? Starting ProZinc today and need advice

sarahlynne1

sarahlynne1

Member
Hi - my 18.5 year old kitty with triaditis (active), hypertension, and dental issues (vets won't operate on her) has been on Lantus for a few years but it quit being affective last year. She has wilds swings and lots of flat days and it just barely works for her. Vets had me convinced it was because of all her issues and there was no hope. Things took a turn this past week -- she'd had progressive weakness in her legs for a while that I thought was just from an injury but turned out to be from a large potassium deficiency. Long-story short, I believe her consistent 300 range numbers with some dips into the 200s has been causing her liver to produce ketones (urine strips showed none but I got a blood meter and she has them) and triglycerides (hers are at 6,000 right now) and lose potassium and muscle for some time. A stay last week in the hospital for IV fluids made her much worse and it looked like euthanasia was our only option.

On a whim I decided to try using Novolin R for her on Saturday morning, 5 hours before the vet arrived at our house to put her to sleep. It worked so well that she perked up enough that I knew it wasn't her time. We cancelled the appt. and went back to syringe feeding her and giving fluids, potassium, pain meds, and cerenia. That night I gave Lantus again and it seemed ok at first but in the morning she was over 300 again and feeling very sick and her ketones that had declined from the Novolin use had come back (3.8 on blood meter, up from 1.4 after the Novolin experiment). Well, that is when I decided Lantus just doesn't work for her and remembered using ProZinc in the past and liking it with another cat.

So right now I have ProZinc but haven't yet given it. I've been giving her Novolin at .1 units every 2.5 hours since yesterday afternoon and have gotten her into a range of about 260-200 the entire time. Right now I'm pushing it slowly into the high 100s. I do want to start ProZinc soon though because at some point I need to sleep and I can't with this 2.5 hour schedule (I test during the shot cycle too!). I'm unsure of what dose to give and how soon I can expect to see a sign that it's working for her -- +1 hour, +2 hour, etc. If it's not doing enough I'd need to give the Novolin to keep her in a good range, but I need to have a basic idea of the peak activity for ProZinc generally. I've read 6-8 hours -- is that generally true (it was 9 years ago that I used it so I don't remember, but I know my mom and I were both doing TR with our cats on it). I just need some pep talking to feel confident in using the ProZinc, especially if I'm going to maybe boost it with the Novolin. I had been giving 1.25 units of Lantus previously and her last shot of that was Saturday night. The vets had her off of it on Tuesday and Wednesday last week so her depot might have been depleted some already.

Thank you!
 
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@sarahlynne1 ,

You're way beyond my level of experience with diabetes. Gizmo was diagnosed in October, so we've only been doing this for a couple of months. However, one thing I do know, is that the spreadsheets that we use to keep track of the numbers are of IMMENSE use. They paint a picture very quickly for everyone including those who have enough knowledge to give advice (definitely not me yet).

Here's the post on FDMB SPREADSHEET INSTRUCTIONS

And info on UNDERSTANDING THE SPREADSHEET/GRID

I hope everything turns out okay.


@JanetNJ , @Deb & Wink - Thoughts?
 
Sarah, this is way beyond what I know. There are only a couple of people that could guide you with using both the Novolin R and another insulin at the same time. I'm not one of those people.

@Wendy&Neko Not even positive that Wendy is the right person to guide you. But I tagged her just in case she knows someone that can help you with this.
 
Sarah previously did a post over on the Lantus forum, cause she has been using Lantus until now. Here is the Lantus forum post if you want to get a bit more history.

But still no spreadsheet. And now as then, no one here, including me, should be giving dosing advice without the data to do so. Bhooma has offered to help her create a spreadsheet.

I will say that shooting R every 2.5 hours is too close together as it usually lasts longer than that. The only people I know comfortable giving suggestions about R dosing have only done it with Lantus or Levemir.
 
Wendy&Neko said:
Sarah previously did a post over on the Lantus forum, cause she has been using Lantus until now. Here is the Lantus forum post if you want to get a bit more history.

But still no spreadsheet. And now as then, no one here, including me, should be giving dosing advice without the data to do so. Bhooma has offered to help her create a spreadsheet.

I will say that shooting R every 2.5 hours is too close together as it usually lasts longer than that. The only people I know comfortable giving suggestions about R dosing have only done it with Lantus or Levemir.
Click to expand...

2.5 hours is not too close for my cat. If it was I wouldn't be doing it. I tested her every 15 minutes, then every 30, then every hour to obtain my results and she consistently goes down 10 to 30 points by the first hour, then 30-60 points by the 2nd hour, then at 2.5 hours stays flat or rises no more than 30 points, then at hour 3 stays flat or rises 30-60 points. At hour 4 she's up at 300+. It's incredibly predictable, yet I am still testing on the hour to ensure nothing unexpected arises. She's not on a second insulin right now -- just the Novolin. I obviously wouldn't dose the Novolin the same once I start the basal insulin again, if I even use it at all.

Sorry that there "is still no spreadsheet." I've just slept for the longest I have in over a week -- 4 hours, and every other minute is spent researching, talking to vets, and tending to my cat, which takes the majority of my time. I'm syringe feeding her 8+ times a day. Dosing insulin 12 times a day. Helping her pee every couple hours. Giving her many meds many times a day. I haven't had time to enter data or to go through my book and get it ready for others to do for me. There's a lot in the book that won't make sense to anyone but me. I've gotten dosing advice in another forum and I'm comfortable with that, and I asked here to get more feedback to weigh against the other advice. I've already said she was on 1.25 units BID of Lantus and it kept her in the mid 300s to mid 200s on most days, stayed hovering in low 300s on more days than I'd like, and sometimes plummeted into the low 100s or even 70s on every once in a while, mostly on days she didn't eat well. The higher the dose though the more likely she was to have really low numbers that went below 70. She had the same response to the Lantus when I'd give .5 units, .75 units, 1 unit, 1.5 units, 1.75, 2, 2.25. 2.5... It didn't matter. I restarted at the bottom many times, held a dose two weeks, then moved up by .25 and repeat. She clearly can respond to insulin because Novolin is doing great in her, but Lantus was not reliable. This goes back to May, 2019 -- before that Lantus worked well for her and she was kept 200-100 on 1 unit. I don't know what you expect to see in the daily numbers -- I've summarized what happened.

I was once on this forum in 2011 for my first diabetic cat and the judgmental and rude tone of comments like yours are why I left.
 
Sorry, I did not mean to be rude to you. I know you've got a lot on your hands right now. The purpose of my message was to let others know the spreadsheet has been discussed with you before and help has been offered to get it set up. With the hope that people would then stop asking you for it.

I really hopes the Prozinc works for your girl - you must be exhausted and I hope that you can get some better sleep soon.
 
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