New dose, no improvement

Lalkabee

Lalkabee

Active Member
Bee had her visit at the vet last friday. Her right eye is healing nicely and her urine test was perfect.
She is now on 2 units of PZ instead of 1. The vet told me to do another curve 1 week later (will be tomorrow)
and if one or more numbers are under 20.0 to send the numbers to her to analyse them (another 50$).
If all numbers are above 20.0, not send the curve and raise the dose to 3 units and wait another week to do
the curve and then send the results (and another 50$).

We also talked about food and she asked me to stop mixing FF with the Purina DM. She suggested to use the
prescription dry food instead if i could not afford the DM cans only. I removed the FF but struggling with money so i will have to add the FF at some point, maybe when her numbers are more stable? I don't want to try the dry food. I am not sure...i feel a bit lost and with the 2 units and DM only, her BG are still terrible.

I just wanted to vent and keep you guys up to date but i also wonder if going from 2 to 3 units is not a bit fast?

Have a good day
 
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Going from 1U straight to 2U was way too fast. I would NOT recommend going from 2U straight to 3U.

The DM dry food is 18% carbs, when the (2018) AAHA Diabetes Management Guidelines for Dogs and Cats
says <12% and we here recommend <10%.

I know a good way you can afford to feed the Fancy Feast for a long time. Stop letting your vet charge you $50 to simply look at the test numbers that you are getting. We don't charge a thing, to look at a spreadsheet and comment on a thread.

How does that sound to you?

My recommendation? Keep feeding Bee the low carb Fancy Feast (or even the Friskies pates are low enough carb for a diabetic cat), ditch the high carb Purina DM entirely wet and dry, let us help you with adjusting the dose, and let your vet know that her pricing is absolutely ridiculous. Sheesh, $50 for a 2 minute look at some BG levels. Plus ask her if she follows those AAHA guidelines, or even knows about them.

We do have some requirements. We need you to test before each and every shot of insulin, and get at least 1 other test in during the middle of the cycle sometime. Both AM and PM cycles need at least 1 more test beyond that pre-shot test. The pre-shot test should be uninfluenced by food for at least 2 hours before. All other tests, feed as you normally would. No need to wait to feed your cat Bee or wait to do a test.

There is one other requirement, and it's in regards to the spreadsheet. Please add a row for each date, do not skip any dates on the SS (spreadsheet). Makes it very hard to follow along with the dosing if you do that. And keep the SS updated.

Are you game? Ready to try this?

We'll teach you about "stalling" with a low pre-shot another time.
 
Hi Deb and Thank you so much :) I did argue with my vet about the dose and the food, but she really believe in her treatment plan...and i am not sure if she is even open to new opinions. She contradict everything i say but always explain why. I am game but also scared. Can she refuse to sell me ProZinc if i refuse to show her the curve and control the dose myself?

One of the reason for my lack of testing is because Bee's ears are very bruised. Doing a curve today (and only half done) made it worst. I feel like a bully, i didn't apply the cool towel after poking (found out today about that tip). Being still bad at it and having to poke 2 or 3 times sometime to get a good drop of blood didn't help...so i was trying to give her ears some rest. I will try to do better and hopefully i won't disappoint you guys.

Thank you again, i really appreciate the time you took to reply to me <3
 
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Have your vet give you a written prescription. Always have a written prescription on hand, just in case your vet is out of insulin and your have to buy the insulin elsewhere. Then you can get the prescription filled other places.

You might want to consider Chewy.com for your next Prozinc purchase. They will contact your vet for you. After that, you can get orders from there. Vets mark up (increase) the price on insulins quite a bit. Chewy has it for less.
Lalkabee said:
Can she refuse to sell me ProZinc if i refuse to show her the curve and control the dose myself?
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Yes, she could refuse. Because she may be concerned about liability and being sued if something goes wrong with Bee. But with your vet raising the dose by 1U increments, that is likely to result in an overdose which would lead to hypoglycemia. Is your vet going to pay for a visit to a 24 hour emergency vet clinic, to put Bee on a glucose drip and who knows what else?

Lalkabee said:
One of the reason for my lack of testing is because Bee's ears are very bruised.
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Are you applying a bit of pressure, after the poke, to stop the bruising? You need to do that if you are not already. The pressure helps to stop the blood from pooling in the area, so will limit or even stop the bruising.
Are you using a little dab of triple antibiotic ointment with pain relief after the poke, on the poke spot? Wipe off any excess.

As long as Bee is eating that high carb food, she is likely to need more and more insulin.
If your vet keeps increasing the dose by 1U increments, you may bypass the correct dose.

What if you were not able to do a curve one week? What would your vet's response be then?
Are you only sending your vet an email with the curve test numbers? Or are you sending her a link to your SS?
 
Bee is not eating high carb food, i removed the dry food and HC wet 1 month ago. I am doing my best since last week to take her BG. I did send my SS to Bee's vet but she is on vacation atm (told me another vet would look at it). They couldn't read the file so i sent a picture of it...no news. I am sick and i am not sure if i will have the strength to fight every ear pokes. She is strong and i am very tired.
 
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The 2U of Prozinc brings Bee's BG levels down into the blue range. There is still room for her to drop lower, into the greens.
For that to happen, Bee will need a bit more insulin. How about trying 2.25U for the next dose? How do you feel about that?

I see you have another kitty in your home, Pie. Bee snuck some of Pie's food I see on your SS notes. It happens. Won't be the first time, won't be the last time she'll sneak into some 'contraband'.
 
Thank you Deb...i am trying to always test in PM but it's not easy. Pie is Bee's mom (Pie was a stray cat and i adopted her) and Bee was born a flat-chested kitten, always been fragile. I try to watch both babies while they eat at AM/PM but i fell back asleep today after feeding because of my meds . I will do 2.25 tomorrow morning. <3
 
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Lalkabee said:
Hi Deb and Thank you so much :) I did argue with my vet about the dose and the food, but she really believe in her treatment plan...and i am not sure if she is even open to new opinions. She contradict everything i say but always explain why. I am game but also scared. Can she refuse to sell me ProZinc if i refuse to show her the curve and control the dose myself?

One of the reason for my lack of testing is because Bee's ears are very bruised. Doing a curve today (and only half done) made it worst. I feel like a bully, i didn't apply the cool towel after poking (found out today about that tip). Being still bad at it and having to poke 2 or 3 times sometime to get a good drop of blood didn't help...so i was trying to give her ears some rest. I will try to do better and hopefully i won't disappoint you guys.

Thank you again, i really appreciate the time you took to reply to me <3
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If the ears are getting bruised then you may be accidentally hitting the vein. Make sure you only poke the edge and not the vein, then squeeze for a few seconds with a cotton cosmetic pad afterwards. My cat gets tested 4-5 times a day for the last four years and her ears look fine. you could also put a little bit of neosporin ointment to help the ears heal up overnight. alphatraks only need a TINY dot of blood. make sure you are dipping the straw of the strip into the drop and not trying to put the drop on top of the black dot.
 
the numbers you are getting are really not bad for a newly diagnosed cat. It took my cat 2.5 months to even see a number in the yellows mid cycle. it's a marathon. Ridiculous your vet is charging you to just look at the numbers! WTH I could understand if you were going for an in person consultation, but to just look at the numbers and charge you is not right.
 
JanetNJ said:
the numbers you are getting are really not bad for a newly diagnosed cat. It took my cat 2.5 months to even see a number in the yellows mid cycle. it's a marathon. Ridiculous your vet is charging you to just look at the numbers! WTH I could understand if you were going for an in person consultation, but to just look at the numbers and charge you is not right.
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Hi Janet, nice to meet you and thank you for taking the time to answer me :) Thanks for your support. I did send my SS to my vet anyway because i don't want her to stop selling me the insulin. Still waiting for an answer, but at this point, i trust you guys more than any vet. I am trying to massage Bee's ear with the rice sock and it seems to help with the blood drop, but she hate that...i do know its for her own good.
 
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Lalkabee said:
Hi Janet, nice to meet you and thank you for taking the time to answer me :) Thanks for your support. I did send my SS to my vet anyway because i don't want her to stop selling me the insulin. Still waiting for an answer, but at this point, i trust you guys more than any vet. I am trying to massage Bee's ear with the rice sock and it seems to help with the blood drop, but she hate that...i do know its for her own good.
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I have a video in my signature showing how I test my cat at home.
 
JanetNJ said:
I have a video in my signature showing how I test my cat at home.
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Yup, watched your video before, more than once, and it was a great help when i got out of the vet with an Alphatrak in my hand and nobody could help because of the Covid. I also went tru a lot of videos to learn how to inject insulin. Your baby girl is way more patient than mine. I know i have to give her time. Thank you Janet <3
 
Lalkabee said:
Yup, watched your video before, more than once, and it was a great help when i got out of the vet with an Alphatrak in my hand and nobody could help because of the Covid. I also went tru a lot of videos to learn how to inject insulin. Your baby girl is way more patient than mine. I know i have to give her time. Thank you Janet <3
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At the time I did that video I had already been testing her like two years so she was super used to it. Other than the first few weeks though she’s chill about it. I got her patient with it by giving treats for each test in the beginning.
 
JanetNJ said:
I got her patient with it by giving treats for each test in the beginning.
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Bribes, we call those "treats" bribes to get our cats used to the ear pokes and the insulin shots.
Break the process down into little steps.
Do those steps WITHOUT the poke a dozen or more times a day. Every chance you think of it.
Then add the poke step, so she never knows if the poke is coming or not.

ALWAYS reward (bribe) with a treat.
Bribes can be non food too. Brushing, petting, sweet talking her, play time after. Use your imagination to gain her cooperation.
 
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Bee already knows that treat means poking her ears. she still sleep spoon me every night but will hide if i try to touch her ears now. i will try to treat without poking
 
So touch her ears so frequently that she gets used to CONSTANTLY having her ears touched.

So she doesn't always associate the ear touching with poking.
 
Try Polysporin Complete with pain relief ointment (not the cream). Maybe she has sore ears from the poking.

For those reading: Neosporin is Polysporin in Canada.
 
JanetNJ said:
It's best to always get a preshot and at least one mid cycle reading. Yeah for green numbers! You're doing great
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Hi Janet :) Dealing with my own health issue so its not always possible to test. I always worry about hypo with the green numbers. You helped a lot with your advice and video, thank you so much
 
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Lalkabee said:
Hi Janet :) Dealing with my own health issue so its not always possible to test. I always worry about hypo with the green numbers. You helped a lot with your advice and video, thank you so much
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I totally understand. Life can get in the way. All we can do is what we Can do. :)
 
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