Dosing Advice - just switched to Prozinc

Discussion in 'Prozinc / PZI' started by Hshray, Apr 13, 2021.

  1. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    Hello,

    I just switched from Vetsulin to Prozinc a couple of days ago due to my cat’s numbers being all over the place on Vetsulin. We restarted with 1 unit of Prozinc twice a day and don’t have a lot of numbers yet, so I’m not sure if they will be helpful at all. I’m also not sure when his nadir is yet, as it appeared to be at +3 on the first day and +8 yesterday. I’m going to get more numbers today, but my question is regarding PM. I’m wondering if it looks like he may be dropping overnight and then bouncing for AMPS? Should I try a little bit smaller dose for PM?
     
  2. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Not sure why you dramatically dropped the dose when you switched insulins. Usually, you want to give about the same dose on the new insulin, maybe a bit less, but not such a big difference. The dose of the new insulin should be either the same or at most 25% less.

    George was dropping down into the blues on 1.75U of Vetsulin, but he still wasn't dropping far enough. He needs to be getting consistent low blues and even green BG numbers at nadir. Right now, I think you need to increase the dose for both AM and PM cycles. That is what I would do if George were my cat. Bottom line, George needs more insulin.

    My recommendation is no on less insulin.

    The only way to see if George is dropping lower overnight is to test some. I know it's difficult, but setting an alarm to wake you up at +5 to +7 will give you more information on what is happening in the PM cycle. I really doubt that is what is happening, him dropping low overnight.

    I see there are multiple comments on your SS about George throwing up his food. Is he doing a "scarf and barf" because he is eating too fast? Is it food he is vomiting or bile/clearish liquid?

    p.s. What does the FD on your SS mean, after some of the foods? I know that YA is Young Again.
     
  3. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    The vet prescribed him 1 unit since we were starting a new insulin. I was going to do that for a week to see how it was working and go from there, but it’s been five days already so we probably have enough data. The Vetsulin just kind of had him all over the place so it was a little hard to tell what all was going on.

    This morning George threw up a hairball for the first time ever. One of the other times I believe was from eating Dr. Elsey’s, which he doesn’t get anymore. He definitely doesn’t eat too fast though, but I’m not sure what would’ve caused the other two times at +8 and +10.

    I completely agree on the PM numbers...it’s still a two person job to get his blood, which we are working on because that makes things a little difficult.

    FD = freeze dried...had to figure out a way to save room in the spreadsheet :) it’s his post-ear prick treat
     
    Deb & Wink likes this.
  4. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    FD = freeze dried Of course it does! Guess my mind was asleep when I read that. There is plenty of room in the SS. If you enter more than fits on 1 line, it word wraps to the next line.

    What does George really love? Food treat? Brushing? Petting? Bribes to gain his cooperation during testing will really help.

    Have you tried doing the testing steps, without actually poking his ear? If you break down the steps, and do them as often as possible, that helps to get a cat used to the testing steps. Make one spot your testing spot. Up on a counter or chair, so you are not looming over him may help. Rattle the treat jar to get him to come running for a treat. Warm his ear with the rice sock. Give a treat. Tell him "good boy!" Add the next step to testing.

    Hopefully, that will allow this to be a one person job at some point.
     
    Hshray likes this.
  5. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    Ooh good idea. I haven’t tried doing the test strips without actually poking his ear, so I like that suggestion. At least I can get him used to that feeling. He does like his freeze dried salmon too and will come when I shake the bag, so that’s a good thing. It’s definitely our goal to be able to get this down to a one person job (hopefully sooner rather than later!) so I think I need to just work, work, work with him.

    I already gave him his PM shot today but will plan on increasing the dose in the morning. Thank you!
     
    Deb & Wink likes this.
  6. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Keeping our paws crossed for George. That he gets used to testing more, and that the dose increase helps him.
     
    Hshray likes this.
  7. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    Thank you! Looks like I’ll be increasing by 0.25 again tomorrow.
     
    Deb & Wink likes this.
  8. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I know it's hard to get those PM +2 or +3 BG tests. But without more PM test data, it's hard to tell what is happening in the PM cycle.
     
  9. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    It’s almost as if the Prozinc isn’t doing much at all. We had at least gotten into the blues at 1.25 units of Vetsulin, but so far they’ve been elusive even on 1.5 units or Prozinc. Do you think I should increase it to 2 units or try 1.75 first?
     
    Deb & Wink likes this.
  10. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Increase. And get some more PM tests.

    George's BG numbers were never particularly good on Vetsulin either.
     
    Hshray likes this.
  11. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    I’ve only been doing 2 units for a couple of days now, but it just doesn’t look like it’s doing much of anything either. He didn’t go very low yesterday but spiked majorly by pmps with no changes to food or anything like that. And he’s already spiked again at +8 today without going very low too.

    It’s strange that his numbers were basically the same on 1 unit as they have been on 2.
     
    Deb & Wink likes this.
  12. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    A cat needs as much insulin as they need.
    So you may end up increasing the dose again soon.
     
    Hshray likes this.
  13. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    Thanks for helping us out and for the reassurance. His pmps was 597 today so starting to feel a little defeated.
     
  14. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    you are doing a great job of testing. 2 units is still a pretty low dose. don't be surprised if you get to 3 before you start seeing real progress. as Deb said, they need what they need. He may be getting a bit of insulin resistance from being in high numbers so long. If you don't see any blues in the next few days I would raise to 2.5 If you do see blues but they are still pretty high, raise to 2.25
     
    Deb & Wink and Hshray like this.
  15. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    Thank you! I’ll see how he does the rest of today and tomorrow and then adjust based on your suggestion above. Appreciate your advice!
     
    Deb & Wink likes this.
  16. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Question, what are you feeding him? Can you add it to your signature, please?
     
  17. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    He mostly gets Friskies pâtés and Fancy Feast classics with freeze dried Pure Bites as treats. Last week I added in some Tiki Cat though, and I have pretty much tried all of the foods on the “acceptable” list - including Young Again Zero and Dr. Elsey’s Clean Protein, but each of those seems to have their own issues for him even though he loved them, so he doesn’t get them anymore. Friskies and Fancy Feast turkey and giblets are his food of choice this week.

    I’ve added it to my signature. Thank you!
     
    Last edited: May 1, 2021
    Reason for edit: Removed question
    Deb & Wink likes this.
  18. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    I’m going to give him 2 units again tonight and then test a few hours after pm shot, but it’s looking like we will go to 2.5 units tomorrow. No blues yet on 2.
     
    Deb & Wink and JanetNJ like this.
  19. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    I think that's a good call
     
    Deb & Wink and Hshray like this.
  20. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Let's see if the increase to 2.5U helps George to go lower, into the blues. It make take 3-6 cycles to see if the increase is having an impact.
     
    Hshray likes this.
  21. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    Woohoo, we’re finally getting some blues today! High blues but at least it’s progress! He actually got his first blue (147) on the first night of 2.5 units (5-2-21). The blue came pretty early at +3 and once I saw his numbers the next morning (in the 500s again) I was actually afraid he might have gone too low that night. Things seem to be evening out a little bit now and the Prozinc seems to be having a longer duration at this dose so fingers crossed that the blues keep coming.
     
    Last edited: May 6, 2021
    Shelley & Jess likes this.
  22. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Keeping all our paws crossed here for George and more lower BG levels.
     
    Hshray likes this.
  23. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    Well that didn’t last long :(
     
    Deb & Wink likes this.
  24. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Then you probably need to increase the dose again.
     
    Hshray likes this.
  25. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    Do you think increase by 0.25?
     
    Deb & Wink likes this.
  26. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    He was just 209 at pmps which is definitely his lowest pre-shot number...so he must have gone lower later today. I gave him 2 units rather than 2.5 so I’m hoping that was an ok call.
     
    Deb & Wink likes this.
  27. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    As we say here, “You hold the syringe, so the choice is yours.”

    Looks like that 2U dose last night kept him high. Glad to see you increased the dose to 2.75U this morning. Hopefully that will bring his BG levels down. It’s scary shooting low, but as you gain confidence in your decisions, you’ll be able to shoot lower and lower.
     
    Hshray likes this.
  28. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    We got our first greens today!
     
    Deb & Wink and Shelley & Jess like this.
  29. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Yeah!!!!! Green is my favorite color for George.
     
    Hshray likes this.
  30. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    I ended up decreasing George’s dose by 0.25 since he went to 81 the other day, but if we don’t see any blues within five cycles should we going back up to 3 units again?
     
    Deb & Wink likes this.
  31. Hshray

    Hshray Member

    Joined:
    Feb 26, 2021
    It’s seeming like the modified method may be better for us than SLGS.
     
  32. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Yes, I think you will need to increase George's dose again.

    The MPM (Modified Prozinc Method) protocol can help many cats, with the more frequent dose changes. I think George is one cat that could be helped using MPM.
     
    Hshray likes this.

Share This Page