should we add this to the sticky?

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Joanna & Bix (GA)

Joanna & Bix (GA)

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Since this is info everyone needs, I'm wondering if we should put it in the sticky somewhere?

Onset, Nadir, and Duration on PZI

Onset is typically around 2 hours after injection. The numbers will continue to rise until the point of onset, when they start to go down again.

Nadir is generally between 5 and 7 hours after injection. With ProZinc, the nadir can move around in the first 45 days of usage, as their body adjusts to the insulin.

Duration is usually somewhere between 8 and 12 hours after injection, with the insulin pooping-out for many cats between +8 and +10.

- info courtesy of Chriscleo (pulled out from my old posts & edited slightly)
 
Two comments:
1. It would be nice to cite the source of the data. Many times "facts" get passes on and nobody knows the real source. I note that the ProZinc study (the Field Safety and Efficacy PDF on
http://www.prozinc.us/for_vets.aspx )
states 5-7 hours for most cats but some had 9 hours or more. It also states that only 7% of the cats in the study had a definite nadir in 25 days.

2. It is not clear what "pooping-out" means. It sounds like it is just the duration. Why not just say:
"Duration is usually somewhere between 8 and 12 hours after injection, with it being between 8 and 10 for many cats"

However, I really do not why you bring up the 8 to 10 hours since to me it just adds confusion and adds nothing. It would make some sense it the "many" was "most".
 
I pulled this information into a single post for the wiki, and Chris got it from there. There isn't a clear reference beyond that. I can't find that page on the wiki anymore so can't give you the link.

The point of the 8-10 hours is because so many vets lead newbies to expect 12 hours of coverage. That rarely happens with PZI until some overlap is achieved. It's why I've always encouraged TID early on--as a tactic to get to the BID schedule.

Joanna, I'd add something about overlap if you decide to post this as a sticky.
 
thanks for the comments... I will make some revisions when I have more time

my motivation for bringing all this up, and for including the 8-10 hours bit, is that it seems like when newbies arrive they often don't know this info already, and are wondering if there is something wrong when they see that for them the insulin poops out before +12, and they don't get onset right from when they give the injection... I thought maybe seeing that what is happening for their cats is typical for PZI might alleviate some stress & confusion over the #s they see...
 
I went ahead and posted something in the sticky (pasted below for reference). I am happy to make edits - I am not an expert on any of it, just trying to get something out there to help people have some basic information. If anyone with comments/changes could post them in this thread rather than in the sticky I would appreciate it, and I will then transfer the edits over there. Feel free to just cut & paste & rewrite here as you see fit.

Newbies, this is a collaborative effort, so if you have comments please feel free to chime in! The Sticky info is something we are trying to develop to help out everyone here, particularly new arrivals, so if there are things that do not seem to be presented clearly, etc., that would be great to know!

If anyone is up to the challenge of trying to distill the ProZinc details for timing of onset, etc., feel free to go for it & I am happy to add that to the sticky!!!

Joanna & Bix said:
Onset, Nadir, and Duration with PZI​

General Information

Onset, when the insulin starts taking effect, is typically around 2 hours after injection. The numbers will continue to rise until the point of onset, when they start to go down again.

Nadir, when the insulin is at its peak and BG values are lowest, is generally between 5 and 7 hours after injection. With ProZinc, the nadir can move around in the first 45 days of usage, as their body adjusts to the insulin.

Duration, the time until the insulin loses most of its effectiveness and BG values start to rise, Is often between 8 and 10 hours after injection. Read more about Duration on the Pet Diabetes Wiki.

Overlap is when one shot is starting to have an effect (Onset) around the same time the previous shot is wearing off (Duration). This prevents the numbers from rising as much between shots, and thus can be an aid in keeping BG values in a more steady range. For some cats, it may be helpful to use an alternate shooting strategy such as TID to achieve overlap between shots. Often this will assist in improving duration and will allow a return to BID with better results. Read more about Overlap on the Pet Diabetes Wiki.

Idexx PZI Vet Typical Onset, Nadir, and Duration

Onset: 1-4 hours following injection
Nadir: 4-7 hours following injection (within 9 hours for 80%)
Duration: 9-10 hours following injection

source for PZI Vet specifications: Pet Diabetes Wiki PZI Vet page
Click to expand...
 
Good work Joanna.

References are nice - but that doesn't make the referenced source correct. Nor is it always possible to find references for certain knowledge. I think the peer review process here should be good enough. But yes, links to more reading on various topics I absolutely agree with.

Larry referenced the study that, at least in my mind, seems to indicate [based on medians if I remember correctly] that the nadir can move around during the start with ProZinc:
http://prozinc.us/document_handler.ashx?document_id=13
I have commented and even asked BIV about the potential contradictions in the table data and the charts in the study. But ultimately it doesn't matter, because the nadir can move around during the first 45 days. Anyway, the point is that ProZinc [and maybe even other PZI flavors???] has the potential to take a while to 'settle' [in the study and potentially even from my own personal experience] in and this should encourage patience in the user of ProZinc at least. I think it is a pretty simple statement backed by a little data that says "Hey, things can move around, this is something you might want to keep in mind when you are starting out." The larger topic of "expectation management" that I think Joanna might be trying to address should not be lost sight of. Expectation management is important [especially related to food switches and the introduction to a new insulin]. I don't think the newbie needs to hear about median nadirs in the sticky, but any links to more reading is very much advised.

Lastly, the language used to communicate with in the sticky should be a hopefully simple as possible as the main user of it will be newbies. The potential for blurring the overall message [in the eyes of a newbie] with statistically correct language should probably be avoided.
 
Joanna - First of all, thank you for even thinking of this. Great job trying to help newbies get an idea or at least some insight of what might happen during the FD challenge :thumbup I was kind of lost on what to do/expect when I first started out. One thing I wish my Vet would of mentioned to me before I actually started the insulin... was to maybe try changing Pru's diet first. It really bothers me that there are a number of Vets out there that do not give enough information on FD. Call me silly, but I don't even see a sticky section for PZI :-| I know Lantus has a lot. Shouldn't these stickys be in the Announcements section on PZI?

I've been meaning to mention that it would be nice to have somewhere in the sticky section types of syringes with some photos for each. Another idea that could be helpful is to post the links with some sugarkitties SS? I don't know if we need to get the OK from the message board admin.
 
Michelle - the sticky is pretty new for us, and consists of whatever anyone has gotten it together to actually write up (thanks Gator!!!). Great ideas to add other things - I started some of that at one point and got bogged down in what to include, what not to include, etc., and shelved it. The sticky is at the top of the forum - I don't know the technicalities of Announcements vs. just at the top, etc. - I guess if you didn't know it was there, it's not super-effective, is it?!?!?!? Hmmmm.

I think Gator put together a whole thing on syringes, but maybe there is more that could be added. I agree on the food link, maybe we just need a note at the top saying how important food is, and see the Health Links forum for info (I think we didn't include food stuff on the theory that it is covered in other forums, if I recall).

Gator - thanks for the thoughts - not sure if/how it translates to suggested edits? I go back & forth on how specific to be (for instance whether or not to remove that PZI Vet section I tacked on at the bottom). On the one hand I want to keep it to "typical" info, just as a general guideline to give people a sense of how PZI works. On the other hand, if I'm a person with a cat who is non-typical, I wouldn't want to read that and then think something is wrong with my cat if the timing is outside the parameters listed in the sticky.
 
LOL Joanna, I wrote a note last night to write you today and was just about to say:

Yes, something must be done about getting people to actually read it. I don't think most people understand what it is [or that they can save the folks here a lot of effort if they read it]. I already wrote Rebecca to change it to something like "PZI resources >>>READ THIS FIRST<<<" Hopefully if you write/remind her it will get the job done.

Also, one last item. Since you are covering terminology, not sure if you want to cover "delta" or not [I won't be hurt if you don't ;-) ]?
 
Yeah, I'm not sure how much Rebecca is around with her health issues, but I think any Mod can make the changes. I requested that maybe they give us 2 edit rights to the whole thread or something like that so we won't have to bug them if we want to make more changes (and you KNOW that we do! :lol: ). I'll probably leave out Delta - I like it, but I don't want to get into too much stuff. Or rather, I'd love a sticky that covers ALL that stuff and exactly how to use PZI and how to shoot TID if you want to & all that, but I think it's a can of worms & am not inclined to go there...
 
One more thing, thought it is not PZI specific is "rebound."

I guess there may be more than a few important non-PZI concepts that one would want to know about. Maybe a section in Rebecca's post for "General Reading Topics?"
 
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