? Should I skip a dose?

Nick & Binx

Nick & Binx

Member
Hey everyone, new here but have been trying to read up as much as possible.

Binx just started Prozinc a few days ago. I've been trying to do regular glucose tests, but I am still learning (thank you to everyone who gave me advice on my other post). Because of all the changes lately (addition of inhaler, insulin, slight changes in food, vet visit, BG testing) my cat is very stressed. For the last few hours he has been hiding under the bed, and won't come out even for treats. He will eat a treat if I bring it to him. Tested him when he started hiding a few hours ago, and his BG levels were far from Hypo, so I don't think I'm concerned about that.

With how stressed he is right now, do you think it would be better to just skip his PMPS test and insulin? I don't want to drag him out from under the bed in an hour and a half just to scare him even more. He usually isn't like this at all. I was very concerned earlier that he was hypo due to me giving him an extra .25u in his shot this morning (I realize I shouldn't have done that).

I was planning on starting a transition to wet food tonight, maybe I should give him some wet food so he gets some water? He has been drinking a lot lately due to the FD, but I'm concerned that he hasn't come out for water in a few hours. I put a bowl under the bed with him but he doesn't seem interested.

I'm heavily leaning towards skipping the dose, but I would really like the insight of some people before I do anything, his behavior is making me nervous, but I think he is just scared. I know more about how to help him be less scared in the future from the helpful people in my other post, but I really need advice on how to help him right now.

Thank you
 
He calmed down and I took his BG, it was high (349) so I decided to give him his insulin. I gave him some wet food and a little less dry food. After having the wet food he was less interested in the dry food, so I had to give him more wet to make sure he ate enough.
 
Anyway, I am really glad that you gave him his insulin. He needs it. So he has asthma? And was on prednisolone for it? That was oral pred? Now he’s just on inhaled steroids? Is that right? If he needs the pred, the insulin can be adjusted manage Bg.
 
Suzanne & Darcy said:
Anyway, I am really glad that you gave him his insulin. He needs it. So he has asthma? And was on prednisolone for it? That was oral pred? Now he’s just on inhaled steroids? Is that right? If he needs the pred, the insulin can be adjusted manage Bg.
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Yeah, I know he needs it. I was weighing the pros and cons of him missing one dose and him being scared of getting his BG taken. I know I made the right choice though.

Yes, he has asthma. He was on prednisolone as needed for several years, but I knew the risk of FD so I tried to use it sparingly. It was oral pred. Yes, he gets Flovent 2x a day and Albuterol for emergencies. He started those at the same time he started insulin, Tuesday. He is doing better now on the inhalers than he has in years on the pred, totally worth the price difference, and I'm disappointed I didn't realize it was an option sooner.
 
Nice nadir last night! I'm anxious to see his pre-shot this morning. What time do you shoot (looks like we're in the same Eastern time zone).

With all the changes lately, insulin/food/pred/inhalers and a new routine, the next couple of weeks will be really important figuring out how Binx responds.

Stopping pred made a big difference for Jess and a food transition can make another big difference. I'm not familiar with the effects of Albuterol or Flovent though, but, you're in good hands with Suzanne around - she's a wealth of information for all things cats!
 
Shelley & Jess said:
Nice nadir last night! I'm anxious to see his pre-shot this morning. What time do you shoot (looks like we're in the same Eastern time zone).

With all the changes lately, insulin/food/pred/inhalers and a new routine, the next couple of weeks will be really important figuring out how Binx responds.

Stopping pred made a big difference for Jess and a food transition can make another big difference. I'm not familiar with the effects of Albuterol or Flovent though, but, you're in good hands with Suzanne around - she's a wealth of information for all things cats!
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Sorry for such a late reply! He was looking good this morning, I kept an eye on him throughout the night. His PMPS was higher than I expected. He doesn't free feed, and I'm still learning, so I'm not sure why he would go back to 375 for his PMPS. Maybe I missed his shot?

I'm keeping an eye on him to make sure he doesn't drop too low. He isn't entirely on wet yet. He gets 1 can of wet, then I give him a little bit of dry. I actually gave him a tiny more bit dry last night after that 142 reading because I was concerned he may drop lower while I slept. Is that a good thing to do?
 
I think maybe it's bouncing? I'm still learning more about that, but he will drop to a healthy level and then shoot back up. Hopefully over the next few weeks that levels out. He is acting healthier already!
 
Keep on doing what you are doing for now. Hopefully you can make the transition to low carb wet food, but these things do take time with all cats and with diabetic cats we must be extra careful. I wish there were mid-cycle tests for today so we could see what happened between amps and pmps.
 
Suzanne & Darcy said:
Keep on doing what you are doing for now. Hopefully you can make the transition to low carb wet food, but these things do take time with all cats and with diabetic cats we must be extra careful. I wish there were mid-cycle tests for today so we could see what happened between amps and pmps.
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You're right, I need to be patient. Unfortunately I worked today and work again tomorrow so I wasn't able to track as much. I'm off Tuesday and hope to get more readings.
 
I’m thinking tentatively that if you haven’t seen better numbers by the Tuesday evening cycle that you should increase to 1.25 units on Wednesday morning. The reasoning behind this is that IF Binx is bouncing from that one blue number then we will have given it six cycles to clear. I do believe he will need the increase, yes, but we need to do this incrementally.

Do you test for ketones?
 
Suzanne & Darcy said:
IF Binx is bouncing from that one blue number then we will have given it six cycles to clear.
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Oh yeah. He dropped 50% between +4 and +6 09/09 PM cycle, definitely the kind of fast drop that can trigger a bounce. With Prozinc, you don't want the drop to be much more than 50% between pre-shot and nadir - cats tend to bounce high if the drop is 50% or more from pre-shot to nadir and that 50% drop happened in just 2 hours.
 
Suzanne & Darcy said:
I’m thinking tentatively that if you haven’t seen better numbers by the Tuesday evening cycle that you should increase to 1.25 units on Wednesday morning. The reasoning behind this is that IF Binx is bouncing from that one blue number then we will have given it six cycles to clear. I do believe he will need the increase, yes, but we need to do this incrementally.

Do you test for ketones?
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Is it too soon to bump his insulin? I agree, it doesn't seem like it's doing enough, I just am not sure about how to go about raising it. Do you think I should wait until his second vet appointment? I plan to cancel the next one with the vet that diagnosed him due to them not seeming very knowledge about FD, I hope I can find a vet that will work with me more on his treatment.

I have Ketone test strips, but I haven't had any luck getting a sample. I plan to buy one of the blood testers with my next paycheck! The vet didn't mention anything about ketones when they did all their tests, but they gave me very little information. I'm going to call and request the results.
 
Shelley & Jess said:
Oh yeah. He dropped 50% between +4 and +6 09/09 PM cycle, definitely the kind of fast drop that can trigger a bounce. With Prozinc, you don't want the drop to be much more than 50% between pre-shot and nadir - cats tend to bounce high if the drop is 50% or more from pre-shot to nadir and that 50% drop happened in just 2 hours.
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Is that kind of bounce dangerous?
 
Nick & Binx said:
Is that kind of bounce dangerous?
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Not really "dangerous"....more like "frustrating" because when they drop that much so quickly, it's almost guaranteed he's going to bounce.

Nick & Binx said:
He is doing better now on the inhalers than he has in years on the pred, totally worth the price difference, and I'm disappointed I didn't realize it was an option sooner.
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Don't know how much you're paying, but I know several people who get the inhaled steroids from a pharmacy in Canada for a lot less. I haven't compared prices lately so I don't know if that's still the better deal, but might be worth looking into.

Marks Marine Pharmacy is a real pharmacy that really cares about customer service and a lot of us have used them for our insulin but they also carry the inhaled steroids.
 
Chris & China (GA) said:
Not really "dangerous"....more like "frustrating" because when they drop that much so quickly, it's almost guaranteed he's going to bounce.



Don't know how much you're paying, but I know several people who get the inhaled steroids from a pharmacy in Canada for a lot less. I haven't compared prices lately so I don't know if that's still the better deal, but might be worth looking into.

Marks Marine Pharmacy is a real pharmacy that really cares about customer service and a lot of us have used them for our insulin but they also carry the inhaled steroids.
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Oh good, I'm glad it isn't inherently dangerous. But it is something to obviously get under control.

Thank you for the link! I paid $180 for a 2 month supply. I read a bit about the online pharmacies and found some that seem to offer a 3 month supply for that cost. It's hard trying to get the best for him on a fixed income, so anything like that helps! I appreciate it. Do you know any good sites for cheaper supplies, like strips?
 
Nick & Binx said:
Is that kind of bounce dangerous?
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The bounce up, no. It probably made him feel crappy though.

His body thinks normal numbers are too low right now - it's gotten used to being in higher numbers and thinks that's where it should be to be safe, so, when the BG drops like that, a little too fast, the liver panics and dumps 'glucose' in his system to get him back up to a BG level where his body thinks it should be, where it's gotten used to being.

Nick & Binx said:
But it is something to obviously get under control.
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As his body learns that normal numbers are actually safe he shouldn't bounce as high or as long.
 
Nick & Binx said:
Do you know any good sites for cheaper supplies, like strips?
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If you're using the ReLion, those are the cheapest strips anywhere. $17.88 for 100 is a lot better than the price for some other strips which can run close to $1 each!

You could apply to Diabetic Cats in Need. Right now we're only doing the One time assistance program, but plan on re-starting the Compassionate Assitance program soon (we hope!) If you're already on the OTA, when the CAP re-starts, you could be switched if your income qualifies you. (there's no income verification for the OTA program. It's open to everybody)
 
Chris & China (GA) said:
If you're using the ReLion, those are the cheapest strips anywhere. $17.88 for 100 is a lot better than the price for some other strips which can run close to $1 each!

You could apply to Diabetic Cats in Need. Right now we're only doing the One time assistance program, but plan on re-starting the Compassionate Assitance program soon (we hope!) If you're already on the OTA, when the CAP re-starts, you could be switched if your income qualifies you. (there's no income verification for the OTA program. It's open to everybody)
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Thank you very much!
 
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