BCP PZI Insulin. Not working yet. :(

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rbrumbaugh82

Okay so I wake up this morning to test Pooper's glucose and it was above 400 like always. Before I went to bed last night he was at 275. The only thing I can think of he ate through the night was the dry food but the dry food I bought has a glycemic index of 10 and therefore supposed to be a low glycemic food. Other than that only wet is in there. I would have thought I'd wake up and test him and he'd be in the 200s or so. I am just losing patience on why this stuff is not kicking in and lowering his glucose. I'm sticking with 2 units and not going for the 1 or 1.5 because those values are not doing anything for him. Keep in mind my cat is obese so he isn't healthy weight compared to maybe many of your guy's cats.
 
The glucose will always be higher at pre-shot tests; it doesn't hold it down permanently. The nadir, or lowest glucose post shot, is when you will see most of the difference. It is possible you may have a higher dose cat.

Low glycemic is a nice idea; it still has carbs to be matched up to insulin. the only low carb dry foods are Evo Cat and Kitten, Young Again 0 Carb (internet only and 5% calories from carbs), and Epigen 90.

Some patient pants to help you be more patient; this is not a quick fix issue.
Patience pants rainbow jeans.png
 
Ok BJ, you mentioned EVO Cat and Kitten dry food. However, I looked at their ingredients and 87% meat protein and 13% fruits and vegetables. How is that considered a low carb food? The food I have for them now the Nutrisca cat food has almost identical ingredients minus all the fish ingredients in them.
 
That calculator shows EVO having 15.5 wet dry matter and 17% carbs. That isn't considered a low carb food IMO!
 
Hmmm, if anyone can look at Nutrisca's cat food packaging it says Glycemic index at 10 and that low glycemic foods are foods under 55. That supposedly say the chicken recipe has a level rating of 10. However, if this nutrition calculator is accurate and current it said 30.5 wet matter carbs and 34% dry matter carbs. :(
 
Funny how they said Young Again Zero Carb but accordingly to the nutrition calculator it says it has 8% dry matter carbs??????
 
The patience pants are courtesy of @Deb & Wink !
The nutrition calculator is an estimate.
Here's another one.

Also, you can edit your post and add on to it; no need to make multiple posts



 
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Okay. Just wanting everyone to see what I write without it getting mixed up.
So if the nutrition calculator is an estimate then how the heck am I supposed to know the true carb count in these dry foods then? If my picky cats are going to want dry kibble food then I need to give them the lowest carb one possible but they don't care for the YA Zero Carb food because I tried that before.
 
Short of making it yourself, you won't ever get a true carb estimate as all data are based on a sample.
The formulas can change with each batch; that's why the labels say minimum and maximum.

You could try baking a low carb canned food into a dry version. use a jelly roll pan, spread it out thinly, bake at a temperature suitable for crackers, check until it is the consistency you want.
 
Thanks for the advice but would be too much putting into buying all of this stuff. I want to go for something with a proven track record and therefore want to hear from others who are feeding dry cat food for a diabetic cat and even for an overweight cat. So I know the choices are between Wysong Epigen 90, Young Again Zero Carb and Evo Cat and Kitten formula?
 
At what point was he at 275? (Don't see it on the SS yet). A typical PZI curve is going to look like a smile. High at both ends and low in the middle. The trick is "not too low in the middle" as that may cause a "bounce", resulting in higher preshots to follow.
I understand that you want to see green in the middle. His system might not be accustomed to green yet, and may react to them by bouncing. Eventually his body will remember that green numbers are normal, but it can take take some time.
Hence the stylish patience pants.
 
the choices are between Wysong Epigen 90, Young Again Zero Carb and Evo Cat and Kitten formula?
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yes... that sums it up....
someone who used to be here had a cat (ninja) who refused wet completely....she was feeding evo..... but her cat's numbers stayed high and dosage stayed high...
when she discovered YAZC , suddenly her cat went into remission and her cat leapt down the dosing scale. It's really hard to follow the protocol with dry food....


with the YAZC, it's so high calorie that a normal days full portion is 2 Tablespoons, so they aren't at the bowl as much as they were with the other dry foods.

Wysong is the newest dry on the block that's low enough.
And if they don't gobble it up, that's a good thing, it's out for them if they want it, but it might be the perfect way to transition all of them to wet food....


I would avoid Evo because I saw how Ninja's chart changed drastically when he switched off of it....


I think you should try pushing them a bit , even if they don't love the food, see if you can't take advantage of that, and make the wet food more appealing.....

I can send you a couple of packs of fortiflora ( unless you have it already)
to try sprinking on the top of the wet food...... see if that makes it better....
 
rhiannon and shadow said:
yes... that sums it up....
someone who used to be here had a cat (ninja) who refused wet completely....she was feeding evo..... but her cat's numbers stayed high and dosage stayed high...
when she discovered YAZC , suddenly her cat went into remission and her cat leapt down the dosing scale. It's really hard to follow the protocol with dry food....


with the YAZC, it's so high calorie that a normal days full portion is 2 Tablespoons, so they aren't at the bowl as much as they were with the other dry foods.

Wysong is the newest dry on the block that's low enough.
And if they don't gobble it up, that's a good thing, it's out for them if they want it, but it might be the perfect way to transition all of them to wet food....


I would avoid Evo because I saw how Ninja's chart changed drastically when he switched off of it....


I think you should try pushing them a bit , even if they don't love the food, see if you can't take advantage of that, and make the wet food more appealing.....

I can send you a couple of packs of fortiflora ( unless you have it already)
to try sprinking on the top of the wet food...... see if that makes it better....
Click to expand...
Thanks Rhiannon! Pooper's does eat the wet food but the other only graze at it. I have gone through alot of decisions with wet foods but none that they gobble right up. Cost wise I just have been sticking with Fancy Feast Turkey and Giblets classic along with the Chicken one here and there but I want to avoid fish if I can even though my garage kitties eat Friskies Pate classics that contain fish and rice in them. However, I hope since it is further down on the list that the fish and rice isn't that much.
 
Carl & Polly & Bob (GA) said:
At what point was he at 275? (Don't see it on the SS yet). A typical PZI curve is going to look like a smile. High at both ends and low in the middle. The trick is "not too low in the middle" as that may cause a "bounce", resulting in higher preshots to follow.
I understand that you want to see green in the middle. His system might not be accustomed to green yet, and may react to them by bouncing. Eventually his body will remember that green numbers are normal, but it can take take some time.
Hence the stylish patience pants.
Click to expand...
Hey Carl, the 275 was from last night before I went to bed. I updated the SS so you can check it out. I was hoping to wake up this morning to a number in the 200s atleast but nope it was above 400 like usual.
 
The 264 and 280 are essentially the same number once you allow for the 20% variance in meter readings so I wouldn't worry too much that the insulin isn't lasting in his system just yet. If you can find out when he starts heading back up to significantly higher numbers, that would give you a better idea of when the insulin's starting to come out of his system.
 
Just read thru your posts.. Purrfection is a pretty steep goal here. I use the bcp insulin and it required a bit of time to be effective.
Baby bear peaks at 8-10 hrs but the numbers move gradually, not the extreme sudden drops we got with other insulins and that you seem to be expecting, but gradual changes are much better for him in the long run. On the food issue, I also free feed dry food because of my crazy work schedule, I am not always home on time and I don't want him without access to food. I use Core original, it's grain free, and supposed to be under 10% carbs.. Also feed FF chicken or turkey 1/2 can bid. ( & yes, my boy is overweight too) Just take a deep breath, we can't fix it all overnight :)
 
kitty & bear said:
Just read thru your posts.. Purrfection is a pretty steep goal here. I use the bcp insulin and it required a bit of time to be effective.
Baby bear peaks at 8-10 hrs but the numbers move gradually, not the extreme sudden drops we got with other insulins and that you seem to be expecting, but gradual changes are much better for him in the long run. On the food issue, I also free feed dry food because of my crazy work schedule, I am not always home on time and I don't want him without access to food. I use Core original, it's grain free, and supposed to be under 10% carbs.. Also feed FF chicken or turkey 1/2 can bid. ( & yes, my boy is overweight too) Just take a deep breath, we can't fix it all overnight :)
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I know its hard and stressful. I just hate seeing his number above 240 because I get that Ketone beep when it goes off. I just would love to be able to take his glucose and see it like 130 or below and not have to worry about strain on his body and also allowing his pancreas to heal. I know he went back up to above 350 a little while ago so for some reason he must have reached his peak with the insulin for today. I don't understand because I thought this insulin is supposed to be in the system for 12 hours or so. I gave him his 2 units around 830 this morning and at 530 it was going way back up but I also know he has been sleeping all afternoon too with little eating. However, the insulin shouldn't cause his body to raise his glucose I don't think? So I gave him his last shot for the night at 530 tonight. I know its not 12 hours apart with the shots because 9 hours is close enough and he was going back up and not going down.
 
rbrumbaugh82 said:
I just would love to be able to take his glucose and see it like 130 or below and not have to worry about strain on his body and also allowing his pancreas to heal.
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And you will - it just takes time. It took Rosa 10 days to start seeing numbers that weren't in the 'HI' range for most of the day. I know only too well how horrible it is to constantly see those higher numbers but it all takes time - longer than we'd really like in most instances - to start seeing a consistent improvement.
 
That's true - mine doesn't do that. Though what I'd really like at the moment is a meter that sets off all sorts of alarms when it gets a below 50, so I'm not sitting there cuddling Rosa and then looking at the meter a minute or so later and going 'Oh !@%# - 43 - better fix that'. Those low numbers can be just as shocking as the higher ones in the end!!
 
Poopers body needs Time. Time to adjust to the new insulin. Time for his body to recognize the new insulin as something it can use. Time for the rest of his organs to get back on the right track and function properly.
I see the results of impatient owners trying to "over fix" the problem in the emergency clinic all the time.
If I may be so bold, Forget the numbers for a minute and look at your cat. How is He? Does he feel good? Is he happy? Is he eating? Is he lethargic? Or depressed?
It's just not an exact science and he may not be a cat that can tolerate low #'s..
 
It has only gone down 52 points in 4 hours to 312 from 364. I am missing the N because it did drop it into the 100s for a time. I can't seem to get him below 260 now and thats not healthy range. I wonder how many more days it is going to take until I start seeing progress? Being a cat insulin it should work. I just wonder if 2 unit is even enough? Maybe 3 units?
 
kitty & bear said:
Poopers body needs Time. Time to adjust to the new insulin. Time for his body to recognize the new insulin as something it can use. Time for the rest of his organs to get back on the right track and function properly.
I see the results of impatient owners trying to "over fix" the problem in the emergency clinic all the time.
If I may be so bold, Forget the numbers for a minute and look at your cat. How is He? Does he feel good? Is he happy? Is he eating? Is he lethargic? Or depressed?
It's just not an exact science and he may not be a cat that can tolerate low #'s..
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Yeah I can see where you are coming from. He does purr quite loud and seems to be fine and healthy for the most part. Yeah he sleeps alot but he eats and drinks and gives kisses here and there. I just don't think being in 200s or 300s is healthy especially hearing meter give me the dreaded sound telling me that he is above ketone level. I just hope soon that this insulin will help his pancreas heal and give me numbers in the 100s and stay that way for a longer period of time. I believe in this insulin and I believe in all of you guys and I know patience runs thin with me but I want this to be the insulin to get Pooper's to OTJ!
 
manxcat419 said:
Beep when the reading's in the possible ketone range. A lot of them just beep to tell you the reading's ready.
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Oh yep my meter gives a beep when his number is below 240 and then if it is above it then its a low pitch dreadful close my eyes I don't want to see the number kind of sound. lol
 
You might want to switch that beep off just for now if it's upsetting you - I think there's a way of switching off all the beeps on just about any meter.

And of course, although he might be in the range where you want to check for ketones, that doesn't mean he'll ever actually have a problem with them. Rosa had no ketones at all even when all her readings were over 600 - not all cats seem to be prone to developing ketones.

Patience is the key to getting him to where you want him to be - I didn't think I was ever going to get Rosa's numbers down, but once they started dropping they just didn't stop. Poopers might be exactly the same way once you give him a chance to show you what he can do with the insulin!
 
Medically speaking 100's are too low for at cat being monitored at home.
I have the opportunity to speak with several different vets on the subject (given what I do for a living) and all have said that 200's are a desirable and reasonable number for a cat. It's good to hear he is feeling ok..
Hypoglycemia is worse than DKA in the fact that his body becomes starved of oxygen at the same time. My kitty became DKA while I decided whether or not to treat his condition and the insulin was on order but he recovered in 24hrs.
I guess my advice is not to aim for remission but aim for good quality of life and the rest may come.
 
manxcat419 said:
You might want to switch that beep off just for now if it's upsetting you - I think there's a way of switching off all the beeps on just about any meter.

And of course, although he might be in the range where you want to check for ketones, that doesn't mean he'll ever actually have a problem with them. Rosa had no ketones at all even when all her readings were over 600 - not all cats seem to be prone to developing ketones.

Patience is the key to getting him to where you want him to be - I didn't think I was ever going to get Rosa's numbers down, but once they started dropping they just didn't stop. Poopers might be exactly the same way once you give him a chance to show you what he can do with the insulin!
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Thanks for the support and encouragement April! I really hope it comes true! I know from reading up on this insulin that it is 1 amino acid away from being what a cat produces so I'd like to believe that it will be recognized in his body and actually start producing healthy numbers for him soon! I just do not want to think about having to switch insulins again.
 
kitty & bear said:
Medically speaking 100's are too low for at cat being monitored at home.
I have the opportunity to speak with several different vets on the subject (given what I do for a living) and all have said that 200's are a desirable and reasonable number for a cat. It's good to hear he is feeling ok..
Hypoglycemia is worse than DKA in the fact that his body becomes starved of oxygen at the same time. My kitty became DKA while I decided whether or not to treat his condition and the insulin was on order but he recovered in 24hrs.
I guess my advice is not to aim for remission but aim for good quality of life and the rest may come.
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But my thing is, what would be considered a great number for him to achieve? I think it would have to be below 240 since anything higher than that produces the ketone level on the meter. I would think anything under 200 would be healthy and what I would need to shoot for. Not 300 or 400's.
 
I think it will - it's just very early days yet. And you only switched to this insulin a couple of shots ago. He'll get there - maybe he'll need an increase in a few days and maybe he'll do just fine on this dose. But either way, you're dedicated to his health and you'll get him to where he needs to be. :)
 
I have to say that I disagree with any vet that says that 100s are too low for a cat being monitored at home.
200s could be above the renal threshold, meaning glucose skills into the bloodstream, and glucose toxicity can set in, causing further resistance to insulin.
On a human meter, blood glucose above 120 to 130 is above normal ranges for a cat.
Perhaps these vets fear, or believe, that a caregiver doesn't know how to react when numbers get low?
I fully understand that you don't want a cat to be hypoglycemic. We "draw the line" at a BG of 50. And there are instructions all over the board that prepare a caregiver as to how to deal with low numbers. If anything, we're probably more cautious than a lot of vets are, because we don't have a handy glucose drip in the next room to rescue a cat from hypo after an IV dose of fast acting insulin causes it to crash.
100's aren't too low for a cat being home tested and monitored. They are normal blood glucose values to slightly above normal values.
And from what I've seen in almost four years of watching well over a thousand cats and caregivers on a daily basis deal with feline diabetes treatment, the cats are monitored more closely and more often than any cat monitored by a vet, unless that vet happens to be working in an emergency room.

We all have a very heathy respect for low BG numbers. Everyone who offers advice or offers suggestions on this board understands what a huge responsibility that is. None of us are experts. None of us are veterinary professionals. We also err on the side of caution. Frankly, especially with new members with newly diagnosed cats, I've seen far too many cases where they have been given terrible dosing advice from their vets that have put their cats lives at risk - things like "give 3u twice a day, don't worry about home testing, and bring Fluffy back in one month for a curve". In cases like that, it is very probable that advice given here has saved a cat's life.


ALL THAT SAID -
I WOULD NOT advise raising the dose above 2u. Not yet. That is the dose that your vet recommended, and I believe you need to give it a few days, and not shoot more often than every 12 hours. And test to try to find his nadir so you can see what the dose does if given regularly. You won't know if it works or not until you can do that. If you see numbers that drop under 200, fantastic. If they drop quickly, or lower than you feel comfortable with, then jump online and post a 911, and call your vet if you need immediate help. Read, reread and print out the " how to deal with low numbers" sticky.

I would not increase the dose before discussing it with your vet.
 
Thanks Carl! I am sticking with 2 units since that was given as to do and will see what it does. So far his levels have been staying in the 300s with an occassional in the 200s for a while. I am not seeing huge spikes up and down except for this morning but he may have ate dry food through the night to give him a 400+. I know I just got done checking his glucose before bed time and it went down to 283 from 312 in 1 hour. Not sure if it will go down any further through the night but I am guessing his NADIR is occurring at the 5 hour range.
 
I will, thank you and hope within 7 days he is achieving better numbers.
 
Goodnight all and thank you guys for being great friends and helping me through all of this!
 
rbrumbaugh82 said:
I will, thank you and hope within 7 days he is achieving better numbers.
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Better numbers are safe, consistent lower numbers, but not necessarily as low as you might wish for right now. After seeing where Poopers was a week or so ago with the food dropping his numbers into a much better range. I really can understand your frustration at the deterioration in his numbers. The new insulin makes things a new ball game. Prozinc has a different action profile to your previous insulin. Changing insulins is - to a degree - like starting from scratch. I'd suggest looking at this transition period as a chance to record Poopers' response to the new insulin so that you'll have the data needed to keep him safe going forward.
 
OK, now I have time to reply before getting to bed. @Carl & Polly & Bob (GA) I would have to agree with you on it being safe to have numbers in the 'normal for a cat' zone while home monitoring. I would also say there is a quality of life issue with keeping numbers up in the 200s, at least for some cats. For instance, with Rosa, at 200 she seems fine and anyone who doesn't know her would say she seems perfectly healthy. She's fairly normal-acting for a cat. But Rosa at <120 is the cheeky, trouble-making, talkative, bouncy cat that I've known and loved for the last 11 years. The differences are subtle, but they're definitely there. To me, that quality of life should be the ultimate aim as long as it can be achieved safely for the cat - why settle for OK when she can have good? And that holds whether insulin is required for life or just for short-term support. And, frankly, with the amount of monitoring everyone I've spoken to on this board does to make sure their cats don't finish up in the dangerously low zone, I don't feel that the risk is all that high for people who are vigilant. I believe that many vets think that most people can't or won't monitor as much as might be necessary to achieve that tight control or that people may take risks to keep their cat in the normal zone - and we don't. I skipped Rosa's shot tonight because we can't monitor - safety first. But I want her to have the best quality of life she can on as many days as she can!

However, I would also agree that this has to be an eventual aim and that raising insulin doses too quickly can be counter-productive and even dangerous until you know how your individual cat will react over time to the current dose.
 
Larry, I think she has shot prior to +12 a few times, and the PMPS is actually the number in the +9, +10, etc. box. Our SS template isn't very well suited for "off schedule" shots, but I am not sure how people compensate for that.
 
Hey Larry, I just haven't labeled things as fine tuned as others. Maybe in ( ) I should show the time frame in the PM when I took it. Most of those shots that are PM shots fall before the 2nd PM shot column. I just didn't label it but I figure you can look at my AMPS and then just count by hour after that to know the time frame when I checked his glucose. Bare in mind that all the AMPS are around 830 am.
 
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