River relapsed- off insulin since 5/10, today 368

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Kym&Jason

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Hello, from River's mom. River was diagnosed with diabetes Feb '10. I was fortunate to find this site and with support, river has been off insulin since May '10. I tested him in July '11 and his numbers were still good (80). He had some problems earlier in the year vomiting so I was testing him for awile. Today I tested him and he was 368. I fear he will need to go back on insulin (hopefully for only a short while)

River- 15 years old
Was 12.5 pounds 3 months ago, now 10.8 pounds
Food- 3oz fancy feast 3x/day

River was on Lantus before. I was ready to switch him over to PZI from recommendations, but River went off insulin before the transfer.

I was out of town for a few weeks and noticed he had lost weight when I returned. I should have picked up new test strips last week, when I returned. I took River into the vet today and realized his blood glucose was elevated. I picked up new strips and am ready for testing again. I recently lost my job and am working freelance so fortunately I have more time at home for awhile to test.

Thanks for your support. Looking forward to get to know my new kitty friends. I feel so fortunate to have others who understand and can help. It has been so long and I am feeling overwhelmed, but know that things will work out just by taking it one day at a time.

cheers,

Kym
 
Hi Kym,
So sorry that River has decided to put the dance shoes back on. First we all fear the diabetes, then we all fear that kitty will never go into remission, and when they do, we worry that they'll someday relapse. If there's a good in this, it's that you already know the dance steps.
You mentioned that he was just about to switch insulins when he went into remission. Do you know what type you'll be using if you do have to start him on it again?

In the time you were off the board, there of course have been hundreds of new members that have joined, but I'm sure that there are still people here who you'll be familiar with.

I'm not sure what I can say to help, other than if you do decide to use PZI, I'm familiar with it, and the small group of PZI users that regularly post in the PZI forum are a really great and supportive group of people. You're already feeding a good diet with FF, you already have a meter and know how to test and shoot, so all my "regular" greeting messages are sort of redundant!

Here's hoping that if River does need to go back on insulin, it'll be a short-term thing,
Carl and Bob in SC
 
Thanks Carl and Bob- Thanks for your prompt reply. Just hearing from someone makes me feel better and not alone. Just now digging thru the storage area to pull out River's old paperwork and a few syringes to get me started. I am not sure what insulin to use. River was on Lantus before, but have heard that PZI may have better results. River had spent 3 weeks in the hospital when he was first diagnosed, and was never regulated l before I found this better, but what is called alternate treatment. I am hopeful he will quickly rebalance himself this time.

I am talking to my vet again in the morning to get a prescription. They ran tests, but they are waiting for results. His glucose was high in his urine, but we did not get numbers, but figured we may need to get him back on insulin. I will need to do a test curve and get numbers. It has been so long I forget what the best numbers are. If i use PZI, what times do I check? Where do I find the starting dose to give him? I am not familiar to the PZI treatment numbers so will be a newbie.

Thanks again,

Kym
 
Hi Kym,
My cat, Missy also relapsed after 4 mos OTJ. She was dxed in March and remitted in April.....relapsed in Aug. Can't find a reason, unless it is her chin acne, but she has had it all along. It did flare up shortly before the relapse, but has been on antibiotics since early Sept along with duoxo. So far no remission in sight, but she definitely is feeling better than t.he first round with this stuff.
No real words of wisdom, just commiserating.....it is hard to have them relapse and not know if a remission will happen again. At least, this time is not so traumatic. I have the basics down, just have to hope and pray that she will remit again. I hope your kitty remits quickly.
Mares and Miss
 
Hello Ms. River,
Just wanted to say that when Sugar Bean was dx, she was put on pzi and remitted within 6 weeks, probably less. Lets hope River does the same! Paws are crossed for her.
 
Kym&Jason said:
It has been so long I forget what the best numbers are. If i use PZI, what times do I check? Where do I find the starting dose to give him? I am not familiar to the PZI treatment numbers so will be a newbie.
Click to expand...

At minimum, you'll want to get pre-shot numbers and at at least one number around +6 per day. This is usually the nadir, or lowest point of the cycle, although it can vary (My Cass nadirs at +4). Until you figure out where the nadir is you can move it around a little; do a +6 one day, a +4 another, a +7, etc. We do recommend a curve (where you test every 2 hours or so) when you have time to do so, usually on the weekend. It may take 3-4 days for River to adjust to the dose and settle into a pattern.

A "normal" starting dose is 1 u bid. Be aware that ProZinc or PZI is a U-40 insulin and uses a slightly different scale than Lantus (U-40 needles have a red cap), although if you still have some old needles, there is a conversion chart that will let you use U-100 needles (with an orange cap). I believe this chart is in the stickies in the PZI forum. (I'd post a link but I'm not sure how.)

Feel free to drop by the PZI forum and post there. It's a really helpful bunch.
 
Not for sure what your vet gave you but this is what Bean received: BCP PZI.. 100-U... SYRINGES are 3/10, 5/16", 30 gauge
I think this is a different PZI than what is usually prescribed????
 
If Lantus brought your cat into remission before and you're familiar with it, I don't know why you would want to switch to PZI. PZI isn't a bad insulin, but studies have shown Lantus has a better remission rate than PZI. I would try the Lantus again if it worked before.

However, cats usually don't get knocked out of remission without an underlying problem. The three big things that can cause a cat to go out of remission are access to high carb food (possibly dry cat food or dog food--one member recently had her cat go out of remission because she was snacking on her corn-based kitty litter), dental problems, or an underlying infection like a UTI. I would start by making sure that none of these are factors as you begin insulin therapy again.
 
I know that my vet did say that Bean could have been dx due to stress... It took me over 3 months to pack up my home (lived there for 18 yrs), moved out of state - 9 hours of travel, and her not being able to do her small bit of outside time. Then within 5 months, packing up again, another 9 hr trip, back to the state I came from.... New home, etc.
Now that we are unpacked, back to normal outside time and mommy bean settled, might be the reason why she went into remission so quickly - along with new diet.
 
Thank you all for your kind words of support. I had forgotten how scary and overwhelming it was, and so grateful to have support!

I am back from the Dr. I was told I was getting PZI, but what they had was ProZinc. I read some notes on the differences, and from what little I read, it sounds like ProZinc may be a bit more tricky. Any thoughts on this? I haven't started insulin yet so have some flexibility.

I will start insulin at 6:30pm after I test. So 6:30 am/pm to start. I was told to start at 1u of Prozinc with u-40 syringe. I take river back in next week for a re-evaluation. My vet is supportive of me doing TR, but unfamiliar with the exact prodigal, so this is where I will need your help and support to do things right. Should I do a curve tonight/or tomorrow? I fortunately have the day off tomorrow so available then as well.

River
9/26 368 10pm (4 hours after feeding)
9/27 478 7am (before eating)

My boyfriend will help me put a chart together later tonight, but this is River's info for now.

Thanks all!

Kym
 
Plan: ProZinc 1cc unit (the smallest amount) after testing blood glucose if over 150 and going up at 12 hours. My vet recommended not to change dosage for 1 week. I am using the u-40 needles I have the luxury of being home for the next week so can check and dose as needed. I know not to dose before 12 hours from last dosage.

Does this sound right with you?

Thanks!

Kym
 
Yes, this sounds reasonable. (it's one unit. One cc would be a lot of insulin.) Watch for the lowest point (nadir) so you can see how it is working. Depending on his nadir, I might be nervous about shooting one unit into 150. But you will be able to see how it's going with his numbers.
 
Re: River relapsed- Prozinc- dosing before 12 hours.

I have been catching up on my reading today. I found diabetic cat care. http://www.diabeticcatcare.com/ I had worked with them before. They discuss dosing before 12 hours if the bg is above 150 and going up. Do you support this method if one is able to tightly monitor the cat regularly? I did something similar with lantus before (after 10 hours) and this is how we were able to get him off of insulin before. I am not experienced with ProZinc, and what that process would be.

thanks for your input.. I want to do it right to get river off of insulin again :-D

Kym
 
We do have people who are dosing 3 times a day and some who shoot later in the pm and earlier in the morning. I would really encourage you to come over to the PZI forum and read through some of the threads and look at some of the spreadsheets to see how it could be done. Ask your questions about TID (3X daily) and alternate dosing times. We will sure try to help.
 
Re: River relapsed- otj since 5/09- now on prozinc

Thanks all. I have posted river's numbers. Unfortunately, i still need to figure out how to tweak the ss so I have the numbers listed in a row. I will need to figure out how to change it but wanted the numbers up.

Is there a place to read about why I would not want to dose at +6 if
numbers are rising
+ bg is above 160-200?

I am home for a for awhile and want to give river the best chance of getting regulated. I work next tues so will need to figure something out then- unemployment has an advantage at the moment, so I can care for my child :smile:

Kym
 
No sure how to read your spreadsheet. You start with the morning preshot number at the amps column, then the amount given at the U column. Every number after that, on that same day, goes across. +3 is a number 3 hours after the shot, +6 is the number 6 hours after, etc. pmps is the evening number before the shot. The farthest columns to the right are any night time numbers you get. The next day, you start again on the right hand side, next line down.

I really would like to see you come over to the PZI forum and get some specific advice on how to use your insulin, whether TID or BID or sliding scale. These techniques are difficult and you really need to have some support (and most importantly, more data) before attempting them. Here is the PZI sticky with information on how it works: viewtopic.php?f=24&t=32799

Did you look at the spreadsheets of Bookworm and kse who are doing TID? Please do that and read their threads over the past few weeks. That will give you a good idea of how much monitoring it takes and how it works.

PZI is not as busy as Health, but everyone there uses or has used your insulin and can advise you on dosing. If you post in the am or pm, you are most likely to get a faster response.
 
In addition to stress triggering the higher glucose levels, did your vet rule out other health issues, such as dental infections, bladder infections, etc.? Some of these can through the glucose control out the door quickly.
 
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