My cat won’t gain weight! Diabetic since 01/2018

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MHorne

MHorne

Member Since 2019
Hi there, first time posting as a last resort. We have had a HORRIBLE diabetic journey.
When he was diagnosed he had dropped to 6lbs, vet put him on Prozinc x2 daily and Hills MD. After a few weeks of adjusting the doses we got in our routine and he gained weight back to 11lbs. Maybe 8 months later he completely refused to eat the Hills.
I did all my research and found that Fancy Feast was a viable option, we were good on that for 3 months or so when it got worse; he became so finicky about what flavors he would eat it was almost impossible. I went from low end fancy feast to $80 cases of premium wet cat food and couldn’t get him to stay consistent. All the while working closely with our vet. He has had a full blood panel, his kidneys and thyroid checked, pancreatitis ruled out, passed his dental cleaning with flying colors and lastly a full senior panel was done (he’s 10years old). Between May and now he has fluctuated from 8-10 lbs currently residing at a low, slightly under 8lbs.
Our vet suggested letting him eat the food he was on pre-diagnosis which is just Purina Pro Plan that our other cats eat. Now he has been eating that for a little over a month and hasn’t gained any weight. By the way we have been closely monitoring his insulin to try and find his “perfect number”. Our vet has been having us do 2-3 curves a month since June and he’s always all over the place; going from extreme highs to extreme lows (30’s-400’s). He vomits a few times a week and becomes very lethargic so we have Cerenia tablets to give him in those instances. Does anyone have any advice?
 

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MHorne said:
Our vet has been having us do 2-3 curves a month since June and he’s always all over the place; going from extreme highs to extreme lows (30’s-400’s
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Anything below 50 is when action to prevent a hypo situation. Please read the following links about what to do when numbers drop below 50 on a human meter.

Just seeing "30s" in your post raises a red flag, then add to that vomiting and lethargy. It is important to test at the beginning of every cycle and get a test or two during the cycle.
Please check out the Beginner's Guide to Prozinc and Protocol for Prozinc

The reason you are seeing numbers all over the place is that the dose is too high. The dose should be based on how low it takes the cat. Anytime the number is below 50, the cat has earned a reduction.

The high numbers are a reaction to the lows. What you are seeing is a bounce. Definition:

Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's mg/dL {11 - 16.6 mmol/L}, 300's mg/dL {16.7 - 22 mmol/L}, or higher for a long time, then even a BG that drops to 150 mg/dL {8 mmol/L} can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast. The pancreas, then the liver, releases glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". (Adapted from the Lantus sticky by Jill)

We are fairly data driven. If you can set up a spreadsheet with what numbers you have, it would help to see the broader picture.

If you encounter problems setting it up, there are spreadsheet gurus who can do it in minutes.

I'm tagging @MrWorfMen's Mom who is very knowledgeable regarding Prozinc dosing. Ask any and all questions. We can help you keep your cat safe.
 
I have to go out for a bit but will delve into your dilemma when I get back. In the meantime, I have a few questions.

When was your cat diagnosed and what dose was he started on?
How often and by how much did the vet increase his insulin dose each time?
What is current dose?
If you can give us a run down of the numbers you got on the last couple of curves, that would be helpful. We are extremely data oriented here and without any numbers to look at, it's not possible to say what might going on although your description of extreme highs and lows as Kel pointed out, suggest the dose is too high.
What home testing have you been doing? Just curves or do you check before every shot? Have you done any mid cycle tests?
I presume your kitty has no other health issues given the info you provided but has he ever had ketones or DKA?

If you can provide the info requested, I'll have a look and we'll see what we can do to get you and your little fella on a better path. :)
 
Red & Rover (GA) said:
Anything below 50 is when action to prevent a hypo situation. Please read the following links about what to do when numbers drop below 50 on a human meter.

Just seeing "30s" in your post raises a red flag, then add to that vomiting and lethargy. It is important to test at the beginning of every cycle and get a test or two during the cycle.
Please check out the Beginner's Guide to Prozinc and Protocol for Prozinc

The reason you are seeing numbers all over the place is that the dose is too high. The dose should be based on how low it takes the cat. Anytime the number is below 50, the cat has earned a reduction.

The high numbers are a reaction to the lows. What you are seeing is a bounce. Definition:

Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's mg/dL {11 - 16.6 mmol/L}, 300's mg/dL {16.7 - 22 mmol/L}, or higher for a long time, then even a BG that drops to 150 mg/dL {8 mmol/L} can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast. The pancreas, then the liver, releases glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". (Adapted from the Lantus sticky by Jill)

We are fairly data driven. If you can set up a spreadsheet with what numbers you have, it would help to see the broader picture.

If you encounter problems setting it up, there are spreadsheet gurus who can do it in minutes.

I'm tagging @MrWorfMen's Mom who is very knowledgeable regarding Prozinc dosing. Ask any and all questions. We can help you keep your cat safe.
Click to expand...

Thank you! I am current at my office but when I get home this evening I will upload this spreadsheet and answer questions. Again, thank you so much.
 
MrWorfMen's Mom said:
I have to go out for a bit but will delve into your dilemma when I get back. In the meantime, I have a few questions.

When was your cat diagnosed and what dose was he started on?
How often and by how much did the vet increase his insulin dose each time?
What is current dose?
If you can give us a run down of the numbers you got on the last couple of curves, that would be helpful. We are extremely data oriented here and without any numbers to look at, it's not possible to say what might going on although your description of extreme highs and lows as Kel pointed out, suggest the dose is too high.
What home testing have you been doing? Just curves or do you check before every shot? Have you done any mid cycle tests?
I presume your kitty has no other health issues given the info you provided but has he ever had ketones or DKA?

If you can provide the info requested, I'll have a look and we'll see what we can do to get you and your little fella on a better path. :)
Click to expand...


Bear was diagnosed New Year’s Day after a traumatizing night of constantly vomiting until he was only vomiting blood. We had taken him to the vet a few months previous in 2017 because we knew something was wrong; he was always ravenous for food and in wild moods. Our vet never thought to check for diabetes I guess, only checked his thyroid, which was fine.
He started him at 5 cc’s of prozinc and over the next 2 weeks brought him down to 4.5cc. Over the next 6 months he went to 4 and then to 3.5 units. We were not testing at all during 2018 as our vet said it wasn’t worth it (different vet than who we’ve seen in 2019).
We have done curves at 3, 2.5, 2, 1.5, & 1cc’s of insulin. He is currently trying out 2.25 and we plan to do a curve on Sunday. We are not testing at every injection, only when he is having a bad day and for curves.
When I get home this evening I will upload all of the curve results! And yes, his urine has been checked multiple times, each time it comes back fine.
Thank you for your offer to help.
 
MHorne said:
He started him at 5 cc’s of prozinc
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Good gracious. Usually it's recommended to start out at 0.25 - 0.5 units. He's probably being severely overdosed, poor guy.

He is not going to gain weight until he gets regulated, which means finding the right dose, and only then is the weight going to come back. My girl was down to 4 lbs and on 4 units of insulin. With the help of everyone here they had me reduce her under 2 units and the weight piled back on. :D Once we get some numbers to review the board can help you and Bear out ^-^
 
when cats get too much insulin and go into hypo numbers, they will get extreme BG readings afterwards, sometimes it lasts a day and sometimes it can last for awhile depending on insulin amount.. This can/will make your curve days inaccurate and you do not up insulin amount based on those wild bouncing numbers, you usually lower it if anything.

“He is currently trying out 2.25 and we plan to do a curve on Sunday. We are not testing at every injection, only when he is having a bad day and for curves.”! you mentioned BG being 30 at times, please don’t keep injecting your cat with insulin without checking BG first and checking it again 4-6hrs afterwards..doing that is more accurate and way more important than doing what is often worthless curves since they could be based on your cat’s BG bouncing or simply higher because your cat us having a grumpy or stressful day on that curve day. you don’t want to be basing dosage on that.

btw checking when he is having a ‘bad day’ could very well end up meaning its too late to stop the damage, you want to catch them low bad day number issues early.

ps: not trying to sound mean or anything so apologize if it sounds like i am.. welcome to the forum btw, loads of things to read here to keep your kitty safe, helped me greatly when my cat got diagnosed.
 
I have included the requested spreadsheet in my signature per the instructions.

Thank you for all the help.
 
Hi and welcome to the forum.
If I were you, I would look at swapping the insulin to another one such as Lantus or levemir. They are both long acting insulins and very suitable for cats.
You have given Prozinc a decent length of time to work well and by swapping insulins you may find he does much better.
I would recommend talking to your vet about swapping insulins and then choosing one of our dosing methods.
Either SLGS...start low go slow or TR ...Tight Regulation.
By following a dosing method it will take the guesswork out of it and hopefully Bear will start to have bette numbers and put on some weight. Until he gets into better numbers he won't gain weight as his body can't absorb all the nutrients in the food, so I would feed him extra if he is hungry.

Please check the blood glucose level before every shot to make sure it is safe to give the insulin. This is very important. And if you can test at times around +4 to +7 to see how low the insulin is taking Bear.
If you get a low test, always test again to ensure it is rising not falling.
 
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All I can say is WOW! I am totally dumbfounded that a vet would start a newly diagnosed cat on 5u of insulin AND tell you home testing wasn't worth it. To be totally blunt, I think you are darn lucky Bear is still with you.

The right insulin for your cat is the insulin that works. While another insulin may very well be something you want to try, ProZinc is a good insulin for cats but given the way dosing has been handled to date, there is no way to determine if the insulin itself or the dosing is responsible for the extremes and lack of regulation.

Doing curves on different doses back to back, one day after another is an effort in futility. I'm not a big fan of curves at any time because as mentioned, if you do the curve on a day when kitty is bouncing, you will get wacky numbers and that can lead to dosing mistakes. The best way to deal with our diabetics is to test before EVERY shot having withheld food for a period of at least 2 hours for that pre-shot test and then to get mid cycle tests every cycle possible. Obviously if you work during the day you have to be a bit creative about testing and we all need our rest so we recommend a minimum of a test before bed every night and if possible based on your shot time vs bed time, another test between the pre-shot and bedtime is very helpful. It's common for our kitties' BGs to drop lower at night than during the day so night time data really is helpful if not critical.

ProZinc generally reaches peak action between +4 and+7 hours post shot so testing in that time frame whenever possible is optimal but again testing anytime you can will start to fill in the puzzle and start shedding some light on what is going on with Bear. It's best to be consistent with dosing and to hold the dose barring any low pre-shots that are not shootable or mid cycle tests indicating a dose reduction is needed, for a period of at least 3 days up to a week. Until you get more consistent/complete data, I would recommend that if Bears BG drops below 90, then you reduce the dose by 0.25u. We recommend 0.25u dose adjustments so the best dose is not skipped over.

I'd continue with the 2u dose for now, do as much testing as you are able and then revisit the dose based on how low the 2u is dropping BG. Right now it looks like Bear may be bouncing a bit which is a normal phenomenon that causes elevated BG due to lower BG occurring that Bear's body has learned to think is not normal. Bear dropped to green a couple of days ago and he's not used to being that low. Bounces can last for 6 cycles in some cats.
 
One other concern is that you aren't testing during the PM cycle. I'd encourage you to get at the very minimum, a test before bed every night. You need to be sure that your cat is. in safe numbers before you turn in for the night.

Are you dosing insulin at night? If not, you should be. (There is no indication of dose for the last several days.) The reason you're seeing such high AM numbers is that you're not giving insulin in the evening.
 
Sienne and Gabby (GA) said:
One other concern is that you aren't testing during the PM cycle. I'd encourage you to get at the very minimum, a test before bed every night. You need to be sure that your cat is. in safe numbers before you turn in for the night.

Are you dosing insulin at night? If not, you should be. (There is no indication of dose for the last several days.) The reason you're seeing such high AM numbers is that you're not giving insulin in the evening.
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Insulin is being given twice a day at each 5:15 time frame; he gets fed at 4:30am and at 5:00pm.
 
MrWorfMen's Mom said:
All I can say is WOW! I am totally dumbfounded that a vet would start a newly diagnosed cat on 5u of insulin AND tell you home testing wasn't worth it. To be totally blunt, I think you are darn lucky Bear is still with you.

The right insulin for your cat is the insulin that works. While another insulin may very well be something you want to try, ProZinc is a good insulin for cats but given the way dosing has been handled to date, there is no way to determine if the insulin itself or the dosing is responsible for the extremes and lack of regulation.

Doing curves on different doses back to back, one day after another is an effort in futility. I'm not a big fan of curves at any time because as mentioned, if you do the curve on a day when kitty is bouncing, you will get wacky numbers and that can lead to dosing mistakes. The best way to deal with our diabetics is to test before EVERY shot having withheld food for a period of at least 2 hours for that pre-shot test and then to get mid cycle tests every cycle possible. Obviously if you work during the day you have to be a bit creative about testing and we all need our rest so we recommend a minimum of a test before bed every night and if possible based on your shot time vs bed time, another test between the pre-shot and bedtime is very helpful. It's common for our kitties' BGs to drop lower at night than during the day so night time data really is helpful if not critical.

ProZinc generally reaches peak action between +4 and+7 hours post shot so testing in that time frame whenever possible is optimal but again testing anytime you can will start to fill in the puzzle and start shedding some light on what is going on with Bear. It's best to be consistent with dosing and to hold the dose barring any low pre-shots that are not shootable or mid cycle tests indicating a dose reduction is needed, for a period of at least 3 days up to a week. Until you get more consistent/complete data, I would recommend that if Bears BG drops below 90, then you reduce the dose by 0.25u. We recommend 0.25u dose adjustments so the best dose is not skipped over.

I'd continue with the 2u dose for now, do as much testing as you are able and then revisit the dose based on how low the 2u is dropping BG. Right now it looks like Bear may be bouncing a bit which is a normal phenomenon that causes elevated BG due to lower BG occurring that Bear's body has learned to think is not normal. Bear dropped to green a couple of days ago and he's not used to being that low. Bounces can last for 6 cycles in some cats.
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Okay then we will start testing before each injection. My husband and I can’t seem to wrap our heads around sticking our cat FIVE times a day between testing and injections. Seems that after a while his ears would be wounded but I’m guessing since so it’s so highly recommended that this is safe. Also yes, I don’t know how Bear is still alive after dealing with this for almost 2 years. It’s very disheartening to me that licensed veterinarians haven’t been able to help and we have spent buckets of money trying to fix him. I just want to help and I want answers.
Thank you for your advice, we will try that out and see how everything looks after the next week or so. His BG read 318 this morning before feeding time so I will give him his regular dose and retest him around lunch time when I get back to the house.
 
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On the days where there is no entry for the dose at PMPS, did you skip the shot?

I'm sorry to be pestering you but it's not clear on your spreadsheet. Often, members will put a dashed line or "ns" or "skip" in the column so it's clear that the shot was skipped versus forgetting to enter the dose.
 
It will probably take a while longer than a week or so. Once I decided to ignore my vet and follow advice here it took about a year to get him regulated and get his weight back to normal. This is probably because he was on a huge dose of 8 units morning and evening and I was advised to go down slow while testing, plus my boy was such a bouncer it was untrue. He had been diabetic for 2 years, so he took a long while to recognise that lower numbers were good.
 
Sienne and Gabby (GA) said:
On the days where there is no entry for the dose at PMPS, did you skip the shot?

I'm sorry to be pestering you but it's not clear on your spreadsheet. Often, members will put a dashed line or "ns" or "skip" in the column so it's clear that the shot was skipped versus forgetting to enter the dose.
Click to expand...
You are right, it isn’t very clear on the spreadsheet and that’s because we weren’t tracking it properly. No need to be sorry! If we didn’t note that we skipped a shot on that entry then we did not skip, and the same amount was given as was in the AM. I apologize for inconsistencies, but as I mentioned we were told not to home test by one vet, went against that finally and started testing only to be told by our 2nd vet the we “shouldn’t let testing run our (or Bears) lives; only do it on bad days and for curves.”
 
MHorne said:
My husband and I can’t seem to wrap our heads around sticking our cat FIVE times a day between testing and injections. Seems that after a while his ears would be wounded but I’m guessing since so it’s so highly recommended that this is safe.
Click to expand...

I know it seems daunting to be sticking your cat like a voodoo doll several times per day but if you give the insulin while kitty has their head stuck in their food bowl, most don't even notice.

A cat's ears don't have that many nerve endings so they don't feel much from the pokes compared to what we feel if we poke a finger for instance. The cat is more concerned with you fussing with their ears than the poke itself. Always hold pressure on the poke spots after testing for a few seconds and that will prevent any bruising. I often tested far more than 2 or 3 times per day and my girl's ears never got sore but admittedly, she was a pretty co-operative patient. Some folks apply a tiny bit of Neosporin with pain relief after testing if the ears get irritated. It is also possible to test the paw pads which allows you more test spots to rotate between. Make sure the ear is warm when testing as that makes it much easier to get a sufficient sample.
 
Welcome to you and Bear! You’ve already got some great advice, I just thought I’d chime in about the testing because it sounds like we have had similar experiences. My cat was started on SIX units of Prozinc twice a day and not once did any vet we saw recommend testing. Luckily she survived a very very bad hypoglycemia situation, but it was close.
I tried for over a year to get her regulated following her vets advice and it was crazy expensive and did not work. 2 months after following the advice of this board, she was regulated and then in remission!

As far as not letting testing “run your life”, I found that the diabetes ran my life more when I WASNT testing. I was constantly worried about whether she was too high or too low, why she felt bad, would she go hypo, etc. Once I started testing her blood sugar, I had much more control and my stress went way down. If you establish a routine with the tests and give lots of treats, most cats tolerate it very well and even like it! Even my cat who was a nightmare when I started testing eventually started reminding ME that it was time for a test :cat:
 
MHorne said:
My husband and I can’t seem to wrap our heads around sticking our cat FIVE times a day between testing and injections.
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Some people on the board poke excessively (6+ times in a cycle), others hardly at all. For me I typical poke twice during the morning cycle (usually alternating +3 and +5 one day and +4 and +6 the next day) and one +3 before bedtime, but it also depends on what your cat's up to that day. If they're running dangerously low you may poke as many as 5-10 times to keep an eye on them. If they're running high it's probably a waste to poke more than one or two times mid-cycle.
 
MrWorfMen's Mom said:
I know it seems daunting to be sticking your cat like a voodoo doll several times per day but if you give the insulin while kitty has their head stuck in their food bowl, most don't even notice.

A cat's ears don't have that many nerve endings so they don't feel much from the pokes compared to what we feel if we poke a finger for instance. The cat is more concerned with you fussing with their ears than the poke itself. Always hold pressure on the poke spots after testing for a few seconds and that will prevent any bruising. I often tested far more than 2 or 3 times per day and my girl's ears never got sore but admittedly, she was a pretty co-operative patient. Some folks apply a tiny bit of Neosporin with pain relief after testing if the ears get irritated. It is also possible to test the paw pads which allows you more test spots to rotate between. Make sure the ear is warm when testing as that makes it much easier to get a sufficient sample.
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Okay, so for example, after testing yesterday and up to now I’d like to show the numbers and get advice:
Please review the spreadsheet.
My question is since he’s at 32 right now do we lower his dose this evening? Do we always just adjust his dose and it never stays constant? When I tested him just now he was sleeping and then he got up to eat. He isn’t lethargic. Does immediate action need to be taken?
 
PLEASE rub some honey or karo on Bear's gums immediately and if you have food with gravy, drain off the gravy and give him 2 tsp. The honey/karo will wear off quicker. The gravy will last longer. If just regular food available, add a drop of honey to a couple tsps. of food. Retest BG again in 20 minutes.
 
Please let us know when you get the next reading. You are going to have to monitor Bear for a while to ensure his BG comes up and stays up.
 
How to Treat Hypos
VERY LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a very low number (under 40 mg/dL or 1.9 – 2.2 mmol/L) administer a teaspoon of corn syrup, liquid glucose, pancake syrup or honey, or INSTA-GLUCOSE and follow with food until the blood glucose numbers rise to acceptable levels. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If using liquid glucose, dilute with water for a thinner consistency.

LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a low number (40 – 60mg/dL or 2.2 – 3.3mmol/L) give food or treats until the blood glucose numbers rise to an acceptable level. If the cat refuses to eat even his/her favorite foods, you can syringe feed or administer a small amount of syrup.

LOW NUMBERS – MILD SYMPTOMS
Try feeding first or give a little syrup or honey followed by food until the blood glucose numbers rise to an acceptable level and the symptoms disappear. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If the cat will not eat, syringe feed. If your cat will eat dry food. the high carbs will help to increase his/her bgs quickly, but remember the effects of dry food usually takes longer to clear kitty's system once the crisis has passed. Feeding a high carb canned food is preferable to feeding a high carb dry food because the effects will clear kitty's system faster. You can then follow with his/her favorite canned food. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

LOW NUMBERS – MODERATE SYMPTOMS
Give a tablespoon of syrup, a teaspoon of liquid glucose, a tablespoon of honey or a tablespoon of sugar syrup followed by food and continue doing so until you see the blood glucose numbers rise to an acceptable level and all symptoms disappear. The syrup, honey, or glucose can be rubbed against the inside of the cat’s cheeks or on the gums for quick absorption. You can also mix the syrup with wet food or pour over dry if the cat will eat it. Continue to give syrup and food as needed and observe your cat for signs of recurring hypoglycemia. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

LOW NUMBERS – SEVERE SYMPTOMS
Rub syrup, honey, or glucose on the gums and cheeks if your cat will allow it. Another option for administering syrup, diluted liquid glucose, honey or sugar syrup to a cat who is seizing is to fill a needleless syringe with the mixture and insert via the rectum.
NEVER TRY TO SQUIRT SYRUP, HONEY, OR GLUCOSE TO A CAT WHO IS SEIZING AS THE CAT COULD CHOKE ON IT! RUSH TO EMERGENCY.

AGAIN! ANYTIME YOU CAT IS SEIZING OR LIMP, RUB KARO, GLUCOSE OR HONEY ONLY ON GUMS OR ADMINISTER RECTALLY AND GET TO EMERGENCY OR YOUR NEAREST CLINIC IMMEDIATELY!!!

Remember that syrup or any other sugared syrup/preparation will spike the blood glucose ONLY for a short period of time, so food is really important with mild and moderate symptoms. Dry food (high carbohydrates) will keep the blood glucose numbers elevated longer.
 
MrWorfMen's Mom said:
PLEASE rub some honey or karo on Bear's gums immediately and if you have food with gravy, drain off the gravy and give him 2 tsp. The honey/karo will wear off quicker. The gravy will last longer. If just regular food available, add a drop of honey to a couple tsps. of food. Retest BG again in 20 minutes.
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Food with gravy is what his current diet is to try and get his weight up. As I mentioned he was eating that. He was just retested and is at 64 now. So just to clarify, because this is where we get so confused...if I retest him later tonight, and his numbers are 350+...do we still reduce his dose to 2? When is the BG high enough to raise the dose?
 
Red & Rover (GA) said:
You are putting your cat at risk. Please do another test.
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How is it exactly that I’m putting my cat at risk?? I’m doing everything I know how to figure what the hell is going on with him.
I’ve done research and I know the basics. This is not a normal case. Something is wrong and I’m trying to get advice.
Do not tell me I am harming my cat.
 
That 64 is still a bit low and you don't want BG dropping again. I'd encourage Bear to lick up a bit more gravy and retest him again in 30 minutes to make sure his BG is staying up.

You don't base dosing on pre-shot tests. You base dosing on how low the dose is dropping BG. With that drop today was too low so that means the dose is too high and needs to be reduced whether BG is higher at pre-shot or not. It's quite likely that BG tonight may be considerably higher due to bouncing which is normal and not a reason to increase the dose again. Bounces can last for 3 days so please just hold the 2.0u dose unless of course you get another low reading under 90 in which case, another reduction would be earned or if pre-shot test is too low to safely shoot.
 
MrWorfMen's Mom said:
That 64 is still a bit low and you don't want BG dropping again. I'd encourage Bear to lick up a bit more gravy and retest him again in 30 minutes to make sure his BG is staying up.

You don't base dosing on pre-shot tests. You base dosing on how low the dose is dropping BG. With that drop today was too low so that means the dose is too high and needs to be reduced whether BG is higher at pre-shot or not. It's quite likely that BG tonight may be considerably higher due to bouncing which is normal and not a reason to increase the dose again. Bounces can last for 3 days so please just hold the 2.0u dose unless of course you get another low reading under 90 in which case, another reduction would be earned or if pre-shot test is too low to safely shoot.
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Okay, thank you. I’m sorry for you repeating yourself with this, it’s just this specific information has never been broken down for us. I really appreciate it very much! I will continue to monitor and test him to make sure we are doing this correctly.
 
MHorne said:
Food with gravy is what his current diet is to try and get his weight up.
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He is still under 68. Please feed a small amount of gravy – just the gravy. You want him above 68.
Also, carbs wear off. Once the cat is above 68, you need to test every 30 minutes until the cat stays above 68 without benefit of food for at least an hour.

If you are feeding food with gravy, then the dose is far too high. He has earned a reduction tonight.

MHorne said:
Something is wrong
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What is wrong is that the dose is too high.

I apologize if my comment came off too harshly. A low hypo glycemic cat can go from having no symptoms whatsoever to having a potentially lethal seizure within seconds. We have seen it on this forum. We are trying to help you keep your cat safe.
 
MHorne said:
How is it exactly that I’m putting my cat at risk??
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Bear has had several occasions of being in very low numbers lately. While he may not have been symptomatic from your perspective, repeated low BG events can have detrimental effects not the least of which is that his body's perception of low BG could become even less "aware". Kitties can go from looking fine into seizures in a flash and not all cats show outward signs of hypoglycemia.
 
MHorne said:
How is it exactly that I’m putting my cat at risk?? I’m doing everything I know how to figure what the hell is going on with him.
I’ve done research and I know the basics. This is not a normal case. Something is wrong and I’m trying to get advice.
Do not tell me I am harming my cat.
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MrWorfMen's Mom and Red & Rover are only trying to keep your cat safe, when you said "Do not tell me I am harming my cat" I'm no expert but when I looked at your SS and saw all those light green numbers it was scary. If I didn't have the help from Linda and the rest of the experienced members I don't know where I would be.
Maybe you should put in your signature the type of insulin you are using and how much and the food, cats age, when diagnosed only because it easier for members to see instead of going through all your posts, good luck with your kitty.
 
Red & Rover (GA) said:
If you are feeding food with gravy, then the dose is far too high. He has earned a reduction tonight.


What is wrong is that the dose is too high.
.
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So you still think his dose should only be reduced by 0.25 at a time? Until we can get him to gain weight he will be eating the gravy based food.
I know that he has been at risk for far too long. And as I’ve said, it’s not for lack of trying. Our Vets never provided this type of information. He means everything to me and I know he isn’t doing well; I want to get him in a better state as soon as possible.
 
MHorne said:
Until we can get him to gain weight he will be eating the gravy based food.
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My vet wanted me to keep my girl on dry food to help her gain weight and then focus on the high numbers. The thing is they're not going to gain weight UNTIL the high numbers go down. Totally get what you're trying to do but you have to do it the other way around. The gravy food is going to make it harder to keep his numbers down, which means the weight isn't going to come back on yet. My girl was down to 4 lbs until I figured out how low her dose was supposed to be. Now she's getting a little chubby!
 
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Diane Tyler's Mom said:
MrWorfMen's Mom and Red & Rover are only trying to keep your cat safe, when you said "Do not tell me I am harming my cat" I'm no expert but when I looked at your SS and saw all those light green numbers it was scary. If I didn't have the help from Linda and the rest of the experienced members I don't know where I would be.
Maybe you should put in your signature the type of insulin you are using and how much and the food, cats age, when diagnosed only because it easier for members to see instead of going through all your posts, good luck with your kitty.
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My point is that I am not purposefully harming my cat. You have no idea the absolute hell we have been through and to go from licensed professionals not knowing what to do to a community of people telling me exactly what to do...it’s a bit overwhelming. I was prepared for people to assume we were bad people for not finding this site sooner, but I am not neglecting my cat. Thank you for your input, I will add those items to my signature.
 
While getting him off gravy food would almost certainly bring his numbers down some, if that's what he will eat, then that's what he gets. Those lows indicate something is changing. Perhaps his pancreas is sputtering back into action at times. Perhaps he didn't eat quite as much that day. The problem is that BG and insulin needs change at times and the testing we do allows us to follow what kitty's BG is doing so we can keep them safe and as healthy as possible. While those lows were scary and not something you want to keep repeating, they suggest something has changed and it looks like it's for the better. So yes, I'd reduce the dose regardless of the gravy food.

Kitties are small creatures on small doses of insulin so 0.25u for a kitty is plenty enough of a reduction to make a difference.

No one here will ever suggest you are trying to harm your cat. Obviously you aren't or you wouldn't be here and wouldn't have been struggling with this all this time. Vets are notorious for not providing a lot of details when instructing folks. Some of it is lack of knowledge on the vet's part and some of it is probably because they don't want to make kitty's care too complicated. In any event, while we aren't vets here, we do or have lived FD 24/7 for varying amounts of time and that hands on experience from this huge community will give you the knowledge and support you need to keep Bear safe and get him better regulated. We all love our fur babies and when you come here, your cat ends up with a family of aunts and uncles looking out for them too! :)
 
MHorne said:
My point is that I am not purposefully harming my cat. You have no idea the absolute hell we have been through and to go from licensed professionals not knowing what to do to a community of people telling me exactly what to do...it’s a bit overwhelming. I was prepared for people to assume we were bad people for not finding this site sooner, but I am not neglecting my cat. Thank you for your input, I will add those items to my signature.
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Hi there, I didn't say you were purposefully harming your cat. I'm sorry if that's what you thought, I know what its like when a vet tells you one thing , or doesn't explain anything at all. No one thinks you are a bad person or that you are neglecting Bear at all. I'm glad I didn't listen to my vet about dosing because my cat was being way over dosed until I found this group, I know its overwhelming but it will get better, just ask all the questions you want to, we are all here to help, are you able to get a few tests in during the pm cycle
 
MHorne said:
Do we always just adjust his dose and it never stays constant?
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So glad that Bear’s BG has come up! Those low numbers can be very scary.

In regards to this, the answer is yes and no. Insulin needs are influenced by a lot of things and do not always stay the same, which is why it is so baffling that so many vets simply say “Give X units of insulin and do not home test”. A dose may work well for a while, and then may need to be adjusted. But as Linda has said, you shouldn’t base dosing on preshot values but instead on how low the dose takes Bear, and you shouldn’t change the dose from shot to shot. Doses are systematically changed so you can get a clear picture of how it works. They’re generally held for I believe at least 3-5 days, although @MrWorfMen's Mom can tell you more specifically, unless the dose takes him too low, in which case you would lower it immediately. If he stays too high during that time, you increase. And it’s generally recommended to only change doses by 0.25 units at a time - cats are very small animals!

I know how frustrating diabetes can be, especially when you feel like you’ve been getting bad advice from professionals. The people here are very passionate and care about our kitties very much, so try not too take things too personally because it’s generally not intended that way :cat:
 
Diane Tyler's Mom said:
Are you able to get some tests in during the night cycle also
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Generally no but I plan to get a few tonight and can incorporate that more frequently if needed. It was mentioned to get testing before bed time so we have started doing that for sure.
 
MHorne said:
Generally no but I plan to get a few tonight and can incorporate that more frequently if needed. It was mentioned to get testing before bed time so we have started doing that for sure.
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Good great news, cats BG usually goes lower at night time, so yes its can good idea to get a few test in during the night cycle too see what's going on and if you are never sure about dosing you can always post a new thread and title it something like this ? Need help with dosing
 
MHorne said:
Lol, yes my husband checked him and he is slowly coming up (70) still was eating though. We will check him again within the next hour to make sure it’s still rising.
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He is now at 306:banghead: I feel better after listening to everyone here about the bouncing effect, but this still is crazy to me how it changes so rapidly.
 
Cats are prey animals and their ability to draw on stored glucose to boost BG is quite remarkable. Unfortunately when it comes to diabetes that ability is just one big frustration for their humans. There is nothing we can do to control it so you just have to let it clear on it's own. In the meantime, don't react to those higher numbers. Look at each BG reading as one moment in time and pay attention to longer term patterns. Stick with the plan because raising doses when they are in a bounce can be dangerous. If the bounce clears and you've raised the dose, chances of dangerously low BG would be increased or set off more bouncing.
As Bear gets more used to lower numbers the bouncing should start to ease off. It may take a while but patience is key. This is a marathon not a sprint. :)
 
Question for today: we tested Bear around 4pm and he was at 61. We tested him again a few minutes ago and he’s at 112. It’s time for his insulin now; do we reduce or skip it??
Just don’t want to do the wrong thing.
 
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