Hi all! Merry Christmas to everyone! Henry is being a cheeky little monkey! His numbers are a bit all over the place, and have been forever!! I was after some advice on whether to just keep patience and increase the dose gradually as I am… or talk to my vet about going back to caninsulin? Or even trying lantus? I know I could do with getting more tests but I work too much to get any more in! He eats animonda carny 3x a day and night He currently grazes a little on beutenah (he goes mental for food- understandably) We’ve just increased to 4.25iu any advice??
Hello there! You have really been trying hard with Henry. What does he eat? I am not familiar with the foods you are feeding because I am in the U.S. but can you tell me, are they low carb wet foods? But you say that he goes outside? And eats things out there? When did he begin ProZinc?
Darned of he still isn’t getting out of reds and pinks on this dose! I would keep adjusting the dose by .25 units at this time. But looking at his spreadsheet is giving me deja vu. He is so high and doesn’t seem to respond to the insulin like he should. This happened to me and my boy. I would consider having him tested for Acromegaly and Insulin Autoantibodies (IAA.). If he gets up to 5 units, I seriously would consider getting these blood tests done (or before.). Here in the U.S., I know where to have the blood sent to for testing. Where do you live? I believe the RVC in London does the testing.
Hello! Thanks so much for your reply the animonda that he eats most is a good low carb wet food. The beutenah is a cold pressed dry food but is only 4% carbs he used to go outside but he hasn’t been out for a month now but I’m starting to think the lack of exercise is not good for him- he used to roam outside for a large portion of the day! I thought by keeping him inside it might be better for him- to stop him scavenging food, but now I think he’s just getting fat and depressed So, I’m starting to let him out during the day again, and we’ll see if exercise helps! I will speak to my vet at the next opportunity- I was wondering if we were getting near to an acromegaly consideration! Henry has been suffering with bloat- the vet thinks is it slow gut motility. He gets cobalaplex every other day which I think helps him in general but he still has a little round belly - I think I read that this is common in acromegaly? Luckily he seems pretty good in himself apart from a little fed up at times! Just still drinking and peeing lots!! thanks so much for your thoughts. How was your experience with acromegaly? hope you’re having a great Festive season x
Hello again. Keep on getting as many tests as you can and add them to your spreadsheet. I am anxious to see Henry in better numbers as well! I would definitely expect a lot of drinking and peeing when he is in these high numbers. Poor baby. But it’s good that you say he seems pretty happy otherwise. I will check in on you again and watch for your posts.
We actually do not test for high dose conditions until the dose gets to 6u twice a day and he’s not there yet. Part of the issue is the dosing. Have you read the two dosing methods available for those using Prozinc? Because you are feeding some dry, even if it is low carb, you’ll still have to use Start Low Go Slow and that is going to hamper his progress in increasing his dose like he needs. My suggestion would be to ditch the dry while monitoring him to be sure it didn’t have more carbs than you think and then start following the Modified PZ method. This would allow you to start changing the dose every six cycles according to the method and also raise by 0.5u which is what he needs right now for where his nadirs are. But....you will have to omit the dry food to do this. The other suggestion that we typically make is if an insulin isn’t showing progress on the BG within six months, it’s time to change insulins. I would suggest you consider Levemir. It’s a great insulin especially for higher doses (whether the cat has a high dose condition or not) because Lantus can sting at higher doses and Lev does not. If you do get to 6u bid and he does test for acro and/or IAA, you will definitely want to switch to Levemir. It seems to work extremely well with high-dose conditions due to the non-stinging. I actually switched my Gracie from Lantus to Lev (she was not a high dose cat) and she did so much better on it. It is known for allowing longer duration and that is what I saw with her. I hope this helps. If you do decide to switch, let us know and we will help you with a dose for starting Levemir. But, I would love to see withdrawal of the dry and using the modified PZ dosing to try and get him into better numbers.
Hi! Happy New Year! thanks for your reply and all your suggestions. I will take away the dry and increase his wet with more portions in his autofeeder. Be interesting to see if this makes a difference. I’ll consider increasing the dose by 0.5 in a few days and then I’ll hold for 6 cycles, and re-assess. I work more than full time so do struggle to get day time tests, although i have started getting up over night for spot tests! I need to get a new bottle of prozinc soon- I was wondering whether this is a good time to change insulin but I think I’ll stick with prozinc for a few more dose increases just to know I’ve really properly tried and tested it! thanks so much for your thoughts! Fingers crossed we get somewhere soon!
Happy New Year to you. For now, I would keep gradually increasing the dose based on SLGS protocol and do modified ProZinc Method if you can get him off the dry food. If you are not making progress, I also would second the recommendation for Levemir. It is gentle and has a nice long duration and can give nice flat cycles (once you get to the right dose.)
You actually have quite a bit of good testing data on your spreadsheet. You’ve been working hard to help Henry, I can tell. Hang in there. We will be here for you!
You’re welcome!! I do agree with @Suzanne & Darcy that he needs to be tapered down on the dry food and be off it a couple days before you start increasing the dose by 0.5u after six cycles. We typically will also increase the dose by 0.5u if the dose falls in the 5u-8u bid category even if nadirs are less than 300 but above the reduction point as at those higher doses, we are looking at increases that are about 10% of the dose (e.g. a 5u dose x 10% would mean increases, when warranted, would be by 0.5u and not by 0.25u). I hope you can get him into some better numbers with the above modifications.
I totally get that frustration! I can't seem to get Sammy's numbers at 3 units to go lower than 285. The vet, after seeing his fructosamine level (507) recommended upping to 4 units. I did a spot check an hour after his first dose of 4 and his BG was 467. And that's on mostly raw food! He prefers it to his FF pates.
I have actually got one started. But as of last night the vet, after okaying prozinc dose to 4 units, discussed whether we should switch to lantus (I want to) but I am actually going to attempt a BG curve today. Hopefully after I get the numbers I will be able to put them into Sammy's sheet and have it handy. I don't have a predose number today but am going for every two hours.
I do have a spreadsheet now and it should be available to everyone. I just did a modified curve 2 days ago. I hope Sammy's sheet is visible.
That’s great. I can see it! Would you be able to start a new thread of your own so that we don’t “hijack” this thread. I see he is pretty high right now. I don’t see any preshot numbers on the spreadsheet. It’s important to test before each shot is given so that you are sure it is safe to give insulin and also, particularly since this is ProZinc, to see if any dose adjustments need to be made. Also, they should not have eaten for two hours prior to the two daily preshot tests - so that the number you get is not influenced (elevated) by food. Forgive me if you were already aware of this. You are doing a great job so far!
Thank you for your support! I did start a new thread I hope - I'm terrible with technology. I do want to try for the AMPS but he is very difficult to swiftly acquire blood drop for the meter, between his black ears and seemingly little blood in the friggin ear veins! He was a trooper for the other day but I'm going to do spot checks this week until he goes to the vet this Friday for a quick chest xray, Cushings test and (ideally) a script for Lantus. He's worth it.
