Oscar new to ProZinc

Hi everyone. Oscar was diagnosed 2 weeks ago with mild diabetes and we switched his food to a few Fancy Feast varieties in an effort to diet control him. His numbers dropped marginally (20-30 points) and his overall numbers are not very high, so the vet decided for us to start with 0.5 units of ProZinc once a day to see where that puts him. He is also a newly diagnosed asthmatic. I have known for years that he had issues, but finally pushed the vet for x-rays to confirm once I did some more reading after being introduced to this board. He is a steroid induced diabetic (a cortisone shot for an asthma attack in November pushed him over I think). He is also on 1 puff albuterol twice a day and 2 puffs 125mg flovent twice a day. I have attached Oscar's spreadsheet to my signature. One thing I haven't been able to find - how long can I use the vial of ProZinc before I need to purchase a new one? Looking at the online prices for this, I am wondering if my vet messed up on the price they gave me for my vial - $72!

Another question - I looked on the manufacturer's website for how to draw the insulin out of their vials. They recommended pulling the syringe out to the desired dose, insert into the vial, pull back out greater than the dose, and push the excess back into the vial. I have read (for Lantus at least) that this is not the recommended way. (I should turn the vial upside down, insert needle, pull out slightly greater than the dose, pull syringe out, and push the plunger up to the desired dose outside the vial) Any ideas? Thanks!

 

Welcome, Kelly & Oscar. We're sorry and glad that you are here. I am still using PZI, but I think I can still answer some of your questions. There should be an expiration date on your bottle. I think Gator said that it's good 2 years from manufacture date. The $72 is a great price from what I've heard. Your insulin is from Boeheringer Ingleheim (BI) correct? (I probably didn't spell that right.) If you look at the top of the PZI board you will see PZI Reading & Resource Links. You'll find more info there on ProZinc, protocols, and syringes.

Your instructions for drawing the insulin are exactly how I was taught to do it for PZI. ProZinc and PZI are more stable than Lantus, so they are treated very differently.

One other thing. Since Oscar's numbers are not that high, you may need to switch to U-100 syringes so you can get more accurate lower doses. I don't think any of us dose once a day, most of us are on twice a day. If you went to twice a day (BID), you would most likely need to lower the dose which can be difficult in a u-40 syringe.

Congratulations on getting started with home testing so quickly. I hope Oscar becomes diet controlled quickly. Others will be on soon with more info, I'm sure.

 

You are correct that it is manufactured by Boeheringer Ingleheim (BI). The expiration date on my vial is October 2011, but I wasn't sure if that date becomes only 3 months out or so once the vial is used. Thanks for the info

 

Re: insulin out of the bottle instructions

Hea there Kelly and welcome [from on Hoosier to another].

Wow you guys are doing awesome! You are home testing already wish is GREAT and you have you SS together, you are ready to rock and roll!

Your next step might be to switch to U-100 syringes: you can read about that in the Sticky at the top of this forum. Also you might put together a "profile" and link it in your sig too - instructions in the Tech Support forum. And once you get going and depending on the curves you get and how gentle you would like it to be for Oscar, as Ele said you may want to switch to twice per day dosing [at a reduced amount for each shot].

Have you guys set a "no shoot" level ?

H is a steroid induced diabetic too.

It depends on how much you end up dosing. My last bottle of PZI Vet which is similar lasted me a good 9+ months. ProZinc is good for 2 years from the date of manufacturer. This remains true if opened and handled correctly [stored in the fridge at 40F with no light and hopefully not dropped/shaken]. $72 is a great price - you are lucky.

I think just about everyone's technique has some minor variations. There is some thought about not first drawing air into the syringe then inserting it and injecting that air into the vial. My technique which I know varies for others and is not the only way about it is to:

(first roll - and I even gently "hourglass" the vial a few times)
1) pull out a slightly greater amount of insulin and remove the syringe
2) give the syringe a good "crack" with my finger to get rid of any bubbles attached to the tip of the plunger [even the super small ones]
4) pull a little air into the syringe to make a "big bubble" at the top and join any bubbles up with each other - so it looks like a layer of air and a layer of insulin
5) push the air/big bubble out of the syringe
6) insert the syringe back into the vial and push the extra insulin back into the vial
7) remove the syringe from the vial and put the cap back on the syringe

If you treat the plunger more like a screw than a nail it will help you get finer gradients.

Hope this helps. Please keep us posted of your progress and feel free to ask lots of questions.

 

I guess my next question is about transport. I will be leaving town next weekend for a few days and will probably be bringing Oscar with me on the plane to NC. With his numbers so low, and so new to insulin, I don't feel comfortable boarding him. I know I can take medical supplies and prescriptions on a plane with me, but what about keeping the insulin cold? The first flight is a non stop. It will be out of a fridge for maybe 4 hours. The flight back has an hour layover and will probably total 6 hours out of a fridge. Should I pack it in a baggie with a small ice pack?

 

I just caught that you guys are feeding dry food? Unfortunately that's not going to work with the DM. And m/d is not a good food for diabetics, dry OR wet. The dry food will have to go. Are you transitioning out of it yet? It is OK to put enough wet food out at night so Oscar can graze [I put a little extra water in H's food so it does not dry out and get the crusties]. When you do transition out of it you will want to keep a very close eye on the BG numbers because you will most likely see a major drop. And make sure you have a reasonable "no-shoot" that you feel comfortably with. It may take up to a couple weeks for the carb "toxicity" to wear off.

Diabetic cats need to be on a "low carb" wet food ONLY diet [for reals]. "Low carb" = less than 9% carb as %Kcal. There are many choices and Janet & Binky's list is a great resource to find acceptable foods:
http://binkyspage.tripod.com/canfood.html
The prescription diets are not needed and are generally of very average ingredients.

As for the travel, they make chilled insulin carriers some can be found here:
http://hocks.com/hocks-healthcare/hocks ... ories.html

At a minimum, the frozen gel packs and a small cooler is the way to go.

When I have traveled with H I pre-filled a number of syringes with insulin. We shoot sliding scale [varying doses], so I just filled to the max dose then pushed out what I didn't need for that dose. BUT on the plane I can imagine the pressure changes excreting the insulin in the pre-filled syringes and you not ending up with the intended amount in the syringes. One idea is that you may be able to get an empty vial from your pharmacy [perhaps compounding pharmacy] then you can put just enough in that vial so that in the worst case you would not compromise a while vial.

Good for you having the courage to take your kitty with you. The other option is a kitty sitter that is capable of DM care - some use vet techs from their vets office [but they can be expensive].

 

We transitioned off of the Hill's M/D wet food on Tuesday of this week. I think I noted this in his BG chart in the remarks. He was only eating the m/d dry food occasionally when he was still hungry and begging for food. I can't leave wet food in the bowl all the time because he will just eat it all and there will be none left in an hour. He used to have weight problems before all of this (16 pounds of goodness!). We are now completely on Fancy Feast gluten free low carb wet food - 2 cans a day. I just went out and bought a bag of Innova EVO low carb/grain free dry (8% carbs and 47% protein) for grazing during the day so he will have a sprinkling of something to munch on. I brought Janet and Binky's charts with me to the vet today and showed her the protein/carb levels of the Fancy Feast because he didn't like the m/d anyway.

 

Unfortuntely there is NO appropriate dry food for DM kitties - even Evo which claims to have 8% carbs as %Kcal but if you read this, in one test it was nearly double that!!
http://www.yourdiabeticcat.com/diet.html

Free feeding [or the closest approximate] is the best policy for use with PZI insulins. I'm not sure about the difference you make between grazing on dry food and grazing on wet food... But anyway, if you have a half piggy-half kitty there are timed feeders than many here use that will allow you to feed only wet food at specific times. Searching this board for "timed feeder" or posting in the Health forum asking about timed feeders will provide you a lot of results. Maybe Nancy & Cody will read this and offer help, I know they use a timed feeder.

AGAIN, there is no acceptable dry food for diabetic cats. Even very small amounts can make their BGs whacky. I'm sorry to be the bearer of bad news for you. But it is just what it is. Dry food is not acceptable.

 

Actually, I think I've read that you don't want to use an ice pack because it can get the insulin too cold. Here is a sticky from the old board on how to ship insulin, not sure it is all that much help though:

http://www.felinediabetes.com/phorum5/r ... 17,1796876

Also, most people I think have found that any dry food, even the EVO (there is some dispute as to whether that stated carb value is true, though I don't recall the details - looks like Gator has posted the link for that), will spike up their BGs. If you have a way to get dry out of the picture altogether (timed feeder maybe for the canned?), that is ideal. Some people do use insulin with dry when they have no other choice, but from personal experience I can tell you that regulation is a lot easier without that in the picture. Of course it is your choice, but I would recommend experimenting with other options if you can (some people freeze portions of canned for instance, so it will become available as the day wears on). It really will give Oscar the best chance at regulation and possibly remission.

Gator - you probably already know that one of the prescription foods is called DM? Just wanted to mention it as sometimes I have to think twice on the abbreviations to follow along. I think more people show up using m/d, but DM is also handed out regularly by vets.

 

The airline security won't let you through with gel ice packs. (They count it as liquid.) So, you'll need to bring a cooler with empty ziploc bags and fill with ice. So, on the way to the airport, you have ice... then dump it to get through security and refill on the other side with ice from a restaurant.

 

Yea the Purina one is called "DM" the Hills one is "m/d." The DM wet is actually OK for diabetic kitties but the m/d wet is not. And BOTH dry food are of course completely not OK. But again the ingredients even of the Purina leave a lot to be desired [and the new DM has an increased fat content :-( ]

 

This is a good solution. Thank you!

It is surprising to hear about the innova evo dry - especially after paying $20 for a small bag :cry: Time to look for a timed feeder for the wet stuff!

 

Timed feeder to the rescue!

There are 2 that I know of, both from PetSafe (yes they make the underground dog fences) Here is the link to their online store: http://petsafe.thepetstoreonline.com/ca ... eders.html

The price online is actually cheaper/same than what I have seen in the pet stores, but I don't know about shipping.

Cody has the 2 meal feeder which I liked, but he is crazy and he was able to break into it :roll: .
The 5 meal feeder is much larger, $47 online, $60 at Petsmart. I haven't gotten it yet, but they are sending me the 5 meal feeder, soon I hope. Others on the FDMB who have have it (5 meal) really like it. The 2 meal uses 1 AA battery and ticks quite loudly. The 5 meal uses a whole bunch of C or D batteries, but is quiet. The ticking is annoying.

It will be great for you guys to spread out the work his pancreas has to do using the feeder.

I would also really look into a vet tech, pet sitter. Our little trip last weekend set us back again, its just so stressful...

 

Thanks for the info on the feeder. I am checking out that page as I write. I do have a good pet sitter that has taken care of the kiddos in the past, but I worry about him being left alone for the better part of each day while being so new to the insulin. He travels pretty well actually - no meowing or anything. I asked my vet about boarding him with them, but the dr. recommended not too since the techs are around less on the weekends. My options are to take him to a nice kennel place that has a cat room, but boards a lot of dogs too, and pay $60 a day for boarding and medicine administering, or pay $100 one way to take him on the plane and monitor him myself. Either way stinks, but I honestly think he will be less stressed by taking him with me. He has stayed at my parents before, so he should recognize the smell of the place a little I think.

 

Wow, you just started prozinc today! good job! your numbers look good

Please please be patient with this insulin and give it a chance to get into his system for a good while before you start to increase. With his numbers so low on their own, I think you could have really good luck. Patience!

But get off and stay off that dry food. ;-) Keep it on hand for a hypo, but don't feed it normally.

As for the vial, on .5 u that vial is going to last you a LONG time, so treat it carefully. If I were you I might decide to waste a bit by drawing a bit too much and wasting a drop in the sink to get rid of the bubbles, but BI says its ok to re inject ...sooo...

I was thinking about this and if you use plain ice, the insulin will never get colder than 32 -33, whereas if you use a gel pack which has chemicals that may be colder than ice, you run the risk of it getting too cold.... Chemistry buffs, am I right? :?: