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Ashley82

Ashley82

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Most of these forums are based in a different scale then the one used in Canada. Here we go based on mmol/L. The goal is 4-9.5

Citrus started on insulin (ProZinc) Feb 20th this year after being sick since September. I had already switched him to a higher end low carb diet starting around October (mainly wet food access to kibble) Feb 10th he started on the prescription wet food and kibble.
His sugar at the vets office was 19.7 and there were no other concerns in his blood work.
The instructions I received was once a day at the same time give him his insulin. Wait 4 hours then check his blood sugar. He is to receive food with his insulin. No pre shot testing is required.
Units are based on the U-40

Here's the low down
Feb 20th 2 units at 2215 24.0mmol at 0200
Feb 21 2 units at 2045 16.4 at 0115
Feb 23 2 units at 2035 16.8 at 1215 excessive hunger (back to the pre illness ways)
Mar 3 2 units at 0840 23.3 at 1250 (more energy, very hungry, hiding)
Mar 4 3 units at 0830 19.9 at 0100
Mar 13 3 units at 0830 16.6 at 0030 (fur is stringy. possible weight gain)
Spoke with vet. Still too high. Increase dose
Mar 14 4 units - not in town for a few days to check sugar
Mar 20 4 units at 2100 23.4 at 0130
Mar 21 4 units at 0830 26.2 at 1230

What is going on? Why does he keep going up rather than down?
He looked to be doing better but not quite there yet Mar 13... and now he is worse again??
His diet is pretty regulated. He gets 1/2 can in the morning and 1/2 can with his shot. I give him 1 piece of freeze dried liver after checking his sugar. He has limited (measured) access to prescription kibble during the day (have to leave something out for the other cat)
I dont know how much longer I can do this if he doesn't move in the right direction.
 
Ashley82 said:
Most of these forums are based in a different scale then the one used in Canada. Here we go based on mmol/L. The goal is 4-9.5
Click to expand...
Hi Ashley,
I just replied to your other post in the main health forum.

Regarding the different numbers used, the US uses a different system of measuring blood glucose (mg/dL). So those of us in the 'rest of the world' just need to multiply our numbers by 18 to get the US equivalent (and conversely we divide their numbers by 18 to see what they'd be in mmols).

Eliz
 
Hi again, Ashley,

I've just rejigged your testing data a bit here to see some aspects of it more clearly (I've put '+4' to show that the tests were done 4 hours after the shot (I realize though they weren't all done exactly 4 hours later))

So, essentially, Citrus is getting one shot of Prozinc a day, and has one test approximately 4 hours after each shot. And the vet raised the dose on the basis of that test result not coming down?

Feb 20th, 2 units; + 4, 24 (432)
Feb 21, 2 units; + 4, 16.4 (295)
Feb 23, 2 units; + 4, 16.8 (302)
Mar 3, 2 units; +4, 23.3 (419)
Mar 4, 3 units; +4, 19.9 (358)
Mar 13, 3 units; +4, 16.6 (299)
Spoke with vet. Still too high. Increase dose
Mar 14, 4 units - not in town for a few days to check sugar
Mar 20, 4 units; +4, 23.4 (421)
Mar 21, 4 units; +4, 26.2 (472)

In a nutshell, there isn't enough data to be able to see what's going on with Citrus.
One test a day can't give the amount of info that's needed. It may be that his blood glucose is dropping low at certain times and these lows just aren't being picked up.

I am a bit concerned that the insulin dose may have been raised too fast. The dose has been raised in whole unit increments on the basis of, what appears to be, very limited data.
But, if you are willing, there is much that you can do to help the situation. And it is great that you can hometest!:)

First off, as I said on your other thread, the insulin shots need to be given twice a day, otherwise Citrus may only have insulin in his system for half the time.
Then, I would strongly advise that you test before every insulin shot.
A preshot test will let you know whether it's 'safe' to give that shot; and it will give you a baseline number that puts any other tests you do during the cycle in context (you'll learn how low and how fast his blood glucose drops on a certain dose).

Do you know when Citrus has his lowest number? (Typically, it may be between 5 - 7 hours after the shot, but we have a saying here that 'every cat is different' (ECID).)

There is every chance that Citrus's situation can be improved.
But in order to understand what's going on with his blood glucose levels we do need to see more data.
Are you up for doing some more tests?

Edited to add; FYI, here's the link again to the Prozinc user guide (there's a lot of useful info here):
Protocol for ProZinc/PZI

Eliz
 
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I'm with Elizabeth 100%. ProZinc has to be given twice daily. One shot is like riding a roller coaster from highs to lows. BUT I would suggest dividing the dose you are now giving in half and giving two times a day, 12 hours apart. Testing before each shot and food twice daily will give you some valuable data as will a test in the 5-7 hour range. Getting rid of the kibble would be a good idea, if he will eat just the wet.

We would be glad to help you with him if you can get us some more data. If you want to get a spreadsheet set up (it's color coded and a wonderful tool to keep track of his levels) I can help you do that. We have an international version that will easily convert from metric to US. Just click on my picture and start a conversation with me.

It is completely overwhelming at first, but once you start seeing his pattern and how the insulin is working, you will feel so much more in control.
 
I'm with Eliz and Sue on this. ProZinc doesn't work great if you're only giving it once a day. It's supposed to last roughly 12 hours...so if you give it just once, there's 12 hours in there that the insulin isn't helping. The fact that you can test at home means that you're already ahead of the game. That was the hardest part for me. Next up is getting that spreadsheet set up. I know it seems like an extra thing to do, but it really helps us. We're all used to looking at numbers in that format and the colors on the sheet sometimes help us to locate patterns we wouldn't see otherwise. Plus, it's an easy way to keep your cat's BG numbers together so that we can always look back and see the numbers in the past.

I KNOW it seems overwhelming. I remember thinking there was no way I could do this. All the testing, shots, interpreting the numbers I got, seemed like too much. But it quickly became routine. It was no more than a few extra minutes of each day to get the tests I needed and come here to get some great guidance on what to do. We'd love to help you with this! Some more tests will definitely help both you and Citrus feel better. :)
 
Twice a day is not feasible at all. I work out of town 17 days of the month and live alone. So am paying some one to come in ($20 a shot) already for the once a day and doing it myself the other days.

I can do more testing - what times?

Kibble is there for the other cat. Tried having them both on wet food but it became too expensive ($5/ day for the good stuff) and half the time they weren't eating it.

I am not sure how much longer I can do this. I have to stay home to give him the shots or change my schedule. I am upwards of $450 between the food, help and insulin.
He is jumping over the cat litter to urinate on my furniture. And I am going to be putting my house up for sale-- can't have cat pee all over the place.
 
Should I cut back to the 3 units? It was giving me the best numbers (although not ideal) and he was putting on weight and being more energetic.
How long between changes of doses when still trying to get the cat stable?
 
My cat Goof, gets one shot a day, of ProZinc. Don't ask me why, but it works for him. His numbers run very close, well with in acceptable range. He gets 2 units, but have recently dropped to 1.5 due to feeding a lower carb dry food, wet makes him vomit. From everything I've read on this board, he seems to be the exception to almost every rule. When he was first diagnosed, his BG was 658. He's really active at night, when I'm trying to sleep of course :( so he must be burning the sugar off.

Try not to get discouraged, it's going to take a while. Maybe a friend would learn to do the shots and help you out? Once you get him regulated, it'll be much easier. The pottying is most likely because he doesn't feel well and so it's causing behavior issues, that's how cats take out their frustration and stress.
 
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Yes, Mog would certainly be an exception. Most often the cat responds well to the dose for 12 hours and then is left in high numbers for the next 12 hours, creating a real roller coaster effect and making the cat feel lousy, bouncing from highs to lows. I would be interested in seeing your numbers. If you want help getting him in better ranges, just ask.

You are in a difficult situation, Ashley. Most people here try to get the ideal situation for their cat in hopes of getting them into remission. So twice daily shots and low carb food are what they work toward, hoping that their cat will eventually go off insulin. Not everyone has that chance because of work and finicky eaters. It depends on what you can do. You might look at training a high school student who wants to be a vet or scientist and see if he/she can help you out with the second shot/test. There are pet sitting services that offer special care for special needs cats. And I would take the days you have off work and try the two shots, getting levels as often as you can. (Any day you can get a number 5-7 hours after the shot will help you see how low the insulin might be taking him.). One day, getting a curve would be very helpful -- getting numbers every 3 hours or so during the cycle. That'll show you when he starts to drop and when the insulin starts to wear off. That'd help you see what is really going on with the insulin and might be encouraging. If you can get that kind of data for us, we'd be glad to try to help.
 
Just wanted to say ... I'm sorry to see that you're in such a tough spot, Ashley - particularly given your work situation.

I hope some of the suggestions that Sue and others above have offered turned out to be viable for you. But if none of those ideas are workable for you - as hard as it may be - you might want to consider seeing if there is some kind soul in your area, someone well-versed in effectively treating a diabetic kitty, who would be willing to take Citrus in (i.e., foster care), at least until he gets well-regulated. It just doesn't sound as though 1 dose/day will work for him. I think, based on the experience of most people of us here, it's a rare cat who can stay even on a single dose of ProZinc every 24 hrs. (Also, you have no way of knowing if he's gobbling up the kibble left out for your other cat when you're not there, which can certainly factor into higher numbers ...)

Again, you have my sympathies for the untenable position you're currently in. My best wishes to you - and for finding the solution that helps Citrus get well.
 
Is there another brand of insulin that would work better for the one dose a day?

In a few months we will be living together again. But even then with 12 hour shift work plus not always being able to leave work right away, there is no foreseeable way to give him twice a day shots.

As for how he is doing. He is still going out of his way to urinate all over the house. Walking right past the litter box to do so.
I have him up to 5 units and 1 day his sugar was in normal range. Otherwise continues to get higher rather than lower. The vet can't figure out why

Thank you for checking on me guys and gals.
 
Please understand that for a diabetic cat, it isn't about "going out of his way to urinate all over". He literally can't control it. The high glucose goes out through the urine, drawing water out of the body. The high glucose damages nerves that enable control of the sphincter, too. The high glucose also makes it easier to get a bladder infection, which results in the need to go, go, go, too. This isn't something he's doing willfully.
Diabetic nerve damage, or neuropathy, can be painful too, and if pain is associated with the litter box, he'll avoid it.
 
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I'm sorry things are so rough right now. Like BJ said, he literally can't help it. I know how frustrating this is.

Have you found anyone who could give shots for you? I don't think any insulins work well once a day except in rare circumstances.
 
Ashley82 said:
He is still going out of his way to urinate all over the house. Walking right past the litter box to do so.
Thank you for checking on me guys and gals.
Click to expand...
Don't know if this applies in your case, but I noticed you mentioned in first post that you have another cat ... anyway, I just happened to stumble upon an episode of "My Cat from Hell" in which the owners had the same problem: Cat peeing/pooping everywhere but the litter box. Turned out (after cat behaviorist set up camera trained on the litter box) that the other cat was attacking her - only when the owners weren't around - every time that poor kitty attempted to get into the box! (Maybe some cats don't like sharing ...)

You might try separating your 2 cats - just for a few days - giving each their own litter box, to see if that makes any difference? Yeah, I know that sounds like a hassle, but ... might be worth a shot.

And speaking of pain, if your kitty has any nerve damage (as mentioned above by others) or hip dysplasia, it can be quite painful to step up into a litterbox. So might try cutting down the opening a bit on his own box to see if that could be why he's not inclined to use one.

I hope things start looking up for you soon.
 
Citrus 95% of the time is using the litter box now... so that's good. Occasionally likes to randomly pee on the floor.
We are now up to 6 units once a day of the ProZinc and his sugar is still out of range.
His fur is gross looking and falling out like crazy. No improvement seen with the diet change and the insulin.
The vet doesn't know why he would be having a reaction that is opposite of how insulin is suppose to work.
Out of ideas so am just keeping going on this hamster wheel.
 
So long as you tell yourself he is doing it on purpose, you are going to feel angry and resentful.

I doubt he 'likes' to pee outside the litter box. I suspect he may have a bladder full to bursting when he goes because the kidneys filter out some of the excess sugar in the blood and excrete it in the urine. The higher the glucose, the more the kidneys do that. He also may have some diabetic neuropathy - nerve damage from the excessive glucose levels - that make controlling his bladder difficult.

Maybe look for a pet sitter, a pre-vet college student or an off duty vet tech to come do a 2nd shot per day.
 
Insulin only lasts 12 hours in a cat's body. (Any exceptions to this are very, very few). Yo see how this regime might be working in Citrus, you could get some bg numbers during the day and night. Most likely he goes down in the 5-7 hours after the shot. By 12 hours after the shot, he likely is in higher ranges and will remain there, climbing until the next morning shot. To see if this is what is happening, on a day when you can, get a number in the 5-7 hours after the shot, then at 12 hours after, then +15, +18 - whenever you can get a number overnight.

If this is what happens with the insulin, you and the vet can see that giving a shot once daily isn't going to work. Increasing the amount of insulin just affects the cycle right after the shot and might be bringing him down too low in the first cycle and cause a bounce into higher numbers in the last 24 hours.

I understand your situation but unless you find a way to give two shots daily, I don't see any way to improve his numbers. As others have said, maybe train a scientifically minded teenager or a friend or relative to give the second shot?
 
Sue and Oliver (GA) said:
Yes, Mog would certainly be an exception. Most often the cat responds well to the dose for 12 hours and then is left in high numbers for the next 12 hours, creating a real roller coaster effect and making the cat feel lousy, bouncing from highs to lows. I would be interested in seeing your numbers. If you want help getting him in better ranges, just ask.

You are in a difficult situation, Ashley. Most people here try to get the ideal situation for their cat in hopes of getting them into remission. So twice daily shots and low carb food are what they work toward, hoping that their cat will eventually go off insulin. Not everyone has that chance because of work and finicky eaters. It depends on what you can do. You might look at training a high school student who wants to be a vet or scientist and see if he/she can help you out with the second shot/test. There are pet sitting services that offer special care for special needs cats. And I would take the days you have off work and try the two shots, getting levels as often as you can. (Any day you can get a number 5-7 hours after the shot will help you see how low the insulin might be taking him.). One day, getting a curve would be very helpful -- getting numbers every 3 hours or so during the cycle. That'll show you when he starts to drop and when the insulin starts to wear off. That'd help you see what is really going on with the insulin and might be encouraging. If you can get that kind of data for us, we'd be glad to try to help.
Click to expand...


I was just reading thru some old posts and saw you reply. I'd love to put my spreadsheet up, but I can't figure out how to do it. I've read thru the instructions at least 10 times, can't figure it out. I'm so electrically illiterate!
 
I know this is a difficult situation for you, Ashley. I understand you can't give insulin twice a day, but it may be (probably is) that this is the only way Citrus will start feeling better. The reason he isn't responding to insulin the way he is supposed to is almost surely because it isn't being given twice a day like it needs to be. All the symptoms you have listed (hair falling out, peeing outside the box, etc.) are signs of diabetes that isn't controlled. Have you found anyone willing to give a second shot for you? If not, please know that Citrus is likely not going to improve. I know this sounds harsh, but we are trying to help, and what you are doing doesn't appear to be working. Try getting the numbers like Sue said...see for yourself. We'd love to help, but we can't if you won't let us.
 
In order to keep it all together I thought I would post the update here.
Citrus has been on Prozinc since February. We made it all the way up to 6 units once a day before I was able to get additional assistance. Thank you very much to this group for helping me find someone!!:cat:
It has been a month that Citrus has been on twice a day Prozinc shots. 3 units in the morning and 3 units at night and we continue with the prescription food.

His sugars are still all over the board. We go from 9.9 (which is right on the money) to the next one being 35 despite nothing changing.
I took him back to the vet and it has been discussed to change him to the Lantus for the twice a day shots and see how that works. He did manage to get 2lbs back.

Here's the big problem. His hind legs are weak, he isn't walking properly, he is having a really hard time with stairs and definitely with jumping. He seems off balance.
Does this go away? Or am I just leaving him in pain?

We are about to move as well and the boxes are causing plenty of stress on all of us. Plus the new place has more stairs...
Looking for some input from others as to whether or not this gets better... or am I being selfish and letting him suffer
 
Glad to see you back. So you are giving two shots a day? It'd be helpful to see what your preshot and nadirs look like. Does he drop 5-7 hours after the shot or is the cycle flat and high? If you'd like some suggestions re dosing, please give us some numbers to look at.

Neuropathy is pretty common in diabetic cats. You can use Methyl B to help, but generally getting the blood glucose levels is important also.

http://petdiabetes.wikia.com/wiki/Neuropathy

Let us know how we can help.
 
When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback without having to go look in all your past posts.

Editing your Signature

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Add any other text, such as
your name,
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Always click the Save Changes button at the bottom when you have changed anything.
 
Hi Ashley. Regarding the weak back legs (neuropathy), they can improve. Merlin had severe neuropathy when he was first diagnosed. He could hardly walk and most of the time, he would only take a few steps before he had to sit. We also had to lay down a bunch of rugs on our tile so he could get better footing because he kept sliding and didn't have any control of his legs. I gave him Methyl B for the first six months of starting my spreadsheet and then I quit giving it to him mostly because I really wasn't seeing any improvement. After another six months, his walking started to improve and after about a year and a half after he was first diagnosed, he is back on his toes and you can't even tell that he had neuropathy. I believe it was mostly due to improving his numbers. I didn't think they could ever improve, but they can.
 
Hi Ashley,
Mitz has been on Zobaline for a few months. It did take about a month to really start seeing improvement but it has definitely helped her. I just dissolve the pill in a little water and stir it into her wet food. Good luck with the move!

Joan
 
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