Baco on ProZinc

Hi Everybody. I've been reading everything that is on this topic. Let me introduce myself, my name is Ruby and i'm the owner of Baco (the cat that you've been talking about) with the strange curve ! Jennie told me about this forum and that she was asking you all questions about ProZinc, and i'm curious myself what your experiences are with ProZinc. Yesterday I was really suprised myself about Baco's curve because at first she was getting hire numbers and later in the day / evening she was getting lower ones (strange) I'm still learning about prozinc myself everyday and about the food that I have to give here so she doesn't get as many carbs than she was used to. @Rachel I will test her every 1 to 2 hours this Saturday to get a nice curve. I just tested her every half hour yesterday to see what ProZinc does to her body but that will be the only time I will test her every half hour (poor kitty) I will put the curve up on tis topic on Saturday for you if you want to see it? For now I will only read the comments on this topic, if you have any questions for me regarding Baco, please let me know

 

Although I hesitate to do this since Murphy is not a normal, easy to regulate diabetic cat, he has been on prozinc since August - please click on the blue hyperlink under my signature and look at his spreadsheet - the amps and pmps = am preshot blood glucose reading and pmps=evening preshot blood glucose reading the U=number of units of prozinc given then +1, +2, +3, etc = number of hours since the prozinc was given - you can see (mostly) the smile effect - he has high preshot numbers as the prozinc doesn't seem to last long enough for him - you can see his nadirs do vary some from day to day - mostly between +4 and +6 though a few times, his pmps has been low and the insulin lasted longer than 12 hours - when this happened, I figured it was too high a dose given in the am --

 

Welcome, Goof was the same way in the beginning, but not anymore. I'm a ProZinc user and have always followedthe test, FEED, shoot method. In a year and a half, we've only experienced 2 hypo's. One was when I started using u100 needles and my husband misread my note (I was out of town) as to what dose to give. One was very early on in this journey.

There was period of a about 3 weeks, where Goof only needed insulin once a day, we don't know why, but it worked for him.

If you've been keeping a log of Baco's numbers, it'd be really helpful if you could enter that info into our spreadsheet. Marje helped me get set up, but I'm sure there are several others who would be willing to help. It's so much easier to get an accurate picture of what's going on. Also, if you could enter some info into your signature, that would be very helpful. That way if a new set of eyes joins in, they'll have the basic info so they don'thave to go back and look for it in the previous posts. The info we'd like to have is: your location, date of diagnosis,meter used, food and type of insulin used.

 

Hi, I will try to figure out how to make a sheet on this forum. I have one on the dutch forum about ProZinc but not on this forum.
When I'm home (in about 1,5hour) I will try to figure out how to put it in my signature.
She was diagnosed at 06.04.2016 and i've been keeping a log of the numbers since 16.04.2016. And i've made just 2 curve's , one last saturday and one just yesterday (and that was the time the smile effect happend) low numbers, from +7 she was starting to get lower and lower numbers (what is great) but that it kept on going so long is really new and strange to me.. althought, everything is quite strange and new to me because I just started with this whole new life style for Baco.

 

Hi Ruby - we all know and understand quite well the whole new life style associated with this -I"m still trying to come to terms what part of the Netherlands are you? I'm half dutch (Zeeland)

 

yes, you have to find a balance in your personal life and work and do everything for your cat as well.. it's working out just fine right now, but the first few days was hard! also with the waking up early thing... men that was terrible because i was used to sleeping in during the weekends so i could recharge for work on monday again.. but i must say, i'm used to getting up early every day now, even in the weekends and i feel much more fit than i have ever been.. so that's a plus ! hihi. I come from Noord-Holland near to Aalsmeer (you know that?) and i live in a small town called Kudelstaart. So you speak Dutch?

 

Hi Ruby - both of my mother's parents were born in Zeeland - she was born in US. I only know a few words my Grandmother used to say, but I'm not sure if they are Dutch or Flemish I went there about 10 years ago to try to find if I had any relatives still around - the area had been pretty much destroyed in the two world wars, so not many old buildings were left. I was treated royally by everyone and absolutely love Holland. Wish I could have found some relatives.

 

Oh that's a shame haha! I think it will be Flemisch they have a dialect in Zeeland. That great that's you've visited Holland i've visited the US quite a few times, New York, Florida, LA, San Francisco, Las Vegas.. I love how welcomed you are in the US, love how people are and the culture.

@Mogmom and Goofus : I've put all the info in my signature. If there is anything missing, please let me know. I update the sheet daily but I already saw that the way you all fill in the sheet is different from mine? If I test Baco it works with MMOL. So she started today with 20.4MMOL and +10 (just now) she was at 16.9MMOL. I hope that is clear for you all because I don't know how the number work that you all work with?

 

Don't have much to add here, but must tell you that I had to laugh when I saw the name of one of the foods that your Baco is eating: BARF (raw).
In English, the word "barf" means ... to vomit! (Regurgitate the food.)

(Am I correct in assuming that your work schedule prevents you from being able to dose Baco with ProZinc twice per day?)

 

@Robin&BB : hahahahaha I know right! I always say it in dutch to Baco "do you want some BARF? " haha well she likes it and that's the whole point
Yes that is true, but also the vet told me they have some cats on ProZinc also once a day and that works perfectly. So yes, work is not letting me do twice a day but if I must, in the future, I will work my way around it...

 

Robin, in the UK a raw diet is often called 'BARF' too. It's a (rather amusing) acronym for Biologically Appropriate Raw Food.
.

 

Time will tell. And will hope that works out for you. But that said ...

Once a day dosing on ProZinc is actually not the most effective schedule, regardless of what this vet would like to have you believe.
Here's why: It is not a 24-hour insulin. Please understand that I am in no way saying that it's not possible that Baco's diabetes can be controlled in the way the vet says works for "some" cats he/she has seen; it's just that it may be more difficult to achieve good glucose regulation in that way (nor is dosing once every 24 hrs. the schedule recommended by the maker of ProZinc). Again, only time will tell if this works for you. Will certainly hope that it does.

 

Ha! Kind of thought it might be an acronym.
Thanks for deciphering that one for me. (But I still can't stop giggling ...)

 

That's true, time will tell. On the Dutch forum they are also sceptical about once a day shot but I would like to try it this way first. And if it doesn't work for Baco then I will give her 2 shots a day. But the problem is my work and my personal life you know. During the week I can possibly give her 2 shots but in the weekends that means no going out, no diner with friends/family because I have to give her a shot extra...... So that's really difficult for me because I have a busy work week and that doesn't mean i'm gone al weekend ( that's not the case) but if i sometimes would like to go away for a long day, i'm not able to do that because then I have to give her a shot in the beginning of the evening. I've talked to my boyfriend about giving her 2 shots a day (we don't live together yet) but if I have plans and i'm on a scedule with 2 shots a day, that's gonna be a problem if I give her her shot later you know what I mean? It's not that I don't want to give it to her, but I don't have someone in the area that can give her a shot if i'm going to be late at home.... so if this works for her with one shot, it would be an outcome for me.

 

Let me introduce myself. My name is Ruby and I live in The Netherlands, and I have a 9 year old cat named Baco. She is diagnosed with diabetes on the 6th of April.
I've been giving her one shot ProZinc a day (the vet's orders) instead of 2 shots a day. She tells me that there are more cats in the clinic that she put on 1 shot a day and are doing great. I'm a little sceptic about everything also because in The Netherlands ProZinc is just now on the market and there aren't a lot of people who are on ProZinc so I don't know what to expect of it.
She gets 2IE a day (I don't know if the term IE is common for you?) I use U40 syringes (maybe that make sense to you?) I made a curve just yesterday, you can find it in my signature to see what her curve does.
It seems that ProZinc (or something else) is working later in the day, because she is getting lower in numbers what sounds strange to me. How do you guys see that with your cat? how is there curve on a day? I would like to learn more about ProZinc and the behaviour of the cat's curve.
If you have any question, please let me know!

 

Below is the thread where Ruby ask a few questions. Ruby's post start on #23

http://www.felinediabetes.com/FDMB/threads/questions-on-prozinc.156524/#post-1657955

 

Hey Ruby, first of all ProZinc is to be dosed twice daily 12 hours apart as per manufacturer. It only last up to 12 hours, (sometimes in some cats it might go longer) So if you are only dosing 1 time a day, Baco is going in higher numbers when the insulin wears off.

Prozinc, according to the manufacturer -
- onset by +3
- nadir/peak between +5 and +7
- duration of 10 to 14 hours
From petdiabetes wiki
Action in cats:
onset 2-5h,
peak 12-24h
duration: maximum 36h.

Generally, depending on an individual cat’s reaction to the insulin and the dosage, BCP PZI will lower blood glucose levels for 10 to 14 hours with a peak in the +6 to +8 timeframe. However, some cats experience shorter or longer duration and earlier or later peaks.

I peaked at you SS and it looks like it only goes to +16. Look at ours and you will see that it is 2 twelve hour cycles. Here is an explanation of how to read ours.

AMPS is the AM Pre-shot test (always test before shooting to make sure they're high enough to give insulin)...then the U column is for "Units" (how much you gave)

The +1, +2, +3, etc are for how many hours since shooting...so +2 is 2 hours after the AM shot, +9 is 9 hour after, etc.....Since we're all over the world here, saying "he was at 148 at 8pm" doesn't tell us anything...we need to know how long since his last shot

At the end of a 12 hour cycle, it's PMPS time! (PM Pre-shot) and the whole thing starts over.

Here is the protocol that Sue and Oliver put together for ProZinc users.

http://felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/

Hope this info helps.

 

Hey, I know that the it is recommended 2 a day, but my vet told me we are going to try it with one dosis a day. There are some other cats that she has treated and the are also on one shot a day and they are doing great. So i'm going to wait to see what it will do for Baco. Yesterday Baco's nadir (peak) was at +14 (that was really late) that was +14 after her shot in the morning. She was at 10.9 (what was really okay considering that she is normally above 20!).

what do you mean with BCP PZI? (sorry, i'm not that good in English haha)

Yes it's true that my SS only goes to +16 but that's because she only get's 1 shot a day in the morning around 07:00 and around +16 it's bed time for me so that will be the latest point that I can check her on a day.

What do you mean? I keep in my SS what time (so +8 +9 +10 ) what her MMOL is.. so that's fine right? I've written everything in my SS. Please look at her curve from yesterday, you can see how it goes during the day.

 

Ruby I am not sure how to interpret your numbers compared to ours. Let's see if someone with more knowledge than me can help you with your curve.

As far as the once a day dosing,I would be quite surprised if you could get Baco regulated or even off the juice with a once a day dosing, IMHO.

As far as our SS goes, so +8 would be 8 hours after injection. We talk in + terms as we are all from all over the world and it helps us understand better what is going on.

 

yes, +8 is 8 hours after the shot ProZinc so the +8 or +9 and so on is the same for you as for me.
I hope someone can help me with a sheet (SS) that can translate it for you....

 

Ruby, would you like to use a sheet in which you fill in the mmol-value, and which automatically (in the cell below) fills in the mg/dl-value? So the people in the US see the values they are used to (and we in The Netherlands see mmol)? You just started, so you could also fill in the few old values in the new sheet

 

How to create our spreadsheet

I am not sure if it will automatically give the option for a world conversion. I will tag @Marje and Gracie and see if she can help you with that.

 

Yes, I would like that so @Bobbie And Bubba understands what i'm talking about.. do you have it?

 

Just gave you the instructions on how to set up our SS

 

We have sheets that calculate from mmol to mg or back. In Belgium they use mg, in The Netherlands mmol, so we deal with this issue on a regular basis with our Belgium members from the dutch-speaking part of Belgium. The idea is the same as on your sheets: een mpre en apre value just before the shot, the +1 one hour after etc. and the eh column for the units. The coloring may be a bit different, however.

 

Meanwhile, regarding conversion of the numbers...
To convert from mmol/L to mg/dL multiply by 18
To convert from mg/dL to mmol/L divide by 18.

 

I've just made a sheet that converts to mg/DL thanks to @Bobbie And Bubba !
It's in my signature, please take a look at it if you have the time and let me know what you think about the curve I made yesterday.

@Nederland I will also put this sheet up on the Dutch forum so everybody can watch the numbers, also the Belgium members.

 

You are welcome. I wasn't sure if it automatically converting but it did! Good.

Since you are only shooting once a day, it would be interesting to see if you could get some numbers beyond your +16 ( I know that would make you having to be up in the wee hours of the morning) but it would fill in the puzzle as to what happens during those hours. Interesting that you got a nadir at +14 today but that was after you increased to 2 units but on the 18th of April, the nadir was more typically at +6 when you shot 1 unit.

Like we said before, twice a day for Prozinc 12 hours apart is going to help you get Baco better regulated so that she will be above the renal threshold. I do understand how confining it is as you stated on the Nederland thread but it could be the difference of better regulation and /or going off insulin (OTJ) Prozinc is a bit more forgiving in that if you are a little late shooting or a little earlier ( say around 30 minutes earlier) it's not a huge deal.

Another important thing is food and we promote a low carb wet diet under 10% carbs. Not sure if that was discussed in the other thread or not.

 

Another thing, we like to see the increases in units of .25 rather than whole units. The reason is that you could go past the ideal dose when you increase in whole units. Also to keep Baco safe and not to go into a hypo situation.

Does your U40 syringes have .50 unit markings? If so, you can eyeball between a unit and the 1/2 marking or you could use U100 syringes which is what a lot of the Prozincers use so they can make those micro dose increases and decreases. If you go with the U100 syringes you will need a conversion chart which we can post for you if you need it.

 

Yes it turned out good again, thanks!
It is interesting to see what it will do for her if I measure her after +16, but I can not say when I will do that. I have to check when I have the time to do that because during the week I have to get up early for work. So I need to do such a thing when I'm free from work and have a couple of days left to rest from such a nighter So I can't promise you that I will do that this weekend.. maybe next week because then I'm free thursday untill sunday (so maybe then).

with the dosis of 1.5IE you're right that the nadir was at +6 so that's why I find it strange that the 2 days later with 2IE she get's a nadir at +14.

I don't quite understand what you mean by the above, can you explain ? (sorry, my English is good but with this kind of stuff...)

Well I give her in the morning Porta21 (I don't know if you know that brand?) on the Dutch forum they told me to use that because it is low carb. So she get's that in the morning 30grams at 07:00. Than at 13:00 she get's 10 grams of porta21. than in the evening 19:00-20:00 she gets no carb food, fresh meat / fish. and then late at night she gets 10 grams of porta21 again 01:00.

I called with the vet yesterday about her new syringes and I told her they are much more precise so if needed I can give her 0.25 more/less instead of 0.5 or 1. So she told me that was a good idea but for now, because of her curve from yesterday, the vet didn't want to change the dosis just yet. I have an appointment with her tomorrow on the phone about Baco and the curve that I made again so I will let her do the talking tomorrow and we will decide what is going to happen. the U 40 syringes have 0.5 unit markings yes.!

 

I do understand how confining it is as you stated on the Nederland thread but it could be the difference of better regulation and /or going off insulin (OTJ) Prozinc is a bit more forgiving in that if you are a little late shooting or a little earlier ( say around 30 minutes earlier) it's not a huge deal.
What I meant by the above is that you had mentioned that it would be hard for you to shoot with your work schedule and social life so that is why I offered to you that if you do choose to start shooting 2 times a day, 12 hours apart, you can be a bit flexible with the times being 30 minutes earlier of later without it causing harm to Baco.

 

The ultimate aim is to reach a honeymoon / remission, not having to use insulin anymore. That can only be done if the cat is well regulated, with twice a day shots, trying to keep him under the renal treshold of around 13 mmol as long as possible during the 24 hours. The body is then able to recover, or not to deteriorate more because of unregulated diabetes. That is also why lantus has such a high honeymoon-rate: they aim at normal values during 24 hours on the tight regulation protocol. The pancreas can recover (no promise, but a very good chance)
Do I say this correctly?

 

Exactly!

 

@Nederland : I'm listening to what you are saying but this is the way i'm going to give Baco her insuline right now, just like i've discussed with the vet. If this is not working the way it should then I will discuse the possibility of giving Baco ProZinc twice a day. I'm not going to change it just because people tell me to do it. And ofcourse a lot of people on the forums are experienced, even more than a vet (maybe) with diabetic cats but I will not change anything without a vet's opinion about it. I'm just on forums to get tips and advice on food, and testing etc but I will not change the dose out of the blue.

 

I know, Ruby. But we can express our opinion about it, just like you can. We only mean to inform you as completely as possible, just like your vet does. It's up to you to decide what to do with the information you get from all sides.
I only explained in my posting what Bobby and Bubba said in posting #28 and what you asked a question about in #30, because you didn't understand what it meant. You asked for an explanation, I gave it.

 

That's the beauty of forums, to gather information and opinions. We would be remiss to withhold information that we know to be true about the best way to use ProZinc. Everyone has freewill. No judgements here. (unless of course I think someone is endangering their kitties life, then I open my big mouth)

 

Ah, yes, when a cat is in danger, I start to scream, too.

 

Hi again, Ruby - glad to see you have this thread & have added a SS that we goofy Americans can understand. (We who live in the only developed country in the world that still does not use the metric system. )

I will offer this up to you now, Ruby, and then I will let it go: The manufacturer of ProZinc recommends twice a day dosing - not once a day. I'm sorry, but I think your vet is just telling you it's okay because either she doesn't realize that once every 24 hours is not really an effective way to get a cat regulated OR she knows that some of her patients would prefer not to have to stick to a "once every 12 hours" schedule. (We all know that it isn't exactly easy.)

No veterinarian is a "god" - and there are many, many (including me) among our membership here at FDMB who can tell you we HAVE learned - sometimes in a very hard, even heartbreaking way - that veterinarians can be mistaken in their beliefs about how to "effectively" treat feline diabetes. They are only human, after all - like any of us - and they are capable of making just as many errors in judgment as any other human being, regardless of education. (Sometimes ego get in the way, too, especially where veterinarians or other doctors are concerned! We laypeople historically have tended to put them all on "pedestals." More's the pity.)

Of course, it is entirely up to you what you do: Whether or not you want to take one vet's word for it vs. reading through the drug manufacturer's recommendations for dosing (based on actual studies). And whether you want to take into serious consideration what the bulk of the experiences of ProZinc users here can inform: That if you desire to get your newly diagnosed cat well-regulated as quickly and effectively as possible, you'll understand the wisdom of twice-daily dosing. (You can always use a timed feeder to make sure your cat is eating - to help guard against hypoglycemia - if you cannot be around to test at certain times after a shot of insulin.)

Please know this: No one is really trying to bash you over the head about your choices; rather, we want you to realize that once-a-day dosing will just make it take that much longer for you to get your kitty regulated. (I would assume that your goal is to have Baco 100% healthy as quickly as possible and in full remission, correct?)

On that note, I'll let it go about the dosing issue. I sincerely hope the best outcome for you and Baco - as I know everyone who has written on this thread does, too. - Robin

 

So tomorrow i'm going to call the vet again about Baco's curve from yesterday, and the numbers from today and tomorrow. What is your advice (if you look at Baco's SS) to do with the dosis? I'm giving her now 2.oIE a day (one shot) and I would like to keep trying this with one shot a day for a couple of weeks to see what it does. What would you'll advise be for me? change the dosis with 0.25 up? and when should I change the dosis? and how much MG/DL is good to be on each day.
And what would you recommend me if i would give 2 shots a day? how much would the dosis be then?

 

And yes, ofcourse I would love it for Baco to be healthy again and even get of the ProZinc so she doesn't need it anymore.. if that means I have to give her 2 shots a day and you can tell me for sure that that is going to work to get her of the ProZinc, then I will do it....

 

Remember, there are no guarentees, we can only go on what research point to. Someone should be along soon to help you with your dose questions. If you go up to the right corner of your screen and click on "edit title" and change to a question mark, it will get more attention. As I said before, we are very short handed with ProZinc advisors right now so please be patient.

 

Thx! I've changed it. I'm going to bed now, hoping that i will receive a message from a ProZinc expert soon, so I can talk about the advice with my vet tomorrow.
Thank you again for the help! I will wait ☺️

 

I cannot give you any advice on dosing just once a day. For all we know, if your vet based the starting dose on the in-clinic blood glucose result alone, she could have started Baco off on too high a dose from the very beginning of treatment. (Noting how high and flat he has remained, with few exceptions in the hours after dosing.)

Before I answer this: Are you serious about possibly changing to twice a day? If so, what times, 12 hours apart, would work for you? (A half-hour deviation from the 12-hr. schedule is not the end of the world, by the way ...)

 

Yes i'm considering after all the posts to giving her twice a day a shot because the changes of getting her of the insuline is higher in that way.
So yes, i would like to hear from you all what type of dosis she is supposed to get with a twice a day shot so i can discuse that tomorrow with the vet.
And i don't think the vet gave her a high dosis because she was a lot higher mmol when she was first diagnosed with diabetes.
But i would like to hear what you think about it.

 

Yes 12 hours apart, maybe 12,5 hours sometimes.

 

Unfortunately, my message above posted 5 minutes too late ...

About a starting dose for twice a day: After looking closely at Baco's SS, if she were my own cat, I would start with just 1.0U dosed 12 hours apart - because you can always increase the dose later on. (As long as there are no ketones or other medical complications, 1 unit dosed this way should be a good start-point for 12-hr. dosing.)

Why do I think this may be a good place to start? Just look at her BG#s when that morning dose of insulin is wearing off (night hours) - look at how much lower they are in the 12 hours or so after that dose was given, when it's starting to wear off/ has worn off. (That should tell you that something is a little bit off about the dose ...)

Please check for ketones regularly. AND monitor her blood glucose levels closely the first days so that you can see when she hits her nadirs each 12-hour cycle. If you have your weekends off, I would recommend that you start her at the beginning of your weekend, as you will be able to monitor her more BG #s well. You will need to set an alarm to wake up to test during the night cycle a maybe 2-3 times at mid-cycle, but believe me: That little inconvenience will pay off by providing you an understanding of how her body is processing the insulin both day and night.

About ProZinc, we often say, "Start low, go slow." Please read through that "ProZinc Protocol" document again (I'm sorry, but you'll have to convert the U.S #s to metric.)

 

Sorry, I was editing my above post in the last few seconds, so you may want to go back and re-read that ... (Please note this is just my own opinion; others here may have another idea as to what your starting dose twice-a-day should be.) I tend to be conservative when it comes to dosing for a recently diagnosed cat - would rather err on the side of safety.

 

Thank you so much for you advice. I will talk to the vet tomorrow about it.
What would i do with food? She gets porta21(low carb hard food) in the morning 30 grams then later 13:00hours she get's it again but then 10 grams (timerbowl) then at night 19:00 (when she should get her second shot) she get's no carb food (BARF ) and then at night with the timerbowl 10 grams porta21.
Is that okay to stick to you think? And yes if i'm going to give her 2 shots a day i will start in the weekend ofcours so i'm with her.
And if you give 2 shots a day, and it goes well, how do you know that she will need less insuline? How do you know/see that she's in 'honeymoon' fase? I really don't know that much about it... I'm sorry..

 

Oh en what do you mean with this?

 

And there is another saying we use a lot on the ProZinc forum as relates to dosing: "Better too high for a day than too low for a moment."

 

How is her weight? Is she considered underweight right now? Overweight? Just about perfect weight? In dosing my cat, I determined what her total daily rations (every 24 hours) should be, based on her weight. Then I divided that in half for each 12-hour cycle. Depending on whether or not I will need to "steer" her BG upward during some point in the cycle (say, if her nair # were out of the safety zone) I reserve some of the portion allotted to that 12-hour cycle to do that. Some people like to divide the 12-hour ration into several portions throughout the day (often using the timed feeder I mentioned), especially if they cannot be available to check blood glucose levels - such as when you have to be at work all day.

The main thing about dosing with insulin is to: Test BG, feed, then shoot. And we don't recommend shooting the insulin if your cat's # is less than 200 mg/dL (that's 11.1 on your metric scale). If BG # is not at least that by shot-time, we recommend you stall for 15-30 min while withholding the food (BG # can rise as cat anticipates the meal), then recheck the BG to see whether it's risen to safe-shooting range.

Is this helpful?

 

She weighs 6.6kilo's right now.. Definitly overweight But with the low carb diet she will lose weight, she has to, the vet also told me.
I will read your last post tomorrow real carefully and discuse it with the vet tomorrow.
I will reply to you asap tomorrow cuz i really need to go to sleep now i have to be up and running in 6 hours sooooooo! Good night (for you i think its mid day right now? Hihi

 

I mean that in the ProZinc protocol document we have available here, the blood glucose numbers are written in mg/dL rather than mmol/L.

 

Sweet dreams, Ruby!

 

You can see mg/dl it is also in the SS but on the second tab! It converts from mmol to mg/dl

 

And as she loses weight on the low-carb diet, her need for insulin may well decrease, too - another great reason for all that glucose monitoring you do at home!

 

No, I can see your SS in U.S #s just fine!
What I meant was that this document is not written in metric #s:Protocol for ProZinc/PZI

(Ok, go to bed now; we can take this up again tomorrow!)

 

Hi Ruby, sorry I couldn't reply before, it's been a crazy day! I'm going to agree with Robin, she's definitely sending you down the right path. I finally figured out how to see your BG numbers in U.S. numbers, I'm quite slow with anything electronic! Lol

Thank you for giving that information, it's very helpful. I don't remember if it says in the ProZinc protocol or not, but with ProZinc, the dose shouldn't be changed until you've gone through 3 full cycles, or 72 hours. Unless you get a test number that is too low or too high, (and that part is really important!) then you adjust accordingly.

 

Looks like you did a great job getting the spreadsheet up and working. Please tag me if you have any problems.

 

Oh, now i see what you mean.. and yes I went to bed but it is to early right now ow men I just had to go to bed a little bit earlier.. well then.
I will talk to the vet today about some good points you've made and will ask her about what she thinks to start with if a will give her 2 shots a day.

Just now (test, eat, shot) i've tested her at 19.9mmol (358mg/dl) so this is the lowest number i've seen before eating in the morning. That is positive

Awww.. and she tried to wake me up when my alarm went off, she was giving me a cuddle and pushing her head against mine to make sure I was awake... Because she wanted to eat, and fast!! hahaha so cute.

Well I have to run now, have to go to work but I will watch the forum, see if anyone reply's this (for me) morning... but I think it is pretty late where you live.

@Mogmom and Goofus : No worries, i'm patient Yes it is in the protocol that I can not change the dosis between 3 days (but in case of lowering the dosis because of a dangerous situation, then yes I can) but today is her 3e day of 2IE a day so if i'm going to change the dosis from one shot to two shots a day, then tomorrow will be fine to do that.

@Marje and Gracie : thank you I had to figure it out but it worked out perfectly thank you!.

 

Good morning, Ruby!

What a sweet way for Baco to wake you in the morning. (My silly cat would just smack at a small item on my bedside table - like a pen or a ring - until it falls onto the floor! )

Yes it is very late at night here in Arizona, but I am needing to monitor Bat-Bat's glucose # for at least one more hour ... (Had I not needed to keep an eye on her tonight, yes, I would be asleep!) So for now just want to say: Will be thinking of you today, and hoping that your talk with Baco's vet about her dosing schedule is a good one! Will look forward to hearing from you later.

 

So sorry I haven't been around! It's been a whirlwind lately, and I didn't get a chance to reply last night. I will give you my opinion. Twice daily dosing is the way to go. I don't mean in general. Looking at Baco's SS, every night, at +12, he has been high enough to shoot. It's been close a few times, but he has been high enough. In the morning, before your shot, he is MUCH higher than at +12. So if you were dosing 12 hours apart, you would almost SURELY see lower numbers in the morning. This would mean you had a chance of going lower and lower and heading to remission.

No one can guarantee that every 12 hour shots will lead to remission. I do think Baco has a great chance of it. Looking at his numbers, they are lower than a lot of kitties who arrive here. That makes me think that every 12 hour dosing could lead to remission in time...but I can't give you a time limit or say it will surely happen. I'm with Robin on the dose. 1 unit every 12 hours...and if that didn't work, we could always go up.

I do agree with Bobbie that some numbers after +16 would really help us. That would fill in the missing info so we can see what's happening at night.

Just to be clear, I am NOT bashing your choices. I wanted to give my opinion and explain why. If you have further questions about why I think this, I will be more than happy to answer them!

I'm afaraid I can't give advice about once a day shots. I can't provide a dose because I've never used that method and looking at your SS it doesn't seem to work well enough.

Okay! I'm going to stop talking about dosing now too. Remember we really do want to help. We just can only give advice on what we know. We're all opinionated here and we want to be sure we explain what we think.

You are doing a FANTASTIC job with Baco. You've been testing and feeding low carb, and getting information on your own. If you feel that once a day shots is the way to go for now, then go for it! If you decide to do twice a day shots, do that. We will be happy to help with that.

Please let us know what you and the vet decide. If he was mine, I'd do some talking too. Ask about twice a day shots. If what I said makes sense, maybe discuss that with the vet. Not saying change, just see what he thinks. I'd be interested on his opinion!

Please do keep us informed! I would love to see how Baco does and hope he goes into remission!

 

@Rachel : Thank you for your advice. I'm going to discuss the 2 shots a day with my vet today. I think there is a really high change for Baco to get a remission. Also because she has never had any health problem but she used prednison for a period of time for an allergic reaction. The vet thinks her being overweight and having to use prednison for a short time made her pancreas to (temporarily) stop working.. so if she loses the weight and i 'help' her with some insuline for a period of time, her pancreas may will be working on it's own again... so that's the reason (and because of your tips and advice) that I want to give her 2 shots a day to get her pancreas working again.
Her numbers have been going down since she was diagnosed so something is going well, and I hope that means she will get better.

And I wasn't thinking people were bashing me, but everything is so new to me, and in my mind i'm like 'why should i trust advice from people i don't even know over my vet who i think has more experience?' but that just sunk in yesterday night that that is not the case and that you (in the US) have 10 years of experience with ProZinc and my vet just has maybe a couple of months experience. So it's nice to ask for your advice and tips about everything with Baco.

Thank you for your kind words about that i'm doing good with Baco, that's really nice to hear because that's something that i've been in doubt for for the last few day because of all the opinions here, and on the Dutch forum so I was thinking, i'm doing everything wrong! But I wanna do everything as good as I can for my baby Baco But now that's sunk in, i'm confident enough and I will take the lead in the conversation with my vet about my opinion and that 2 times a day will give her a bigger change of getting in remission and that's what I want, and Baco (I think) would like that 2

I will call my vet at around 17:00 o'clock (that will be in about 4 hours from now) so I will let you all know what we've decided together and what her (the vet's) opinion is about the whole matter.

 

Good Morning Ruby~ or afternoon there. So glad that Rachel posted. She knows her ProZinc stuff and was a really big help to me when Bubba was on it.

Glad you mentioned the prednisone. It is often we see cats that arrive with steroid induced FD and after a short time on insulin along with a low carb diet, their pancreas starts to work again! That would be wonderful wouldn't it? Once they get off the insulin it is important to continue with a low carb diet because once diabetic, always diabetic but just in remission. And the twice day dosing will be your best bet at getting Baco into normal numbers the majority of the time.

Good luck with your talk with your vet. Perhaps after he realizes that you have had contact with us and gathered our experience and knowledge, he will understand where you are coming from.

Keep us posted.

 

It's already afternoon here Goodmorning to you!
Yes I'm glad Rachel also posted, that post was a great help and i'm so convinced now that in a couple of hours I will talk to my vet about 2 shots a day..
It is a real big possibility indeed that Baco's pancreas has stopped working because of the prednisone, so i'm going to give her 2 shot a day with (in the back of my head) that she will go in remission with also the help of low card food.
She (the vet) is a really nice lady, and understand were i'm coming from. When I talked to her last wednesday I already told her that I was on forums and she was only really supportive towards me because it is a really big help.
So if I tell her that i'm also on the US forum, were people are more experienced (10years) then I will think she is willing to believe what you all say about ProZinc.

 

Baco is a very lucky kitty to have you as her human! You obviously love her a lot!

 

I do love her a reaaaallll lot... words can't discripe how much
My boyfriend thinks it is sickening how close Baco and I are because she always wants to be with me, on my lap, giving me cuddles, kisses on her head (so cute). To bad for my boyfriend hahaha! and Baco doesn't like my boyfriend at all (after almost 3,5years she does NOT want him to be around) hahaha she just thinks she loves me more then him I think hahaha

Baco and I are really close because when I got her, at the time I had two brother cats Sam and Minnie. Sam past away 3 years ago and had cancer. Minnie is still around and is 12 years old.
Baco didn't fit in the group, never did, so she was always with me.. that's why we have a real close bond. She is almost a human in some ways of her behaviour, hihi.
Love her so much! So i'll do anything for her <3

 

Tell your boyfriend if he starts purring and preening you will love him lots more too.

 

hahahahaha maybe I will

no no, but it's just funny to see the battle (from Baco's side) even after all these years she doesn't like him, althought he is really loving towards her. But she just want to be with her 'mammie'

 

Hello everyone. Here is the update you've been waiting for all day
I finally talked to the vet just now, she was very busy today and called me after work hours.
I've told her about how I wanted to change the dosis from 1 shot a day to 2 shots a day with a dosis of 1IE. I askes her opinion and she was very pleased with my decision. She told me we tried once a day because the representitive of ProZinc in the Netherlands told her about the working hours of ProZinc and that it works longer and it may be possible to help cats with one shot a day BUT 2 shots a day is the best ofcourse. I also talked to her about you guys and she was excited about the forum. She literally told me : this product is also new to us, we just started working with it and people in the US have been working with it for 10 years + so if you have questions that I can't answer you have to ask them, it's good to have people that have years of experience on a forum to ask for help. She can help me answer medical questions, put personal use questions is really difficult for her because she just started with ProZinc so she is encouraging me to ask you personal question about ProZinc (you see, I told you she is a really sweet lady )

She wants to learn more about ProZinc herself, and she has a lady working in the office that is a specialist in Lantus and Canisuline and that lady is just learing about ProZinc herself. She wanted to know on what forum I am so I gave it to her. We have a appointment next week to call again with eachother and she wants to learn some 'new' stuff from me by you and this forum so that is a real big plus for her.

I asked her al kind of questions and had a really good discussion about everything, but there is one question that I didn't get an answer and she told me to ask you guys because you have personal experience with ProZinc. So here it goes: I'm going to give Baco 1IE in the morning (IF she doesn't have a BG of 200 or lower (11.1MMOL) and one shot in the evening (12 hours apart). I will give her in the morning 70 grams of BARF and 6 hours later she'll get 15 grams of porta21. the same goes for in the evening hours she'll get barf and porta21.
BUT, I don't have anyone near me living that can give her a shot when i'm away. in 2 weeks 5/10/16 i have to work and then after I have a concert and I can't go home between to give Baco a shot. How is this going to work if I really don't have the time to give her a second shot? this is something that will not happen often, but how bad is it for her to miss one shot?

I hope you guys have got some experience with that?
Please let me know.

ps: i'm really excited to try the new routine out tomorrow.

 

Wonderful that your vet is supportive and interested in learning herself! You are right, she seems very nice. So to answer your question, it's always better if you can be consistent every 12 hours but, life happens and if there is no one to give her the shot, it will have to be a missed shot. We can think of it as a "fur shot". That is when you give the injection and she jerks away from you and you only get some of the insulin in her or you go all the way through her skin and it comes out the other side, (yes it happens) With a fur shot, you NEVER want to give another one because there is just NO way for certain to know how much got into her and if you were to give another one it could be an overdose. So, the night of your concert if no one can give it, it's like you gave a "fur shot"

Some vet techs .for a fee will come to your home and give shots. It's an idea for another time or if you go out of town. I recently found a pet sitter who I taught to test and he all ready knew how to shoot insulin. He came 5 times over 2.1/2 days for me and it was a God send. Teach your boyfriend to test and shoot to help you in times you get delayed at work or in traffic.

Hope you are seeing someone good in concert.

 

I'm so happy with the support of my vet I'm even teaching her some new things. I told her just now : we are in this together, you and I both don't know so much about ProZinc and I can teach you 'personal experience' things and you can learn me medical things. I even told her about de syringes I am using thanks to @Nederland because I was using the once with only 1IE on it and not 0.5IE. So I told her to buy it, and she will because she also thinks that those once are better! haha see, I learned her someting today

Okay, so if it happens to be that there is no way that I can give her her shot, than it is not damaging her?

I know, I want to teach my upstares neighbor (she is really sweet and has 2 cat's herself) so she know'sthe situation with Baco, she became a good friend of mine. But I have to 'massage' it you know what i mean? I don't want to just ask her straight... so she is coming over next week and i will ask if she want to giv Baco a shot for me sometimes...

Yeah, stand up comedian he's been of the grid for a very long time and my boyfriend bought tickets a while ago so...

btw: He is going to learn is this weekend how to test her and give her shots. But during the week he is at home at his parents house (he lives there and works there, own company) and during the weekends he's with me.

 

The upstairs neighbor sounds promising and love the "massage" description. You can ask your vet for some saline solution or sterile water for Boyfriend and neighbor to practice giving the injection.

To answer your question, the skipped shot is not going to "hurt' Baco, it's just not going to help. You are on your way, Ruby!!! I am so happy that you are going to dose twice a day and to optimize the efficacy of Prozinc for your baby girl.

 

hahaha massage is the correct word for it She is a really sweet lady and my friend so i think she will do it.. but maybe she is afraid to do it, what is also understandable, so that's why I want to massage it hahaha..

My boyfriend already tried to give her a shot at the vet's with water, that's the same way i learned it. but you know, practice makes perfect and he only tried it once so he also needs a 'massage' hahaha. I told him when Baco was diagnosed that I'm going to do the shots, but i wanted him to learn it if something ever happens to me, and I can not make it home in time or something that he can help Baco for me.

I'm so happy myself, I have a possitive feeling about this I can't wait untill tomorrow to try Baco's new routine.
And I hope she will feel much better already this weekend.

 

How interesting, Ruby ... my Bat-Bat doesn't like my man, either!

 

hahahaha, It's a cat thing I guess Baco is freaking jealous I think of my boyfriend hahaha

 

I just NOW finished reading all of the posts above, Ruby ... and I AM SO HAPPY that you're going to twice a day dosing, and that your vet is so very willing to learn! WOO-HOO!!! Great job, Ruby!!!

P.S. You've MADE my day a very happy one with this news! (Thank you.)

 

hahaha, you are so welcome.. big thanks to you (just like other people on this page) to have changed my mind about the shots.. I'm going to start tomorrow with 1ie shot in the morning and 1ie in the evening (12 hours apart). @Nederland helpt me with a striked dieet plan for Baco with her BARF food(hahaha) so it will work out great. tomorrow i will also test random during the day and ofcourse before every shot.

just one question.. what, if in time Baco's BG is around 200 in the morning before eating, and i wait for 15 to 30 minutes, and it is still not going up.. then what do you do? don't give her a shot? (picture this with a time limite because I have to work) so I get up at 06:45, test her BG, she is at 200 or lower, then wait, then still isn't getting higher.. then wait.. the still isn't getting higher, and then it's like 07:30 and I HAVE to go to work.. what am i supposed to do in that kind of situation?

 

Well guys, for now i'm checking out, i'm really tired and Baco is also telling me to come to bed.. She is almost sleeping.. see the picture below! haha. We will talk tomorrow, I will keep you updated about how tomorrow goes and I'll try to mesure her BG every 2 to 3 hours.
good night (for you, good day haha)

 

Until you have enough data to know how she responds when she gets into lower numbers, it would be best for you to skip it to keep her safe since you are gone all day.

 

I agree with Bobbie's answer above ... (and from the ProZinc protocol document):
Low Preshot Numbers
The general recommendation for new diabetics is not to shoot a preshot under 200, but to wait 20 minutes (without feeding as food raises blood glucose levels) and retest. If the number is rising and above 200, then a shot can be given with perhaps a little less insulin given.

I would say that you want to err on the side of caution where Baco's dosing is concerned because of two things:
- You had mentioned that Baco had recently been on a steroid, which can temporarily cause blood glucose levels to be higher than they normally would have been (it takes a while for the effects of steroids to work out of the system entirely);
- You have Baco on a strict diet now, so is extra-important to be pay attention to her BG#s, as they may drop more as she loses some weight.

 

I'm so excited you'll be going to twice a day shots!!! Bobbie and Robin are correct that you should skip if the BG is too low and doesn't go up.

Can't wait to see how the new routine goes!

 

Goodmorning! I can tell you this already is working! when I woke up I tested her and she was at 349. then I gave her some raw food (BARF) and gave her her shot of 1IE after eating her food. now at +2 she is already down at 248! That is amazing I've only see her do that once but that was with that strange curve you guys saw earlier this week. So i'm betting on it that she will be +4 somewhere in the blue numbers! oehh I'm so happy this is working.

 

Looking good! Watch out for any numbers 50 and under (on a human meter) or 68 on a pet meter. At that point, you'd want to intervene with a small snack of regular food, retest in 15-20 minutes to see if it is rising. If falling, some gravy off higher carb food or honey rubbed on the gums, retest. We say 3 rising tests before you can relax.

And we'd encourage you not to shoot under 200 at this point (as you get more data, that can change). If you get a preshot under 200, wait 20 minutes, without feeding (which can raise the levels on its own) and retest. You want a number that is rising, not falling and at or very near 200. And then, consider a smidge less insulin than the dose that gave you the lower preshot.

How nice to be able to share the lower range info - paws crossed that you are on your way!

 

Hi @Sue and Oliver (GA) I will watch out for that kind of numbers! I use a human meter, so 50 or less is a no no.
She is down at 169 / 171 +5 / +6 so I'm really happy about that. I have to leave the house right now and will be back in a couple of hours so i'm not able to test her at +8 and up.. that's a shame but she will be fine. And I can test her again in the evening and tomorrow so I get a clear view at what the Prozinc is doing for her.

just on more question.. I've read that you can not give her a shot at 200 or less. but what if she is at 201 - 234 or something like that? do I also wait a bit? because that is near the edge and i'm scared that if I give her her shot then, and i go off to work, she might get in TOO low numbers..

 

You should always go with your gut. You hold the syringe and she is your cat. Above 200 should normally be a good cutoff, but if you are ever nervous about giving insulin, give a little less and be sure you can monitor. The 200 cutoff is good for new diabetics, usually a safe number because she has 150 points to drop before hypo range. As you get more data and learn how the insulin works for her, how much and when she might drop, you can get more aggressive. Lots of people (especially when they look like they are headed for remission and are on tiny doses) shoot in the 160-180 range but plan to monitor that cycle.

 

And anytime you worry about leaving and her dropping, leave out some food. Lots of kitties eat to bring themselves up when they feel like they are dropping.

 

Thanks for the tips. I have food for her always. She gets raw food in the morning along with a tiny bit of hard food. (What she didn't eat today because she was full from the raw food) and then midday she gets fed with the timer bowl. So there is always food

 

Ruby, what beautiful numbers!! I'm thrilled this is working already.

 

Me, too! Ruby, I'm so very happy that you're seeing such a change in Baco's numbers today - just what we were all hoping for! Good job!!!

 

I would like to ask and learn something about the levels today. They are 'normal' for an prozinc curve. However, the days before, there was no normal prozinc curve.
This morning the dose was lowered to 1 unit, and this was the first shot ever of a twice-a-day-shot (so no influence of last night's shot, because there was none.
Two things have changed: the food and the dose. What could have caused the change?
Food:
- Today a full no-carbs-raw meal at shot-time, low carb kibble 6 hours after the shot
- Days before: a half no-carbs-raw-meal plus low carb kibble at shot time, low carb kibble 6 hours after the shot.
I can imagine that giving only no-carb food at shot time means the body is given the opportunity to react to the insulin, not being hindered by carbs. The low carb kibble is now used only to help the cat if the levels get too low at the nadir. I think this could have caused a normal curve today.
But the dose is lower, half of what it was before. Could this also mean that the dose the days before was too high? That the body reacted against it? Is that possible and is it also possible that the body forgot all about that counter-action within a day, showing a normal curve now?
Or could it be a combination of the two?

I am really happy that Baco is doing so well, but for my comprehension of the workings of Prozinc it would have been better to have changed one thing at a time .... However, that said, the most important thing is that Baco is doing well, whatever the cause.

Sorry, Ruby, this time I steal your topic ....

 

Hahaha @Nederland no problem, you can always steel my topic, because the questions you have are very interesting, and I would like to know the answer to them too! because I find it strange that the curve is normal today with a half dosis of what she got yesterday. So i'm going to sit and wait for (hopefully) the answer to your questions

 

Really, it could be either one. We often do change only one thing at a time so we can know what causes any changes. However, it was best to change the dose so we'd be more sure it wasn't too high. Itw as also good to go ahead and begin the lowest carb food so we can be sure any dose changes in the future are needed, but not because of food. Basically, we're kind of starting over with Baco. The right food, a lower dose (which we would normally start with here) and two shots a day. From here we will use the data Ruby gets to help decide a good dose...and hopefully get Baco into remission (anti jinx)!

 

This is just wonderful Ruby! Now that you are shooting twice a day, you will get a better handle on the numbers and Baco won't be unprotected so to speak. Good job! Keep asking questions so Jeannie @Nederlands can take back information to the forum in The Nederlands. That's what we do here, we share information.

 

Thnx!
Yes I will ask questions here, and I also keep the dutch forum up to date every day how it is going with Baco and info that i have from you guys. And Jennie s also reading this topic so she doesn't miss anything.

 

So I tested baco before her second shot and she was at 265 that was oke for her. then she at some raw food again like this morning and at +2 she was at 340 (what?) so I wasn't looking later on but someone, I think Baco, was eating later on before i was suppost to test her, some hard food. Is that the reason you think she is higher in numbers right now?

btw: can some one take a look at my sheet? it doesn't do a vlookup / re-calculate as from colomn P.. I now re-calculated it myself and put it in the sheet that you can see the numbers, but normally it changes the numbers if I put everything in the sheet with MMOL..

 

I think you're seeing a food spike. Most kitties go high at +2. If you test again in an hour or 2 it will be probably be lower. When you say Baco may have been eating earlier, what do you mean? She was eating in the 2 hour time period before the test?

I'm not great with SS...I just read them. @Marje and Gracie might be able to help.

 

I just told her on the dutch forum to take away the low carb food 2 hours before the shot.
And not to give any low carb kibble aroud shooting time, to reserve that for 6 hours later. Around the shot until 6 hours later only no-carb raw food.
Is that an okay advice?

 

Well this morning I tested her +2 and she was dropped, so that's strange that that didn't happen just now. What I meant was, she get's BARF in the morning and some (really little) hard food but this morning she didn't eat them. 6 hours later she gets hard food out of the timer bowl. and this repeats itself in the evening. but she didn't eat the hard food in the afternoon and in the evening she got BARF, then after that I heard her eat som hard food.. so I think that is what cost the BG to increase..
There is always some food (hard food) for her but normally she doesn't eat that, knowing she will get enough of the raw food but tonight she dicided differently i guess.. hope that she will drop a little in numbers at +4. I've taken away the hard food for now, and she will get some at night (in about 2 hours with the timer bowl)... It's not like she hasn't have anything to eat, because her raw food isn't even finished yet..