13yo - Prozinc to Humulin N - hunger and poor attitude

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leikvold

Member Since 2010
Hello,

My 13 year old cat (estimated age, he was a shelter cat), Steve, has been diabetic from for 3 years (with a one year honeymoon). When diagnosed (and when he came off honeymoon) he BG was in the 500-600 range, but it was easily regulated on 1/2 unit of Prozinc twice a day. For the past 7 years he always eaten Weruva wet food, and since his diagnoses, now eats only the Grain free varieties of Weruva.

3 months ago we moved cross country and began seeing a new vet who began him on Humulin N because they could not provide Prozinc (previously I purchased insulin directly from my vet) - but the transition is not going well. Reading this forum has been a wonderful crash course in feline diabetics, and now I hope you can help me re-regulate Steve.

He is now taking 2units of Humulin N twice a day, but his BG is still only getting to about 300 mid-day when I've taken him into the vet. I test his urine at home, and continue to get positive reading for glucose (usually in the 1000mg range) with no ketones (thank god!). His weight has dropped from 13lb to 11.9lb and feels much bonier and "senior" then ever before, but his appetite has become rampant! He now BEGS for food nonstop 2-3 hours before feeding, sometimes getting so worked up he begins vomiting clear mucus. His water consumption appears normal (he doesn't try to drink from my glasses, which he did when we began him on 1unit of Humulin N) but I still feel his litter box urine clumps are significantly larger then my non-diabetic cats. After eating/insulin he tends to lay under the bed and rest all day, where as before his was much more interactive with humans, toys, and other cats all day... he seems depressed...

Because Steve's diabetes was so easily regulated previously, not requiring much personal education on the disease and just following my vets instructions, I feel like a newbie! Based on what I've read on this board, it sounds like the Humulin N is simply too fast acting/not suited for my cat, and that he should be moved to Lantus or Levemir. Do these symptoms sounds like just a case of non-compatible insulin, or are there other issues I should be concerned about/lifestyles changes I should make.

Your experience and advice is infinitely helpful, and hopefully with your insights we can get Steve re-regulated! THANKS!
 
A lot of cats here have had success with Lantus; I would highly recommend asking your vet for a scrip for it, or for PZI and have it filled at your local pharmacy.
Sorry to say that your vet isn't up-to-date on diabetes management if his/her go-to insulin in Humulin-N. Unfortunately, we're well aware here that the majority of vets are treating this disease as if we're still living in the '80s....

I'm sure the experts will chime in, but the extreme hunger is a diabetic symptom. I don't know about the vomiting, although when my cat was dx'ed, he was throwing up a lot as well. Now that he is regulated he doesn't do that much anymore.
 
Are you home testing?

You can get your vet to write a prescription for Prozinc and have it filled at Costco. They need to order it so it takes a few days to get but it is less expensive than buying it from the vet. Or a prescription for Lantus that can be filled at any pharmacy.

Humulin N is a short acting harsh insulin for your Steve. I don't understand why a Vet cannot provide Prozinc for you.
 
Yo can buy ProZinc from various places via the internet. Just Google for "buy prozinc". You do need a script from your vet though. When comparing prices make sure you include shipping since usually overnight shipping is required.
 
I see that you are testing for glucose in the urine. Have you looked into testing with a home glucose meter like humans use? There is lots of info here on how to get little drops of blood from your kitty's ear to do this. Most kitties adjust well to this kind of testing, and it will help you get a more accurate view on your kitty's blood glucose levels and also how the insulin is working. The curves you can do at home and they will be more accurate since going to the vet is probably stressful... and stress effects blood glucose levels.

If you start testing this way at home, you can also begin a spread sheet that all of us can see. This will help us help you. Gathering these numbers will also be valuable to you vet.

Humulin is fast acting and harsher than your previous insulin. My experience with Humulin was difficult. Lulu is currently trying life off of insulin, but if he needs it again I will not use Humulin. But this is what you have right now, so lets see what we can do... I strongly recommend home testing with a human blood glucose meter.

I found that Lulu was dipping quickly and his body was reacting to this intense dip by releasing it's own glucose. This caused the preshot blood glucose numbers to be very high... so we reduced the amount of insulin he was getting. You can check out our spread sheet in my signature and see where we went on our little Humulin journey.

I don't know much about your kitty... was he on 2 units of the other insulin too, and were you testing for glucose in his pee then? Was glucose showing up when he was on the other insulin? I'm wondering if he doesn't need less Humulin because it's harder on his little body... but I don't know. 2 units of Humulin sounds like a lot because of how fast it works.

Don't know if this helps...
Amanda
 
Thank you for all you advice. When he was on 1/2 units of Prozinc his BG was perfect, in the 100-120 range at the bottom of his curve, and he never ever had glucose in his urine. At his check up in August the vet actually thought he was entering a honeymoon again, but thought I should wait until after the (stressful) move to take him off insulin... but that's obviously not what happened. He's going to see a new vet tomorrow...
 
Since you are in a large urban area, you should be able to find a vet that is more up to date or even a feline only practice. There have been many new people recently using Humulin either because it was cheaper or the vet is unfamiiar with the other insulins. Most of them had horror stories like yours. Your cat should easily get regulated again once he is on the right insulin. PS. Don't let the new vet sell you one of the alpha trek meters. They are very expensive and the human meters work the same.
 
Something that has not been mentioned yet ---- it is possible that it is NOT just diabetes coming back ----

One of my cats has Hyperthyroid. He is not diabetic. The Hyperthyroid caused increased thirst, increased peeing, increased hunger and bad temper. He also puked clear fluid nearly every day, and licked his fur off his back legs and belly (like he was itchy).

His regular bloodwork showed his Thyroid value was near the top of the NORMAL range and he was 10 years old.

Since he was obviously sick, I asked for the Free T4 test, and sure enough, he tested positive for Hyperthyroid. Turns out, older cats can be in the high NORMAL range on the regular test and still have Hyperthyroid.

He has been on Tapazole pills for a bit over two years now - and he is pretty much normal -- just an occasional upset stomach with the clear vomit. Drinking and eating are normal - attitude is normal or even better than before. His fur has grown back.

We do have to get the Free T4 test done every 3 months or so to make sure his dose is still good. In 2+ years, we have had to increase his dose twice.

I mention this -- because all the symptoms you mention could be HyperT - and it is very possible for diabetic cats to also get HyperThyroid.
 
Your vet can write a paper prescription that can be filled elsewhere - they do not have to be your direct source for meds.

BCP Vet Pharmacy supplies PZI - and you can order different strengths - U40, U50 or U100 in either a 5ml or 10ml vial.
www.bcpvetpharm.com

Just fax the prescription and place the order.

Alternatively -- you could request a prescription for Lantus or Levemir (human insulins) and buy at a regular human pharmacy with the prescription written by your vet. The only thing -- your cat is probably not covered on your medical insurance, so save hastle and time and tell them it is not covered by insurance.

Many of us order from Canada, as the price is less - even with shipping costs. A prescription is still required (as of 1/1/2010).

Ask your vet to write it for the 5-pack of 3ml cartridges "for use with pen" - we actually use syringes though.

Also - ask your vet to write the prescription for a 1 year supply (refills!) This can be estimated from your dose and the size of the container.

For PZI, it is usually good to the last drop -- so a 10 ml vial of U40 == 400 units

For Levemir (my favorite), 5 x 3ml x U100 = 1500 units and I've been able to use it all up before it goes bad (3 to 4 months per cartridge)

Lantus may break down sooner -- the guarantee is 4 weeks, and some get 5-6 weeks per cartridge. So 2 refills of the 5 pack would be needed for a year if you figure 1 pen cartridge per month.
 
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