BG 422, anything I can do?

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KaitlynandScamper

KaitlynandScamper

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My cat Scamper was diagnosed about 2 weeks ago, and has been on 2 units of ProZinc twice a day. He seemed very well for the first week, but is now peeing like crazy and very thirsty, same as just before I took him to the vet. I just got the glucometer in the mail today (cannot thank you enough, Lori!) and the first reading I got from him is 422 mg/dl. This is 1 hr 45 min after receiving the 2 units of ProZinc and eating one can of Fancy Feast Classic. This seems outrageously high and I wonder if there is anything I should do immediately? Now that I've got the glucometer, I will set out to make a curve, but for the time being should I increase to 3 units? He is 11 lbs, btw.

Thanks!
 
Hi Kaitlyn (and Scamper),
Do you have any BG numbers from the past 2 weeks, like where he was at at diagnosis by the vet? My first instinct is to say "don't up the dose until you get a few more pre-shot and feeding readings, so you can have a more clear picture of what his BG is before the insulin and food start changing his numbers."
What concerns me is that after a week or two of acting like he's felt better, now he's again drinking and peeing a lot more. That sounds like he's gone back to square one, and your natural assumption that the insulin dose isn't high enough would seem logical. That said, it might be too soon to tell. 2u BID is a healthy dose of insulin. That's about where Bob was a couple weeks into the dance. He ended up needing more for some time, but that determination was made with a couple weeks of data for me and the vet to look at. I'd feel a lot better about advising one way or the other if you had a few more tests worth of data you could share.
If you were to increase, I think it might be better to make a smaller jump than from 2 all the way to 3 this early in the dance. "Start low - go slow" would indicate an increase of maybe 1/2 a unit (or less).
I'm hoping some more experienced dancers come along to chime in soon.

Carl in SC
 
Thanks Carl! His test results from the vet just say "3+" for glucose. I don't know what that means... The fructosamine test reading was 622. I will definitely take more readings tomorrow. In this case, I literally walked in the door to find the package with the meter had arrived and immediately used it, so I have no other data yet. What is your recommendation for taking readings? I was planning just before his morning dose and then 4 hours later, since ProZinc is long-acting. I'm still reading up on making curves, so I don't quite understand yet what the best schedule is.
 
No, there is nothing you should do immediately.

The onset of Prozinc varies, and it is not unusual to see kitties bg increase for a couple of hours after dosing prozinc before the bg starts coming down. I would not change the dose without more data. If you can give the 2 units and then get test every two hours and post your "curve" it will provide necessary data to adjust your dose.

It would be really interesting if you could get a +6 test tonight. If not, that is okay---just see if you can get a curve in tomorrow.

Good Luck!
 
Since it is your first curve---can you get the preshot +2, +4,+6, +8 ,+10 and the next preshot? If not then get +3, +6 +9 and your next preshot.

What are you feeding?
 
An ideal curve would be every 2 hours, but if you could get readings at +3, +6 and +9 that would be great. PZI is supposed to reach "nadir" at +6, so assuming that's what is happening with Scamper, you should get a starting number, a +3 snapshot that would show the insulin starting to work at the same time the food is keeping the number elevated, then at +6 you should see how much the insulin is pushing it down. At +9 it should be somewhat higher as the insulin starts to wear off, and then just before the PM meal, it should no longer be supressing his BG. Then the whole 12 hour dance starts over.
Make sure to test before feeding, and then let him eat, and shoot insulin soon after he finishes eating. You can give him more food during the first 6 hours after a shot, but you should avoid feeding after +6 if at all possible. This assumes he's on a 2x per day feeding schedule of course. Other people can advise on what to and when to feed if he's one of those "eat many small portions a day" kitties. Bob eats twice a day, with a snack or two along the way.

That 3-6-9-12 schedule assumes that you are able to test at those times. On a day off, it might be possible and any time I tried to run a curve, I did it on a day where I didn't have to work or be anywhere else all day. During a "normal" day in your life, any tests you can do beyond the AMPS and PMPS will be beneficial. It'll give you a better picture of what the doses are doing for Scamper, and it will allow people who are looking at your data and trying to help you a better picture too.

Carl in SC
 
Many thanks! I will be able to gather the 7 item curve tomorrow for sure.
I am feeding him FF classic as of diagnosis, and he nibbles a little bit at our other cat's Purina indoor formula.
 
That's ok. Just keep poking every 2 or 3 hours and you'll have a good picture for peiple to look at. Try to keep track of when he eats and how much as well.
carl
 
Yes, like Carl said...just keep checking..he could be having a slow onset and there is a food spike normally after eating.

Stay with it and get the data!
 
KaitlynandScamper said:
Many thanks! I will be able to gather the 7 item curve tomorrow for sure.
I am feeding him FF classic as of diagnosis, and he nibbles a little bit at our other cat's Purina indoor formula.
Click to expand...

Purina indoor dry is really high in carbs. This could be keeping his blood sugar high. Even just a little bit of dry food can skyrocket a diabetic cat's blood sugar levels. Bandit's blood sugar will shoot up from the low 100s to 300-450 if he just eats a few pieces of dry food.

Can you switch your other cat to an all canned diet and ditch the dry food completely? It will be much healthier for both of your cats. If the other cat won't transition to wet food immediately, I would recommend doing controlled feedings of the dry and not leaving it out for Scamper to get into. It's easier to transition cats on dry food to wet if they have controlled feedings (like you would do with wet food) instead of leaving dry out to free feed.

If you're worried about having to leave food out for your cats when you're not there, you can free feed canned food. You just freeze portions and then set them out to thaw in a dish or an automatic feeder.
 
I free fed Bandit Purina Indoor formula for the first 6 1/2 years of his life. This is what he looked like at 6:
FATBANDIT.jpg


This is what he looked like at 8, after a year on an all wet food diet:

SkinnyBandit-1.jpg
 
His last two readings are 466 and 448. Effectively no change, and I am additionally troubled by the fact that his breath smells very strongly. It's almost like the smell of human urine. I'm wondering if it's time to take him to the vet again?

One thing I can say for sure is that the Purina dry food is OUT -- those are really persuasive images, Julia!
 
KaitlynandScamper said:
His last two readings are 466 and 448. Effectively no change, and I am additionally troubled by the fact that his breath smells very strongly. It's almost like the smell of human urine. I'm wondering if it's time to take him to the vet again?

One thing I can say for sure is that the Purina dry food is OUT -- those are really persuasive images, Julia!
Click to expand...


Does it smell like nail polish remover (acetone) ?

Very serious....Keytones are very serious and need immediate treatment.

I would not even wait until tomorrow (Monday) but take him to an ER vet NOW.


Do you have keytone testing strips to test his urine for keytones.
 
I do not have urine test strips, but it definitely does not smell like nail polish remover. Is that something I could buy at the pharmacy to make sure?
 
KaitlynandScamper said:
I do not have urine test strips, but it definitely does not smell like nail polish remover. Is that something I could buy at the pharmacy to make sure?
Click to expand...

Today being Sunday, you need to find a pharmacy that is open today.

Ask the pharmacist for "KetoStix". There are 50 test strips in a package
and I think they run around $15 or so.

You wait for the cat to go to the box, then stick the test strip into the urine
stream. Or you can 'catch some pee' by using a soup ladle under the cat
as he/she is peeing.



KetoStix is something you should have on hand as part of your kit.
 
Yes. Where they sell diabetic meters you'll see boxes of keytone test sticks. You will need to catch him while he's peeing. I would also call the vet and let the one on duty know what's going on asap
carl
 
Kaitlyn,
I wish you the best of luck getting a ketone test tonight. If he has more than a trace of ketones, I'd get him to the ER.
I use a small plastic cup that I hold under J.D.'s tail while he's peeing. Some people use a ladel. Some people put a film of plastic wrap over the litter with a little bit of litter on top and dip the stick in the puddle after they pee.
Please let us know, okay?
 
Ditto to everything said....get the strips and check for ketones......very serious condition.

My cat had DKA, it is very serious. I would not put any test off until tomorrow.

I might have missed this in the thread.....is he eating okay today?
 
Thanks so much for your concern everyone! Very fortunately, my friend who is a former vet tech came by right away to take a look at Scamper. He did not have any strips but said he was 100% sure he did not smell ketones on his breath or from his urine. He also called his former vet employer and told him the story, with the BG data and all. The vet suggested I increase to 2.5 units and inject in the side of the belly, rather than the scruff (which is the only way my vet showed me), where it might absorb faster. I did so, and 3 hours later Scamper's BG is way down to 75! This seems too good to be true, so I'm going to follow up with another BG test in an hour. His poor ears have been through so much today. I feel like I'm no closer to regulating, what with this dramatic flip. Is the side injection the way I should always be going about it? I can't tell if the dose or the method is the key.
 
Also, kse -- he was eating fine all day, but right now he seems absolutely starving. Should I let him eat or will that just cause another BG spike?
 
Okay, I have no idea what is going on. But, what I do know is if you injected Prozinc and he is at 75---- 3 hours later, you need to monitor closely. Normallly Prozinc has a nadir at between +4 and +8-- you could have awhile to go before hitting his lowest point. I am not trying to panic you, but if he got into low numbers do you have some higher carb food (like the dry you were feeding) available.

When they start having big blood sugar drops they get hungry--trying to protect themselves from going low. That might be why he is acting like he is starving. I would feed him.
Please recheck his bg.
 
Kaitlyn
What time did you dose, and what time was the +3?
Carl in SC
 
Carl,

I dosed around 7:30 (I usually dose at 8:45), per the vet's instructions, so the +3 was about 10:25. He's eating some dry food right now, so I'm going to wait another 15 minutes or so before I retest. He seems completely fine aside from being very hungry.
 
Come on Scamper, don't scare your momma and us others like this! Goooood that the vet tech came over and even called the vet employer so you at least got a lower number.

I can't advice you on whether the scruff or the side. Myself only gives in the scruff, but that is because Simba wouldn't tolerate shots anywhere else, he think they hurt. But I do know that many rotate the shots practically all around the body and that many give shots in the side --- just as the vet employer said the closer to the chest the better and faster absorption.

As comparison: When I used the 12 mm long needle syringes, they went in deeper under the skin, and had a more faster absorption and onset. The ones I used now are 8 mm long needle, that is just a difference of 4 mm (VERY small difference) but makes a huge difference in absoprtion and onset because they don't get as deep in under the skin as the 12 mmm do. So now I have a slower onset of the insulin.
 
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