Glucose increasing rather than decreasing after Prozinc injection.

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Chicklet's mom

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Hello,

I completed a second glucose curve on Chicklet. Vet advised mme to take her BG every 3 hours until the second shot of insulin. Chicklet's BG increases rather than decreases after the injection. She was on 2 units of Prozinc at the time of the curve. The vet increased her to 3 units after this curve. I am not seeing any improvement to date. I will be doing another BG curve this weekend. Chicklet s now eating Purina ProPlan DM. I am trying everything to get her to eat high protein soft food but she will not eat any soft food. I have tried every strategy. I know the food is not helping out the matter but could she be resistant to this insulin?

2 unit of Prozinc insulin


8:00 AM- 21 mol/l or 378 mg/dl


11:00 AM- 22.22 mmol/l or 399.96 mg/dl


2:00 PM-22.25 mmol/l or 400.5 mg/dl


5:00 PM- 23.77mmol/l or 427.86 mg/dl



8:00 PM- 22 mmol/l or 396 mg/dl

Any advice would be much appreciated.

LM
 
Hi there Chicklet's Bean. So glad you are testing to keep Chicklet safe. Looking over the numbers you got in the curve, it was a rather flat cycle she had today. Usually with ProZinc, there is a lower point, the nadir somewhere between +4 -6. Again, not a lot of difference in the numbers you got.

As far as increasing the insulin, we recommend that you only increase by .25 units at a time not 1 whole unit. The reason is that you could very well miss the right dose and be giving too much insulin.

I suspect that the numbers you are getting have much more to do with the food you are feeding. Dry food is much higher in carbs than the wet food.

Check out this link for helping you transition from dry to canned food.

Getting dry food addicts to eat canned food

Hope this helps you.


 
Giving some more thought to you curve today, sometimes a high flat cycle could mean too much insulin. What was the starting does that your vet started Chicklet at? It is recommended that you start at 1 - 1/5 units and as I had mentioned in my first post to increase in .25 of a unit at a time, not in whole units. Are you using U 100 syringes where you can do smaller doses? If you are not it would be helpful but you will need to use the conversation chart because ProZinc is a U 40 insulin. @Rachel or @Robin&BB , do either of you have the conversation chart you can give to Chicklet's bean if she needs it?

Please let us know if you have any more questions.
 
Bobbie And Bubba said:
I suspect that the numbers you are getting have much more to do with the food you are feeding. Dry food is much higher in carbs than the wet food.
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Hi, Chicklet's Mom! (What's your first name, btw?) I agree with Bobbie about this. Although I quickly scanned some of your earlier threads and noted that sometimes you've had some trouble getting Chicklet to eat. But then on the other hand, I also noticed that you'd written in an earlier post:

Chicklet is very much a free feeder. I tried to time her feedings correctly but am really unsure if I did it right. I took her BG level, let her eat for the next hour and than removed the food 2 hours before the next GB test. Is this alright? I did not want the carb in the food to influence my results. Chicklet has not yet transferred to wet food. She is resisting this change. I had to make sure that she was eating enough today.

So ... would appear to me that Chicklet has (historically) been getting more food than she needs. (I also note that you'd written that Chicklet weighs 21 pounds. That's a lot!) And yes, dry kibble is bad news: The carbs are simply too high for a diabetic, so please study that link Bobbie provided on getting a dry-food addict converted; you don't have to make the transition all at once (in fact, it's better that you do it gradually when a kitty is on insulin, because the BG #s should start coming down as the carb load decreases, often requiring a reduction in the amount of insulin dosed.)

When you're doing a curve, you do the pre-shot blood glucose test, feed, then shoot the insulin and then you do not keep letting her eat after the preshot meal - because you want to see how the insulin is working throughout the cycle - without the influence of additional meals on her blood glucose. The only time you'd feed during a curve would be if your kitty's BG level dropped into the hypoglycemia zone (less than 69 on an AlphaTrak2 meter/ less than 50 on a human meter). And yes - for any cycle, you don't want her eating in the 2 hours before your next preshot test (unless you happen to be dealing with an unexpected hypoglycemic event during that time frame).

So I am unclear about this: Did you let her do any free-feeding while you were doing that curve today? Please advise. Thanks! - Robin
 
Good morning! Yes, it would be best if we could get her on wet food. I know it's frustrating when they don't want to, but do it slowly, and hopefully, over time, we can get her eating better!

An increase of an entire unit isn't great...it's a big jump. You might try half units if you don't have u100s. You can eyeball them. That way, you have a better chance of getting the right dose, and not skipping over it. :)
 
Robin&BB said:
Hi, Chicklet's Mom! (What's your first name, btw?) I agree with Bobbie about this. Although I quickly scanned some of your earlier threads and noted that sometimes you've had some trouble getting Chicklet to eat. But then on the other hand, I also noticed that you'd written in an earlier post:

Chicklet is very much a free feeder. I tried to time her feedings correctly but am really unsure if I did it right. I took her BG level, let her eat for the next hour and than removed the food 2 hours before the next GB test. Is this alright? I did not want the carb in the food to influence my results. Chicklet has not yet transferred to wet food. She is resisting this change. I had to make sure that she was eating enough today.

So ... would appear to me that Chicklet has (historically) been getting more food than she needs. (I also note that you'd written that Chicklet weighs 21 pounds. That's a lot!) And yes, dry kibble is bad news: The carbs are simply too high for a diabetic, so please study that link Bobbie provided on getting a dry-food addict converted; you don't have to make the transition all at once (in fact, it's better that you do it gradually when a kitty is on insulin, because the BG #s should start coming down as the carb load decreases, often requiring a reduction in the amount of insulin dosed.)

When you're doing a curve, you do the pre-shot blood glucose test, feed, then shoot the insulin and then you do not keep letting her eat after the preshot meal - because you want to see how the insulin is working throughout the cycle - without the influence of additional meals on her blood glucose. The only time you'd feed during a curve would be if your kitty's BG level dropped into the hypoglycemia zone (less than 69 on an AlphaTrak2 meter/ less than 50 on a human meter). And yes - for any cycle, you don't want her eating in the 2 hours before your next preshot test (unless you happen to be dealing with an unexpected hypoglycemic event during that time frame).

So I am unclear about this: Did you let her do any free-feeding while you were doing that curve today? Please advise. Thanks! - Robin
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Hi everyone,

Thanks for all your replies. The vet started Chicklet at 1 unit of Prozinc. She (the vet) always increases Chicklet by 1 full unit every time I do a curve. I will ask her about using another needle with smaller increments. My worry is that she will say that Chicklet is not regulated and needs the full unit increases. I always remove her food, two hours before I take her BG so that the food does not influence her reading. So these numbers are not influenced by the carbs in the food. What else can these numbers be saying? Is she just very hard to regulate?

LM
 
Hi Everyone,

I thought I just posted a replay but am not really sure where it went. Chicklet's vet started her at 1 unit of Prozinc. I always remove her food 2 hours before the next BG reading. So these results are not influenced by the high carbs in the food. I am trying to get her to eat soft food but have been unsuccessful to date. I will keep trying though.

Questions:

Can Chicklet just be very hard to regulate?
Are any cats regulated if they continue eating dry food.
At what point should I consider trying another insulin?


LM
 
Hi LM,
Some cats are more difficult to regulate than others. How long has Chicklet been on ProZinc and how often have you increased the dose? If you can get that spreadsheet set up it will help us,and your vet, to see what's going on-if you need help (I know I did!) just ask. Please read over the link on transitioning your cat to the wet food and keep trying. That's the best thing you can do, but if you absolutely can not get Chicklet to eat the wet, then we'll try to find a lower carb dry. The Purina DM is around 18 carbs. Where are you located, so we can give you food ideas?
 
Hi LM, you might want to check with these folks regarding the u40 syringes with half unit markings since if I remember correctly, you are in Canada. They deliver anywhere in Canada and may even be cheaper than your vet. I don't think ADW delivers here and you might have border issues/fees and excessive delivery costs from them.

I too have a kibble addicted cat so I understand your frustration. I have been trying to transition mine since she was 10 weeks old, long before her diagnosis and five years later still no joy! I'm not suggesting you give up by any means, but there are some reticent cats that just won't transition so we have to work around that. Dry food takes longer to get into the system so I try to not feed for 3-4 hours before pre-shot tests hoping that provides enough of a cushion to keep the food influence down on pre-shot readings. I have taken mid cycle readings 2 hours after food and her readings have been up.

There is nothing here in Canada in the way of low carb kibble. The lowest options I am aware of are:

Purina DM (I rough calculated it to be 11% based 0n guaranteed analysis. Sharon's 18% may be based on as fed and more accurate.)
Petcurean Fit & Free GO! which is around 14% (based on guaranteed analysis)
Nature Variety Ultimate Protein which is around 15% (based on guaranteed analysis)

Just a curiosity, are you using a human or pet meter? Pet meter numbers are always higher and look a little more daunting in comparison to those from a human meter. ;)
 
Chicklet's mom said:
I always remove her food 2 hours before the next BG reading.
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I'm still not clear on what you mean. Are you saying that yesterday - when you were testing her BGs every 3 hours for that curve - that she would have access to food in the first hour, then you'd pick it up for the next 2 hours, then test BG at the 3rd hour, and then put food down again after each BG test?

The reason that we like to use spreadsheets here - and plug in the blood glucose #s we record each day - is so that we can see the individual cat's patterns emerge. (Every cat is different!;)) This helps us (along with knowing what they eat, when they eat, and how much) in understanding how well the insulin is working for that diabetic cat.

Doing a full curve every now and then can certainly provide useful information, but it really pays to consistently test blood glucose levels at home daily if you can manage it. That's because the blood glucose is not static: It changes - from day-to-day and hour-to-hour. And the amounts of food, the type, and when it is fed really plays a key role in achieving an effective balance between insulin and glucose in the diabetic cat.

This is just one of the reasons we feel it's so important to test before every shot of insulin - because a cat's need for insulin can change, and it's important not to give a cat more (or less) insulin than that she needs. And learning when your cat's blood glucose hits its nadir (the lowest point) in each 12-hour cycle is important day-to-day, too - this #, along with the AM preshot & PM preshot #s, helps guide us in adjusting the dose, to help keep the kitty safe from hypoglcemia as well as to help get too-high blood glucose numbers down to a more reasonable level overall.

- Do you measure Chicket's food every time you put the dish down for her?
- If so, how much would you say she eat per day (the total, every 24 hrs), in ounces (or cups?)
Chicklet's mom said:
Questions:Can Chicklet just be very hard to regulate? Are any cats regulated if they continue eating dry food. At what point should I consider trying another insulin?
Click to expand...
As a general rule, it is much harder to get a kitty regulated on dry kibble: Almost all dry foods - with rare exceptions - are far too high in carbohydrate content for a diabetic cat. That's why canned foods that are under 10% carbs are recommended for diabetics. And for some cats (mine is one of them) even 10% carbohydrate in the food is too much.:rolleyes: Luckily, there are plenty of brands that are anywhere from 3% to 4% carbs. You might be amazed at the difference in need for insulin once you can gradually reduce the amount of carbohydrate she's getting. (This needs to happen slowly, monitoring blood glucose, in case the dose of insulin needs to be reduced.)

Unfortunately, the prescription DM dry @ 18% carbs, will make it harder to get your cat regulated on any type of insulin. We've found it to have been a pretty common experience (among our membership) to have a veterinarian recommend expensive prescription diets that are higher in carbs than a diabetic cat should be consuming. It's important to note here that most veterinarians get very minimal training about feline diabetes in veterinary school. (Sad, but true!) Many vets are not nearly as well-educated as they should be about the latest "best practices" in treating diabetes in cats. Dr, Lisa Pierson's website catinfo.org contains a wealth of information about diabetes in cats, including a great chart of good commercial food choices for diabetic kitties.

I'd say it's a little early, at this point, to determine whether or not the ProZinc is working for Chicklet. Perhaps you should try to work on getting your kitty's daily rations in line with what she needs for whatever her healthy-weight goal is before giving up on the ProZinc just yet ...

Hope some of this info I've offered here is useful.:)
 
I emailed Nature Variety- it's what I feed my kibble addicted civvies- here is their reply for the regular kibble:
image.jpg
 
Sharon14 said:
The 18% came from the Purina website
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Well DAH! I didn't scroll down far enough. My bad! Thanks for the clarification. I also noted the calories per cup and the DM is a recipe for disaster if not very carefully monitored and controlled at 592/cup! That's interesting that the carbs are 7% higher than using the quick calc on the guaranteed analysis.

I feed the NV Ultimate Protein but it looks like the Instinct Regular kibble could be an option although it has fruit in it but then both have tapioca (YUCK!). Good to know! I have a very fussy cat and she wouldn't eat the NV Raw Boost at all which come to think if it might be another option available here. Thanks for the info!
 
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