Forced to change from prozinc to caninsulin

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by C1gar, Jun 25, 2020.

  1. C1gar

    C1gar New Member

    Joined:
    Jun 17, 2019
    Hi

    I’m just wondering if anyone has any knowledge or suggestions on my little cats challenge - prozinc to caninsulin due to the ongoing shortage. She was very stable on prozinc with good control.

    she was on 3.5 units of prozinc, how much difference is caninsulin to prozinc?
    is it stronger? As we have started on 2 units to air on caution.

    Any comments would be greatly appreciated
     
  2. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Usually you don't really change the dose. If you are worried I would start at 3. Do you have a spreadsheet you can share of the BG numbers?
     
  3. C1gar

    C1gar New Member

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    Jun 17, 2019
    Thank you for your reply!

    I struggle to get any readings from her so a BG curve is always incorrect.

    I am hiring it to 2.5 tonight as she was on 3 for one day but went into a very very deep sleep
     
  4. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Please don't give up on testing. It truly has saved my cat's life probably a dozen times in the four years she's been diabetic. The first couple of weeks you do it there will be a lot of failed tests... but then new capillaries will grow and make it much much easier. You could also try getting a meter that only needs .3 size sample. I have a video in my signature showing how I test my cat at home.
     
  5. C1gar

    C1gar New Member

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    Jun 17, 2019
    thank you I am going to look in to the .3 size I have the
    AlphaTrak 2 but it seems to want a lot of blood, do you know of the type that requires less?

    Thank you!
     
  6. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    alpha only needs a.3 sample.... it's what I use.

    Just to clarify, when you try to get a sample, you are DIPPING the edge so the tiny straw protruding from the side sucks up the drop, right? You aren't trying to scoop a drop in top of one of the dots, correct? This is all the blood you should need to get a sample.... It's literally a drop. CD31AF45-7B61-42FE-A19A-DF014280A0FC.jpeg
     
  7. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    you DIP one of the little straw into the drop.... do you see the straws on the edge? It sucks the blood up into the strip. [​IMG]
     
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  8. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    This picture is of a ferret getting tested, but it's a good photo to show you the angle you need to use to DIP into the drop. [​IMG]
     
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  9. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    One big difference between Prozinc and Caninsulin (Vetsulin) is the much shorter duration with Caninsulin. Usually only 8-10 hours.

    Was your vet unwilling to write you a prescription for Lantus or Levemir? Those 2 are nice long lasting insulins in cats.
     
  10. C1gar

    C1gar New Member

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    Jun 17, 2019

    Thanks for the reply

    They just reccommned to switch to caninsulin we didndt have a say in it really
     
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  11. Deb & Wink

    Deb & Wink Well-Known Member

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    I'm a bit puzzled here. You are the cat's owner. Why wouldn't you have a say?
     
  12. C1gar

    C1gar New Member

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    Jun 17, 2019
    Hi

    Thanks for your reply

    We do not have a clue about what is best for a cat with diabetes and take their advice in good faith. We have just spoken to another vet today (same practice) and she says the that caninsulin is stronger than prozinc and reccomend to lower the dose back to 2 - so we really are at a loss.

    We gave her 2.5 units this morning and she seems very sedated - we intend to lower it to 2 and take her to the vet in the morning for a curve.

    It is just such a shame she was doing so well on 3.5 * 2 a day but now all she does is lay around
     
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  13. JanetNJ

    JanetNJ Well-Known Member

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    It's stronger in that it will lower the number quickly but does not last add long.
     
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  14. JanetNJ

    JanetNJ Well-Known Member

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    Did you see the info about using the alpha track I posted above? You may have been trying to get the sample wrong if you were needing a lot of blood. Another thing you can do is scrape the drop onto your nail and test from there.
     
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  15. C1gar

    C1gar New Member

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    Jun 17, 2019
    yes thank you

    We tried unsuccesslfy to get readings or we got extemely low which could not be correct as (my cat) was up and around.

    I am going to try the finger nail idea, thank you!
     
    Last edited: Jul 10, 2020 at 7:14 AM
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  16. JanetNJ

    JanetNJ Well-Known Member

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    When you say extremely low what do you mean? My cat had been as low as 37 with no outward symptoms but it's still life threatening
     
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  17. C1gar

    C1gar New Member

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    Jun 17, 2019
    I believe the reader was saying 8

    this happened to the vet as well who got a reading of 8mml but took it again and she was in the 500 mg ml
     
    Last edited: Jun 27, 2020
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  18. C1gar

    C1gar New Member

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    Jun 17, 2019
    Just got a true reading

    22 mml - so she is high but the vet maintains to keep her on 2 units *2 a day for three weeks and get a fructosamine test.

    any thoughts would be much appreciated
     
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  19. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    22 mmol/L times 18 = 396 mg/dL
    No too horrible, but could be better. At least it's not in the black color range, over 500 mg/dL (27.7 mmol/L).

    Do you home test the BG levels? It gives you more of a real time understanding of the BG levels.

    It soundslike you do, but you don't have a spreadsheet setup in your signature. That would really help you and us see what is going on. Setup instructions for the spreadsheet (SS) are here >>>>> FDMB Spreadsheet Instructions

    And what it all means is here>>>>> Understanding the Spreadsheet/Grid

    A fructosamine test will give you an average blood glucose over the past 2 weeks. But it can't tell you if your cat dropped really low or was really high, over 500 mg/dL(27.7 mmol/L)

    What food is your cat eating? That can make a big difference in the BG levels.

    Adding information to your user id signature is really helpful too. Editing your Signature, Profile, and Preferences
     
  20. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Hi there, are you in the UK? Just wondering because you're saying you're having to switch to Caninsulin because of Prozinc shortage. ...I'm in the UK, and am waving to you from Surrey! :bighug:

    There are some little differences between Caninsulin and Prozinc.
    Caninsulin isn't 'stronger' than Prozinc (it has the same number of units of insulin per ml as Prozinc), but it 'typically' has a faster action and so can drop the blood glucose faster and more steeply in some kitties. Also, it 'typically' has a shorter duration, and may not last the full 12 hours.

    A lot of UK kitties will probably be switched (by vets) to Caninsulin because of Prozinc not being available at the moment. Hopefully this will only be a temporary issue (fingers crossed).
    If Caninsulin doesn't work well enough for your kitty then your vet can prescribe an alternative insulin. Since Prozinc isn't currently available that would mean switching to a human insulin such as Lantus or Levemir. There are now quite a few UK kitties on these insulins. ....However...since your vet hasn't actually suggested that you switch to one of these it seems reasonable to suppose that your vet has no experience of these insulins. That is not unusual in the UK. A vet's willingness to prescribe human insulins varies a lot. Some vets are keen to prescribe them, some vets totally refuse, some don't even know they have the option to prescribe them...

    Do persist with learning to hometest blood glucose. 'Hometesting' is enormously helpful in managing diabetes. And if you can test at home you will be able to 'see' how the insulin is working in your kitty's body. If it's not working well then that blood test data could be very helpful in persuading your vet to prescribe an alternative insulin.
    Janet has given you some great advice on hometesting (and some fab pics!). In addition to that here are a few things that I wrote for someone else that may be helpful. If you need more help, just shout out!

    HOMETESTING TIPS & TRICKS
    1. WARM EARS. Probably THE most important thing. Warm ears bleed very much more easily than cold ones. You can warm an ear by massaging it, or by holding something warm against it; ie a pill bottle filled with warm water, or a ‘rice sock’ briefly warmed in the microwave.

    2. MASSAGING immediately below the ear prick, with finger and thumb, can ‘milk’ more blood out. I almost always do this, if only for a second or two.

    3. VASELINE. A teensy weensy smear of Vaseline on the outer edge of the ear will enable the blood to ‘bead up’ and stops it disappearing into the fur. This also makes it easier to see the blood droplet if the kitty has dark ears.

    4. RESISTANCE. The lancet needs something to ‘resist’ otherwise it can push the ear away rather than pricking it effectively. Some folks use a piece of cotton wool or folded tissue. I use one of my fingers, but sometimes do accidentally take a blood sample from myself that way.

    5. TWO EAR PRICKS close together can often produce enough blood for a test when one ear prick might not.

    6. SCOOPING THE BLOOD DROP ONTO YOUR FINGERNAIL. Doing this is a game-changer for some people. If you can get that drop of blood on your finger or thumb nail you can then let the kitty go and finish the test without her/him.

    7. TREATS. It is important to reward the kitty for each attempted test, whether the test was ‘successful’ or not. Cats very soon learn to associate tests with treats. And some will soon come running for their tests. A ‘treat’ is usually a food reward of some kind, but some folks reward their kitties with a cuddle or a grooming session. I actually crumble a few treats for my cat and test him while he’s hoovering up the crumbs.

    Remember to reward yourself too. Chocolate is good…

    8. GET COMFORTABLE. If you are physically comfortable you’ll be more relaxed, and also less likely to try to rush the process. Some people like to test their cats on a counter top or a desk, maybe next to a desk lamp. Some people prefer to hold their cats on their laps when they test. Some folks incorporate testing into a grooming session. You’ll find what works best for you. And once you get used to home testing you’ll quite possibly be able to do it anywhere, and maybe even while the kitty is asleep.

    9. RELAX. Cats pick up on our moods. The more relaxed and ‘matter of fact’ we are, the more relaxed and confident the kitty is likely to be. Some people chat or sing to their cats while they test him. Try it. It might help you too.

    10. PATIENCE. Be kind to yourself. You’re learning something new. (And you’re learning something wonderful!)

    For sensitive cats who really resist testing it's possible to use the pleasure association of food to make the process easier. This really good little video shows the principles of 'desensitisation and counter-conditioning'. The vet in the video is getting a cat used to injections, but the same principles can be applied to testing:

     
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  21. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    The "Sticky" or pinned posts at the top of this forum have just been updated. So you might want to take a look at them.
     
  22. C1gar

    C1gar New Member

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    Jun 17, 2019
    Thank you all for your guidance! I am based in the uk.

    I am still struggling to get readings from my cat but she has just drunk 10 mins straight - so she must be high and I think I need to higher the dose and pray that she doesn’t go to low

    as living in a water fountain is no life for her.
     
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  23. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    What size lancet are you using
     
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  24. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Aw, sweetie. Take a few deep breaths... And be kind to yourself. We all understand how difficult and stressful this can seem at first. But it honestly does get easier.

    It can take time to get the hang of testing. And every cat is a bit different when it comes to what works for them.
    I'd been dealing with my first diabetic for 11 and a half years when I adopted my second diabetic. And I thought testing her would be a 'piece of cake' and that I'd be able to do it the same way that I did with my old diabetic boy. But....she was very different, and it was a humbling reminder that every cat has their own specific needs and preferences... I will confess that, even having tested for many years, I felt lost, and I really cried at one point, feeling that I was failing the cat that I'd adopted... But, then I took a step back and re-approached things in a different way....

    My first diabetic (who I initially swore to people here was "impossible" to test) was quite food-motivated. So, I found that I could pop him on a table top, crumble a few treats for him, and then test him while he was hoovering up the treat crumbs. That 'distraction' was key in being able to test him, because he was a big powerful kitty, and there was no way I'd be able to test him if he didn't 'agree' to it.
    My adopted diabetic girl isn't particularly food motivated, so treats didn't distract her sufficiently to be able to test her. But, I found out that she loved to be brushed, and so I managed to sneak tests into a little cuddle and brushing session, and she barely notices the test... She still gets a food treat at the end. But the treat is a small part of the whole thing.

    With both my diabetics I spent quite a lot of time just getting them used to the sensations and sounds involved in testing. So, at various times during the day I'd go to where they were, stroke them, hold or massage an ear for a second or two, and then immediately give them a treat, and just walk away.
    Similarly, I'd rattle the test strip container, or click the lancing device (it can be used a bit like a training clicker), give a treat, and then walk away.
    It's also helpful initially if you can test in the same spot in the house so as to establish a routine. So, I'd pop the kitty on a chair or table top, and give a treat and lots of praise.
    If you can get the kitty to your 'testing spot', hold or massage an ear for a second or two, and then reward with a treat, you are most of the way to being able to test....

    It's also important to remember that cats pick up on our moods. If we are stressed, they pick that up. So, taking time to take a few deep relaxing breaths prior to testing can help a lot. ...Also, and this is probably going to sound really daft, some folks sing to their kitties while they test them. I've done this myself, without even thinking about it! But, strangely, if you hum or sing a tune, it can be relaxing for both human and kitty... Strange but true.... :smuggrin:
     
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  25. C1gar

    C1gar New Member

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    Jun 17, 2019
    Thank you all for your input

    she went back to the vets to day her blood sugar was 28mmol so now we are getting into dangerous territory. Frutosemine test done we are awaiting there guideance

    We left her in for 2 sepatre days to get a curve. They said - both times - there were able to get a curve as she is far too stressed to see a correct reading :-(
     
    Last edited: Jul 10, 2020 at 7:14 AM
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  26. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Do you mean they could NOT get a curve, either of the two times you left Sugar at the vets?
     
  27. C1gar

    C1gar New Member

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    Jun 17, 2019
    Sorry, yes they have been unable to get a curve.

    We have left her again today at the vets, for a curve. I pray it goes ok
     
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  28. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Have you thought about using a CGM (continuous glucose monitor) like the Freestyle Libre? They last about 2 weeks on average but give you data every 15 minutes.

    It's something to consider. Probably no more expensive than having your cat stay at the vet for a curve.
    If I were you, I'd ask my vet about the Libre.
     
  29. C1gar

    C1gar New Member

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    Jun 17, 2019
    thank you for your input! I will ask my vet this when they open at 11!!!

    she was in all day again yesterday and the vet was unable to get a accurate reading due to stress.

    so they want us to bring her down every few every hours for a spot check on a day to see if that can get a better reading
     
    Last edited: Jul 10, 2020 at 7:15 AM
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  30. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    That just sounds like she would be stressed again, and again and again from the ride to the vet and back.

    Please, do ask your vet about the CGM. Not cheap, but should be worth it.
     
  31. C1gar

    C1gar New Member

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    Jun 17, 2019
    Just a quick update

    Are vet is not being at all helpful with regards to CGM she says her pratice would not consider it - nor change to a new insulin (human one). So regrettably we have taken her down every 2 hours for 2 days now and have a curve of sorts - and need to re up the insulin accordingly and back to praying that it will be ok.
     
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  32. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Hi, Prozinc is currently available at Viovet if you can get a prescription from your vet. :)
    https://www.viovet.co.uk/ProZinc-Insulin/c35418/
     
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  33. C1gar

    C1gar New Member

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    Jun 17, 2019
    ThAnks for the input

    sold out atm :-(
     
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  34. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Only 2 words for you.

    New vet. Second opinion. Different practice.

    Pray hard. Pray the dose is not too much.

    p.s. Ok, that's more than 2 words.
     

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