Diesel insulin discussion (cont)

Continuation from previous threads https://felinediabetes.com/FDMB/threads/my-cat-diesel-was-diagnosed-i-need-help.236899/#post-2657806 & https://felinediabetes.com/FDMB/threads/was-able-to-test-diesel-finally.236944/


Ok so @Pookie suggested calling other local vets for syringes and Prozinc

@Nan & Amber (GA) I just googled Marks Pharmacies but I am unsure if this is the correct info http://canshipinsulin.com/ @Diane Tyler's Mom

 

Buying insulin from Canada

 

OK AND WEIRDO GOOD RANDOM NEWS My vet just called and she has a bottle or prozinc and syringes she had to special order for a pervious patient and they never used it ANYWAYS she has it and total going to cost me around $190

 

Expiration date???

 

Shoot I didn't even ask !

 

April 2021

 

Anyone have an idea of dosage I should give him? The box and vet told me 2 units but wanted to check with y’all?
His BG was 364, 2 hours ago and he ate 1 hour ago combo

 

I dont but maybe @Panic does?

 

Should I check his BG rn?

EDIT CHECKED BG is 327

 

Usually when switching insulins we do roughly a 1:1 swap, so I wouldn't give 2U. I hope a Prozinc person can be more specific.

Are you about to shoot? You absolutely need to get a pre-shot value, yes. If you just generally want to get a test to see where he is, that's fine too, it will help establish a context for the pre-shot number.

You don't need to wait 60mins between pre-shot BG/meal and shooting with prozinc, I think you can do it all at the same time, let me re-check on the Prozinc sticky and verify though.

 

OK, yes, it's test-feed-shoot all within a small time window. Prior to that, you want to have a 2-hr window without food, so that the pre-shot value is unencumbered.

How long until your preferred shot time?

 

Yes I took his BG and it was 327 and I read the Prozinc thread and went off that and only gave one unit ugh.

 

OK, I think 1U sounds fine, I'll leave all the details to the prozinc folks though!

 

Yeah I was thinking the same. I know panic is working so probs why they aren’t replying

and I’m sorry what do you mean by how long before my preferred shot time?

 

Oh, I just didn't know you'd already shot and was trying to figure out when you would.

Pending Elizabeth (or another Prozinc'er)'s return, I think I'd plan on getting a +2 test (ie, 2hrs after you shot).

 

I'm new here and know pretty much nothing, but I do know that Lola was started at 1 unit twice daily The forum's dosing guidelines say:
Starting Dose:1u BID if kitty is not on a wet/canned low carb diet. I think 1 unit was probably a good starting point. I'd rather be safer with a lower dose than sorry with a higher one. (My routine is: fast for 2 hours prior to testing, feed after testing and then go draw up her dose and administer.)

 

Don't forget to update your spreadsheet to reflect the change of insulin.

 

If you have been giving 0.5 units I recommend sticking to that, especially since you're going to be switching to low-carb food.

Here are your options now:

1) Buy another bottle of Novolin and order Lantus from Marks Marine Pharmacy ($165 + $25 overnight shipping, this will last you 1-2 years)
2) Buy Prozinc now, then either switch to Lantus after the bottle has run out in 3-4 months or continue using Prozinc (get a prescription to buy from Chewy.com)

I'd rather you avoid the Novolin altogether but I know your funds limit your options.

Prozinc averages $120 a bottle on Chewy that lasts 3-4 months. Lantus from Marks is $165 + $25 shipping and lasts 1-2 years, depending on your cat's dosage.

Both insulins are good for cats. Lantus is the gold standard though and some cats are too "bouncy" for Prozinc and ultimately need a switch to a depot insulin (Lantus). Aside from cost, the biggest difference between the two is dosing time. Lantus works BEST when dosed within 15 mins of the last dosing time. Meaning, if you give shots at 6 AM, your 6 PM shot should not be earlier than 5:45 or later than 6:15. 30 minutes early or late is the most you can go per day (or 15 min each cycle equaling 30 min per day) without it affecting the dose. Too early is like overdosing, too late is like a dose reduction.

Prozinc is less strict in that you can go up to 1 hour early or later (no more than 1 hr early!) IF needed. It's not recommended to do this regularly.

Consider your home/work schedule before deciding. I was very hesitant switching to Lantus because I did not think I could stick to the 15 min rule but I ended up not having problems whatsoever. Also note that Lantus has the highest rate of remission in cats - it overall just works better with them. But Prozinc is not a BAD insulin by any means, Lantus just does a better job managing blood sugar.

 

Hey @Panic thanks for the extensive reply! I went with option 2 for now! I got the Prozinic but before seeing your reply I had already given Diesel 1 unit and since I started later today I am like all over the place with timing lol...so much for starting fresh! But later...I'll most likely be giving him a .5 unit

 

You may want to test him around +7 or 8 oops I mean +8 or 9

 

I'm still trying to get used to the spreadsheet format, I apologize I don't feel smart cause I'm still not catching on quickly! Especially with the PM side. I just tested him though cause I wanted to see what it was after his insulin shot I gave him. BG was 284

 

That's okay! Do watch him though, it's entirely possible that 1u is how much he ends up needing, but you want to do it slowly and build up to it.

Here's some different info for you ... Novolin is a very harsh insulin and has more strict rules to it, so Prozinc's are a little different.

Prozinc

You can test, feed, shoot all within 15 minutes (or however long it takes you to do it all). Prozinc is a slow-acting insulin so we normally do not see insulin hit the system until 2 hours later. Therefore, as long as Diesel is showing an interest in food, it is considered safe to give insulin the same time he is snacking.

Do not shoot anything under 150. Between 150 and 200 you can skip, give a token dose (which is 10-25% of the regular dose - so if regular dose is 1 unit, a token dose might be 0.25 units), OR feed and test in two hours and decide a dose based on that. That will throw off your schedule however!

Any drop under 90 at ANY time earns a dose reduction of 0.25 units!

Instead of snacks every hour like with Novolin, a good general rule is to give snacks every two hours (or so). So a snack at +2, +4, and +6 will be a good start. Why do we do this? For one, cats in general do better with multiple small meals than just two big ones a day. It is easier on the pancreas and helps it to heal ... remember, with diabetes the pancreas is damaged, so we are essentially nursing it back to health! The other reason we feed snacks is to "steer the drop" of insulin. Onset (when insulin begins working) is normally around +2 with Prozinc, so we feed a little bit at +2 to keep the insulin from dropping too fast. The food slows it down. We also do it a couple more times before nadir (when insulin is working the most, and BG is at its lowest) to keep it from dropping too much/fast. We recommend the bulk of food be given prior to nadir, as food after it can "burn up" the remaining insulin faster than we'd like, and ultimately not last the full 12 hours. Right now, we do not know what Diesel's onset and nadir is yet, it varies cat to cat. Onset is usually +2, and nadir is usually between +5-7. We can change snack time accordingly.

Here is a loose guide for you to follow ... does not have to be exact, this is just a guide to help you fill in the "gaps" on your spreadsheet.

Snacks @ +2, +4, +6 (you CAN feed more than this!!)
Test @ +2, +4, +6 one day and +3, +5, +7 the next. Zigzag so you fill the gaps on your spreadsheet
Get at least a +2 at night and a "before bed" test to make sure he is safe.

BG: Blood glucose, or blood sugar
Onset: When insulin kicks in and BG starts dropping (usually +2)
Nadir: When insulin is at it's max effectiveness and BG is the lowest of the cycle (usually +5-7)
Cycle: A cycle is 12 hours. There are two cycles per day (24 hours). A cycle begins when you give a shot and continues until the next shot 12 hours later.

For your spreadsheet understanding:

AMPS: AM Pre-shot. The test right before the morning shot.
U: Units given. It's best if you keep it simple. If it's a half unit, we put "0.5", or if it's 1 unit we put "1".
+1, +2, etc: This is how many hours have passed since the last shot. +1 means one hour has passed. +2 means two hours have passed, etc.
PMPS: PM Pre-shot.

 

no problem took me FOREVER to get use to all this
Dont feel bad! that is not allowed

 

I am one who had a very bouncy kitty on Prozinc. Switched to Lantus and now no bounce. Blues and greens. If you look at my SS before the switch compared to now, the difference is amazing. Plus Lantus in the long run does cost less.

As they say ECID and Diesel may be fine on Prozinc.

 

I know Diane already explained this to me but i'm still like umm what lol I'm just bad at learning things by reading on my own and I am better with hands on and people showing me!
So like for example lets say my morning shot is 8 AM and every hour after that is +1 +2 so on so forth so then my PM shot would be 8 PM and the times after that would be +1 9PM +2 10PM +3 11...etc ?
I hope I am learning that correctly

 

Oh I am DEFINITELY a visual learner too haha. What are words!

Yes exactly!

The reason we don't use "shot at 8 PM, at 11:30 he was etc etc" is because we're all in different time zones. 11 PM means different things for different people. So yes, if it's easier and you do your shots at 8 AM/PM you can see it this way:

9:00 - +1
10:00 - +2
11:00 - +3
12:00 - +4
1:00 - +5
2:00 - +6
3:00 - +7
4:00 - +8
5:00 - +9
6:00 - +10
7:00 - +11
8:00 - +12 (shot time!)

 

LITERALLY haha ok. I think I am understanding more and more. it's just been harder today and yesterday since I am not on my schedule! So he was at 284 when i tested him about 45 mins ago....and he had a snack as well. Its been +5 since I have given him a shot...would you even suggest a shot this evening again? It would be super late and I think it would overall mess up my schedule for tomorrow as well

 

Nope, never give insulin in the middle of a cycle. Start again tomorrow morning at a good time for you.

 

And don't forget to breathe! There's so much to learn, you simply can't retain it all in one day! Step back, relax. You got this.

 

Ok perfect...that makes sense just wanted to make sure. Hahaha yeah i know i know....

 

Hey guys just catching up on all that's happened, I was up so late with Tyler
last night that I took a few naps today and then had to run some errands
I'm glad everything worked out.
Kayla one thing since Diesel is on Prozinc for now go into your signature and change the insulin to Prozinc, members will think he's on Novolin
You're doing good