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Victoria & Buttons

Victoria & Buttons

Member Since 2012
Buttons has been on Prozinc for quite a bit now but I still cant seem to get her numbers stable. Shes now at the point shes losing weight again and is very frail. Am I doing something wrong? Should I be considering changing her insulin?

I will be trying to get another curve today. My daughter broke my last meter.
 
Hi Victoria and Buttons, :bighug:
So just curious, did Buttons ever go into a remission? Or has she bee on insulin since 2012? How long has she been on Prozinc? What meter are you using?
If you can update your Signature with some of those questions, they'll be less likely repeated :D: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

Hard to say if you should change insulin without more data on her BG numbers. We would be glad to help you out with her dosing and finding patterns since you are home testing.:cat: Oh, are you testing for ketones? How is her she acting, otherwise? Sorry more questions :smuggrin:
 
Hmmm...the numbers you've gotten on the SS so far are very interesting. That blue you got a few days ago makes me wondering if you're seeing bouncing, and it just takes awhile to clear the bounce (it can take some kitties longer than others). That +3 you got today supports that theory, but of course there's no way to be sure just yet.

The questions Yong asked above will definitely help us help you. I wouldn't think about changing insulin JUST yet...Lantus and Levemir are both great (and I see you've been on Lev before) but I would give Prozinc a good try first and then you can switch if needed later. Heck, you already paid for the Prozinc! ;)

I do think as you get some more mi-cycle numbers we can help. I'd be very interested to see how low she dips today.
 
All updated. She has been on insulin since 2012 and no remission unfortunately. We were started on Caninsulin and I switched her to Levemir with research. The vet changed her to Prozinc last year. So it may be a year shes been on it? I just find that I cant keep her numbers lower with Prozinc. I am using the Breeze2 meter.
Ill try and test for ketones tonight. She has been acting more slothish or stoned which i just contributed to high sugar levels.
 
Victoria & Buttons said:
All updated. She has been on insulin since 2012 and no remission unfortunately. We were started on Caninsulin and I switched her to Levemir with research. The vet changed her to Prozinc last year. So it may be a year shes been on it? I just find that I cant keep her numbers lower with Prozinc. I am using the Breeze2 meter.
Ill try and test for ketones tonight. She has been acting more slothish or stoned which i just contributed to high sugar levels.
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What does she eat?
 
Based on her numbers, I would think yes, but why did you reduce her dose tonight? Is there something going on that led to that?
 
Yes, exactly. With it being that high at +6, I figured I gave a fur shot so gave her some more insulin. Her numbers this morning now confuse me though haha. Still go to 2 units?
 
Victoria & Buttons said:
Yes, exactly. With it being that high at +6, I figured I gave a fur shot so gave her some more insulin. Her numbers this morning now confuse me though haha. Still go to 2 units?
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We don't recommend doing this because it throws off the cycle. Just make a note in U section as FS (fur shot) and wait until next shot time. We've all given those dreaded fur shots :bighug:

For now, move the 459 to the correct +6 and next to it in +7 put dose. I would not increase to 2.0U until you get her back on schedule and when you increase, go to 1.75U. Remember, insulin is a hormone, not a medication that acts right away. Can't just give it to her and a random time, the schedule is important :)
 
Yes to what Yong explained. It's very important to keep the insulin at a 12 hour schedule. Hormones behave differently than medications, and act on many functions of the body, so changing the dosing and timing can have some negative effects on your kitty.

Please do correct the spreadsheet so we can see that the 459 was +6, not +12. Having the spreadsheet be an accurate reflection of the timing and doses is important in being able to give you accurate information so you can help Buttons feel better.
 
Hey, just checking in. Her numbers are still so high. I did one 1.75 units and it seemed her numbers went higher the next day, not sure if thats normal. Either way this morning I gave 2 units and ill do a curve before work.
 
Victoria & Buttons said:
Hey, just checking in. Her numbers are still so high. I did one 1.75 units and it seemed her numbers went higher the next day, not sure if thats normal. Either way this morning I gave 2 units and ill do a curve before work.
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This takes so much patience. It would help a lot if you could get mid cycle data at least once a week. Without that it's hard to know what's going on.
 
You need a lot more mid cycle numbers. There's no way of knowing how effective a dose is without knowing how low it's going.
 
I do believe we can help you figure out what's going on. Any mid cycle data you can get would help...even if that was a nadir just once or twice a week and then a +2 or +3 test in the evenings!
 
I didnt get a curve that I wanted, only nadir. Its left me more confused today and yesterday. Either Im really sucking and doing fur shots, or is it possible the vile of Prozinc is off? It doesnt expire until November but I was looking at it today and it had white crystals in it. Is that normal? I feel bad because Im not helping her feel better :(
 
Where are you giving the shot? Can you take a picture of the insulin? I'm pretty sure it should not have actual crystals. How do you store it? When you first get it out, should be more clear on top and cloudier on the bottom. This is why we gently roll it between our hands before drawing dose.
 
I store it on the top shelf in the fridge, not the door. I give it to her in the skin between her back leg and belly.
 

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I've heard if there are floaties that the insulin has gone bad, but I don't have any experience with that myself. Maybe call your vet and see what s/he says?
 
If those are clumps in the bottom of the vial in the second photo they shouldn't be there. ProZinc looks milky white and translucent throughout when properly mixed, no clumps.
 
Im feeling a bit overwhelmed. I cant get her numbers down at all and I dont know what Im doing wrong. Do I do a lower dose or a higher dose? Im scared she'll go too low when Im not here. Does this mean this insulin isnt working? Am I doing something wrong? Help :(

p.s. I did get her a new bottle of insulin
 
Hi Victoria! I'm so sorry to hear you're feeling overwhelmed. In order to get Buttons' numbers down, there are a few things you're going to need to do.

First, please read the stickies at the top of the Prozinc forum to educate yourself about how this insulin works and how we recommend dosing. The more you know and understand, the better you'll be able to help your kitty. As you read, make note of any questions you have and ask them. We are happy to help clarify.

Second, you need to get mid-cycle tests whenever you can. That includes during the evening cycle. You're testing before each shot which is great, so keep doing that. But in order to know if a dose is working, we need to see those mid-cycle numbers too. You've done a few which is helpful, so keep it up, and start getting a before-bed test each night as well. There is often a difference between the daytime numbers and the nighttime numbers.

Third, we recommend moving the dose based on data, in a relatively systematic way. Right now it looks like you have bounced around a bit from 1.0 to 1.5 to 2.0. Moving the dose around like that can be hard on your kitty and also make it hard to figure out the right dose. It does look like Buttons is going to need more insulin, but in order to keep her safe, you need to be testing and only increase by 0.25 every three to six cycles - not just moving it around from cycle to cycle.

I would recommend getting a mid-cycle test today if you can, then get the pre-shot this evening and a before bed test. Stick with 2.0 for tonight (assuming you have a normal PMPS number) and post your numbers. Then tomorrow post again and we can start to help you find a better dose to bring those numbers down.
 
You might also want to pick up some ketone test strips from a pharmacy. You'll want to keep an eye out for those with her still having higher PS numbers and we're not sure where she's going mid-cycle. If you get a reading above trace, you'll want to get her to a Vet soon after. :)
 
I haven't updated her spreadsheet but I didn't give her insulin last night. Woke up tested her, she's 13.1, fed her and checked an hour later and she's up 25.6 then gave her insulin. It's confusing me so much
 
Victoria & Buttons said:
I haven't updated her spreadsheet but I didn't give her insulin last night. Woke up tested her, she's 13.1, fed her and checked an hour later and she's up 25.6 then gave her insulin. It's confusing me so much
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Her dose has to come up in careful 0.25 u increments and you have to get some mid cycle numbers. The longer she spends in high numbers, the harder it'll be to get her down. Her body can lose sensitivity to insulin when it's constantly exposed to a high level of glucose in the bloodstream.
 
I second what Kris said. She's been sitting in higher numbers preshot, but without mid cycle data, we cannot know why. Can you do a curve this weekend and get some other tests before? Like tonight, a before bed test? We need to get her down, but we need to know what's going on first.

Also, can you please update your SS?
 
quick question for the moment, though i need more advice on other stuff, what is the best, high protein wet food i can get for buttons? I know shes not regulated at all and that can be a cause of her weight but i need to get her gaining weight asap.
 
Victoria & Buttons said:
quick question for the moment, though i need more advice on other stuff, what is the best, high protein wet food i can get for buttons? I know shes not regulated at all and that can be a cause of her weight but i need to get her gaining weight asap.
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Many of us feed plain old Friskies or Fancy Feast pates in whatever amount kitty wants to eat, preferably divided into several meals a day. I see you listed Fancy Feast in your signature. How much are you feeding per day?
 
Victoria & Buttons said:
I haven't updated her spreadsheet but I didn't give her insulin last night. Woke up tested her, she's 13.1, fed her and checked an hour later and she's up 25.6 then gave her insulin. It's confusing me so much
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Hey there Victoria and Buttons! And isn't she as cute as a button too! :)

I'm not sure why it's confusing? I don't give dosing advice but maybe I can help a little. After reading your SS it has me confused too lol regulating her will help her put on weight too :)

Here's what I did. And why.

Insulin must be given 12 hours apart at the same times every day. So for example I shot at 8am and 8pm - which is why I found your comment confusing about testing, feeding and then shooting later after the first test? What are your shot times?

Tempest didn't get any food for 2 hours before her shots so that her blood glucose wasn't affected by food. Food makes the bg rise. So it's not surprising she tested 13.1 and then higher after food.

Getting middle of the cycle numbers are really the only way to know how well the insulin is working. That would help you a lot I think. :)
 
oh haha tempestsmom, that was a bit ago. I do realize i need to get her under control but shes super immaciated so im trying everything to get her to gain weight and im really thinking the prozinc isnt working anymore. i havent had time to type up my questions but i hopefully will tonight. im doing everything i can to save her basically because the vet wants to put her down
 
Victoria & Buttons said:
oh haha tempestsmom, that was a bit ago. I do realize i need to get her under control but shes super immaciated so im trying everything to get her to gain weight and im really thinking the prozinc isnt working anymore. i havent had time to type up my questions but i hopefully will tonight. im doing everything i can to save her basically because the vet wants to put her down
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The only way to get her to put weight on is to get her regulated, there is no other way, you could feed her as much of anything as you like but until her blood glucose is regulated it won't work.

are you still following the same protocol as you did then? Insulin is not going to work if it's not given regularly 12 hours apart. I'm trying to get a picture of what's going on here to be able to offer suggestions :) x
 
Victoria, Tara is right. In order to gain weight, her blood glucose needs to be regulated, and to do that it's very important to carefully follow the protocols.

1. Two shots each day. They must be 12 hours apart, and they need to be at the same times every day.
2. Pre-shot tests right before the time you give the shot.
3. Mid-cycle tests as much as possible. The mid-cycle tests are how we decide if the insulin needs to be raised or lowered, so those are very important whenever it's possible to get a few.

Can you decide on a test/shot schedule at times that you can keep consistently, and then post here every day so we can try to help you make some progress with Buttons?
 
yes sorry. im a bit flustered. i lost my job today because i phoned in sick to rush buttons to the vet. its stupid. either way, the vet said i need to up her to 2.5 units twice a day, and so last night and this morning she read HI on the meter which is above 33 i believe. i feel bad because right now i have to give her antibiotics morning and night and IV fluids morning and night along with insulin and testing. shes getting poked so much :(
 
Victoria & Buttons said:
yes sorry. im a bit flustered. i lost my job today because i phoned in sick to rush buttons to the vet. its stupid. either way, the vet said i need to up her to 2.5 units twice a day, and so last night and this morning she read HI on the meter which is above 33 i believe. i feel bad because right now i have to give her antibiotics morning and night and IV fluids morning and night along with insulin and testing. shes getting poked so much :(
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Maybe you could give us some information on Buttons' other health issues so we have a better picture of what's happening. Could you please tell us why she's on antibiotics and why you give fluids? Other health issues can have a big effect on BG numbers.

I'm sorry you lost your job. That's so very stressful. We can certainly help you with Buttons but we need to know you've read and understood what we've suggested. That's why it would be best if you could make a point of replying to our posts as often and as soon as you can.
 
Kris & Teasel said:
Maybe you could give us some information on Buttons' other health issues so we have a better picture of what's happening. Could you please tell us why she's on antibiotics and why you give fluids? Other health issues can have a big effect on BG numbers.

I'm sorry you lost your job. That's so very stressful. We can certainly help you with Buttons but we need to know you've read and understood what we've suggested. That's why it would be best if you could make a point of replying to our posts as often and as soon as you can.
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I am sorry to hear about your job :arghh:

As Kris says, we need to know you are reading and understanding what we are saying. I've asked similar questions and not got one answer, so am still in the dark as to what's going on. :confused: I can't keep asking the same questions in different ways. I can't even look at the SS because it's not updated so I'm not sure how anyone here can help - :banghead: we need some information of some sort to work with. Please? :)
 
I hope Buttons is getting better. I know how frustrating it all can be. Don't feel bad about your job. Your priorities are in order and you can always find another job. You'd feel guilty forever if you had gone to work and Buttons died.
 
Oh Victoria, I am so sorry to hear about your job! I can only imagine how stressful that is for you. :bighug::bighug:

We'll definitely be glad to help with Buttons. I won't reiterate what the others have said because you don't need to hear it again, but the info they've asked for will help us to help you!
 
Rachel said:
Oh Victoria, I am so sorry to hear about your job! I can only imagine how stressful that is for you. :bighug::bighug:

We'll definitely be glad to help with Buttons. I won't reiterate what the others have said because you don't need to hear it again, but the info they've asked for will help us to help you!
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I would really like to help if I can. I can't offer any dose advice but I can try to help in other ways :bighug:
 
Yes, I understand all that is being said.

This is getting harder and harder everyday. And I need some honest advice and what you would do in this situation. Buttons has been diabetic for 5 years with no remissions at all. I took her into the vet last week because I cant get her sugars regulated, shes skin and bones, and not doing well. He has basically told me this is the beginning of the end. He said she was in ketoacidosis (though I find it weird he never kept her overnight to help treat that). He is pretty sure she is in kidney failure (though havent done test to confirm) that is why she is so dehydrated/has no muscle mass left, so I'm having to give IV fluids twice a day. She does have urinary tract infection which is why she is on antibiotics. He is convinced she has built up a resistance to the insulin (I cant get her out of the HI zone these last few days). I went in again today. He said she is better hydrated, he doesnt think its a good idea to switch insulin. He said I can raise the dose but hes basically saying at this stage, I wont ever get her down and regulated. Im heartbroken. I dont know what to do. She is doing way better than a few days ago. I cant give up on her. Im stuck. Am I prolonging the inevitable or am I really going to pull her out of this? I dont know whats right, I just dont want her to suffer. Please any advice would help.
 
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If anyone knows anything about kidney failure. I did read some and it says I should be feeding with less phosphorus in it and that fancy feast isnt good for that. Any options that are still diabetic friendly? thanks
 
Oh Victoria! This is a really hard thing to deal with, and going through it for 5 years would be enough to exhaust anyone.

My honest advice? I'd get a second opinion. I find it extremely suspicious that your vet is saying she's in DKA and hasn't done anything to treat it. If she was in DKA, most likely you'd know it AND no vet worth their salt would say that and not do SOMETHING to treat it. Also, I find it extremely irresponsible of the vet to say she's in kidney failure without ANY testing. So here's what I'd do:
  • Find another vet to get a second opinion. You don't have to CHANGE vets, but this way, at least you have info from one other person.
  • Demand ketone testing (or do it yourself if you can today) AND testing for CKD. Request that they hand you a copy of the labs and test results. You can post them here and there are plenty of folks that can read the labs and give feedback.
  • Do a bit of research if either of those conditions is present before making any decisions. DKA is treatable, though she might need to be at the vet for a day or two. We've had plenty of kitties make it through and live long healthy lives. CKD is also treatable and you can make some changes to help. There are plenty of people here who have great experience with it and can help you do what is needed!
  • As for insulin, you want to test regularly (AM and PM before shot), as much as often between cycles, and we can help you get her into better ranges! Looking back at your SS, the insulin IS working. She's had some blues and greens sprinkled in there, so you know it does work. Without regular testing and as many mid cycles as you can get, there's no way to know what is going on and we can't really help you figure out how to bring her down.
I wouldn't give up yet, Victoria. Second opinions, actual testing for conditions, and our combined experience and knowledge here are all tools that you have. Until you give those a try, I wouldn't make a decision that is final. :bighug::bighug::bighug:
 
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