Advice for the newly diagnosed please!

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bgenick

Member Since 2014
My cat was diagnosed about five weeks ago with BG around 350 and started on 1 unit of ProZinc insulin. About 10 days later, when his BG was unchanged, his dosage was increased to 2 units until now, he is up to 5 units. It seems to have little effect at all. His BG is still in the 300s, where it remains throughout the day (does not vary much) and he is rapidly losing weight. Basic bloodwork did not reveal anything of note, and a urine culture is in progress.

I'm terribly worried about him, but can't afford to spend thousands of dollars. Have others experienced this situation?
 
Hello and welcome to the FDMB!

First of all, what are you feeding? It's very important to feed a low carb wet food to help control diabetes. We want them eating less than 10% carbs (which means no kibble!) Just as with human diabetics, carb control is a very important part of treatment. The good news is you don't have to spend a lot of money either! Lots of people here feed Friskies pate's or Fancy Feast Classics!

Next, we never increase in whole unit increments....insulin is a very powerful hormone and even tiny increases of .25 can make a big difference, so your vet has increased your kitty way too fast.

Too much insulin can look like too little!!

It's important to learn how to home test too. This not only saves you a lot of money since you don't have to keep going to the vet for expensive (and mostly useless "curves") but it will really help you to keep your cat safe as well as knowing exactly what's going on inside his body. If you live near a WalMart, one of the favorite meters around here are the Relion Confirm or Micro (about $15) and the strips to go with it are $35.88 for 100

We can help you learn how to home test as well as help you make good decisions on dosing...and the people here have a lot more real life experience dealing with diabetic cats. (most vets might have a handful of diabetic cats their entire career...the people here do this 24/7)
 
Chris & China said:
Hello and welcome to the FDMB!

First of all, what are you feeding? It's very important to feed a low carb wet food to help control diabetes. We want them eating less than 10% carbs (which means no kibble!) Just as with human diabetics, carb control is a very important part of treatment. The good news is you don't have to spend a lot of money either! Lots of people here feed Friskies pate's or Fancy Feast Classics!

Next, we never increase in whole unit increments....insulin is a very powerful hormone and even tiny increases of .25 can make a big difference, so your vet has increased your kitty way too fast.

Too much insulin can look like too little!!

It's important to learn how to home test too. This not only saves you a lot of money since you don't have to keep going to the vet for expensive (and mostly useless "curves") but it will really help you to keep your cat safe as well as knowing exactly what's going on inside his body. If you live near a WalMart, one of the favorite meters around here are the Relion Confirm or Micro (about $15) and the strips to go with it are $35.88 for 100

We can help you learn how to home test as well as help you make good decisions on dosing...and the people here have a lot more real life experience dealing with diabetic cats. (most vets might have a handful of diabetic cats their entire career...the people here do this 24/7)
Click to expand...

Chris & China said:
Hello and welcome to the FDMB!

First of all, what are you feeding? It's very important to feed a low carb wet food to help control diabetes. We want them eating less than 10% carbs (which means no kibble!) Just as with human diabetics, carb control is a very important part of treatment. The good news is you don't have to spend a lot of money either! Lots of people here feed Friskies pate's or Fancy Feast Classics!

Next, we never increase in whole unit increments....insulin is a very powerful hormone and even tiny increases of .25 can make a big difference, so your vet has increased your kitty way too fast.

Too much insulin can look like too little!!

It's important to learn how to home test too. This not only saves you a lot of money since you don't have to keep going to the vet for expensive (and mostly useless "curves") but it will really help you to keep your cat safe as well as knowing exactly what's going on inside his body. If you live near a WalMart, one of the favorite meters around here are the Relion Confirm or Micro (about $15) and the strips to go with it are $35.88 for 100

We can help you learn how to home test as well as help you make good decisions on dosing...and the people here have a lot more real life experience dealing with diabetic cats. (most vets might have a handful of diabetic cats their entire career...the people here do this 24/7)
Click to expand...

Chris & China said:
Hello and welcome to the FDMB!

First of all, what are you feeding? It's very important to feed a low carb wet food to help control diabetes. We want them eating less than 10% carbs (which means no kibble!) Just as with human diabetics, carb control is a very important part of treatment. The good news is you don't have to spend a lot of money either! Lots of people here feed Friskies pate's or Fancy Feast Classics!

Next, we never increase in whole unit increments....insulin is a very powerful hormone and even tiny increases of .25 can make a big difference, so your vet has increased your kitty way too fast.

Too much insulin can look like too little!!

It's important to learn how to home test too. This not only saves you a lot of money since you don't have to keep going to the vet for expensive (and mostly useless "curves") but it will really help you to keep your cat safe as well as knowing exactly what's going on inside his body. If you live near a WalMart, one of the favorite meters around here are the Relion Confirm or Micro (about $15) and the strips to go with it are $35.88 for 100

We can help you learn how to home test as well as help you make good decisions on dosing...and the people here have a lot more real life experience dealing with diabetic cats. (most vets might have a handful of diabetic cats their entire career...the people here do this 24/7)
Click to expand...

Thanks for the response! I am VERY worried! I am feeding primarily the Fancy Feast Classics that have <10 carbs, although I want to keep food in front of him as much as possible since he is losing weight--he was 12 lbs., now down to 8.25, and is a long lanky cat. I tried to find some dry Evo to leave out for between meals, but can't find any in my area. I have taken away his previous dry food, though.
My vet did show me how to do ear pricks, and I got the same glucometer that she has. I'm not too good at it, but I CAN do it!
Can you elaborate on how "too much insulin can look like too little?" I just assumed that, if the current dosage wasn't working, it was reasonable to increase it. If, for example, on 5 units his BG remains in the 300s throughout the day, how could LESS insulin work?
Thanks!
 
Because if it's TOO much insulin it can be taking him too low...and then his liver releases stored sugar and hormones to bring him back up fast...it's called "bouncing".

In simple terms, back when our kitties were wild, if their blood glucose got too low (like from starvation), the liver would dump these sugars and hormones into the bloodstream to bring them back up...hopefully long enough to hunt and get a meal. The liver still works the same today, so if your kitty is getting too much insulin, and it's taking his blood glucose too low, the liver is still there, doing it's thing. We've seen kitties go from 400 to 40 and back to 400 in the same 12 hour cycle!

Most insulin doses are based on how low it takes them, not how high their numbers are.

It sounds like you have the AlphaTrak meter? If so, that's fine to use if you want to continue, but the strips for it are awfully expensive (about $1 each) which is why the majority of us here use the human meters like the Relion Confirm or Micro.

It's very important to get back into the habit of testing at home so you can really know what's going on inside your extra sweet kitty's body
 
If you share with us some of your blood glucose levels, we would be able to see more clearly what is happening. For now, something like this:

Amps (the test number before food and the shot in the morning)
+#. Any tests you get during the cycle. Like a test 6 hours after the shot would be +6
Pmps. (The test number before food and the shot in the evening

Especially good would be tests in the 5-7 hour range after the shot, when the insulin should take him lowest.
 
Chris & China said:
Because if it's TOO much insulin it can be taking him too low...and then his liver releases stored sugar and hormones to bring him back up fast...it's called "bouncing".

In simple terms, back when our kitties were wild, if their blood glucose got too low (like from starvation), the liver would dump these sugars and hormones into the bloodstream to bring them back up...hopefully long enough to hunt and get a meal. The liver still works the same today, so if your kitty is getting too much insulin, and it's taking his blood glucose too low, the liver is still there, doing it's thing.

Most insulin doses are based on how low it takes them, not how high their numbers are.

It sounds like you have the AlphaTrak meter? If so, that's fine to use if you want to continue, but the strips for it are awfully expensive (about $1 each) which is why the majority of us here use the human meters like the Relion Confirm or Micro.

It's very important to get back into the habit of testing at home so you can really know what's going on inside your extra sweet kitty's body
Click to expand...

I know what you mean about bouncing--years ago, I had a diabetic cat who was confirmed as having acromegaly--now THAT was a challenge! But he survived to age 15. This cat, though, when tested throughout the day, never drops below the 300s. He hasn't had a reading below 300 since initially diagnosed. I got the Accu-Chek Aviva meter so it would be same as my vet's.
 
bgenick said:
I know what you mean about bouncing--years ago, I had a diabetic cat who was confirmed as having acromegaly--now THAT was a challenge! But he survived to age 15. This cat, though, when tested throughout the day, never drops below the 300s. He hasn't had a reading below 300 since initially diagnosed. I got the Accu-Chek Aviva meter so it would be same as my vet's.
Click to expand...

He doesn't seem to have any "curve" at all--never out of 300s! I am wondering if I somehow rolled the insulin around too much (I know not to shake it) and it is damaged. But at $160/bottle I'm not too quick to buy a replacement.
 
Here is an example of one day's readings:
830 am food and insulin
10 am 370
1230 pm 353
6 pm 307
8 pm (prior to food and insulin) 356
 
Is that 5u 2x/day? That's what my cat is on too. He had lost a lot of weight, but has gained it back, so I've made some progress. Hope you do too. Get those readings and set up a spreadsheet so people here can help you like they've helped me. You can get ProZinc from Valley Vet supply for $95
 
bgenick said:
Here is an example of one day's readings:
830 am food and insulin
10 am 370
1230 pm 353
6 pm 307
8 pm (prior to food and insulin) 356
Click to expand...
Sharon14 said:
Is that 5u 2x/day? That's what my cat is on too. He had lost a lot of weight, but has gained it back, so I've made some progress. Hope you do too. Get those readings and set up a spreadsheet so people here can help you like they've helped me. You can get ProZinc from Valley Vet supply for $95
Click to expand...

Yes, 5U twice a day. Thanks for the tip about where to get the insulin. Do they require a prescription? I remember years ago finding out to my surprise that, at least in my state, one did NOT need a prescription. Though most humans have one so that their insurance will pay.
 
Looks like you have been getting some good advice with regard to nutrition and insulin knowledge as well. Something to consider as well is working out a time frame for his/her response to the insulin. My vet recommended 7-10 days between dosage changes. Insulin is a very potent harmon that can be lethal. I am blown away by the fact that it does not require a prescription. Where in the heck do you live? That is a significant weight loss too. How often do you feed? What is the size of the portion that you give? My cat receives insulin twice daily. Yet, feeding only twice daily did not satisfy her and her sugars rose because of the stress. Depending on the season...she is fed 4 to 5 times daily with the larger portions coming at insulin times. There's a lot to learn...and a lot of knowledge acquired through trial and error. Be kind to yourself. Take each day at a time. And, roll with the punches. You can do this!!! Good luck from Jane and Stewey
 
ProZinc is a veterinary insulin so you can only get it from your vet or veterinary supply places so I'm sure you'd need your vet to call in a script if you wanted to get it from Valley Vet

Do you have any testing at night? Most cats go lower at night, and if he's doing that, it could explain the high numbers during the day....also, even if he's always in the 300's doesn't necessarily mean he's not getting too much insulin....if he's constantly getting too much, his liver is constantly dumping sugar and hormones to keep it up

As I said above, we don't EVER do increases in whole units unless the cat has worked their way up slowly to something like 10U (since 1U is only 10% of 10U, a 1U dose increase really wouldn't be that much, but increasing 1U when the dose is only 1 unit is a 100% increase)

We have a spreadsheet that we use here that's a very valuable tool in helping to make dose adjustments. It would really help if you'd get it going and enter the test results you have....maybe the last 2 weeks if you have them. Here's some Instructions on setting up the FDMB spreadsheet.
 
Chris & China said:
ProZinc is a veterinary insulin so you can only get it from your vet or veterinary supply places so I'm sure you'd need your vet to call in a script if you wanted to get it from Valley Vet

Do you have any testing at night? Most cats go lower at night, and if he's doing that, it could explain the high numbers during the day....also, even if he's always in the 300's doesn't necessarily mean he's not getting too much insulin....if he's constantly getting too much, his liver is constantly dumping sugar and hormones to keep it up

As I said above, we don't EVER do increases in whole units unless the cat has worked their way up slowly to something like 10U (since 1U is only 10% of 10U, a 1U dose increase really wouldn't be that much, but increasing 1U when the dose is only 1 unit is a 100% increase)

We have a spreadsheet that we use here that's a very valuable tool in helping to make dose adjustments. It would really help if you'd get it going and enter the test results you have....maybe the last 2 weeks if you have them. Here's some Instructions on setting up the FDMB spreadsheet.
Click to expand...

Thanks for all the advice! Simply as a matter of interest, take a look at this spreadsheet showing how many states do not have laws requiring a prescription for insulin or insulin syringes. I think this does not preclude companies or pharmacies from requiring one regardless. Don't think you will find many places that do not. Still, I do remember buying both with a prescription.
http://www.isletsofhope.com/diabetes/state-law/state-prescription-laws.html
 
Yeah, I've seen that chart....the key is where they say
Note 1 for chart below: Older insulins such as regular (R) do not need a prescription except in Alaska. The chart below only specifies if older insulins require a prescription.
Click to expand...

Lantus, Levemir and ProZinc are newer insulins and as far as I know, require a prescription in all 50 states....although in Canada, Lantus and Levemir can be bought OTC!...Lucky Canadians!!
 
Yes, you are right. It was an older human insulin (for cat, long before the advent of the zinc's) I was buying at the time.
 
That is certainly a flat cycle. The trouble is that it could be too much or too little insulin. Most cats use less than 5 units but there are some high dose conditions. See if any of the symptoms fit:

http://www.felinediabetes.com/FDMB/...-other-high-dose-conditions-what-we-know.375/

I am not sure all the links work, but there is good general info.

The only way to find out if it is too much insulin is to reduce the dose for a few cycles. It is a little scary. If you decide to do that, you need to test for ketones

http://www.felinediabetes.com/ketones.htm

I would think you might cut the dose in half and hold it for a couple cycles. If the numbers increase or stay the same, go right back up.
 
Sure enough too much insulin. Yesrerday morning bg 425. This morning rushed to vet with bg 27. Now at vet school.
 
Chris & China said:
Wow!! Hope your kitty is OK!!

Scary number!!
Click to expand...
Yes very scary! He is at NC State Vet School. They will look for underlying infections and problems. So far starting antibiotics for "trash" in gall bladder per ultrasound. BG back to 200 to 3oo range but only getting 1 unit insulin with 24 hour monitoring.
 
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