New to Prozinc need help adjusting dosage

Discussion in 'Prozinc / PZI' started by Marianne M, Jun 17, 2019.

  1. Marianne M

    Marianne M Member

    Joined:
    May 27, 2019
    Hello I am here with an update on sugar baby. Mango was diagnosed five weeks ago. Friday he had high ketones in urine and was not eating his normal amount and was generally not feeling good. We headed off to see a new vet on Saturday and as couldn't get in touch with our regular traveling vet. On blood testing he was found to have high protein and everything else was good. Was given an antibiotic in case of inflammation in the pancreas. He has no symptoms of pancreatitis. He had his first Fructosamine test which was 277 and BG 227. Vet gave him SQ fluid, the antibiotic shot, a pill to stimulate his appetite if needed, and switched him to Prozinc after he looked at his spread sheet. He prefers a longer lasting insulin so he started Mango with 2.5 units of the Prozinc. Was told that to get rid of the keytones he needs higher dose of insulin, fluids and to let him eat as much and as often as he wants. We are doing all that and his urine ketone strip test yesterday evening went from the high on Friday night of 8 to 1.5. Today he is back to his old self. I trust the knowledge from this board so I am asking for some suggestions. Where to go with the dosage to get the numbers down or should I wait until the vet gets back next Monday? If I do adjust the dose should I wait until his ketones are negative? And lastly would I adjust down toward the 1.5 units with Vetsulin? I stepped Mango up and down in 1/2 units. I know we are starting at square on again and want to make sure I do what is right for my boy. Mango and I would be grateful for the help.
     
  2. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    Wow, he is staying really high since the change to ProZinc. I have to ask... Have you started a new vial of strips? Have you confirmed that the cat code on the vial has been selected on the AT2 meter? Now that Mango is getting to eat more food, are you giving him something with higher carbs? I am just trying to figure out if some other factor is making him run so high.

    Based on how high he is running, I would increase the dose, especially with him having had ketone issues. Normally, it is suggested to up the dose in 1/4 unit increments, but I think that in his case I might go up by 1/2. It looks like you are able to monitor pretty closesly. Let's see if others chime in.
     
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  3. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    No. High glucose is one of the factors that contributes to ketones.
     
  4. Marianne M

    Marianne M Member

    Joined:
    May 27, 2019
    Yes I have the AT2 coded properly from the container. No he is eating the same diet of FF or Friskie pates.
     
  5. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    If the test results in your spreadsheet are accurate, it looks like he is running too high, so I would not decrease the dose. Sometimes, high numbers can be the result of too much insulin, but normally, you would see some point where the cat went too low THEN went high as a reaction to going too low (aka 'bounce'), but I am not seeing that. There are no mid-cycle tests last night, so I suppose it is possible it happened then, but I am doubtful.

    If your PMPS is still as high as the other numbers on ProZinc have been, I would increase by at least 1/4 unit.
     
  6. Marianne M

    Marianne M Member

    Joined:
    May 27, 2019
    I have not done anything differently with him other than he is eating more frequently.
     
  7. Marianne M

    Marianne M Member

    Joined:
    May 27, 2019
    I increased the Prozinc to 2.75 units. Will do that for three cycles and if needed will increase it another 1/4 Unit until the numbers are good. Just took a 2+ BG test and will do it every two hours until I crash.
     
  8. Jenna Josie

    Jenna Josie Member

    Joined:
    Jun 30, 2018
    Hi Marianne. I’m sorry Mango is having such a hard time. Your plan sounds like a good one (assuming, of course, that his ketones stay negative)!

    Maybe you already know this, but with ProZinc, nadir typically happens around +6, so at nighttime, most of us try to get a +2 or +3. That test will help you know whether or not Mango will be having an “active” cycle. You might actually expect him to be a little higher around +2 due to a “food bump” from the meal he got with his shot, and then from there, hopefully his BG level curves downward toward +6, at which time he’ll start coming back up. So if the +2 is about the same as the PS or a little higher or about the same, you know you are probably good. If it’s lower, it’s a good idea to get another test at the +3 to make sure he’s not taking a dive.
     
  9. Marianne M

    Marianne M Member

    Joined:
    May 27, 2019
    Thank you Jenna for educating me about testing. I tested +2 after PMPS and it dropped 7 points and just did a +4 and it dropped 62 points. I fed him a snack after that testing. Will get another testing in 3 hours then bed as I have to be up at 5am for amps.
     
  10. Jenna Josie

    Jenna Josie Member

    Joined:
    Jun 30, 2018
    So that looks like about a 20% drop so far, which is good! Although my goofy cat hardly ever does this, I've read that a 50% drop is to be hoped for/expected by nadir ~ +6. I'm impressed with your commitment to staying up with him! Your +7 tonight will give you a good sense of how he may be doing on ProZinc.
     
  11. Marianne M

    Marianne M Member

    Joined:
    May 27, 2019
    I get to test in 20 minutes. I am so tired as I suffer from MS and stress causes me fatigue. These last five weeks has been extremely stressful with all that is entailed with caring for a FD cat. But the most positive thing coming out of all of this is finding this message board. Having folks like yourself to help someone new at this like me is simply priceless. I am so grateful. I sometimes have to laugh at myself as the learning curve has caused me some funny moments that found me laughing out loud. Mango at times looks at me with wonder. Wondering what is coming next! Strangest thing is that my sugar baby knows when he has to be in the kitchen to do our new daily routine. Good night!
     
    Jenna Josie likes this.

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