Anyone use ProZinc and Novolin together?

I also have a post asking anyone to look at my spreadsheet, which a kind person also posted here, Thanks!
I am also looking for anyone with experience using ProZinc and Novolin together. My 4 yr. old Payne was
throwing off ketones and going into DKA on just ProZinc, when 1 unit of Novolin bid was added AND we
watched what she ate, we have been able to keep the ketones away!! (crossing my fingers)

Although her BG #'s are still high she is doing really well! and gaining weight and being a pain but am I
just being impatient? Is it too early to start decreasing her insulin? Her vet believes she has IBD although
she had none of the symptoms, from something in saw in her ultra-sound?

Any thoughts? It would be most appreciated!
Nancy and Payne

 

I encourage you to expand your base of people to folks with PZI experience and N or R even. Or even PZI with a "booster" or "bolus" insulin.
http://petdiabetes.wikia.com/wiki/Booster
http://petdiabetes.wikia.com/wiki/Bolus

Here's a link on the old board about giving boosters:
http://www.felinediabetes.com/phorum5/r ... msg-219488

Few have experience with ProZinc let alone ProZinc and N,R. But there are some of the old timers around here that have used PZI with a booster or bolus.

Out of curiosity, how are you feeding? Timed feeding or free feeding? Have you been given any instructions regarding the use of N with feeding?

From your SS I don't think you are ready to decrease. Your numbers lately have all been above 200. You might even need to increase. Also the keytones on 11/18 indicate that perhaps this dose is not enough. And the keytones are being currently aided though the additional fluids. But that is just my opinion not having any experience with bolus dosing. So take it with a grain of salt.

If you did start increasing the PZI portion we would be glad to try to help you with that a little. We like to make smaller and methodical dose increase with ProZinc. The use of U100 syringes can really help with that - read the PZI sticky about that. Between 3-4u the dose increases we would probably recommend would be in the .2u-.4u range every few days or so. I know since I do not have any experience with bolus or booster shooting I would be more [perhaps unnecessarily so] cautious. That's just one reason I'm hopeful you can find someone to help you with that side of things.

Do make sure to read the booster and bolus links I provided. There will be much into in there and links to topic on FDMB [some to the old FDMB] about giving booster shots. I did notice that Jock was noted as being in the booster cases. Worst case you could PM [private message] Steve & Jock - an old timer here and see if he has the time to help you or can point you to someone who can. But it looks like his experience was with Levimir and N not PZI and N. But Steve is very knowledgeable.

 

I think Gator might be right since Prozinc has only been around for a year there may not be many people with experience with both insulins so his suggestion to contact Steve & Jock might at least be a start.

Welcome to our little group.

 

I think Steve might also have PZI experience too. If he balks because of the ProZinc just tell him that at least Gator thinks they are very similar with only *maybe* some small differences. I certainly used ProZinc just like the old PZI in a scale or variable dosing type system. And Robin is very successfully using ProZinc in a scale/variable system too. I'm probably the only one who has both PZI and ProZinc experience - or at least I'm the only one I can remember [I'm luck to me able to just remember that]. :mrgreen:

He may recommend changing to Levimir but tell him that you need to use PZI to maintain your relationship and guidance from Davis. At least that was the case with H and I. They did not like Lantus up there and when I was there they only had one cat they had ever seen who was taking Levimir. Also I think a switch would have to be planned out very carefully because of the keytones - you would probably have to use a booster with the Levimir while the Levimir built up in the system.

 

Thanks for all the suggestions and stuff to read, will do after I feed the family.
Payne was actually playing with one of the other cats when I got home .... haven't
seen that for a long time. I plan to stay around and learn, learn, learn!!
(so much to take in with no previous experience with diabetes and an inward dislike
of all things blood and needles!)
Thanks to all!
Nancy and Payne

 

I also wanted to note that when I took my cat to Davis to see their diabetes expert, they said my cat was "too well regulated!" :lol:

So I just wanted to let you know that their goals may end up being different than your goals. Again I think it's a great institution and an incredible resource, but I got questionable diabetes advice up there. On the other hand, IMHO you are absolutely in the #1 best spot for IBD which is sounds like they might suspect [or am I not remembering you other post correctly]?

 

this is what I get for posting with my phone lol...

Is the vet suggesting novolin n or r? R is better.. shorter duration.
And no, booster use is not always necessary with levemir use, even in ketone prone cats.

 

We are using Novolin R with the ProZinc, 1 u of Novolin and 3 of ProZinc bid. We give both shots at the
same time, didn't know there was another way to do it .... I plan on getting up to speed quickly,
(hopefully) but most of it is still over my head.

I feed twice a day after I
take her AM/PM BG readings but give her some food, mostly raw turkey meat, throughout the day. As I
said, she is on pred and is always hungry! Since she lost so much weight, I am trying to beef her up some.
And yes, the vet suspects IBD but we have seen no symptoms.

As for Davis, I take what vets say with a grain of salt. We used to own a business called
Fleabusters and I spent 12 years going to vets offices, saw way too much! they are just people who
know more about medicine than I do but NO ONE knows my animals better than me! I always make
the last decision.

My vet is a good guy but in the beginning he did
not want us to home test but with us sending him #'s and updates, he is eager to see her SS.
(working with tech to get it to him) His theory about home testing is that it overwhelms most people,
but we have stayed after him!

Gator, I don't think I'm ready for Steve yet, let me absorb all this so far and I will certainly put this
on my radar. (you are a hoot!)
Nancy and Payne

 

Carolyn,
Looks like you might be a real help for Nancy. Yea! Happy ending.

Nancy how long has Payne been on ProZinc?

For Carolyn,
I think the general consensus is that it takes maybe up to 6 weeks for the bean and the kitty to get used to it. I think this would be true of just about any insulin really. In the mean time, it is not uncommon to see onset and nadir differences as time goes on. At the very start some cats have experienced some sharp onsets. One other potential difference to PZI is that it *might* seem that small changes in dose might have larger effects with ProZinc. I always said using PZI was like trying to balance a elephant on a pinhead and ProZinc might be more like trying to balance an elephant on a pinhead while dancing the two step. But I think that's kind of a worst case assessment and really there might be no difference of consequence. I might just be getting to romantic about PZI. I think it's interesting to note that the two people I'm aware of - that post regularly in here - [Robin and I] that have used ProZinc with 'success' over a longer period have used it in a variable dosing fashion. My impression was that this was fairly true of PZI too. Also my cat ended up needing more ProZinc than PZI but that is a trend that seemed to be developing before we switched. I think your PZI experience is completely applicable [and will prove to be very valuable] to this situation. :smile:

And if anyone is switching from PZI Vet to ProZinc it is important to treat it as a change to a new insulin - that means testing like it is a change to a new insulin.

 

I forget is she on the Pred for the presumed IBD or for something else? If it's just for the IBD, personally I'd be really wary of continuing with Pred. No symptoms continues to leave me puzzled where the vet is coming from in medicating it, and also I'd try Budesonide 1st in a diabetic kitty for IBD. Of course if the Pred is for something else, never mind.

That is great you are keeping the ketones at bay, YAY!!! Some of the #s look a little funky to me, but I don't know R so can't really comment.

IMO you want to know the onset/nadir/duration for R, as well as for ProZinc, which we can definitely help you with here if you don't already have that info. I think the concept is that the R is kicking in for the first few hours or so of a 12-hour cycle, and by the time it has worn off, the PZI has kicked in. Still may leave the end of the cycle uncovered, so to speak, but unless you have a pretty good idea what your duration on PZI is and what your R duration is, there might be risks to moving the timing around on the R shot. What you don't want, presumably, is the two insulins peaking at the same time.

As for the idea of decreasing the insulin, you would really only want to do that if you are 1) seeing BG#s that are starting to get too low for comfort, or 2) seeing signs of rebound. Especially with a ketone history, generally speaking you wouldn't do any sort-of preemptive dose decrease - you let them prove it to you with the #s and earn the decrease. That is speaking for a standard PZI BID approach - with other approaches, such as yours, the approach may be different (i.e. maybe there's a point where you drop the R so you can see what the PZI is doing on it's own - that I don't know).

 

Payne's ketones are spiking and she's probably headed to the ER. :sad:
viewtopic.php?f=28&t=31350

 

Oh darn. :sad: Thanks for the update.

 

ProZinc was the original insulin she was started on Oct. 11 and on Nov. 8 the Novolin was
added. The pred is for the IBD and vet believes she might always need to be on to some degree.
I don't understand Carolyn commenting about her phone #, was something done? still over
my head.

 

I talked to the vet and he said to give her 1u Novolin, that was an hour ago and her
ketones are dropping fast ..... what causes this? nothing has changed. It hits like a
bolt out of nowhere!

Thank God for this list that has taught me testing, testing, testing, you are really kind
people to help newbies chart these waters. This is the second time we have been able to
help her at home, if only I had known all this the first three times, maybe she
wouldn't have gone into DKA 3X.

But we have made progress and I am looking forward to what you will teach me in the
future, thanks!
Nancy and Payne (feeling better)

sorry I forgot I was in two places ..... may find a nice bottle of something tonight,
been a hell of a day!

 

If you post personal info like a phone # it will usually be edited out, so I assumed it was something along those lines - probably nothing to do with you directly. Either that or she tried to post from her phone & lost the text or something.

Thanks for the update, glad the ketones are coming down, that's a relief. Chocolate and drinking09 sound about right to me after a rough day!!! But not so much that it will impair your testing ability! :lol:

 

I can see the Californians are up and about still but thanks to all her have helped me
through this ..... she is doing well, her last urine stick was down to trace AND the monitor
was 1.0! So, she either had a small surge (as I said she seemed fine physically) and when
we checked with the monitor (3.8) it had to be off?

As someone mentioned in health, monitors can be? it is a new NovaMaxPlus and when I
called the company about only testing from the finger, their comment was they have no
idea how it would work on cats!! We thought that by using 1.5 as a base we would be
okay, but to go from 3.8-1.0 in three hours! with BG reading in the 200's, sounds as if
I can't rely on the monitor?

Thanks to all of you, I love the addition of the chocolate! Looking forward to working with
all of you all because I need to figure out the ProZinc and the Novolin and how they
work on Payne. A lot of information has been given but I am still?? oh yes, a newbie!
Nancy and Payne

 

Just to clarify, I think that Carolyn was trying to post in another thread using her cell phone and got in this thread instead.

Sorry you had such a tough day. The days will get easier and easier.