Dose increase?

Discussion in 'Prozinc / PZI' started by Megan and Bernie, Mar 1, 2020.

  1. Megan and Bernie

    Megan and Bernie New Member

    Joined:
    Feb 11, 2020
    Hi, all!
    My sugarkitty Bernie was diagnosed at the end of January, and I’ve been fiddling with her times and diet a couple times and lurking here while trying to get her routine set. This past week I’ve finally got her times down, and I think she might need a dose increase??

    She’s on 1u Prozinc twice daily, but her numbers are always in the yellow/pink. She was super bony and had lost two pounds when she was diagnosed, so she currently eats a lot to hopefully gain some of her fat stores back (she was SO skinny, my poor baby). Right now, she eats Tiki Cat with her insulin shots and I give her snacks when she asks throughout the day, up until 2 hours before shot time. I messed that up the first few weeks, so her earlier PMPS were not fasting numbers. Also, I thought she might have bounced a few mornings ago (in the SS notes), but after further investigation, I’m almost certain she got into her brother’s kibble over night (his feeder was spilling and has since been fixed).

    I’m also in the process of finding a new vet, so I’ve been hesitant to change her dose, out of fear of messing it up and not having a vet I can call.

    I’ve not done a complete curve on her, since her spot checks are always in the yellow. Should I do a full 12-hour curve before changing her dose? Or do y’all think she needs to go up to 1.25u with the data I currently have? Or should she stay at 1u?

    Thanks!
     
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  2. Megan and Bernie

    Megan and Bernie New Member

    Joined:
    Feb 11, 2020
    I also just realized I may have screwed up her ProZinc, as I’ve been pushing the excess in the syringe back into the vial. Is the whole vial bad now? My vet NEVER mentioned I shouldn’t do that and was like zero help when Bernie was diagnosed; I left with more questions than answers. Do I need to buy new insulin?
     
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  3. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Oops. That should be SLGS in your signature.

    Your vial is likely still good. Are there floating particles in the more clearish liquid at the top of the vial before you roll it to mix it?

    p.s. More later, after I look at the SS.
     
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  4. Megan and Bernie

    Megan and Bernie New Member

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    Feb 11, 2020
    Thanks, I fixed it! :) Not that I can tell, but I also had it stored on its side (I’m a mess LMAO) and it was just mixed about an hour ago. I’ll check in the morning after it’s been upright and settled and let you know for sure.
     
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  5. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Read other members posts here in Prozinc. Read the newly updated "Sticky" or pinned posts at the top of this forum.

    She needs a dose increase, Up by 0.25U to 1.25U total each 12 hour dosing cycle.

    You need to get a few more tests in during the 12 hour cycle, when your schedule permits. Try especially to get a test in every PM cycle. Before you head off to sleep. Every day.
    That is because many cats drop lower at night because they are awake and more active, and you want to see what Bernie is doing then.

    A regular +10 and or a +11 test is also very useful. To see how long the duration of the insulin is for YOUR cat.

    And you need to be a bit more consistent on keeping the dosing cycle at 12 hour intervals. Too much bouncing around makes the numbers bounce around too.

    p.s. I'm a "just the facts mam style poster." Information is power.

    Hi Megan and sugar girl Bernie and welcome. See, I did remember that part, finally.

    There is not always someone in this forum so if you have a question or low number and you need immediate help, please post in the Feline Health (Welcome & Main) forum for more eyes on you.
     
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  6. Megan and Bernie

    Megan and Bernie New Member

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    Feb 11, 2020
    Thank you so much, I appreciate your help! I’ll up her in the morning and get some more numbers. Thanks for the info on the night time data too, I’ve been wondering why her AMPS numbers always seem a little lower, now it makes sense. Thanks again :)
     
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  7. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Tag me any time. Happy to look at an SS, when I'm awake that is.;)
     
  8. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I see you posted over in the Feline Health forum and I already answered you over there.;)
    ProZinc dose question?
    Would you be willing to try and post in this forum from now on?

    Trying to keep the Prozinc folks all together here.

    Of course, it's fine to put a post in Feline Health if you don't get a timely answer, or have an emergency low number or such.

    p.s. Trying to do followups with people today.
     
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  9. Megan and Bernie

    Megan and Bernie New Member

    Joined:
    Feb 11, 2020
    Of course! :)
    This morning was Bernie’s second dose at 1.75 and she seems to be doing well so far! I have an appointment with a new vet this week to look at why her weight is slowly (over the last few weeks) going down, and to follow up from a previous UTI. I’ll update her SS with results and probably tag ya next Friday if it’s time to go up to 2 (after watching this week’s response to 1.75).
    Thanks again for all your help :) :)
     
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  10. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Sounds like a plan.
     
  11. Megan and Bernie

    Megan and Bernie New Member

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    Feb 11, 2020
    Hey @Deb & Wink! So Bernie has her appt with her new vet tomorrow, and I was wondering if I should see about switching her off ProZinc to Lantus. I’ve read a couple of articles that it’s associated with flatter curves (she’s bounced twice since upping her to 1.75) and increases the chance of remission for newly diagnosed cats, and was wondering what your thought are? I know the goal is regulation, not remission, but if anything increases her chances of not having to be stabbed multiples times a day, I’m all ears haha! :)
     
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  12. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    There have been some studies that Lantus has a greater chance of remission. IF the TR (Tight Regulation) dosing protocol is used.

    SLGS (Start Low, Go Slow) protocol has a lower remission rate.
    Flatter and more gentle curves is also something you see with lantus, once regulated.
    Bouncing does occur with Lantus insulin also.

    Even if Bernie does not achieve remission, improvements in his signs and symptoms is a worthy goal.
     
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  13. Megan and Bernie

    Megan and Bernie New Member

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    Feb 11, 2020
    Thanks! Okay so Lantus SLGS has a lower remission rate than Lantus TR, but how does it compare to ProZinc SLGS?
     
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  14. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    I don't know. No statistics have ever been collected here to see what the remission rates are.

    There is a new Prozinc dosing protocol, MPM (Modified Prozinc Method) which is a variation of the lantus TR method, with more aggressive dosing increases, lower nadirs for dosing adjustments, shorter time frames for dosing increases (3-6 cycles), etc.
     
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  15. Megan and Bernie

    Megan and Bernie New Member

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    Feb 11, 2020
    Thanks! And thanks, as always, for letting me pick your brain :)
     
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