Starting Prozinc tonight

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Adam Flowers

Adam Flowers

Member Since 2017
Mogee will be starting Prozinc tonight. My vet prescribed 2 units/twice a day.

Mogee weighs 18 lbs and his bg has been between 266 and 326.

Does this sound like a good starting dose for a cat his size with his numbers?

Also I will test before I feed and shoot but my vet did not tell me what bg to not shoot at. They said to continuously give the 2 units twice a day until we get a glucose reading next week. I have read numbers at which not to shoot at on here and was confused why they didn't give a number.

I have posted a lot lately but this is all new to me and I am just making sure Mogee will not get too much insulin.
 
Are you planning to switch him to 100% low-carb wet food diet? Remember that when you do that, it could bring his numbers lower.

I would want to start with 1 unit twice a day to see how he responds to that rather than jumping in at 2. Granted, he is a big boy, but still. His numbers have not been outrageous, and he may respond very well to the insulin and drop quite a bit. I use a pet meter, but I believe I have read 200 as a no-shoot when using a people meter. I am sure others will chime in.

The goal is to give the least amount of insulin needed to bring him into healthy numbers but not drop him too low. Too low is bad. Speaking of that... be sure you have read up on how to handle a hypo in case he does drop too low at some point.
 
Here are a couple of excerpts from the Beginner's Guide to Prozinc sticky in the ProZinc forum:
"In the beginning, if your cat’s BG is not up to at least 200 mg/dL {11 mmol/L}, if your schedule allows, you can stall (without feeding) for 20+minutes, then retest the BG. You are looking for a number that is rising, not falling and up to 200 mg/dL {11 mmol/L}. If you stall once, but can’t do another round of stalling and your cat hasn’t reached a BG of 200 mg/dL {11 mmol/L}, you’ll need to skip the dose and wait until the next cycle."

"FDMB has general BG references for use with human meters: A cat is considered regulated if BG is in the mid-200s mg/dL {mid-11s mmol/L} for pre-shot and in low 100s mg/dL {low 5.6s mmol/L} or double digits (U.S. mg/dL) for nadir. (BUT not below 50 mg/dL {2.8 mmol/L} which is approaching hypoglycemia range, which is too-low blood glucose - we commonly call this “hypo.”)"
 
Thank you again for all the information.

I got a second opinion here in Lincoln and I know most will not like this but I am keeping him on the Glycobalance as of now.

I will be able to do the mid cycle test and plan on staying up til 1 or 2 am to do so. I will be giving him his first injection tonight after I test and after he eats a bit.

I am just worried 2 units was to much to start but my vet insists that it's okay.

I will post his pre shot bg here soon and will post tomorrow what his mid range was. Hopefully that will give me a better idea. Obviously just worried about getting too low as this will be his first dose, but the vet said he will be fine. Ugh.
 
His pre shot is 284.
 

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Is it okay to give the insulin half way through eating so he doesn't notice or is it better to wait and do it away from the food?

Don't want him to be afraid to eat if he is afraid of the shot.
 
In the beginning, I gave it when she was eating. She barely noticed. I have had to adjust my techniques as time goes on, based on her mood, but she has never become afraid of eating.
 
You are the best! I appreciate your help so much.

I gave it half way through his meal and he didn't even budge. Oh, the relief getting the first injection under my belt. I have been stressing about this moment for weeks!

Now I will set an alarm.and wake up and check his bg at midnight. Hope all goes well!
 

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Hello Adam and welcome!
I also used ProZinc and really liked it, our starting dose was .50 which is half a unit, but because I switched to low carb right away and because my kitty was so sensitive to the insulin we nose dived straight to a hypo. The ProZinc guidelines are 1U for a starting dose.

On the plus side the food change and ProZinc got Tempest into remission in 2 months with the help of the forum members and we celebrated our 1st OTJ (off the juice anniversary this September) :)
 
You guys have me freaking out now that 2 units is too much. I hope he will be okay. When do you recommend I test his bg again?
 
I love how you post photos of everything.. documentary.

If you can (does he take the testing well?), maybe test him more than just at midnight. Nadir can occur at various times. It will not always be at +6. I have seen it anywhere from +2 to +8. Since it is his first dose, and it was a pretty big starting dose, and his pre-shot result was not super high, I would check him at least at +3 and + 6.
 
We are not trying to freak you out. Sorry. :bighug: Just monitor him, and if it starts going too low, you can intervene with carbs. You got this.
 
I've only tested him 4 times but he doesn't seem to mind and comes when he hears the stuff getting ready. I've got blood each poke and have only had to poke twice one time because I smeared blood and didn't get enough on the strip. I am sure he will let me test him as much as needed.
 
I am just worried I shot too soon. He ate for a bit but like 2 mintues after I shot him, he left the food bowl. He seems fine. I'm just on high alert as this is all new!
 
Oops sorry Adam, I didn't mean to freak you out, didn't realise you'd already shot (late to the party)

Test at midnight and if you are worried post up on here. They glycobalance is fairly high carb so I doubt the insulin would make a massive dent in the numbers. But every cat is different.
 
They really do not have to eat very much before they get their shot. So, do not worry about that. He will probably circle back and eat more in a couple of minutes anyway, right? At least my girls would.
 
Yeah he comes back for more. If I stir it again after a while, as I mix the dry and wet, he thinks I'm remaking him dinner so he eats again. He always finishes his food by the time I feed again.
 
Adam Flowers said:
An hour and a half in and Mogee's bg is 277.
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ProZinc usually onsets around 2 to 3 hours after the shot. The two BGs you have are essentially the same because meters are allowed a 20 % variance. It's also quite common for response to insulin to be erratic at the start as Mogee's body learns to adapt to it.
 
3 hours in. Mogee is at 258. Should I stay up and test at the 6 hour mark? He should be fine if his levels are still that high correct?

Do you recommend I give 2 units at 6:30 am if he is under 200 when I test?
 

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All I can tell you is that, if it was me, I would still test at +6. The more data you can gather, the better. You do not know when in the cycle he will be lowest since this is his first time. He does not seem to be dropping very much though.. it's your call. Every cat is so different. I have a very 'bouncy' kitty whose numbers can go from sky high to too low and everywhere in between. I have to test her a lot and move her dosing VERY slowly to allow her body to adjust. Your cat may be completely different.

As far as what to do if he is under 200 in the morning at shot time, I would refer you again to the ProZinc protocol on this site:
"In the beginning, if your cat’s BG is not up to at least 200 mg/dL {11 mmol/L}, if your schedule allows, you can stall (without feeding) for 20+minutes, then retest the BG. You are looking for a number that is rising, not falling and up to 200 mg/dL {11 mmol/L}. If you stall once, but can’t do another round of stalling and your cat hasn’t reached a BG of 200 mg/dL {11 mmol/L}, you’ll need to skip the dose and wait until the next cycle."
 
Hi Adam! My cat Goof has been on ProZinc for nearly 3 years now. True that it's a pricier insulin, but it's flexibility is a must for us. We started at .5 u, his diagnosis number was 652. By starting at 2 u you might miss his "sweet spot" which could be a much lower dose. It takes time, usually 72 hours for ProZinc, for the kitty's body to "learn" how to process the insulin. That's why it's recommended to start low and change the dosage every 72 hours if needed. Also, with those low diagnosis numbers, he could very well go into remission! :) Cats will do that quite often.

One other thing, I was floored when I saw Mogee's pic! I have a cat that looks just like him, his name is Moggie! :cat:
 
FurBabiesMama said:
All I can tell you is that, if it was me, I would still test at +6. The more data you can gather, the better. You do not know when in the cycle he will be lowest since this is his first time. He does not seem to be dropping very much though.. it's your call. Every cat is so different. I have a very 'bouncy' kitty whose numbers can go from sky high to too low and everywhere in between. I have to test her a lot and move her dosing VERY slowly to allow her body to adjust. Your cat may be completely different.

As far as what to do if he is under 200 in the morning at shot time, I would refer you again to the ProZinc protocol on this site:
"In the beginning, if your cat’s BG is not up to at least 200 mg/dL {11 mmol/L}, if your schedule allows, you can stall (without feeding) for 20+minutes, then retest the BG. You are looking for a number that is rising, not falling and up to 200 mg/dL {11 mmol/L}. If you stall once, but can’t do another round of stalling and your cat hasn’t reached a BG of 200 mg/dL {11 mmol/L}, you’ll need to skip the dose and wait until the next cycle."
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I appreciate the help more than you know! I did not test him at midnight. I got up and he was eating and was acting normal. I felt bad I poked him that many times already with it being his first night.

He was 334 when I tested this morning. I then did my first fur shot. Shucks. Had to reshoot. I will get his +6 bg on my lunch break today.

Have a good day!
 

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Hello and good morning!

Is it possible to do any monitoring other than the +6 today (sounds like you might be out of the house at work)? We don't recommend re-shooting a fur shot-- you just never know if some of shot #1 went in, so you could end up with a larger dose than intended. Definitely make sure there's plenty of food out for him to munch on today, if you can't be around in the morning when the ProZinc onsets-- lots of cats will go seek out food if they start to go low, which helps keep them safe.

I hope this doesn't freak you out-- I think he should be fine today, just giving you the fyi for the future.

Will be looking out for the +6 (or earlier if you can swing it)!
 
Nan & Amber said:
Hello and good morning!

Is it possible to do any monitoring other than the +6 today (sounds like you might be out of the house at work)? We don't recommend re-shooting a fur shot-- you just never know if some of shot #1 went in, so you could end up with a larger dose than intended. Definitely make sure there's plenty of food out for him to munch on today, if you can't be around in the morning when the ProZinc onsets-- lots of cats will go seek out food if they start to go low, which helps keep them safe.

I hope this doesn't freak you out-- I think he should be fine today, just giving you the fyi for the future.

Will be looking out for the +6 (or earlier if you can swing it)!
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Thank you for the advice! I hesitated and Mogee moved as I was holding his scruff. This was only my second injection. I am not sure if him moving caused me to miss completely or if the needle went through the scruff because I saw the end of the needle and the insulin squirt out. I know that may sound bad that I kind of freaked when he moved but I am still getting comfortable with this. I saw the insulin and felt it on his coat. I feel awful but I know I have not hurt him yet.

So I felt I should still refill and do the 2 units as I'm almost certain I missed completely. I will see if I can leave work for a bit to test at +3. I know I can get a +6 for sure on lunch break.

Thanks again for the help!
 
You'll be surprised at how quickly this becomes routine. Your calmness and confidence will grow quickly. We all understand how anxiety-provoking it is at the start. Feel free to come here and ask questions anytime! :)
 
It's hard to have a job or get any sleep when you are trying to get your cat regulated. :) You are doing SO good for how fresh this all is. The fact that you started home testing right away is impressive.

Maybe during the weekend you could do a curve (test every two hours for 12 hours.. or 24 hours). That is the best way to get a picture of the insulin impact throughout the cycle. (AAHA guidelines say to base dosing changes on curves; they also say that in-clinic testing is impacted by stress so at home testing is best.) I found that getting more data made me feel less anxious because I had a much better idea of what was going on with my baby.
 
I was a bit late getting off for lunch. Could not get a +6.

Mogee's +7 was 332. Does it usually take a few days for the body to adjust? I know Mogmom and Goofus, you mentioned 72 hours? The lowest he's gotten has been 258.

My vet wanted to see Mogee a week and a half after starting yesterday to check glucose. Seems like a long time to go back in and adjust if needed.
 

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Remind us of your feeding schedule.. are you leaving the Glycobalance dry out for him to free-feed on? I could not find a straight answer on the carb % in that stuff, but doing the calculation based on the guaranteed analysis data that I did find, it could have as much as 29% carbs. So, it will have a big impact on his numbers. (Sorry, it's just the truth.) On a few occasions when Mia was starting to go too low, I gave her a few kibbles of a dry food with less carbs than that and saw an immediate impact in her numbers. I keep it on hand for 'emergencies' like that but would not feed it to her as meals since I KNOW it impacts her glucose. (Some vets would rather put them on a higher carb diet and give them a higher insulin does to counteract that. I do not get that logic. I would rather feed lower carb and need less insulin.)

Every cat is different, but the effects of the insulin do seem to change after a few days (and continually over time). That is why it is a good idea to hold a dose for a few days before deciding to make changes.
 
Since you do not have a spreadsheet yet, let's compile the numbers you have so far so it will be easier for anyone that pops in to comment:
PMPS 284
+1.5 277
+3 258

AMPS 334
+3 269
+7 332

And, maybe we can get a few folks with ProZinc experience in here to give their input so you are not hearing from just me. :) @Yong @Rachel @Kris & Teasel (These are the ones that have posted to give me input in the past.. I am sure there are many others, too.)
 
FurBabiesMama said:
Since you do not have a spreadsheet yet, let's compile the numbers you have so far so it will be easier for anyone that pops in to comment:
PMPS 284
+1.5 277
+3 258

AMPS 334
+3 269
+7 332

And, maybe we can get a few folks with ProZinc experience in here to give their input so you are not hearing from just me. :) @Yong @Rachel @Kris & Teasel (These are the ones that have posted to give me input in the past.. I am sure there are many others, too.)
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The high carbs will offset the insulin, so more insulin will need to be given. In cases of dka or hypo then a higher carb can be necessary.
So consider it this way. You have a scale and on one side you have carbs, on the other you have insulin. To get them to balance the amount of insulin must be in proportion to the carbs.
The more carbs you have, the more insulin is needed to balance the scale.

Going on the numbers above in this case, the amount of insulin is less than the carbs.

The option is to give less carbs so the insulin can work, then reduce the carbs slowly while reducing the insulin to find a happy balance that works for the cat.
Otherwise you are dosing insulin the cat doesn't need because the blood glucose is artificially inflated by the high carb food. BUT it's important to reduce carbs slowly when insulin is being given to make sure the correct dose is given and prevent a hypo.
 
It's really too early to assess the dose. He's only had two shots, right? Keep up the dose for now. The others have addressed the carbs issue. That can certainly affect the BG level.
 
I am by no means an expert but I can share my experience with you. When Sookie was first diagnosed she had similar numbers to Mogee and my vet also started her at 2 units of prozinc. I didn't get any tests other than preshots for the first week. Mostly because it was so new and we had a hard time adjusting to it, but we both survived just fine. :)

My vet asked me to do a curve at home after that first week and the insulin seemed to be working. Even though I didn't test mid cycle the first few days, I really think it takes time in some cats to work. For example, whenever I change her dose the first day is always a weird one where her numbers stay high and flat and the insulin doesn't seem to work at all. Now I know to evaluate it the next day and it will work just fine. I read something about it on here and it was called new dose wonkiness.

That may be what's happening, maybe not, but with this condition nothing is linear and doesn't always make sense. It really just takes time to see what's going on. Don't get too caught up in individual numbers (unless you get a low one), we look for patterns. Patience is important, give him and yourself time to adjust to the new normal. :cat:
 
Thank you for all the responses. I will re read through and respond after work tonight!

I know my vet started Mogee out at 2 units/twice a day but he did say he believes, based on his weight that we will probably get to 4 units twice a day.

I am feeding him twice a day. 6:20 am and 6:20 pm. He usually eats half the amount given and I allow him to graze on the rest. The remainder is usually gone by the next feeding time .
 
Adam Flowers said:
Thank you for all the responses. I will re read through and respond after work tonight!

I know my vet started Mogee out at 2 units/twice a day but he did say he believes, based on his weight that we will probably get to 4 units twice a day.

I am feeding him twice a day. 6:20 am and 6:20 pm. He usually eats half the amount given and I allow him to graze on the rest. The remainder is usually gone by the next feeding time .
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The insulin dose isn't always weight-related. There are very large cats here on tiny doses and vice versa. It's a hormone, not a drug so viewing its dosing as being proportional too weight can lead to overdosing. The dose also changes over time - it's rarely static.
 
Hmmm, yeah the insulin and weight aren't necessarily related. I agree that you should stay the course for now...give it a few days of dosing and let's see what kind of numbers you get. Feel free to keep posting...we like being updated on numbers!

It's fine to let him graze, but if you can, it's best to keep him from eating 2 hours before the shot. That way, you get a true number that isn't food influenced. If you're at work at that time, a lot of people use a timed feeder and just set it to rotate to an empty slot 2 hours ahead of time.
 
Thank you for the advice everyone. I do not have a vet appointment until the morning or October 7th. So Mogee's insulin would not be increased or decreased until then. Unless something crazy happens with his numbers.

This is still new to me. Just letting you guys know what I've been told so that you can help me with the best advice. I know nothing about weight to insulin ratio, just know that when told his initial dose of 2 units, I believe my vet said he thought Mogee would end up on 4.

I hope that is not the case and this all starts to work out. All of your input is greatly appreciated.
 
My laptop has been giving me some trouble and I have not been able to figure out how to get a link on my phone. I have been keeping a spreadsheet though. If anyone knows how to get a link via their phone I have the Google drive spreadsheet. Otherwise I will put the link in my signature once I get it on my laptop. Thanks again guys.
 

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Adam Flowers said:
My laptop has been giving me some trouble and I have not been able to figure out how to get a link on my phone. I have been keeping a spreadsheet though. If anyone knows how to get a link via their phone I have the Google drive spreadsheet. Otherwise I will put the link in my signature once I get it on my laptop. Thanks again guys.
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Download Google sheets to your phone and then you can open the spreadsheet. Once opened, you simply click on share and export (should be in a drop down menu), then click get link and it should be copied to your phone.
 
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