Starting Lantus or ProZinc - timing and questions

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JenM

JenM

Member Since 2013
So... Tink is doing quite well on his current regimen of bg test, syringe feeding and Humulin R dosing every 6 hours. However, it's NOT the most convenient thing. It was never meant to be a long-term solution, but he was not responding to the longer term insulins at the vet (but he was also VERY sick and weak). However the vet is adamant that Lantus should work immediately and I'm seeing on here that it can take several days to take effect. He only tried each for a couple doses, which unfortunately resulted in huge setbacks in Tink's initial recovery because his bg sat extremely high for an extended time.

Tink is starting to eat on his own, though not much. He did eat 1/4 can of Weruva "Paw Lickin' Chicken" last night, in two sittings about 15min apart. I'll go get some more today, along with some of their other flavors. I'm still syringe feeding him (he decided to remove his feeding tube our second day home) 1/3 can of a/d (less if he eats a decent amount on his own) at each dosing.

Anyway... I'm thinking that trying "the switch" to either ProZinc or Lantus (both of which I already have) could potentially happen this weekend. I have Monday off, so can be home for three full days. Alternately, I could do it over the Thanksgiving Holiday (for which I have no real plans) and would be home for 4 full days - could even take a day off on either end if I needed to.

The vet does not believe that using Humulin R in conjunction with Lantus is an option. My main concern is that if the longer lasting insulins dont lower his bg right away, I dont want him sitting in the 400's for days until they do. Would love to hear from folks who've made this switch. My vet seems to truly care, but he does NOT seem to know a lot about FD. He's not really on board with the low-carb food either - he'd rather prescribe Science Diet's diabetic dry food and repeatedly states that fiber is more important than low-carb. Just kind of seems like if Tink was a human, he'd tell him it's ok to eat donuts, just take more insulin. :-x

Anyway... I'd love to start this weekend if 3 days of heavy monitoring will be sufficient (or is likely to be). However I do have to work on the 4th day... so Thanksgiving might be better as I have some flexibility there. Suggestions? How do I make the switch? Also, I'm now realizing that ProZinc and Lantus are not really the "same" as I thought they were. What are the pro's and cons to each? Someone mentioned ProZinc providing more flexibility - how so? ProZinc is also half the price, so I'm definitely open to it. I wish my vet were more helpful in this particular situation... but I really think you guys know WAY more about FD than he does.
 
I don't feel qualified to comment on the rest of your post, but regarding the 'flexibility' of Prozinc, it's because it's an 'in and out' insulin, whilst with Lantus each shot is affected by the previous shots (a 'depot' insulin). With Lantus, if you deemed a dose too high or too low and adjusted it, it would take a few days for the change to really take effect. With Prozinc, each shot will have its own cycle, according to how much you used, and you can shoot as much as you want each time you do so to immediate effect.

It's wonderful to see Tink doing so well :-D
 
ProZinc, like R, does not have to build up like Lantus. Thus, you should take a drop on the first dose. Thus, you can start ProZinc this weekend since you should be able to see results (BG drop).
I would hold off and mixing R with another insulin. I would first wait until yo see what the other insul does.
 
Of course... I would just want the R on hand in case there was no lowering of bg with the ProZinc. So the ProZinc should work right away... that's good to know. I do like the ability to regulate each dose. Not being able to do so with Lantus scares me a bit. Maybe ProZinc is the way to go. Or, at least try it first and see how it goes. I'll talk to the vet about dosing. If I do give ProZinc, say at 6am - based on a bg of 250ish... how long would I want to wait before thinking about giving R if the bg was still rising? Assuming I wouldn't really need to do anything unless it went into the 400ish range... On the bright side... it seems the R is bringing his bg down better than it was initially... I'm frequently giving 1 or 1.5u, rather than the 2u we needed just a week ago. This morning I gave less than 1u. I'm thinking he's got a good chance of remission if I can get him eating on his own. I'm finding myself syringing extra a/d into him because even with 1u, he's dropping below 100 (as low as 65, which is a little too close for comfort as I'm terrified of the thought of a hypo event!).
 
With PoZinc, I'd wait 8 hours and then only if the number is rising. That is another option with ProZinc. You can dose 3 times a day, every 8 hours, if necessary. That requires careful monitoring and I am not sure if it would work with your life and schedule. But if you had to dose every 8 hours with ProZinc, you could only use it and not have to add the R into the mix?
 
Hmmm... that's good to know. Every 8hrs would be better than every 6... or at least I think it would be?? I'm just worried what to do if the ProZinc doesn't work AT ALL - at what point to step in with the R, which I KNOW works on him, just to prevent (or fix) a super high bg level. I wouldn't want to use R AND ProZinc on an ongoing basis - I'm just talking about initially - in case he doesn't respond to the ProZinc.

I wouldn't be concerned about this if we hadn't already tried ProZinc... but since it did NOTHING for his bg levels while he was at the vet (granted, it was a very limited attempt) - I just worry that it may not work AT ALL on him. I guess we'll find out. I'm guessing it may work now since A) his levels wont be so high starting out, B) he's out of DKA now and feeling MUCH better overall than he was during his hospitilization, and C) even the R is working much more effectively than it was at first. He was on death's door when we realized what was going on. The day before (and for a couple days) he'd been a little under the weather, but nothing I thought warranted concern. It seemed like your typical "I dont feel good, I'm not going to eat for a day or two" cat/dog style cold. Then suddenly he could barely lift his head.

On the bright side, the vet is nearby and open 7days/week. When I do start the ProZinc, I'll do it first thing in the morning, so by 9am when the vet opens, we'll already be a few hours in. On the not-so-bright side... I'm not so sure the vet knows what he's talking about. ;-)
 
Which ever insulin you choose, you could start it on Friday night (as long as you're going to be home) and that would give you an added 12 hours of monitoring to your "weekend". That's what I would do.
 
True... I guess I'm already in the routine of a 6pm bg test & dose, a 9pm bg test and midnight test & dose. So I could just test at 9 & 12... and I guess even 3am if I have to. Though sleeping more than 3hrs at a time on my weekend would be grand. @-) But you're right... that might work better.

I've only been giving between .75u and 1.5u for the most part, of the R. I'll ask the vet about dosing for the ProZinc based on those lower doses. We'd started at 1.5u and upped it to 2u after the first day or two. That got the bg in check, and now I'm afraid to give more than 1 or 1.5 most of the time (or even 1 sometimes!) for fear of sending him into hypo. Of course if he'd actually EAT anything, his numbers may be higher. Still, he's being syringed over a can a day of a/d - which is 15% carbs. I did see his numbers go lower when he actually ate some Welluva food I'd gotten him. I supplemented with a/d also, but not as much. Ended up giving him more a/d at 9pm because he tested at 65 and I wasn't sure if we'd reached nadir yet.

Ok... I think we're gonna do this! Will consult with the vet tonight or tomorrow morning. It's been a crazy day at work, and soon I'm off to go buy more Welluva since he actually seemed to like it. 20th time's the charm. :lol: Gotta love our crazy cats. :dizcat
 
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