Oscar - got the approval to switch to L

Well I finally convinced the specialist to allow us to switch. For the majority of the conversation it sounded like she wasn't going to write the script. Here is how the convo went -

Her: How are his clinical symptoms?
Me: Still drinking a fair amount even though I add water to his food. Peeing orange size clumps. Would like him to gain another pound - weight holding steady no matter how much food I give him.
Me: I would like to see his numbers lower. They are the same as the numbers before we started insulin.
Her: Yes, but we should base the effectiveness off of his clinical symptoms. I would like to see him stay in the low 200's.
Me: I don't think ProZinc is working that well and I would like to switch to Lantus.
Her: We usually don't say an insulin isn't working well until we reach 5 units or more with no change in numbers. Cats don't give nice perfect curves - they are usually flat like Oscar's. I would like to see his curve just slightly lower though. Lets raise his dose to 2.4u and stay there for 2 weeks.
Me: But we've been on this insulin for 4 months and were at a higher dose during that time. I think we have given it enough time.
Her: We are going slower with his dose increases so he has time to settle in. You should give it more time. But ProZinc and Lantus are the 2 most common insulins for cats. We could either do 2u of Lantus or 2.4u of ProZinc.
Me: I would really like to try Lantus. Can you write me a script?
Her: Sure. I can call it in for you.
Me: Can you mail it to me? I need to call around to find the best price.
Her: Sure, I'll get it out to you tomorrow. Stick with 2u for 2 weeks and keep a watch for hypo episodes. If you see him wobbling or acting weird, test his glucose.
Me: OK thanks.

So short of it - I have a script and approval coming to me. It is obvious that she is not familiar with the Lantus protocol developed by Dr. Randal. She also recommended rolling the Lantus cartridge! A big no no so I have read. I am still miffed that she advocates waiting until hypo symptoms are present before testing. It would seem logical to test in order to avoid a hypo from happening.

Either way - I'll switch Oscar over tonight. I'll borrow a few doses from Yoda's supply until our pens get here. I'll still check the PZI forum as much as possible since there are few beans over here. ProZinc helped us get rid of much of Oscar's clinical symptoms, but I am still optimistic that we can go otj. Wish us luck!

 

Congratulations! I'm still working with the ProZinc for Blackie. She's only been on it since May 12th, but then she was given too high of a dose then, too. Not anymore. She's at 1.2 units, and is on LC diet.

 

Best of luck! We're looking forward to Oscar's (and Yoda's) OTJ party in a couple of months!

 

Kelly,
Congrats, hope it helps!

FYI when I switched from prozinc to lev, the lady who helped me, had me skip a cycle because she was concerned that Prozinc may in fact have a "shed" (it is a human recombinant insulin and does seem to take 45 days to work well- why is that? - possibly because it builds a shed?)

She also mentioned that many many of the older type pzis --> to lantus cats she has helped switch over the years, bottomed out in the first 2-3 cycles. Please start SLOW and watch closely- set your alarm tonight. I do not know the onset of lantus, but I was surprised how slowly Lev kicks in (like +4), but then lasts so much longer than Prozinc ( like +13) Make sure you have some idea when to be extra vigilant.

Oscar is ketone prone? right? Make sure anyone helping you knows this. Is he completely healthy and not stressed right now? Haven't I read that ketones are more likely with not enough insulin, infection, stress, not enough food/fluids IN COMBINATION?

Are you well stocked on test strips, ketone strips? Have you posted over there to get some help in advance?

Don't be a stranger- (I still feel like pzi is home )

 

Wow Kelly
I just looked at your ss and it really is looking pretty good....I love the blues..... how much prozinc do yo have left?

 

Good job steering the vet conversation, lol, too funny!!!! Hope everything goes great!!! Please do still visit & help out here!!! :mrgreen:

 

I have half a vial left of ProZinc and am well stocked up on strips He has always had an issue with ketones - which has always concerned me. Oddly enough he has been looking at halfway decent numbers lately (with exception of the over 300 wonkyness). Maybe his body heard that I am seriously going to switch him and is protesting lol. I think what our biggest issue with prozinc has been when we get a dose high enough to have a long enough duration it brings his nadir too low. When trying tid we couldn't get the numbers to drop much at all with the smaller doses. I am hoping that the long overlap with lantus will help us out in that area.

I have high hopes for Yoda. He is already ketone free and completely out of the pinks and reds. He likes to ride in the blues most of the time now.

Interesting thing regqarding the prozinc study. It was only for 45 days, so I wonder how much of this 45 day for settling thing is because of that. Though I do believe it does take a good amount of time for it to settle in.

 

looks like you started the Lantus. I'm sure you'll keep close tabs the next few days especially. you have your HC ready -Yes?
How long is the onset for lantus? If its like Lev it takes a few days (weeks) to really get going to its full ability.

 

I haven't shot yet .... opened a condo in LL for advice to confirm my plans. I do have several of the cans of gravy flavors on hand plus a bottle of karo just in case. Yoda started seeing results within the first 2 to 3 days with Lantus, but Oscar laughs at doing things by the book :lol:

 

Congrats Kelly! I hope Lantus works well for Oscar. Don't be a stranger! :smile:

 

of course not! I will definitely be popping in here as much as possible to help everyone out!