? New Member - Asher - Cannot Get Regulated

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HHolly

HHolly

Member Since 2022
Hello!

My name is Holly and my constipated diabetic kitty is named Asher. He is 12 years old.

I need help! Asher has been diagnosed diabetic for about year, and I am having the hardest time getting him to a good place. My vet has great, trying different foods and insulin, but I was wondering if anyone here had any experienced something similar and had any recommendations.

He is currently receiving 8 units of prozinc twice daily. We tried vetsulin and switched him to prozinc when that wasn’t impacting him much. Prozinc was doing a little better, but never great so we kept increasing the dose. Now, he is back up and will not improve. His ear prick usually is in the 600s, sometimes high 500s. His most recent curve dropped from the 500s to the high 200’s, but shot back up to the 600s only two hours later. We are going to try the Lantus pen next.

Asher is chronically constipated (which came first). He has a prescription gastro food (Royal Canin Gastro dry) that has helped tremendously. His qualify of life is really dependent on his daily poops, so this food is critical for him. Lactulose, pumpkin, and other supplements did not help.

He gets a mix of wet and dry food. He needs at minimum 50% of the gastro food, which is mixed with 50% proplan diabetics management dry food right now. The 50% gastro is the lowest I can give him that keeps him pooping. The dry food is free fed. I have another cat with his own food and bowl, but he often eats Asher's food too so its hard to measure the amounts. Asher cannot jump to get to the other cat's food.

For wet food, which he gets twice per day, he only eats pate and is picky. I have tried a lot of low carb options. Right now, he is on Tikicat since he eats it all. We recently tried prescription proplan diabeties wet food, which had no impact on his numbers and he left much of it behind.

His only symptom is that he pees SO MUCH and that he has stopped cleaning for the most part. He seems happy and content otherwise, as long as he poops.

Does anyone have any recommendations on what else I can do?

Thank you!
Holly
 
Hi Holly, and welcome! Asher needing dry food to poop puts you in a difficult place, as diabetic cats do so much better eating all wet food. Having a chronically constipated kitty at home, I really empathize - in my house we stalk said cat to the box and cheer loudly every time he poops without difficulty!

Have you ever tried a high-fiber GI canned food by any chance? There's a prescription one called GI Biome, that a lot of people on the megacolon board I checked for ideas for my kitty swear by. My vet and her vet tech call it "poop magic". It's in stew form, and disclaimer, it's probably not low carb, but more experienced members can correct me if I'm wrong, it seems even medium or high carb wet food would go easier on his system than dry food.

There is also a petco food called "Whole Hearted Easy Digestion" that someone recommended on that same board I believe.

All this to say, I hope you can find a GI wet food to feed him aside his 50% dry, and maybe up the ratio gradually and still have him poop regularly. People on this forum are great and always full of wise advice, so there will plenty more ideas coming your way :)
 
HHolly said:
Hello!

My name is Holly and my constipated diabetic kitty is named Asher. He is 12 years old.

I need help! Asher has been diagnosed diabetic for about year, and I am having the hardest time getting him to a good place. My vet has great, trying different foods and insulin, but I was wondering if anyone here had any experienced something similar and had any recommendations.

He is currently receiving 8 units of prozinc twice daily. We tried vetsulin and switched him to prozinc when that wasn’t impacting him much. Prozinc was doing a little better, but never great so we kept increasing the dose. Now, he is back up and will not improve. His ear prick usually is in the 600s, sometimes high 500s. His most recent curve dropped from the 500s to the high 200’s, but shot back up to the 600s only two hours later. We are going to try the Lantus pen next.

Asher is chronically constipated (which came first). He has a prescription gastro food (Royal Canin Gastro dry) that has helped tremendously. His qualify of life is really dependent on his daily poops, so this food is critical for him. Lactulose, pumpkin, and other supplements did not help.

He gets a mix of wet and dry food. He needs at minimum 50% of the gastro food, which is mixed with 50% proplan diabetics management dry food right now. The 50% gastro is the lowest I can give him that keeps him pooping. The dry food is free fed. I have another cat with his own food and bowl, but he often eats Asher's food too so its hard to measure the amounts. Asher cannot jump to get to the other cat's food.

For wet food, which he gets twice per day, he only eats pate and is picky. I have tried a lot of low carb options. Right now, he is on Tikicat since he eats it all. We recently tried prescription proplan diabeties wet food, which had no impact on his numbers and he left much of it behind.

His only symptom is that he pees SO MUCH and that he has stopped cleaning for the most part. He seems happy and content otherwise, as long as he poops.

Does anyone have any recommendations on what else I can do?

Thank you!
Holly
Click to expand...
8 units is alot of insulin. I understand he's constipated my boy has the same problem. Have you tried mirilax or psyllium husk? My boy gets 1/4 tsp of miralax 2xs a day & it seems to do the job most of the time. I know you say the dry food helps with his constipation but as long as you keep feeding it his numbers will continue to be high. Are you home testing? Diabetic cats need 2 bigger meals at shot time & at least 2 smaller snacks (meals) through the day. I'm going to tag a prozinc expert. @FrostD
 
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8 units is a LOT of insulin, at that dose (if it's not overdosed), it's pretty much guaranteed he has another endocrine disorder causing the resistance. You don't necessarily need to switch to Lantus just yet, but I never stand in the way of people wanting to switch to depot insulin.

What can happen when dose is too high is it drops them way too low, and their liver "panics" and dumps stored glycogen and counterregulatory hormones in order to spike BG back up. The effects can last up to 6 cycles. It's a defense mechanism.

First things first, we absolutely need to make sure he is not overdosed. That dose can very easily be fatal. How were increases determined, and by how much at a time? You mentioned curves, are you doing those at home, was the vet doing in office? The ear pricks you're currently doing, when are you doing them?

What is your schedule like? To verify he is not overdosed, you'll need to get midcycle tests for about 7-8 cycles straight, ideally in the +4 to +6 (4 to 6 hours after the shot) range both day and night. That will be difficult if you work outside the home, or have something limiting your ability to test and test during those windows. If that's the case, we can probably make do with some +2/+3, and +8/9 possibly...

Secondly, are you aware if he has any conditions like acromegaly, IAA, hyperthyroid, hyperaldosteronism?

Thirdly, we will want to try to address the food but I don't want to touch that until we figure out if the dose is safe, as a change in carbs can drastically lower numbers - and in his case at this dose, also easily be fatal.
 
Virginie said:
Hi Holly, and welcome! Asher needing dry food to poop puts you in a difficult place, as diabetic cats do so much better eating all wet food. Having a chronically constipated kitty at home, I really empathize - in my house we stalk said cat to the box and cheer loudly every time he poops without difficulty!

Have you ever tried a high-fiber GI canned food by any chance? There's a prescription one called GI Biome, that a lot of people on the megacolon board I checked for ideas for my kitty swear by. My vet and her vet tech call it "poop magic". It's in stew form, and disclaimer, it's probably not low carb, but more experienced members can correct me if I'm wrong, it seems even medium or high carb wet food would go easier on his system than dry food.

There is also a petco food called "Whole Hearted Easy Digestion" that someone recommended on that same board I believe.

All this to say, I hope you can find a GI wet food to feed him aside his 50% dry, and maybe up the ratio gradually and still have him poop regularly. People on this forum are great and always full of wise advice, so there will plenty more ideas coming your way :)
Click to expand...

Thank you so much! I will talk to my vet about the GI Biome to see if that might help instead of his current gastro food. I did have him on the Whole Hearted Easy Digestion for a long time, pre-diabeties. He would not eat it canned, and eventually the dry food stopped helping his constipation.
 
Chrispooky12 said:
8 units is alot of insulin. I understand he's constipated my boy has the same problem. Have you tried mirilax or psyllium husk? My boy gets 1/4 tsp of miralax 2xs a day & it seems to do the job most of the time. I know you say the dry food helps with his constipation but as long as you keep feeding it his numbers will continue to be high. Are you home testing? Diabetic cats need 2 bigger meals at shot time & at least 2 smaller snacks (meals) through the day. I'm going to tag a prozinc expert. @FrostD
Click to expand...

Thank you! We tried Miralax but it was inconsistent. I will try the psyllium husk though! I am doing home testing. He gets two meals of wet food per day, plus the free fed dry food.
 
FrostD said:
8 units is a LOT of insulin, at that dose (if it's not overdosed), it's pretty much guaranteed he has another endocrine disorder causing the resistance. You don't necessarily need to switch to Lantus just yet, but I never stand in the way of people wanting to switch to depot insulin.

What can happen when dose is too high is it drops them way too low, and their liver "panics" and dumps stored glycogen and counterregulatory hormones in order to spike BG back up. The effects can last up to 6 cycles. It's a defense mechanism.

First things first, we absolutely need to make sure he is not overdosed. That dose can very easily be fatal. How were increases determined, and by how much at a time? You mentioned curves, are you doing those at home, was the vet doing in office? The ear pricks you're currently doing, when are you doing them?

What is your schedule like? To verify he is not overdosed, you'll need to get midcycle tests for about 7-8 cycles straight, ideally in the +4 to +6 (4 to 6 hours after the shot) range both day and night. That will be difficult if you work outside the home, or have something limiting your ability to test and test during those windows. If that's the case, we can probably make do with some +2/+3, and +8/9 possibly...

Secondly, are you aware if he has any conditions like acromegaly, IAA, hyperthyroid, hyperaldosteronism?

Thirdly, we will want to try to address the food but I don't want to touch that until we figure out if the dose is safe, as a change in carbs can drastically lower numbers - and in his case at this dose, also easily be fatal.
Click to expand...

Hello, yes 8 is a lot! He started off with one unit and increased slowly to six over time, after doing curves and per my vet. He stayed at six for a long time while we tried different foods to see if anything would help as the vet thought his diet was a big part of his high numbers. We just upped him to eight a couple weeks ago to see if that would impact anything. It lowered his curve, but for only a short two hour window.

He does not have any other conditions that we are aware of, besides the constipation and an issue with his spine that may cause occasional pain (he has never indicated any discomfort though outside of the troublesome poops).

I am doing the at home ear pricks and curve tests. We tried the monitor at first, but it never stuck and he is *not* a good in office vet patient. He is good with me doing the ear pricks and injections luckily. For the curve, I do a twelve hour window with an ear prick every two hours. I do pre-dose ear pricks on occasion, especially when changing his diet, but not every time anymore since he is consistently so high.
 
The main downside to curves is that it's possible you do it on a day that's high and flat (i.e., the bounce I was talking about) and miss lows. I'd still recommend what I mentioned above with the midcycle tests to verify dose isn't too high.
 
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