Question for ProZinc users

Tres has been on PZI for a long time and done really well on it. Today we switched from the discontinued PZI to ProZinc. His blood sugar this morning was at 280 (before breakfast and his shot). I've been testing him every 2 hours- and it has gone steadily up throughout the day. It's at 484 now. I don't know whether to give ProZinc again- does it take a couple of days to start working? Or go back to the discontinued PZI (I have a little left) for his evening shot. Obviously can't reach the vet. If anyone has had experience going from one to the other- I would really appreciate any feedback. (He was getting 1 +1/3 units of PZI. I gave him 1 unit of ProZinc this morning. Also he eats only wet low carb Fancy Feast.)

Thank you!

Teresa and Tres

 

Hi Teresa! I have no experience with PZI, so I can't help you with the switching over question, but we use prozinc. It will take some time for Tres to adjust to the prozinc, a few days at least, maybe a little longer. It needs time to settle. We really like prozinc, but it can be a little frustrating in the beginning. I would not go back to the PZI, it will just prolong the process of switching over.

One unit is a good starting dose for prozinc, but I don't know how that compares to the dose of PZI he was on. I know there are different types of PZI, it might help other people help you if you could post more info about the PZI you are discontinuing. Was it u40 or u100? Which brand?

 

I haven't used ProZinc, but use PZI Vet, and have been following along with several here who use ProZinc. Based on what I've seen here, it works great, and pretty close to how PZI Vet works - some differences, but nothing to worry about or need to radically change strategies. I would stick with your plan for ProZinc at the dose you are giving and give it at least a couple days for him to adjust. I know when I switched from Vetsulin to PZI, the first couple days I was panicked over possible bad effects from the change (or course that was the day he picked for random vomiting & diarrhea), but it all turned out just fine.

I think you will find you are happy with the ProZ once you get settled in a bit with it and fine-tune the dose. We are seeing really good results with it lately, yay!!!! Hopefully some who have made the exact switch you are making (I think Gator did that, and I'm almost certain there are a few others as well), will be able to chime in as well. I agree not to switch back to the old PZI - in my experience the dregs of the vial don't give good results anyhow. If it were me, I would probably just go light on the testing for a couple days (maybe just get PSs and a spot check here & there) and let him adjust to the switch before worrying too much about the #s. I'm not sure about the dosing either, whether it's 1 to 1 or not when switching, so you may find it's just the slightly lower dose making the difference in the #s. Makes sense to me though to stick with just 1u for a couple days (barring any complications like ketones), and then reevaluate.

 

I'd suggest giving it another day to settle in and get some overlap going before you panic. If he's still running in the high 400's, I'd increase the dose, but only by a tiny bit. Go from 1 to 1.2 and then hold that for a few cycles. Are you using U100's to dose?

My Ari's dose was pretty 1:1 from PZI to ProZinc so you may need 1.2 or 1.4 to equal the 1 1/3, but I'd definitely work up by trying the 1.2 first for at least 2 days and grab some mid #'s and nadir's if possible. Is Tres ketone-prone? That also makes a difference in how long you can let them run at high #'s. My girl has a tendency to get ketones, so we would adjust after 3 cycles (3 shots @ BID), which was a day and a half, but in general I'd say let it settle in for at least 2 days before upping the dose.

Do you have a spreadsheet set up? That will also help you monitor trends. I'm a big one for number trends

 

We did 1:1 from PZI Vet to ProZinc. I was hard-headed and did not treat it as a change to a new insulin ---- that means testing yo!

So make sure you are doing the mid-cycle testing and that will help.

H ended up needing more ProZinc than PZI Vet, but that trend may have started earlier. Also the small changes thing: I found that VERY small changes in dose [like "0.05" U changes made a difference - we were using less than 1U]. You can go back and search my posts to when the new board started to read my comments. I'll be happy to try to answer any questions.

Another main point is that you need to see things through for about 6 weeks to really be able to tell where you are at. It seems to take a while for the change to settle. So stay patient -- if that's possible. ;-)

You should read this:
http://www.vetlearn.com/Media/Publicati ... 2_24_0.pdf

Good luck and pipe up if you have more questions :smile:

 

Thanks all! I really appreciate the feedback. It's been a rough couple of days. His numbers had started to come down a bit (to a low of 364) yesterday afternoon- but then last night he went up to 522. I took him to the Pet ER- and they tested for ketones and gave him some short duration insulin to bring his numbers down. This morning he was at 190 so I didn't give any insulin (per my regular vet). But he was way up again by this evening. So we're kind of starting over tonight- with a bit more of the ProZinc then we started with. We gave him exactly the same amount as the PZI he had been getting. Really hoping that he'll start to come down a bit over the next day or two...

It is so hard to be patient while things settle. He also has pancreatitis and has a recent cancer diagnosis. So he has so many complicating factors. I just don't want to end up back in the Pet ER this week. If we can avoid that- I'll consider it a success!

Thanks again for the encouragement! It means a lot. We'll hang in there...

Teresa and Tres

 

I glad Gator posted- I thought I remembered that H needed a bit more Prozinc than PZI. I am glad you are increasing that dose to start out 1 to 1. It was pretty apparent he needed more. Easier to treat some low numbers than DKA so long as you are around to test.

Will the vet show you how to give some sub cutaneous fluids at home? It can help the pancreatitis, and help level out the high sugar numbers a bit, and offset dehydration (from the high numbers) until you get to a better dose.

 

Gator,
I'm so glad you pulled that article out- I hadn't reread it in a long while and it is really helpful.... I need to book mark it. Is it in the stickies for Prozinc? It definitely should be, for anyone changing from PZI vet to Prozinc.

 

Awww, sorry you ended up at the ER! Did they find ketones? I don't know too much about them, but if you are battling those too now, I think people often give fluids at home, as well as taking a more aggressive strategy with giving insulin.

 

Nancy,
There are some unique things about that link. It is from the vetlearn site which may be a pay site?? Boehringer Ingelheim Vetmedica would not share that article directly with me and made a big stink that they had to fax it to my vet. And, as soon as I let BIV know that that article was freely available via the vetlearn site [with the insinuation that they should get off their high-horse] in an HTML form it instantly disappeared from the vetlearn site. So, if you believe in conspiracies...

It just so happened that I had linked to the PDF version which was also available before it disappeared in one of the topics I started about our switch to Prozinc here:
viewtopic.php?f=24&t=1817&p=15963

The bottom line is that I hesitate to make that PDF super noticeable as the PDF version might disappear too since BIV thinks there is some reason it cannot be shared on their site with the public and owners should not have unfettered access to it. It befuddles me what they may be so scared of? Since it is copyrighted material it would be technically illegal for an individual to post it somewhere public on the Internet. An individual getting a getting a cease and desist from something hosted on their own server is not that big of a deal, but if one were sent to say Google, I could see Google taking the position of deleting an entire account [even though historically Google had broken copyright massively by publishing scans of books to the Internet].

If you have any thoughts about how to solve this conundrum please let me know.

Anytime I want that link I search "thoughts" in the PZI topic titles only. I also think that Prozinc advice givers should probably have a copy of that study on their own computers.

Sorry to hijack your topic Teresa.

 

thanks for the heads up- for loss of a better plan - it is saved over here...

 

First and Foremost GREETINGS GATOR!!!!!!!!! Sooooo very happy to have you back with us!!! My sugarkitty switched from Vetsulin to ProZinc about 6 months ago, and we are very happy with it overall...Puttz had high numbers in the beginning, it took about a good month and a half to get him stabilized...We test about twice a week, and he is just doing fine! Good luck to you...Terry and PuttzerMan