Xuxu , switching to PZI.
- Thread starter DebH
- Start date
- Status
Sue and Oliver (GA)
Very Active Member
Looking over your spreadsheet, he seems to be really bouncing from highs to lows. So, I would start at .5 units of ProZinc. When ProZinc, you don't have to hold the dose for a week like with Lantus, so with ProZinc, after 3 cycles or so, you can raise if he is higher than looks safe.
I am wondering why you are changing. It is true he is really bouncing on Lantus, but he could do the same with ProZinc. Have you sure gotten some advice on dosing from the Lantus forum? I don't know a whole lot about Lantus but I do know it works best if you hold the dose for several days unless the nadir is in the 40s. Then you reduce by a small amount, but try very hard not to skip. Skipping empties the shed and makes the dosing really difficult. It may be that the timing of Lantus is difficult for you and if that is the case, ProZinc is a little more flexible in terms of dosing and scheduling. I am just hoping that he won't be a bouncing a cat in general. Some cats are.
Here is some info on ProZinc:
http://felinediabetes.com/FDMB/viewtopic.php?f=24&t=32799
I am wondering why you are changing. It is true he is really bouncing on Lantus, but he could do the same with ProZinc. Have you sure gotten some advice on dosing from the Lantus forum? I don't know a whole lot about Lantus but I do know it works best if you hold the dose for several days unless the nadir is in the 40s. Then you reduce by a small amount, but try very hard not to skip. Skipping empties the shed and makes the dosing really difficult. It may be that the timing of Lantus is difficult for you and if that is the case, ProZinc is a little more flexible in terms of dosing and scheduling. I am just hoping that he won't be a bouncing a cat in general. Some cats are.
Here is some info on ProZinc:
http://felinediabetes.com/FDMB/viewtopic.php?f=24&t=32799
BJM
Very Active Member
Xuxu is not reading "How to be a Feline Diabetic". A dose one day that worked, the next day may send him crashing. Very erratic in onset and duration. He is confounding all of us, both expert vets and FDMB members. That makes the depot insulins hard to manage, to say the least.
A list of her prior posts is here
A list of her prior posts is here
Rob & Harley (GA)
Very Active Member
Hi and welcome Deb and Xuxu,
Since Lantus is a depot insulin you would have to stop giving insulin for the 3 to 5 days to let the depot deplete down to nothing and then start with the Prozinc probably .5 unit, get a feel for how it is working in his system and then adjust from there.
You will need to test for ketones religiously while stopping insulin and be ready to step in if they start showing up.
Since Lantus is a depot insulin you would have to stop giving insulin for the 3 to 5 days to let the depot deplete down to nothing and then start with the Prozinc probably .5 unit, get a feel for how it is working in his system and then adjust from there.
You will need to test for ketones religiously while stopping insulin and be ready to step in if they start showing up.
Rob & Harley (GA)
Very Active Member
BJM said:
Thanks, I did, that's why I suggested the 3 to 5 day wait, we don't want any overlapping insulin problems. When he starts the Prozinc we need to know what we are seeing is only the Prozinc.
When I switched from Lantus to Prozinc I think the wait was 4 days, by then we knew the Lantus was out of his system by his bg's.
Sue and Oliver (GA)
Very Active Member
Since Robin has switched and I haven't, I like her idea. Maybe stop giving insulin for a few cycles, monitoring bg levels and ketone levels carefully. It does take awhile to empty the shed and since he has been bouncing all over, to stop the bouncing. We can certainly reevaluate at any time if you see high numbers and get nervous.
thanks for the info everyone. Xuxu definitely hasn't read that book. He's trying to be a good diabetic, but just can't get the hang of it. Plus it does appear that his metabolism has changed in the last 2 weeks and I've got to figure that out too.
My vet pressed me yesterday to give (as the last expert said) the Lantus anytime over 100, the same amount. I did at 216, and guess what. He crashed. I caught it at 35 when I noticed he wasn't responding when I talked to him. The karo brought it up. I didn't bother to test because I could see him feeling better. But I kept an eye on him and sure enough he started to crash again. Maybe it would have worked if I'd dropped it to .25.
What are the syringes for 40 insulin called? I knew they weren't units but couldn't remember the term.
I know it seems like I've been switching him around a lot, but I have given each type enough time to see how it works. PZI is the last resort, 1. because my vet has worked with it a lot before, and 2. it doesn't have the same action type where it's easy to neutralize it (ph) and 3. I did read that it would be easier to regulate. Lantus just isn't working for him because of the ph/absorption problem. Levemir was requiring such small doses that I couldn't get them consistent and he was just crashing too much. I hope PZI works, because I don't know what to do after that.
So on the insulin depot. It has seemed to me that he's never gotten it filled since he was going back up to 750 within 12 hours. Is that incorrect? I don't think I can let him go for 4-5 days, he seems to start producing ketones after 24 hours at high levels. Would giving him R or NPH for 2 days be ok or does all insulin go into the depot?
My vet pressed me yesterday to give (as the last expert said) the Lantus anytime over 100, the same amount. I did at 216, and guess what. He crashed. I caught it at 35 when I noticed he wasn't responding when I talked to him. The karo brought it up. I didn't bother to test because I could see him feeling better. But I kept an eye on him and sure enough he started to crash again. Maybe it would have worked if I'd dropped it to .25.
What are the syringes for 40 insulin called? I knew they weren't units but couldn't remember the term.
I know it seems like I've been switching him around a lot, but I have given each type enough time to see how it works. PZI is the last resort, 1. because my vet has worked with it a lot before, and 2. it doesn't have the same action type where it's easy to neutralize it (ph) and 3. I did read that it would be easier to regulate. Lantus just isn't working for him because of the ph/absorption problem. Levemir was requiring such small doses that I couldn't get them consistent and he was just crashing too much. I hope PZI works, because I don't know what to do after that.
So on the insulin depot. It has seemed to me that he's never gotten it filled since he was going back up to 750 within 12 hours. Is that incorrect? I don't think I can let him go for 4-5 days, he seems to start producing ketones after 24 hours at high levels. Would giving him R or NPH for 2 days be ok or does all insulin go into the depot?
Sue and Oliver (GA)
Very Active Member
Again, not a Lantus user, but I think his numbers (from very high to crashing) look more than big bounces than the shed not filling. It's true you skipped a few and that can deplete the shed. I think our concern is that he doesn't get a double of leftover Lantus with a new dose of ProZinc when he is so prone to sudden lows.
I would not put R or N in the mix. How about a full cycle off - testing for ketones - and see what his numbers look like? If he is doing okay number wise, then another cycle? As soon as you start to see reds or blacks, try .5 units of ProZinc.
I will certainly admit this is new territory for us. We see bouncing cats but he is really a crasher. You hold the syringe; it is ultimately your decision. The only other cat I've seen with such volatile numbers was Sev. You might search for him and check out his ss.
ProZinc is a U40 insulin so you use U40 needles. But you can use U100 needles with a conversion chart. That is the way most users are able to dose in small increments like .1, .2 etc.
I would not put R or N in the mix. How about a full cycle off - testing for ketones - and see what his numbers look like? If he is doing okay number wise, then another cycle? As soon as you start to see reds or blacks, try .5 units of ProZinc.
I will certainly admit this is new territory for us. We see bouncing cats but he is really a crasher. You hold the syringe; it is ultimately your decision. The only other cat I've seen with such volatile numbers was Sev. You might search for him and check out his ss.
ProZinc is a U40 insulin so you use U40 needles. But you can use U100 needles with a conversion chart. That is the way most users are able to dose in small increments like .1, .2 etc.
Rob & Harley (GA)
Very Active Member
I have to agree with Sue. Lantus and Lev are depot insulins and after 3 to 5 days the shed is full.
The only other spreadsheet I've seen with that much black on it is Sev. But after we convinced him to lower his dose they were able to go OTJ. Do a search for Sev and look at his ss.
The only other spreadsheet I've seen with that much black on it is Sev. But after we convinced him to lower his dose they were able to go OTJ. Do a search for Sev and look at his ss.
BJM
Very Active Member
Sev's Posts
and spreadsheet
Is the PZI you have U-40 or U-100; it makes a difference!
U-100 ha 100 units per mL
U-40 has 40 units per mL
There are U-40 specific syringes, however they are difficult to find with half unit markings. If you use U-40 syringes and need to measure half units or quarter units, you might try Making a reference gauge
It is possible to use a conversion chart, or to do the math, to use the U-100 syringes with a U-40 insulin.
The chart may be better, because you can post it.
The U-100 syringe marking * 0.4 = the dose of U-40 insulin
so
0.5 * 0.4 = 0.2 units
1.0 * 0.4 = 0.4 units
1.5 * 0.4 = 0.6 units
2.0 * 0.4 = 0.8 units
and spreadsheet
Is the PZI you have U-40 or U-100; it makes a difference!
U-100 ha 100 units per mL
U-40 has 40 units per mL
There are U-40 specific syringes, however they are difficult to find with half unit markings. If you use U-40 syringes and need to measure half units or quarter units, you might try Making a reference gauge
It is possible to use a conversion chart, or to do the math, to use the U-100 syringes with a U-40 insulin.
The chart may be better, because you can post it.
The U-100 syringe marking * 0.4 = the dose of U-40 insulin
so
0.5 * 0.4 = 0.2 units
1.0 * 0.4 = 0.4 units
1.5 * 0.4 = 0.6 units
2.0 * 0.4 = 0.8 units
- Status