Suggestion on the dose

Discussion in 'Prozinc / PZI' started by leona1117, Dec 6, 2018.

  1. leona1117

    leona1117 New Member

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    Dec 6, 2018
    Hello everyone, I live in Hong Kong and vets here do not have much experience on using Prozinc, but my cat did not react well on Lantus and Caninsulin which are common here, the vet ordered Prozinc to give her a try and it works---- but the vet still do not have much experience on it and he's unsure sometimes, so I would like to know if we are doing alright. I can't even find discussion on Prozinc here in Hong Kong, and others can only give me advise base on their experience on Lantus.

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    Her BG before dose became unstable these few days, but I am not sure the dose is too high, too low or should stay on the same dose and observe for a few days more. But she still looks fine and do not drink water more than usual. She's been eating same low carbs canned food all along these days, but last night (6/12) she only eats about 3/4 and the BG rises again this morning, I don't know if it can affect this much or there's other reasons.
     
  2. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Hi! Welcome to our little forum! First off sorry you got no responses last night. With the time zone differences, most of us were probably asleep when you posted. But we always show up the next day if we don't reply that night, so please feel free to post any time!

    What kind of meter are you using? It's fine to use either a pet or a human meter, but that definitely changes the numbers, and it'll change how I feel about the numbers you are getting for sure!

    Not knowing for sure what meter you are using, I can say with confidence that you are bouncing. This is what Kris wrote about bouncing:

    Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:
    1. BG goes low OR lower than usual OR drops too quickly.
    2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
    3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
    4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
    5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
    6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
    That's what I'm seeing looking at your SS. Your cat goes low and then jumps sky high in the morning.

    I see you went from 1.5 where you were getting some lime greens to 1 where you're getting some blues instead. My guess is you've reached a place where you are so close to a good dose now that you're not getting super low numbers. Is it possible for you to do smaller increments? My thought is that 1 might be a little too low of a dose but 1.5 might be a little high...1.25 might be just right. But before we make any decisions, I'd like to be sure what kind of meter you're using so we can sort of fine tune things!
     
  3. leona1117

    leona1117 New Member

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    Dec 6, 2018
    Oh I am so glad that I found here, I have been so lost these days since I can't find anyone who's familiar with prozinc in my city.... It's so kind of you.

    I am using u-100 syringes (hard to get those u-40 syringes here) and 1 means the first line of the syringe.
     
  4. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    If you use U100 syringes to dose ProZinc which is a U40 insulin you need to do a volume conversion:
    http://www.felinediabetes.com/insulin-conversions.htm

    Notice that if you want to give a dose of 1 unit of ProZinc using a U100 syringe you have to draw up the insulin to the 2.5 mark on the U100 syringe. Is this what you've been doing?
     
  5. leona1117

    leona1117 New Member

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    Dec 6, 2018
    The vet told me to start with 2.5 mark of the u-100 syringe, he always give order by marks on the syringe, not by unit
    That means I am currently giving 0.4 units
     
  6. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    And are you using an AlphaTrak glucose meter for pets? Or are you using a human meter? Either is fine, we just want to make sure we are understanding the numbers correctly.
     
  7. leona1117

    leona1117 New Member

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    Dec 6, 2018
    Human, I am using Roche ACCU-CHEK Guide
    Thank you again for helping
     
  8. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    I think I might try 0.5u then. So draw the insulin between the line for 1 and 1.5 (if I'm understanding correctly how you've been dosing). It's just a tiny difference, but it can really matter for some cats. You don't want your kitty to go below 50 on a human meter, so if you see anything below that, go back down to the line for 1 (0.4u) again.
     
  9. leona1117

    leona1117 New Member

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    Dec 6, 2018
    Thanks so much!!! I will start trying on next dose
     
  10. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    I'm just jumping in to say hello and that it is great that your vet was willing to let you try ProZinc when it is uncommon there. It looks like you are doing really well so far!
     
  11. leona1117

    leona1117 New Member

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    Dec 6, 2018
    Hello! I feel great about that too because some might give up on her while she's not doing great on the common ones... glad that she's now doing great with ProZinc.

    So.... this is what happened last night and today:

    [​IMG]

    I am not sure what's happening. Was last night something would happen after some robounds?
    Is today another rebound? I am so confused.
     
  12. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Yes, those highs could be from dropping a little lower in the day or even dropping faster than usual but not too low. Keep up the 1.25 u dose for now.
     
  13. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Yes, it can be startling when they jump up like that, but it's quite normal. I agree with Kris about staying with this dose for a couple more days and let's see what happens. Of course if she drops to 50, reduce the dose again.

    It may be easier for you to link your spreadsheet into your signature so you don't have to insert screen shots each time:
     
  14. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Yeah that does happen and it can be concerning! It happens a lot though and usually their system starts to calm down they settle in to better numbers.
     
  15. leona1117

    leona1117 New Member

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    Dec 6, 2018
    Thanks everyone I will keep it up, glad to hear that its the sign of her system calming down
    Also the temperature varies rapidly in Hong Kong last few days, maybe this is another reason that their BGs have some kind of reactions about it
    The other diabetes cats in the city seems to be having trouble too
     
  16. leona1117

    leona1117 New Member

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    Dec 6, 2018
    Finally there are some yellow or even blue pre-shot figures... but it rised to purple this morning again, I guess we are still on the way of settling?
    Does it look okay to keep the 1.25 dose? (I put the spreadsheet on my signature :))

    Also I adjusted the time of her meals. She usually eat 2/3 or 3/4 of her food right before the shot, and I used to give her the remains at +7 around the nadir.
    Now I give her the remains at around +4 so that her BG won't drop too fast, maybe that's one of the reasons that the BG figures look different now.
    Not sure if this is the right thing to do, but this is also for preventing her to steal the dog's food when she's too hungry while the BG's dropping fast.
     
  17. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Hmmm...it's a tough call. That blue you got preshot the other day is lovely, and the yellows are nice too. You've been getting mostly blues or higher for mid cycles, so I think I'd want to raise the dose to 1.5 on a day you can monitor. You haven't had any days where the BG has gone scarily low lately and other than that one day of a slightly lower preshot, they've been in a good range...but if you could get consistent yellows and then blues/greens at nadir, that would be nice.
     
    Djamila likes this.

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