Wilson 9ui PZ numbers consistently high

C

CTB

New Member
Hi everyone!

Looking for some advice or reassurance. My 12yo boy Wilson was diagnosed 2021 and we struggled to get him in consistent numbers on caninsulin and subsequently prozinc. We are UK based. Last year we saw a specialist who increased his PZ dose to 9ui 2x daily. It's a huge dose i know. He was doing great for a while, had 2 meals Katkin(meat only, low carb) daily and had hills w/d dry available at all times. We noticed his weight creeping up late last year and clinical signs of high blood sugar returning earlier this year- lots of water drinking, frequent urination, ravenously hungry, loss of mass around ribs and hips but pot belly. We moved him to Katkin only and started feeding him at set times because he was breaking into anything food related he could find. (He eats at Shot time, +3 and +7).

His last fructosamine 2 weeks ago was 531 up from 405 6 months ago. We bit the bullet and started doing home glucose monitoring (we'd failed every time we had tried before) and his numbers are through the roof.

He's still good in himself, going for little walks with us and playing as much as he ever did. But I feel like I'm fighting a battle im losing terribly and I'm so frustrated that nothing seems to work.

We're booked in with the vets for blood work and urinalysis. Does anyone have any advise or suggestions as to where we go from here? Honestly I am losing hope and so worried We're losing the battle.

Link to his sheet.

https://docs.google.com/spreadsheet...rwfKCnLI_C2uGOz_rHzs__32hMU/edit?usp=drivesdk

Thankyou so much in advance, this website has been my lifeline these past 2 years.

Charlotte
 
Hello there. So you just started home testing (very good!) for Wilson. It's very hard to say much without any BG history that I can see. Can you please tell me how he got to 9 units? I mean, what is his dosing history? What was his dose prior to going to 9 units? Was it a big jump in dose from the previous dose. It looks like 9 units is too much for him. I see that you are starting to get more mid-cycle tests and that is extremely important. Without knowing what the nadirs are, then we can't really say much.

Have you had him tested for Acromegaly or Insulin Auto Antibodies yet? I think the Royal Veterinary College does these tests in the U.K.

I understand how you are feeling now. My cat was on a dose much much higher than 9 units at one point.
 
Hi!

So he originally started on PZ at 2ui after switching from caninsulin. Our vet had him quickly move up to 4ui, for about 3 months and still his numbers were high. They referred us to a specialist who put us on the freestyle libre for a week to monitor him and they increased the dose to 6. We worked with them for about a month and they settled on 9 UI and almost immediately his numbers moved into the normal range and his clinical signs stopped.

I will ask the vet to test for that thankyou, he's got tests coming up soon. They're understandably concerned about increasing his dose and I wasnt sure given how high his numbers are if that was even the right call.

X
 
On May 20, he hit 72. His dose should have been reduced by one unit to 8 units at that time. On the evening on May 24, he was at 111. By the next morning he had bounced to red. I believe he dropped low that night and that’s why you saw red in the morning. On 5/28 he started out with a yellow preshot but by +2 he was black. That’s a bounce from going too low in the night. Many cats drop lower at night than they do in the day. Please keep up the testing - even at night where we advise getting the test before you go to bed so you can see if there are indications of dropping too low and know if you need to set an alarm to test in the night and/or if you need to give a snack.
 
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A lot of vets tend to do these big increases in dose — like one or more units at a time. You can just blow right past a good dose for the cat and put them into a situation where they’re constantly dropping too low and bouncing too high.

If you can continue with the excellent job of getting tests like you have in the last few days — and add in a night test or two so that we have a more complete picture of what he’s up to (or down to) it would really help us to help Wilson.
 
So just to confirm— he doesn’t eat any more of the high carb w/d right? Just the low carb Katkin? If so, this is good.
 
Diabetic cats do much better with more small meals spread out throughout the early part of the cycle. I would recommend giving snacks of low carb wet food at +2, +4 and +6 if at all possible. We don’t recommend feeding much after nadir because it can shorten the duration of the insulin — so approximately +6. Hopefully soon we can see when and what his nadir is.

This reminds me of another question that I have for you. Are you feeding him prior to the AMPS and PMPS BG test? He needs to not have eaten anything for two hours prior to those two tests — so that we can make sure that the numbers are not elevated by food.
 
Suzanne & Darcy said:
So just to confirm— he doesn’t eat any more of the high carb w/d right? Just the low carb Katkin? If so, this is good.
Click to expand...
Just low carb now. We feed him about 2.5-3 hours prior to shot and we test pre shot (learned pretty quickly after we tested him post meal but pre shot the first couple of times and his numbers were crazy. )
 
Thankyou so much both of you! I'm going to take all this away and keep testing and looking at his lower numbers. It would be interesting if he's getting too high a dose. Managing diabetes seems to be one part science and one part art!

Really appreciate you taking the time x
 
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