Opinions on my beginning numbers?

Oscar just started ProZinc on Friday. His first dose was as soon as we got home from the vet, about 2 hours after he ate. I gave him a smaller snack when I gave him the shot, but his first day numbers dropped to the 160's at +3/+4 and then raised. Yesterday and today his overall numbers are higher than they used to be off the insulin and the low seems to vary between +3/4 and +6 with very little drop. Is this normal for just beginning? Should I call my vet on Monday and push for giving insulin twice a day? I know ProZinc has a duration of 10-14 hours, but his initial numbers are not high and we were worried. I have been giving the insulin while he eats and have been tinting the skin so it shoots under the skin. Friday and Saturday I shot on the side of the belly and today I shot in the scruff to see if it would change anything. confused_cat

 

Hi Kelly, I would agree that 2x day will probably give you better results. PZI works well when you can get a nice overlap between doses and achieve more of a steady-state with it that way. It can take a few days to really see results and get clearer on the dose you will need. Also if you just stopped dry food, his #s may come down some on their own for a few days after that. I would probably stay with this dose, but shoot it 2x/day instead of just once, and then see how things look in a couple days. You did see a response, but it looks to me to not be enough insulin.

 

Thanks Joanna. We stopped dry food all together about 2 weeks ago. He has had only a few pieces of kibble of the m/d dry, but didn't like it, since then. I will call my vet tomorrow to let them know that I would like to shoot twice a day to keep them informed.

 

Sounds good! If you want to post his #s every day go ahead, then people can help you know how to interpret the data you have and know what to do at each step. His #s are really pretty good for a diabetic kitty, so you are in a great place to start with, and it's great that you have started with a low dose like that. As I understand it, ProZ can be somewhat variable the first 45 days or so as their body adjusts to it, so going slow like you are is a smart move (assuming he doesn't have ketones, is eating well, and acting reasonably ok).

If you can get in a mid-cycle spot test every day or two (like a bedtime check if he got a nightime shot, or early morning/late afternoon - whatever you can work into your schedule that will still give you some clue what is happening), that is great to keep tabs on making sure he is not getting #s on the low side. With PZI, it takes a day or two (sometimes longer) of shooting BID to start seeing the effects of the overlap, and then hopefully you will get better #s at that point. Good to keep an eye out though to be sure they aren't too good!!! In effect, if you go BID you will be doubling the dose. Since you aren't seeing much drop with SID I think it should be fine though. If you or your vet is worried about it possibly being too much, I would try a slightly lower dose BID rather than staying with SID.

To answer some of your questions too, with PZI you often see a good response like that on the first shot at a new dose (someone the other day called it the "wow factor"), and then their body adjusts to it and you don't see the same response after that. Usually then it indicates you will need to raise the dose, which you will be doing by going BID. Some people also like to hold a dose for longer than just a few days, and sometimes there can be more improvement after that (never happened with my cat, but it has with others apparently). Since his #s are not bad (and I'm assuming he is acting fairly well and eating ok and ketones are negative? if not, please be sure to let us know!) you don't need to rush things with fast dose increases though.

If anyone else is around, I'd appreciate more eyes on his #s, and a second opinion to be on the safe side. Thanks!

 

I haven't tested for ketones because he hasn't shown any symptoms so far. I am waiting on a Precision Xtra meter to come in the mail to test for it via his blood because it is hard to catch him in the litter box since it is upstairs. The ketone test strips are MUCH cheaper on ebay! As far as how he is acting - it is hard to tell because we are also beginning treatment on his asthma. He gets albuterol 1 puff twice a day and flovent 220mcg 1 puff twice a day. He is not on oral steroids because of the diabetes. All together, he is not as playful, lethargic, eats like a horse, but has dandruf, unhealthy looking fur, and has dropped 5 pounds in almost 3 months. :cry:

I can see now how people get anxious and change the dose all the time. It is quite hard not to just jump right in and change it before it has settled in!

 

It's really pretty amazing how well he is doing on just one shot a day. He needs two shots though. Not sure why your vet would prescribe 1 a day when the manufacturers clearly state it's a twice a day insulin. When you do decide to go with the 2 per day, you may want to cut back on the dose a bit (somewhere between 1/2 and 1 unit).

Congrats of getting him to take the 'puffs.'

 

Hi Kelly, and welcome! You've already gotten some good advice, and it sounds like you have a handle on things. I just wanted to chime in about the Precision Xtra meter. I got it initially for the same reason you are, to test for ketones, as I was unsuccessful testing Buzz's urine. I was not aware how large of a blood sample is needed with the meter to check for ketones. I wasted quite a few strips because there wasn't enough blood. It's just something to be aware of; make sure your ear poke is extra-good when you check.

I did use that meter for awhile to check BG as well, but then I went to the One Touch Ultra. I'm now back to using the Xtra after months and months of the OTU (we had some leftover strips for the Xtra and none for the OTU) and man oh man, it's hard to switch back! You are so right about the ketone strips being cheaper on eBay (BG test strips are as well). I nearly passed out when I bought the first box of ketone strips. Ugh!

Keep on asking questions and posting your numbers. You're doing great so far!