03/26/2024 New Member

[KLD]

Hello!

My 3-year-old cat Emmett was diagnosed with diabetes beginning of March 2024. In October/November 2023 he went on a 20 day (shortened from the original planned 30 day) course of steroids to treat suspected eosinophilic granuloma. The course ended up being shortened due to the side effects he was experiencing, particularly increased thirst and hunger (normal for steroid use, but extreme in Emmett's case). His thirst returned to normal after being weaned off the steroids, but the hunger remained pretty high, which is unusual for him because he has generally not been a very food motivated cat his whole life.

At the same time, Emmett had started a diet around May/June 2023 and was slowly losing weight at a reasonable rate. However, by December 2023 we noticed he was quite small (though still within a good weight for him). I didn't think anything of this, as he was on a diet and eating better food than he had been. In hindsight, this, in addition to the increased hunger following the steroid use, was likely the first sign he had developed diabetes.

In February 2024 we noticed that Emmett really wasn't his usual self. He was lethargic, didn't want to play with my other cat, and was no longer so goofy. He also started drinking and peeing a lot, which set off alarm bells. He got blood and urine tests done at the end of February and was officially diagnosed with diabetes March 1, 2024.

Emmett started on 1 unit of Prozinc on March 1, but it really didn't seem to be doing anything. His BG levels were still sky high. We have been steadily increasing his dosage since then. He is currently on 3.5 units. The insulin really hasn't been lowering his BG to good numbers, which has been frustrating and confusing.

Then, on March 21, I noticed that Emmett had been throwing up about 3.5 hours after receiving his PM insulin. I could count on one hand the number of times Emmett has thrown up in his life, so this was really unusual. I tested his BG and it was 19.6 mmol/L, (352) which is the lowest it had ever been that early in the cycle (but still really high!). At +6 he was down to 13.4 (241).

This was so bizarre to me, so I relayed this to the vet, who suspected he might have pancreatitis. The vet put him on a four day course of Cerenia to see if it helped. At the same time, she wanted me to go up to 4 units (I increased him to 3.5 instead because I was worried about his BG now dropping too low at that big of a dosage increase in combination with the Cerenia potentially helping to improve his symptoms and in turn decreasing his BG).

Well, something seemed to do the trick. I started to see nadirs a good 10 points (mmol/L) lower than I had ever seen them before. At the same time, Emmett seemed to finally get his personality back. He has had more energy than I have seen from him in months.

My vet went on vacation, so I asked Vet 2 if he should be continuing the Cerenia. She said to hold off on making any more changes and see what happens with his BG. That is where we are right now.

As you can see from his spreadsheet, his numbers are still ridiculously high. I'm excited by the one blue number I saw March 23, but I'm also not sure what to make of his preshot numbers all being in the red/black.

Any advice would be appreciated. I'm not really sure where to go from here. Thanks!

 

[Bron and Sheba (GA)]

Hi K and Emmett and welcome to the forum.
Thanks for setting up the SS and signature. Both very helpful. You are well organised.
While the cerenia helped the vomiting, I doubt it would help lower the BGs.
Pancreatitis usually causes loss of appetite and pain as well as vomiting.
It is possible you have just not reached the best dose yet. The alphatrack meter always reads higher than the human meters so the numbers can look more alarming.

I’m glad to see you are testing for ketones…that is good. I would continue to do that a couple of times a week until he gets into better numbers and more often if he is unwell. ,

Try and get at least one test in every pm cycle to see if he is dropping lower at night. And you can get other tests in during the cycle apart from the +6. It all helps to complete the whole picture.

Are you testing, feeding and giving the insulin in that order?
And do you give a couple of snacks of food in the first half of all cycles?

I am going to give you the links to information about Prozinc below. Have a look at the dosing methods. Would recommend you follow one of them as you are more likely to get results.

Prozinc Basics

PROZINC DOSING METHODS

 

[Hendrick Cuddleclaw]

Hi and welcome to the FDMB! Excellent job with the signature and spreadsheet, you're hitting the ground running for sure. This forum is the best possible place in the whole world to get your boy regulated. They are very numbers driven here, I love it! The dosing methods developed over decades of time are proven to have high success rates in regulation and sometimes even remission.

 

[KLD]

While the cerenia helped the vomiting, I doubt it would help lower the BGs.
Pancreatitis usually causes loss of appetite and pain as well as vomiting.

Hello Thanks for your response. This is also what Vet 2 said when I mentioned the lower numbers. My usual vet had mentioned that pancreatitis can really mess with regulation, hence why I thought that addressing any potential pain or nausea might help. Aside from the one instance of throwing up, he wasn't necessarily showing any other signs; he's been lethargic and sleeping in his "I don't feel good" spots around the house, but that's so nonspecific it was hard to attribute that to any one thing. However, the Cerenia has definitely helped some symptoms I wasn't seeing because he has done a 180 and turned into a new cat.

Try and get at least one test in every pm cycle to see if he is dropping lower at night. And you can get other tests in during the cycle apart from the +6. It all helps to complete the whole picture.

Are you testing, feeding and giving the insulin in that order?
And do you give a couple of snacks of food in the first half of all cycles?

I will definitely get some more varied tests in. And yes, testing, feeding, then giving the insulin in that order. During the day, he gets small meals throughout the first half of the cycle (usually +3 and +6, but sometimes I split that even more in +2, +4, +6). In the evening, he gets a snack at +2 before I go to bed. He eats Fancy Feast pates, but does sometimes get freeze dried raw treats as well.

I will also try to follow the dosing methods, thanks.

 

[KLD]

Hi and welcome to the FDMB! Excellent job with the signature and spreadsheet, you're hitting the ground running for sure. This forum is the best possible place in the whole world to get your boy regulated. They are very numbers driven here, I love it! The dosing methods developed over decades of time are proven to have high success rates in regulation and sometimes even remission.

Thank you! Really hoping we can get him regulated.

 

[Bron and Sheba (GA)]

Aside from the one instance of throwing up, he wasn't necessarily showing any other signs; he's been lethargic and sleeping in his "I don't feel good" spots around the house, but that's so nonspecific it was hard to attribute that to any one thing. However, the Cerenia has definitely helped some symptoms I wasn't seeing because he has done a 180 and turned into a new cat.

If he’s been lethargic and sleeping in his I don’t feel good places, that could be seen as him being in pain. If the cerenia has helped that’s good. Just keep in mind, it could have been pancreatitis….some flares are worse than others so it could have been a less severe one.

will definitely get some more varied tests in. And yes, testing, feeding, then giving the insulin in that order. During the day, he gets small meals throughout the first half of the cycle (usually +3 and +6, but sometimes I split that even more in +2, +4, +6). In the evening, he gets a snack at +2 before I go to bed. He eats Fancy Feast pates, but does sometimes get freeze dried raw treats as well.

I will also try to follow the dosing methods, thanks.

Good!
does he always eat the snacks as soon as they are put down? If not you might be able to put out another snack for overnight.
Failing that you could have a look at a timed feeder that opens when you set it. I found they were invaluable and a lot of us use them here.

 

[KLD]

If he’s been lethargic and sleeping in his I don’t feel good places, that could be seen as him being in pain. If the cerenia has helped that’s good. Just keep in mind, it could have been pancreatitis….some flares are worse than others so it could have been a less severe one.

For sure. I’m definitely keeping an eye on it. Since the Cerenia he’s been doing gymnastics around the house, so I think he’s feeling better. His vet mentioned possibly testing for pancreatitis if we felt the need, but she’s been away so I haven’t had the chance to run that by her yet.

Good!
does he always eat the snacks as soon as they are put down? If not you might be able to put out another snack for overnight.
Failing that you could have a look at a timed feeder that opens when you set it. I found they were invaluable and a lot of us use them here.

Since starting with insulin (and to a much lesser extent, since the steroids), he’s been a food fiend, so he eats everything as soon as he sees it. A timed feeder might work, but I have a second cat who is also a little food goblin. They both try to steal each other’s food, so I feed them separately. I’m afraid that they would steal each other’s food overnight and I wouldn’t know who was actually eating the food. Separating them at night isn’t an option; they’re a bonded pair and would get too stressed out over that. I’m sure other people have experiences with that, so any advice on the overnight snack would be great.

 

[Suzanne & Darcy]

I’m replying over on the ProZinc forum to your question from today.