Tom & Mindy

Discussion in 'Prozinc / PZI' started by Mesacakes, Jul 20, 2020.

  1. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    Starting a new thread because the other was too long.
    Tom is low tonight so I will do a token dose I guess. I don’t want to give him none and the full dose will be too much. So I’ll get him through tonight and reduce his dose back to 2.25 I guess for tomorrow.
    I’m surprised/baffled as to why he randomly goes low and some days has almost no response. Ugh! He is eating well And a happy cat. Good news is he has been low the last two days so it’s working! Just not the way I want.
    He will eat anything I give him but I have not specifically tested the medium and higher carb foods on him because he generally is a pig.
    Toms spreadsheet: https://docs.google.com/spreadsheets/d/1N6uWa0dckCqQxw7e0qqOuka3ke2LoIj0Nk1xfOxPAYM/edit
    Old thread: https://www.felinediabetes.com/FDMB/threads/rx-or-dose-help-needed.231358/
     
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  2. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    Oh and after reviewing your many posts/notes I am not doing a token dose but am doing a reduced dose of 2.25 tonight. I will keep my medium and high carb food handy. I do have to work tomorrow so will be gone probably 5-6 hours so hopefully nothing crazy happens on the reduced dose.
     
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  3. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    Oh and the cat treats & kibble Yesterday were gobbled up right away. I gave him those because they are high carb and he ate the low carb food so I thought together they would be Digested like medium carbs... as I was afraid the low carb food wasn’t quite enough.
     
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  4. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Keeping paws crossed that the lower dose helps Tom to even out his BG levels.

    Some cats bounce, from one low to high numbers, for cycle after cycle.

    If you are concerned with Tom dropping low while you are gone, leave some MC food out for him.
    "Better too high for a cycle. Or two"
     
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  5. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    So another low day today. 75 at +7 and 98 at +11...
    I guess that earns him another dose decrease even though some days he runs high???
    Tonight I will delay a while (I am leaving for an hour) until he is higher and then try 2 units instead of the 2.25? I really don’t want to give him 2 until he is over 150 probably... will see. I guess I’ll feed him a bit early and check him when I get back at +12.5...
     
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  6. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    So he is still only 116 after eating... I’ll test him again in two hours. Looking like no shot tonight unless he can get a token dose in two hours.
     
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  7. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Looks like Tom cleared the bounce from yesterday and is giving you nice low BG numbers.
    That BG of 75 did earn Tom a dose reduction of 0.25U, so the dose for next time when you can give him the full shot would be 2U.

    Remember, it's the mid-cycle nadirs that determine when the dose should be adjusted, not the pre-shot levels.
    Also, you have to take into account when a cat is bouncing and not increase on the bounce, unless you are ready for a very active cycle and can stay around to test.
    To me, those red pre-shots say "bouncing" loud and clear.

    One question I have, is did Tom have a good appetite? Sometimes a cat that is not eating as well can give you those low BG levels at mid-cycle.

    Second question I have, is the shot time has been adjusted a bit earlier. Is this the new schedule for Tom? the earlier time?
     
  8. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    I wondered if those were bounces...
    Yes he ate all his food like normal.
    Yes I’m moving him up to the 6-6:30 times so it’s better aligned with dinner time. We got off a few weeks ago when I had to delay 3 hours so I have been working my way back slowly. I did a hair over 2 units (2F) as it seems like when he was on 2 before it wasn’t enough but the 2.25 might be a smidge high...
     
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  9. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    So is there anything I do to help the bouncing or just continue as planned? Is it normal to bounce this much?

    I got a 142 preshot tonight and a 153 preshot a few nights ago. I only did a token 0.5 dose a few nights ago and it wasn’t enough so this time did 1.5 instead of his normal 2 unit And I will keep an eye on him and I have lots of wet carby foods on hand.
    I was surprised by the 142 tonight because he was so high this morning.
    Does this mean I need to drop his dose again?
    All food is the same. He eats two “portions” of Sheba pate every morning and evening plus gets 5 oz. Tiki twice a day which usually has a little leftover. He also will snack on the Proplan (4carbs) I feed my other cats after he eats his food. This has been his routine for a while. He seems less starving but is always hungry. Urine output is generally better.
     
  10. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    If he's always hungry, then you may need to feed Tom a bit more food. Does he need to gain a bit of weight?

    When you feed can make a difference.
    You want to feed more in the first half of the insulin cycle, in the first 6 hours.
    For some cats it is perfectly normal.
    Bounces happen until they don't happen any more.
    "The faster the drop, the higher the bounce."

    You have been getting some better mid-cycle BG numbers for Tom. With the test data to back you up, you can lower that pre-shot BG test shoot/no shoot level if you would like.

    Try to get at least a +2 for each PM cycle. That number can tell you which direction the BG levels are headed.
     
  11. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    No he is fat and still needs to lose weight. He has Tiki food most of the day and sometimes all day if they don’t finish it. I think some of it is Just in his mind because he was skin and bones when he showed up.
    ok I was going for +3s because there didn’t seem to be much activity at +2 but that could be changing now.
     
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  12. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    +3 BG tests are fine too.

    Try substituting play time or a grooming session for the food, when Tom is begging. They've trained us pretty well, that whenever we are in the kitchen, that must mean our cats get fed too! So his attention needs to be redirected, to not expect food every time he meows and begs.

    For my civie cat, it's the sound of a Ziploc bag being crumpled that gets her going. That's because I store her next meal in the fridge in one of those bags. Now, every time, every single time she hears that sound, she comes running. But other things get stored in the Ziplocs too, like my chocolate supply! So she is disappointed frequently. She was a former feral colony cat, so even though she gets fed plenty of food, she has that mindset of "when and where is my next meal coming from?"
     
  13. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    So Tom has been on these higher doses of ProZinc a month now. I will probably need to order another vial sometime soon. Is it too soon to decide if the ProZinc is working well for him or if the drops are too steep & I should order Lantus instead?
     
  14. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    The choice of deciding to switch insullns is entirely up to you.

    A 2U dose really is not a large dose at all. Above 5-6 units, and we think about testing for high dose conditions like Acromegaly or IAA (Insulin Auto Antibodies).
     
  15. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    I guess I’m asking more of how or when do you decide a different insulin might be better for the cat? Is it only if they don’t respond or do you base the decision off the curves.
     
  16. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    Well I had a long night. I gave Tom his full dose even though he was only at 202 preshot. I did the full dose because he was over 200 and the other partial doses didn’t seem to help. So I checked at +2 & +4 and he was dropping as expected. I gave him extra food to try to slow the drop since I was sleeping. At +2 gave him 1/2 can FF 5 carb food and at +4 gave him 1/2 Sheba 11 carb food. So by +10 he was good at 214 but then two hours later was high. I’m assuming another bounce?
    I reduced his dose again to 1.75 because if I hadn’t given him extra food he would have dropped below 90 for sure. Also maybe the lower dose will help the bouncing? Sigh
     
  17. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Cats can take months to regulate. A month on the higher doses of Prozinc is no time at all.
    But, the flip side is that Tom has been on the Prozinc since December 2019.

    There is no "magic insulin" that works for all cats the same.

    Lantus is a depot type insulin. Dose changes take longer to see the full effects. Sometimes 3 days or more.
    Prozinc is an in-and-out insulin. Dose changes are usually seen much quicker.

    Think of it as driving a speed boat (Prozinc) vs steering a huge cruise ship (lantus).
    Weigh the pros and cons. Lantus likes consistency in times more than Prozinc. Prozinc gives you a bit more leeway in the time of the dosing.

    I'd suggest you go to the Lantus ISG forum here, and read through all the "Sticky" or pinned posts at the top of that forum.

    Cost of lantus is higher, but you can order from Marks Marine Pharmacy to keep the cost down.
    You'll need different syringes too, since lantus is a U100 insulin and Prozinc is a U40 concentration insulin.

    There are no guarantees that Tom won't bounce as much on Lantus as he does on Prozinc.
    Look for @Patty & Teal'c over in the Lantus forum. She switched her cat from Prozinc to Lantus.
     
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  18. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    Ok thank you. I will do more reading and since he earned another decrease maybe we are moving in the right direction. Thank goodness for the pandemic for Toms sake. Ugh! Normally I am gone a lot But at least I am working from home most days to deal with this. My friends think I am Pure crazy and I want to be gone a few weekends in September so my neighbor will be dosing him then... Hoping he stabilized a bit by then.
     
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  19. Patty & Teal'c

    Patty & Teal'c Member

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    Nov 8, 2019
    Hi Mesacakes. Teal'c was also very bouncy on Prozinc, however I don't think Prozinc is a bad insulin, just didn't work for Teal'c. If you look at Teal'c's SS you will see a lot of red and blacks. If Teal'c even flirted with the idea of a blue, green, or yellow he would bounce. Deb suggested I consider Lantus and I needed to try because the bounces were tearing me up inside.
    I was able to outsource some Lantus while I worked at finding a vet who would prescribe Lantus for him. As you can see on his SS he would still bounce a lot. I started out SLGS because of my work schedule. On 5/3 on Lantus he hit every possible color. Started pink, then blue, green, back to blue, then red ending a 12 hour cycle with black. I didn't give up.

    As you scroll on down through his SS you will notice that soon enough the reds and blacks started to become less and less. The last red I recorded was on 6/26, the last black was on 7/3.

    On 7/3 is when I also decided SLGS was not working well for us, and even though it meant there are times I'm running on a wing and a prayer because of my schedule, it was a decision I had to make to switch to TR. Since that point we have seen the pink numbers all but disappear. Last pink 7/27.

    He is now a kitty that runs mostly blues and greens with a sprinkling of yellow. There are 3 things at play here. The switch to Lantus, the switch to TR, and on 7/17 I opened his first Lantus pen from his own prescription, one that was not outsourced from an individual.

    It wasn't like Teal'c's numbers changed right from the beginning of the switch, it still took time for his body to get accustomed to lower numbers, time and perseverance paid off.

    Also, I want to mention TR with a schedule like mine is not ideal. I would not suggest it to anyone. That's a decision everyone has to make on their own.

    Sorry so long.
     
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  20. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    Wow he was all over. Ok so I’ll give the ProZinc more time as even if I change it could take months. Bummer.

    Tom is not eating as well today and really yesterday too he was a little off. His eating has been reducing over the last week and I attributed it to his sugar being lower. He usually eats all his Sheba and some Tiki but didn’t finish his Sheba this morning. He did eat about 1/2 Small can of Tiki at lunch and was 115 before eating lunch. He is purring and kneading but didn’t inhale his food. So now I’m worried. I did make a vet apt for Saturday morning to address his diarrhea that I thought I had eliminated but it’s back. He has had diarrhea most of the pandemic. I thought it was the fish foods and changing his food but he has been steady on his Chicken foods for a while and it came back.
     
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  21. Patty & Teal'c

    Patty & Teal'c Member

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    Nov 8, 2019
    Didn't mean to chase you away from Lantus. The cost difference between Prozinc and Lantus is about $40 more for Lantus from Mark's marina in Canada and what I was paying the vet for Prozinc. Got the pens. Vet called Mark's and set up his prescription for me, it was easy. Also not sure why but the pens of Lantus last way longer then the vials of Prozinc. So I'm actually saving money with Lantus.

    Not even sure I could have gotten a handle on Teal'c's BG without switching to Lantus. He was on Prozinc for 5 months and still never gained control. 5 months on Lantus and it appears we now are in control of his BG.

    I personally think you should consider trying Lantus, I just wanted you to know don't expect it to happen over night if you make the switch.

    5 months Prozinc = no control

    5 months Lantus = well controlled

    Prozinc=$120 per vial thru vet

    Lantus=$160 5 pens thru Mark's marina

    5 Lantus pens last much longer then 1 Prozinc vial = savings.

    Just some things to consider.
     
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  22. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Thanks Patty, for giving your "2 cents worth". As someone I knew that had made the switch in insulins, I figured your input would be very helpful.

    Hope those night shifts are treating you ok.
     
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  23. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    So Toms numbers are still staying low today from his shot yesterday.... I could probably do one now at +5 but he is rising so slowly I would rather wait until evening, only 4 more hours.
    & Can I change his Shot time back up to 6:30 PM if he is high enough by then? Or do I need to stay with 9:30 even though I skipped this AM dose.
    Then what do I do about the actual dose? Give a lower dose unless he is Really high again at shot time?
    https://docs.google.com/spreadsheets/d/1N6uWa0dckCqQxw7e0qqOuka3ke2LoIj0Nk1xfOxPAYM/edit
     
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  24. Patty & Teal'c

    Patty & Teal'c Member

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    Nov 8, 2019
    Those are some pretty blue numbers for Tom today. Since you skipped today changing shot time should not be a problem.
     
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  25. Mesacakes

    Mesacakes Member

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    Mar 25, 2020
    So I shot my lowest number so far. He was 143 this morning just like two days ago when I skipped. So instead I reduced by 0.25 and gave him his shot. I’ll be home to check him through the day. So he got 1.5 units this morning.
     
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  26. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Keep low Tom. Keep low BG levels.

    Let's see some green numbers mid-cycle please Tom.That gives your pancreas time to heal and rest.
     

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