u insulin now to see how river reacts to the prozinc to create the sliding scale

Any feedback on this scale? I realize every cat is different but not sure how to adj for the prozinc from the pzi scale recommended by Dr Hodges. Is there enough data here?

(US)mg/dl-----Prozinc Units/Insulin
Blood Glucose --- to Give
160-170 ----------.----.25
171-185 -----------------.25
186-200 -----------------.5
201-220 ------------------.75no readings in this range yet
221-250 ------------------1
251-290 ------------------1* (288 brought down to 78 with 1 unit)
291-350 --------- ------1-1.25
351-410 ----------------1-1.25
411-450 --------- -------1-1.25
451-500 ----------------1-1.25
*made adjustments in regards to how river responded with 1u

Date BG Food Prozinc Insulin

Sept 26
06:15pm...........................ate 3 oz FF
10:15pm...............368- time to get more insulin
Sept 27
06:15pm.....+0........441.....ate 3 oz FF.........1u
08:15pm.....+2........478
Sept 28
12:15am......+6.......315.......ate 1.5 oz FF
12:45am......+6.5.....327......ate 1.5 oz FF........1u
04:45am.........+4.......315.......ate 1.5 oz FF
07:30am......+7........359......ate 1.0 oz FF........1u
09:43am......+2.25...280......ate small amount left in bowl from earlier
11:30am........+4.......263
01:30pm.......+6.........245
02:10pm.......+6.5.....288................................1u
05:30pm........+3....................ate2.5 oz FF chicken
06:10pm.......+4.........221
08:10pm........+6........107........ate .5 oz FF
08:50pm........+6.5.....109.........small piece of turkey
10:15pm........+8.25.....89.........1.5 oz FF (going back down!)
11:25pm........+9.5......206........1.5oz FF........... .75units
sept29
04:40am.........+5.25...448........the .75 was too much or too little? lower next dose that is around 200? ate 1.5oz ff
05:30am.........+6........457.......1.5 oz FF............1.25 units
10:15am.........+4.75.....372
11:45am.........+6.25....494......piece of turkey.....1Fat unit
03:45pm.........+4.........360......piece of turkey
04:30pm..........5.25...............1.5oz FF turkey
05:50pm..........+6........386.....1.5 oz FF turkey....1fat unit
10:15pm..........+4.5......324......1/8 oz FF
11:50pm...........+6........352....1/8 ox FF......1 fat unit
10:15pm.........+4.5......324......1/8 oz FF took 2x to get reading
11:55pm.........+6.........352......1/8 oz FF took 2x to get reading....1Fat unit (jason did w/ me helping)
Sept 30
04:15am..........+4........570......1/3 oz FF took 3x to get reading (bg so high from stress or fur shot?)
06:15am...........+6.......500......1/3 oz FF took 2x to get reading (must have been stress-
would like to set up so not testing as much to give poor river's ear a break)
07:15am...........+7.......459.......1/3 oz FF
 
Thank you for your feedback. Sounds like I need to a curve tomorrow. Will this work the same to get River's nadir if I am qid? River seems to do well the more frequently he is given insulin- from past experience- but if I need to back off to get important information on his nadir and how he is reacting to Prozinc I will do that.

Thanks again!

Kym
 
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