? How to Regulate cat's BG?

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garbagecat

garbagecat

Member Since 2021
Hello!

Can anyone help me figure out what's going on with our guy Frank?

Spreadsheet linked here

Labwork linked here

He is on 1u of Prozinc every 12 hrs. After our curve this weekend we thought we might need to up the dosage (by such a small amount, .25).

Today at +7 I got my first ever over 400 reading at home. What are we doing wrong? His numbers almost never seem to be in the safe range, and when they are it's totally random.
He is eating FF classic pate (currently seafood because we couldn't find chicken anywhere) and blue buffalo wilderness pate. both are under 5% carbs. about a small can and a half per meal, twice a day. He is still acting like he's very hungry but seems to have put on a little weight (he should be around 10 lbs and was only 9.1 when he was diagnosed at the vet)

Any advice? How do we get this guy consistently in the safe zone with numbers? It seems like upping the dose may not be the answer. Should we try different food? Not sure what to do now.

From what I can see on his labwork, he has high cholesterol and elevation of ALT (google says: Alanine Aminotransferase (ALT) is a cellular enzyme released in response to injury of liver cells). Should I be looking for a lower fat food option? Are these elevated levels normal in a diabetic cat? He is only 4 years old
 
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Welcome to FDMB.

I suspect that you're not doing much if anything that's wrong. You've got your kitty on a low carb diet. You probably can feed him a bit more but as long as he's gaining back any weight he lost, that's a good start.

You might want to take a look at the sticky notes at the top of the Prozinc forum. There is information on how to dose your kitty. My look at your spreadsheet suggests that you need to have raised your cat's dose a bit sooner. In addition, you want to try to get at least one spot check during both the AM and PM cycles. We generally suggest getting a test before you go to sleep so you know that your cat is in safe numbers. We generally evaluate the dose after no more than a week.

I wouldn't worry about the cholesterol level in a cat. It's likely related to your kitty's diabetes. I also wouldn't take one ALT test value out of context. None of the other values are high. It may be an artifact or something to mention to your vet. If you have an older set of labs, you can compare the values.
 
Sienne and Gabby (GA) said:
Welcome to FDMB.

I suspect that you're not doing much if anything that's wrong. You've got your kitty on a low carb diet. You probably can feed him a bit more but as long as he's gaining back any weight he lost, that's a good start.

You might want to take a look at the sticky notes at the top of the Prozinc forum. There is information on how to dose your kitty. My look at your spreadsheet suggests that you need to have raised your cat's dose a bit sooner. In addition, you want to try to get at least one spot check during both the AM and PM cycles. We generally suggest getting a test before you go to sleep so you know that your cat is in safe numbers. We generally evaluate the dose after no more than a week.

I wouldn't worry about the cholesterol level in a cat. It's likely related to your kitty's diabetes. I also wouldn't take one ALT test value out of context. None of the other values are high. It may be an artifact or something to mention to your vet. If you have an older set of labs, you can compare the values.
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Thank you! We are trying to increase by .25 but our needles do not even have half unit measurements on them so it's really just an eyeball measurement.

I don't trust our vet, to be honest. We will be moving around 45 minutes away in a few months and I will be getting a new vet then - there's a cat specific clinic in the new city we'll be in and I'm hopeful they will be more encouraging about diabetes. Our current vet completely discouraged home testing and told me carb count in a food was not as important as "having a good brand" (she tried to push purina OM (Overweight Management) wet food on me despite my cat being underweight and diabetic...$55 a case AND carb count of 21%). I don't think she will be much help conversationally unless I need a new prescription so I definitely need as much guidance as I can get from here.

Do you recommend trying to keep the 1.25 dose consistent? Or go up to 1.5?
 
Now I’m even more confused / someone just told me that since my cats numbers were lower in the beginning on .5 that we should reduce. Our latest high is from a bounce and because he’s been increased too much. What should we do?
 
garbagecat said:
Now I’m even more confused / someone just told me that since my cats numbers were lower in the beginning on .5 that we should reduce. Our latest high is from a bounce and because he’s been increased too much. What should we do?
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I'll preface this by saying I don't use Prozinc, so I will leave the aspect of additional feedback regarding that insulin to those who are, other than to say, I see Sienne has provided quite a lot of good information in post #2, and I wholeheartedly agree that getting some mid cycle tests will help you immensely, since at the moment there are more white spaces in your SS than BG tests ;).

What I will say is that I'm not sure where you are getting such advice to drop the dose back down unnecessarily, and that IMHO is bad advice. We have been seeing a lot of this lately, and I'm afraid that advice is misguided, to say the least.

What they have suggested is called a rebound check, and this is problematic because it can end up setting the kitty back, and it puts them at risk for glucose toxicity, because they just get stuck in high numbers. You end up having to increase to break through the glucose toxicity.

I'd re-read the sticky about dosing from the Prozinc subforum that Sienne posted, and hopefully others with Prozinc experience will be by.
 
Can you get a mid cycle test each day and a before test in addition to the preshots? Without data is hard to say if it's time to raise the dose. ProZinc is dosed based on how low they go mid cycle.
 
I couldn’t agree more with what Christie posted. I’ve been a member of FDMB since 2009. I don’t ever recall anything good coming our of a rebound check. All that ever happens is you lose time getting to a good dose since the dose eventually is increased back to where you were.
 
JanetNJ said:
Can you get a mid cycle test each day and a before test in addition to the preshots? Without data is hard to say if it's time to raise the dose. ProZinc is dosed based on how low they go mid cycle.
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Actually I do work from home (unfortunately I have a pretty busy job with client meetings) but I can try to get a mid cycle test daily. What do you mean by a mid cycle and a before test in addition to the preshots? I understand a mid cycle test (+6ish hours after shot) and I understand a preshot test but I’m not familiar with a “before” test

What does this mean in terms of the dose I should be giving? 1u? Or 1.25? It sounds like I should not drop it down. I gave him 1u tonight. His numbers were higher than ever and I am nervous I am doing the wrong thing.
 
Look at my spreadsheet last year for a rebound check, and look how well it worked out for me :arghh:At the time I didn't know it was called a rebound check or that it wasn't recommended, and I'm still kicking myself for the wasted time.

To be clear - bounces don't come "from giving too much insulin". A bounce comes from numbers dropping lower and/or faster than a cat is used to. The threshold, so to speak, is different for every cat. Correlation does not imply causation - there are a number of reasons why numbers can drop lower or faster, insulin dose only being one of them. This is part of why it's recommended to hold a dose for a few days/week, the cat's body needs time to adjust to the insulin.

Like Janet said, it's hard to tell if it's too much or not enough insulin without more mid-cycle tests. A "good" dose will have nadirs around 90 or so on ProZinc, and over time the preshots should come down into the blue range.

If she doesn't get a chance to reply - I'd hold the 1.25U dose until you can get more mid cycle tests in. I don't think he's dropping so low as to risk hypo-ing.
 
garbagecat said:
Actually I do work from home (unfortunately I have a pretty busy job with client meetings) but I can try to get a mid cycle test daily. What do you mean by a mid cycle and a before test in addition to the preshots? I understand a mid cycle test (+6ish hours after shot) and I understand a preshot test but I’m not familiar with a “before” test

What does this mean in terms of the dose I should be giving? 1u? Or 1.25? It sounds like I should not drop it down. I gave him 1u tonight. His numbers were higher than ever and I am nervous I am doing the wrong thing.
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oof a word was left out of the sentence. (Face palm). That was supposed to say a before bed test.
I just mean before you go to bed at night take a test. So like I do my cats pmps around 7, then take another test before I go to bed at 10.
 
I agree with Janet, we can't really tell without mid-cycle tests whether the dose needs tweaked or not just yet.

Ideally, you will want to check BG at least a couple times during the cycle. An earlier test around +2 will usually give you an indication of how the cycle is about to go (sharp drop would mean to keep an eye out and possibly intervene with food for example). Another test between +4 and +6 would be helpful too, plus a "before bed" test every night.

One thing you can do if you have the time is alternate tests, so do say a test at +2, +4 and +6 one day and the next test at +1, +3, +5. That will help you understand his cycles better. That's a rough guide anyway, nothing set in stone. :)

The only other thing I'd like to mention is to have some food in between meals! It's much better on the pancreas to have multiple small meals instead of just two big ones. It will help "steer the drop" as well and prevent numbers from dropping too low or fast. Ideally you'd give food at onset (around +2 or so) and a couple more times before nadir (between +5 and +7). Night times too.
 
Following on from Elizabeth's suggestions on feeding above, for night time mini meals (or during work hours) many members use a rotary timed feeder (the Petsafe 5 is very popular). It can be used to dispense wet food. Also, you can set it to rotate to an empty compartment two hours before the next preshot test is due, meaning that it won't be food influenced.


Mogs
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garbagecat said:
Now I’m even more confused / someone just told me that since my cats numbers were lower in the beginning on .5 that we should reduce. Our latest high is from a bounce and because he’s been increased too much. What should we do?
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In my experience (have been on here since Jan 2007) it absolutely 'can' be the case that if numbers go up as the dose is increased, this can mean the dose is too high rather than too low. (We've seen this happen here when cats have had doses increased unnecessarily by their vets....)
However, there is very little that can be determined by preshot numbers alone. And it is really, really important to get some tests during the insulin cycle.
The preshot numbers mainly tell us whether our cat's blood glucose is high enough for insulin.
But it is the tests during the insulin cycle that show us how the insulin dose is working in the cat's system.

When my first diabetic was diagnosed back in Jan 2007 I joined FDMB and sought help, and there were quite divergent opinions on why my cat's blood glucose was high. Some people thought the insulin dose was too low. Others thought the dose was too high. Both opinions had merit at the time based on what those particular people advising had seen happen in other cats. ...But, it was gathering more blood test data in my own cat that really helped to determine what was going on. Testing blood glucose is key. Test, test, test....

Eliz
 
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Elizabeth and Bertie said:
In my experience (have been on here since Jan 2007) it absolutely 'can' be the case that if numbers go up as the dose is increased, this can mean the dose is too high rather than too low. (We've seen this happen here when cats have had doses increased unnecessarily by their vets....)
However, there is very little that can be determined by preshot numbers alone. And it is really, really important to get some tests during the insulin cycle.
The preshot numbers mainly tell us whether our cat's blood glucose is high enough for insulin.
But it is the tests during the insulin cycle that show us how the insulin dose is working in the cat's system.

When my first diabetic was diagnosed back in Jan 2007 I joined FDMB and sought help, and there were quite divergent opinions on why my cat's blood glucose was high. Some people thought the insulin dose was too low. Others thought the dose was too high. Both opinions had merit at the time based on what those particular people advising had seen happen in other cats. ...But, it was gathering more blood test data in my own cat that really helped to determine what was going on. Testing blood glucose is key. Test, test, test....

Eliz
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thank you! Yeah, I’m seeing that the need for mid cycle tests is pretty important. I’m going to try to sneak up on him while he’s asleep . We do our pre shot tests together - my partner holds him and I poke him. With one person it’s a squirmy fight and then I’m chasing him around holding a lancet..not a good scene. I can get him while he’s napping and he doesn’t mind

what ended up being the case for your cat?

also an update - I dropped it back down to 1u and this morning his preshot was 277. Way better than the 400+ we’d been getting. I am going to wait until we get more solid mid cycle tests to determine what to do. Though our curve was at 1u and he never seemed to drop into the normal range
 
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Ok an update:

I honestly think we’ve been overfeeding and he’s been scarfing food, despite it being low carb blue Buffalo wilderness pate.

We got a +4, just now. We feed him 8pm so tested at midnight. We were giving 1.5 cans of food at a time because he is underweight but I think he has been scarfing! He’s puked yesterday morning and today midday (but didn’t have low BG and was active and hungry otherwise)

Tonight we did only one can of 3oz blue Buffalo wilderness chicken, 1u of ProZinc and his +4 is 155, the lowest it’s ever been. I just bought a full case of the bbf wilderness chicken pate. I’m hopeful we’re on the right track
 
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