Dosage advise please

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Hi Amber,

I see that Lucy was off her food a bit a couple of days ago. Is she still not eating properly? How are her clinical signs in general (energy levels, peeing, pooping, playing, etc.)? Any signs of a UTI or dental issues?

I'm tagging @Deb & Wink to ask her to look at Lucy's spreadsheet for you when she checks in (I've not used Prozinc so can't help with that).

In the meantime, could you let us know if Lucy's showing any signs of nausea, and whether you're checking her pee for ketones (as a precaution because she's running high and might not be eating properly). Here are helpful links:

Nausea and Inappetance - Symptom Checker

Testing Your Kitty for Ketones

Tips for Collecting a Urine Sample


Mogs
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Last night at about midnight she tested 263 In about 15 minutes later she was 272. This morning she tested 346 ( pre shot) she's usually in the red or black first thing in the morning.She ate great this morning. I also gave her a hole Zobalin atAat dinner again this morning. Where normally she only gets a half morning and night.
I wonder if given her a whole one made any difference. I wonder if she was just not hungry because I was trying to feed her a bunch of small meals throughout the day versus that I was feeding her two big meals morning and night and one small meal right before bed.so I'm going back to the 2 big ones and 1 small one..
She has neuropathy really bad so she is not very active. But that's nothing new since this all started. She It's constipated quite a bit she's on left to lactulose. She doesn't have any teeth. She's peeing like she normally does.
 
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8catsplus2 said:
Last night at about midnight she tested 263 In about 15 minutes later she was 272. This morning she tested 346 ( pre shot) she's usually in the red or black first thing in the morning.She ate great this morning. I also gave her a hole Zobalin atAat dinner again this morning. Where normally she only gets a half morning and night.
I wonder if given her a whole one made any difference. I wonder if she was just not hungry because I was trying to feed her a bunch of small meals throughout the day versus that I was feeding her two big meals morning and night and one small meal right before bed.so I'm going back to the 2 big ones and 1 small one..
She has neuropathy really bad so she is not very active. But that's nothing new since this all started. She It's constipated quite a bit she's on left to lactulose. She doesn't have any teeth. She's peeing like she normally does.
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Those are not bad numbers to get her started on the b12 methyl for the neuropathy. Have you done that yet? It really helped Minnie recover from it
 
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Thanks for the further information, Amber.

For general info, constipation can sometimes elevate BG levels. It sometimes makes a kitty less inclined to eat (understandable!). It can also cause vomiting sometimes. Neuropathy can also affect gut motility. Fingers and paws crossed that as Lucy gradually gets the benefit from her Zobaline treatment it might help her poop more easily and frequently.

I've not used lactulose so I don't know whether or not it has any impact on BG levels. Other members may be able to chime in on this. (FYI, there are other ways to help with constipation that definitely don't impact BG should you need them, e.g. pure pumpkin or psyllium husk (fibre sources) and Miralax (stool softener). Here's another very helpful site:

felineconstipation.org

WRT feeding schedules the most important thing is that a cat eats comfortably and consistently. Sometimes just giving a teaspoon or two of food to help steady out insulin levels during a cycle may be all that's needed. Hopefully some members familiar with Prozinc will be able to give you more tips in this regard. At the end of the day this is all about Lucy and helping her to feel better, and what works for Lucy is the right thing to do. ECID - every cat is different. :)

While all this is going on, if you're not already testing for ketones, I'd recommend getting some Keto-diastix (or similar) and checking every day or two as a precaution, especially if her appetite is iffy.

Sorry I can't give you any input on Prozinc. Hopefully other members will be able to help you out on this shortly.


Mogs
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Lucy has been on the 1.5U dose for quite some time. Though she is dropping down into the yellow and blue BG ranges occasionally, those lower numbers are not happening frequently enough.

You should also try to switch you cat to a different substance, for the constipation. The lactulose contains sugar (mostly sugar in fact) and is not recommended for diabetic cats. When did Lucy start taking the lactulose?

In fact, I think you should stop the lactulose and see how your cat's BG levels do off the high sugar lactulose before you increase the insulin dose.

My recommendation would be to increase the Prozinc dose to 1.75U if taking her off the lactulose does not cause a decrease in the BG levels.

Quoting from this link about the lactulose: https://www.petrescuerx.com/index.cfm/product/164_50/lactulose.htm
"What is this drug?• A disaccharide sugar molecule
• Given by mouth

Reasons for prescribing:• To treat constipation
• To treat hepatic encephalopathy

What dogs/cats should not take this medication?• Animals with diabetes

Other options for constipation:
1. plain canned pumpkin. Try 1 teaspoon to start and increase as needed
2. Miralax ( or generic is fine) link for you on the Miralax. https://www.vetinfo.com/miralax-for-cats.html#b
My civie gets 1/8 teaspoon of the Miralax mixed into her AM meal. Miralax has no taste.
More miralax info for you: "MiraLAX (polyethylene glycol 3350) is used as a laxative to treat occasional constipation or irregular bowel movements. MiraLAX is available over-the-counter and in generic form."
3. psyllium husk fiber
My civie gets 1/8 teaspoon of the psyllium husk fiber mixed into her first AM and first PM meal, with the addition of water. Gets "gluey" fast, so it's better if your cat will eat their food right away.
 
Deb & Wink said:
Lucy has been on the 1.5U dose for quite some time. Though she is dropping down into the yellow and blue BG ranges occasionally, those lower numbers are not happening frequently enough.

You should also try to switch you cat to a different substance, for the constipation. The lactulose contains sugar (mostly sugar in fact) and is not recommended for diabetic cats. When did Lucy start taking the lactulose?

In fact, I think you should stop the lactulose and see how your cat's BG levels do off the high sugar lactulose before you increase the insulin dose.

My recommendation would be to increase the Prozinc dose to 1.75U if taking her off the lactulose does not cause a decrease in the BG levels.

Quoting from this link about the lactulose: https://www.petrescuerx.com/index.cfm/product/164_50/lactulose.htm
"What is this drug?• A disaccharide sugar molecule
• Given by mouth

Reasons for prescribing:• To treat constipation
• To treat hepatic encephalopathy

What dogs/cats should not take this medication?• Animals with diabetes

Other options for constipation:
1. plain canned pumpkin. Try 1 teaspoon to start and increase as needed
2. Miralax ( or generic is fine) link for you on the Miralax. https://www.vetinfo.com/miralax-for-cats.html#b
My civie gets 1/8 teaspoon of the Miralax mixed into her AM meal. Miralax has no taste.
More miralax info for you: "MiraLAX (polyethylene glycol 3350) is used as a laxative to treat occasional constipation or irregular bowel movements. MiraLAX is available over-the-counter and in generic form."
3. psyllium husk fiber
My civie gets 1/8 teaspoon of the psyllium husk fiber mixed into her first AM and first PM meal, with the addition of water. Gets "gluey" fast, so it's better if your cat will eat their food right away.
Click to expand...
She has been on lactulose since
Deb & Wink said:
Lucy has been on the 1.5U dose for quite some time. Though she is dropping down into the yellow and blue BG ranges occasionally, those lower numbers are not happening frequently enough.

You should also try to switch you cat to a different substance, for the constipation. The lactulose contains sugar (mostly sugar in fact) and is not recommended for diabetic cats. When did Lucy start taking the lactulose?

In fact, I think you should stop the lactulose and see how your cat's BG levels do off the high sugar lactulose before you increase the insulin dose.

My recommendation would be to increase the Prozinc dose to 1.75U if taking her off the lactulose does not cause a decrease in the BG levels.

Quoting from this link about the lactulose: https://www.petrescuerx.com/index.cfm/product/164_50/lactulose.htm
"What is this drug?• A disaccharide sugar molecule
• Given by mouth

Reasons for prescribing:• To treat constipation
• To treat hepatic encephalopathy

What dogs/cats should not take this medication?• Animals with diabetes

Other options for constipation:
1. plain canned pumpkin. Try 1 teaspoon to start and increase as needed
2. Miralax ( or generic is fine) link for you on the Miralax. https://www.vetinfo.com/miralax-for-cats.html#b
My civie gets 1/8 teaspoon of the Miralax mixed into her AM meal. Miralax has no taste.
More miralax info for you: "MiraLAX (polyethylene glycol 3350) is used as a laxative to treat occasional constipation or irregular bowel movements. MiraLAX is available over-the-counter and in generic form."
3. psyllium husk fiber
My civie gets 1/8 teaspoon of the psyllium husk fiber mixed into her first AM and first PM meal, with the addition of water. Gets "gluey" fast, so it's better if your cat will eat their food right away.
Click to expand...
She probably started lactulose sometime around the end of May. That was prescribed it by the vet who knews she is diabetic. She gets 1 ml one to two times a day please check out her new spreadsheet she's had better numbers since I posted this thread
 
Aleluia Grugru & Minnie said:
Other members have been successful with Miralax. I think Deb is suggesting that you switch since lactulose is filled with sugar. Vets don’t always know best o_O
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Yes, that is what I meant. To get your cat Lucy off the high sugar laxative (lactulose) and taking a better option.
Please, discuss options for dealing with the constipation with your vet, as they may not have thought about the sugar content in the lactulose and the fact that your cat is diabetic.
 
Deb & Wink said:
Yes, that is what I meant. To get your cat Lucy off the high sugar laxative (lactulose) and taking a better option.
Please, discuss options for dealing with the constipation with your vet, as they may not have thought about the sugar content in the lactulose and the fact that your cat is diabetic.
Click to expand...
The Vet is suppose to call me tomorrow.. so we can discuss that and her BG numbers
 
8catsplus2 said:
I will I don't know if you've looked at her spreadsheet today. But it's looked better for the last 2 days since I posted this.
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I'm actually one of those detail oriented people, and always look at the SS and the Remarks in the column to the right hand side before I reply. :bookworm: Looking for trends, so giving the SS a good read is always a good idea.

Were there doses of insulin given for 8/7, AM and PM cycles? Not seeing those on the SS, is why I'm asking.

Yes, some of the mid-cycle numbers are a bit better. Still think the lactulose is keeping Lucy's BG numbers higher than they would be without all that sugar.

Usually when a cat won't eat well, like Lucy on 8/2/20 PM cycle, their BG numbers tend to be lower.
The Gerber meat baby food should not have caused her BG number to spike to the black (>500 mg/dL) range.

p.s. Not sure what happened to your PM test columns for +9, +10, +11. Somehow they "went bye-bye". Dissappeared, vamoosed, scramed.
Do you think you could add those columns back to your SS?
Know someone that could probably do it for you, if you have trouble with that.
 
Deb & Wink said:
I'm actually one of those detail oriented people, and always look at the SS and the Remarks in the column to the right hand side before I reply. :bookworm: Looking for trends, so giving the SS a good read is always a good idea.
Did not notice that +9 ect was missing will fix it.. I don't test between 1 am and 7 am
Her unit if insulin was 1.5 am and pm for today

Were there doses of insulin given for 8/7, AM and PM cycles? Not seeing those on the SS, is why I'm asking.

Yes, some of the mid-cycle numbers are a bit better. Still think the lactulose is keeping Lucy's BG numbers higher than they would be without all that sugar.

Usually when a cat won't eat well, like Lucy on 8/2/20 PM cycle, their BG numbers tend to be lower.
The Gerber meat baby food should not have caused her BG number to spike to the black (>500 mg/dL) range.

p.s. Not sure what happened to your PM test columns for +9, +10, +11. Somehow they "went bye-bye". Dissappeared, vamoosed, scramed.
Do you think you could add those columns back to your SS?
Know someone that could probably do it for you, if you have trouble with that.
Click to expand...
 
Deb & Wink said:
You quoted my post, but your reply is missing. When I do that, it's usually because I hit the "Post Reply" button too quickly.

Would you please try again to reply? Thanks.
Click to expand...
Deb & Wink said:
You quoted my post, but your reply is missing. When I do that, it's usually because I hit the "Post Reply" button too quickly.

Would you please try again to reply? Thanks.
Click to expand...

I never noticed that it was missing +9 ect.. I don't test between 1am and 7 pm
Her unit of insulin was 1.5 am and pm
 
Hello!

My Cosmo has megacolon and constipation issues, so thought I could help?

We also give lactulose when he is constipated. In talking with other megacolon+diabetic kitty parents, they say that lactulose is non digestible/non soluble sugar, so shouldn't affect BG. I'm not sure we are 100% sold on that, but was what we had learned when we did our research. We also give cisapride (which helps gut motility and move things along).

For diabetic kitties, high protein, low carb food is recommend, but constipated cats need fiber to hold the moisture in the stool to prevent a blockage. Psyllium husk is diabetic safe to sprinkle on their food. (Metamucil - non flavored. Just a sprinkle)

Miralax - usually 1/8 tsp - 2x per day. I have heard of cats receiving more (1/4tsp). This can be a balance/dance between too runny and too hard. Cosmo didn't respond well to it, so we stuck to lactulose until he took a #2.

Water is very, very important. Lactulose, fiber and or miralax draw moisture into the stool. Diabetic cats are more prone to dehydration, so if you use either, kitty will need more moisture. Soupy food can work. So can sub q fluids.

If Cosmo doesn't #2 for 36 hours we start his regime (cisapride, Lactulose, fluids, enemas), but since he was surgically unblocked last month, he has been good!

Hope that helps!
 
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