Do I keep upping insulin?

[Felix and Ron]

What to do?

 

[Critter Mom]

Hi Ron,

I've not used Prozinc so I can't suggest anything. I'm tagging Sue to see if she'll have a look at Felix's numbers and hopefully suggest something to help.

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Hi @Sue and Oliver (GA) - When you get a chance can you have a look at Felix's spreadsheet, please? (Prozinc - very high numbers).

 

[Robin&BB]

Hi, Ron - I'm looking at Felix's spreadsheet, and am not seeing any AMPS/ PMPS BG# on it since the morning of 8/4. Are you testing him before every shot? As this is essential for your cat's safety ...

If you have been testing, please plug those #s (and any others you may have written down) into your SS. This data will help us to help you figure out what's going on with Felix.

 

[Sue and Oliver (GA)]

Hi Ron,

I am not sure what to think about Felix's numbers. They do seem high, but I wonder what his pre shot tests are like. We highly suggest that you get a test before each shot, before food so you know where he starts, and whether his number is high enough to shoot. Could you get a pre shot test tonight before you dose?

It is possible that he needs more insulin but I don't know for sure. The period he was on one shot a day was not good - insulin lasts only 12 hours in cats, so he could have spent a lot of the time in high ranges and gotten used to them. The other thing I see is that he got better numbers at lower doses. I wonder whether you went past a good dose and now he is getting too much insulin.

More data - especially pre shot numbers- will help us figure Felix out.

 

[Robin&BB]

Would also like to know:
- Is Felix underweight/ overweight? Do you know what his ideal weight should be?
- How much food does he get each 24 hour period (in either cans or ounces)? It's great that you're feeding low-carb Fancy Feast, btw!
- As you've been to the vet recently, I would assume they've found no other health problems; is that correct?
- Have either of your vets looked in your kitty's mouth/ or suggested a dental cleaning? (As untreated gingivitis can make it hard to get a diabetic cat regulated. And some vets don't even think of this when treating for diabetes. I know that sounds crazy, but it happens.)

 

[pevsfreedom]

Hard to tell anything without pre-shot test #'s. I'd try to get at least amps/pmps and a +5 during the day and +2 at night before you adjust any more.

 

[Robin&BB]

Ron, I hope I didn't overwhelm you with my additional questions above ...
Am wondering if your vet may have discouraged you from regular testing? Because some vets do; and I think everyone here would agree that some vets don't know as much about effectively treating feline diabetes as we'd all hope they all do. (They're only human, like the rest of us; and sometimes they really don't know everything.)
So just wanted to say: Everyone here just wants to help you as much as we can so that you can get Felix's diabetes under control. We all know how confusing this can be; we've all been there.
Give Felix a scritch under the chin for me, ok? - Robin

 

[Felix and Ron]

Thank you everyone. The +10 I had on the SS should be PMPS. No other health problems. Did not have vet check for gingivitis. He eats 3 to 4 cans per day and weighs 15 lbs which is a decrease of 3.4 lbs since diagnosis. Not sure how to determine ideal weight. My vet is all for home testing and yesterday suggested bumping him up to 5. It is hard for me to do AMPS since I leave house at 5:30 am but will try tomorrow. I am going to stay with 4 next few days. Is it possible too much insulin could cause high BG?

 

[Critter Mom]

Here's a body condition chart to help you assess Ron's weight.

 

[Critter Mom]

Is it possible too much insulin could cause high BG?

Yes.

Too much insulin can look like too little insulin.

Insulin allows glucose in the bloodstream to enter cells where it is used as energy to fuel normal bodily functions. If there is too little insulin, the process where glucose passes into the cells is impaired and the glucose just builds up in the bloodstream until such time it reaches a concentration where it tips over into the urine and some of it is excreted from the body.

If there is too much insulin in a cat's system the body's counter-regulatory mechanisms kick in to dump glucose into the bloodstream to protect the cat from hypoglycaemia. (Glucose is produced either by breakdown of the liver's glycogen stores, or the liver breaks down other nutrients to make more glucose if necessary.) This counter-regulatory response can also increase the concentration of glucose in the blood.

Testing at every preshot and regular tests at appropriate times mid-cycle will help to determine what is happening with Felix's BG levels and how any given dose is affecting him.


Mogs
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[Robin&BB]

Thank you everyone. The +10 I had on the SS should be PMPS. No other health problems. Did not have vet check for gingivitis. He eats 3 to 4 cans per day and weighs 15 lbs which is a decrease of 3.4 lbs since diagnosis. Not sure how to determine ideal weight. My vet is all for home testing and yesterday suggested bumping him up to 5. It is hard for me to do AMPS since I leave house at 5:30 am but will try tomorrow. I am going to stay with 4 next few days. Is it possible too much insulin could cause high BG?

Hi, Ron - Am glad to hear that your vet endorses home testing. As others have noted above, is hard to know what's going on and how to adjust dose when there's so little data to tell the story.I know you get up early and I don't know how long you're gone before returning home. But as ProZinc is usually shot twice a day with the shots 12 hours apart, I would hope you are able to test - pre-shot - every 12 hours. I don't know if you can arrange to have anyone else do additional tests for you during a cycle, but if not, could you possibly accomplish that, say, over a weekend when you're not working? Just summarily upping a dose of insulin without data to show that this is prudent is playing with fire, IMHO.

I'd also recommend you get a scale & weigh Felix weekly. (If you already have a human-type scale at home, you can weigh yourself, then pick up the cat & weigh again, then note the difference. That will do in a pinch if you don't want to get a baby scale in which to weigh him.) Sounds like Felix used to weigh about what my cat used to weigh (obese); and that Felix may, in fact, still need to loses perhaps 2-3 more pounds. To give you an example: My cat maintains her 11 lbs. at only 7 oz. of Fancy Feast daily - that's about 2-1/3 cans every 24 hours. If your cat is not all that active, keep in mind that the "recommended" daily amount on the can may be too much ration for your cat - esp. if he is still overweight. Also keep in mind that your cat will feel extra-hungry until his diabetes is well-controlled; is something that we just have to deal with for a while (I know how sorry I felt for my cat when she fussed so much at the change in rations at start of treatment).

 

[Felix and Ron]

Thanks again. Felix is a large cat. My daughters cats are smaller and of course way less. Body condition chart is helpful. He may need to shed another pound. I was able to test at + 5 this morning and will pre shot test tonight and then +2. Will pre shot test in morning as well and see if my wife will test at +5. All the PMPS I have done Felix is always around 500. Will keep him 0n 4 units and test as much as possible this next week. Need to get a grasp of which way to go. Frustrating!

 

[Robin&BB]

Need to get a grasp of which way to go. Frustrating!

Oh, I know, Ron - the first few months can just about drive you crazy. Sounds like you have a good plan going there about the testing!

Does Felix live with your daughters' cats? If so, is there any chance he's been getting into their food when no one is looking? (These diabetic cats can be so clever. And sneaky.And determined to snatch food from wherever they can. )

 

[Felix and Ron]

No but we have two other non diabetics in the house. So it's a struggle.

 

[Robin&BB]

No but we have two other non diabetics in the house. So it's a struggle.

Best way I can think of to handle that: Feed them all at the same time; feeding Felix in a separate room if necessary, and not letting him out until the others have finished their meals. So if the others free-feed now, you'll need to find a way to change that. Because any time Felix manages to get into additional chow (even a few quick bites out of one of the others' bowls) can impact his BG #s significantly. If that's happening, it may be a piece of the puzzle re: not getting him under control.

I realize that's not always an easy thing to do in a multi-cat household , but may be necessary for Felix's successful treatment. Helps to think of the food as "medicine," too, while treating a diabetic: It can either work with the insulin, or against it.)

 

[Sue484]

Helps to think of the food as "medicine," too, while treating a diabetic: It can either work with the insulin, or against it.)

I've found that out. Frankie used to love the Felix chunks but his BG was always a lot higher than when he is on the Felix Senior food. My other sugar cat Romulus it was the other way around!! Plus I've found out that if I give Frankie a really good meal at his shot time and then another about 2 hours later before the Lantus kicks in, it satisfies him all day/night and it doesn't affect his BG too much. Rom I have to feed again at about +5 or 6 to keep him low, but he is on Caninsulin. You just need to work out what works for your kitty.

 

[Robin&BB]

I've found that out. Frankie used to love the Felix chunks but his BG was always a lot higher than when he is on the Felix Senior food. My other sugar cat Romulus it was the other way around!! Plus I've found out that if I give Frankie a really good meal at his shot time and then another about 2 hours later before the Lantus kicks in, it satisfies him all day/night and it doesn't affect his BG too much. Rom I have to feed again at about +5 or 6 to keep him low, but he is on Caninsulin. You just need to work out what works for your kitty.

You're so right, Sue! ECID ... and you find out, over time, what works with the insulin (or doesn't) in feeding your own unique diabetic kitty for better glycemic control. With Bat-Bat, I've learned that even a low-carb content of a few more percentage points can deeply impact her BG#s. There's simply no way I can feed her anywhere near 10% carbs - I need to keep her on canned formulas that are 3% to 4%. She's pretty insulin-sensitive now, too. (Which makes it a real eyeball challenge to squeeze out those mini-doses that are under a half-unit, even with a U100 syringe!)