I'm planning on switching Sammie from Lantus to Prozinc tomorrow . I've read conflicting info on how to switch. Some say just switch at same dose, some say don't give insulin for 12-24 hours to clear depot so insulins don't mix, my vet says drop dose way down and then start over with Prozinc. I have dropped his dose down from 5.5 units to 2.5 over the past few weeks and plan on starting him at 1.5 units of Prozinc, but am unsure if I should skip a dose before the switch. Please advise.
I don't think you need to skip a dose beforehand. You can just switch over. Since you're dropping to a low dose note that you may need to up the dose fairly quickly. It's possible you'll hit a dose that is great early on, but you want to be aggressive in your dose changes to get to a good dose to avoid any glucose toxicity. Will you be able to do daily preshot tests and some mid cycles with this switch?
I can do daily preshot checks and some mid cycles today and sunday to keep an eye on his numbers. I'll try to get in some nite time numbers, too. I'm hoping since his diet is better and by doing smaller dose changes maybe this will work better for him the second time around. The first time he was on Prozinc, his crazy drinking and peeing stopped, but his numbers were not great. I hold a dose for 3 cycles-is that right?
Generally we hold for 6 cycles unless the numbers are super high. Let's see what happens when you get started and we can make recommendations on faster if we need then.
Sammie's been on Prozinc 3 days now. No real change in numbers, although he seemed a little slow yesterday. He has been eating well and seems better today. No ketones in urine. I'm thinking I should increase his dose to 1.75 tomorrow. I should be home most of the day to watch him. Any advice?
Try to get at least one test in the +5 to +8 range to see how low he goes. I’d bump him up tomorrow and only keep the 1.75 u dose 3 or 4 cycles if it doesn’t give you blues mid cycle.
Ok. I was planning on getting a mid cycle reading tomorrow after increasing his dose. If he's still high, I won't be home much again until Thursday to get more mid cycle readings in if I need to increase his dose sooner. We'll just have to see how it goes.
Sammie is still high, so I think I’ll increase his dose to 2 tonight since I should be home. Is this a good plan?
Sammie's numbers still high after 3 cycles and high this afternoon, should I increase by 0.5 again tonite or hold off?
He's still high, I increased to 3.25 this morning. Should I continue with this pattern of few days on dose, then increase by 0.5 if still high until I see some improvement ?
Try to get some more midcycle tests around +4-+8 so you can get a better idea of how low he’s going. I wouldn’t raise the dose without being able to test midcycle at least once.
You need middle of cycle numbers showing you how low he goes in order to properly evaluate the dose. The PS numbers don't help with that much. They're more important in telling if it's safe to give insulin.
I got some mid cycle numbers today-they're all high. I'll see how he's doing in a few days before even considering another dose change. I can only get mid cycle numbers on some Sundays and Thursdays-my days off from work. I've tried a few times in the middle of the night, but I can't seem to get blood out of him then.
He's still high all day, so I increased his dose to 3.75 tonight. I wish he would show some improvement, this is all so frustrating. His numbers aren't much different than when he was first diagnosed a year and a half ago. I wish I had found this site sooner, but you always want to think your vet knows best. I'll certainly keep trying to get Sammie straight.
One thing to keep in mind is that you lowered the dose quite a bit when you switched back to Prozinc, so you're just now getting back to where you were. Given the numbers you're seeing, I would suggest increasing every third or fourth cycle at this point, and keep getting mid-cycle numbers between +4 and +7 as much as you can. Hang in there!
Need more advice for Sammie. We're up to 6.25 units and really no change. I need to buy a new vial of insulin soon and am wondering if I should just keep trying the Prozinc or switch to something new. If I stick with the Prozinc, how high can his dose be? We got up to 8 units before switching last time. He has been fighting me on ear pokes, so I haven't been getting as many as I should. He either hides or just cowers, so I gave him a break for a few days. It also seems the more I poke him, the harder it is to get blood. After 3 pokes, I usually have to quit so I don't stress him out too much. I feel bad for him and I don't want him to start fighting me on the insulin injections as well. All I can do is keep trying, I guess.
Omg I'm in the same boat. My cat was on vetsulin... Up to 6.5.... Switched to ProZinc... Up to 6 and the numbers aren't budging.... Even less than with vetsulin. So frustrating. Sorry you are having the same problem but nice not to be alone.
I would strongly recommend that you not switch insulin again. Switching insulin won't solve the problem you're seeing. High numbers like this are usually caused by some other issue. 1. exposure to high carb food - even just a little 2. secondary health issue 3. high-dose condition Usually around six units, if no other health issue is known and the cat is only getting low carb food and treats, we recommend getting tested for high dose conditions. You might want to read through the stickies in the Acromegaly/IAA/Cushings forum and start to familiarize yourself with those a little to consider if you want to pursue that testing. Generally you get the blood drawn at your vet, and then your vet sends it off to the lab where they do the testing. For now, keep going with the testing and increases. Do make sure that at least once/week you're getting a test during the night, even if it means setting an alarm. The AM and PM cycles can sometimes be quite different so you do need data from both. I understand how frustrating it might be to collect data and keep seeing these numbers, but hang in there.
He was tested for all those conditions last winter I think before switching him from Prozinc to Basaglar and all tests were negative. I'll just keep trying and hope he responds better soon.
Sorry haven't posted for awhile. Work is just killing me, but I did go on vacation to rejuvenate. I don't have results for all Sammie's insulin resistance tests-vet just said all were normal. I may have to get a copy to see what they really did. Anyway, I need some advice here. Earlier this week his numbers took a nose dive for no reason I'm aware of. He dropped from 340 to 146 last sunday. I stalled giving his insulin that nite until he came up to 253 after dinner-only about 40 minutes. Is it normal to shoot up that fast ?I also reduced his dose a bit. He went down to 65 by 1 am and that scared me-he acted fine, but I was afraid he would go too low , so I gave him some dry food. Numbers came back up by 3 am and then shot up to 356 by 6 am. Is this normal-did he bounce or react to dry food that quickly? He's been high again ever since. I'm afraid to increase his insulin and see another big drop. What should I do? I work a lot of crazy hours so it's hard to monitor him like I should and he won't let anyone else poke his ear to check him. Another question-he's due for his vaccinations soon and I'm not sure if he should get them. There are so many different opinions online-what do you suggest?
I don't understand why you went up to 7u right after he showed you that 6.5u was too much? I understand long and exhausting work schedules, so consider if you might be able to get some data on weekends. You got some great data the other night, although I know that sleep doesn't make that possible very often. It takes several cycles to clear a bounce. Several cycles to recover from getting an influx of carbs. So right now with the change in food, change in response, and change in dose, it's too many changes all at once to know what is going on. How is your weekend looking? Will you be around and able to get some test? You don't need to do a full curve, just a couple of test around +4 to +7 for a few cycles would really help to sort out what's happening.
Hmm...I agree. It looks like 6.5 dropped him low. I'm guessing you increased due to the high preshots...but remember those are surely bounce numbers. You can't always get data, and we get that. We have to work (how else do we keep kitties in the manner they've become accustomed to??). But get data when you can and we can help fill in the gaps as best we can.
He had been on 7 units since Sept 9 with high numbers. When he dropped, I dropped his dose to 6.5. A couple days later, I took him back up to 7 and he's still high,. Unfortunately, I work today and won't be home tomorrow to get more data. The next day I'll be home is Thursday (Thurs and Sun are my days off). I can try to get some late nite numbers in the meantime.
Ah. Thanks for sharing your thinking. Work schedules do make all of this tricky. Hopefully the data on Thursday and Sunday will help shed some light on what's going on with Sammie.
