Increase dosage to 3.5u?

[Howiesmom]

Hello! @Deb & Wink @Panic
I know that I have posted recently about questioning if I should increase Howie's dosage. His PM dose today will be his 6th dose at 3.25units and it doesn't seem to be doing much for him. He's been pretty much in the 300s with the exception of his nadir (high 200s). When it was suggested on here that I increase him from 3 to 3.25units, he had only been on 3 units for 7 cycles before the increase.
He is eating fine but now is not drinking a whole lot despite peeing a lot. I also just started seeing white sticky kittie paws on my hardwood floors as he exits the litter box today. I know on SLGS I am supposed to wait a week to increase his dose, but these don't seem to be good signs that increase to 3.25 is doing much. Do I wait longer despite the white sticky paw prints on my floors or go up to 3.5 tonight? I am concerned that he has drastically cut back on his water intake. I've tested for keytones since he had elevated levels last weekend and he seems to be fine. I do have some more sub q fluids from the vet that I could give him if necessary. He has had diarrhea/soft stool so has been on Jarrows S. Boulardii + MOS and some pumpkin to try and get that under control (which seems to be getting better in the last 24 hours). Would either of those things keep his BG at elevated levels? Thanks for your help.

 

[Panic]

Can't comment on most of it but pumpkin shouldn't affect his BG. I think Deb might recommend another increase; let's see what she says.

Slightly off topic, but have you ever tried wood burning pellets instead of clumping litter? It's so much easier to deal with when you have that extra sugary cat pee (cheaper too!).

 

[Howiesmom]

Can't comment on most of it but pumpkin shouldn't affect his BG. I think Deb might recommend another increase; let's see what she says.

Slightly off topic, but have you ever tried wood burning pellets instead of clumping litter? It's so much easier to deal with when you have that extra sugary cat pee (cheaper too!).

I haven't heard of using the wood pellets! I'll check into it! Thanks for the quick response and I will wait to hear from Deb about dosage. THANKS!!

 

[Panic]

No problem!

I get mine from Tractor Supply; $5 for 40 lb bag, lasts forever (maybe a little sooner with diabetic pee though). The urine turns the pellets into sawdust and you don't get the pee smell at all. It doesn't mask poo smells though. You just change it out when all the pellets have crumbled to sawdust.

 

[Lisa and little]

Wood pellets?!! Who knew! I may take that tip as well. Thank you. As for the white sticky paw prints, I had that too and found it was from Little having some neuropathy in her back legs and stepping in her pee puddle while exiting the box. Does Howie show any signs of Neuropathy in his back legs?

 

[Howiesmom]

Wood pellets?!! Who knew! I may take that tip as well. Thank you. As for the white sticky paw prints, I had that too and found it was from Little having some neuropathy in her back legs and stepping in her pee puddle while exiting the box. Does Howie show any signs of Neuropathy in his back legs?

He’s been showing some weakness and my shipment of methyl b12 and folic acid just showed up today. He had sticky Pawprints this summer but it’s been a while. I can’t figure out why he’s stopped drinking (but eating fine). I’m assuming he’s too much sugar in his urine. Even when he had elevated keytones last weekend, he was drinking his normal amounts.

 

[Deb & Wink]

The elevated ketones is from a cat burning their own muscle and fat tissues to provide energy. Not enough food + not enough insulin + infection/inflammation can lead to ketones which can lead to DKA. So feeding Howie a bit more could be good too.

Yes, please increase the dose to 3.5U of Prozinc. That is my recommendation.
Sometimes, you have to increase the dose faster than the standard guidelines in the SLGS Prozinc dosing protocol.
But with the ketones, I think it's even more important to get more insulin into Howie.

Please monitor closely when you increase, since the BG levels may dip lower than you have seen before. Have your hypo toolkit ready, with that all important chocolate for the caregiver (YOU!!)

Drinking less could be because the diarrhea is lessening and he doesn't feel so dehydrated and thirsty.
Another reason for a cat to drink less, is because they are getting most of their water intake from their canned/wet food.

Dehydration check. Pull up a "tent" of skin, it should go right back into place if no dehydration. Tent stays up a bit, dehydrated.
Also, press a finger against your cat's gums. They should turn white and then pink right back up if NOT dehydrated. If the gums feel "sticky", that is another sign of dehydration.

If Howie shows signs of dehydration, I'd go ahead and give him some fluids.

 

[Howiesmom]

The elevated ketones is from a cat burning their own muscle and fat tissues to provide energy. Not enough food + not enough insulin + infection/inflammation can lead to ketones which can lead to DKA. So feeding Howie a bit more could be good too.

Yes, please increase the dose to 3.5U of Prozinc. That is my recommendation.
Sometimes, you have to increase the dose faster than the standard guidelines in the SLGS Prozinc dosing protocol.
But with the ketones, I think it's even more important to get more insulin into Howie.

Please monitor closely when you increase, since the BG levels may dip lower than you have seen before. Have your hypo toolkit ready, with that all important chocolate for the caregiver (YOU!!)

Drinking less could be because the diarrhea is lessening and he doesn't feel so dehydrated and thirsty.
Another reason for a cat to drink less, is because they are getting most of their water intake from their canned/wet food.

Dehydration check. Pull up a "tent" of skin, it should go right back into place if no dehydration. Tent stays up a bit, dehydrated.
Also, press a finger against your cat's gums. They should turn white and then pink right back up if NOT dehydrated. If the gums feel "sticky", that is another sign of dehydration.

If Howie shows signs of dehydration, I'd go ahead and give him some fluids.

Thanks so much! He has been getting 2cans of food in a 24-hr period (1 can collectively at breakfast and dinner and the other can spread through 4mini meals each cycle.) So I hope he doesn’t need more food. He’s begging a little more, but not like it was before I started the auto feeder!! I am putting a bit of water in each of his mini meals to keep it from drying out, but he is down to drinking less than 1oz/day otherwise. He was drinking 4-6 oz a day even last week. His water intake dropped off during/after giving him sub q fluids over the wkd for the keytones. I didn’t think much of it while he was getting the fluids, but now I’m a bit nervous. I bumped up the dosage tonight. I just want him to crack 250 again. How long can his little body live in constant hyperglycemia?

 

[Deb & Wink]

How long can his little body live in constant hyperglycemia?

A very long time, many months, unfortunately.

He may not FEEL good while his BG levels are that high, but hopefully we can get his dose adjusted and get his BG numbers down out of the pink and yellow color coded number ranges.

Keeping our paws crossed for Howie, that the BG levels start to come down more.