starting out on the journey

Discussion in 'Prozinc / PZI' started by mouse16, May 12, 2018.

  1. mouse16

    mouse16 Member

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    May 12, 2018
    Hi, I posted on the main forum. Mouse has been on Caninsulin/vetsulin for past ten days, 1.5 u twice daily. I am switching him to Prozinc and he is due to get his first dose tonight.

    The vet said to leave a 24 hr gap between Caninsulin and starting Prozinc so I have done that. She said to give him 1.5 units ProZinc, which is higher than the starting dose recommended in ProZinc protocol, so maybe i should just give 1 unit?

    His fasting numbers have been high, 27 mmol, and 19 mmol 3+ and 5+ caninsulin. Am going to try to do the spreadsheet!
     
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  2. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    I think 1.5 units would be fine. Sounds like he's been staying in high numbers. It's up to you...if you feel more comfortable with 1 unit for a few cycles, you can do that. But Prozinc is gentler than vetsulin usually so most likely the drop won't be as dramatic (don't know if you've been seeing that or not). Usually we suggest starting at 1 unit for new folks...but if you're switching from an insulin, we suggest starting at a comparable dose. Since you're switching, I think you'd be fine to give 1.5 if you're okay with it.

    Getting that SS done will really help us to help you!
     
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  3. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
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  4. mouse16

    mouse16 Member

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    May 12, 2018
    Hello to you both!
    I didnt see your advice before his first shot Rachel probly due to UK time zone, so i gave him 1 unit last night at 10pm. I am so astonished by his AMPS this morn at 9.15, it was 15.4/ 277, the lowest since he was diagnosed 3 weeks ago!!! I waited 30 mins without feeding and it was DOWN to 12.2/ 220!!! This is with Alphatrak so my No Shoot is 14, so I did not give him shot this morn.

    220!!!! lowest he has been in 3 weeks has been 325 but usually higher.

    I think this is good right? but its a big surprise and I'm not sure how to proceed..

    This is my first try at ss: https://docs.google.com/spreadsheets/d/1ds50OhzJjsRrGAIK8GLoz5CKK1tEbRgaeqOyIkndTlw/edit?usp=sharing
     
  5. mouse16

    mouse16 Member

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    May 12, 2018
    for some reason only the mmol is showing up, not the US conversion mg/dl. That happened after I deleted what was in the box and changed the number, before i did that the mg/dl was showing, but afterwards not.
     
  6. Sharon14

    Sharon14 Well-Known Member

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    Aug 16, 2015
    Your SS looks good to me. There’s a tab at the bottom for World numbers and US numbers. I can see both.
     
  7. mouse16

    mouse16 Member

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    May 12, 2018
    yay, thank you :)
     
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  8. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    I can see the 22.6, but not the 15.4. That happens if you delete a box because the formula gets deleted as well. You might want to manually enter the US number so folks that just read those will know there's something there.

    As far as how to proceed, you'll need to get some mid-cycle tests the next time you give insulin, so you can see how the insulin is impacting the BG. The PS numbers don't give you that information. Then based on that a decision is made to increase or decrease the dose.

    Great job getting your spreadsheet set up! Here is a little video to show how to link it in your signature:

    And here are some ideas of what you can put in your signature so we don't ask you the same questions over and over :)
    http://www.felinediabetes.com/FDMB/threads/creating-a-fdmb-profile.159626/
     
  9. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Just dropping in to say hi and welcome! You've come to the best place for advice and support. :smuggrin:
     
  10. mouse16

    mouse16 Member

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    May 12, 2018
    that is very helpful thanks Djamila (sorry if i call people by wrong names), agh thot i posted this hours ago! the video on how to put spreadsheet etc on signature is great!!
     
  11. mouse16

    mouse16 Member

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    May 12, 2018
    thank you Kris and Teasel :)
     
  12. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Great job getting your spreadsheet linked and getting your signature done!

    And yes, you got my name right: Djamila or Jamila, either one is fine :)
     
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  13. mouse16

    mouse16 Member

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    May 12, 2018
    Feel like I am doing it all wrong, so worried. After getting some hope yesterday, his numbers stayed high all thru night, and his neuropathy is worse today :(
     
  14. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    It's okay. This is a long process for many cats. It takes some time to find a good dose, and they need time in healing numbers before the neuropathy will really start to go away. It looks like you're already giving B12, so that's good.

    And great job getting those extra numbers last night. Since you lowered the dose when you switched insulin, I'd recommend going ahead and moving up to 1.5u on the next cycle that you can monitor like you did last night. Normally you wouldn't change the dose until the cat has had some time to get used to the new insulin, but I think you started at too low of a dose in the first place, so you don't need to wait around at that dose right now.

    His numbers are going to bobble around sometimes. It's important to look at the big picture of the numbers and not get too excited or discouraged about single numbers. Sometimes they'll be unusually high or unusually low for no logical reason. It's hard at the beginning when you don't have a lot of data to see a "big picture" but over time as the numbers fill out it gets easier.
     
  15. mouse16

    mouse16 Member

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    May 12, 2018
    That is such helpful advice Djamila, I am so grateful!

    I wonder if I could give him 1.5 units tonight even if I'm not able to monitor tonight (as i feel so burned out), but maybe that is risky, maybe I need to be patient and wait till tomorrow morning to give the 1.5 units, cos i can monitor him tomorrow.
     
  16. mouse16

    mouse16 Member

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    May 12, 2018
    I just discovered that the syringes that I have been frantically waiting to arrive for days, that finally came today just as i used my last syringe, are NOT what I ordered. They have no half unit markings. I am so furious. I can't dose him properly. I gave him 1.2 units tonight as this is the most accurate I can see on the U100 syringe (3 unit mark re conversion chart). I will have to order again. ARGH.

    His PMPS was 560 , the highest its EVER been. I gave him 1.2 units. I am going to monitor him tonight.
     
  17. Becky & Baby Girl Kitty

    Becky & Baby Girl Kitty Well-Known Member

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    Sep 15, 2017
    The majority - so I’ve heard, stick with the U100 syringe & conversion chart for finer dosing. The u40 is not easy to find with half unit markings or with the finer 31 gauge needle. (The smaller the gauge number, the larger the needle size) i started with 29 gauge in Baby & quickly learned here that she doesn’t even feel the 31 gauge. She flinched each time with the 29. I remember looking also when I started on prozinc. I have just used the conversion because I can run to Walmart or most pharmacies & get the syringes easily. Just a FYI if it’s helpful! It’s awful to order something, send it back & wait again! Argh is right!!
     
  18. mouse16

    mouse16 Member

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    May 12, 2018
    Thanks Becky. i have been using the 29 gauge (that my vet gave me), but today i used 30 G for first time, so much better ! (if only they had the half unit marks grrr). Would love to get 31 G but it seems to be unavailable in UK unless you have a prescription.
     
  19. mouse16

    mouse16 Member

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    May 12, 2018
    His BG is up in 500s for first time (it went up yesterday). When he was diagnosed 3 weeks ago he was staying around 300, and that was before starting insulin. I know I need to be patient but its so worrying to see him getting worse and feeling miserable.

    I wonder if the new food I gave him yesterday has caused this dramatic rise? I can't see how it would cause it because I checked the carb percent with two calculators and it is only 1.9%. It is Gourmet Gold Savoury Cake (UK, wet food) and has 17% protein content.

    Or is the new syringe/needle too short, started using 5/16 ″ (8mm) length yesterday, had been using 1/2 inch before? I feel like I am doing the injections well with the shorter needle.

    I am baffled.

    Didnt manage to do mid cycle test last night but am doing tests at 3+ and 7+ today. (the 3+ was 500 (27 mmol) :(


    .
     
  20. mouse16

    mouse16 Member

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    May 12, 2018
    mid cycle is 3+ 500 (27 mmol) and 7+ 450 (25)

    I really think I need to up his dose tonight??
     
  21. mouse16

    mouse16 Member

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    May 12, 2018
    Would it be ok to increase dose from 1.2 units to 1.6?

    Am waiting for U100 syringes with half unit markings to arrive, right now I only have U100 with whole units so if I dosed 1.6 units it would be 4 units on the U100 syringe.
     
  22. mouse16

    mouse16 Member

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    May 12, 2018
    After reading the advice again on this thread, i am going to increase from 1.2 units to 1.6 units tonight.
     
  23. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    I'm so sorry no one was around for you today :oops:. You did great though. When the nadir values are above 200, you can increase by 0.5u at a time (or in this case 0.4u ;)) We do generally recommend holding he same dose for three cycle between increases because some cats don't respond until the 2nd or 3rd cycle, but again, given the numbers you're seeing, I think the increase was appropriate.

    Come on, little Mouse, give your mama (or papa?) some better numbers!
     
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  24. mouse16

    mouse16 Member

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    May 12, 2018
    Aww thank you Djamila for reassurance and this good info about dosing :)

    i tested him at 5+ last night and he was in the pink :p yay!!! (300/16) He mustve heard you! :cat:
     
  25. mouse16

    mouse16 Member

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    May 12, 2018
    I am mama Lila ;)
     
  26. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Hi Mama Lila! Nice to meet you! If you look at the US page on your spreadsheet, that PMPS is yellow :cat:
     
  27. mouse16

    mouse16 Member

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    May 12, 2018
    :) So it is, wooo! and yellow for AMPS too! so I reduced 1.6 to 1.4 just to make sure..
     
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  28. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Hi Lila! you're doing great! :) This is very hard and confusing at the beginning. Try holding the 1.4 u dose for a few cycles to see if he settles a bit. The yellow PSs are nice so you need to collect data in this dose range. Too much dose changing can get them scrambled. If you can't get any daytime data, a before bed test every evening is strongly recommended. That would be followed with a curve on a day off.
     
  29. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Yes, I agree with Kris, try to get some mid-cycle numbers, and if you can't during the day like you did on 5/15, then definitely in the evening or on days off.

    I don't think you needed to reduce. You want the PS numbers to get lower like that. It's an indication that the 1.6u was working. It also shows us that Mouse might need a few extra cycles at a given dose to see what it will do. Which means slower dose changes. The first couple of cycles at 1.6u didn't look like much, but the 3rd and 4th cycles hinted at a lowering PS which is good. So try not to change doses before cycle #4 or 5 unless you see a lime green number.

    As Kris said, this is a tricky process, made extra difficult since we're in such different time zones. You're doing just fine - it's just things to know for next time. :bighug::bighug::bighug:
     
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  30. mouse16

    mouse16 Member

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    May 12, 2018
    Thanks so much for supporting me Kris and Djamila despite the time zones!! Oops guess I was being overcautious reducing his dose, will hold steady on 1.4 for few cycles but maybe the 1.6 was better for him. Have done 4+ today: 268 (14.9) so not much drop, and will test at 7+.
     
  31. mouse16

    mouse16 Member

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    May 12, 2018
    his 7+ has gone UP to 376 after AMPS of 286
    looks like i should've stuck with the 1.6 u. Do i need to stick with 1.4 for another cycle or two, would it mess with him to go back to 1.6u tonight?
     
  32. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    You can either keep 1.4 u for a few cycles to see if he drops on it or go back to 1.6 u and stay there at least 2-3 days (4-6 cycles). He needs to settle for a bit. :)
     
  33. mouse16

    mouse16 Member

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    May 12, 2018
    thank youuuuu Kris!!!!
     
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