4 units of ProZinc twice a day and still over 400

Status
Not open for further replies.
Hemingway

Hemingway

New Member
I am new to this so I apologize if there is a thread on this.

My cat is about 8 years old and recently diagnosed with Diabetes. Below is our story and my issues/concerns frustrations is we are at 4 units twice a day and he is still over 400 and even has been as high as 592.... any advice is wanted... :(
  • He had blood work in September and his Glucose was 118 - Vet suspected Diabetes but glucose was in normal range. March was tested and it was 456. He was peeing, eating and drinking lots.
  • Food - switched(March) to the DM wet and Royal Canin dry for diabetes. Was eating Royal Canin Urinary SO wet and dry. His appetite is not great.
  • Hemingway was a healthy 20 pounds he is a HUGE part main coon tom cat. He is now 14 pounds(since Christmas) and still dropping weight. He is super skinny.
  • We started at 1 unit 2/day... glucose stayed the same.
  • Moved to 2/units 2/day.. glucose went up
  • Moved to 3/units 2/day.. glucose hit an all time hight of 592.
  • Moved to 4 units 2/day... glucose finally dropped to 425. We are going to the vet tomorrow and hopefully it is down.
  • After our Vet appointment tomorrow I am starting home testing.
  • I travel for work and have had to cancel meetings so Im home to give shots and take him to the vet. What do people do? I have a flexible work life but I can't cancel customer meetings...
What should I be asking my Vet? She suggested he may have Cushings. I have read so many different things. They have yet to test his urine. Should they be? Is there anything we should be doing that we aren't.
 
I am glad you are going to home test. That's the best way to know what is happening

One thing you could look at is the food. Dry food is very high in carbs. I switched my kitty from Science Diet (38% carbs) to Fancy Feast (8%) and overnight he dropped 100 points. BUT be confident about testing first before you make a food switch so you can monitor changing levels carefully.

Here's a website by a vet on the value of wet low carb food: www.catinfo.org
 
As far as Cushing's goes the easiest test is the UCCR test (urine cortisol to creatinine ratio test). This is done with a sample of urine collected at home and taken to the vet who would have to send it out to a lab that does this test. My kitty is early Cushing's and I have had many different tests done over the last year or so.

However at this point home testing would give a much better picture of how the insulin is working. It may be that the dose is too high and your kitty's numbers have been "bouncing" from going too low. By testing at home you will get a much clearer picture of how the insulin is affecting the numbers.
 
Thank you both.

Hemingway eats wet food mostly. I leave a little bit of dry in his bowl while I'm at work etc. He rarely ears it and it is the diabetic dry food from my vet. Hopefully that is okay. He eats less than 1/4 a cup per day of it.

We go back to the vet tomorrow for more tests. Hopefully his glucose is out of the black and red.

I can't test him at home through out the day as I work. Is testing morning and night okay?
Any other health issues I should be watching for?
 
I agree with Sue and Mary Ann. Home testing will help you figure out what's really going on. Remember, vet stress can raise the BG by over 100 points, so the number at the vet is almost SURELY not the number he is really at. He's probably much lower at home.

The dry food (especially the prescription stuff) can raise the levels a lot too. Switching to a wet, low carb food will probably be a giant help. But, as Sue said, it is imperative you're testing at home BEFORE you switch. Get confident with testing, then think of switching.

It might also be that you skipped right past the ideal dose. We never raise by 1 unit. We go 0.25 units or 0.5 at most. It's actually very possible to skip past the ideal dose if raising too fast.

Sooo...it could be something like Cushings, but I really wouldn't worry about THAT yet. I think it is almost certainly a combo of the things above.

We can help! Once you start testing at home (which we can also help with) we can take a look at the data you gather and help figure out what the right dose is. Please keep posting here with questions (you're in the right place!) and with the numbers you get once you start testing. We'll be glad to help you figure out how to help Hemingway!

BTW, I LOVE that name! It's so appropriate for a cat!
 
We cross posted! So to answer your questions: morning and evening tests are good. We ALWAYS test before each shot. As a side note, we recommend new diabetics to not shoot under 200. If you get a number under that, wait 20 minutes WITHOUT FEEDING and test again to see if the number is rising. Other than that, it's test, feed, shoot, all in about 15 minutes or so.

You do need to get some mid cycle tests. They're important so we see how much your kitty drops. They also tell us what's going on throughout the cycle. Someone likened it to a puzzle once. The preshot tests are the edge pieces but without the mid cycle tests, you can't see the whole picture. However, we all have lives and we know it isn't possible to get them every day. I used to get mid cycles always on the weekends. I would occasionally get them at night too...either set an alarm or (more likely) just be up anyway part way through the night and grab a test then. Also, during the week, if you can grab a before bed test, roughly 2 or 3 hours or so after the shot, that's helpful info. Basically we need mid cycles, but we get them when we can, and we work around it when we can't!

The other thing to watch for is ketones. You can pick up urine test strips from any pharmacy...we use the same ones humans use (so you can just ask if you can't find them). You want to test for ketones especially when he is in higher numbers. But even in regular numbers, ketone tests are important. Not every day! I want to say it's like...once a week? Check out the ketone post pinned at the top of this forum for more info. If you ever test and get more than trace ketones, it is an emergency that requires a vet visit immediately.

Don't let that scare you, though! Just wanted you to be aware. Again, we are here to help you out! This sugar dance is much easier when you've got others going through it with you. :)
 
How do I find out the carb content in his food? I am feeding him Purina DM wet food and a little bit of the dry is - http://www.royalcanin.ca/products/catalog/DIABETIC/226040 The Vet recommended this one to me. I don't see the carb content for either one of them. Hemingway eats less than a 1/4 of a cup per day. Sometimes less. Its just there as a back up. I can easily take it away from him.

We switched Hemingway over to this diet BEFORE he started on insulin. So I can't test him on his old food. :(

The syringes I use are marked off in units only. There is no way I can see what .25 or .5 of a unit would be?

If he gets too much insulin will that keeps his numbers high? Last week I tested him at 8am, Noon and 2pm his numbers were - 529/ 464 / 562. I give him his shots at 6.30 am and pm. If that helps.

We are going to the Vet this afternoon and I will ask about Keytones.. I don't know how you guys do it. I am struggling and its only been a month. :(

PS - He was names when I adopted him. I think he looks like a Hemingway so I left it. He was a rescue.. someone dumped him outside and he was all cut up wiht open sores and bruising when they finally caught him. I have only had him for about 2 years and they think he is 8 or 10. :)
 
http://binkyspage.tripod.com/dryfood.html. We have an older food chart which is the only one with dry food. Check this page for Royal Canin choices.


They look to be about 30%. With some kitties, just a few pieces can really spike the carb levels, so if you can eliminate it, that would be good.

You can get U40 syringes that measure in half units. If not from your vet, AWD should have them.

You buy the same ketone strips human diabetics use. We stick them in the cat's urine flow. If he won't let you do that, we have other ways........

I'd suggest that you change the food when you can test regularly during a cycle just in case it makes him drop more than you expect.

It is a steep learning curve at first, but believe us when we tell you it gets easier and becomes routine. And. Pat yourself on the back - you have learned so much already!
 
When you increase the insulin and the glucose just gets higher, it can be that the dose is too high. The check for this would be to reduce the insulin, monitor for urine or blood ketones, test the glucose, and observe how the cat is doing.
See my signature link Secondary Monitoring Tools for tips on urine testing, checks for dehydration, and more.
 
Hi, I'd suggest looking at and posting kidney values too on this board. he might have another problem which is raising him. And BJM is so correct. Please reduce that insulin and check as suggested above. Can't you tell me what the phos is bun/creat and creat/urea
I'd like to see this cat initially on a low carb food wet. I would suggest Evo wet chick and turk. It is low carb high protein and low phos to protect kidney. you need to absolutely add water to foods. I am so sick over losing my cat right now, but.... Something is not right
 
Thank you.

We are doing the test on Friday for Cushings... Cross fingers that is not the case.
He is on DM wet food only right now. I have stopped the dry food. March 22nd was the last time I saw the results for BUN/Crea and it was 15. I don't know the Urea but I can ask and let you know. I am afraid to adjust his insulin as the Vet has told me what to give him. I know that sounds terrible but she is lovely and I trust her.

Has anyone had any different results by switching up the injection site?

Im sorry you have lost your cat. I am just heart broken over what Hemingway is going through.. I can't even imagine. :(
 
4-33 is normal for that but that is not indexx labs, which picks up early kidney problems. what is the phos? and reg creatinine. Glucose is way too high. you need to home test prick ear. Don't you have a alphatrak? get one on amazon you can get the dip strips there too. i know this board like likes generic, but just it is easier.
 
i just looked at her spreadsheet. it is hard to tell what you are doing. is that 4 units a day, 2units am/2units pm? are you using U40 syringes? please reply asap
 
dm is purina. just check. well how much are feeding him? half can am/half can pm. if you are feeding more than that, that might be the problem.
 
I am feeding him 1/2 can morning night. We are at 4 units twice a day - 6.30 am and 6.30 pm so a total of 8 units per day.
Sorry.. I was messing around with the spreadsheet and made some changes for me when I was looking at his glucose tests.
His Creatinine is 1.8(March 22nd). I don't know his Phos his updated blood work from yesterday other than his glucose everything was in normal range she said.? I will ask the Vet and I am using u40 needles.

Hope that helps.
 
So, see if you can fix the spreadsheet to reflect 4 units given twice daily.

It is possible that he is a high dose kitty. It is also possible that the dose was raised too fast and by too much each time and that he is, in fact, getting too much insulin. Unfortunately there is no way to know without trying a lower dose. We hesitate to suggest lowering the dose if the cat is not eating well so you might try a different food. Many people here feed Francy Feast or Friskies. If he starts eating well for you, and you are sure the UTI is gone, then you might restart at a lower dose.

If you decide to do that, first get confident testing for ketones so you can monitor those. Then lower the dose for a few cycles - maybe 2 units twice daily for two days. Pick a time when you can test several times in the middle of the cycle. If he drops into lower numbers, then you know he needs less insulin. If he stays high, then you start looking at high dose conditions.
 
Thank you..
You said to wait till the UTI is gone? He doesn't have one... unless I am missing something?

As well.. I did 1 unit twice a day(6.30 am and pm for one week and his sugars increased.
We upped it to 2 units twice a day and tested him mid day after 3 days and they were up again. Then we did the glucose curve and and they went up or stayed the same. So we increased to 3 units and he stayed up or increased. Then went to 4 units twice a day and we had a test and he was down a little but but then up 48 hours later.

Also you keep mentioning different foods. I am feeding him Purina DM which is for diabetic cats and I get it from the Vet. Am I understanding what you are saying is that it is too high in carbs?
You guys have been great thank you! :)
 
Hi there! Yes, the purina dm is high in carbs. I can't recall the amount off hand. The prescription foods really aren't that great. Check out catinfo.org. Dr. Pierson gives some great information on feeding cats (and also gives good information on urinary issues if you run into those in the future!).
 
Wet DM is okay. It is low enough in carbs, but liver based and often cats tire of the taste. If he eats it, fine. If not, you might try something else. Dry DM is too high in carbs.

I was thinking there was a UTI early on - sorry if I mixed that up.

We suggest increasing by 0.5 rather than one unit. It looks like he was raised more than that, and pretty fast. But I agree, you haven't seen any lower numbers. I don't have the answer - it might be that he is getting too much insulin and it is keeping him high. It might be that he is a kitty who needs more insulin than most cats.

Here is some info on high dose conditions. Some of the links are broken, but the general info is there.

http://www.felinediabetes.com/FDMB/...-other-high-dose-conditions-what-we-know.375/
 
Status
Not open for further replies.
Back
Top