http://www.felinediabetes.com/FDMB/threads/prozinc-dosing-question-amps-133.225602/#post-2529886 Hello! For anyone that hasn’t seen my posts in the Main, my name is Krystie, and my kitty is Sirius. Quick catch-up: We were diagnosed a few days before I had to travel. My vet gave me a crash course at our dx appt, he mentioned home testing and sent me home with DM low carb foods. I taught my bf and my sister-in-law how to shoot before my trip just fine. Upon returning from my week long trip I found out my bf was microwaving the insulin. Yes, microwaving...the entire bottle. It took several days to get a replacement, as this was discovered on a Friday night. So, Sirius only received a few days of good insulin, then had over a week long break from it. We’ve been back on the juice and testing for 8 days now. I still have a million questions, make tons of mistakes, and am unsure about dosing a lot of the time. @Deb & Wink have been a saving grace and have helped me so much. She pushed me to post on here for the first time, for PZ specific dosing advise. Right now I’m trying to fill in my SS as best I can, and will attempt my first day-time curve this weekend. Thankfully Deb let me know before I did it, that it is not in fact a full 24 hours of testing...only 12! I was fully prepared to do it, but what a sigh of relief I had when she told me. I’m keeping a steady 2 drop dose going, and his numbers seem ok, but we’re all aiming for those greens, right?!? We do get them, but not consistently. Any advice is always appreciated. And tips or tricks for the pokes too; w CNN his little ears are a mess, and they make me want I cry just looking at them. He yelps every time I poke him Thanks for reading all of that!
Don’t cry... his ears will get used to it. My girl now comes when I just sit in “the spot” to get tested. I know this whole process is stressful and can make you crazy,sad, scared etc. but you got this and are doing fabulous for someone who just started this dance. Remember to breathe and reach out to the peeps here whenever you need to. I couldn’t have gotten this far without them. Hugs and love to you and Sirius
Hello Krystie! Took a peek at Sirius's SS. I think we need to do a bit of a sliding scale, like I did for Kerri & Tigger. How about this for the new sliding scale If BG < 90 skip shot (or stall) If BG = or > 90 and < 130 0.2U (2 drop) If BG = or > 130 and < 160 0.3U (3 drops) If BG = or > 160 and < 200 0.4U (4 drops) If BG = or > 200 and < 240 0.5U (5 drops) If BG = or > 240 0.6U (6 drops) This would be easier if you had U100 syringes to use with your U40 insulin. Then, you would use the conversion chart and simply draw the required amount into the U100 syringe. For example, 0.2 U x 2.5 = 0.5U in the U100 syringe Prozinc U-100 amt syringe amt 0.2 U = 0.5U 0.3 U = 0.75U 0.4 U = 1U 0.5 U = 1.25U 0.6 U = 1.5U Trying to tweak these BG readings more down into the healing green number range.
Hi Deb! I’ve been thinking about his doses. I’m definitely doing his day-time curve this Saturday, so should I try the sliding method right away? Or wait until after the curve? I think I’m pretty confident about the drop doses...at least up to 3 drops; 2 and 3 drops I’ve practiced a lot. Thankfully his numbers seem to be consistently lower than 160, so paws crossed I won’t need to go to 4 drops. Concerning the syringes, which gauge do you think is best? The syringes I have now are 29g, do you think I can go lower, to say 31g? I’m also debating if I should switch from the 1/2” to the 5/16” ?
If his ears are a mess then you may be accidentally hitting the vein. Maske sure you are aiming for the very outer ear edge, not the vein. I test my cat 4-6 times a day for years and her ears are fine. A little neosporin ointment with pain relief will help her eat heal. Also after the reading I squeeze the ear with a cotton cosmetic rounds. I have a video in my signature showing how I test my cat CC at home.
I’ve been pretty careful not to hit the vein; I did it once and there was a lot of blood. Plus I gave him a little lump on that ear. It’s slowly going down, and didn’t seem like anything more than a little scab of some sort. (I posted a picture of it in the linked thread) I even shaved the edges of his ears to see the vein better. I purchased smaller lancets last night to minimize his pain, but those don’t seem to be giving me enough blood. This morning was such a struggle with him. Multiple pokes, multiple test strips, I’m bleeding...we’re both pretty frustrated at the moment.
Sometimes it feels like you should just aim for the vein after all, doesn't it? But sounds like he's letting you use both ears now?
I’m still waiting for his ears to “learn to bleed”. I thought that would have happened by now. *sigh* If by letting me, you mean holding him captive, then yes. Lol. I ripped open my knuckle with a lancet this morning by him pulling that other ear away from me. Even when I think I have a good grip on him...
Sometimes I think we really need three hands. Or else maybe a little velcro suit for the kitty and a matching velcro glove. I had a lot of trouble getting enough blood for my human meter too....I guess it all adds up to more bandaids for you and more tuna for Sirius!
Wait until after the curve. See if you catch an "unexpected low" BG reading. Then try the sliding scale after that. I think Sirius is close to getting to remission. We just need to tweak his numbers down into the greens a bit more at mid-cycle. Smaller gauge is bigger needle. So the syringes like the 31G (gauge) hurt less, smaller needle. Needle length is your choice. Some people like the shorter needles, because they are less prone to sticking the needle out the other side of the pinched up "tent" of skin. I never did switch to the lower gauge lancets with my diabetic cat. Always used the ones marked "for alternate site testing" on the box.
I never did switch to the lower gauge lancets with my diabetic cat. Always used the ones marked "for alternate site testing" on the box.[/QUOTE] I’m using 26g, they were the only thing I could find at the time. But I’m thinking they may be too thick. And, the smaller ones I got last night seem to be too small. I guess I’ll try something in the middle next. Everyone else seems to have kitty’s with normal looking ears; Sirius’ ears look like he’s abused. (I’m probably totally exaggerating, but to me they look so awful, and sore)
Hi Krystie! A few days ago, I ordered the same syringes in your photo, and they just arrived. I was using U-40, then U-100 (but forgot to look for the half-unit markings first time around). I haven't used one of these yet, but I just took one out to examine, and they seem really good. Better quality than my others....Both of my other kinds feel a little "loose" (hard to explain) and not always aligned really well. Like, before I draw up a dose I have to check the alignment of the plunger against the bottom line, when pushed all the way down. If that makes sense. I guess some of the pet syringes are just not as quality-controlled as human, maybe? Anyway, these seem GREAT--but I haven't Tigger-tested them yet. It's my first time with the shorter needle and higher gauge/thinner needle. Will let you know how it goes! EDIT/UPDATE: Just tried my first dose with one of these. I like them a lot. I never had trouble poking through to the other side of the tent, but sometimes I did let the half-inch needle touch the inside of Tigger! She was quick to let me know. Seems I'm less likely to do that with these shorties.
I’m using 26g, they were the only thing I could find at the time. But I’m thinking they may be too thick. And, the smaller ones I got last night seem to be too small. I guess I’ll try something in the middle next. Everyone else seems to have kitty’s with normal looking ears; Sirius’ ears look like he’s abused. (I’m probably totally exaggerating, but to me they look so awful, and sore)[/QUOTE] I use 28
Time for your Closeup glamour shot Mr Sirius. Let's see those ears of yours. You may win a big prize for participating.
Deb try as I might, this cat hates his picture being taken. He’s so weird about it! Every time, yet somehow...
Hey, Kerri! Much better than expected! I had the element of surprise most of the day, and snuck attacked him while he was napping a few times. He doesn’t seem to be that mad at me, but he’s definitely watching me closely tonight. I haven’t poked him in a few hours, but he’s still side-eyeing me every time I move. Lol
I'm so glad it worked out without too much drama! Or too much people blood. I hear you, about the side-eye. You know how cats like to play inside paper bags? Now Tigger loves to EAT inside a paper bag. So I can't poke her. And since she rules the roost, that's what we do.
Want me to go take a look at the SS and the curve? Did even if you did not want me to. I'm like that. Looks good. Not too low, never down below 50. 2 drops is working for Sirius. Krystie, would you put some notes over in the Remarks column on when you fed Sirius? Please? Every day would be nice to see. + hour times, amount fed, etc. I'm especially interested in knowing when Sirius was fed in relation to those curve BG tests. Thanks.
He’s a grazer; unless it’s breakfast of dinner time, he’ll eat a bite or two, then go back sporadically for another bite or two. It’s how he’s always been. Sometimes he just goes to check to see if his food is still there, and will take a bite... Now that I remove his food prior to his shots, he’s ravenous at breakfast and dinner.
In some ways, that is good. At least you know he'll eat well before you give him the insulin. Even a rough idea of what he eats at pre-shot test times would be helpful. Then, an estimate on what he eats during the day, as snacks. p.s. You should remove the dose of insulin from your signature. The dose changes too often to make having that info there be helpful.
Hi Krystie, I simply wanted to make you aware of this. All the "Sticky" or pinned posts in the Prozinc forum have been updated and there are a couple of new ones. Highly recommend that everyone using Prozinc or helping those using Prozinc read them thoroughly. I'll be doing that myself. Been expecting this for some time. Came about a week before I thought it would. Thanks Marje, and Robert, and especially Djamila for the Modified Prozinc Method. You folks are FANTASTIC!
Hello Deb! Quick question about my PZ. The sticky says it should be clear. Both of the vials I have had so far have been a milky color. They came from two different veterinarians. This is the first time I’ve seen PZ refereed to as clear, everything else I’ve read here, and other articles, have mentioned it being a milky color.
No, Prozinc insulin should be cloudy. Like the color of skim milk, but lighter. Could you tell me which sticky said that? I'll let the appropriate people know and hope to get it fixed ASAP. Thanks for noticing that. Haven't had time to review all the new "Stickies" myself - yet. Working on it.
I've let the moderators know Krystie. Thank you for your "sharp eyes" and catching this. Much appreciated. The first spot has been fixed already. Found one more spot that needs correction. Moderators are working on other fixes. p.s. Knew I should have read through all those documents first thing this morning.
Hey @Deb & Wink would you take a look at Sirius’ ss. He’s pretty low right now, he’s 68 at around +4.5. I gave him soon food, which he scarfed down. Should I be worried? I’m thinking he’ll go back up soon, especially since he just ate a good amount of food. His nadir seems to be around +4...I think. I can probably run home to test him again soon if you think I should. Thanks!
Yes Krystie, I think you want to get another mid-cycle test today. If possible. And think about reducing to 1 drop of insulin for tonight's PMPS dosing cycle.
And leave some extra food out for Sirius too. So he can eat if he feels his BG levels going down. Can't remember if you have more than 1 cat. If so, sequester Sirius with said food and a litter box in his own separate quarters for the rest of the afternoon, til you are home from work.
No other kitties. He ate a good amount of his ff, and there was some left on his plate. I will test him in another hour. Thank you!
+5.5 is back up to 86! Edit: It’s actually five hours and 45 minutes, but I didn’t know whether to mark that as +5.5 or + 6.
Love it if you could do 1 more test in 20-30 minutes. If not, leave food for Sirius to munch on while you are gone.
Poop, I do. I actually tested him and managed to get back in 20 minutes time. Soonest I can get back would be at least an hour now. My boss is going to catch on soon and read me the riot act. I did leave him plenty more food.
Ok. he's probably headed back up. And as I said, having food available, Sirius will seek out food if he feels hungry when his blood sugar drops low. p.s. Don't suppose it's "Bring your fur kid to work day?" It's not that critical Krystie. He'll be fine.
I know PZ is supposed to nadir around +6, give-or-take, but Sirius seems to nadir around +4. That seems like to short of a cycle. Have you ever encountered such a short cycle? Do you think it will be a detriment to him getting to remission? One more...is he dropping to low? His pattern looks to nadir in the the high 60’s and come right back up, is this too low?
ECID Every Cat is Different. Sirius proves that. Averages do not mean that all cats will have their nadir or low at +6. Wink on a different insulin had a nadir around +3 to +4. He got a bit of overlap with the Lantus. ( I know, different insulin than the Prozinc that Sirius is getting.) Prozinc can also have a bit of an extended duration. Up to 14 hours. So you may be seeing a little bit of that with Sirius and his +4 nadir.
Oh right! Okay, possible overlap instead of short duration. Yikes, I feel like a scientist sometimes Deb! So much to take into consideration. So now, do you think I should change his dose to one drop tonight? Or base it off his pmps number? What should that number be if I were to lower the dose? Last nights pmps was pretty low, but I made sure to test him a few times mid cycle. He was great, playing and cuddling, the whole night.
No, I do not. Maybe. That is why I want you to switch to the 1 drop dose for tonight. 60 is a bit low for Prozinc. I'd rather see him a tad higher, nadir around 70 or so. Yes, 1 drop tonight. I would not give more than 1 drop for now on a pre-shot BG <110. Lucky Sirius with the hugs! Bet the BF was jealous. p.s. He may be getting close to OTJ trial. But 1 drop dose first.
Hmm, his last 3 cycles he was above the 110, but only just slightly. Tonight’s pmps will be a ponderous one. Lol. The bf hasn’t been around, it’s just me and kitteh. Wouldn’t that be lovely!
Let's see if I can help you understand Prozinc a bit better. Prozinc has 2 component parts. 1 faster acting, 1 slower acting. That is what gives Prozinc it's longer duration. 10-14 hours. Similar to Lantus, but not as long a duration, so less overlap. But it does happen sometimes, the overlap from 1 dose to the next. Now, because of those 2 component parts of Prozinc insulin, there can be a 2nd dip in the BG numbers later in the cycle. Doesn't happen with all cats, nor at all doses. But sometimes. So a test later in the 12 hour Prozinc cycle can be helpful. To see if Sirius gets that 2nd dip. Realize you might not be home then, but a test somewhere in the +8 to +10 time frame can help you see that 2nd dip. If it's happening. Any day you get home from work before the +8 to +10 time. Got to love it, because it is helping Sirius. No matter how complicated this sugardance is. Next day off from work, you should do another curve. But test every 2 hours starting at your +1 and then every 2 hours after that. So +1, +3, +5, +7, +9, +11 and throw in at test at +8 or +10 if Sirius lets you. Yes, it's a lot of testing, and Sirius's ears look like crap. But it's going to help him in the long run.
I didn’t know that the PZ has 2 components. That’s very enlightening, thank you. So I’m thinking that Sirius does get a second dip. It seems as though he dips right around the +11 hour mark. I was wondering why his number is slightly lower at that time. Ugh, I’m not sure when I’ll be able to get another curve. Not this weekend, unfortunately. Maybe next weekend?
Well, his pmps was 100. I was tough and stalled 20 minutes. But now his BG is 91. I think I’m going to have to skip his dose tonight.
Yeah, Krystie. Good not bad. It's why we have you doing the drop dosing with Prozinc. Because Sirius is thisclosetoremission.
I was just really confused because his number dropped after the stall. I honestly just thought he was messing with me. Lol. And I was surprised about the drop because he fought me so much for both tests. I though they would have rose because of the stress.
I was just really confused because his number dropped after the stall. I honestly just thought he was messing with me. Lol. And I was surprised about the drop because he fought me so much for both tests. I though they would have rose
So normal numbers....? It’s anything <150, right? Should I stick to the one drop dose for numbers at or below as preshot of 110 still? (Sticking to the one drop dose for a bit) Or not shoot again tomorrow if his amps is below the “normal” 150?
Normal numbers are anything < 120 without insulin. Tightly regulated - generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin Normalized - 60-120 (3.3-6.7) except perhaps directly after meals -- usually not receiving insulin Krystie, please remember to get at least 1 BG test in the PM cycle AFTER the pre-shot test. One more test before you go to bed. Skipped shot or not, one more test please. Pretty please with sugar on top as we used to say when I was a kid. Which I barely remember.
Oooh, so Sirius is tightly regulated at the moment. That is very encouraging. I’m not sure what’s going on with him lately, but he’s been very combative, especially at night. Maybe he’s just had enough of the daytime tests that by night time he fights me really badly. He’s also been pulling his fur out, in chunks. He actually woke me up at 4am puking on my bed next to me. I thought the fur pulling was stress because of my personal life effecting him, but I’ve eliminated the main stressor 2 days ago, and he’s still pulling his fur out. I’m hoping it’s not an allergy developing. But he’s only pulling out his undercoat, like on his chest and stomach area. I just don’t know... I’ll have to try to stay awake for more night time testing.
Is the fur pulling because it's shedding season? Or because he is matted? Redness on his belly area? Puking food or hairball or foamy type stuff?
I’ve been trying to figure it out. There doesn’t seem to be any irritation of any sort, no redness or wounds. I was starting to think it was because the weather here was unseasonably warm for a few days. I thought maybe he was getting ready to blow his winter coat. But, it’s turned bone chilling cold again, and he’s still doing it. That and he’s never done this before. Ever. And it’s so much! So so much! He will actually stop mid walk or playing to tear out a few tufts. I’m finding areas of tufts of fur all over my house. And of course now he’s getting hairballs from it. The vomit it mostly hair, some bile. He’s always been a puker. He’d go through a week or so of vomiting once a day, or more, then just suddenly stop for months. No changes to ever warrant it, just random pukes. It was a mix of undigested food, and then sometimes just loads of bite. But now it’s just huge hairballs. I’m considering shaving him. Just where he’s pulling the fur from.
Hi Krystie! Okay, every cat is different, but Billy has had this hair pulling out before, so I thought I would tell you about his issues. Billy has asthma and allergies. One of the things he is allergic too is fleas. Even though I couldn't find any fleas on him, he must have had at least one, and that is all it takes. Billy seemed fine except for the pulling his hair out in tufts. Took him to the vet, vet said it was an allergic reaction, and that his skin had gotten infected. Antibiotic, flea treatment, and no more pulling out of fur. Now if I see him even start to pull out fur, I give him a flea treatment just to be safe. (and to be clear, even with the skin infection, we saw no redness or sign of irritation. His skin did feel too hot though) Now, Siirus might not be allergic to fleas, but he could have some sort of allergic reaction causing his skin to irritate him so much he's pulling fur out. If you can, take him to the vet and ask them to check for signs of skin infection. That's what had Bill tearing out patches until he was getting bald in places. You could also talk to vet about maybe Sirius trying an allergy tablet like Zyrtec, if the vet thinks it could be allergy related. Billy takes half a Zyrtec once a day, and it really helps. (and the generic over the counter brand is cheap.) You might also try giving him a flea treatment, even if he doesn't look like he has fleas. One that also kills skin-biting mites is a plus. I know this might not be what's effecting Sirius, but it's worth looking into.
Hmm, that’s definitely worth a shot! I still have some Advantage left I can give him. I recently moved, and my landlord (god love him, he’s so kind) feeds some strays. Well two of them like to try to sneak into my place whenever they can, so I gave Sirius a flea treatment just in case. My landlord told me he does treat them for fleas, so Sirius hasn’t had a treatment since September. (Well October since I gave him his advantage in September) I’ll definitely try that and see what happens. Oddly enough he does have allergies. Spring allergies! Every spring he starts sneezing like crazy. Sometimes his eyes will water as well. But in about 3-4 weeks it clears up and he’s over it. But, he’s never pulled his fur out from it. Maybe the warm weather here kicked up some other allergens. If the advantage doesn’t work I’ll bring him to the vet. Thanks, Juls!
Omg, I just went home quick to check on Sirius and his BG was 86 @ +5. This was a little confusing to me as his amps test he was at 102, and I decided not to shoot. But I think I gave his his insulin! I’m sitting here racking my brain, and I think I was on autopilot and shot the one drop. It’s the only explanation. He seemed fine though. There was a very small amount of vomit when I came in. It looked like just liquid ff; Completely liquid, and dark brown like the food. (Not something I’ve seen before though) I noticed that he barely ate any additional food since I left this morning, but he meandered out to his bowl when I went to the kitchen. I gave him a bite of ff Purely Natural Tuna treat and he went over to his bow like he was going to eat more. I didn’t stay long enough to make sure. I’m just freaking out thinking what his BG could have dropped to while I was at work. But, he didn’t eat what was left for him, so maybe he wasn’t too low? Ahhh, I’m so mad at myself!
Remember, cats can be producing a bit of insulin on their own. Some people put 2 insulin syringes in a mug or container next to the insulin shot area. That can help them to remember if they gave the shot or not. Simply load the mug with 2 insulin syringes for the day. If you still see only one syringe in the mug, you know you gave at least one shot that day. Memory aid. We need them when we are really busy. I do notes, lots and lots of sticky notes. Or pages of notes on my "to do's list" for the day. p.s. Thread is getting long. Please start a new thread next time and link this old one at the top.
Try not to worry. He's got food out and will want to eat if his number drops anymore. And like Deb said, his pancreas could just be making some extra insulin today, even if you didn't give the shot. And you are on a super low dose, and that helps as well.
I'm going to add with that 86, ProZinc protocols say reduce the dose. Might be time to give up that drop for 3 cycles and see what happens.
When I skip a dose, his next preshot number is higher, in the 120’s. The OTJ trial is enticing, but also worrisome.
Thanks, Kerri! I’m still concerned with those 100’s, but I’m starting to think maybe that’s just “normal”. He’s fine everywhere else: The three P’s, cuddling, less water consumption, and he’s playing and getting random zoomies; he’s doing fantastic!
Hi Krystie, Moderators are reminding me to ask people to keep posts down to 50 replies. When you have a chance, from working those back to back double shifts to keep those trucks picking up goods to restock our stores, would you please start a new thread. Thanks, Deb, the "bad traffic cop".