Frozen insulin

J

James kelch

Member
My 14 year old cat has been well regulated. I may of froze his i ikon and it’s 5 months old. It’s not working. He’s been in the 4 and 500s last few days. Lethargic. My vet opens tomorrow. He doesn’t have sweet breath yet. Should I still give him his shot tonight even though it only went down 30 points all day today? Or wait until I can get him to the vet in the morning for a shot and some fluids. Or should I rush him to the med vet? Thank you.
 
So sorry you didn't get a response in time, the Prozinc forum is a lot quieter than the Main Health forum. Is your kitty okay? 5 months is a little old for Prozinc, not including the fact it may have froze.
 
Panic said:
So sorry you didn't get a response in time, the Prozinc forum is a lot quieter than the Main Health forum. Is your kitty okay? 5 months is a little old for Prozinc, not including the fact it may have froze.
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He’s lethargic and drinking aloe. Hasn’t lost weight. Going to the vet today. Prozinc has done well for him. But now it seems his levels will barely drop and be even raise a little before barley dropping. Going to the vet This morning.
 
Yes, please let us know. I imagine your vial has lost its effectiveness. Please have them check for ketones and maybe pancreatitis since his numbers are high and he's not feeling well.
 
I do believe it’s the Insulin. Although I did give him a unit of Vetsulin last night that didn’t seem to help. This morning vet said he had no keystones in his pee. Did see a couple white blood cells. But said they were scattered and nothing to worry about. He had blood test done 3 weeks ago. Came back perfect. He had me give him the ProZinc anyway this morning. New ProZinc should be here tomorrow. He will eat some salmon treats now Scarfed then down. Gonna test him again in about 30. See if his numbers dropped at all. Thanks for talking with me. I’ll let ya know what happens.
 
Glad to hear he's free of ketones! Thanks for the update, fingers crossed the Prozinc comes quickly and it was just an old vial causing the issues.
 
Ok. It’s probably the insulin. Pretty sure. Vet had me raise it to two units. because 1 did hardly anything. Gave hit 2 units at 8:24 am. By 1:30 pm he tested at 372. 183 point drop. Is 183 to fast in that’s amount of time. Like he would rebound? New insulin tomorrow they say. I know some cats get used to higher numbers and rebound at normal numbers. It’s I’m guessing bad insulin because 1 unit did nothing and 2 units did something but not as good as 1 unit has been doing.
 
A cat's insulin needs fluctuate, very few cats need to stay on the same dose longer than a week. Sometimes they need more, sometimes less. We increase and decrease slowly - by 0.25 units - because cats are so small and sensitive to insulin. It doesn't take much. Jumping from 1 to 2 units isn't preferable because it's easy to bypass the perfect dose. He might need something in between.

Rebound (or bouncing as we call it here) will happen if the dose drops too much or too fast. Typically if they drop more than 100 points in an hour they will bounce, or if they drop more than 50% in a cycle, that can trigger a bounce.

If you'd like, we'd love to take a look at his numbers and see how he's doing! We make a spreadsheet on Google and record blood glucose readings, then we can see the patterns and note when an increase or decrease is needed. You can see mine in my signature below.

If you would like to, but need some help setting it up we could ping a mod to do it for you. Up to you but it makes diabetes life a LOT easier. :)
 
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This is the last few days after I began to suspect bad insulin. His numbers haven’t but even though isn’t high for a few years. He isn’t really wanting to eat and they still stay high.
 
Oh excellent, let me tag @Bandit's Mom - could you help James set up a spreadsheet for his kitty please? :)

What was your kitty's name again? Is he acting nauseous - licking his lips, going to the food bowl but not eating? What did the vet say about him being lethargic? He may need some anti-nausea and appetite stimulant.
 
3 weeks ago. We had a blood test done. Came back good. Vet told me his levels where kinda low for that time of day. 3:30 after he ate much. It was a 70. That’s why I was thinking he could also be bouncing. But then all the test I didn’t after that showed him high at most times. I’d love help. Thank you.
 
Panic said:
Oh excellent, let me tag @Bandit's Mom - could you help James set up a spreadsheet for his kitty please? :)

What was your kitty's name again? Is he acting nauseous - licking his lips, going to the food bowl but not eating? What did the vet say about him being lethargic? He may need some anti-nausea and appetite stimulant.
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His name is Button. He’s 14. Been diabetic for 7 years now. Yes. He looks at the food and turns away. Will eat trays and cheese if I let him for the most part. Vet says he’s tires because of the high levels and we should just try and get them down. He’s old school for sure. Licks lips sometimes but not a lot. Soon as we had him in the 300s today he seemed more perky. He’s in 400s now and sleeping. Still weak when he tries to jump on the couch. Scarfed down some blue craving treats and cheddar cheese today. Are some raw chicken breast at much Heyerdahl but turned nose up to it at dinner. My vet says let him eat anything at the moment. Better than nothing. We sure about that? Even had me give him his shot when he wouldn’t eat. Levels still stayed high those days.
 
70 is a bit low for that late in the day...did your vet reduce his insulin after that? That can cause bouncing, which can last uo to three days of high numbers before coming back down. But if he is still on a high dose and he bounces again it can just be an endless bounce until insulin is adjusted.

Okay, he is nauseous then. You need to have the vet give him cerenia, ondansetron and an appetite stimulant. I'm going to tag @Deb & Wink and @Critter Mom and @Aleluia Grugru & Minnie in case any are online that can help since I'm not sure if cerenia is only recommended if vomiting is involved or if it's fine either way.

Did your vet run a pancreatitis test? It's important to know what's making him nauseous.
 
I would rather a cat eat anything he's willing than nothing at all. Low-carb requirements need to take a back burner in that case. Have you tried simple baby food, chicken flavor? Make sure it has no onions in it.
 
I haven’t tried baby food yet. But I will thank you. I was thinking the same as you. He may be getting to low and bouncing like mad. Just didn’t seem like when the numbers came back high. But you know how that goes. Could be fooling me. New insulin should be here tomorrow. Wondering if I shouldn’t start a lower dose and go from there.
 
Okay. A SNAP fPL test is separate from regular bloodwork, it would tell if he has pancreatitis or not. It doesn't tell how severe it would be, a SPEC fPL would but they take 2-3 days. Some cats have it very bad and need hospitalized, other just have very mild cases with few symptoms. If he did have it he'd need fluids and painkillers to feel better on top of anti-nausea and appetite stimulant.
 
Gave him a little more than his normal 1 unit. should I just give him him the 1 unit of the old insulin tonight? Doc had me give humble 2 this morning because we think the insulin’s is old. I really appreciate your help. Thank you. What if I didn’t give him any insulin tonight? Would his numbers go down if he has been getting to much?
 
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I have more experience with ondansetron and Minnie is on it daily, vomit or not vomit so yes, you can give it to them consistently to help with nausea and keep them from vomiting too. I believe Cerenia is the same except you can’t give it to them every day. You do 5 days then stop for 3 then start again for another 5, and on and on. I wanted a Minnie to be covered daily so ondansetron works for us. Cerenia just also never seemed to control her vomiting well, it actually induced it which is one little known possible side effect.
 
Sorry I didn't see your edit earlier! It's hard to say since the vial is old ... I might go with the 1 unit for now but maybe @Deb & Wink has a better suggestion.
I think with him being nauseous and not wanting to eat, skipping is a bad idea as that can invite ketones to develop. It only takes a few hours for them to show up.
 
First things first.
Go out to the drugstore right now, and get some ketone test strips, to test your cat's urine. Let's have you and us make sure there are no ketones present before we start suggesting a dose.

Second things second.
Signature information needs to be set up ASAP, please. Pretty please with sugar on top. Helping too many people right now, to go back and read through this entire thread to see what is happening.

Third things third.
Get our standard format SS set up, and put any test data you have in there. Instructions were probably posted in a previous reply by someone.

Fourth things fourth.
If you aren't home testing yet, get started. You'll likely save your cats life.
Plus, very few people here will be willing to make suggestions on the dose, if there is no SS and test data to look at.
That is like asking us to drive down the Autobahn, at 120 mph, backwards, with our eyes closed, with thousands of other cars on the road to avoid hitting. In other words, impossible.
 
I do test him myself. His levels were 575 tonight before shy. So I gave him the 2 units. Vet said today he didn’t have keystones. When hisblevels got into the 300s today he had a little energy. Now he is tired and weak.
 
James kelch said:
I have a question. Should I ever give an in between shot fin his levels are out of control ?
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NO.

Not without a lot more years of experience, a ton of test data to know how the particular insulin and dose is affecting your cat, and knowing how to interpret the BG levles on the SS, and the guidance of preferably a vet ( or an extremely experienced member of this message board with the particular insulin you are using. That would not be me.)

James kelch said:
Vet said today he didn’t have keystones.
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Ketones are not a one shot deal. They can develop very quickly, from one cycle to the next.
Not enough food + not enough insulin + infection/inflammation (think bad teeth, UTI, etc) or any combination of those factors can lead to ketones. Too many ketones leads to DKA (diabetic ketoacidosis) an extremely expensive complication to treat, with a week or more stay at the 24 hour emergency vet. Think thousands of dollars, high 4 figures at least. Sometimes more.
 
James kelch said:
I have a question. Should I ever give an in between shot fin his levels are out of control ?
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I'll elaborate on what Deb said - you don't want to give insulin in the middle of a cycle because that will overdose your kitty. Better too high a day than too low for a minute. You just have to ride those high numbers out until next shot-time. You already are aware of what a bounce/rebound is - you wouldn't want to "feed" a bounce more insulin.

I know it's annoying since you were literally just there today but I would take him back for anti-nausea, appetite stimulant, and a pancreatitis test. If pancreatitis is negative, find out why he's nauseous. Some other illness or infection. See if he's dehydrated. Is he pooping okay? Things to think about and things to bring up to your vet. My vet shrugged her shoulders when I brought my girl in for nausea, said she was fine and her bloodwork was normal. She didn't test for pancreatitis, didn't give him his insulin while she was there, and sent her home on just a shot of cerenia. She had pancreatitis, was dehydrated, and had small ketones by the next morning. I don't say this to build up a scary story for you, but to tell you the reality of what I went through with my girl and how on top of things you need to be for Buttons. Those things, coupled with a few other vet errors, she did not make it. :(
 
Last night I only gave him 1 and a half prozinc. 4 hours later he went from 500s to high 300s. This morning the test said hi. Gave him 1 and a half again. 3 hours later he tested 506. Do we think it’s the insulin being old and bad. I test him multiple times a day since he started acting weird. And haven’t seen him once with low numbers.
 
And all these hi numbers are without much food at all. His new insulin should Be here today. Should I give him husband normal 1 unit. Or should I start new and do a half? I’m not sure what to do. His numbers stay hi right now.
 
I'm at work at the moment and can only give brief answers, but we look at how low the insulin takes BG, not how high. He doesn't feel good and his insulin is old so keep that in mind. I might do 1.5 tonight, but that's based off very little data.

Are you going to get him some anti-nausea and appetite stimulant from the vet to help him feel better? I would get ketone sticks from the pharmacy too, you want to check every day right now to keep an eye on them.
 
I’m gonna get the keytone sticks today. Vet said all he had was a anti depressant for humans that caused cats to be hungry. Gave him some antibiotics the other day. Told me to wait a day or two for those to work then call him. The lowest I’ve seen Bieber numbers the last few days was a 283. Hasn’t been believe hi 300s since. 2-3 days now.
 
Let’s say I find keytones. Then what. Horrible thing isn’t I can’t afford. Well I think I can’t. To leave him in a emergency vet for days. When this first happens years ago I didn’t. It was 1800 for whatever they didn’t over night.
 
Okay you can't give an appetite stimulant without anti-nausea, it makes it worse. Can you/r vet call around for anti-nausea? Your vet should have had some on hand. Or ask for a prescription for ondansetron and get it filled at a human pharmacy, they're cheap. He needs to feel better.

If ketones are above trace, he'll need to go to the vet for fluids. Best to catch them super early if he does develop them, so you can flush them out before it gets worse. Much cheaper to give fluids for trace ketones than be rushed to the ER for high ketones.
 
Panic said:
Your vet doesn't seem to be taking this seriously. The sooner he's eating in his own the less chance for ketones, the less chance of it turning south. Did you ask about a pancreatitis test?
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I don’t know wha to think about my vet. Nicest guy ever. Calling him today about test. Any tricks to getting his paw pad to bleed? His ear is sore now.
 
Your vet is probably more experienced with canines...high numbers are less of a big deal for them but is major concern for cats. We want to prevent those high $$$ visits by nipping it now while he's still ketone-free. Please get a script for ondansetron at least. If he doesn't have the SNAP fPL test call around. Took me 5 calls before I found someone but that's apparently rare.

No personal experience with paw pads, I would ask on Main Health forum. Are you switching ears and the area where you poke? You can poke all along the edge of the ear. Neosporin Ointment w/ pain relief helps the ears.
 
Yeah. This insulin isn’t working for sure. Gave him his shot. 3 hours later it was down barely. Waited another 3 just tested. It’s going back up. He’s 513 now. Was 506 3 hours ago
 
Panic said:
Yeah I would give him a break right now. When the insulin arrives do wait until next shot time though.
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Called the vet. Wants me to bring him in For another unit. Says with levels that high there no chance of dropping low madness we need to get the those levels down. ???
 
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