Hello all! Today I'm taking Kitsu to my new vet and I'm wanting to speak to them about switching her to ProZinc. She has been on Vetsulin for almost 7 months now and while most of the time the results are decent, I still feel like she might benefit more from ProZinc because of how gentler it is (less risk of hypo) and how the curve for ProZinc makes more sense than Vetsulin. There have been times that Kitsu has gone hypo because of her appetite issues and how hard Vetsulin hits, so I would like to play it safer with ProZinc, especially as I will not be around to BG test her during the cycle as much as I am now (starting school soon). Ideally, I wanted to put her on Lantus, since it seems to have great results for most cats, but I feel like I wouldn't be home enough to test her and Lantus seems to require a lot more BG tests during the cycle to make sure they are properly regulated. Am I misinformed on that, or is that accurate? Anyway, I've been reading some threads here on how ProZinc works, but have some questions of my own. First off, in case the vet doesn't advise me correctly (has happened before with other vets), what dose should I start her off with? I see the "start low, go slow" method being recommended, but does that apply when she's being switched off another type of insulin? Right now she is on 1 unit twice daily, unless her AMPS/PMPS shows up at 160-190, in which case I give her a half unit instead (and skip her dose all together if lower than 160). Should I start her on 1 unit twice daily for ProZinc as well, since it's a gentler insulin than Vetsulin? Or maybe start her out on 0.5 unit just to be safe? Secondly, does anyone have any recommendations on what I should watch out for on ProZinc that I didn't have to worry about with Vetsulin? Last, any tips on the transition would be more than welcome! I plan to keep my Vetsulin vial until it expires (March 2019) as a backup or in case I need to switch back to it, but I'm hoping that ProZinc will help me regulate Kitsu more and maybe even give her a better shot at remission. I can dream, can't I? Thanks in advance!
Hi Jenna! I kind of followed your journey to Ireland out on Main (was interested to see how it was going to go) so it's nice to see you over here as well! First off, welcome to our little forum! We're kind of a small group, so we're not always as busy as the others. However, we mostly try to check in during "normal" shot times in the US...which means that we may not always be around for yours. But we can work around that! We've had plenty of overseas members and we usually just try to advise ahead of time if it's going to be a middle of the night for us shot. Okay, as for dose, we usually kind of go with the dose you're on with your current insulin. 1 unit seems to be getting you decent enough numbers with Kitsu right now...I'd probably stick with it. You could go 0.5 for a few days if you wanted, or if the vet recommends that, too. It won't hurt to drop to that and then move up to 1 after a couple of cycles. As for what to watch out for...hmmm. Prozinc and Vetsulin do have similarities. Neither has a depot so you can adjust the dose more as needed. Vetsulin drops more harshly as you mentioned and sometimes wears off before the end of the cycle. Prozinc is usually gentler (I say usually...we are very big into ECID over here!). Prozinc will often last 12-14 hours...so you can sometimes be shooting a bit of an overlap, which helps keep the insulin levels better. With Prozinc, you do have about an hour's leeway with shot times if needed...I can't think of anything you'll need to specifically look out for, but maybe check out our Protocol and let us know if you have any quetions? I think Prozinc might help regulate Kitsu. Kitsu already seems to be getting good greens mid-cycle, so we'll have to see how Prozinc affects her. We'll be happy to help get you figure out dosing and how to get Kitsu into the best numbers she can be in!
Hey Rachel, thank you for your quick reply! Yeah, I made it here to Ireland, and today will be all about seeing how the vets are here. I'm kind of nervous, since I don't have a lot of options for vets near me, so I hope this one is good! Don't worry about delayed responses, I understand, especially being in a different time zone and all! I'll see what the vet recommends on dosing, but what you recommended sounds good if the vet says something completely different. I kind of already have an idea in my head on what I want to do with it - basically, 1 unit if I will be around to test her in the cycle, or 0.5 unit if not. I'm thinking that if I start her on the ProZinc this weekend, I'll probably do 0.5 unit, since I won't be around much to test her in the cycle, then I can raise her to 1 unit once I'm around the house again (probably Wednesday). That all sounds good about ProZinc, which is the main reason I want to switch (gentler and longer lasting than Vetsulin). I'll probably still keep her shots at 12/12 as best as I can, but when I'm out of town, I'll let her caretaker know they can do 13/11 if needed for their schedule. Like you said, every cat is different, so I'm hoping she responses well to this insulin. I'll check the guidelines out again, I've been kind of skimming them as I prepare to go to the vet here in a couple of hours. Yeah, I know it may seem crazy to want to switch when you look at her SS right now. But it's mainly because she's on YAZ Mature dry food only, which keeps her BG levels low along with the low dose of Vetsulin. I want to keep trying to feed her wet food for all the benefits (more moisture, etc.), but that's when I start having problems with Vetsulin. Kitsu will either eat the wet food and her BG levels will raise accordingly so that I need to give her more insulin, or she will not eat the wet food and go hypo after I've given her the insulin, since she decided not to eat again after her AMPS/PMPS meal. I leave her food out for her to graze on, but she only eats a few bites at a time, and with wet food, that's an issue because it gets nasty the longer you leave it out. I've even left out small portions and she just gives up after the first initial snacking. I could go on about this and the headaches it has given me for ages, so I'll skip all that and basically just say that yes, her SS looks great on low carb dry food right now, but I really want her to eat wet food in moderation as well, and because Vetsulin hits so hard in the first 4 hours, it puts her at an increased risk for hypo when she decides she doesn't want to eat again. This worries me, as I will be going back to school soon and won't be able to test her during the day while I'm gone, so if she goes hypo, there's nothing I can do to help her. That's why I think ProZinc might be a better choice, but time will tell. I'm also interested in seeing if ProZinc will keep her in the greens later in the cycle as well, like at +7 and +8. Again, thanks for your help on this, and for your detailed reply!
I'm a huge fan of Prozinc because I've tried them all and this one works best for my cat. However, I'm wondering if you might want to consider Lantus. It's even more stable and gentle in its action than Prozinc is. If that's what you're aiming for with the transition, it might be worth taking a look in that forum.
I'm thinking along the same lines as @Djamila. If you are going to switch because you want less 'deep' curves and something longer lasting and more gentle, I suggest considering Levemir. (Or Lantus, but my research made me choose Levemir instead. Here is an interesting thread regarding Lantus vs Levemir: http://www.felinediabetes.com/FDMB/threads/why-is-lantus-so-much-more-popular-than-levemir.195958) I switched Mia from ProZinc to Levemir. I was able to get her somewhat regulated on ProZinc, but she was still spending too much time in higher numbers. The pre-shot values, especially in the AM, just were not coming down to my satisfaction. If I raised the dose a little in an attempt to get her down, she ended up going too low at nadir. It was not uncommon for her to surprise me with a low PS number, then I had the stress of deciding what dose to give her - over time, you get a lot of data, and you are better equipped to make the call, but you still just never know how it is going to go. She would also throw me unexpectedly low numbers 'out of the blue' sometimes, then I had the stress of using just the right amount of carbs to get her up but not too far up. Oh, and she was quite bouncy. So, after 9 months, I decided I had to try something different. There is a learning curve with changing to a different type of insulin, and there is an adjustment period for you and them, but I am so glad I did it. You can look at her spreadsheet and see the difference. It went from looking like Skittles to only blue and green. She was getting 2.5u of ProZinc when we switched. I started with 1.5u of Levemir, and we are down to 0.25u now.
Djamila and FurBabiesMama, thanks for your input on Lantus/Levemir. I'll have to consider it if ProZinc isn't the best insulin for Kitsu - right now, I've already bought the ProZinc, so I'll give it a shot (pun intended). I haven't given her any yet, simply because I'm still getting used to my new glucose meter and its readings (mmol/L instead of mg/dl), so I'll give Kitsu her first shot of ProZinc probably on Wednesday morning. That will also be when I'm home again for the most part - kind of busy running around this weekend and Monday/Tuesday as well. I do have questions on the syringes, though. The vet wanted to charge £55 for 120 syringes (about $72 USD). I thought that was way too high, so I declined to purchase any, especially since that's more expensive than the insulin is. I still have 22 syringes left from my US vet that I bought before I moved here. I see that ProZinc also uses U-40 syringes, like Vetsulin does, but are they the exact same syringe? These are what I used to get from my US vet: https://www.vetmedicinesforless.com.../images/01101UC-03CC-1-HR.jpg&maxx=300&maxy=0 Will these work with ProZinc? These are what the vet here tried to sell me yesterday: https://www.vetuk.co.uk/veterinary-...-141_154/prozinc-u40-insulin-syringes-p-30031 Could I not just pick these up instead? https://www.vetuk.co.uk/veterinary-...nsulin-syringe-with-needle-box-of-100-p-11335 Thanks for the help! Edit: I read the reviews of the VetUK syringes I was looking at and one of the commenters said she uses it to give ProZinc to her cat, so that answers that. However, I'm not really happy with the markings on those syringes... it goes from 0 units to 5 units with fine lines between for each unit. Kitsu's dose is usually between 0.5-1.5 so I would rather find syringes with better markings, if possible. Will keep looking! Edit2: I'm wondering if I should consider U100 syringes instead and just do the conversions? As far as I know, I just take her dose for ProZinc and multiply it by 2.5 to get the dosing for the U100 syringe. So 1 unit of ProZinc becomes 2.5 units inside the U100 syringe. I'm thinking that U100 would be better because of the smaller markings.
ProZinc is a good insulin. I did not realize you already had it, or I would not even have mentioned the other. Hopefully, it will work out just fine. If not, you can always consider a different one later. U-40 syringes are the correct ones to use with ProZinc. These are the ones I used to get: https://www.adwdiabetes.com/product/5739/ulticare-u100-vet-rx-half-unit-syringes-31g-3-10cc-60ct You do not want the ones that jump from 0 to 5 units. You could get U-100 and convert. I chose not to do that when I was using ProZinc. I felt like there is enough confusion to all of this, why add anything extra, but a lot of people do it.
The u100 needles make it awfully easy to give smaller doses, which helps give you better control. It's completely up to you if you'd prefer to use them or not (we want the bean to do whatever is most comfortable). If you do decide to get the u100s, you can use this Conversion Chart so you don't have to do any math. That way, you can be sure you're giving the right dose even if you haven't had any coffee!
I was actually buying it at the vet’s office when both of you posted, sorry for the confusion! Rachel’s post was the only one I saw before I bought it. I agree it’s extra work to buy the U100s and convert, but I can’t seem to find any U40s here that have decent markings (other than the ProZinc brand syringes, but those are the ones that are $72/£55 for a box of 120, which is way out of my budget). ADW doesn’t look like it ships to Ireland, sadly, otherwise I would love to get the ones you linked. They are similar to the ones I use now that I’m running out of (the ones I got from my US vet before coming here).
Thanks Rachel, looks easy enough to convert! I don’t really want to mix conversions into this, I’m just having issues finding smaller marked U40s that I can use instead. I’ll keep searching, though, and if I can’t find anything better, I’ll get the U100s.
I've been using the u100's with prozinc for a long time. It's really quite easy once you figure it out. I make myself a little sticky note with the dose I'm using and dose up and down from there so I'm not distracted by anything else. Then just make a new one as needed. The u100 syringes are easier to find with half-unit marks, and since they are what human diabetics use, they are easy to find at any pharmacy.
Just a small update to this thread, I ended up buying the U40s on VetUK's website after searching a bit more into them. I don't really want to deal with conversions unless I have to, especially if I find someone to care for Kitsu when I'm away and they may get confused on dosing with the different syringes. If I don't like them, I'll manage to get through the box I ordered, and then I'll order the U100s next. There's just not a lot of choices on syringes where I live, so I'll have to take what I can get.
I just started her on ProZinc this morning. At +3, she was 68 (down from 257) on only a half dose (0.5 unit). The drop definitely surprises me - I've only ever seen her drop this fast on Vetsulin when she wasn't eating, but she has been eating well so far today. Will do another test at +4 and see what's going on with her then. Hoping that she's not extra sensitive to ProZinc or something. 68 is a great number, don't get me wrong, and I'm hoping she stays around that number through her cycle and doesn't dip down again so much in the next couple of hours. Just concerned with how fast she dropped, since I thought ProZinc hit a little later into the cycle, but every cat is different I suppose! Edit: At +4, she was 92. Very interesting change in just an hour's time. Could just be the meter as well, though. Will continue to monitor her. Didn't plan on doing a curve today, but might end up doing a partial curve anyway.
Did you do a second test right away when you got the 68? Your last Vetsulin dose was only 0.5u so she might just need less insulin now.
I probably should have, but I didn’t, sorry Kris. I’m going to do another test at +6. You could be right about her needing less, since my last two PMPS were kind of low, so I only gave her half a dose (but a full dose in the morning).
I agree, especially after seeing her results today. I couldn't get a test at +6, had an unexpected visitor and it scared Kitsu off into the woods where I can't reach her, so I had to wait until he left to get her to come out for her +7 shot. She was 171 at +7, I think this may have been because the visitor was using power tools and other loud equipment outside near where she is, so it may have spiked her BG a tiny bit more than it normally would at a +7. I will do another test on her at +9 or +10 to see how she's looking. Plan to do another 0.5 dose at PMPS if her numbers aren't too low.
