? Prozinc stopped working?

Discussion in 'Prozinc / PZI' started by MayL, Sep 10, 2018.

  1. MayL

    MayL Member

    Joined:
    Feb 24, 2018
    Hi everyone,

    Milo has been on prozinc since December 2017 and even though he is a bouncy cat he seemed under controlled. However, we tried to do a curve twice for our vet this last week and he stayed flat in the 300 range the whole 12 hours. We tried testing every 2/3 hours and I don't think we missed the nadir so.... did Prozinc stop working? He started budesonide for IBD in April and it didn't really impact his BG. The only new medicine he is on is gabapentin and we started that late July for his really bad arthritis. In June, the vet checked his fructosamine and that looked great.

    I apologize that I haven't updated my spreadsheet. There is data until 8/21 and I plan to update it tonight when I get home.

    Any thoughts would be helpful. Thank you!
     
    Last edited: Sep 10, 2018
  2. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    It's quite possible that on the days you tried to do a curve he was elevated from bouncing so the data wouldn't be very useful for evaluating the dose. Are you testing daily at home?
     
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  3. MayL

    MayL Member

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    Feb 24, 2018
    Hi @Kris & Teasel, we always do a pre-shot AM and PM but are not home to do mid-days. We did get some mid-days in July and they do suggest that the prozinc is working. We have done two curves back to back (Saturday and Sunday). Could he be bouncing two days in a row? We trying to get a curve in today and it is look weird again, i.e. it's still high even a few hours into the cycle. And what if I try to do a curve tomorrow as well? So four days in a row. Would the bounce have stopped by then and I would capture some meaningful data to evaluate the dose? Thank you!
     
  4. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    Cats bounce until they stop (I know that's about the least helpful statement ever uttered on FDMB :p). If you can get a curve in today, it could be helpful. No way to know if he'll be bouncing, but maybe try to get the first few tests, and decide from there if he's staying high and making it not worth it or not.
     
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  5. MayL

    MayL Member

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    Feb 24, 2018
    Thank you! Could he also be flat because it's not enough insulin?
     
  6. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    That's also possible. Often, though, not enough insulin looks like a downward curve but all the numbers are skewed high.
     
  7. MayL

    MayL Member

    Joined:
    Feb 24, 2018
    And since Milo has no curve at all then that suggests a bounce more than anything? What if he's resistant to prozinc? Could he just not be responding to it anymore and so it's flat? Also, how fast can a bounce happened? My sister is at home testing him today and it looks like he went from 300 preshot to 400 at 3+ and had low carb food about 1.75 hours ago before the testing at 3+.
     
  8. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    It’s hard to say without having a spreadsheet of data to look at. It’s those trends over time that tell the story.
     
  9. MayL

    MayL Member

    Joined:
    Feb 24, 2018
    Ok, I updated the spreadsheet. You can see on 8/21 he had somewhat of a curve. A couple of days before 8/21 I suspected his dose was too high because his preshots were higher than usual. So wanted to see how he would respond to 2 units. So we've stuck to 2 units for several weeks and then like I said we tried to do the curve and he was flat on 9/8. The vet thought maybe the dose was too low so then we upped it back to 2.5 units and now we have two flat days in a row. Does this add any clarity to what is going on with Milo? Thanks!
     
  10. John Irene and TITAN

    John Irene and TITAN Member

    Joined:
    Aug 6, 2018
    It is possible for the prozinc to stop working if it has "gone off" Sometimes this is because it has been left out of the refrigerator. I would suggest getting a new vial and trying that, before increasing the dose. But that might be the expensive option. I am not as experienced as most of the people here. I would like to know what Wendy and NEKO, or JeffJ think
     
  11. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    Hmmm...without mid cycle data, it's hard to be sure, but it really looks like possible bouncing to me. That 8/21 data tells us he almost surely was bouncing that day. You also keep getting these yellows and sometimes blues which tells me the insulin is probably WORKING...but with those pinks, my guess is you're seeing some bouncing. The mid cycles you've gotten so far make that likely too...high and flat is the normal pattern after a bounce, and those bounces can last for a bit.

    If he was mine, I think I'd try to get whatever mid cycle data I could whenever I could. It doesn't mean you have to curve every day (I know THAT would be no fun!), but just get any tests in between shots. It's most helpful if you can grab tests at different times of day (say one day you're able to get a +2 and a +8 and the next day you can get a +4 and +6 etc). Doing it that way allows you to sort of get a "curve" over time without having to do it all in one day. And getting whatever data you can will help us to confirm what's going on and help you to fine tune the dose a bit if needed. Any chance you can get some mid cycle data over the next few days? I know life and work can get in our ways.
     
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  12. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    I agree with Rachel. given the low on 8/21 and then the flats you've had the last few days, it's really hard to know for sure. It has the look of not enough insulin, but the gaps in the data and that one cycle make me hesitate to just tell you to raise the dose. Even if you're working during the week, any extra data you can get is helpful. Get a test before you go to bed in the evening, or as soon as you get home from work, or right before you walk out the door. Consider if there is a way you can adjust the shot schedule to allow you to grab an extra test - for example, I started getting up an hour earlier and doing test/feed/shoot as soon as I wake up. Then I have a couple of hours to clean the house, read, or whatever, get ready for work, and grab a test before I walk out the door in the morning. Then I test/feed/shoot as soon as I walk in the door in the evening, and that gives me a few hours before bedtime to get a test at night. Some people skew the other way and test/feed/shoot as they go to bed, but then they can wake up six-eight hours later and get a test the second they wake up in the morning, then wait a few hours for AM test/feed/shoot. There are lots of ways to make it work for those of us who have to be out of the house for longer periods of time during the day. And if you're one of those people with a monster commute that keeps you away for 12 hours/day, you can leverage the weekends and evenings to collect most of your data.

    If you look at my spreadsheet for the past couple of days, you can see that my guy is running much lower at night, indicating that he's getting a little too much insulin. Then his daytime cycles are pretty flat. If I just looked at his daytime cycles, I would be increasing his insulin, but because I know he's so low at night, I'm actually decreasing it. So it's possible that something similar is happening with Milo.
     
  13. MayL

    MayL Member

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    Feb 24, 2018
    Thank you! This is actually a brand new vital so finger crossed that's not the issue.
     
  14. MayL

    MayL Member

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    Feb 24, 2018
    Yes, more mid cycles test at various times make sense. I will try to get those tests in!

     
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  15. MayL

    MayL Member

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    Feb 24, 2018
    great tips! Thank you!
     
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