should i lower the dose? or get more numbers first?

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monkeykisses

monkeykisses

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So it's been a while since I've been on this site or the boards. One thing I am starting to see is this ProZinc which I don't recall hearing about back when my other cat (now in remission) was on insulin. His sister (Fluffy) is now diabetic. She is not responding as well to the BCP PZI and am wondering if I should make a switch. Anyone else make this switch?

I'm also seeing a lot of discussion about switching to completely wet food. Perhaps I should consider this as well. Not sure though how much I should feed them if only wet food. Any help would be much appreciated.
 
Re: should I switch to ProZinc?

I can't really anwser your question about switching insulin but as far as diet goes - all canned lo carb is the way to go. Keep the carb % under 10 but most try for under 7. It doesn't have to be the expensive stuff either - lots of options for supermarket brands as well. Here is a couple of links for canned food to look for:

http://binkyspage.tripod.com/canfood.html

https://docs.google.com/leaf?id=0B8Uu8g ... ist&num=50

If you are not home testing you should really start before switching to the all lo carb canned. Some cats have dropped over 100 points just from diet change so you would need to change the insulin amount. *edit - just noticed you use a one touch so you must be home testing :smile:

As for how much - mine probably eat between 7-9oz a day

Good Luck
Sharon
 
Re: should I switch to ProZinc?

Can't advise on insulin switch but as far as food goes.....

I have two cats. I feed them either 2 13oz. cans or 4-5 5.5 oz cans per day (they each go back and forth between their bowls - grass is greener on the other side effect, me thinks). A rule of thumb that adds up in my house...20 calories per lb. of cat weight.

Hope that helps! :smile:
 
Re: should I switch to ProZinc?

Hi and welcome
The best thing to do is feed wet food and it would be very helpful if
maybe you could give us some data, (I see that you are home testing and maybe it would help us
to see what is happening so we can better advise on the numbers)
 
Re: should I switch to ProZinc?

Hi Monica,
The old version of PZI went away about 3 years ago (PZI Vet). PZI is now a compounded formula, which is what you are now using. It is still a "bovine" insulin like the old stuff was. Prozinc was also created, but it is a recombinant human insulin specifically designed to work for cats. Compared directly to PZI, it has a little longer duration. Here's some info from their website:
PROZINC provides predictable, lasting control

PROZINC is a protamine zinc insulin, a type of long-acting insulin that is ideal for your cat's condition.
Protamine zinc insulin formulations have a typical duration of effect in the cat of 10-14 hours.1
PROZINC insulin releases slowly over time to help maintain a stable, consistent blood glucose level throughout the day.
PROZINC was made for cats

PROZINC is the first long-acting protamine zinc insulin with FDA approval for diabetic cats.
In fact, PROZINC was specifically designed for feline diabetes and is backed by extensive clinical studies in diabetic cats.
176 cats were treated with PROZINC in the efficacy trial,3 making it the largest prospective study conducted in diabetic cats to date.
PROZINC works:

Quickly and effectively, with just two doses a day.
To regulate blood glucose regardless of the diet a cat is fed.2
For newly diagnosed diabetic cats who have never been on insulin before.2
For diabetic cats who haven't responded well to other treatments, including other insulin products.2
Click to expand...

http://www.prozinc.us/how_prozinc_helps.aspx

It is not a "shed/depot type" insulin like lantus or levemir. If you were to switch, the transition from PZI to Prozinc would be more simple than a switch to one of the "L's". But people have had a great deal of success using Lantus or Lev as well. If you do decide to switch, you should probably consider all three options. Of course you know that ECID, so don't be frustrated because PZI worked for Fluffy's brother but doesn't seem to be working for Fluffy.
I would definitely try a switch to all canned lo-carb food, which will bring about a quick improvement in Fluffy's numbers all by itself.
And like everyone else has said, home testing is probably the best thing you can do right off the bat, if you aren't already doing that.

Food quantity - a simple formula that I used when Bob was getting insulin (He was a PZI kitty too, but went into remission after 10 weeks of treatment):

20 calories per pound of "ideal body weight" per day. If Fluffy, for instance, would be ideally 10 pounds, then 200 calories per day should maintain that weight. Add some calories if her numbers are not controlled or regulated to compensate for her not being able to metabolize her food at 100%. If you look at Binky's food charts, the calories per can is on the charts. 200 calories is about 2.5 cans of FF classics or 2 cans of Friskees Pates, for example. Here's the links to the charts:
http://binkyspage.tripod.com/CanFoodOld.html
http://binkyspage.tripod.com/CanFoodNew.html


How long has Fluffy been on PZI?
What sort of numbers have you been seeing with her BG?
What is her dose currently?
You're shooting every 12 hours?
Does Fluffy have any other conditions or health issues going on besides "just diabetes"?

Let us know the numbers, and we'll be able to help a lot more,
 
Re: should I switch to ProZinc?

Hi Carl,

Here are responses to your questions.

How long has Fluffy been on PZI? - since summer of 2009
What sort of numbers have you been seeing with her BG? pre shot her numbers are around 430's - I admit I do not check very often (bad mommy). :sad:
What is her dose currently? 5 units twice a day (u100 syringe)
You're shooting every 12 hours? yes
Does Fluffy have any other conditions or health issues going on besides "just diabetes"? just diabetes

Fluffy is 12 lbs. and Peanut is 16 lbs.

So after much reading on this site I decided to take away the dry food and do just wet food. I downloaded the tracking spreadsheet. I started checking her numbers pre-shot and throughout the day. I will post the spreadsheet either tonight or tomorrow. But WOW! her numbers are SIGNIFICANTLY better pre-shot and at +3 and +6!!!!! Just from taking dry food away! She is now around 120 to 140 PS. I only gave her 1 unit twice a day yesterday and 1.5 this morning. This is just amazing! I am still in awe and scratching my head.

Now her brother (Peanut) had some high numbers on his CBC late last year so I do need to watch phosphorus. But I found some foods that I think they can both do well on.

Thank you all. I love this community! It got me through Peanut's diabetes and now it is helping tremendously with Fluffy. So glad I found this place.

dancing_cat
 
Re: should I switch to ProZinc?

Wow that is wonderful news,
so glad you were able to drop so much and get great numbers
Cant wait to see your SS
The more data the better!
 
Re: should I switch to ProZinc?

Monica,
I admit I do not check very often (bad mommy).
Click to expand...

okay, so you know the "error in your ways"? lol, you must test at least twice a day, before each and every shot. A nadir test is always a great thing to get too. That makes you know for sure A) that it is safe to shoot, and B) if the amount is correct.

5 units twice a day (u100 syringe)
Click to expand...
Assuming you are using u40 PZI? (It comes in u100 also, so I have to ask). Is that the 5u line on the u100 syringe? So it would be 2 units in u40 speak? IF that is so, then when you "report" the dose, use the u40 amount in your posts so we understand exactly how much insulin she is getting.

So awesome that you saw that much of an improvement just from the diet change! And terrific call on cutting back on the dose. Now we need to convince you to hold a dose for a few cycles so you can see what it does once it "settles" in.

Looking forward to seeing the SS. Of course, it helps you tremendously to keep track of the data. It is an awesome tool for us as well, and will help us to help you!

Great job,
 
Re: should I switch to ProZinc?

Thank you. Yes, I was administering 5u line on the u100 syringe of BCP PZI - the bottle says 100-u/ml. This was the recommendation from the vet as her numbers were just not coming down. We have treated her several times this year for UTIs. She recently had a uralysis completed and came back fine. Waiting for culture results.

I have posted Fluffy's SS (and picture) on my signature. I added some numbers I had stored on the meter just so you get an idea of what her numbers looked like. I did go up to 1.5 this morning (from 1u) because I fed more wet food as I was going back to work today and they didn't have dry to free feed. Perhaps that was a mistake. Her PS number was in low 200's. I will stick to the 1u before making a change again.
 
Re: should I switch to ProZinc?

I was administering 5u line on the u100 syringe of BCP PZI - the bottle says 100-u/ml. This was the recommendation from the vet as her numbers were just not coming down.
Click to expand...

OKay, important info there. Most people don't wind up getting the u100 version of PZI, so very good that we know that now. Wow, that is a high dose! No worry though. At least we are all on the same page now, and the SS will help a lot.

Lemme take a look...
 
Re: should I switch to ProZinc?

Adorable kitties! They are beautiful!

And look at you go! Spreadsheet up and with numbers! Woot! \M/

Holy moley! Look at the drop in BG with the removal of dry food! Should also help with the UTI's I'd think. :smile:
 
Re: should I switch to ProZinc?

Thanks for getting that data out there, Monica.

From the numbers you did have, I can understand the vet thinking "increase", because it didn't look like she was responding much to the 2.5 back then. The dry food must have been wreaking havoc with her BG. What a difference, huh? Plus at any time she had a UTI, that would have messed up her numbers too.

I don't think you messed up with the 1.5 this morning, but not sure how low the middle of the cycle may have been. No big increase from a bounce in tonight's number though.

You can shoot 1u tonight, and tomorrow morning, and just that will give you some useful data. A good general idea is to stick with a dose for 2-3 days, see what you get, and then adjust accordingly. We usually advise increasing .25 at a time, but that can be hard to eyeball. Your syringes have the half-unit marks?

If you were brand new to the dance, we'd caution holding off on shooting numbers below 200. But you've been doing this for quite some time, and with much higher doses, so what it will come down to is what number you feel comfortable shooting into. And only collected data will give you that picture, figuring out how much insulin it takes to give you a drop you would like to get. You'll just have a lot more confidence from having the numbers, so that's a great thing. As she gets used to not having dry food, and she continues to heal, it should take less and less insulin to do the trick. Her numbers over the past few days look really good.
 
Re: should I switch to ProZinc?

In the beginning we advise to not shoot insulin if the bg is under 200. At least until you have enough data to know if it is safe to do so.

On the 16th you shot 1 unit into a bg of 123 and got an inverse curve which means that was too much insulin for that bg.

Now that you are all set up and testing I think you should start over at 1 unit. That way you won't miss the right dose by starting too high.
 
should i lower the dose? or get more numbers first?

hello everyone. so i get settled with fluffy's SS posting and of course the darn batteries on the meter died. today i was finally able to stop and pick up new ones. i have started testing again. her BG pre shot was in 200s then at +4 it was in low 300s. should i do more testing before adjusting the dose? would i adjust up or down?
 
If it were me, and I just replaced the battery, I'd stick with the 1u and try and get a curve, or mini curve, in before thinking about changing dose. (Testing every 2-3 hours, especially during the 5-7, if possible.)

And isn't it amazing how much the BG dropped after stopping the dry food? Wow! :o
 
Thanks Teresa and Poopy!

just found a great page on the 5 steps to regulation. will follow those instructions and get a curve before making any changes. :-D

http://binkyspage.tripod.com/SLGS.html

I do think it is so amazing the change from just eliminating the dry food! ohmygod_smile why didn't i do this sooner!
I told my vet when she called with fluffy's urine culture and she said "huh, that's interesting".
 
Great link, and what most here advise to do...other than the changing dose by .5u. Most recommend or suggest changing dose by .2 or .25u at a time. :smile:
 
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