New DX, doing first home curve today, a couple questions

Hi Everyone,

This is my first post and first of all, I wanted to say thanks for all the information here. So far, I've learned more here than from my vet, and that's made this whole diabetes thing much easier to understand. God bless whoever came up with rice sock on the ear idea, that made testing a snap.

My 10 year old kitty Max was diagnosed last Thursday with a bg of 426. Last Friday he was at the vet's all day for a glucose curve with 1 unit Prozinc, and the lowest bg reading they got was over 500. The vet sent him home, said 1.5 units BID and come back in a week. We also switched his food at the time, per the vet, to Hill's wet M/D. I had already ready Binky's food list, and so I'm mixing that with okay foods from the list for now. Max was on Iams kibble. Once we get him regulated, we'll probably ditch the M/D, but for now, I want to do what the vet says.

Some background: there are 5 cats in the house and 2 ferrets. My 15 year old cat is on K/D, and the rest were on Iams kibble, which has now been banished from the house. My only prior experience with pet diabetes was with our dog when I was a teenager, and all I knew was how to give the shot and that she was to only eat her rx food. The dog lived for 8 years post-DX. I've had ferrets with all sorts of health issues and so was used to injections. Cats are way easier to inject than ferrets, thankfully.

The vet wants to see Max Friday for another curve, but Max is a total scaredy cat and I think doing a curve at home will be more accurate and get him on the right dose faster, especially since his first curve results were so high.

Yesterday the AlphaTrak glucose meter arrived, and we started home testing. (I've read here that lots of people use human meters, but the vet wanted the AlphaTrak, no matter where we bought it, and if he's more comfortable with that, so be it.) Our first bg reading, right before Max's meal, was 54. My husband and I were suspicious of that result, so we tested ourselves to see if the result was consistent two times in a row, and it was. Max's next reading, 30 minutes post-food, was 54. We were reluctant to give the shot at that level, so called the emergency clinic (it was 9 pm) and they said wait two hours, test again, then give the shot if the number came up. Two hours later the number was 175, so we gave the shot. This morning, pre-food, the bg was at 125, so we gave the shot as normal, but we're wondering what the heck was up with that 54 reading last night. That seems so low when Friday the bg was over 500, we were pretty concerned. Does anyone have any ideas on what could cause that?

Max is acting fine, more active than he's been lately actually, and the weight loss has stopped. There are still big bricks of urine litter clumps in the box, but less than before the insulin.

So we're doing a glucose curve ourselves today, and I have some questions. Is it better to test the bg every hour or two hours? What about treats after the tests--what's safe to give and will treats skew the results and should be avoided until he's regulated better?

Has anyone had experience with Prozinc insulin?

Thanks for taking the time to read this post, I know it's long.

Kira & Max confused_cat

 

Hi there!

wow, that is some change in bgs. Tell me, how was he diagnosed? Did your vet do a fructosamine?

Given the discrepancy in numbers, I'd bet that his stress at the vet manifests itself in higher bg numbers. I'd seriously consider a few things

1. no shot unless 200
2. cut the dose to 0.5 units
3. do that curve at home today and test every 2 hours...give treats as needed and as usual, but try to keep them low in carbs

You are soooo lucky that you are testing! Wow! Let us know how things go

Jen

 

Jen's answered most of your questions, so I'll just mention "healthy" treats for diabetic cats:

These have few or no carbs:
Freeze dried meat (cut into little bites) (salmon, chicken, bonito (fish))
cooked chicken
tuna (canned in water or oil)
cheese
cooked egg

Avoid gravy and grains, avoid stuff with sugar like ice cream or flavored yogurt - (plain yogurt usually has no sugar added)

Some people give a few Temptations - just be aware that they do have carbs and keep it to a few.

 

I can't add to the advice or treat information you were given, I agree with all of it. Just wanted to say hi and welcome. Looking forward to learning more about you and your kitty in the future.

 

There's really no reason to wait on the food. M/D is not good for diabetics. Just tell the vet Max won't eat it; they will refund your cost. It appears you have a kitty with major Vet Stress issues.

You are correct. Your home results will be more accurate.

Ugh! Yes, it's designed for animals, but so many vets think it's the only thing that works. So not true. And you are going to find the replacement strips extremely expensive, not to mention only available when the vet's office is open.

Wow! Wanna bet it's all because you removed the IAMS dry? You may just have a kitty who responds beautifully to a low-carb, wet diet!

I've put a shout-out over on the PZI Insulin Support Group. Prozinc has only been around for maybe three months. We have a few users who have been with it since the beginning, collecting data. They can answer this question much better than we non-Prozinc users.

 

Welcome. :smile:

ProZinc seems pretty similar to the old PZI Vet insulin. Many here have lots of good experience with the old PZI Vet insulin that transfers very well to ProZinc. I've found the two to be very similar if not maybe even the same. And there are a growing number here that are currently using ProZinc as well.

Also I would continue to make sure to be clear in your posts that you are using the AlphaTrak - maybe put "AlphaTrak" in your signature. As you are probably aware, the AlphaTrak is calibrated a little differently than the human meters. It's a good meter but the strips are expensive.

As for how to do curves.

There is some reading in here about doing curves:
http://www.felinediabetes.com/bg-home-test.htm

But to your specific question about every hour:
When I first started out, I can a couple FULL curves - every hour. Then I backed off to every other hour. Sometimes it is best to grab a set or a couple sets of consecutive hours, like +2,+3,+4 and/or +5,+6,+7. And sometimes it is nice to grab a curve with just every other hour. It really depends on what you are trying to nail down.

As for treats - as long as they are low carb treats then you are fine. Cats on ProZinc should actually be fed many times a day [10-20 perhaps]. Optimally, free feeding is best. Then one does not worry about how food effects the curve.

 

Wow, thanks for the fast replies!

I don't think the vet did a fructosamine test, just a regular panel. When he called me, he said blood sugar, so it was probably just that test and nothing else diabetes-specific.

I haven't been giving treats after the testing, so I guess I'll keep to the usual, just lots of love and chin scratches today. I don't want to skew the results if the vet will change insulin dosage based on them, you know?

Thanks for the advice on treats--Max has always loved tuna and the other kitties who are now on his feeding schedule do, too. After the curve today, tuna it is!

I'm glad you guys think doing a curve at home will be more accurate, too. I was a little nervous about taking so much of this in hand so soon, but Max still freaks out at home with normal loud noises that's used to, I know he's a stress-bomb at the vet's.

The Alpha-Trak--yeah, I saw the test strip prices, and our vet never has anything in stock anyway, but my mother works for a vet supply company and gets a decent discount, so the cost shouldn't be too much more. We did get the whole kit--meter, strips, lancets, at a much better price on Amazon than the vet's. I just know we're going to have to work closely with the vet, and if he's going to trust results better with one meter vs. another, Max can only benefit.

I certainly hope removing the dry food is the reason for the normal-ish bg results. It would be fantastic if he could be diet-controlled. After reading the food info at catinfo.org, I was so upset. We've fed IAMS all of our cats lives, because we believed it was high quality healthy food. And probably that expensive diet caused his diabetes. All of our cats are on low-carb wet food now, just trying to find the one they all seem to like. Feeding five cats three different diets is challenging.

How do I find the PZI support group board?

Thanks again everyone!

 

Here's a link to the PZI group.

viewforum.php?f=24

Or you could go to the top of the page, choose Board Index, then you'll see Insulin Support Groups, you should be able to choose PZI from there.

 

Thanks!

 

Welcome Kira & Max,
Sorry you're here, but glad you found us. You've already received good advice from others here, but please visit the PZI group: viewforum.php?f=24 The group is not terribly active, but you will find support from other Prozinc and PZI users.

Hope to see you there,
Ele & Blackie

 

Weatherford!

Kira! I just saw you are in Weatherford! (Did you just add that?) I'm waiving at you from my office on I-20 in Abilene! Do you see me???

mdmelvin1128 just joined, and she is in Odessa. So looks like we've got an I-20 corridor going on. We actually go through Weatherford quite frequently with either high school sports, or going to visit our son and DIL in the Keller area. Perhaps we can meet somewhere sometime.

And yes, we have several members in the Metroplex and Austin/San Antonio/Houston areas, but it's so exciting to have some members out here in West Texas! (Although I guess Weatherford is really on the edge of being East...)

party_cat

 

Just trying to get a handle on how much insulin he should have. We have no data right now, and the vet's suggestion of "try a dose, check in a week" makes me uncomfortable when I'm able to home-test.

Free-feeding would be easier, but I'm not sure how I can do that now since the diet that's okay for Max + the other three cats isn't what my 15 year old cat is on. I didn't know cats on ProZinc should eat that much more often. Maybe I'll have to segregate him a few times a day with food?

 

Given those low numbers, I'd consider 0.5 units if he's over 200

And that KD for your older cat, is it KD dry? it is a horrible food for any cat let alone those in renal failure ...see www.catinfo.org

 

Re: Weatherford!

I did just add that. I'm about five minutes off I-20, but since Weatherford is only 20 minutes from Ft. Worth, we kinda get lumped in with the Metroplex. My best friend lives in Keller

 

Is it okay to change the dose this soon after starting without the vet's input? I just don't want to cause more problems that we began with.

The K/D is wet, and the older cat, Samoa, hasn't tested in renal failure, but the vet put her on it as a preventative. She was getting both wet & dry K/D until I read catinfo.org; now exclusively wet.

 

You want your vet to be your partner. However, with such low numbers, you can safely lower the insulin dose (as long as there are no other health issues) and test for several cycles to see what happens. Then you take your data that you've compiled and say, "I just wanted to show you how well Max is doing on .5u bid!"...

It's increases in dosage that you have to be very careful about.

 

> Feeding five cats three different diets is challenging.

I know you have a diabetic and a kidney cat; not sure if the third diet is a different medical problem or just what you feed your 'normal' cats. But there are folks here who have diabetic cats with kidney disease and there are foods that will work for both problems. I know you've overwhelmed with diabetes at the moment but, when you have some time, you might want to check out Melissa's periodic CRF post here http://felinediabetes.com/FDMB/viewtopic.php?f=3&t=4983.

 

Depends on how closely you want to work with your vet; it is not required to feed a preventative diet like KD, even KD wet. If you've read Dr Lisa's page you should know that a canned or raw diet that has moderate high quality protein is the way to go...so if you don't want to feed KD you don't have to. Just watch that you don't feed foods that are high in phosphorous.

 

Hi - I have 3 cats - one diabetic in remission, one with early kidney disease, and one without issues.

Regarding feeding, since I didn't want to go crazy in that area, I've come up with a three choice buffet for all my cats. It's all wet food, low carb - for diabetes, and low phosphorus - for kidneys. I let them free feed and choose what they like from the buffet.

I don't use any prescription foods, as I find it overpriced and I can get better quality foods from the store, using Binky's chart.

Regarding the meter, for the heck of it, why not pick up a human meter - you can get a cheap one at Walmart - Relion brand - they use smaller amount of blood than alphatrack and are cheaper and do some tests with it and double check the results. You may find you like the human meter better and can get strips easier. Then you don't need to tell the vet that you're not using the alpha, just bring in your spreadsheet that you can create in google docs.

Directions are in the tech forum for spreadsheet creation and linking.

Yes, you can change the dose without the vet's approval. The point of home testing is so that you collect data and can make informed decisions about when and how much to change a dose.

After all, you don't want to stick with a dose that may be too high (or low) and have hypo or DKA issues.

Speaking of which, do you have ketostix? If not, go to any pharmacy (even walmart) and pick up a container. This is used to test if there are ketones in the urine. A necessary testing tool. Once you get it, we can help you with how to collect urine to test.

I used to catch Maui while going and put it under her and let her pee on it. There are other methods if that doesn't work for you.

Just some things to think about.

 

Hi Kira, welcome to the board! You've already gotten some great advice and it really sounds like you are on top of things. Good for you for being so proactive in your reading and for home testing already. That is really awesome; you're way ahead of the game.

Keep up the good work and give all kitties and ferrets some extra chin scratches!

 

I haven't turned up much info on low phosphorus foods. Would you mind sharing where you found that info or what you feed? Your solution sounds like a good one. I would love to have all 5 cats on the same diet. One of my "normal" kitties is really upset with the change to 2 meals a day.

Informed decisions about changing a dose--I wish I had a chart that said "if bg is X then shoot Y." We just don't know how much is too much or too little or what yet. Maybe after the curve test today we'll have a better idea.

Thanks!

 

Not at all :smile: Click on the "Home Cooked" in our signature - I mix 50-50 with Wellness Turkey. It makes for a relatively lower phosphorous, low carb, medium fat and higher protein food. :smile:

 

> I would love to have all 5 cats on the same diet. One of my
> "normal" kitties is really upset with the change to 2 meals a day.

We use Wellness Grain-Free Chicken for our cat (diabetic and CRF).

The two meals a day thing is generally to make sure that the diabetic cat will eat around injection time and is much more important for cats on 'harsh' insulins like Vetsulin / Caninsulin, NPH< etc. When we started using insulin, we just kept free-feeding.

It's also easier on the diabetic cat. Diabetes means they can't digest their food properly, so their bodies (legitimately) report that they're starving and should eat lots. Once the diabetes comes under control, their appetites get back to normal. In general, a lot of us free-feed.


> Informed decisions about changing a dose--I wish I had a chart that said
> "if bg is X then shoot Y." We just don't know how much is too much or too
> little or what yet. Maybe after the curve test today we'll have a better idea.

Every cat reacts to insulin differently; worse, every cat reacts to every *different* insulin differently. And, yes, right now, you're starting to collect the data that will help you make dosing decisions based on how your cat reacts to your insulin.

 

It's a good thing we are collecting the data--this has been an interesting afternoon. An hour and a half ago his bg was at 45. We fed him and twenty minutes ago it was 62, so it's heading upwards, but man, is he getting too much insulin. That could have been very bad if we'd done what the vet said, just wait until this Friday and bring him back for a curve then.

 

Wow! yes, it soon becomes apparently that hometesting really does help!

as for phosphorous content, look on janet's charts for foods under 200 in the phosphorous column...

 

SO glad you are hometesting!

 

You and me and Max both! That could have been an emergency vet visit by this evening, I think. We got the vet on the phone and are dropping his dose to 1 this evening, assuming he tests above 100. And the vet finally gave us a target range of 100-200 today, the first we've gotten.

 

Just to clarify, you are planning to give 1u of insulin if Max's BG is above 100?

 

Good job on the testing!

I switched Calliope to the no grain fancy feast varieties and returned the vet food to the vet's office. I simply told her I'd decided to go with a lower carb all wet diet. Well, she didn't really agree with me, but about a month ago, she called me and asked me to give her the list of the no grain FF flavors, so she could give it to a new client with a diabetic kitty! She's coming around.

She also told me to start with 4 units of insulin BID. I started with 1u and never went up. After the food switch and a little insulin, Calliope went off the juice in about 18 days. It happens sometimes with food changes and just a bit of insulin therapy. No guarantee we will stay this way, but we've enjoyed it while it's lasting...about a year and a half, so far. Vet was amazed. I simply told her I was too afraid to start that high and when I got to testing, we would see. It took me a while to test because Calliope didn't take to that very well, to say the least. I won't get into that journey! Anyway, the vet knew I was testing for ketones, even though she didn't tell me to do that. Another thing that impressed her.

Bottom line, I didn't listen to anything the vet recommended other than the fact that she told me that hometesting was an absolute must and that I should get a human meter rather than the alpha track because even she said it was too expensive. She also said I needed to test at home because Calliope was so stressed at the vet that we wouldn't get accurate readings. No doubt about that.

My vet is now used to the fact that I may well go my own way on some things. She works with me, on that, because she knows I do my homework. I just recently convinced her to let me give adaquan shots to Calliope at home. I'm the first client she's allowed to do that. She knows how much Calliope stresses at the vet's office, so that was part of the persuasion, plus I sent her info and the name of another vet in my area who would let me do it, if I switched. Ha! As difficult as Calliope is at her office, I'm sort of surprised she didn't tell me that I could switch! :lol:

What I learned is that vets are not all knowing. Neither are human docs. I've had to diagnose myself twice after seeing multiple docs about a few issues, who either misdiagnosed the issues or just couldn't figure it out. They weren't bad docs. These were unusual occurrences. It's okay to question the vet and it's okay to go your own way, if you've researched and you know what you're doing. Your cat's treatment is ultimately your decision and not the vet's and not ours.

Calliope was recently diagnosed with CRF, early stages. I'd switched all the kitties to FF gluten free varieties, but now, Calliope is eating the Wellness and Friskies Special Diet. She likes to have her bowl in certain places, so she hasn't really gone to the other bowls to eat the other food. That's why I haven't had to worry about that, yet. This is brand new to me, so I'm just learning. It took me a while to get all the other cats on board with the wet foods. Initially, a few of them weren't too excited. I switched the dry food to EVO kitten because it was lower in carbs than other dry options and they begin to eat both the dry and wet until one day, Calliope found out where I was feeding the dry food, which was on top of a table. She had neuropathy with the FD, so she couldn't jump up there, but she sure figured out how to jump after she was off the insulin and back to her old self. That was the day that they dry food went away!

 

Also not true! You can get the strips online for $51 for 50 via Amazon, not just at the vet's office. (Yes, this still costs more than human meter strips, but I'm so annoyed that every thread lately has something untrue about the Alpha Trak simply to make vets look bad and people who buy them look like dummies.)

 

Yes. The vet today suggested we go to 12.5, but after seeing that bg 40 test, we want to go down more.

 

>>>Also not true! You can get the strips online for $51 for 50 via Amazon, not just at the vet's office. (Yes, this still costs more than human meter strips, but I'm so annoyed that every thread lately has something untrue about the Alpha Trak simply to make vets look bad and people who buy them look like dummies.)<<<

That was not my intention at all. I should have known the strips would be available online now. Glad to hear there is an economical means.