help...my cat not responding to prozinc

[Janet & Wendell]

Can someone please help me as I am in tears. My cat, Wendell, has been on Prozinc since last January, increased slowly to 4 units a day and still there has been no improvement other then maintaining his weight and now it seems his hind legs could becoming weak as there are times he stands (not walks) on his hocks. Please can someone help me what can be done?

 

[Amanda and a Loudogg]

Unfortunately, it sounds like he's starting to have diabetic neuropathy, which can happen from extended amounts of time at higher numbers. It's my understanding that this can get better with regulation. Are you testing Wendell's BG numbers at home? If not, I would strongly recommend doing so, as 4 units a day (is it 4 units twice a day or 2 units twice a day?) is a high dose to blind shoot insulin. What can be frustrating, among other things, with FD is a dose that is too high can cause numbers that look like the dose is too low. If you are checking his BG at home, what have the numbers been looking like? Do you by any chance have a spreadsheet set up?

 

[Janet & Wendell]

Unfortunately, it sounds like he's starting to have diabetic neuropathy, which can happen from extended amounts of time at higher numbers. It's my understanding that this can get better with regulation. Are you testing Wendell's BG numbers at home? If not, I would strongly recommend doing so, as 4 units a day (is it 4 units twice a day or 2 units twice a day?) is a high dose to blind shoot insulin. What can be frustrating, among other things, with FD is a dose that is too high can cause numbers that look like the dose is too low. If you are checking his BG at home, what have the numbers been looking like? Do you by any chance have a spreadsheet set up?

Insulin is 2 units in am and 2 units pm. I do not test his BG because when asked vet should I, she said is was to difficult and Wendell would not tolerate it. Surprising he is handling his injections perfectly. I am sorry to say, I do not have a spreadsheet set up, but I do write down in a booklet everything I notice. I do urine testing and that has showed NO improvement since day one and we have increased insulin slowly taking urine tests. I do bring him to vet way under six months apart for blood tests and they showed no improvement at all. I also believe he is starting diabetic neuropathy and I want to get him on a right tract (regulated) before this gets worse. Also, since we increased to 4 units daily he is back to being hungry all the time as if insulin is not working. He has gained back about a pound since this started last year. Wendell does look much healthier, but I feel we must get the insulin regulated much better then this. His BD tests at the vet's office still show in way to high even with increase in insulin. Thank you for any help you can give me, I really appreciate it.

 

[Amanda and a Loudogg]

Unfortunately, your vet is an idiot in my humble opinion. The problem is most vets have little to no experience with feline diabetes, and they treat it all wrong. The first thing I can stress to you is you absolutely should test Wendell's BG at home. Random spot checks at the vet will tell you absolutely nothing. Cats' BGs are extremely sensitive to stress, and so visits to the vet can increase a kitty's BG 100 or so points higher than the actual value. The vet sees this higher number, decides the insulin dose isn't working/high enough, and then increases the dose. Regulating a cat's BGs can take months, and a lot of fine tuning. I've found that things can change daily, and home testing is the only way to stay on top of things. Unfortunately, all the urine glucose tests tell you is if your kitty is above the renal threshold (which means the BG is so high the excess urine is spilling over the kidneys' filtration system and comes out in the urine. This renal threshold number depends on the cat. Usually around 260-280, but for some cats as low as 200.). I won't lie to you, it may be hard to get Wendell on board for home testing, but I had the same fear when I started. Turns out, my buddy Lou took to the BG testing much faster than the insulin shots. We test the tip of the ear and there's less nerve endings there, so he usually doesn't even flinch. As a matter of fact, he frequently purrs for me while I'm testing, so I'm pretty happy with how he tolerates it. Check out @JanetNJ's signature. She has a great video of her testing her kitty CC.

I truly do not mean to scare you or make you feel bad. We can definitely help you help Wendell. First things first:

1. You may have already found it, but a great place to start reading up is our Health Links/FAQs page on the forum here. It's located at http://www.felinediabetes.com/FDMB/forums/health-links-faqs-about-feline-diabetes.14/. There is information for newcomers, diabetic neuropathy, and hometesting links. I was here for quite a while before I found out about this part of the forum, so I wanted to give this info to you right away.
2. Go ahead and pick up a glucometer for home BG testing. You can use a standard human glucometer and many folks here buy the Relion Confirm or Micro brand meters from Walmart. They take a small amount of blood for testing and the strips are pretty inexpensive. I use a Contour Next meter and get my strips relatively cheaply from Ebay. There are a lot of options out there for you. Get some 28 or 29G lancets (the ones that come with the meter are usually too tiny), cotton rounds from the nail section (to hold behind the ear), and some Neosporin ointment with pain relief for your kitty's ears (if they get sore).
3. When you're ready, set up a spreadsheet to track Wendell's numbers. They're color coded to let you quickly see what's going on in a quick glance. The spreadsheet instructions are located at http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/. If you have any problems setting up, please let us know. We've got quite a few gurus here who would be happy to help you out there.
4. Breathe! I've been told plenty of times myself that this journey is a marathon, not a sprint, so it may take some time. I think once you're home testing we can try to see where Wendell is and make adjustments as you are comfortable. I don't profess to be an expert at dosing advise, but there are others here who can help you out there.

You are definitely in the right place! I'm sorry about the book.. I'm information-oriented (I need to know now!) I think tend to try to give all information first and come up with a game plan later, haha. I hope I haven't overloaded you. Many hugs for you and scritches for Wendell!

 

[JanetNJ]

Sounds like he's is still very uncontrolled. Your vet have you terrible advice discouraging you from home testing. My vet wasn't against it but said "some do home test, most don't....it's difficult to do.". It is absolutely not difficult unless the cat is semi feral. I have a video in my signature showing how I test my cat CC. It's the best and really only way to keep your cat safe and find the ideal dose.


The neuropathy will most likely reverse itself once the numbers improve, but to help that along start adding vitamin b 12 methylcobalamin supplements to his food. Many use one called zobaline... No perscription needed you can get it on amazon. B12 methylcobalamin can not be overdosed as they pee out the excess.


Please set up a signature with vital info so it's easy to see at a glance. Click on your name at the top right corner and choose signature. Add info such as your pets name, date diagnosed, insulin type and dose, food you're feeding and any other health concerns.

 

[Yong & Maury GA]

Don't be discouraged if you can't get him regulated, as long as you can get his BG under better control, the neuropathy can reverse. My boy had it in his hind legs and front paws, he was on his hocks and his wrists . It took me 4 months of controlling his BG to start seeing the neuropathy reverse and by month 6, I say it was gone and you cannot even tell he ever had it! He is still not technically regulated but his BG is under control; he runs around the house again and up and down stairs .

Home testing is the best tool you can have on your FD tool belt. Gaining some weight back is a good sign though, his body is able to absorb the nutrients so he might not be as bad as you think. Home testing will also give you more "real" numbers, as they can be like 100 points higher at the Vet's office due to stress. As for the Vet saying it's too difficult, I would have told her I will make that decision . If you like and trust your Vet otherwise, the only reason you might want to "fire her" is if she won't work with you. Wendell is your kitty and you want to do what's best for him .

Hope to decide to get a Spreadsheet going so we can help. We always err on the side of caution when giving advice on the forum but keep in mind, while we're not Veterinarian's, we all have or have had a diabetic kitty

.