Tiny dose change; big BG change

M

MaggiesMom

Member Since 2021
This is my first post (sorry if I ramble or leave out important details) and I have a newly diagnosed 12 year old cat. She was put on ProZinc when her BG levels were shown to be 320 then 340 at the vet a week apart. (She had lost two pounds, was drinking a lot of water...) I started at 1U and took her back a week later for a BG curve. They tested her a couple of times during the day and got BG readings in the 300's and 400's, so we increased the does to 2U. I ordered a human BG monitor and started checking her BG occassionally and it was as low as 43 and 150 at feeding/insulin time. Called the vet and he thought the monitor might be incorrect.

After another week, we put a FreeStyle Libre on her. The blood glucose monitor had been correct. So dropped back to 1U. I was still seeing nadir BG at around 60-70 and peaks around 200-250. She pulled it off after 6 days and I sent results to the vet. These were low enough numbers that he wanted me to change the dose to .75U. Now I get lows around 200 and highs around 350. UGH! It is such a tiny amount of difference in dosage but such a big swing in BG. I don't think I can adjust the dose any more closely than this.

Has anyone else seen this before? The vet mentioned we many need to change to a different type of insulin.
 
Hello and welcome! :cat: Well it certainly is good to see that your kitty is responding to insulin, although I feel your frustration! What are you currently using to monitor her blood sugar, another libre or a meter? One thing that would be really helpful is if you could set up a spreadsheet with her blood glucose (BG) readings. That will make it much easier for people to give advice. Here is a link on how to do that. It is a lot of writing, but if you follow it step by step it is actually pretty simple :cat:

https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

What kind of food is she currently eating? One thing that can really help lower BG in a lot of cats is low carb food. If she is not already eating low carb food, I'm wondering if switching to it might help her numbers come down even more. However, you do not want to switch her food if you are not currently monitoring her BG frequently, as some cats can have a very strong response.

How long have you been giving her 0.75 units? We typically recommend holding the dose for 7 days (unless she goes low, then reduce immediately) to give the dose time to work. If you have been giving her 0.75 units for at least 7 days and are still seeing those kind of numbers, two things that come to mind that I would recommend. You could either trying "fattening" the dose, or dosing with u100 syringes. To fatten the dose you would give just a smidge more insulin, basically between 0.75 and 1u. Are you using syringes with 1/2 units? That will make it much easier, if not. A more accurate way to do this would to be to use u100 syringes. To do this, you will have to use a conversion chart. You can read more about that here, under "microdosing":

https://felinediabetes.com/FDMB/thr...inge-info-proper-handling-and-drawing.225856/

Here is a link to the conversion chart. Using this method, you could try giving 0.8u of Prozinc to see if that brings her BG down a little more.

http://www.felinediabetes.com/insulin-conversions.htm
 
Thanks so much for the response! Yes, she is eating low carb food - Friskies seafood pates, 2/3 can, 2x time (7:00 am and pm) since I got a confirmation of her diagnosis and started her on insulin (May 6th). Before the diagnosis she was eating higher carb food (by choice, as she wouldn't eat much of the friskies, so that could have been why initially she appeared to need a higher dose and then didn't as she adjusted to the low carb diet.)

She has been at the lower dose for 4 days so far and I was planning to give it a week, but then got impatient. So I will do a decent BG curve after a full 7 days. I will do a chart if I have the time or at least for the full day monitoring. (It's getting much better, but getting a blood sample off as a little traumatic for Maggie, and I don't want her to run from me whenever I walk towards her! Right now I just spot check her BG maybe once a day.)

I will read up on micro dosing. I do have syringes with 1/2 units and feel like I'm pretty consistent with the dose. Hopefully things will be a bit better after 7 days!
 
Good to hear about the low carb food! :cat: I understand about the testing, I have one that will now tolerate it but definitely isn't a fan. Spot checks when you can are good. We recommend testing before every preshot and then at least once per cycle (one cycle is 12 hours). Are you using treats for her BG tests or any other kind of motivation that she likes? Treats were the only way I got my wild one to come around, but she is very food motivated :rolleyes: Other people's cats like pets or brushing as a reward

Does she only like to eat 2x per day, or would she be willing to eat more often (if you're able to do so)? Feeding multiple smaller meals throughout the day can make it easier on the pancreas.
 
I haven't done treats, but will do that when I test more.

She would definitely eat more often, but I know there are different theories on this and my vet says eat with insulin 2x a day. As well, I am not always home to do this consistently, so I guess I would like to do what I can do consistently. Hard to know.... I can't say that I will always follow my vets advise, but for now, and with my schedule, it seems like the best idea. In the future, if I can't get her stablized on a dose, it is something I would try.
 
It's true that she does need to eat with insulin, but the "only two meals a day" thinking is actually old and outdated advice (Here is the AAHA recommendations on feeding). Feeding multiple smaller meals can make it easier on the pancreas and keep it from having to work so hard, and may help to bring her numbers down as well. That being said, you have to pick a feeding schedule that works for you too! If you do decide to try multiple meals, or even just one extra meal midday, many of us use timed feeders for when we are not home. We can give recommendations if you are interested :cat:
 
Sarah&Soph said:
the "only two meals a day" thinking is actually old and outdated advice
Click to expand...

I vehemently agree omg. My vet demanded only 2 meals a day, of course i listened at first, then I stopped all together listening when they wanted me to push 4u after my cat went hypo on 2u. 4 meals 2am 8am 2pm 8pm has really helped me understand how my cats BG works with food. My cat gets a higher BG when he's fasting apparently! Something about somogyi effect? Anyways I can correct it now with food! My cat did WORSE with higher insulin shots and less food. He is now 4 days away from official remission with no insulin eating 4 meals a day with treats :)
 
You must log in or register to reply here.
Back
Top