Advise please re: dosage and insulin viability

[Alfred's Human]

Hello,

I am a returning poster. Originally posted in 2014. My cat Alfred has been in remission but recently has started insulin again due to high numbers.

Just started PZI 1 unit twice a day on 9/19/17 pm. Since then he's not been feeling well, off his food, some vomiting and diarrhea. I've skipped some doses due to him not eating. Took his temp today and he doesn't have a fever but I fear either a UTI, kidney infection or pancreatitis flare up. He has a history of pancreatitis and is currently early CKD.

I've given him some cerenia to help with nausea which has gotten him eating a little bit, but not much. Have a vet appointment tomorrow to collect urine and will talk to vet about his not eating etc. then.

However in the mean time I'm not seeing any real changes in Alfred's numbers with the 1 unit of PZI. His pre-shot #'s are basically the same as his +2 and +4.

I'm concerned that the insulin isn't viable. When I got the insulin from the pharmacy the pharmacist dropped it on the table, about a 1 ft drop. Could that have rendered it inert?

Just looking for any advice anyone might have, I'm feeling very ineffectual right now and hate seeing him not eating and feeling poorly.

Thank you!
Clare

 

[Amanda and a Loudogg]

Oh poor baby. He is a gorgeous kitty though. If he's not eating properly and/or feeling well, I'm guessing it could be affecting his numbers... With that being said, I'm not even close to being an expert, so I'll let one of them chime in about that portion. It is possible that the insulin bottle could be okay, although I'm rather surprised the pharmacist would drop it in front of you and then hand it over like nothing is wrong. I did a quick internet search and found a FDMB thread from last year regarding dropped Prozinc. It seems as long as there are no cracks, leaking, or floaties, it should be okay. Although the caveat is usually if the numbers are increasing, that could tell you the insulin may not be working as well, but it's hard to say since he's not feeling the best. I probably sound like I'm waffling a bunch, so I'll just say I'm sorry that your buddy isn't feeling well, and I hope the vet can give you some answers.

 

[Kris & Teasel]

Many people find that a kitty who won't eat needs both antinausea meds and an appetite stimulant. If pancreatitis is the cause, pain meds and sometimes extra fluids can be added to that.

 

[Alfred's Human]

Thank you for the replies!

It is possible that the insulin bottle could be okay, although I'm rather surprised the pharmacist would drop it in front of you and then hand it over like nothing is wrong. I did a quick internet search and found a FDMB thread from last year regarding dropped Prozinc. It seems as long as there are no cracks, leaking, or floaties, it should be okay.

Yes I was very annoyed when the pharmacist dropped the insulin like that! Thank you for the link to the earlier thread. I'm hoping it's ok and he just needs a dose increase. There were no floaties etc. so keeping fingers crossed.

Many people find that a kitty who won't eat needs both antinausea meds and an appetite stimulant. If pancreatitis is the cause, pain meds and sometimes extra fluids can be added to that.

I've emailed the vet re: his current status so that they're prepped for me when I arrive tomorrow. I just wish they were open today. I am going to really push for antinausea, app stim and pain meds. Sometimes my vet is hesitant about giving the meds I ask for which is irritating. I know my cat isn't feeling well and I don't want to mess around with waiting and seeing!

 

[Chris & China (GA)]

When I got the insulin from the pharmacy the pharmacist dropped it on the table, about a 1 ft drop. Could that have rendered it inert?

You don't say, but when did you buy it?

Dropping it wouldn't cause it to not work.....although we scream a lot about treating it very carefully, we've really found that they're not as delicate as we once thought.

 

[Wesley and Spicoli]

Sometimes my vet is hesitant about giving the meds I ask for which is irritating.

Glad I'm not the only one...

Hope Alfred gets to feeling better soon!!! I've dropped our Prozinc bottle before, and it didn't seem to affect it's viability. Just watch for those floaties

 

[Alfred's Human]

You don't say, but when did you buy it?

Dropping it wouldn't cause it to not work.....although we scream a lot about treating it very carefully, we've really found that they're not as delicate as we once thought.

I've dropped our Prozinc bottle before, and it didn't seem to affect it's viability. Just watch for those floaties

I purchased the insulin 9/19/17.

Thank you for the reassurance re: it not being as delicate as it seems

Just got back from the vet. Of course Alfred started eating again today prior to my taking him to the vet. He was even begging for food like his normal self so that is reassuring! It's like when my car makes a weird sound, as soon as I take it to the shop it stops making the sound! ;P

The vet did urinalysis, blood work and gave him cerenia and famotidine. She suspected he was nauseous. She gave me cerenia to bring home as well as an app stim. So success this time in getting meds. But no pain meds, she said he didn't seem painful when she palpated his abdomen and that she wasn't comfortable giving buprenorphine with mirtazapine. Fair enough.

She said to increase his insulin to 2 units twice a day. I'm going to increase to 1.5 units and then see how he does with that. I'm nervous increasing it that much that quickly, but I do suspect that he may need the 2 units given how little his numbers have changed with the 1 unit. Although it's been basically no time at all since we started so I need to collect a lot more data to get a better idea of what he's going to do with his numbers.

Right now I'm just going to get him eating normally again and hopefully be able to shoot tonight.

Thank you all for the input!