Relapse question

Discussion in 'Prozinc / PZI' started by NatashaL, Feb 20, 2022.

  1. NatashaL

    NatashaL Member

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    Apr 9, 2019
    Hi,

    Ron has successfully been in remission for over a year now. But we got lazy in terms of monitoring other cats’ food and he has been eating their dry food. This morning he was 258. Do you think we need to go back to pro zinc or is it possible to get him back on track just by being strict with his eating again? Thanks!
     
  2. Daddy Jack's Mommy (GA)

    Daddy Jack's Mommy (GA) Well-Known Member

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    Feb 18, 2019
    If it were my kitty, I would hold off on the insulin and be diligent about what food he gets into. They're such little buggers! Keep an eye on his BG and his food, and if his BG remains elevated or if you get a very high number, then start him back on Prozinc. Good luck!
     
  3. FrostD

    FrostD Well-Known Member

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    May 27, 2020
    A
    Agree with this. One number does not make a pattern. Try getting back on track with food and see how he does over the next 2 weeks. Also keep an eye out for illness, that shot my cats BG way up
     
  4. NatashaL

    NatashaL Member

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    Thank you so much (both of you!). This is super helpful. We’ll watch for two weeks with the good dirt and see how he does. This afternoon he was down a little to 237. Really appreciate the feedback!
     
  5. Daddy Jack's Mommy (GA)

    Daddy Jack's Mommy (GA) Well-Known Member

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    You're welcome! I'd love to know how this turns out for both of you, so maybe you can pop back in on this thread in a couple of weeks and let us know? I'm rooting for you!
     
  6. NatashaL

    NatashaL Member

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    Definitely! I'm so grateful for this board getting him into remission in the first place, and grateful for your help now! I'll report back soon. :)
     
  7. Daddy Jack's Mommy (GA)

    Daddy Jack's Mommy (GA) Well-Known Member

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    We're keeping all fingers and paws crossed!
     
  8. NatashaL

    NatashaL Member

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    Apr 9, 2019
    Hi again, so I know I have to update his spreadsheet but I tested him this morning after he hasn’t eaten for six hours unless he has a secret stash that I don’t know about, and it was up to 427 and then this morning I tested him six hours after he ate and it was all the way up to 538. I made an appointment with the vet so I could get a prescription to prozinc again for first thing tomorrow morning. Do you think it’s okay to wait until then? I don’t know why it’s climbing! Thanks so much.
     
  9. FrostD

    FrostD Well-Known Member

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    I would actually be leaning illness or infection at this point, or teeth. Rule those out first
     
  10. Daddy Jack's Mommy (GA)

    Daddy Jack's Mommy (GA) Well-Known Member

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    I second this. Seeing the vet so soon is a great idea and you may very well need to get him back on prozinc. But it's possible that he fell out of remission due to a bladder infection or a bad tooth. It's good that you're taking care of it so quick. Good luck!
     
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  11. FrostD

    FrostD Well-Known Member

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    May 27, 2020
    Oh and of course spot check ketones to be safe
     
  12. NatashaL

    NatashaL Member

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    Apr 9, 2019
    So we went and got a full blood panel and urinalysis and he's fine other than the high blood sugar. The first test in the office he was 357 but that was after he had eaten a couple of hours before and super stressed at the vet. The doctor said the blood work showed it was 438 but he was even more stressed then. So we're thinking of doing a curve test tomorrow morning? Any other thoughts about what we should do? Do you agree we should do a curve test? Thank you! @FrostD
     
  13. FrostD

    FrostD Well-Known Member

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    May 27, 2020
    I'm not entirely sure what a curve will show if he's not on insulin...just that maybe his pancreas is helping a little bit

    Tagging @Wendy&Neko to see what she thinks, not sure if/when to restart insulin or if there's other things to consider
     
  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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  15. NatashaL

    NatashaL Member

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    Apr 9, 2019
    Oh okay. We were going to do the curve because I thought that’s how we would know how much to give him? It’s been two years so I guess our memory is foggy about how to proceed. The doctor said to start with two in the morning and at night. Does that seem right?
     
  16. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    We don't typically base starting dose on curve numbers. There are two dosing methods listed for Prozinc, each with different starting doses. Given that he has come out of remission, MPM or the Modified Prozinc Method might be a good way to start if you can do it. That would mean a 1.0 unit starting dose.
     
  17. NatashaL

    NatashaL Member

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    Apr 9, 2019
    Okay twice a day? And is it okay to feed him throughout the day?
     
  18. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Yes, dosing is twice a day. And it's OK to feed throughout the day, though we suggest that in the beginning you withhold food two hours before preshot, so the test you get is not influenced by food. It's also better to feed more in the first half of the cycle before nadir, as feeding after nadir when the insulin is waning can shorten duration and give you higher preshots.
     
  19. NatashaL

    NatashaL Member

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    Apr 9, 2019
    Hi again, so we have been giving 1 unit twice a day and tonight he was 155. Should we still give him his dose? Yesterday morning (the last time we tested) he was 438. Thank you!
     
  20. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Sorry, but I don't give dosing suggestions without spreadsheet data. Nice to see him getting to the blues.
     
  21. NatashaL

    NatashaL Member

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    Apr 9, 2019
    Thank you, I will update it soon, or rather my husband will because I find it very confounding! But I wanted to update that we did give him one unit last night when he was 155 and this morning he was 105! So obviously we didn't shoot. I am so excited that it seems like he's going back into remission.
     
  22. NatashaL

    NatashaL Member

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    Apr 9, 2019
    Okay we updated it! As you can see, he was 130 tonight. Do you think we could not test him in the morning and skip the shot, and just test him again tomorrow night? Or should we keep doing the routine until he's down more? Thanks again!
     
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  23. FrostD

    FrostD Well-Known Member

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    Unfortunately we are going to find it difficult to advise without any midcycle testing. There are doses under 1U - 0.75U, 0.5U, 0.25U, and 0.1U and drop doses if needed. His numbers are a smidge high, but I cannot say if any dose would be good or safe right now. I do find it odd that he came down from the 400s right away
     
  24. NatashaL

    NatashaL Member

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    Apr 9, 2019
    I also thought that was odd, how quickly it happened. So are you saying you need a curve report before you can advise? so tomorrow if we tested every two hours starting at 5:00ish?
     
  25. FrostD

    FrostD Well-Known Member

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    Yes. Need to see how low he's going on insulin, or what happens after a skip (how functional his pancreas may be). I would not be giving 1U though. Safest thing is a skip.
     
  26. NatashaL

    NatashaL Member

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    Apr 9, 2019
    Okay, so tomorrow we'll test him starting in the morning. Are you able to give advice in terms of if at 5:30 he is still in the 130 range how much we should give him? Or just skip and report everything and check in tomorrow when we're done? Thanks!
     
  27. FrostD

    FrostD Well-Known Member

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    I would skip if below 200. Above 200, it is your call if you want to try something like 0.25U (eyeball it) but I do not know if even that is safe.
     
  28. NatashaL

    NatashaL Member

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    Do you think we should test him tonight to be safe? He just ate like an hour ago.
     
  29. FrostD

    FrostD Well-Known Member

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    Sorry just now seeing this, yes I would
     
  30. NatashaL

    NatashaL Member

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    Apr 9, 2019
    I've updated the spreadsheet. He's eating now, so the last number will probably be on the higher side. Any recommendations about how much insulin we should give, if at all at 5:45? Thank you!
     
  31. NatashaL

    NatashaL Member

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    Apr 9, 2019
    Hi there, I wanted to tag you too just in case FrostD doesn't see this in time and hopefully you do! I'm going to test him soon and since he recently ate (but will again) I'm guessing he'll be in the low 200s and just wondering how much to shoot if at all. Thanks!
     
  32. FrostD

    FrostD Well-Known Member

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    I suspect he's bouncing from a low overnight, but the fact he came down a little on his own is good.

    Unfortunately that obscures the data :/ I suppose if I were you I would keep skipping until I could do another curve, or try something like 0.1U the next cycle I could monitor and had hypo kit. This image says U100 but concept is the same, hairline of insulin in the syringe.
    upload_2022-3-2_17-49-42.png
     
  33. NatashaL

    NatashaL Member

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    Apr 9, 2019
    Hi again, the spreadsheet is updated, we are only testing at night because we're not shooting. I just tested him before his night time feed and it was 177, last couple nights it was 201ish. Do you recommend that we keep not shooting and then do a curve maybe Sunday? Thanks!
     
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  34. FrostD

    FrostD Well-Known Member

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    Yes those numbers are too high. Tagging @Wendy&Neko for her opinion on dose.
     
  35. NatashaL

    NatashaL Member

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    Apr 9, 2019
    Thank you!!
     
  36. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    I don't see colours on the spreadsheet - sorry, been wired to read that way for 10 years now. Also did you dose this AM? If not, please put Skip or NS for no shot, so we know you didn't just forget to enter the amount.

    It's hard to say with just one cycle worth of data, but those numbers aren't remission ready. I don't have experience with Prozinc to suggest a dose, but suggest you follow whatever the dosing methods say to do, they've been proven time and time again.
     
  37. NatashaL

    NatashaL Member

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    Apr 9, 2019
    OK we will consult the prozinc method. I’m not sure why the color wasn’t showing up I thought it did it automatically. And we did not shoot this morning. Or yesterday at all.
     
  38. FrostD

    FrostD Well-Known Member

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    I would try something like 0.25U then next cycle you can monitor and have hypo kit
     
  39. NatashaL

    NatashaL Member

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    Apr 9, 2019
    Thanks, FrostD. Does that mean do another full 12-hr curve? Or just normal preshot/nadir/preshot kind of monitoring?
     
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  40. FrostD

    FrostD Well-Known Member

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    Not a full curve, though it may end up that way ha

    Preshot, a +2, and go from there. Just to catch any potential big drops
     
  41. NatashaL

    NatashaL Member

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    Apr 9, 2019
    Hi again, So we are doing a curve today. Can you let me know your thoughts on how much we should shoot in a couple of hours? Thanks again for your help!!
     
  42. NatashaL

    NatashaL Member

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    Apr 9, 2019
    Hi again, he was 111 for the last check on the curve. We didn’t dose. Any thoughts? Thanks! @Wendy&Neko
     
  43. FrostD

    FrostD Well-Known Member

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    May 27, 2020
    Interesting. Let's see what happens with skip. That was long duration/slide down. Next thing you could try is drop dose - hold plunger down all the way, insert into vial, release. Result is a drop of insulin in the needle itself, not visible in barrel. When giving the shot, hold the plunger down for 10 seconds to give it time to absorb if you can
     

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