4th day of insulin-#'s moving in wrong direction

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Ginny & Alex

Ginny & Alex

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I posted on the general message board and someone suggested I post here.
We started insulin this past Wednesday and I felt very encouraged with the first day's BG #'s. But the last couple of days, we appear to be back sliding.

Any comments?
 
Hi Ginny,,,,it's me. This is quiet today but this should be your home base for the pzi use. i would say the insulin could be cut back to a skinny Unit. does that make sense. just shy of a unit. it is quite common to see a kitty go the 'wrong way' on too much insulin. You will find out if you actually lower to .75 if the change is better or worse much quicker. giving the dose 3 or 4 cycles to kick in.
 
I agree with dropping your dose, since you are just getting started 1u may be too much. I'd be tempted to drop to .5u see what happens and then adjust from there.
 
Hi & welcome!!!

Can you fill us in on what food you are feeding, and any background info we should know (like other health issues, ketone history, etc.)?

Thanks!
 
OK I just saw the food is in your signature :) is the EVO canned or dry? I'm not sure of the carbs on the canned...? The FF is LC flavors?
 
The vet prescribed Hills WD, but after reading here for a few days, I stopped that.
So, we bought some EVO canned (all in the 2-4% range), thinking it might be higher quality then FF, but they only had chicken and beef. The chicken was a hit, but not the beef. He seems to like FF just fine and it is readily available. I am choosing FF flavors that are on Janet and Binky's list --picking ones that are between 8-10% of their calories from carbs--not just the classic flavors, but some flaked and chunky too. And I am still feeding a little bit of EVO dry, primarily for the non-diabetic cat. The numbers on this dry food (again from Janet and Binky's list) has only 8% of its calories from carbs--the best I could find.

As far as other health concerns, I'm not aware of any. My biggest concern is his temperment. He gets really hissy when we go to the vet and with some visitors that come to our house, and sometimes even with DH and me. Now I've found a vet that comes to my house. He probably has more experience with farm animals, but I was desparate. I was very concerned Alex wouldn't let me do the home testing and insulin shots, but he's tolerating the prick in the ear quite well. The first couple of shots went well, but now he's getting squirmier and whimpers when I give the shot.
 
Ginny there are many many flavors that go below 8 carbs and i reccomend them too. did you see both the old and new list. the new list does not contain the old list flavors.
 
yes, we're using lots of different FF flavors.

Explain this to me. A couple of you have suggested that I possibly reduce the dosage. You have lots more experience than I do, but I don't understand this at all. Why do you suggest less insulin and not more?

Still trying to figure this out.
 
Lori,
I'm on east coast time, so I went to bed, but would love to hear your explanation.
I have a busy day, but will be checking off and on.
 
ok, if the kitty (or human) body see's there is too much insulin in the blood stream it will have the liver release glucose to protect the body from hypoglycemia.
that is it in a nut shell.
now the fact that the numbers are high...could be as stated above.
it may sound strange but we have seen it on many many many occassions.
if i can think of a few on this very page who have had this on their own cat i will post the names so you can look at their SS and see that with a lowered insulin the numbers also lowered.
does this make sense?
 
Makes sense.
I'm also losing my confidence that I'm giving the shot correctly. I keep reading that the shot isn't painful to cats, but Alex is crying when I poke him. And today, the needle was bent when I pulled it out.
 
bent? don't poke too hard now. if you just tent the skin between 2 fingers and aim for the inside of the tent...gently but firmly. does that sound like what your doing?
 
Just took his +6 reading and it was 310.

Just to make sure I understood your ealier recommendation, you suggest I reduce from 1 unit to .5 units.
I don't know if 1 Unit is the same when we're talking about the different insulins, but I'm using U-40 insulin.
 
oh i know exactly what your doing...u40 1 unit. and i don't think .5, i think .75 if you can eyeball that.
 
I shot just less that 1 unit this morning and what I think was .75 this evening. I know I need to learn to be patient, but our appt with the vet was Feb 21 (when I first noticed the excessive drinking and peeing). Then it took 2 wks to get blood work results, then we ordered special food that took another 1 or so, and then we fed that diet for a week or so to see if numbers improved. I'm anxious to get moving in the right direction.
 
No, I'm not testing for ketones. The vet did a urine analysis last Wednesday and all he said was the ketones were what would be expected in a diabetic cat.

I assume there is a way to do this at home? Details, please.
 
When I got urine sample for vet, I simply held a cup under Alex's while he peed in the litter box--he didn't seem to mind that.
So, do I find these strips at a pharmacy like the glucometer? Are ones used for humans also used for cats? How often should he be tested for ketones?
 
Yes, they are in drug stores - the same kind that humans use. If he is eating well and seems well, once or twice a week should be okay. Anytime you get anything other than normal, you need to pay attention.

One thing that helps with ketones is to add water to the wet food. Some cats like the soupy texture. This helps with dehydration. It can be like gravy which can be popular.
 
THey are ketostix. Same as for humans. Ask your vet how often to test. I would think that when the BG is high it should be every few days. Catching his urine in a cup is fine. The test needs to be done with fresh urine.
 
I started my other post answering your question---I should have started by saying Hi and welcome! Good job testing! You picked that up really fast. Is the shot going easier now? If it is painful I think something is wrong. And definitely the needle should not be bent. Did your vet check the way you were shooting?
 
You may have to ask behind the pharmacy counter, I think that's where my Walgreens had them (Ketostix - Walmart also has a generic for 1/2 the price, if that is a factor. I think the brand ones are around $10 and Wmts were around $4). It's a good idea to check at least weekly - ketones should NOT be expected in a diabetic cat, not sure why the vet said that. You don't want to see any. Yes it is a possible side effect of diabetes, but not an automatic one (like glucose in the urine, THAT you would expect!).

I would pull the dry food if you can. Even though it says it's LC there is debate as to whether or not that is really accurate, and we have generally seen that with any dry food in the picture cats' BGs just shoot sky high.

If dry food is in the picture I'm not sure lowering the dose is the ticket, and also if you are feeding FFs close to the 10% range. Yes their body can resist the dose and high #s can be a sign the dose is too high, but I'm not sure that is the case here. It looks to me like you got some WOW factor on day 1 and then lost that.

The only way to know really is to make a change like you did and collect data. If you don't see better #s in a couple cycles, I would raise the dose back up & not wait too long. Given the food might be slightly higher carb than many cats here are on, I'm leaning toward dose may be too low. As long as ketones are negative and his symptoms aren't too bad there's no big harm in trying the lower dose for a day or two and see what happens.

If you do see any ketones though, or if his symptoms are pretty bad right now, I would go back to (at least) 1u immediately.
 
Just wanted to say hello and welcome to PZI. I know it's no fun to be patient, especially as you've been waiting for test results and to start insulin and want improvement for Alex. This first part when you're just starting insulin is a lot about data gathering and learning how the insulin works on Alex. I don't think there is any way around having to be patient. You're doing good with the home testing and diet change. I've had some bent syringes too. Takes a little practice to get the hang of the injections, especially if you're like me and a little squeamish. I would give my cat Max his shot while he ate cause he noticed it less then.
 
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