New Spreadsheet, cat has neuropathy :( Can anyone offer advice about dosage?

Todd's mom Heather

Todd's mom Heather

Member Since 2018
Hello! My cat has been diabetic for 3 years. In the past month or so, he has started showing neuropathy (his wrists sag, and he has fur twitches) so I think I should raise his dose again.. But many people have cautioned that maybe I'm giving too much, since that can present as not enough?

Here is his spreadsheet since January:
https://docs.google.com/spreadsheets/d/1P1kJq8mCtFu68eXde2yb8hrWPvcmRnAJAuo9hr_AaAU/edit?usp=sharing

How do I know if it's too much (bouncing) or simply too little? Do you have a suggestion for where to start? I can't decide if I want to back off for a while, and work my way up, or just start giving 6.5 or 7 units for a week or two, to see if his numbers get better....

He also has frequent pancreatitis flare ups, and he is on Prednisolone. So I have no idea if I can ever get him into normal ranges :( But I hate that neuropathy is happening to my poor boy. He eats Fancy Feast Pate.
 
Tagging some more experienced users to advise @Deb & Wink @JanetNJ

Looking at your spreadsheet, his pre-shot numbers are very inconsistent which suggests he is bouncing. 6 units is very high as a starting dose. I believe the recommended starting dose is 0.5-1 units for ProZinc and then you adjust from there based on the nadir (lowest point) after a few days of consistent dosing. In my opinion I would reduce the dose immediately, but I will see what others say.

It's good that you're getting some readings during the day cycle, but you should also try to get some in the evening too. If you could get a +2 so you can see whether he's dropping too quickly, and then another before you go to bed that would help to get a fuller picture of what's going on.
 
Wonderful you're getting some more testing in. But you need to test the PM cycle too.
He earned a reduction on 26 of February, any reason you didn't take it?
When you get a green, it's a good idea to keep testing so you know he won't go lower.
Too much insulin can look like too little, which I'm suspecting is what's going on..
 
Thank you both for your thoughts! The reason I didn't reduce insulin after a low number, is because I have also heard that if kitties are high for too long, they will drop low. Does that not happen? Is it only the other way around? I guess I always assume the low values are a fluke.

I've been working his way up to the current six units for 3 years, he has never had consistent, nice, low numbers. If I showed you a spreadsheet from when he was a 2 or 3 units, it would look the same.

This morning in fact, he was 60 ‍:/ Then three hours later, 90. But I know tonight he will be 450 again. I just wish I could get his numbers consistent, and help his neuropathy. I feel so awful that after all this time, he might be doing worse than when we started.
 
Todd's mom Heather said:
Thank you Oscar and Carrie :) I really do agree. I need to take more readings at night, and in the middle of the night when he wakes me for food.
Click to expand...

Defintely a good idea to test when he wakes you up for food. It may be that he's dropping low. Cats will seek out food to try and bring their sugars up.

Yeh I think you might be slightly confused about the numbers. If the insulin dosage is too high, and the blood glucose therefore drops too quickly or too low, the body releases sugar to help bring it back up, leading to a high number. This can then cause bouncing, which I believe is what you are seeing.

Glad to see you've done a +2 tonight. Good rule of thumb is that if the drop between pre-shot and +2 is more than 100 then he may be dropping too quickly and more frequent testing that evening is required.

Anytime you see a number under 90, at any point in the cycle, then you've earned an immediate dosage reduction of 0.25.

Try not to beat yourself up about it. Main thing is you're here now and we'll all help to try and get Todd's numbers under control.

I have no experience with neuropathy so hopefully someone can advise you there.
 
Have you considered trying another insulin?
Give Deb and Janet some time to work their magic, if it doesn't work I would switch.

I can't see the logic in if they're too high too long they'll go low...
It's more like, if they go lower than their body is used to, it thinks it's in danger and releases glucose, making them high so it seems they're getting too little insulin. I think that's what you're seeing. If he's waking you up in the middle of the night, do please test him! Cats usually goes low at night, and they seek food when they're too low.

So start testing in PM cycle, and in general test more. I'm thinking this will make sense and you'll see improvement fast :bighug:
 
Yeah, it was Todd's dental surgeon at the emergency and referral center who told me their bodies will dump a bunch of hormones and drop their BG if they have been high for too long. I have never seen anyone say that here, though.

Thank you for all of your help and thoughts.

Does anyone have a suggestion to how much I should reduce? Should I start with .25u, or more? And just keep reducing from there? I'm looking forward to the night time numbers and data!!
 
SashaV said:
Have you considered trying another insulin?
Give Deb and Janet some time to work their magic, if it doesn't work I would switch
Click to expand...

I have tried Lantus 2 different times, and both times he got so sick he ended up with hepatic lipidosis and a feeding tube in his throat. I don't think I will ever try to switch to anything else..
 
Right now, I would not recommend that you reduce the dose at all. More monitoring, definitely. A dose reduction, not until we can see more mid-cycle numbers.

Todd needs his medications for his other conditions, both the prednisolone and the flovent. So you have to adjust the insulin dose around those medications, both of which can keep the BG levels high, and require higher doses of insulin.
Todd's mom Heather said:
Yeah, it was Todd's dental surgeon at the emergency and referral center who told me their bodies will dump a bunch of hormones and drop their BG if they have been high for too long. I have never seen anyone say that here, though.
Click to expand...
Well, that vet got it partially correct. A cat's body does react to a "lower than usual number" by dumping sugars and hormones into the bloodstream. But that is not happening because they are too high for too long. It's because their body is not used to normal numbers, and overcompensates when it drops lower than they are used to. That "Low" could be 200, or 100 or something else.

We call that bouncing. A bounce can take anywhere from 3 to 6 cycles or more to clear. A cycle is 12 hours, a dosing period.

A cat needs as much insulin as a cat needs.
 
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