Vet switched Linus from Novin N to ProZinc, need urgent help

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Susan Jacobson

Susan Jacobson

Member Since 2016
I ha started a thread and was directed to post here where the Pro Zinc experts would be. Linus was diagnosed 3 years ago and used Novolin N for the entire time, we had good success for the first 2 years, since then it has been a roller coaster ride. The vet finally switched him to ProZinc, but trying to get the dosage so he does not drop too low or get too high is difficult. We are cat people, we have 7, Linus is 14, his mother Abbey is 17, Frank Sinatra 11, Blondie 11, Molly 11, Cleopatra 11, Garfield 6, he was found in the back of a delivery truck at 3 weeks old, we got him through pneumonia, and he had mega colon so his colon has been removed. Our kids are grown and have families of their own, our cats are our family. We lived in the country for years, and plan to do so again soon, when we did, people were always dropping cats off , we would take them in , bring them to the vet to get fixed and healthy, inoculations, vitamins etc and adopt them out for free. We are not strangers to medical needs and hands on care, but this diabetes has thrown us for a loop. Linus has lost so much weight he is skin and bones, I fear for him right now and need help to get him healthy and managed. I will be providing a spread sheet when someone helps me make one. We started the ProZinc on Thursday Morning July 14th, this is the data I have compiled thus far... A couple questions first please, what is the idea number for his BS I am shooting for so he can gain some weight? The vet gave us some wet and dry W/D Digestive/weight management, would this not make him lose more weight? He is not a big eater per meal, but grazes every couple hours per day. I do have open feeding with 7 cats with dry food, I have Cat Naturals and Kitten Chow as those were the higher protein foods I could find in our price range. Linus eats mostly wet food, Fancy feast chicken, turkey and giblets, chicken and liver, and some Friskies turkey and giblets. He will eat a bit of dry but not more than a couple times per day, and approximately 5 to 6 pieces per time. Here is the data:

Blood sugar morning 376, gave him 1 UN Prozinc;
1 hr after shot BS 313
2 hrs 343
3 hrs 285
4 hrs 297
6 hrs 252
Keep in mind he is a grazer so this is not going to be easy.

Evening Blood sugar 381, gave him 1.5 as we thought his daily numbers were a bit high
1 hr after shot 329
3 hrs 215
6 hrs 190

Day 2:
BS 349, we gave him 1.5 UN, still trying to get him between the 120-170 that he should be at, is this the right range, will he gain weight as he needs to badly?
2 hrs after shot 247
4 hrs 136
6 hrs 98, we gave some wet food and few drops of Karo as we thought below 100 was not good.
15 minute check after the wet food with the Karo BS is 113
7 hrs 200

Evening BS 308, we gave him 3/4 of 1 UN
got up 4 hrs later to check him and BS was 190

Day 3:
BS was 363, we gave him 1 UN as we feared he would drop too low like the day before
3 hrs after shot 150BS
4 hrs 98, gave a few drops of Karo in wet food again as he was below 100.
5 hrs 116
6 hrs 120

Evening:
BS was 381, we gave 3/4 of 1 U
3 hrs after shot 330
5 1/2 hrs 317

Today thus far:
BS 329, we gave him 1/2 U ( .5)
2 hrs after shot 312
4 hrs 300
6 hrs 347
8 1/2 hrs 382
I use a human blood sugar meter Relion Confirm, we had the same tester for 3 years so we just went and bought another to make sure we were getting the correct readings, they us .3 blood, and don't seem to bother Linus too much. Will this give the correct readings for a cat? We love this meter, happy we bought the same one.
With the Novolin N , he had been on it so long we had a cheat sheet we used to know within 10 BS points what dose to give him, with this new insulin I am worried we will not get him regulated, he has lost SO much weight, I have to get some weight on him, any suggestions and help will be more than appreciated. Thank you :) Anxiously awaiting a reply in Minnesota.
 
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Hi Susan! Welcome to the ProZinc forum. We're a small, friendly group. Quick note, if you ever have an emergency situation, post both here and on Health so you can have lots of eyes on the situation.

I have read your thread on the intro forum. I'd like to know what meter you are using. Is it the Alpha Trak 2 or a human meter? Either is fine, but the number ranges are different depending on which.

I will say that on EITHER meter, 98 isn't too low. It's a really nice number actually. On the pet meter, you want to worry around 68..human meter 50.

He's actually look really good. I know it may not seem it, but you've had some lovely lower numbers in the last few days. I know Sue suggested maybe 1.25 units and I think that would be a great dose. Obviously the doses under 1 unit haven't been enough. I think 1.25 would keep him in good ranges and help you feel comfortable that he wouldn't go too low.

To answer your question about numbers. Basically, for regulation, you are looking for yellow preshots (which are in the 200 range) and double digit nadirs (mid cycle) that don't go below 68 on the pet meter or 50 on a human meter. That's regulation. From there, we work on possible remission.

I know that the weight is a concern, but as he gets regulated on insulin, he is probably going to gain weight much more easily. His body will be able to use the food more efficiently and it will help. I know you said he free feeds and that's fine (mine all do too). However, the prescription food the vet gave you isn't necessary. It's not very high quality and very few people here use it. A low carb wet food is best.

I don't want to overwhelm you, Susan, so I'm going to leave it at that for now. I think 1.25 is the dose I would give if he was mine. What questions do you have for us? We're happy to help in any way we can!

Most important thing of all: Breathe. It's going to be okay. You're not alone in this, and we have all been there...and are here for you.
 
It is a human one, we always used the relion confirm so we bought a new one it uses .3 for blood sample. It was recommended by the vet as well.
 
Sounds great! We usually use that meter around here too. Some folks use other meters, but the relion tends to have the cheapest strips with the smallest blood sample. I love that your vet suggested it. Mine did too, but most vets don't. It's nice that another one out there has sense!

With the relion, hypo range starts at 50. So really his numbers have been great.
 
Hey, Susan. Glad you made it over here. I think I covered most everything in my post to you on the Welcome Forum. Glad to see Rachel thinks 1.25 may be a good dose also.

This is a small forum but most of us have notifications for people who post on it so we should find you. You might have to wait awhile to get an answer so if it's an emergency, post on Health also.

Take some time to read some of the threads here and look at other people's spreadsheets so you can see how they are dosing ProZinc.
 
I am using the conversion chart for U40 needles to U100's because they are smaller, the closest to a 1.25 would be a 1.2 is that correct?
 
Yes, 1.2 is fine.

When you look at other's spreadsheets, remember that every cat is different and what works for one won't necessary work for another. But checking them out will help you see the possibilities and how having data helps people make dosing decisions.

Have you see the protocol we put together for ProZinc? It is in my signature in blue.
 
Hi Susan and Linus and welcome!
I'm also part of the prozinc group/family:) if you have any questions, don't hesitate!
I'm from the netherlands and in a different timezone what maybe come in handy for you if it's the middle of the night for you or something like that;)!
:bighug:
 
I did a weigh in for Linus last night and he is down to 6 lbs 8 ozs, we was at 7 lbs the night before we started the pro zinc ( human insulin). I don't know what to think at this point, he is far more active, up and walking around more than when he was on the Novolin, eating about the same and same foods, but still losing weight. He is sticking to me like glue which tells me something is not right. He has been reading the higher 300's and lower 400's before shots so we have increased his Pro Zinc to 1.4 for the higher 3oo's and 1.6 for the lower 400's bs readings. I don't know what else I can do, but I am scared he is not going to make it. Any suggestions would be great.
 
If someone know what canned food I could give him that has highest calories and low carbs so I can get some weight on him that would be great. I do have a list I found online, but would much rather hear from someone who may have gone through this themselves. He would need a pate' not any chunks or shreads. Thank you :)
 
The first thing I would do is breathe, long deep breaths. You and he haven't been at this long. It will take his body awhile to learn to use the insulin efficiently. You are on a good insulin; he is on a tiny bit of insulin and his numbers are not awful. I assume the numbers you gave were before shot numbers? Do you have any tests in that 5-7 hour range? Those tests will show you how low the insulin takes him; it makes it much easier to adjust the dose if you know how the insulin is working midcycle.

I know Marji offered to fix you up with a spreadsheet. It is really hard for us to understand what is happening with his numbers without the history of doses/levels. Was there some issue with joining Goggle? The spreadsheet is a google document and being on google allows all of us to view it, when you want help. Can I encourage you to get back with her and get a spreadsheet set up?

It sounds like one of your biggest concerns is his weight? There are higher calorie, lower carb foods. You could post on the Health forum for ideas or go to the food chart we use. Check the carb column (8-10% and under) and the calorie column (farthest over to the right) and see what looks good. You can also add some protein to his food; lots of people supplement with baked chicken (no spices). http://catinfo.org/docs/FoodChartPublic9-22-12.pdf
 
It's going to be all right Susan! We're here to help. As Sue said...breathe. You're not alone in this.
 
I went to WalMart and the local grocery store in the small town we live in ( population 3,000) they had nothing in the way of wet food except fancy feast, so I stocked up more of that. At the local grocery store I found a new dry food called Diamond naturals : Protein 40%, Crude fat 20%, crude fiber 3%, moisture 10%,Zinc 150 mg/kg, Selinium 0.3 mg/kg,vitamin E 150 IU/kg, taurine 0.1%, omega 6 fatty acids 6%, Omega 3 fatty acids 0.05%, DHA 0.05%. 4000kcal/kg(400kcal/cup) Calculated metabolizable energy. The ingredients are : chicken meal, ground white rice, chicken fat, natural flavor, fish meal, flaxseed, salmon oil ( DHA),dried chickory root, dried kelp, kale, chia seed, pumpkin, blueberries, oranges, coconut, spinach, carrots, papaya, yucca extract, vitamins and minerals.

We bought this hoping the higher fat content would help him gain some weight, and noted that there was no corn or gluten or fake flavors or colors compared to the dry food he nibbles on here and there. Opinions please? This is 6% more protein and 7.5% more fat, it does not appear to have as much carb's as most dry foods. It is listed as Active cat chicken meal and rice.
 
I don't know the carb count, but the first two ingredients sure have the potential to be high carb. The rest of the ingredients (spinach, papaya, pumpkin) aren't things cats need......

If there is any way to get a wet low carb food that is more calories that would be the best of all worlds.
 
It doesn't sound like that dry food is low enough in carbs -any thing with rice and other starches are no-nos. There are a few dry foods that are lower carbs - the best (in my opinion) is Young Again Zero Carb - you can only order it on-line https://www.youngagainpetfood.com If you call the 800 number they will send you free samples. The good thing about this food is that it is very calorie dense - 600 calories/cup) My cat used to eat it, but won't any more but when he did, it did not raise his blood sugar. The other dry food you will hear about is called Evo (can order on line or some boutique pet food stores sell it) it used to be very low carb but they changed their formula and now it is higher carb - it definitely raises my cat's blood sugar but it too is calorie dense with about 600 calories per cup) My cat can only eat super premium wet food so I have to order most of his food on-line
 
The Diamond Naturals is high carb. As Sue said a low carb higher calorie wet food is best. If you have a Petsmart, Petco or Tractor Supply near you, you can get the Wellness GrainFree wet food, or order online. But if you must have dry, Young Again is low carb and high calorie. If you call the company they will send samples.
 
With the Young Again, you feed much less as it is very concentrated calorie-/nutrition-wise.
 
As BJ said, you feed less of the Young Again, so it's not as expensive as it seems. Having said that, I understand the cost thing. The Fancy Feast Classic is fine, as is Sheba Pates which are a bit cheaper at Walmart. How much are you feeding Linus?
 
He eats 3 to 4 cans of Fancy Feast per day. I am trying to find a dry kibble because he is a all day and night grazer. I did notice that the dry we got ( which he loved immediately) has 10% less carbs than the Cat Naturals and Kitten Chow he is use to. I was excited about the higher fat for calorie count and hoping it would help him put a bit of weight on. The Kitten chow has 35% carbs, the new food has 19%. I liked that it had no corn which I know is useless to a cat. I basically want to give him a supplement to help him gain some weight, he never eats a lot of dry, just nibbles. We have 6 other cat family members so free range feeding is a must, although they all get wet food 2 times per day as well. I did notice that his bs tonight was 459, which is high for him by 50 to 60 points, if we can get him regulated he would benefit so much from the 20% fat in this food ... thats my trend of thought. A low carb high fiber food would not benefit his weight issue, am I looking at this the wrong way?
 
Sometimes you have to make compromises. If your budget and circumstances mean you have to feed some dry food, then that's your reality. It's not only the carb count but also the dehydration factor, so make sure water is always available. It may mean that you have to give more insulin to counteract the higher carb.

One option is that wet food can be left out for grazing. The drying out doesn't hurt as long as it is not too hot. Another option is to feed two meals a day, not leave out any food between meals. But again, you have to do what works for you - whatever you can do that is close to the ideal: wet low carb.
 
I understand the multicat, kibble addicted grazers- I have 12 of them in my house! When Colin was diagnosed it took awhile to get a routine that they, and I, could deal with. At first nights were horrible, yowls and occasional fights, but now it's all quiet until T/F/S time @5AM. Then the fun begins! The kibble addicts get fed in a room with the door shut so Colin has no chance at their food, and I do a check for any spilled pieces before I open the door. The cats that eat the wet food eat in the kitchen with me watching so Colin gets his food and they get their Friskies. As Sue says, you'll have to decide what will work for you. If you go to the Young Again website, they have some dry food charts showing carb levels of some foods.
 
We plan on ordering some of the young again, do we want the zero carbs? or start with the 5-6 % as I don't want to send his blood sugar in the ditch. He is an older cat 14, he benefits from the smaller pieces as he has had some teeth removed. Until we can get some ordered we are giving him a little of the Diamond naturals when he eats his wet food, it seems to stick with him a bit longer, plus it has 10-15% less carbs than the dry he was nibbling on. He seems more perky and active, and when he sleeps he seems more relaxed. His blood sugar has been in the lower to middle 400's, so we decreased the amount of the dry he can have to a smaller amount, now his blood sugar is in the 350-390 range, so we are fine tuning until he gets some weight on and then will be reducing the carbs. We gave him 2 U today at a BS reading of 384, checked him at 2 hours out and he was at 286, at 4 hours out he was at 291, will update with a 6 hr reading, and an 8 hr reading. I plan on doing a every 2 hour curve in the next few days. :)
 
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You are doing great Sue. Murphy's 11.5 years old and I fed him the zero mature If I were you, that is what I would get. Do call on Monday and they will send out free sample. A word of warning You have to introduce the food gradually or you will see tummy issues
 
Thank you Carol and Murphy. He already has a very fussy tummy when we introduce new foods, we will go slow with it, I appreciate you letting me know this. :)
Murphy is a very handsome kittty!!
 
Yes, the Zero Mature is what you want. It's possible that when you get the blood glucose under control, Linus will begin to gain weight.
 
Well the dry food is a total bust, his BS has stayed in the lower 400's for this afternoon, that is not good. Until we can buy the Young again dry for his urge to munch and graze we are using the w/d dry the vet gave us, along with the fancy feast. Its sad because just one night and part of a day eating a little of the diamond naturals his stomach actually feels a little fuller, and he was eating less often, but it is not going to work for him.
 
The wellness has less protein and more carbs than the Fancy Feast, I think we will stick with the Fancy Feast for wet food, I will get the Young Again dry food ordered on monday. I was going to drive to a bigger town about an hour away to Petco if they sold Young Again, but I did not find anything that had the same nutritional values at their web site.
 
I will be ordering the Young again tomorrow, and thank you all for the wonderful advice :). I think I have figured out part of the problem getting him regulated on the new insulin, when he was on the novolin n and an example here.... his BS was a 380, we gave him 2.5 units, that would be 250 mg of insulin, now we started on 1 unit of the ProZinc, that is 40 mg is that correct?
 
So was he getting2.5 units of Novolin when he switched? but when I looked at his first numbers, one unit of ProZinc gave you a 98?

Susan, trying to stay on top of his history is hard without a spreadsheet. We just can't be trying to figure out dosing by trying to find a thread that has some of his numbers. We want to be able to respond when you need help, but be able to give good, safe advice. Please contact Marji and have her set you up with a spreadsheet. You will need to set up a Goggle account first - easy to do, free.
 
You were asking about more calories. That's why I mentioned wellness.
Susan Jacobson said:
The wellness has less protein and more carbs than the Fancy Feast, I think we will stick with the Fancy Feast for wet food, I will get the Young Again dry food ordered on monday. I was going to drive to a bigger town about an hour away to Petco if they sold Young Again, but I did not find anything that had the same nutritional values at their web site.
Click to expand...
 
My offer to do a SS still stands at any time, Susan. It’s a quick thing for me to do and will benefit you both very, very much in the long run.
 
I made one in excel, but thank you for the offer. :) Linus was at 7 lbs on Monday this week, started the young again zero carbs on Tuesday and weighed him tonight to find out he weighs 6 lbs 8 ozs, so he has lost weight, I am going back to the w/d we got from the vet with the fancy feast and will see what happens.
 
Hi Susan - welcome to ProZinc land :)

The spreadsheet that Sue, Marje, and Rachel are talking about is actually online and can be posted in your signature (look at the link to Rain's spreadsheet in my signature for an example). This way when you have dosing questions, anyone responding can click on the link in your signature and actually see all the values on the spreadsheet and how Linus has been responding to insulin. It's extraordinarily helpful and time-saving when trying to answer dosing questions or help with interpreting values (for example, my Rain experienced some bouncing and all I had to do was post asking if that was what was going on, and other more experienced members could look at my spreadsheet and see all my values and help me interpret them).

Just curious, but has Linus been checked for other things that might cause weight loss? I'm particularly thinking of hyperthyroidism. Has he had senior bloodwork done recently?
 
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Yes, the vet did blood work for the thyroid and says all is well. I am wondering if he may have an infection somewhere. We have an ongoing prescription for liquid amoxicillin that my vet writes in for a year at a time, long story short, Blondie, one of our cat people has cancer, and believe it or not having him on a daily dose of the anti biotic has kept it at bay for over 3 years. I called to fill it again and will give to Linus as well. The Young again food is not doing a thing for his weight at all. The young again and fancy feast have kept his blood sugar in the low to mid 200's which has taken the insulin injection amounts down to .6, but today he dropped to 58, so reducing to .4 tonight. We test every 12 hours before eating and then injection, he does not always get the same amount, it depends upon his numbers.
The whole thing with a spread sheet is I do not want any google account, I had one before and it forces you to be signed in for everything you do online such as it will no longer remember your passwords for email accounts, you tube, websites and/or blogs unless your constantly signed in to the google service. I would rather just have my spread sheet chart in excel, I appreciate all the information and suggestions. :)
 
I started Linus on the Amoxi today and also talked to the vet. She said the w/d my hubby got from them was the one for weight loss, and not to use it. Being that he has not gained any weight and since the zero carb formula a week ago he has lost a few more ounces, she wants me to continue with the fancy feast as usual, but allow him to graze on what he is use to ( kitten chow and cat naturals) until he puts some weight on. We will have to adjust his insulin to balance out the carbs, he should gain weight. It's interesting to me that after all the money for special foods, he has not gained, and instead he has lost weight. Her school of thought right now is to treat the diabetes, and not try to get into remission, when she first started treating him she was all about remission. I tend to agree with her at this point, Linus is 14, he has dealt with this disease for 3 years and we are spinning our wheels with this never ending different foods that never seem to work for him. I do have a bowl of the Diamond naturals as well because it has high protein as well as some high good fats. The carb levels of the kitten chow and cat naturals are 33%, and the diamond naturals is 26%, so they are high in carbs, we will balance with the insulin and fingers crossed he will gain some weight, once we get the weight up to an optimum weight we can fine tune things.
 
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