? Back Again - Freya Glucose Curve - Need Dosing Advice (Prozinc)

So last month after her numbers started going up I listened to the advice I received, and took her to the vet. Vet ran tests, and seemed satisfied with the results. He did want an increase in insulin, but also told us we should not change her dosage so much, and try to stick with the same dose for a while.

We slowly moved her up to 1.5 units, and her results are getting worse! We finally thought we had a breakthrough on the 12th of this month, but then ended up with the evening of the 13th her blood sugar never went down. We thought maybe it was a fur shot (though we did not think it was, and felt no wetness), and figured her results would be high the next day. But 5 days later, and her results continue to be high. It feels like each increase leads to a couple of better days, and then she shoots back up.

Is this a sign we should move up her dosage again? Go down? Should we give it a few more days?

I do still wonder if her Prozinc bottle was off to begin with, the issues started shortly after starting her new bottle. Or maybe she just isn't responding the Prozinc the way she used to?

Because of the 300+ days she is back to increaed thirst/urination/hunger. She has been having to take a little Miralax as it is causing a bit of constipation. Other than that she still is pretty normal (not going outside her box, still grooming, etc). I want to do whatever I can to get her feeling better ASAP.

Thanks in advance for all the help/advice.

 

When was Freya's last dental? Did the vet check her out for any kind of infection? Either could be why her numbers are wonky.

 

I think she needs more insulin. Have you looked over the Prozinc dosing guidelines? I would suggest increasing by 0.25u rather than trying to "fatten" the dose. The only time that smaller dose adjustments are useful is if you are very close to an ideal dose and you're seeing lots of normal range numbers.

Generally, you don't want to hold the dose longer than a week if the dose isn't bringing your cat into a desirable range. I have to disagree with your vet. Holding a dose for overly long can result in glucose toxicity developing. The name sounds worse than it is. What this means is that your cat's system gets used to the higher numbers and treats the higher range as the new "normal."

 

Hi there just looked at your spreadsheet and for 10-18 you have 15 units in there for the AMPS , I know you probably meant 1.5
Just wanted to let you know

 

Freya's last dental was years ago. I always worry about a dental now that she is older. When she went to the vet he looked at her teeth and said they looked fine, but then again, she is terrible when people grab her face, and I know he didn't get a long look. I also know she had lost a couple of teeth over the years. I tried looking in just now, and I don't see any obvious redness/irratation on her gums, but she doesn't really give a chance for me to really look inside.

Other infections he did not check for. He called to say her labs looked fine, but I did not get a copy of the results. Is it possible for there to be an infection somewhere that isn't obvious?

Her appointment was really a basic checkup (weight, temperature, listening to heart/lungs, and basic blood panel). I told him my concerns about her numbers going up after having decent numbers for so long, but he said that happens, and doses need to change. He is a great vet, but he also doesn't have the most experience with diabetic cats. I feel like a lot of his suggestions are geared towards dogs.

I am going to bump up her dosage again, but I am not sure at what point we should take her into the vet again. Or perhaps look into a new vet for a 2nd opinion. I like my vet, she is used to them, and they are nearby. I obviously will change if it would be best for her.

 

Thanks for the info. I feel like I was trying to follow modified Prozinc, and then when her numbers went crazy I went off course, panicked, and listened to my vets advice.

I am bumping her to 1.75 tonight. I will see how she does. I hope we end up with better numbers, and for more than a couple of days!

 

Fixed! Thank you.

 

Unless I've missed it earlier in the thread, another usual suspect to check for is a UTI, especially when BG is above the renal threshold for part of the day.


Mogs
.

 

I was wondering about that. I got some of those urine test strips, and was able to collect a sample of her urine tongiht. Everything looked within normal range except leukocytes. Would that be a sign of UTI by itself? Last time she had a UTI (at diagnosis) she didn't have any normal symptoms other than urinating out of the box. She has been using her box like normal. I will call the vet tomorrow and let them know. Her numbers keep going up!

 

According to my vet, the leukocyte test on the home strips isn't reliable but you might want to run the result by your own vet. Sometimes the strip might test positive for blood if a UTI is present but the best way to check is a cystocentesis with culture and sensitivity. If you give your vet a call about the urine test results they should be able to advise you on how to proceed.


Mogs
.

 

She had a vet appointment today. They said her heart/lungs sound good, and her teeth looked good. They did a urine test, and said she has a mild UTI. She is now on antibiotics. Her +3 was at 93 this evening, which is the lowest +3 since August. We will be staying up with her tonight checking her glucose to make sure she does not drop too low. I am hoping between the new bottle of insulin and the antibiotics her numbers will get back to normal, and we can lower her dosage. Thank you for mentioning checking for a UTI!