Starting Elmo on New Insulin Prozinc Advice please

Hi,

Elmo has been on compounded PZI U100 from Wedgewood Pharmacy for about a month. Numbers ok but need some work.

I expressed my interest in trying Prozinc with me vet and he ordered me some .

Here are my questions.

1. Since his numbers are not so bad should I keep him on the compounded insulin a little longer?

2. If I start him on Prozinc should I start at one unit?

Would like any input on likes and dislikes of prozinc.

So far the compounded insulin is ok, I am not a fan of it since one batch can vary from the next, prefer largely manufactured insulins like prozinc but I don't want to change him if he is ok...

overthinker I guess.

Many thanks as always

 

It is up to you if you want to change insulins. Cost is one factor and the other is convenience in getting new vials. Based on your spreadsheet I would at least use up the existing vial of the Wedgewood insulin. With the exception of the 109 you measured on 4/15, I would start at 1 1/2 units with the ProZinc. However, that 109 scares me so I would start at one unit bid.

 

Hello-
Just wanted to give you my experience with the prozinc from Wedgewood.

My fd was dx last sept and we went on the prozinc. At the time, our vet did not encourage hometesting or lc canned food. So, we fed the expensive prescription kibble and gave the insulin without testing. Charlie's symptoms began to get better, and after a few months he was doing well (but not great). I attribute this to the kibble and not hometesting (we were up to 3u bid).

In January, we had run out of the kibble, and as you might guess--Charlie hypoed. We began testing and he was almost immediately otj!

I think the wedgewood prozinc is an acceptable choice, but I can tell you that if my kitty comes out of remission--I will probably choose either pzi, or possibly lantus. The people at wedgewood were always great to deal with, and their product always arrived in excellent condition. The cost is less, and that is something to consider.

As far as dosing, I won't be much help, but there are many here who are experienced and can offer advice. If it were me, I would continue with the prozinc for a few weeks to see how it goes. It can take upwards of a month to see improvements in the numbers.

Good luck!

 

From what my vet told me, switching to Prozinc they usually start out at .25 to .5 unit and see from there. Don't know if that helps. You could work a TID schedule as you start out to zoom into your dose and then switch back to BID.

 

It is up to you if you want to change insulins. If you feel comfortable enough with switching to Prozinc, although you had bought your previous insulin... not sure how much you've spent on it? I'd switch, BUT if it were me, I'd try a few things first since you've invested almost a month already and Elmo's body is probably getting use to your previous insulin. Looking at your spreadsheet... I see there were a few times when he's got into the kibble ohmygod_smile

Have you thought about changing Elmos diet? Are you feeding dry food? If you do plan to change to a low carb diet. Please know that you need to read this first. http://catinfo.org/felinediabetes.htm#Very_Critical_Points

I really can not offer advice by looking at Elmo's SS since I am not familiar with how most sugarcats react to insulin while NOT being on a lc diet. The 2.0 units 2xs day seem to be better for now. Is he eating before AMPS and PMPS? You also may be dealing with the insulin wearing off right before his +12's ?

You can try this for a week - If Elmo eats more than 2x a day, you won't know if his bg changed because of extra food or too little insulin or too much insulin, and you really have to know why in order to make dosing decisions. You want to know what the insulin is doing, with him getting into kibble once and awhile doesn't help. I can't stress enough how important it is to be consistent. I am not barking at you :smile: and I am sorry if this comes across that way... I am only trying to help.

 

Thanks everyone!!

I should have mentioned Elmos diet Michelle - he eats only friskies canned 3 times a day. He used to be on canned and free feed dry but I took all the dry away more than a month ago when he was diagnosed.

I tried to see if just taking him off of the dry would help lower his BG's it did not so thats when we started with insulin.

I only feed the loaf kind, no gravy, no shredded etc.

I have 7 other cats so it is quite the expense for me, they eat 2 cans 3 times a day and sometimes when they finish that I give them an extra, so each cat gets about a can a day. I do still have dry that I feed my other cats, some that are very old, etc that I do not want to take the dry away but I put the food down and they eat and then I take it up so Elmo does not get any.


So what I think I am going to do is leave him on the compounded for now, give it some more time and if it is not working then start the Prozinc. My vet specially ordered it for me so I am going to get it obvioulsy but not use it just yet.

Is 90 a good price for the Prozinc?

 

To me it is... my vet charges $130 ohmygod_smile

That's awesome that you're feeding canned, but is it the lc type from Janet & Binky's page? I know the feeling with so many furbabies around. I have 5 myself As far as Elmo's SS.. you may want to consider TID if that's doable? It can be a bit of a challenge, but it's always an option. Keep us posted!

 

Hey she's right about the kibble screwing up the numbers. Cody is a maniac and sneaks around hunting every little crumb in the kitchen, and walking out of the room with an unsupervised dog food bowl and I'm dealing with messed up numbers FOR DAYS. Why the stupid (sweet) drooler doesn't gobble it down like a normal dog-- I wish I could tell you ohmygod_smile

I guess its still being absorbed pretty far down the intestines; that's why it affects him so long.

You have mentioned earlier that cost is a consideration. That 5ml vial has 500 units in it. At 5 units /day, that vial could last over 3 months. Maybe you should hang in there a bit longer and try to keep all the other variables minimal to give it a fair chance.

I pay $84 for Prozinc, but that's one of the lower quotes I've seen.

 

Is your vet charging you 90 for wedgewood compounded prozinc? If so, that is high--I haven't ordered it since January, but at that time I think it was around 30-35 plus 15-20 for shipping. I can look up the records after work tonight, if you like.
If you mean 90 for the mass-produced prozinc, then yes, that is an excellent price.

eta:
If you decide to stick with your current prozinc--I can give you the number for wedgewood so you can order it directly from them (without paying a vet mark-up).

 

I do refer to the food charts and always get the lowest carb friskies that hte store has.

I am going to use up this bottle from the compounding pharmacy before I start the Prozinc.

I should have jsut waited to get it now I spent 90 I did not need to this week and it is going to be a struggle for me to get test strips that he needs .

And his AMPS was 445 this am!!!

Must get some more spot checks to see what is going on...

My vet charges me 35 or 40 for Wedgewood Compound PZI and 90 for Prozinc.
I have Wedgewoods # on bottle, so I can get directly from them without rx?

Thanks again

 

I would just get the prozinc from your vet--those prices are pretty good. By the time you add in the shipping charges, you would end up paying more. You do need an rx from the vet, but they can always call it in for you.

 

just chiming in to say that I think both the Wedgewood and the PZIR call themselves Prozinc.... I can't keep up but thankfully I don't have to, at least til my new Idexx vial runs out....

That $90 sounds awesome to me... I'd hold on to it if you think you will switch when the WW bottle expires/runs out, or maybe your vet would take it back if you aren't sure?

 

Numbers for today

AMPS 445

+6 - 82

+11 - 110

Possible rebound? maybe that why AM AND PM PS has been higher than usual?!!

going to test him again at PMPS and see

To shoot or not??? He is currently on 2.5 units compounded wedgewood phar PZI.

I was going to not shoot under 15o , if between 150-200 maybe 1/2 unit ??

THanks again everyone, I am soo proud of his spreadsheet :mrgreen:

I am going to use up the compounded insulin and we wil lgo from there.

Just to make it simplier I call the compounded insulin Wedgewood PZI and the new stuff Prozinc sorry I am confusing in general

 

89 is a good # for a nadir. Maybe Elmo just needed quite a few days to settle in on the dose? I personally would stick it out for at least another dose or two to see what happens. I know with my Oscar, it was looking like 2.8U was too much for him this time, but was just right last time maybe with enough food. I waited and shot 2.8U again today and we are magically getting a little less of a drop now. Go figure!

 

I'd probably lower it a hair - it's a great nadir, but a steep drop. I definitely wouldn't go as low as 0.5 though even on a low PS. I would probably try 2.25u (not sure if you can measure that with the U100 insulin?) and then get in a spot check around +2 or +3 to see how things are shaping up...

You need to shoot what you feel safe with though. In reality with Bix, I took the route of shooting really low, like 0.5, on a low PS, and his #s always just went high off stuff like that, that's why I would recommend staying closer to the current dose, but lowering just a little. Just my guess though, I am not a dosing expert by any means...

 

ok tested about an hour after the 110 PMPS and was 250

So instead of giving him a real low dose like 1/2 a unit, I gave 1.5 units. He normally gets 2.5 now but I was a little afraid to give 2 and other doses are hard to measure.

Will test later again and see. Fed him when it was 110 and then up to 250.

Thanks everyone

 

Yowza, that is some zoom!!!! Sounds like a plan.

You might experiment at some point with measuring just a hair over 2u, like just enough where you can see a glimpse of the insulin between the line & the plunger. It may not matter literally what dose you are measuring, if you can find a way to stay consistent (and a spot on the syringe that works well for him!!!).

 

You are seeing zooms like I have seen with Oscar. I have learned that with a dose change often comes a low preshot # a day or so later. That low number is always followed by a zoom an hour or so later, so I usually wait a half hour or so from the normal time and shoot our regular amount or really close to it.

 

Thanks,

AMPS today 266!!! I was expecting it to be high again since I only gave 1.5 last pm but hey.....

I am afraid to give him 2 units with that number and I really do not want to wait till it goes higher after he eats, I would rather shoot now a lesser amount.

I know he could stand to go a bit lower but better than hypo right since I am still messing around with doses.

Glad I did not start him on Prozinc yet yikes!

 

:thumbup great!