Switching

Status
Not open for further replies.
B

Barbara Carella

Member Since 2011
My cat is currently on prozinc but I am starting to run low and after finding out about the shortage, I am getting very worried. My vet doesn't have anymore. So I'm trying to prepare in case I can't get anymore. How do I switch to another insulin like Levemir? I test my cat twice a day.
 
Is your vet on-board with you switching? That is easiest, although many, like myself, made the switch on our own.

Can you tell us about your cat (name, when diagnosed, how long s/he has been on prozinc, any other health issues, etc.), what her BG's have been for the past couple of weeks*, and what dose s/he is on?

Usually, the switch is to a lower dose than before, testing to get an idea of how the dose is working and then slowly increasing. Testing in between the shots is needed to see how low the BG is going. This is important is determining dose changes.

*I don't suppose you have a spreadsheet with kitty's numbers? If not, you can post numbers like this:

7-15
am 250 shot 1u
pm 225 shot 1u

7-16
am 275 shot 1u
pm 280 shot 1u

7-17
am 175 shot .75u
pm 250 shot 1u

etc.

Lev is a great insulin. There is lots of info about it in the Lev 101 "sticky" at the top of this forum page.
 
My cat's name is Simon. He's been diabetic for about two years. He's a rescue cat so it's hard to tell how old he is but I think he's about 14 or 15 years old. I haven't talked to the vet about switching him yet. I asked his assistant to order the prozinc but I don't know if I will get it in time due to the shortage and I'm running low. I don't have much faith in my vet because he hasn't been much help in trying to get Simon's numbers down. I've basically been on my own. His numbers have been all over the place but his teeth are really bad so that might have something to do with it. I think he was rebounding a lot and that I was giving him too much insulin but I've since gotten it down to 1-2 !/2 units twice a day.

7-14
am 193 shot 2
pm 149 shot 1 1/2

7-15
am 59 shot 1
pm 265 shot 1 1/2 unit

7-16
am 322 shot 2 units
pm 63 shot 1 unit

7-17
am 373 shot 2 units
pm 192 shot 1 1/2 units

7-18
am 117 shot 1 1/2 units
pm 168 shot 1 1/2 units

7-19
am 228 shot 1 1/2 units
pm 79 shot 1 units

7-20
am 196 shot 1 1/2 units
pm 302 shot 2 units

7-21
am 337 shot 2 units
pm 180 shot 1 1/2 units

7-22
am 223 shot 1 1/2 units
pm 168 shot 1 1/2 units

7-23
am 103 shot 1 1/2 units
pm 328 shot 2 units

7-24
am 213 shot 1 and 1/2 units
pm 144 shot 1 1/2 units

7-25
am 80 shot 1
pm 190 shot 1 1/2 units

7-26
am 219 shot 1 1/2 units
pm 166 shot 1 1/2 units

7-27
am 309 shot 2 units
pm 266 shot 2 units

7-28
am 336 shot 2 units
pm 190 shot 2 units

7-29
am 297 shot 2 units
pm 229 shot 1 1/2 units

7-30
am303 shot 2 units
pm 74 shot 1 unit

Where do you get Levemir? I use a Relion meter.
 
Unfortunately Levemir is only available from the pharmacy with a prescription, unless you happen to be in Canada, then you can go get it without a prescription. A veterinarians could write you the script, but most will not because they are not familiar with it. We can provide you with more info to share with the vet if you need it.

There is a section like this for Prozinc insulin. You may want to post on there for some insight in to the numbers you reported. Although Prozinc should work with a sliding scale kind of like you're doing (adjusting the dose based on the preshot value) Levemir does not work that way, so you would need to understand that to use it.

You are getting some very low preshot numbers and it's not advisable to even give insulin at BGs of 63 with a faster acting insulin like Prozinc. Simon might do better (more stable BGs) if you kept the Prozinc dose the same for a while, such as 1U. But consider getting help with Prozinc from that ISG here http://felinediabetes.com/FDMB/viewforum.php?f=24
 
Barbara, I do think that Simon is probably rebounding. Seeing PS numbers in the 50-100 range, followed (or preceded) by 200-300s is a sure sign of it to me.

I actually think that his base dose should be 1u, with a sliding scale and no insulin below 150. Although, you would want to wait and retest in 30-60 mins and see if his BG was climbing. Also, getting spot checks in throughout the cycle would be very helpful and should be done when you can. At least try for a before bed test on weekdays. I know its hard to get any other tests in when you are working. On the weekends, or days you are home, you can test every 2-3 hours and that data will tell you a lot about how the dose is working. He might be even lower than those 60s a few hours before that. That is data you want to have.

If his teeth are bad can he have a dental? Or at least pulse antibiotics. I know cats that age can be at risk to go under anesthesia.

Maybe you can provide some information to the vet about lev and ask him to write a script for it. He might surprise you, can't hurt to ask. A lot of us have had vets that don't know much about diabetes in cats. That is why this board exists and does so well. IMO, with the info available here and caring day to day for a diabetic cat makes you an expert in no time!
 
What helped me change- and I had JUST switched to a new vet, too! was I printed off the information on Lev and took it to the vet. He already knew I was a fur-parent that went above and beyond his normal FD patients just because I home test and I do research into the food to make sure her carbs were under 5%. So he didn't mind that I was asking to use an insulin he had never heard of becuase he trusted me to have already done the research.

Explain that you have been informed of the PZI shortage and you don't want to get stuck. Ask if he will give you a prescription for the PENS, not the vial. Larger up front cost but the pens are 3ml instead of 10ml and you get 5 of them in a pack. Only dosing 1u- or with the changeover I would suggest less than that- .5u until you see her numbers- the large vial would poop out or become contaminated long before it was finished and you would have to toss it and buy another. The pens- less to toss and you have 4 others to use. Just make sure you get the syringes with the .5u markings on it.

If your vet doesn't want to help because he is afraid to- see if someone will sell you a pen to try out. If you can take him better numbers on Lev than PZI that might help you and any other kitty that comes along with FD.
 
Status
Not open for further replies.
Back
Top