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Max & Lori

Max & Lori

Member Since 2021
My cat Max is 11 years old with IBD and diabetes. He weighs 17 pounds. He was diagnosed on 6/24/21 with diabetes and we’ve been unable to get his glucose regulated. He was started on Prozinc 3 units twice a day and the vet had increased him weekly until we got to 6 units twice a day without much improvement. He runs mostly in the 400s, but has been over 600. He has IBD which complicates things with his diet due to his diarrhea. He eats Fancy feast or Purina pro plan Metabolic canned chicken mostly. No dry. He was in the hospital last week due to his sugar being over 600 and he stopped eating, plus had diarrhea. Dehydrated/questionable DKA. The vet changed him to Vetsulin 5 units twice a day. I know this insulin does not last more than 8 hrs in a cat although it has brought him down into the 250-300’s range for the most part. It just shoots back up to the 400-600 range when the insulin wears off. I give it at 6 am and 6 pm. I feed him one can of Purina pro plan or one can Fancy Feast in the morning and the evening. He stays hungry all the time but since he’s so hard to regulate I don’t know if he should be eating more, but if he does I can’t get his glucose level down. I free really wish this insulin would last longer or we could find something to regulate him more. I do have a spreadsheet on him of that would be helpful. Any recommendations about getting Max’s glucose under control?
 
Hi Lori! Glad to see you over here from the Feline Diabetes group!

If you have the time, it will be helpful for you to go ahead and add your "Signature". Just click on your name and then "Signature" and a new little box will come up for you to add information in like:

Your name/Cat's name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health issues or meds? and at the end put the link to your spreadsheet.

By doing that, all your posts will have the Signature automatically attached so people won't have to keep asking the same questions multiple times.

Your vet actually started you at a high dose. Most cats should start at .5 to 1U so it's possible your dose is actually too high. No cat should be on 6 units of any insulin after less than a month!

ProZinc is usually a much better insulin for cats than Vetsulin which is more geared towards dogs. When we can see your spreadsheet, we'll probably have more suggestions for you.

This "Help us to help you" post can be helpful for new members too!
 
Thank you! My spreadsheet is actually from another FB Diabetes site and I’m not sure how that works here. I’m still trying to get acclimated to this site.
 
Lori Taylor said:
My spreadsheet is actually from another FB Diabetes site
Click to expand...

If it's the other Facebook group, they pirated theirs from us in the first place, but somehow they did something that causes it to crash on a lot of people's phones/tablets so you'd need to switch to our original version but you can copy/paste the information from one to the other so you wouldn't have to totally start over. Here's the Instructions on getting the FDMB spreadsheet (which you'll notice looks very familiar)
 
I added my spreadsheet to my Signature. Could you take a look at that? If he did start with a dose too high, can that be fixed without harm to the cat?
 
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I will tag
@Chris & China (GA)

@JanetNJ

for you Lori switched from Prozinc to Vetsulin on 7-16
Can you please take a look at her SS

Also on your spreadsheet could you please put a line above when you switched to
Vetsulin , I don't anyone might see it in your remarks section
The SS in your signature works, you might want to get rid of the other one at the end of your post in #4
 
Diane Tyler's Mom said:
I will tag
@Chris & China (GA)

@JanetNJ

for you Lori switched from Prozinc to Vetsulin on 7-16
Can you please take a look at her SS

Also on your spreadsheet could you please put a line above when you switched to
Vetsulin , I don't anyone might see it in your remarks section
The SS in your signature works, you might want to get rid of the other one at the end of your post in #4
Click to expand...

Im not sure how to put a line on the spreadsheet where I started Vetsulin without messing up my spreadsheet. Could you fix it for me? If not, just let me know how.
 
Hi Lori I only know how to do it on my tablet,
I will ask @Chris & China (GA)
Or
@Bandit's Mom
to fix it for you Bhooma will be on tonight she lives in India
Hi Bhooma could you please add a line above Lori's SS on 7-16 She switched to Vetsulin
I'm hoping others will give you some advice about insulin :cat:
@Sienne and Gabby (GA)

@Wendy&Neko
Her kitty was on Prozinc then switched to Vetsulin on 7-16
Giving very high units of insulin
 
Last edited:
Diane Tyler's Mom said:
Hi Lori I only know how to do it on my tablet,
I will ask @Chris & China (GA)
Or
@Bandit's Mom
to fix it for you Bhooma will be on tonight she lives in India
Hi Bhooma could you please add a line above Lori's SS on 7-16 She switched to Vetsulin
I'm hoping others will give you some advice about insulin :cat:
@Sienne and Gabby (GA)

@Wendy&Neko
Her kitty was on Prozinc then switched to Vetsulin on 7-16
Giving very high units of insulin
Click to expand...
I believe Wendy used Caninsulin and then Lantus and finally Levemir. I’m pretty sure she never used PZ.
 
Chris & China (GA) said:
I think Diane was tagging Wendy for advice on insulin and then added the extra information that Lori had switched from ProZinc to Vetsulin....not that Wendy went from ProZinc to Vetsulin
Click to expand...
I think you are right!! Sorry @Diane Tyler's Mom

Lori and I were discussing her SS in a PM and I noted her switch from PZ to Vetsulin. She mentioned this was her vet’s decision. This is what I told her which I am putting publicly for peer review.

“The fact that he has seen some numbers in the 100s on a lower dose makes me wonder if he is overdosed.

I don’t know where you are located but you might want to start a post on Main Health asking for vet recommendations in your city. If you can afford it, Lantus or Levemir would be much better options and we can help you with a dose. If you can’t afford it, going back to PZ would be fine. Do you have any PZ left? If so, maybe we should help you get him back on that on a lower dose.”

Lori…one thing they can really help us see if 6u is too much is for you to get a test or two every single night after PMPS. If you could do a +2 and a “before bed”, we can see where he’s headed. It’s quite common for cats to drop low at night and then pop way back up after. This is called a bounce and it can last up to six cycles after the low number. You can see an example of him dropping down into the 100s on 7/7 and 7/8 and then popping way back up.

We don’t want to just drop the dose way back without doing this kind of investigation because it’s always possible he might need close to this amount of insulin. We don’t want to put him at risk for DKA by cutting the dose too much. So, first, we figure out how low this dose is taking him and then we can safely adjust.

What do you think?
 
Marje and Gracie said:
I think you are right!! Sorry @Diane Tyler's Mom

Lori and I were discussing her SS in a PM and I noted her switch from PZ to Vetsulin. She mentioned this was her vet’s decision. This is what I told her which I am putting publicly for peer review.

“The fact that he has seen some numbers in the 100s on a lower dose makes me wonder if he is overdosed.

I don’t know where you are located but you might want to start a post on Main Health asking for vet recommendations in your city. If you can afford it, Lantus or Levemir would be much better options and we can help you with a dose. If you can’t afford it, going back to PZ would be fine. Do you have any PZ left? If so, maybe we should help you get him back on that on a lower dose.”

Lori…one thing they can really help us see if 6u is too much is for you to get a test or two every single night after PMPS. If you could do a +2 and a “before bed”, we can see where he’s headed. It’s quite common for cats to drop low at night and then pop way back up after. This is called a bounce and it can last up to six cycles after the low number. You can see an example of him dropping down into the 100s on 7/7 and 7/8 and then popping way back up.

We don’t want to just drop the dose way back without doing this kind of investigation because it’s always possible he might need close to this amount of insulin. We don’t want to put him at risk for DKA by cutting the dose too much. So, first, we figure out how low this dose is taking him and then we can safely adjust.

What do you think?
Click to expand...
 
Please help. I'm not sure if I'm supposed to continue commenting here on this post or not but Max's regular vet just called me about Max and said that I could go back to the Prozinc but he wanted me to give 7 units twice a day. I've already discussed with some of you the possibility that Max started on a dose of Prozinc that was to high (3 units), then he went up to 6 units. He then was hospitalized for possible DKA and the vet changed him to Vetsulin 5 units per day, then Vetsulin 6 units per day. I do not like using the Vetsulin because it is so short acting in Max. I questioned the vet about this some time ago and he wanted me to keep with the current plan. Being unhappy about this, I called around to get an appointment with another vet. I hated to do that since Max has been with this vet for 11 years and he knows his history of asthma, IBD, heart murmur due to a mildly enlarged heart. I did get an appointment with a new vet for tomorrow. I know nothing about the new vet, but I was hoping he would give me Lantus. That is not a sure thing though. I guess the new vet requested records from the old vet because the old vet just called me about Max and wanted him to go back to the Prozinc 7 units twice daily. My question is what should I do? Should I give the Prozinc another try? If the dose is too high, what dose should I give him? Or should I keep the appointment with the new vet and take a chance on what he will do? I don't want him to get DKA again. He was just in the hospital last week. PLEASE HELP! I am so confused and frustrated. @Marje and Gracie @Chris & China (GA)
 
Marje and Gracie said:
I think you are right!! Sorry @Diane Tyler's Mom

Lori and I were discussing her SS in a PM and I noted her switch from PZ to Vetsulin. She mentioned this was her vet’s decision. This is what I told her which I am putting publicly for peer review.

“The fact that he has seen some numbers in the 100s on a lower dose makes me wonder if he is overdosed.

I don’t know where you are located but you might want to start a post on Main Health asking for vet recommendations in your city. If you can afford it, Lantus or Levemir would be much better options and we can help you with a dose. If you can’t afford it, going back to PZ would be fine. Do you have any PZ left? If so, maybe we should help you get him back on that on a lower dose.”

Lori…one thing they can really help us see if 6u is too much is for you to get a test or two every single night after PMPS. If you could do a +2 and a “before bed”, we can see where he’s headed. It’s quite common for cats to drop low at night and then pop way back up after. This is called a bounce and it can last up to six cycles after the low number. You can see an example of him dropping down into the 100s on 7/7 and 7/8 and then popping way back up.

We don’t want to just drop the dose way back without doing this kind of investigation because it’s always possible he might need close to this amount of insulin. We don’t want to put him at risk for DKA by cutting the dose too much. So, first, we figure out how low this dose is taking him and then we can safely adjust.

What do you think?
Click to expand...
Diane Tyler's Mom said:
Lori was he DKA or not, can you add that to your signature also so members know about this I see you said he was in the hospital last week
@Max & Lori
Click to expand...
Hey can you tell me how to add my signature? I’m still trying to figure out this site. Also the vet told me that he thought he was on DKA, but of all things he didn’t check that. He checked a CBC, gave IV fluids and treated him for an infection because he had a fever. Max had quit eating and was symptomatic of DKA so he treated him.
 
Max & Lori said:
Hey can you tell me how to add my signature? I’m still trying to figure out this site. Also the vet told me that he thought he was on DKA, but of all things he didn’t check that. He checked a CBC, gave IV fluids and treated him for an infection because he had a fever. Max had quit eating and was symptomatic of DKA so he treated him.
Click to expand...
Your signature is already there :cat:
What do you mean
 
Wow going to 7 units is a lot. I wouldn't raise in whole units. I'm glad you're doing back to ProZinc. Makes me wonder if something else is going on, like acromegaly. Might be something to test for. How are your cats teeth? Any infection?
 
Max & Lori said:
Please help. I'm not sure if I'm supposed to continue commenting here on this post or not but Max's regular vet just called me about Max and said that I could go back to the Prozinc but he wanted me to give 7 units twice a day. I've already discussed with some of you the possibility that Max started on a dose of Prozinc that was to high (3 units), then he went up to 6 units. He then was hospitalized for possible DKA and the vet changed him to Vetsulin 5 units per day, then Vetsulin 6 units per day. I do not like using the Vetsulin because it is so short acting in Max. I questioned the vet about this some time ago and he wanted me to keep with the current plan. Being unhappy about this, I called around to get an appointment with another vet. I hated to do that since Max has been with this vet for 11 years and he knows his history of asthma, IBD, heart murmur due to a mildly enlarged heart. I did get an appointment with a new vet for tomorrow. I know nothing about the new vet, but I was hoping he would give me Lantus. That is not a sure thing though. I guess the new vet requested records from the old vet because the old vet just called me about Max and wanted him to go back to the Prozinc 7 units twice daily. My question is what should I do? Should I give the Prozinc another try? If the dose is too high, what dose should I give him? Or should I keep the appointment with the new vet and take a chance on what he will do? I don't want him to get DKA again. He was just in the hospital last week. PLEASE HELP! I am so confused and frustrated. @Marje and Gracie @Chris & China (GA)
Click to expand...
First, if he had DKA, he would have been really sick and in the hospital for a few days, at least. Perhaps he was just showing ketones which is not the same thing. Are you testing urine ketones at home?

Did you talk to your vet about whether he’d give you Lantus? If that’s your goal and he won’t give it to you, I’d see the new vet and hope he will. Under. I circumstance would I raise his dose u til you have a few nights of data and are testing ketones. It’s really important until l we figure out how many units he really needs to test his ketone every single day and tell us if he stops eating/drinking, is lethargic, doesn’t feel well.

And even though his BG is high tonight, please get a before bed test so we can see if it’s coming down any.

If you decide to switch to PZ instead of Lantus, go ahead and give it in the morning at current dose u til we can figure out what he’s doing.

how does that sound?
 
Max & Lori said:
My question is what should I do? Should I give the Prozinc another try? If the dose is too high, what dose should I give him? Or should I keep the appointment with the new vet and take a chance on what he will do?
Click to expand...

For now, I'd just stay at the 6U dose of Vetsulin you're on since you're going to see the new vet tomorrow. Making a change tonight or in the morning doesn't make much sense since we don't know what the new vet might say or if they will give you a script for Lantus or Levemir (if you can, get Levemir...it's usually a better choice for higher doses)
 
Marje and Gracie said:
First, if he had DKA, he would have been really sick and in the hospital for a few days, at least. Perhaps he was just showing ketones which is not the same thing. Are you testing urine ketones at home?

Did you talk to your vet about whether he’d give you Lantus? If that’s your goal and he won’t give it to you, I’d see the new vet and hope he will. Under. I circumstance would I raise his dose u til you have a few nights of data and are testing ketones. It’s really important until l we figure out how many units he really needs to test his ketone every single day and tell us if he stops eating/drinking, is lethargic, doesn’t feel well.

And even though his BG is high tonight, please get a before bed test so we can see if it’s coming down any.

If you decide to switch to PZ instead of Lantus, go ahead and give it in the morning at current dose u til we can figure out what he’s doing.

how does that sound?
Click to expand...
I have not been checking for ketones. Should I check his urine with the urine strips?
 
Marje and Gracie said:
First, if he had DKA, he would have been really sick and in the hospital for a few days, at least. Perhaps he was just showing ketones which is not the same thing. Are you testing urine ketones at home?

Did you talk to your vet about whether he’d give you Lantus? If that’s your goal and he won’t give it to you, I’d see the new vet and hope he will. Under. I circumstance would I raise his dose u til you have a few nights of data and are testing ketones. It’s really important until l we figure out how many units he really needs to test his ketone every single day and tell us if he stops eating/drinking, is lethargic, doesn’t feel well.

And even though his BG is high tonight, please get a before bed test so we can see if it’s coming down any.

If you decide to switch to PZ instead of Lantus, go ahead and give it in the morning at current dose u til we can figure out what he’s doing.

how does that sound?
Click to expand...
I did ask for Lantus but he disagreed with me on that.
 
Chris & China (GA) said:
For now, I'd just stay at the 6U dose of Vetsulin you're on since you're going to see the new vet tomorrow. Making a change tonight or in the morning doesn't make much sense since we don't know what the new vet might say or if they will give you a script for Lantus or Levemir (if you can, get Levemir...it's usually a better choice for higher doses)
Click to expand...
I will go to the new vet and see what he says. I will also check more BG levels at night. If I still can’t get Levemir or Lantus, I will let you know. Thanks so much. I know I’m a disaster right now but I really appreciate you all.
 
Max & Lori said:
I have not been checking for ketones. Should I check his urine with the urine strips?
Click to expand...
Yes. Urine ketone, not urine glucose strips.

Max & Lori said:
I did ask for Lantus but he disagreed with me on that.
Click to expand...
Time for a new vet. You are Max’s advocate and you are learning. Your vet should investigate and see how widely Lantus is used. If he’s not willing, I’d move on. Whether it’s FD or not, no vet should dismiss you and your ideas unless he can prove it’s completely unsafe.

Max & Lori said:
I will go to the new vet and see what he says. I will also check more BG levels at night. If I still can’t get Levemir or Lantus, I will let you know. Thanks so much. I know I’m a disaster right now but I really appreciate you all.
Click to expand...
Did you ask when you made the appt if he uses Lantus in cats? Thanks for checking BGs tonight.
 
Marje and Gracie said:
Yes. Urine ketone, not urine glucose strips.


Time for a new vet. You are Max’s advocate and you are learning. Your vet should investigate and see how widely Lantus is used. If he’s not willing, I’d move on. Whether it’s FD or not, no vet should dismiss you and your ideas unless he can prove it’s completely unsafe.


Did you ask when you made the appt if he uses Lantus in cats? Thanks for checking BGs tonight.
Click to expand...
I did not ask if he used Lantus. I spoke with the receptionist and I just assumed she wouldn’t know that info. I did have some ketone strips that I got a couple of wks ago. I’ve just been unable to catch him in the litter box but I did see a little urine on the wall of the litter box after he went this morning so I checked that. No ketones. I will try to catch him in there again.
 
Max & Lori said:
I did not ask if he used Lantus. I spoke with the receptionist and I just assumed she wouldn’t know that info. I did have some ketone strips that I got a couple of wks ago. I’ve just been unable to catch him in the litter box but I did see a little urine on the wall of the litter box after he went this morning so I checked that. No ketones. I will try to catch him in there again.
Click to expand...
If he's hard to catch in the box, there are ketone blood meters as well that work just like reg bg meters.
 
Max & Lori said:
I did not ask if he used Lantus. I spoke with the receptionist and I just assumed she wouldn’t know that info. I did have some ketone strips that I got a couple of wks ago. I’ve just been unable to catch him in the litter box but I did see a little urine on the wall of the litter box after he went this morning so I checked that. No ketones. I will try to catch him in there again.
Click to expand...
If he got into any low numbers, we should know by tonight. Since bounces usually break within six cycles, he could have gone low 7/19 which means tonight is his sixth cycle after that.

However, it’s possible he’s going to be a high dose cat so don’t rule that out in your mind. There are many possibilities for that. One is he just was diabetic longer than you know and he has a lot of glucose toxicity built up so it might take a higher dose to break through it, he might have a condition where antibodies attack the insulin and make it partially unusable to him (there are ways to combat this & it’s self-limiting within about a year), or he could potentially have acromegaly. But…baby steps. Let’s see what the next two cycles bring.

Good luck today!
 
Marje and Gracie said:
If he got into any low numbers, we should know by tonight. Since bounces usually break within six cycles, he could have gone low 7/19 which means tonight is his sixth cycle after that.

However, it’s possible he’s going to be a high dose cat so don’t rule that out in your mind. There are many possibilities for that. One is he just was diabetic longer than you know and he has a lot of glucose toxicity built up so it might take a higher dose to break through it, he might have a condition where antibodies attack the insulin and make it partially unusable to him (there are ways to combat this & it’s self-limiting within about a year), or he could potentially have acromegaly. But…baby steps. Let’s see what the next two cycles bring.

Good luck today!
Click to expand...
Just checked BG at 10:00 and it’s higher than the AMPS and he’s had 6 u of Vetsulin. He ate 1 can of Fancy feast chicken pate and I gave the insulin 25 minutes after that. It makes no sense to me.
 
Max & Lori said:
Just checked BG at 10:00 and it’s higher than the AMPS and he’s had 6 u of Vetsulin. He ate 1 can of Fancy feast chicken pate and I gave the insulin 25 minutes after that. It makes no sense to me.
Click to expand...
Each meter can have a variance of 20% between tests which means he’s just flat today, he’s not higher.
 
Good news! Max and I went to see a new vet today and we had a great visit. We have a prescription for Lantus. The vet actually wanted him to be on that. We got the pens instead of the vial so it will last longer. He is supposed to start off on 2 units twice a day since he was already on such a large amount of Vetsulin. We will do a glucose curve here at home after he has been on the Lantus 10-14 days and email to vet. We will start Lantus tomorrow morning. I’ve got to do some reading on that tonight. Hopefully I can order from Canada next time to save some money if anyone knows of a good pharmacy. Max is also being tested for acromegaly and pancreatitis. He also will be scheduled for an echocardiogram to see what’s going on regarding the heart murmur. The vet was awesome and spent about an hour with us. Very knowledgeable about feline diabetes. He was very impressed with the spreadsheet I’ve been keeping here. I am so relieved now that we are at least on the right path. Any advice you want to give me about Lantus would be great. I hope and pray we will start seeing some improvement in things soon.Thank you so much @Chris & China (GA) @Marje and Gracie @Diane Tyler's Mom
 
So happy to hear you are so thrilled with the new vet! I know it's hard to leave one that you've used for years but it sounds like it was a very positive experience!

You might want to call them and ask if they can add the IAA test along with the Acro test. It's another condition that it helps to know if it's in the picture and both are done at the same place.
 
Lori that is such Great News, sounds like you have found a really great vet
I'm so happy !!!
I'm glad you got the pen, now did you get the U-100 syringes for Lantus with the half unit markings. With the needle or whatever you call it that comes with the pen you can only adjust by whole units, so we the pen like a vial and use U-100 syringes to stick inside the gray rubber stopper on the pen and draw our insulin
If not get them next time , we adjust doses by 0.25 units
What did the pharmacy charge you for the Lantus pen?
I will give you the link for Lantus and you can read about it, if you need to ask a question go ahead
There are 2 dosings methods when using Lantus TR Tight Regulation and SLGS
You can read about them also

Oh I'm glad he is checking for acromegaly and pancreatitis
@Max & Lori
 
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Chris & China (GA) said:
So happy to hear you are so thrilled with the new vet! I know it's hard to leave one that you've used for years but it sounds like it was a very positive experience!

You might want to call them and ask if they can add the IAA test along with the Acro test. It's another condition that it helps to know if it's in the picture and both are done at the same place.
Click to expand...
Lol Chris I was going to say that but couldn't remember what it was called
You are good Chris :cat:
@Chris & China (GA)
 
Chris & China (GA) said:
So happy to hear you are so thrilled with the new vet! I know it's hard to leave one that you've used for years but it sounds like it was a very positive experience!

You might want to call them and ask if they can add the IAA test along with the Acro test. It's another condition that it helps to know if it's in the picture and both are done at the same place.
Click to expand...
I believe he did do that as well.
 
Max could you add to your signature you are using the Alpha Trak



Here is the link for Marks Marine Pharmacy in Canada
I suggest buying the 5 pens they will last a year depending on the dose you give
Just go to the site and type in Lantus
https://rxcanada4less.com
Also once your vet sends a script over , you will never need another one to reorder
They are very nice people, when you want to order just call them and they will explain everything
@Max & Lori
 
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Diane Tyler's Mom said:
Lori that is such Great News, sounds like you have found a really great vet
I'm so happy !!!
I'm glad you got the pen, now did you get the U-100 syringes for Lantus with the half unit markings.
If not get them next time , we adjust doses by 0.25 units
What did the pharmacy charge you for the Lantus pen?
I will give you the link for Lantus and you can read about it, if you need to ask a question go ahead
There are 2 dosings methods when using Lantus TR Tight Regulation and SLGS
You can read about them also

Oh I'm glad he is checking for acromegaly and pancreatitis
Click to expand...
I am so happy too! I’m kicking myself that I didn’t change vets sooner. It was a set of five pens for a little over $400. I got syringes from the vet and they do have the half markings. Yes send me the link on Lantus please! I’m so thankful for y’all!
 
Max & Lori said:
He is supposed to start off on 2 units twice a day since he was already on such a large amount of Vetsulin.
Click to expand...

I'm not sure I'd drop back that much. Lantus isn't "stronger" than Vetsulin the way you're thinking and dropping back that much will probably just result in a lot of wasted time while you work your way back up. Also, be prepared to test your patience. Whatever "starting dose" you begin with, it usually takes 5-7 days before you're going to see how he's really responding to that dose (although some cats can react much sooner)

I'd probably suggest that if you do drop the dose, you start at 5U....yes, I said 5 units. Let's get some other opinions though. We have until tomorrow to make a decision.

@Marje and Gracie

ETA...I'll also put a new line in for you on your spreadsheet for the change to Lantus
 
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Max & Lori said:
I am so happy too! I’m kicking myself that I didn’t change vets sooner. It was a set of five pens for a little over $400. I got syringes from the vet and they do have the half markings. Yes send me the link on Lantus please! I’m so thankful for y’all!
Click to expand...
Holy crap over 400 bucks ,yes it's extremely expensive in the US
Sometimes the pharmacy you get it at has a coupon to apply for you
Like CVS, Walmart, Costco . It's about 198.00 from Marks
 
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