New Member: Me and my Scruffy McGee

Hi, been lurking here a couple of months, felt it was time to say hello especially as we seem to be in something of a ProZinc crisis

Rotten timing for my Mr 'Scruffy'McGuffey.

Scruff was diagnosed earlier this year and started on caninsulin, 1 unit.
After a month on Caninsulin, the vets moved him to ProZinc, 0.9 units twice daily. Covid came along and interrupted regular vet visits, I did manage to get 2x repeat prescriptions as the shortage started and have slowly and carefully increased his dose. He is still very high BG (around 20-25 mmol/L on a good day) on 2.3 units twice daily but not found that at least this level stopped his diarrhoea and thirst, but not an insatiable hunger that, if I give in to, sends his BG spiking all over the place in the following 24 hours.

I guess I'll be asking more questions soon if I cant get ProZinc ASI get the feeling he isn't going to do to well back on the Caninsulin

Unfortunately I don't have much knowledge of him pre diagnosis as he came to me in a bit of a state, having been a foraging Tom with an abcess, tested fiv+ and the usual stud tail and wiry fur. Pompoms were renoved and he's a fluffy scruffy again

 

WELCOME! We are glad you found us. I see you already have a signature thats great As you may have already guessed we are a dedicated community of kitty cat lovers tied together with one common thread, Diabetes. you may want to start here:
New? How You Can Help Us Help You!

LOVE the name Scruffy McGuffey! lol and hes lost his pom poms!
Welcome to our family. We all look forward to helping you navigate this disease and Help "Scruffy" get on track asap.
You can find that info here:
FDMB SPREADSHEET INSTRUCTIONS

Again WELCOME to the best darn site on this planet to help you help your kitty!
jeanne

 

Are you in the UK? They have been having an on-and-off again Prozinc shortage.

Low carb food should not create spikes. What are you feeding? Your signature mentions wet pouches, and a very few treats. And yes, being a food thief does not help. There have been a few notorious thieves on the forum.

 

Welcome to yourself and Scruffy McGuffey(great name!).

Scruffy's blessed to have found you to love and care for him. I'm sorry to hear that you're having difficulty regulating him. As you're home testing him I assume that you've got a log of his dosing and BG values. It would really help us to help you if you could get your data into an FDMB spreadsheet. Then, experienced Prozinc users will be able to get a handle on how Scruffy's currently responding to his insulin and hopefully help you to get a better handle on his BG levels. Here's the info you need to get going:

FDMB Spreadsheet Instructions

Understanding the Spreadsheet Grid

(If you need help with it, just give a shout and someone will be happy to assist. )

I'm tagging @Deb & Wink to ask her to keep an eye out for your spreadsheet, particularly because Scruffy's BG is running so high right now. Deb is highly experienced in the use of Prozinc.

FOOD / WEIGHT:

Please let us know the type of wet food Scruffy is currently eating (so that we will know his current carb load - Brand/Variety will do if you don't know the carb %). As you probably already know, Scruffy's ravenous at the moment because his body's not currently able to utilise his nutrients properly. With improved regulation his appetite should normalise.

Can you also please let us know if Scruffy is at normal weight or underweight/losing weight.

INSULIN:

Are you by chance in the UK? I ask because you've been treating with the two insulins currently licensed in the UK for feline diabetics and I've heard that there have been Prozinc shortages here. Working on the assumption that you are - and for general information - if it can be shown that a cat is poorly regulated on both of these insulins then UK vets are legally free to consider prescribing other insulins under drug cascade rules (e.g. Lantus or Levemir - both long-acting insulins suitable for feline diabetics). Maybe that might be an avenue to explore with your vet if you find that Prozinc can't improve Scruffy's regulation - or if you're in danger of running out of Prozinc! I'm tagging another UK member, @Diana&Tom. Diana's knowledge of the situation in the UK is more current than mine and she may be able to help you further.

GI ISSUES:

Can you give us a little more history of Scruffy's recent diarrhoea issues, please? Am I correct in understanding that the diarrhoea stopped when you increased Scruffy's insulin dose? If that's not correct, please can you advise what did stop it.

Has Scruffy had any issues with pancreatitis at all since he has been with you?

KETONES - IMPORTANT SAFETY INFO:

[Emphasis mine]

If you're not already doing so, I strongly urge you to start daily monitoring of Scruffy's pee for ketones immediately. It's an important safety precaution for cats running in high BG ranges, especially if they're not able to metabolise what they're eating efficiently. Diabetic ketoacidosis (DKA) is a potentially fatal complication of diabetes that is very hard on the cat and the pocket. A quick daily test is a simple and effective way to steer well clear of it. Here are helpful links with further information:

Testing Your Cat For Ketones

Tips for Collecting Urine Samples

You should be able to pick up some test strips quickly at local pharmacies (e.g. Keto-Diastix or similar) but when restocking you might find cheaper on eBay or Amazon (NB: always check the expiry date with the seller before purchasing!).

Hope the above is helpful. It's a bit of a pain getting all the info onto FDMB initially but once it's in it'll save you having to answer the same questions all the time ( ) and the faster we'll be able to help you both.


Mogs
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Oi! Stop nickin' my lines!!


Mogs
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SS please? Pretty please with sugar on top? Can't really see what is going on without the data on the SS.
Tag me again, once that SS (spreadsheet) is set up.
We have people that can do the setup for you, if you need help. (I'm not one of them.)

Please, talk to your vet way before you think you might run out of Prozinc. I'd recommend the lantus over caninsulin, if your vet will prescribe it.

 

@Critter Mom , my knowledge is nowhere near as up to date as Elizabeth’s and I’ll tag her now @Elizabeth and Bertie

 

@Diana&Tom - Thanks, Diana!

 

@Sheffield_Tiger -

Just checking in to ask how yourself and Scruffy McGuffey are getting on.


Mogs
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Hi, getting around to putting the bloods on the spreadsheet. Also waiting for fructosamine test back from vet, and ordered some keto sticks.
I did ask the vet about a kind of sweet smell from the litter box when he first went on to Prozinc from the initial Caninsulin but she didn't seem overly concerned which I wonder about now...but that smell has gone since increasing his dose so I'll definitely check, I've taken 2 urine samples from him to the vets earlier this year and they didn't highlight any concerns though.

 

Hi there,

Good to hear from you, and great that you've got the ketone test strips on the way. As soon as they arrive you'll be able to start doing the quick daily check. It is a very wise precaution to take.

Usually a sweet smell in the litter box is due to the glucose that has spilled over into the urine when BG levels are high. Sometimes urine with a lot of glucose in it is a bit sticky (like syrups) or frothy. Some ketones can cause a 'fruity' or nail polish smell on the breath - not sure about the urine - but not all ketones can be detected by smell. I think if you could smell ketones then a call straight away to a vet would be in order and, if necessary, emergency treatment. I'd not have known to check for ketones if I hadn't done my own research. From what I've seen here since I joined there appear to be many vets that never mention ketones to their clients.

Good to hear you're making progress on the spreadsheet. Getting it started is the tough bit. Once it's up and running it's really quick to update.


Mogs
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Hello (waving from Surrey).

How often are you testing blood glucose?
...When you say that his blood glucose is still around 20 - 25, is that prior to an insulin shot? Or is it at some other point in the insulin cycle?
What is a typical pre-shot blood glucose for him? And what numbers are you seeing around the lowest point of the cycle (maybe 5 - 6 hours after the insulin shot, or a bit earlier or later than that)?

High numbers can sometimes be misleading. That's because, strange as it sounds, high 'flat' blood glucose levels can be caused by too much insulin as well as by too little, or it can be caused by rebound from the cat's blood glucose just dropping significantly lower than its body has lately become accustomed to. If you're only testing before insulin shots, or just testing occasionally, it's 'possible' that there are lower numbers that you may have missed... This is why it is so important to get more blood glucose data.

Eliz

 

Regarding the Prozinc shortage, availability does seem to be extremely patchy at the moment, with some vets still having it in stock (mainly larger practices), some having none at all, and some able to get it from Canada or the USA...
You may be interested to see this info from the BSAVA (British Small Animal Veterinary Assn). There is a contact email here for vets:

"There is currently a temporary supply interruption for ProZinc® 40 IU/ml suspension and as a result Boehringer Ingelheim Animal Health are currently asking that vet practices do not start any new patients on ProZinc® until supply is re-established.
For any existing patients already receiving ProZinc®, practices are recommended to contact their Technical Services Team on 01344 746957 (UK) or via email (vetenquiries@boehringer-ingelheim.com) for assistance.
Boehringer Ingelheim Animal Health are currently doing all they can to keep as many existing patients in an uninterrupted supply of ProZinc® as is possible. There is no directly equivalent licensed veterinary or generic insulin product available in the UK. The only other licensed veterinary insulin in the UK is Caninsulin, an intermediate, or medium acting, lente insulin containing 40 IU/ml porcine insulin. This alternative may not be suitable for some patients and other solutions may be required."

Some folks have managed to get Prozinc by getting their vets to use the info above.

Note: When Prozinc isn't available some vets are just switching cats to Caninsulin by default. But there are also human insulins available, notably lantus/glargine and levemir/detemir. (There are quite a few UK kitties on human insulins now). So, this 'may' be an option for you to think about if your vet absolutely cannot get Prozinc... Regarding vets just switching cats to Caninsulin do note the last few sentences of the BSAVA info above: "There is no directly equivalent licensed veterinary or generic insulin product [to Prozinc] available in the UK. The only other licensed veterinary insulin in the UK is Caninsulin, an intermediate, or medium acting, lente insulin containing 40 IU/ml porcine insulin. This alternative may not be suitable for some patients and other solutions may be required."
....This would seem to suggest the human insulins as an alternative...? ....That's my reading of it anyway....

 

@Elizabeth and Bertie -

That's exactly my take on it, too. It reads like a nudge to, or a 'permission' for, vets to consider Lantus or Lev if they can't get Prozinc for their feline patients.


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