Change to Lantus?

Discussion in 'Prozinc / PZI' started by Sudio3, Feb 7, 2020.

  1. Sudio3

    Sudio3 Member

    Joined:
    Feb 12, 2019
    Hello!
    So my cat Nudi started Prozinc in November 2018 went into remission July 2019 and went off insulin at that point and then at the end of December 2019 he went back on Prozinc. His numbers (morning & night before his dose) were always between 300’s-low 400’s whether the Prozinc dose was .5, .75, 1 or 2 units. So the numbers were always in the same range (high) no matter the dose. I assumed the insulin stopped working but then I had the Freestyle monitor put on him and that showed that on 2 units he was having a huge dip going from the 300’s down to the 70’s and then spiking back up to the 300’s- low 400’s during the day. So I lowered to 1.5 and there was still that big drop and spike. I then lowered to .75 but at this time the Freestyle came off but his morning and night numbers with the ear prick were in the 400’s on this dose and the vet was thinking it may still be doing the drop and spike so I lowered to .5 as I did get a day worth of data from the Freestyle on .5 and there was no drop and was pretty stable in the 200’s. So he has been on .5 with morning and night numbers still in the 300’s. I can’t seem to get him regulated into the 200’s. I stopped giving him any insulin today to see how he does without any Prozinc and to give his system a rest so that I could possibly try Lantus instead. I’m also getting another Freestyle put on him tomorrow. I have no idea if stopping the insulin is the right decision. I’m just reaching here as I don’t know what to do. He feels pretty sick when his numbers are in the 300’s.

    * Note* Also I did not record the numbers the first time I had the Freestyle put on. I should have done this. Then I got the Freestyle put on a second time and it was faulty. So the one day in blue on the chart are the wrong numbers then the Freestyle broke completely. Tomorrow I will be getting another Freestyle put on.

    Also, the day the Freestyle was giving the wrong readings Nudi didn’t get any insulin because it was showing his numbers were low so vet advised not to give insulin

    My partner also gave him the wrong dose of .75 one day when he had been getting .5. So I’m sure this isn’t helping with his regulation.

    Thank you so much!!
     
  2. Si am cat mom

    Si am cat mom Member

    Joined:
    Nov 11, 2019
    Hi. I am not super familiar with Prozinc. I mainly wanted to comment so that this might bump the conversation to the top of the pile so to speak. It did look like around 1/31 you started to make some progress on that dose and got some good numbers. That evening though, with a PMPS of 330 it looks like you didn't give any insulin either? With not giving the insulin now, and having his numbers in the 300s...I do think that can set things back a bit. Especially, if you say he doesn't seem to feel as well when he is in that range. Are you in the process now of getting the Lantus and just wondering if it is okay to start that after being on Prozinc?


    I might also edit the post and add a question mark to the title so folks know you are still in need of clarification. You can click on the THREAD TOOLS and edit the title
     
  3. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    We can help you with the Prozinc dosing.
    But we need some BG test numbers on the spreadsheet.

    Do you know how to home test the BG (blood glucose)?

    It's a good idea to have either a pet meter or a human meter for backup. In case the CGM (continuous glucose monitor) you use has problems. And you have had problems.

    Think of having a glucometer as an additional tool to help you manage Nudio's feline diabetes.

    How is Nudio feeling?
     
  4. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    I don't understand why you have stopped insulin when you are getting BG numbers in the 300s and 400s. This is dangerous and could lead to ketones developing in the blood/ urine.
    You need to start insulin again AND you need to be testing the urine for ketones.
    I would go out and buy a bottle of Ketostix from Walmart or a pharmacy as soon as you can. Collect a urine sample from Nudi and dip the test strip in and read against the colours on the bottle exactly 15 seconds later. Anything above a trace needs vet attention.
    I can't stress enough how important it is that you do this test...and continue to do this test daily until Nudis BG levels improve.

    Please let us know when you have restarted to insulin ( providing the BG is high enough to given insulin) and have done the ketone urine test. We are concerned..

    Further down the track I would definitely look at swapping to Lantus.
     
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  5. Sudio3

    Sudio3 Member

    Joined:
    Feb 12, 2019
    Yes we have the alpha trak 2 and have been using that. We have a new Freestyle on him and the numbers are usually a lot lower then then the alpha trak. So we’re not putting much stake in the Freestyle at this point. I have been logging his numbers in the spreadsheet. Is what I have enough? He is off insulin now and I just called my vet to prescribe Lantus for him as the Prozinc didn’t seem to be working. I honestly have no idea what to do but hoping the new insulin will help get him regulated? Thank you!!
     
  6. Sudio3

    Sudio3 Member

    Joined:
    Feb 12, 2019
    Thank you. I stopped the insulin because the Prozinc didn’t seem to be working at all from what I could tell. I honestly didn’t know what to do to help him at this point (I’m in touch with the vet regularly and they have no idea either). I took him off the insulin to see if his numbers changed at all or if they stayed the same because again the Prozinc didn’t seem to be doing anything at all to bring his numbers down and when I went with a higher dose of Prozinc (the highest was 2 units) he was having huge drops into low blood sugar (60’s & 70’s) and then spiking back up to the low 400’s in a short amount of time, so the higher doses were not working either. Along with attempting to get information (ie is the Prozinc doing anything at all?) I was also thinking that detoxing him from the Prozinc and giving his body a rest from that insulin was a good idea before starting him on a new insulin, Lantus. I have know idea if this was the right thing to do. I’m on my own in this basically just doing the best I can in a situation where he seems to not be doing well and the Prozinc does not seem to be a help. I will take him to the vet tomorrow if they can fit him in hopefully to test for Keytones. I’ve done this many times before but thank you for the reminder to do again especially since his sugar has been so high for so long. It’s extremely hard for me to test for Keytones myself as he hates to pee inside and can hold it forever. Even though he is sick he still insists to pee outside. I have asked the vet to order the Lantus which I’m hoping will be available tomorrow or the next day the latest. Thank you for your help. I really appreciate it.
    On another note: I have been having trouble testing Nudi with the Alphatrak and getting readings lately. my partner has much better luck then me but he is not always around. Nudi is also not thrilled about it getting done and loses his patience. I’m also working so not home all the time as I pet sit away from the house, I’m pregnant and have a toddler and now also my other cat is feeling sick so there is a lot going on but I will do my best to get his readings and keep giving him the best care I can. When I start him on Lantus should I start posting in that group instead? I will give an update on regarding the keytones as soon as I find out. Thank you.
     
  7. Sudio3

    Sudio3 Member

    Joined:
    Feb 12, 2019
    Nudi is not feeling great. He never feels good once his BG hits the 300’s and having it be so high for so long he’s definitely not feeling good. My plan is to check for Keytones tomorrow at the vet and get the Lantus as soon as possible and try him on that. Thank you for your help. I appreciate it. I’m hoping this is the right thing to do. Thank you.
     
  8. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Good to hear back from you.
    Yes get the ketones tested as soon as possible. It is important.
    Ketones in the blood can be tested by using a meter like you test the blood glucose as well.
    When you get the Lantus, post on the Lantus forum and we will help you get Nudi sorted.
    Post and ask for the starting dose fir Nudi.
     
  9. Sudio3

    Sudio3 Member

    Joined:
    Feb 12, 2019
    Ok thanks. I have an appointment today for this afternoon to test for Keytones with the vet. I will try and google the blood test meter that you mentioned for testing Keytones. That would be great. If you happen to know the name of it please send along. I called the vet this morning and they said they will call in the prescription this afternoon so I’m hoping to have the Lantus by tomorrow. Ok great I will post in the Lantus forum once we start. Thank you for your help. It’s truly appreciated.
     
    Bron and Sheba (GA) likes this.
  10. Amy and Socks

    Amy and Socks Member

    Joined:
    Sep 30, 2019
    I have a Nova Max Plus blood ketone meter. There may be other blood ketone meters, but that’s the only one I’m familiar with. It’s definitely a lot pricier than the urine strips, but I had issues getting urine to test as well.
     
  11. Sudio3

    Sudio3 Member

    Joined:
    Feb 12, 2019
    Ok thank you so much. I will check this out. It will be so nice to be able to check him myself!
     
  12. Amy and Socks

    Amy and Socks Member

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    Sep 30, 2019
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  13. Sudio3

    Sudio3 Member

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    Feb 12, 2019
  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Just for the record, you don't need to "detox" the cat by withdrawing Prozinc before starting Lantus. People who switch do Prozinc one cycle, Lantus the next.
    Don't be surprised if you see the same behaviour with Lantus. Nudi is not used to low numbers yet, and as a result his body is compensating by dumping sugars (what we call bouncing) and resulting in those higher numbers. It is very common for new diabetics to start high, drop, then go high again in the same cycle. Only once their body spends more time in normal numbers and gets used to it, will they stop bouncing as much.

    One other note, dosing decisions with Lantus are based on how low it takes the cat. Those lows are typically in the middle of the cycle, so you will need to learn to look for those nadirs in both the AM and PM cycles. In the PM a test before bed will help you determine whether he is going lower that cycle. Or maybe your partner can help with those tests.

    One other note, the Freestyle Libre is a human meter, which typically shows lower numbers than the pet meters like the AT. However, our dosing methods are written using human meters so they are numbers we are used to.
     
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  15. Sudio3

    Sudio3 Member

    Joined:
    Feb 12, 2019
    Ok thank you. So Nudi did not have Keytones. His numbers have also been in the 200’s recently (high 200’s) but I still thought this was weird as it’s been in mid 300’s-low 400’s steadily for a while. It made me think that maybe I shouldn’t give him the insulin? But regardless I am picking up his insulin (Lantus) tomorrow. So, since his numbers may bounce on Lantus as well would it just make sense to keep him on the Prozinc and see if he balances out? I will need to buy a human meter for the Lantus and figure out how to use it and also it just seems confusing and like a lot to deal with. I will do my best to do whatever I need to do for him but I really don’t have a lot of time and I’m frankly nervous about starting him on the new insulin but also want to give him the care he needs. I would go with the slow and steady approach starting him on Lantus. I need to re-read that sticky again. It may be hard for me to take his sugar 4-5 times a day in the beginning so this is a concern for me. I’ll keep learning/reading/asking questions and I’m sure things will get more clear.

    Thank you for letting me know there is no waiting period between starting a new insulin and also that the Freestyle is showing human numbers so that most likely was the difference in readings.

    Thank you! I appreciate all the help!
     
  16. Sudio3

    Sudio3 Member

    Joined:
    Feb 12, 2019
    Thank you for your message I somehow missed it!! I appreciate your feedback and thanks for bumping the post. Yes I will be picking up the Lantus tomorrow I’m working on figuring it all out and I’m hoping to start him on it soon! Thank you!!
     
  17. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Looking at the SS he definitely still needs insulin.
     
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  18. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    If you already have the Alphatrak pet meter and can afford the cost of the strips. You can keep using it.

    The people on the lantus forum may be more used to human meter readings, but they should see your signature data that indicates the Alphatrak being used and you have it noted on your SS.

    It's up to you which meter to use. Pet or human.
     
    Sudio3 likes this.
  19. Sudio3

    Sudio3 Member

    Joined:
    Feb 12, 2019
    Ok thank you. Appreciate your help.
     

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