PZI and chronic overdosing / rebound

Some history: Buddha was dx in June 2009. He ate dry food (M/D or Wellness Core) and was on Vetsulin BID with little hometesting until he went DKA in November last year. He's been on ProZinc since and I test all the time and am unable to get him regulated. He eats fancy feast, under 4 carbs, no gluten varieties.

He either needs more insulin, or less insulin. Or perhaps a different insulin. I would like to get the ProZinc to work for us. I would prefer not to switch. I know that ProZinc is NOT PZI, but it is supposed to be very similiar. It seems that many beans here use lantus or levemir, but I'm hoping that someone with former experience with PZI might look at Buddha's spreadsheet and have an aha! moment and help me solve the problem.

Please be kind, I'm doing my best.

 

Wow, his numbers really are all over the place! It looks like the right dose tends to be between 1.6u and 2u for him, but those are some crazy zooms! Oscar had much of the same randomness for a while, but his numbers were much lower. I have heard that Lantus gives a much flatter curve rather than a roller coaster like you guys are on, so that might be a really good option for you guys since you are dealing with such high numbers often for your pre shot numbers. I wish I could offer you better advice, but you guys have well passed the 45 day mark for optimal effectiveness to start taking hold. I saw on the spreadsheet that he was on Clavamox sometime in march. What kind of infection did he have? Is it possible that it hasn't fully cleared up? How are his teeth? Any possible issues there that could cause bg issues due to infection? I am just trying to come up with reasons that could explain those numbers!

 

Clavamox was for a UTI. At that vet visit I asked about a dental and annual vaccinations. I was told that he had to wait for shots and dental because he wasn't regulated. Buddha did get his vaccinations at the 2 week follow up visit, and we didn't discuss dental. He does have tartar buildup, but no other known issues.

That clinic offers 1/2 price dentals in February and ... early fall? So I have been waiting for fall to save $$.

 

I have read on here about many kitties that go in for a regular dental and the vet discovers an infected tooth, abscess, or sore in the mouth with no prior knowledge it was there. If there is a possibility that there could be something going on in his mouth then changing insulins will not help at all really. I know money is always an issue - I buy test strips on ebay to save $$. But I really think that either the UTI might not be completely gone, or there is an infection somewhere that we don't know about, and the mouth is my first guess.

 

This is a difficult one. If I'm reading this right, recently we had a possible fur shot, then tested with expired strips, then a new meter? I'd be hesitant to give advice on that, but would say that if the numbers are correct given the strips and meters, Kelly's point of 1.6U being a more comfortable dose could be right.

I'm not familiar with ProZinc, I've used PZI BCP and Idexx in the past.

Dentals are important and will help with regulation, if there is an infection going or a tooth that needs to be pulled that could be causing the wonky numbers.

Maybe try the 1.6U dose for at least 7 days, see if it can settle in before changing a dose. Give your kitty some time to get used to the dose and see if he can work with it.

 

Thanks for your input. I will give 1.6u a try tonight.

 

Two things before you raise the dose (again):

A 1.4U gave him a nadir of 55 just yesterday from a AMPS of high 400's. Would hate to see rebound numbers come back up since he's had no possible rebound for a few cycles and you're in the process of learning what a lower dose actually does w/o Symolgi complicating things. Going back at least to the 18th of April - it's possible that many of the high readings were the result of rebound. I'd hate to see you lose any progress from the last couple days by inducing possible rebound once again. Just be careful. :smile:

If you continue with the 1.3U for another cycle or two and Buddha still rockets up, then you would most likely know for sure that another insulin type is needed or something else is amiss.

Cats that have infections of some sort - (this is more of a question to all). Don't the cats tend to stay high(er) as long as there is infection? Or, do they sometimes have high PS's and then drop down to green even in the case of infection? My Blue Cat seems to stay high until we rid him of the infection. ECID I suppose?

Good luck with whatever route you take. I'll be peaking in as I'm very curious how this turns out.

 

Went with 1.3u tonight after all. PMPS came 1/2 hour early tonight and was a nice yellow. Thought about reducing, but will try to stay the course a while longer. +3 is only slighter higher than pmps, which is good in my ecid kitty.

 

Yesterday started to look promising, but I see Buddha zoomed back up to the 400's again this morning. :YMSIGH: I'd have to think that if he does not have any type of infection then a different type of insulin like Lantus Glargine may be in order should he not level out in the next cycle or two. You could try the other avenues and increase the dose a bit again, but it looks like you've already been there/done that. No hurt in trying again I suppose - you never know as Buddha's pancreas seems to have a mind of it's own. :smile:

 

ProZinc after PZI Vet

My vet ran out of his supply of PZI Vet and Danzig was switched to ProZinc about a month ago. He was doing fantastic on PZI Vet and I'd actually been able to reduce his dosage slightly, but as soon as he started on ProZinc, I could tell he was having problems - his levels were jumping up and down. Today he had a seizure and I was lucky that my daughter happened to come home in time to rush him to the vet. The vet wrote a prescription for glargine insulin. From what I'm reading about it on-line, it sounds like it's safer and actually can lead to remission. I was wondering what insulin people have had the most success with and also wanted to warn people to lower the dosage when switching to ProZinc until they see how things go.