New prozinc user question

Lmiller86

Lmiller86

Member
Hello!
My Baby Cat came off Novolin to ProZinc nearly 3 weeks ago... and we have experienced something twice now that's totally new. Late nadirs and low PMPS readings. From what I've read, you can try to wait the 14 hours off and dose regularly or adjust dose, is that correct? Also, does anyone have dosing guidance? Like go down. 5 unit" or something? For instance, last night Baby was in 200s still and so I fed (400s) then dosed her but not after 14 hrs, so I scaled back and at hour 10 she's already very high. I'm more worried about this happening before I have to leave for work one morning. Thanks!
 
Ok you are changing the dose too much and too fast. You need to stick with the same dose for at least 5-7 days while she's on the high carb food. She was seeing low numbers at the lower doses, and that's what matters. I know the high numbers are scary, but nadir is the important part - you don't want her going too low. We say "better too high for awhile than too low for a minute" - because hypos can kill, paralyze, cause blindness, etc.

I would go back to 2.4U and hold that for at least 5 days, and be sure to get a +4/+5 every night to see how low she's going.

What you are a seeing is a mix of bounces from numbers/drops she's not used to, changing dose, and the dry food

Have you been checking ketones? If ketones are in the picture we may consider faster increases.

At her current numbers and dose, I would shoot full dose if above 350. Below that stall without feeding and ask for help on the main forum.
 
FrostD said:
Ok you are changing the dose too much and too fast. You need to stick with the same dose for at least 5-7 days while she's on the high carb food. She was seeing low numbers at the lower doses, and that's what matters. I know the high numbers are scary, but nadir is the important part - you don't want her going too low. We say "better too high for awhile than too low for a minute" - because hypos can kill, paralyze, cause blindness, etc.

I would go back to 2.4U and hold that for at least 5 days, and be sure to get a +4/+5 every night to see how low she's going.

What you are a seeing is a mix of bounces from numbers/drops she's not used to, changing dose, and the dry food

Have you been checking ketones? If ketones are in the picture we may consider faster increases.

At her current numbers and dose, I would shoot full dose if above 350. Below that stall without feeding and ask for help on the main forum.
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Thank you for the feedback! My vet bumped her to 2.5 units but that is hard to measure on u100 syringes converting. I was thinking it'd be OK to do a sliding dose... Between 2.4 and 2.6 depending on her readings? Those are clear markera on syringes. I used to do the sliding method for the 5 months she was on Novolin. Is that not a good idea with prozinc?
 
Lmiller86 said:
Thank you for the feedback! My vet bumped her to 2.5 units but that is hard to measure on u100 syringes converting. I was thinking it'd be OK to do a sliding dose... Between 2.4 and 2.6 depending on her readings? Those are clear markera on syringes. I used to do the sliding method for the 5 months she was on Novolin. Is that not a good idea with prozinc?
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ProZinc is not as harsh as the Novolin, so no need to do sliding scale just yet at these numbers. I tossed out the 350 cutoff because her numbers are a little unpredictable, so below that yes it becomes a bit of a sliding scale til we have more data at lower numbers. We usually say 200 is the cutoff, but not for her right now.

What dose did you give the night she went down to 108?

I worry 2.6 is too high based on the 146 at 1.6U. I personally would feel more comfortable at 2U, but I know you have to weight vet vs what we say.

If you want to stick to 2.4/2.6U I'm actually thinking use 400 as a cutoff for full dose until there's more data
 
FrostD said:
ProZinc is not as harsh as the Novolin, so no need to do sliding scale just yet at these numbers. I tossed out the 350 cutoff because her numbers are a little unpredictable, so below that yes it becomes a bit of a sliding scale til we have more data at lower numbers. We usually say 200 is the cutoff, but not for her right now.

What dose did you give the night she went down to 108?

I worry 2.6 is too high based on the 146 at 1.6U. I personally would feel more comfortable at 2U, but I know you have to weight vet vs what we say.

If you want to stick to 2.4/2.6U I'm actually thinking use 400 as a cutoff for full dose until there's more data
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The day of 108 was back on 1.6, which she was on for awhile. That day was, in my opinion, a fluke... She didn't eat anything until that read. That never happens. Was trying some new kidney wet she didn't really like. The day she hit 146 was, I believe, also a bit strange for 2 reasons... This was the night after a 14 hr duration AND a 4:30 pm vet visit. This happened last trip to the vet... Her numbers went lower... Not sure stress or lack of appetite. Today, I kept her at 2.6 and have been checking and she is making the same curve so far as yesterday. I will make sure she has a good amount of food in the pm so hopefully it will curve up a bit. I do Intend to try to get her at 2.4. My vet did scare me a bit about ketones as she has been mostly high this entire transition. I do have strips now and will test. She also gets fluids for kidney issues... So hopefully that has been helping.
 
Hi Melissa! Thanks for all your advice so far... Wanted to let you know, tested today for ketones and it was negative! Whew! Let me ask for your thoughts on this-if the 2 and a half dose is too high (which I started Tuesday PM with one night of me lowering dose when I shouldn't have--14 hr duration day) wouldn't I see low nadirs by now? I definitely don't want to keep increasing too fast. She's acting pretty well with this dose... Except at preshot hours her thirst is high.

@FrostD
 
Also, one thing I think I forgot to put in my sheet... I was trying to mix her kidney diet with low carb fancy feast when I started the insulin switch in February... I realize now I should not have done that. She was coming off 2.5u novolin and I was terrified what 1 U would do.
 
I don't have access again lol

If you haven't already, can you note the food stuff in the remarks column? Then I can take a look.

I'll look once I have access, but depending on how many days at a dose it's hard to say. Sometimes they bounce for a bit, sometimes it takes a few days to settle in. Unfortunately because of the kidney food, that really affects things over spans of multiple days, which is why we say hold each dose for 7 days when there's dry and/or high carb food in the mix.
 
FrostD said:
I don't have access again lol

If you haven't already, can you note the food stuff in the remarks column? Then I can take a look.

I'll look once I have access, but depending on how many days at a dose it's hard to say. Sometimes they bounce for a bit, sometimes it takes a few days to settle in. Unfortunately because of the kidney food, that really affects things over spans of multiple days, which is why we say hold each dose for 7 days when there's dry and/or high carb food in the mix.
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Grrr! Sorry! I blame all the cat photos on my phone!

https://docs.google.com/spreadsheet...dCDnw42M7WeKVhKMCZGMYXyCnBw/edit?usp=drivesdk
 
Ah yes now I remember, the partial dose is also pulling a bit of a cumulative effect.

So the official guidance in the dosing methods is you would hold for a total of 7 days/14 cycles.

But realistically, if she's not seeing blues or lower in another 2-3 days, you can try an increase if youd like and can monitor. You are testing enough to know how low dose is taking her most cycles. If you do get some blues or lower let me know
 
Thank you! I'm a school teacher at home for spring break, so poor girl has probably gotten over tested... I've assured her it won't be like this everyday.
 
Yes it is! Would you say that I'm due for a bit of a bump up tomorrow? I'm gonna get a 6.5 hour read tonight. Happy Caturday night BTW
 
If no blues or lower tonight, yes another 0.2U increase. Looks like that blue the other night was a temporary blip and toxicity took over again
 
FrostD said:
If no blues or lower tonight, yes another 0.2U increase. Looks like that blue the other night was a temporary blip and toxicity took over again
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Hi Melissa,

When you have a moment... I'm just curious about something. I've been getting better preshot numbers and I am slowly increasing as still no blue or greens in peak. However, I am terrified of a fast plummet after giving insulin... Which I know is not how Prozinc works BUT on 2/27, Baby dropped significantly in the first 2 hours, requiring some extra carby treats (remember she's on kidney food already). This has been the only time that happened. Do you think that drop by hour 2 was because I had been changing her dose too quickly and it kinda caught up? (not much else was different food- wise and that morning I increased her by 0.2.) That's the only thing I can think of. I know, I know... I am seeing the errors of my ways.

Tonight she was 409 but did a second reading with new bottle of strips and it was 367. So I let her eat, waited 20 mins and read before dosing and she was already to 492! I wanted to be extra sure bc i'm bumping her 0.1 tonight and 0.1 tomorrow. I messed up my hour change and it's when I'm trying to increase, feeling like such a rookie!


https://docs.google.com/spreadsheet...ijEBEQPb5AieYhN1klLbRGGovlw/edit?usp=drivesdk
 
Do you remember how early that shot on 27th was?

I hate when there are odd cycles like that, makes things harder lol darn cats! I don't quite think it was dose catching up, but could be part of it. My guess is variety of factors - dose catching up, possibly didn't eat as much, but more possibly that PM cycle on 26th was a long slide down, and you shot as she was coming down. Hard to say. Regardless, it's been awhile since then, I would increase.
 
FrostD said:
Do you remember how early that shot on 27th was?

I hate when there are odd cycles like that, makes things harder lol darn cats! I don't quite think it was dose catching up, but could be part of it. My guess is variety of factors - dose catching up, possibly didn't eat as much, but more possibly that PM cycle on 26th was a long slide down, and you shot as she was coming down. Hard to say. Regardless, it's been awhile since then, I would increase.
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Yes, those types of situations sure do make it difficult! The read was early, dose was actually 10 minutes late. Dosed her at 12.5 hrs past pm dose. I did write in my journal that she didn't eat full portion breakfast before insulin, but she had some dry before that 2 hour mark. Looks like I may have fed her some fancy feast overnight and not her kidney formula. So yeah, probably a giant mix of the options you mentioned! And hopefully will not be seen again! Thanks!
 
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