Switching from vetsulin to prozinc: Part 8

Discussion in 'Prozinc / PZI' started by Lisa and Smoky, Feb 13, 2017.

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  1. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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  2. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I have another post on part 7, meant to post it on part 8:eek:
     
  3. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I am home from work today so can get in some spot checks. I have to do a drug screening and physical for a new job I'm starting on March 1. I'll be out of the house for about 2 to 3 hours for that.
    I can do a +2 and a +4 test before I leave for appt. I can probably get one in at +8 or +9 as well.
     
  4. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That should be good data. Hurray for your new job! I hope it's something you'll enjoy and/or will come with good benefits, etc. :)
     
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  5. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thanks Kris, I'll be getting into a new line of work so a little nervous about that. The job comes with a salary increase though.:rolleyes:
     
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  6. Kris & Teasel

    Kris & Teasel Well-Known Member

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    A new line of work can be a bit daunting but also energizing. Salary increase is great - especially with an expensive FD kitty to look after! ;):)
     
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  7. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I'm going to ask my vet again about B-12 injections or at least some zobaline to put in his food. The last three times he had blood work done she said he was slightly anemic but his levels stayed the same.
     
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  8. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky dropped down to 257 at +2. He only ate a 3 oz can if food this morning.
    He is pretty hungry so am giving him another half of a 3 oz can to eat. I'll check him again in two hours after he eats his second breakfast.:p
     
  9. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Nice drop. Knowing Smoky, any bouncing this might trigger will be small. Teasel had a big drop this AM by +2. I'm sure that'll send him skyrocketing.
     
  10. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    It looks like Teasel dropped a little more than Smoky did by + 2. I'm not sure how to convert that, is it world system? The BG multiplied by 18?
     
  11. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, it's in world system so you multiply by 18. I gave him a small snack at +2 to see if the drop rate will slow. Will test him again shortly.
     
  12. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I fell asleep so missed the +4 check.
    :oops: I'll be leaving soon for my appt so will get in a +5 test before I go.
     
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  13. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Teasel gave me a blue at +4 and that's with my AT meter! There'll be bouncing for sure ...
     
  14. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I updated his SS and have to leave to go to my appt. I hope he will be OK while I'm gone. He seems to be in safe numbers so don't think he will drop into too low numbers
     
  15. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I like that 118. :)
     
  16. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Yep me too. I'm just hoping that he doesn't continue to drop more. He is almost halfway thru the cycle so I think he will be fine.
     
  17. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I agree. Just had another blue from Teasel (+6 test).
     
  18. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Go Teasel:D waiting for my turn at appt
     
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  19. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    OK didn't get back in time for more tests.
    I left his food down for him when I left so I don't know when he ate last. He has less than two hours before his PMPS so I'll just wait until then. I asked my vet about giving him B12 shots or maybe zobaline. She wants me to bring him in again first. I was just there two and a half weeks ago.
    The one thing that irritates me about this vet is she wants me to bring him in all the time for recheck. Does anyone have any ideas on OTC treatments I can try that have worked for your cat? I don't have the money to keep taking him in for every little thing.
     
    Last edited: Feb 13, 2017
    Reason for edit: Add on to post
  20. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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  21. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thank you Sue,
    Your help is very much appreciated.:bighug:
    I don't even know what my vet is basing the diagnosis of anemia on outside of blood work.
     
  22. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yup! Looks like Smoky's pattern on budesonide is to be high in the AM. You can dose around that with ProZinc because sliding scale works well with it.
     
  23. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Oddly Kris, he didn't have the budesonide last night. The vet told me to skip a dose to see if his BG was still high the next morning. I'm now at a loss since it was the same for am today as yesterday. I did only give him 1.5U last night but 2U this morning.
     
  24. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Strange residual effect? Maybe the stuff hangs around in his system for a bit?
     
  25. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    That's what the vet thinks too. She is trying to tell me I need to bring him in for a recheck all the time. I shld be able to get a different kind of med for nausea w/o having to pay for another exam.:mad:
    I have cerenia but want to try ondansteron since he has nausea but not vomiting. Smoky is getting checked for his PMPS in about 15 minutes. He had a pretty good BG for +6 today.
     
  26. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I agree about the constant request for rechecks. Nice +6.
     
  27. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky- PMPS was 207. I'm giving him the budesonide tonight. I gave him cerenia about 45 minutes ago. I'm getting ready to give him his pm shot and then the budesonide. Fingers crossed:joyful:
    I'm thinking either 1.75 or 2 units tonight, have to figure dose to counteract the steroid which seems to last about 36 hours.
     
  28. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    It's weird but the budesonide actually seems to either cause nausea or it kills his appetite. Either way, I may have to give him some cyproheptadine later.
     
  29. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You've given 1.75 u before on a BG like this and he was fine. Maybe time to try 2 u and get a +3 or so?
     
  30. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    It seems the old vial is too far down to get any insulin in the syringe. I will have to start the new vial tonight. What dose shld I give him since it is fresh insulin?
     
  31. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'm always cautious with fresh insulin. Maybe 1.5 u?
     
  32. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I will have to set an alarm so I can get up and do a +3 test. I'm giving him the pm shot about 12.5 hrs since his am shot. I don't know if it makes much difference
     
  33. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I was thinking the same since it is fresh plus effects of steroid
     
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  34. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky was 123 at +2.5 hrs after pm shot.
    I gave him half of a 3 oz can of FF before bed to keep him from dropping too low tonight.
     
    Last edited: Feb 14, 2017
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  35. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky was 368 for am so I'm guessing he didn't really need the 3 teaspoons of HC food last night.:oops: lesson learned.
     
  36. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That's the way this all works, Lisa - lessons learned. His AMPS is from the steroid.
     
  37. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    The vet suggested I give him a dose every other day for a week and see how he does.
     
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  38. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Worth trying especially if there's a residual effect from a dose.
     
  39. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    OK so 368 in am to 188 in pm. Is this caused by the budesonide or is it a bounce? If I follow vets suggestion I wld skip the steroid for tonight. Now to figure out what dose to give for tonight.
     
  40. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You've given 1.5 u at numbers like this before. Try that? My opinion is that the highs in the AM are related to the budesonide. You never have a pink in the PM and the AM pinks began after you started this med.
     
  41. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I thought the 1.5U would be a good dose to give since I'm giving him fresh insulin.
     
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  42. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I stayed up with him late last night to keep an eye on his BG. I might have slept about four and a half hours but my boy was in safe numbers. He is happy about skipping the budesonide but still has to get the cerenia and denamarin yet before bed.
     
  43. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Do you have ondansetron for nausea as well? I read a post here by @Marje and Gracie (I think) that said the two can be given at the same time because they act differently on nausea.

    Did you decide to order a pill gun?
     
  44. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I did order a pill gun for Smoky.
    I would have to ask the vet about the ondansetron. She will most likely tell me to bring him in for a recheck again first.:confused:
     
  45. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I forgot about that. Makes you wonder if it's worry about professional liability or just a money grab ...
     
  46. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Yes...you can give ondansetron and cerenia at the same time. They work well together to address nausea from different modalities. Your vet just needs to give you a script as it might be unlikely for her to carry ondansetron. If she's recently seen Smoky and prescribed cerenia, hopefully you can talk her out of another visit that you'd have to pay for.

    B12 shots are usually cyanocobalamin which will not help with anemia. You need to give oral methylB12 and a MultiB like Jarrow B Right. The dosing on the methylB12 is 250 mcg bid and the Jarrows is 1/10 a capsule bid. If you don't give both, it won't address the anemia.
     
  47. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Thanks for this, Marje. :)
     
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  48. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    You are very welcome!,
     
  49. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thank you very much for the info Marje.
    Could you please explain what all that terminology means? :bookworm:
     
  50. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'll take a stab at some of it:
    methylB12 - methylcobalamin, another form of B12
    multiB - multiple B vitamin supplement like the brand Jarrow B Right (from a health food store?)
    250 mcg bid - 250 micrograms twice a day
     
  51. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I'm baffled this morning with smokys BG.
    AMPS was 411, PMPS was 188 and I gave 1.5U last night. :eek: He didn't have the budesonide last night so I would have to assume the big jump in BG is partially a bounce.
     
  52. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, it could be, Lisa. Who knows - maybe the steroid increases the "bounce producing" processes as well as BG as well as having a residual effect. Impossible to say. At least it's consistently AM so you know you can give a higher dose then and back off in the PM.
     
  53. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky, 276 for PMPS. I'm figuring out his pm dose again. :facepalm: giving budesonide tonight so maybe 1.75 or 1.8U dose?
     
    Last edited: Feb 16, 2017
    Reason for edit: New info
  54. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Either of those should work based on past data.
     
  55. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I've given him those doses on lower PS than that while still giving him the budesonide. Still learning yet. I have a feeling I have a bit more studying to do yet.:bookworm:
     
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  56. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That's all we can do. Every kitty has a different rule book and some of them are in foreign languages we don't understand. :confused:
     
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  57. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    How is Teasel doing these days?
    I read that you were able to go out a little bit. I'm glad to hear you could get away for some me time.:cool:
     
  58. Kris & Teasel

    Kris & Teasel Well-Known Member

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    He's OK, Lisa. Still very early in the Lantus journey and I'm fine with that. Today he was high and flat from bouncing so I wasn't worried about being gone much of the day. We need a break occasionally. :)
     
  59. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I think I need to get out a little bit too. I've been spending all my time at home. I guess if he missed a shot it wld not be the end of the world. I would like to go out to see a movie once in a while.;)
     
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  60. Rachel

    Rachel Well-Known Member

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    You should! Getting out and having a few hours to yourself can do worlds of good.
     
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  61. Kris & Teasel

    Kris & Teasel Well-Known Member

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    So true! An outing or even a day shopping, etc. where you're out of the house and less focused on your kitty really refreshes your perspective and energizes you. If going to a movie means a missed PM dose, think of it as a fur shot ... same end result. :)
     
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  62. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky was 257 PMPS, giving 1.6U dose.
    No budesonide tonight, can do a before bed test.:)
     
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  63. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Feb 18, AMPS was 297, didn't give steroid last night. PMPS was 230 and about to do pm shoot. I'm giving the budesonide tonight so wondering what dose to give?
     
  64. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    He had a similar BG on 2/8 in pm of 232 and I gave him 1.75U and then the steroid.
    The next morning his BG was 364. My question wld be was the 1.75U not enough of a dose to counteract the effects of the budesonide or was it too much based on his BG?
     
  65. Kris & Teasel

    Kris & Teasel Well-Known Member

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    The steroid complicates things. Your SS tells you that the steroid is going to give you a high (for Smoky) AMPS which you can dose according to what the BG number is. The AMPSs are always lower. It might be simpler to just dose according to what the PS is instead of trying to guess what the effect of the steroid will be in the hope of preventing a pink AMPS. What do you think?
     
  66. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I gave him the 1.75U for tonight. I was thinking about meeting halfway to decide on dosing. I think maybe base it between his actual PS number and possible elevation from the steroid. I'll have to get in a curve to know for certain.
     
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  67. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky was 230 for PMPS on Feb 18th and 236 for AMPS on Feb 19th. I gave him the budesonide last night. My roommate forgot to pick up the dry food her civvies eat and caught him eating it about 30 minutes before Smokys am test. He will rarely eat dry food unless he is super hungry. How long does it take for BG to be influenced by food? She is not sure if he was eating the dry food before she woke up and saw him eating it.

    He was so hungry that I just got up and tested him this morning at +11 hours. I could kick myself for not getting in a before bed test.:banghead: I suspect he may have dropped fairly low last night. The steroid usually raises his BG quite a bit so I am surprised to see a lower yellow BG number. I'm off to figure out what dose to give him. @Kris & Teasel gave me some good advice last night and I value her thoughts and ideas.:):bighug:
     
  68. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I'm getting ready to give smoky his am shoot in about 10 minutes. I'm deciding between 1.6 units or 1.75 right now
     
  69. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Hi Lisa,
    Wow! A 236 after getting the steroid?! As you said you're not sure how low he went last night. You're home today, right? Ideal time to do a curve on 1.75 u but if that's worrying go with 1.6 u or eyeball 1.7 u. A fat 1.6 u is also an option.

    Re how fast food affects BG: I think it might go to work within 15-20 minutes, certainly by 30 minutes.
     
  70. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I can do a mini curve today, had planned to do a full curve tomorrow with the AT2 meter. There are two thoughts I have: Smoky may have been lower than the 236 since he ate dry food before his am test which may have raised it.
    Second, I did test him at +11 in am so he may have been a little higher by +12.
    I think I will try the 1.75U and monitor today with a mini curve, at least for the first half of the cycle. BTW, Teasel threw you a pretty low number for am. It was a blue number right? That's a good thing, the blue surf I mean?
     
    Last edited: Feb 19, 2017
    Reason for edit: Add on to post
  71. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yup! Teasel gave me a 113 (AT meter) this AM. He stayed blue the whole time from +2 yesterday AM right through to AM today. I tested him at +2 and +4 last night and set an alarm for +7 - all blue. Lantus dosing is different from ProZinc. The PS only gets a nod for dose decisions - it's the nadir that's the key number. You also give the full dose on a low PS if the kitty hasn't earned a reduction by going below 50 on a human meter or 68 on a pet meter on that dose. That's the "tight regulation" protocol that I'm trying with Teasel.
     
  72. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Holy Moly Kris! That all sounds very complicated. I have thought about switching Smoky to Lantus but would worry about not being able to test him throughout the cycle on days I am working.
     
  73. Kris & Teasel

    Kris & Teasel Well-Known Member

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    There
    There's also the "Start Low Go Slow" protocol that's a bit more forgiving - dose reduction at BG of 90, etc. However, Smoky does well on ProZinc and isn't a very bouncy cat. You're much more in the driver's seat with ProZinc. The insulin depot is the driver with Lantus.
     
  74. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I agree that he does well on the Prozinc. I was just thinking that most of the sugar cats on the FDMB go into remission on Lantus. I don't know if that's a real possibility or not for Smoky. I'm thinking that his multiple health issues may prevent that from happening.:(
    My main concern with him right now is in treating the IBD and finding a way for him to gain weight.
     
  75. Kris & Teasel

    Kris & Teasel Well-Known Member

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    There are many cats who have gone into remission on ProZinc as well as Vetsulin. Lantus works really well for many and there's research supporting its use to get to remission but ECID.

    Multiple health issues are an extra challenge for sure. I think the ProZinc is doing a good job controlling his BG and you're wise to focus on his IBD and weight gain.
     
    Last edited: Feb 19, 2017
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  76. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Just to recap and update: Feb. 19, AMPS was 236, +2 was 174, +4 was 113. I gave him a low carb snack after +2 and his lunch after +4. I'm wondering if I shld check him at +5 or can wait until +6?
    154 @+7 hours
     
    Last edited: Feb 19, 2017
    Reason for edit: New info
  77. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I think you can wait until +6. By then his +4 lunch will be out of the picture.
     
  78. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Yep you're right Kris. I picked up his bowl about 35 minutes ago. It might be more of a +6.5 or +7 before the influence of food is finished
     
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  79. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I just updated Smokys SS for today.
     
  80. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Earlyish nadir today. How is he feeling? Any sense that he's a bit better with the steroid ?
     
  81. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    He seems to be slightly better in the second half of the cycle. He feels worse for a few hours after the budesonide is given. Is it common for cats with kidney issues to develop diabetes? My roommate has a cat who has some signs of diabetes.
     
  82. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I think the reverse is more common - the diabetes can be hard on the kidneys.
     
  83. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I checked my roommates civvie and his BG was 56. Is that good or bad? He does have kidney problems and an irregular heartbeat.
     
  84. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Great number for a non-diabetic cat. Hyperthyroidism can cause weight loss and heart rhythm effects. Has your roommate's cat been checked for that?
     
  85. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    She did have him checked for thyroid problems when she had blood work done a few months ago. He is due for another round of blood work in a month. She just wanted to see if his BG was high. She doesn't think she could handle him being an FD kitty but would have to put him to sleep.:blackeye:
     
  86. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Heck! It's a common reaction of pet owners though. The people who come here to FDMB are of a very different mind set. I'd get another thyroid test done at the next round of blood work.
     
  87. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I'm kind of nervous about what Smokys BG will be later on. He hit nadir pretty early in the cycle and I don't know if a +6 wld have been lower yet than the +7.
     
  88. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I said the same thing when Smoky was diagnosed but look at me now. :rolleyes:
     
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  89. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky is bugging me for food but still has 30 minutes before pm test. ;)
     
  90. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Wanting food is a really good thing! :)
     
  91. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    We all figure out how easy it is in time (well...I say easy..I mean testing and shooting is easy, but the data analysis can be hard!). I sobbed through the vet visit when I found out and sobbed through the first few days. Then I realized the only one who was traumatized in my house was...ME!
     
  92. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I was totally shell shocked after Teasel's diagnosis. Couldn't believe it. That turned quickly into how the blank do I deal with this?
     
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  93. Lisa and Smoky

    Lisa and Smoky Well-Known Member

    Joined:
    Sep 6, 2016
    Smoky dropped from 238 AMPS to 109 at +4 hours. He just ate his lunch so hopefully that will keep him from dropping too low. I'll check him again at +6 just to be safe. BG at 100 at +6 hours.
     
    Last edited: Feb 20, 2017
    Reason for edit: New info
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  94. Lisa and Smoky

    Lisa and Smoky Well-Known Member

    Joined:
    Sep 6, 2016
    OK so Smoky PMPS at 253 and I'm giving him the budesonide tonight yet:nailbiting:
    He has his pm shoot in 10-15 min.
    Don't know what dose to give, what to do?:facepalm:
     
  95. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I suggest 1.8 u like this AM. Test before bed.
     
  96. Lisa and Smoky

    Lisa and Smoky Well-Known Member

    Joined:
    Sep 6, 2016
    I was thinking 1.75 but the 1.8U is much easier to draw up. I can only do a +2 or maybe a +2.5 if I can stay awake that long.
    How was your day out Kris? I'm moving on Sat so extra stress piled on right now.
    I need a day out soon, maybe a movie night with friends.:joyful:
     
  97. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I thought you could try 1.8 u because you can do a +2 and also the steroid has a tendency to raise BG.

    Whew! Moving on Saturday! So stressful and disorienting. And aren't you starting a new job soon? I think you'll need a movie night. o_O:)
     
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  98. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    Movie night with LOTS of wine!
     
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  99. Lisa and Smoky

    Lisa and Smoky Well-Known Member

    Joined:
    Sep 6, 2016
    Yep I'm moving on Sat plus I have to work a half day that day. I have off work Sun and Mon and start my new job on March 1. I am supposed to get my pill gun on Monday.;)
     
  100. Lisa and Smoky

    Lisa and Smoky Well-Known Member

    Joined:
    Sep 6, 2016
    Smoky dropped from 253 PMPS to 168 at +2.5 hours. Is that a big drop so early in the cycle?
     
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