? Prozinc..need dose advice for PM shot in 3 hours..extra dose was given

See spreadsheet. I'm really concerned.

 

Test again. See if he's coming down.

 

475 now

 

Agree with above advice. If not coming down, I would give more insulin but probably only half a unit.

 

How long ago did you give him insulin?? And his BG had gone from 452 to 475? if more than two hours I would give a half unit more now.

 

I am not familiar with Prozinc, so I can't advise whether giving more is a good idea or not. Is he eating/drinking and using the litter box normally?
I would test for ketones if you can since he's been in high numbers for a while.

 

I just reread what you posted on FB and that he was over 500 at one point. So he is coming down.

 

He is 416 now.

 

That's better. You said he's dehydrated? Has he been eating? is he lethargic at all?

 

I gave him 80ml of fluids and his skin is bouncing back quicker now. His fur is also softer. He has perked up in the last hour. Asked me for food so I gave him some and he ate. His body absorbed the fluids fast so he certainly needed them.

 

384

 

That's good he's coming down. It looks like he hasn't been in normal range for a while... I don't know much about Prozinc, so hopefully somebody that does will chime in and give you some advise on dosing. If not, re-post tomorrow to get some more attention to it as there will be more people online. Can also post it in the Prozinc forum, might get more traffic there.

You can sleep now
Might need higher dose in AM so maybe post a +11 to get advice on that. and check for ketones or buy some ketostix tomorrow to be safe.

 

It wouldn't hurt to increase his dose by. 25u, if you can eyeball the dose. Will anyone be home to watch over him afterwards? Pro-zinc is more gental and slower acting then some other insulin, but he would need a couple tests somewhere in the middle. Do you have some honey or syrup and some high carb food on hand in case he goes hypo? Most of us don't increase doses unless they can be monitored.

 

A couple of thoughts. How old is the insulin.?Sometimes as the insulin starts to lose effectiveness it will still work, just not as well and the numbers can start to trend upwards. Also when was the last time you had blood work done? If there is any infection or inflammation that can also cause numbers to rise. Have you changed foods lately?

With the higher numbers checking the urine for ketones would be advisable.

ETA Could you get a curve done this weekend..test every 2 hours for one cycle. This would show whether your kitty is dropping to lower numbers during the cycle and bouncing into higher numbers because of it. Trying to get a bedtime test each night will also show if there are any big drops.

 

The insulin was purchased in August. He's high again. 517 at +7. I gave him 0.5u and 100ml of fluids.

I did a curve last weekend. Unsure if I will be able to do another this weekend.

Blood work was done in August.

No change in food for 2 months.

I don't have ketone strips on hand. Also, don't I need special litter for that?

 

There is a good chance that the insulin could be losing effectiveness. Did you store it in the refrigerator the entire time? Are you gently rolling the vial before use?It would be about 3 months old which is past the usual effectiveness time for Prozinc. That would be my first suggestion is to try a new vial of insulin. Although some people have been able to get 3+ months use out of a vial, there is a good chance that it may have lost some of its effectiveness.If that does not help, then another blood work should be done.

 

It's always been in the fridge and I always roll it first. The vet isn't open until Tuesday. Can this wait or do I need to do something sooner?

 

There is a chance that some of the higher numbers could be from bouncing off a low number, but without tests in the middle of the cycles it is hard to make that call. If possible could you try to get a couple of mid cycle tests, at +4 or +5 if that works for you. I personally am leaning towards the insulin starting to fizzle out, but it would be good to rule out bouncing as well.

I f you are testing the urine for ketones, the waiting until Tuesday should be okay as long as you do not get ketone readings. Unfortuately you need to get your prescription from a vet, and most vets will not prescribe unless they have seen the kitty in the last few months.

 

I got a +7 today and will be home all evening. I have no ketone strips on hand. I also do not have non absorbent litter. The vet just saw Orion last month for a dental but her office is closed til Tuesday.

 

With the numbers running in the higher range it would be good if you could test for ketones. Most pharmacies will carry Ketodiastix or a similar type, so if you are able to pick up some it would be helpful. If you are able to watch Orion and watch when he is going to the litter box you can hold the strip under the urine flow and have something you can time the results with.

 

So I don't need keto strips that are cat or veterinary specific? There is a CVS just down the road from where I live. I can check there.

 

You don't need non-absorption litter - put some saran wrap on the litter. He'll wad it up when he gets in but enough should be on it to wet the pad.

CVS carries ketone strips - humans use them also. Ketones are ketones...

EDIT TO ADD: If you can't get any with the saran wrap, dip stick in as wet of litter as you can holding it there for 2-3 seconds to wet the litmus paper pad.

 

No, human Ketodiastix are fine. I use those.

 

All that people here use is the human type...even vets....so any urine test strip as long as it measure ketones as well as glucose in the urine will work.

 

@Airway ....would you edit your subject line and remove the 911 please? Every time we see it, our hearts skip a beat

Just go to the "Thread tools" and edit the subject line....choose "No prefix" instead of the 911

That way, if you DO have another emergency, you can put it back or start a new thread and we won't think it's the same thing

 

He's at 386 at +8.

 

Are you giving Prozinc any more often than every 12 hours? You said at +7 that you gave 0.50 units. Was that in addition to the 2.5 units you gave earlier?

 

Yes, in addition. This is the first time I have given any insulin outside the normal schedule.

 

OK That is not a good idea. By giving extra insulin in the middle of the cycle it throws off the Nadir (lowest number) since it will change with the extra dose. Instead of the nadir maybe just happening at +6 or +7 it will now be pushed forward or extended another 4-6 hours. This makes it very hard to see if a certain dose is working or if it is taking the numbers too low, since you will have in effect 2 nadirs or at the least an extended nadir. Prozinc will last 10-14 hours depending on the kitty so it is not advised to give extra shots in between the usual 12 hour time period.,

 

It was advised to me on this forum last night to give an additional 0.5u if it had been more than 2 hours since his last shot.
http://www.felinediabetes.com/FDMB/threads/please-help.167735/#post-1816577

 

That was not the best advice. I see that was given by someone that was newer on the board and maybe they were not aware of the usual protocol for Prozinc.

Here is some information on Prozinc:

• Prozinc is an “in and out” insulin. This means that the insulin does not build up in the system and stay there. “Onset” is when the insulin starts working, usually between 2 to 3 hours after the shot is given (depending on your cat’s own unique metabolism). ProZinc generally lasts 12 hours (“duration”) resulting in a “curve” of BG numbers, downward around mid-cycle, then back upward toward the end of each 12-hour cycle. For this reason, it’s dosed twice a day.

• Prozinc does provide a cat with an excellent chance of getting well-regulated and going into remission. We’ve had many different cats go into remission using this insulin.

• Prozinc dosing can change more often than other insulins, since it is ‘in and out’. But generally - especially at the start of treatment - it’s advisable to stick with a dose for at least 3 cycles; changes can be made after that, as needed.

• We recommend starting low: 1 unit is a good starting dose for most cats. Then insulin changes can be made by .25 or .5 units.

You can read more at this link:

http://www.felinediabetes.com/FDMB/...prozinc-pzi-insulin-for-diabetic-cats.164995/


ETA And more information here:

http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.165103/

 

So what should I do now? I can't get the 0.5u back.

 

No...now what you should do is notate on your spreadsheet the dose and when you shot it, in case you need help and another member comes on who hasn't read all your posting. How long since you gave the extra 0.50 unit...it isn't a lot, but enough that you want to do some extra monitoring..you said you gave it at +7, so the initial dose should have reached its peak at that point

 

It's been about 90 minutes since he got the 0.5u. I made a notation on the spreadsheet.

 

OK Thank you. The extra 0.50 dose will either be kicking in soon or within the next hour OR prolonging the nadir from the original dose. Orion is in safe numbers so no need to panic with the extra dosing. Just to be safe though I would restest again in about 45 min- 1 hour. It is hard to say if the +8 reading of 386 was from the initial dose and Orion was clearing a bounce or if the extra dose was starting to kick in. That is why shooting extra in mid cycle is not a good practise...you can't be sure what is affecting the numbers. So retest in 45 minutes to 1 hour and you can post the number when you get it.

 

At +9 Orion is 369

 

Thank you for the update. At this point the number could be either the nadir from the original shot OR a combination of the original nadir AND the extra shot starting to take effect since it is +2 from the extra shot. The effect of the extra shot could last for another 4+ hours, so trying to get another test in about 1-2 hours would be a good idea. At this point there is not a major drop happening but it is hard to say how much effect the extra 1/2 unit will have.

 

Thank you. His shot is due in about 2 hours. I can get a +10 and yet and then his PS number. Should I give him his regular 2.5u tonight or wait to see what the numbers are?

 

Now another issue is what and when you are going to give for the evening shot. Since you have given the extra in mid cycle the usual 12 hour/12 hour is out of whack. I would suggest changing the title of your post to "Prozinc..need dose advice for PM shot in 3 hours..extra dose was given" I would like to get some more people weigh in on what the right approach would be with the extra shot on board.

 

I have also posted on the Prozinc forum

http://www.felinediabetes.com/FDMB/threads/prozinc-need-dose-advice-for-pm-shot.167787/

And tagged a couple of members and asked to get some experienced Prozinc users to give some input on your PM dosing.

 

Thank you so much for your help. I changed the title on this thread.

 

Great!! Now hopefully the people I tagged or some other experienced prozinc users will be on before shot time

 

Orion thanks everyone who has been helping him.

 

What a furry, fluffy sweetheart. And look at those big paws...all the better to hug you with

 

I am not sure if I understand. So his regular shot was 2.5 and then you gave 0.5 at +7? He was at 369 at +9 after the first shot?

Can you monitor tonight?

 

Sue..I think she is off right now but will be back with the +10 reading. She gave the normal 2.5 units at AMPS and then gave an additional 0.50 units at +7, since someone last night had advised giving an extra shot if the numbers were high So now the +9 reading is not only from the original shot but the extra shot may be starting to kick in as well.

ETA The problem is what to do about the PM shot, with that additional 1/2 unit shot thrown in there

 

Hard to understand what is going on. The higher levels the last few days could certainly be bounces like the cycle on the 29th. Not sure about the black today - wonder if there was a low before that..or maybe he needs a little more insulin.

Angela, the safest dose would be at least 8 hours after the second shot, so you aren't dealing with the second dose creating a nadir while the next shot is starting to work. You don't want to shoot a dropping number.

 

I'm here! I plan to go to bed shortly after his PM shot.

 

You are correct, Sue.

 

I guess wait till your +12 and see what the number looks like. That's in 2 hours? I can be around then and will check in on you then.

 

His +10 is 320. Shot is due in about 2 hours.

 

PMPS is 356

 

Well, he is high enough but still dropping - although not by a lot. The safest thing would be to skip and shoot earlier in the am. (You can adjust for DST anyway?) You can shoot a smaller than usual dose now. It does make me a little nervous because you aren't sure what the two doses will do. Maybe 2 units?

Angela, I would start posting daily on the PZI forum and get advice. A curve tomorrow with some numbers early might help you see if there is a low early in the cycle. You got questionable advice from someone who doesn't use your insulin on this forum.

 

You did what you thought was best so don't kick yourself over it....In the future, it's a good idea to look under people's profile pics....it will at least tell you how long they've been a member so you can weigh how much you want to trust that advice. If you click on their name, you can go to their profile and check out "postings" and see some of the other advice they've given too

If you don't get a reply on the ProZinc forum quick enough, you can also post here in Health....that way you have a better chance of getting replies from more people