@Deb & Wink , Could look at Ninja’s SS? I bumped his dose back up to 0.75 as he was getting higher numbers on the 0.5. His number to me still seem to higher than desired, but not horrible I think. Should I stay with the 0.75? I’ve had the vial of vetsulin for a month now. Time for a new one or should I see if my vet would let us try a different insulin?
I'd bump to 1U. Try to hold the dose for at least 3 cycles, unless of course you see really low BG readings, <100. Then ask here if you can, have time. Numbers are drifting higher. The 0.5 wasn't enough and the 0.75 doesn't look like enough either. You're at 37 days using this vial of Vetsulin if I counted right. Can't say yes or no for sure on that question, if you need a new vial or not, but I'd guess yes you do. Soon. Label says 42 days on Vetsulin once it's opened. Don't know if it's effective much after that point. I believe the "42 days after vial is open" is because of risk of bacterial contamination (sterility) and how much active insulin is in the vial. Since Vetsulin is made of 2 different components, it can be difficult to get those 2 parts mixed back together evenly with the "shaking" of the vial before each and every use. That can change the effectiveness over time. Got those details from here. You try to mix the Vetsulin well before drawing each insulin shot, but there can be variations in how well the vial gets mixed. That is part of the 'active insulin' remaining. Might not be a case of "Well, the vial looks more than half full to me", as it is of the insulin losing it's effectiveness. Insulin degrades over time. Not as stable as say a bottle of tylenol capsules. Some cats respond well to Vetsulin. Some don't. No single insulin works well in every cat. ECID. I'm not seeing the duration with the Vetsulin that should be happening if the Vetsulin was working and working well for Ninja. If you are thinking of a different insulin for Ninja, you might consider either Prozinc or Lantus or Levimir. Prozinc is an in-and-out insulin, usually only lasting 12 hours. I think of Prozinc as a longer lasting for 12 hour cycle insulin good for cats. Lantus and Levimir are both longer acting insulins, lasting more than 12 hours. It's why cats that get regulated on Lantus or Levimer get those nice shallow U shaped curves. Please, please do not let your vet talk you into using NPH type insulin. Cats might get a 6-8 hour duration. If you can't dose 3 x a day, then Ninja would be in high numbers for most of the time. NPH insulins work better for dogs. Don't let the different forums scare you off, each one has it's own style and the Lantus forum gets real busy and likes people to post a certain way. May seem picky, but it helps the experienced people look for any issues and prioritize which thread they open for the day. Think of it as being only so much of our time to go around to all those asking for help. Let me know if you decide to switch insulins. There are some ways to purchase the insulin besides your vet or a US pharmacy that will save you a LOT of money, especially with Lantus. Maybe read some of the information in the 'Sticky' posts over in the ISG forums. There are "beginners guides to....." or "new to the group start here" type documents in the different Insulin Specific Forums (ISG). The choice of insulin is really 6 of one, half a dozen of another. If you want some info to share, make your case for a different insulin with your vet, both the (2018) AAHA Diabetes Management Guidelines for Dogs and Cats and the (2015) ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats are a good starting point. Both published journal/vet knowledge type of articles a vet should have access to. p.s. Lantus requires no shaking or mixing. Even though many vets (including the ones I worked with) think so. It's not a suspension. There is nothing to mix. p.p.s. Sorry for the long post. It's my besetting sin when helping people out here. If you have more questions, simply ask. I'll try to find out answers for you. Or do a brain dump of what I know.
3 cycles? Is a cycle a 12 hour period or a day.? I think I will talk to my vet about prozinc or Lantas. Would you recommend one over the other? Thankfully he appears to still be happy, eating, pooping, playing.
Each cycle is a 12 hour period. The time period that elapses from insulin dose to insulin dose. Either insulin is good. Prozinc is a FDA approved insulin for veterinary use. Lantus is prescribed 'off-label'. Vets use various medications all the time with that 'off-label' prescribing. Some vets have more experience than others with one or the other of these insulins. It may be their experience and willingness to prescribe a different insulin that makes the decision for you. Getting your cat feeling better is the ultimate goal. Glad to hear Ninja is happy, eating, pooping, playing. Purring up a storm I bet too. Was he the one responsible for the snowstorm on the east coast here last night? After all, if the butterfly effect can have such world shaking consequences, why not a cat purring?
Ok, so he has been on the 0.75 for 5 cycles. Continue that dose or bump it up? I’m going to present my vet with Ninja’s SS and the articles you provided. I think it is in Ninja’s best interest to try an insulin for cats. As for the snowstorm my kitty is innocent, he hates snow! Lol!!!!
Yes, bump it up. You can try to keep the increased dose for longer than the 3 days. You'll just have to see how he does on the increase to 1U. Especially point out the duration is not there. If you have a chance before a vet visit, do your own curve at home. Testing every 2 hours from pre-shot to pre-shot.
Ok I’ll give him 1 unit tonight. I can do a curve tomorrow as I am off. Once again. Thank you so much fur your help.
Emailed my vet this morning asking to try a different insulin. I provided him the articles and Ninja's SS. Hopefully he will agree.
My vet said he would be happy to switch his insulin and gave me the choice as to which one I would like to try, any suggestions? I was leaning towards Prozinc simply because I have 100 u40 syringes but would love opinions.
Maybe post that question in the Main/Welcome forum too? More likely to get other opinions there. There are pros and cons to both. Change the title on this post here, to reflect your new question. (upper right, edit thread) People here in the Vetsulin forum may chime in also. Read the stickies at the top of the Prozinc forum for more info. See if you think it would work for you and your schedule. Prozinc pros - It's an in-and-out insulin like Vetsulin. Longer lasting, better duration than the Vetsulin in most cats. May work better with your work schedule. More flexibility with shot times, adjusting back on schedule if you are late/early giving shot easier than with Lantus/Levimir. You've got some experience with an in-and-out insulin. I think it's a good insulin for cats. cons - not as many people here that have that Prozinc knowledge to help you. Don't let that be your deciding factor. Read the stickies at the top of the Lantus/Levimir ISG to learn more. Lantus/Levimir pros - Long lasting. Lots of experienced people to help out. Picky about how you post, but I understand why. It's because they have so many people they keep an eye on. Specific title formatting helps them to do that. cons - Understanding the "depot' effect. Not a real con, but works differently than the in-and-out insulins. More expensive, but there are ways to get it at better cost, (canadian pharmacies, craisgslist, etc.) As long as you don't pick NPH insulin, I think you are good. Sorry, but that one scares me. Drops hard and fast. Even harder and faster than Vetsulin. If you can dose every 6-8 hours, then maybe. But you work full time. NOT my recommendation for ANY cat. It's cheap, and that is the only pro for NPH insulin in my opinion.
Good luck! I'll watch for your posts. Let me know when you do the switch. Start posting over in the Prozinc forum. Please. Be sure to prominently mark on your SS when you do the switch. An entire row across the SS, on the AM cycle side will show up better. In large font size too helps, or all bold. Good to do if you ever make another major type switch like in food from dry to all wet, or from a pet meter to a human meter or vice versa. And put a link in at the top of your first post over there, to your other posts from the Vetsulin forum. And maybe even your first thread from the Feline Health Main forum. It's good to be able to look back at the history, and easier to do if it's linked into your post. How to is here, from the Announcements forum 'sticky'. HOW-TO USE THE FDMB: The Basics Not sure how much your vet charges for Prozinc. I know some people buy it through Chewy.com but your vet has to be willing to send them a prescription. I used Chewy for an antibiotic my cat needed, that my vet didn't carry. I ordered it first in my Chewy account, and put in the vet info and Chewy did the contact with my vet. Worked ok for me. Prozinc is $106.29 at Chewy with free shipping. Cold temps this time of year may be a factor, as you don't want insulin to freeze. Ever. Where is that darn thumbs up smilie!?! Well, that is what I'm thinking for you and Ninja.
OK, will do!! The vet told me they have an online pharmacy that they will have to order it from, I haven't received the email yet to confirm the order. I may ask to go thru chewy if is much cheaper. I do know that my vet charges a 10.00 fee if they go outside their pharmacy but it still may be more cost effective doing it that way. I read many positive reviews on chewy regarding the shipping of the insulin. Either way no matter who I get it thru it will have to be shipped. I was told the vet would calculate his dose but I am going to ask you all first to avoid the fiasco that I had with starting the Vetsulin. Thank you so much!! I'll keep you posted!!
Prozinc is ordered. We did go thru chewy.com. The vet put the dose "use as directed" He said you know your cat best and I trust the help you have been getting and I feel comfortable with you monitoring his dose." I will post when I get the new insulin in the prozinc forum for dosing instructions with your instructions to include prior posts. I am indebted to you @Deb & Wink . You have been a God send!!
When switching from one insulin to another, you take the current dose into consideration. (That is one good reason not to lie to your vet about what dose you are giving. Yes, we have had members do that, lie about the dose to their vet.) If you share the SS with your vet, they see immediately what dose you are giving. Then you may be in 'deep kimchi.' Please don't get yourself into hot water with your vet. I certainly would not start the Prozinc with more than the 1U dose that Ninja is on now. Let's see what your vet says. Second opinion so to speak. Shoot/no shoot number PS (pre-shot) BG for Prozinc should be 200, just as it was for Vetsulin. That can be lowered in the future, depending on how Ninja does. Lime greens on SS at mid-cycle, yell for help, 911 in the Main forum or call your vet. Lime greens on SS before mid-cycle, yell for help. Print out that dosing Protocol from the Prozinc forum. Read it. Understand it. I know that people are working on getting some documents updated, and that may be one of them. It's a good general guide though for now. I'll help as much as I can. Learning more of the ins and outs of Prozinc myself. By reading, reading, reading and finding some good past threads from other experienced Prozinc users. ECID. Every Cat is Different and Every Caretaker is Different. You should see more of a 'Smile' shaped curve when using the Prozinc. Another way to say that is that Prozinc 'flattens out' the bottom of the curve at nadir time (+4 to +7) instead of diving as deep as Vetsulin. I can see it when I look at spreadsheets. Practice, practice, practice. Looking at lots and lots of spreadsheets. You've got this.
I did show Ninja's SS to my vet so he is well aware about the changes I have done. I have a feeling that's why he put prescribing dose as "use as directed." He told me feels comfortable with me adjusting the dose as needed. He only asked that I provide him with a weekly progress report so they can put a note in Ninja's medical chart. I feel very fortunate that my vet has been very open minded with this change. I will read up more on Prozinc tonight with the links you have provided.
You have a good vet. He's a keeper. Weekly update in the vet chart is an excellent idea. p.s. My civie (non-diabetic cat) just had her annual vet visit this week. Vet just called with the lab results. Most things look good. High cholesterol, thyroid normal, BUN/Creatinine normal. Still low Urine specific gravity. My vet says she is an 'anomaly' but we are treating her as if she has early kidney disease. She is more than her lab values and is a happy cat, eating, pooping, purring, playing. She just pees tons. Like enough for 3 kitties. And no, she is not diabetic, HyperT or other conditions. I ear test her now and then to double check. Happy cat and feeling good are enough for me. (Although she is not too happy with me if I spend too much time on the computer. So we just did snack and playtime with her.)
Awe your kitty sounds like a sweetie!! Hope she feels better and labs stay unchanged or better. I get the stink eye too from all 3 at times. Ninja walks around and meows telling me he wants to play fetch, Jasper just stares at me until I provide him my undivided attention, Smokey just comes up and plops down on my chest no matter what I am doing!! She's a bit pushy! LOL!!
