Insulin seems to have no effect on blood sugar, what's going on?!

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Ali and Gem

Ali and Gem

Member Since 2021
Hello all,

Gemma has been on Prozinc (1 Unit) for about a month and a half. Some days it seems like the insulin is making a difference, but most of the time she goes up after her shot. It just seems like the insulin isn't doing anything, or doing very little. Any ideas about why this might be happening? I am getting the feeling she has pancreatitis, as she sometimes throws up and has pale, sometimes loose stool. Could this be having an effect on the effectiveness of the insulin? She just started on pancreatic enzymes about a week and a half ago. Anyone else seeing this with a newly diagnosed kitty?

Thanks in advance,

Alison and Gem
 
Hi Alison! I actually think you’re getting some pretty good numbers and a nice long duration from your Prozinc. One thing that the group will recommend though is to choose a dosing protocol (either Start Low Go Slow (SLGS) or the Modified Prozinc Method (MPM)). This is the link to those if you haven’t had a chance to read them and think about it yet:

https://www.felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/

Choosing a method will help you know how long to hold a dose (so you’re not holding it too long) and when to increase and decrease.

Generally any numbers above 200 are ok to give her a full dose. It took me way too long to learn that, but I wish I had been following it much sooner. I was scared to shoot a full dose when George was in the yellows before but started getting much better numbers when I finally did. It also isn’t uncommon for them to go up for the first couple of hours after the shot (George was up at +2 today and then started going down after that). Sometimes he’ll go up significantly…such as if you look at the 6/23 pm cycle on my spreadsheet. For him, that drastic of an increase is usually due to a bounce (caused by a previous low, and most likely meaning that he will resume normal numbers again soon after he “breaks” the bounce).

If no one has explained bouncing to you yet I can copy a nice explanation that one of the other members gave yesterday.
 
Sorry I see now you’re doing SLGS! It was kind of off the page when I looked at your spreadsheet.

With SLGS increases and decrease are generally done in 0.25 unit increments, and she would earn a reduction every time she goes under 90 on a human meter. The dosing protocol is written with a human meter in mind, so I’m not sure what the reduction number is on the Alpha Track meter that you’re using, but hopefully someone who knows will chime in. It looks like she would have earned a couple of reductions already either way though. When the 0.25 reductions are put in place they should be held for a week too and then adjusted from there.
 
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Thank you for responding! At this point, any advice helps so I'm glad you think the numbers look okay. I see everyone else's spreadsheets and they're in the blues and greens and I just want to get Gem there. I'm starting to wonder if anything I'm doing is helping, this is really tough. Please do copy the explanation of "bouncing", I need all the info I can get!
 
Alison Finnman said:
Thank you for responding! At this point, any advice helps so I'm glad you think the numbers look okay. I see everyone else's spreadsheets and they're in the blues and greens and I just want to get Gem there. I'm starting to wonder if anything I'm doing is helping, this is really tough. Please do copy the explanation of "bouncing", I need all the info I can get!
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I will! If you look at my spreadsheet it took MUCH longer to see blues on Prozinc than you’re seeing, so I think what you’re seeing is absolutely normal. The best advice that I can give is to stick with the dose when in the yellows. I was scared to at first, but I feel like I lost a lot of time getting George into good numbers but shooting reduced doses in the yellows. Eventually you will move your full dose point lower and lower into the blues, which will really help too. When I was shooting reduced doses in the blues I got a lot of bouncing, but he has gotten a lot better/more consistent now that I am shooting full doses at lower numbers. He still bounces high sometimes, but this is usually from him dropping low very quickly in a previous cycle. I will share the post about that in a minute.
 
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This was a discussion on the ProZinc page about bouncing yesterday. I’m quoting some information from one of the members that’s really familiar with Prozinc, @FrostD.

https://www.felinediabetes.com/FDMB/threads/help-to-understand-skippers-values.249096/


“Bouncing is when a cat's BG drops faster or goes lower than they're used to, the liver can "panic" and release sugar into the bloodstream [causing higher BG as a result]. There's nothing to do about it, they eventually get used to lower numbers and bounce less often. A bounce generally clears in 2-4 cycles.

A bounce break is when the bounce, which I described earlier, is over. The liver stops panicking and throwing glucose into the blood...for the time being anyway. So the cats BG comes down naturally, but at the same time you're still giving insulin. So the insulin brings it down further. Anecdotally, in my experience, most bounce breaks return the cat to pre-bounce numbers. But if the timing is right with insulin, it can go up to 20 points lower. Every cat is different of course, some may drop more.”
 
You're seeing pretty good numbers for a newly diagnosed cat, although consistent dosing will help. It's best to stick with the same dose unless you get a preshot under 200. Hilary covered the rest of what I was going to say! Just be patient and methodical, and you'll get there!

If she had pancreatitis, generally you'd know without a doubt. She would not be eating much if at all, very nauseous (just kind of hanging head over food and water bowls, licking lips), lethargic, dehydrated, showing signs of pain (sitting like a loaf of bread, other things). Was she ever tested for it? Why were the enzymes started?
 
Alright, well she most certainly has an appetite! She doesn't seem nauseous, maybe slightly lethargic, she does sit at the water bowl but she's drinking water while she's there. The enzymes were started because it just seems like her stomach is super upset. She's thrown up the last few weeks, but there were hairballs in her vomit so that might have been the cause. She'll go a few days with pretty normal stool but then have a couple of days with very pale, soft, smelly stool. I was thinking that might be having an effect on her numbers, so I talked to the vet about doing something that might help without dropping $$$ on a bunch of tests. It hasn't seemed to make much of a difference so far.

I really appreciate the advice about sticking with the dose unless under 200. I think I've been freaked out to give her insulin when she's even slightly low and so we've really been messing with the dosing. We're going to give that a try, shoot 1 Unit unless <200. The fact that you think her numbers are alright gives me some hope. This has been pretty hard so far and I think we thought that by now she'd be doing a little better than she is. We'll just have to stay patient and consistent.

Appreciate the help :)
 
Alison Finnman said:
Alright, well she most certainly has an appetite! She doesn't seem nauseous, maybe slightly lethargic, she does sit at the water bowl but she's drinking water while she's there. The enzymes were started because it just seems like her stomach is super upset. She's thrown up the last few weeks, but there were hairballs in her vomit so that might have been the cause. She'll go a few days with pretty normal stool but then have a couple of days with very pale, soft, smelly stool. I was thinking that might be having an effect on her numbers, so I talked to the vet about doing something that might help without dropping $$$ on a bunch of tests. It hasn't seemed to make much of a difference so far.

I really appreciate the advice about sticking with the dose unless under 200. I think I've been freaked out to give her insulin when she's even slightly low and so we've really been messing with the dosing. We're going to give that a try, shoot 1 Unit unless <200. The fact that you think her numbers are alright gives me some hope. This has been pretty hard so far and I think we thought that by now she'd be doing a little better than she is. We'll just have to stay patient and consistent.

Appreciate the help :)
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No problem! We've all been there. Ideally we do want blues and greens eventually, it just takes awhile to get to the right dose carefully. And eventually you'll learn to shoot lower and lower numbers, it gets less scary.

Have you thought about probiotics? A lot of people here use s. Boulardii. Some use pumpkin and some other things, I can try to dig for some links here if you want?
 
Going to quote a few posts since I can't link to exact posts from my phone:
Sienna and Gabby (GA) Moderator
S. boulardii for diarrhea. (You start with 1/4 of a capsule mixed in to food twice a day and gradually increase if the problem persists.) It's likely that a GNC or maybe Whole Foods has it on hand. Otherwise, you can order from Amazon -- either ReNew or Jarrow's are reliable brands.

Pumpkin can help with both constipation and diarrhea, I believe most people start with 1 tsp of canned plain pumpkin (no spices!) I actually think @Katsallday used it for Tuna and diarrhea if I remember correctly?

I actually stumbled across this link in the process, it shows the nauseous and pain pictures: https://www.rawfeedingforibdcats.or...es-slippery-elm-bark-powder-instructions.html
 
Don't reduce your dose. You started to see better preshots but then reduced. If you get a strange low preshot like that 63, take a second test to make sure it's accurate.

If you get a preshot under 200. Stall without feeding for up to an hour and see if the number is going up.
 
JanetNJ thank you for your response. I am a total newbie and a very nervous mom, so when she was "low" I was nervous to give her a whole dose. Time to get brave and keep her dose steady (unless under 200). I do appreciate you taking the time to respond!
 
FrostD said:
Going to quote a few posts since I can't link to exact posts from my phone:
Sienna and Gabby (GA) Moderator
S. boulardii for diarrhea. (You start with 1/4 of a capsule mixed in to food twice a day and gradually increase if the problem persists.) It's likely that a GNC or maybe Whole Foods has it on hand. Otherwise, you can order from Amazon -- either ReNew or Jarrow's are reliable brands.

Pumpkin can help with both constipation and diarrhea, I believe most people start with 1 tsp of canned plain pumpkin (no spices!) I actually think @Katsallday used it for Tuna and diarrhea if I remember correctly?

I actually stumbled across this link in the process, it shows the nauseous and pain pictures: https://www.rawfeedingforibdcats.or...es-slippery-elm-bark-powder-instructions.html
Click to expand...

Wow that link with the pictures was very helpful. I think I've seen her in the "nausea meatloaf" position. I may try the pumpkin first, since I have some on hand and see if that makes a difference. Although, she's getting Tiki with pumpkin in it too...
 
Alison Finnman said:
JanetNJ thank you for your response. I am a total newbie and a very nervous mom, so when she was "low" I was nervous to give her a whole dose. Time to get brave and keep her dose steady (unless under 200). I do appreciate you taking the time to respond!
Click to expand...
Oh I totally get it. It's nerve wracking when you first start seeing those lower numbers, but it's exactly what you want to see. :)
 
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