Cannot bring BG down, can insulin cause behavior changes?

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Felix and Ron

Member Since 2015
It has been two months now. Started at 2 units prozinc once a day then have progressed to 2, 2.5, 3 units two times per day. Have never had a home test reading under 238 in past month. That was when dosing 1.5. Now I am up to 3 and yesterdays reading 3 hours after morning dose was 399. So gave 3.5 units at 6:30pm then noticed his behavior quite odd. He was afraid of us. Not himself at all. So I tested at 8:30 pm and he was 454. Vet advised to keep pushing his dose but after last nights freaky behavior I am at a loss.

 
Hi,

I'm not familiar with Prozinc insulin but I'm tagging @Sue and Oliver (GA) to come and have a look at your thread. In the meantime, can you please post to tell us what you're feeding your kitty and also what type of meter you are using (human or pet-calibrated) so that we can properly understand your kitty's numbers.

EDITED TO ADD:

Did the freaky behaviour subside later in the cycle?

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Feeding Fancy Feast pate 90% of the time. The other 10% Fancy Feast medleys. He still eats a couple teaspoons of dry at night as we have two other cats. His behavior did subside later. I use the Relion meter. Thanks!
 
It has been two months now. Started at 2 units prozinc once a day then have progressed to 2, 2.5, 3 units two times per day. Have never had a home test reading under 238 in past month. That was when dosing 1.5. Now I am up to 3 and yesterdays reading 3 hours after morning dose was 399. So gave 3.5 units at 6:30pm then noticed his behavior quite odd. He was afraid of us. Not himself at all. So I tested at 8:30 pm and he was 454. Vet advised to keep pushing his dose but after last nights freaky behavior I am at a loss.
Hi, there - So sorry you're having such trouble with high #s.

We're going to need you to plug your kitty's BG #s history into a spreadsheet - it's GREAT that you're home-testing, but we'll need more info to get a clearer understanding of what's really going on. @BJM - Can you help get him set up with a spreadsheet?

You should test his urine for ketones; strips are readily available at most pharmacies.

Are there any other health problems besides the diabetes that vet has identified? (Urinary tract infection, etc.)

Ditto what you were asked above by Aine aka Critter Mom: What are you feeding; when & how much per day? Any other cats in your household? (And could you give us your sugar-kitty's name, please?) Thanks! - Robin
 
Feeding Fancy Feast pate 90% of the time. The other 10% Fancy Feast medleys. He still eats a couple teaspoons of dry at night as we have two other cats. His behavior did subside later. I use the Relion meter. Thanks!
Glad to hear there are no other health problems.
Will still need to know total amount you feed him & how/when you feed. Are your other cats allowed to free-feed? Any chance at all that your diabetic cat is getting into their rations? Does your diabetic cat get to go outdoors unsupervised? As any additional food sources/ overfeeding, etc. will make it EXTREMELY hard for you to get his diabetes controlled. (Must think of food as "medicine" when treating a suger-cat...)

There are instructions on setting up spreadsheet on Main - Feline Health & FAQ page, I believe.
 
I was so nervous about last night I gave him 2.5 this morning at 6am. He just ate again and I tested him. 504. Should test a certain time after he eats? In the evening I test before he eats and still high.
 
Cats are allowed to free-feed. He does get into their food. We pretty much feed him when he asks. He does not go outdoors. I assume feedings should be scheduled. How do I know how much to ration him?
 
I'm fairly certain your problem is rooted in his overeating + mealtime routine in multi-cat household. Please tell me what he weighs now & what his optimum weight should be, in pounds.
(What time zone are you in, btw? Helps to know when you're talking about shot times, etc. ... I'm on California time here in AZ.)
 
Thanks for letting us know that his odd behaviour eased off later in the cycle. All clues appreciated when doing diabetes detective work! Good news on the ketone front too: I'm assuming that your check gave a negative result. I'd check every day while he's at high numbers to be extra safe; doubly so because he has been exhibiting peculiar behaviour.

I was so nervous about last night I gave him 2.5 this morning at 6am. He just ate again and I tested him. 504. Should test a certain time after he eats? In the evening I test before he eats and still high.

At the moment because we don't know what his BG is doing, I'd suggest getting a test at +1hr, +2hrs, and +3hrs after his dose tonight to see what's happening at onset time for his insulin - and also because his behaviour went weird 2 hours after injection time last night.

Question: What was his BG before you gave the 2.5 unit dose this morning?


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I am in AZ. He weighs 15 lbs, but is a very big cat. He was 18.4 before the diabetes started. I did not test before feeding and dose this morning.
 
Fair warning of the lengthy post to come, Ron. (That is your first name, right?)
So here goes ...

Re: Your multi-cat household - You're in a tough spot, feeding-wise; I feel for you. You have 1 diabetic kitty + other non-diabetic cats, all of whom are accustomed to grazing (which how I used to feed Bat-Bat, pre-diabetes; most people feed pets this way).

Getting a kitty’s blood glucose #s under control requires both insulin AND diet controls.
There are two parts to this problem:

1) Multi-cat household.
2) For someone with a recently diagnosed cat, if you’re feeding “on demand” or in mini-meals, it’s very hard for you to determine where his nadirs might be, on-insulin. (Plus snacks. And possibly also due to your diabetic cat scarfing a little of the other cats’ food unless you are watching like a hawk the entire time they're all eating - which is almost impossible to do ALL of the time ...) Because every time he eats, his blood sugar will rise - so how do you uncover nadir with a cycle full of mini-meals?

The solution that follows will likely not be very popular to most anybody, especially anyone in a multi-cat household. (How do you all manage it?) But it’s the best I can come up with, and is offered sincerely --- & with sympathy for the difficulties of feeding when you have multiple cats.

The way I can see it might happen for your sugar-cat is ... ALL of your cats transition (can’t be done overnight!) to a “non-grazing” feeding schedule (preferably twice-a-day meals, if at all possible) - at least for now & especially because the current feeding schedule of all the cats is keeping you from getting your sugar-cat’s diabetes well-controlled.

This would mean you have to take a hard line, toughen up & be the “alpha cat-mom” to your pride o’ kitties.

Keep this in mind: In the wild, cats will characteristically eat a BIG meal, then not eat for an entire day! Our “domesticated” cats have learned to become grazers because we humans turn them into grazers - they would not normally eat this way otherwise. (Remember, I’d done that myself to Bat-Bat - which is how she ballooned up to 18 pounds before the diabetes hit her & whittled her down to skinny by the time she was first diagnosed.) So once we’ve turned them into grazers, it’s only natural for them to heartily pitch a fit (read: buy lots of earplugs:eek:) until we transition them out of that not-so-helpful habit of grazing throughout the day.

It’s hard. You have to stand firm while all those adorable kitty-faces whine & pout & cry & yowl pitifully to try to convince you that they are just STARVING:oops:. (Some may even go as far as to pull a little “hunger strike” - not unlike a bratty 4-year-old who threatens, “I’ll hold my breath until I TURN BLUE!!!” Ha, my daughter tried that once, and found she didn’t win the game. No, it wasn't about food.)

Guess what? Your kitties won’t actually starve. :cat:(Ask Bat-Bat, who for a while sounded like an entire Mormon Tabernacle Choir of kitties as we were making the transition to twice a day feedings. She was a master terrorist, but I didn’t give in.)
She’s still alive & well today.

Will they like it? H*ll, no!:mad: (Why no "furious kitty" emoticon to insert here?) But here’s the deal: You have a sick kitty on your hands. Changing his feeding schedule won’t kill him ... but uncontrolled diabetes can.

How might you manage it?

Well ... it’s you who will have to decide how quickly you can best transition from multi-meals to fewer meals. If they’ve been eating, say, 5 times a day, maybe shift it to 4 times for a few days, then 3 for a few days, then 2. (And no snacks in between.) But here’s the foundation to help you get Rupert’s #’s to come down & stay down:

1) Your diabetic cat eats in a room BY HIMSELF closed off from the others at mealtimes. He get the correct amount of food for his optimum weight and no more than that (unless you’re dealing with hypo event, of course).
2) Any slow-eaters in the non-diabetic bunch stay in another closed room until they finish their respective meals. (Give them a reasonable time limit, hen pick up the food if they’ve not finished. And don’t give it back: they just have to wait until the next mealtime to eat again. Believe me, those two will learn to quit dawdling.)
3) If you have other (fast-eating) non-diabetic cats, they can eat wherever they wants, so long as they’re not with your sugar-cat while eating.

What to do about the large meal/ scarf & barf problem that can occur with 2 large meals per day? (Yep, we went through that messy bit, too!:rolleyes:)

1) As you’re transitioning, the AMPS/PMPS meals gets gradually larger, and any other meals in between get gradually smaller.
2) If you can make it down to 2 (large) meals/day, add water to the food (slows them down) AND pick up the plate for a short “food rest” halfway through the meal. (Essential for Rupert, maybe not so much for the others ... unless you actually get a kick out of cleaning up cat-barf. I am now an expert cat-barf cleaner-upper.)

You will find, over time, that without so many meals/ snacks throughout the day, your sugar-cat will (generally) be ready to eat, pre-shot. And perhaps if you can get all cats in your house on board, your life will feel saner/less stressful, given that you’re now actively treating a diabetic.:cool:

Will you run into an occasional snag? Sure! Bat-Bat recently barfed her ENTIRE meal, right after one of her “as needed” insulin shots. arghhanic time!) So first, I reminded myself to breathe. I waited 15 minutes & fed her 1/3 of the usual ration. (TG, it stayed there.) Then 10 minutes later, fed the 2nd 1/3; and in 10 more min. fed the final 1/3. It all stayed down. Checked her BG - it was going up. Checked again at nadir-time to reassure myself. All was ok; crisis averted.

Once you have made the transition & are able to get a clearer picture of when your cat nadirs, things get a lot easier. A couple examples: If he drops too low @ nadir, you give a little higher-carb something & test in 15 min. to make sure that # is rising; if his nadir # is too high after a few cycles at the same dose, you’ll likely need to bump up the dose.

I did not start giving Bat-Bat mini-meals until her pre-shot numbers were starting to average around 150 (or less) at a micro-dose of ProZinc. (She eats at around 6:45 am, 11 am, 6:45 pm and 10:30 pm., with the AMPS/PMPS meals being slightly larger than the other two.) If she actually makes it into remission, I will likely transition her - gradually - to 3 meals/day, then 2 meals/day, because I’d like to have my life back one of these days.

It isn’t an easy task to accomplish, I know: This type of plan may not be workable for you at all (maybe you can only get down to 3 meals/day, for example). And when there are other health complications, too - like pancreatitis, CKD, etc. - you must do what works best to treat all of those conditions simultaneously.

Barring such complications, while I realize that every diabetic cat is different, diabetes is always the same for every cat: It sickens. It emaciates. It weakens. And it can kill.

So do your best; discover what works for you and your kitty. (Take what you need from the above, and leave the rest.)
I will leave you today with the little line that is in a frame above my desk:
“The greatest pleasure in life is doing what others say can’t be done.” :bighug:
 
I am in AZ. He weighs 15 lbs, but is a very big cat. He was 18.4 before the diabetes started. I did not test before feeding and dose this morning.
My Bat-Bat is a very big cat, too. (Lengthy & big skeleton, for a female!) Used to weigh 18 lbs; then lost weight before diagnosis. Here are a few more thoughts on that ...

Looking back to the years before Bat-Bat was diagnosed, I now realize that if I had wrapped my head around looking at her food more like it's medicine, I would have paid serious attention to how I was feeding her back then. Because - if I'm brutally honest with myself - I know now that I was feeding her all wrong! (Just kept dumping "...a 'wee' bit more" kibble in her dish when she'd yowl, "Hey! I'm hungry!" because I was on deadline for a client, or late for a meeting, or distracted in any number of other ways.) I didn't pay all that much attention to actually measuring out the amounts of food she was given; I only "kinda" did that. She was fed some canned, but the staple of her diet was dry kibble because, well .. heck! It was organic! it was good for her! And because southwestern Colorado & northern AZ can get hot as blazes, I'd tell myself, "It's sooo hot out - no wonder she wants more water ..."

In my experience, most vets don't even mention feeding habits for our kitties until they're already obese! And look at how cats have historically been pictured in our culture: The plump kitty curled up on a chair, the plump kitty sitting by the hearth. (Anybody remember the cartoonist B. Kliban, whose cat drawings were so wildly popular in the 70's? The cats were all fat cats!) And don't even get me started on cat food commercials (Sorry, "Blue Buffalo" dry-food company ... but if your dry formula is soooo healthy, why did you refuse to give the carb info to Dr. Lisa Pierson?) We've been encouraged to free-feed our cats. But if we take a cold, hard look at that, dry foods were developed for human convenience - not because it was healthier for our pets. So then, not realizing what the consequences might be, we - as a society - bought into all that the marketing hype. I believe that we, as a culture, have come to perceive that it's okay when our cats begin to plump up a little, over time. We barely notice ... not until diabetes strikes.

For me, feline diabetes was an unfortunate wake-up call: Hey, Robin - treat the food as medicine, too! Measure her low-carb diet carefully, and monitor its consumption. Don't give in to her adorable kitty face when she begs for more ration than is correct for her optimal weight and her unique metabolism. (Bat-Bat doesn't get a treat in exchange for an ear-poke; she gets soft words before, during & after, then a nice scritch under the chin. She's being treated for a disease; she's not being rewarded for cleaning up her room.:D)

Don't worry, Ron - you've come to the right place! I'm just sorry that (apparently) your vet didn't give you much guidance on feeding a diabetic cat ...
We'lll all be rooting for you and ______ (KITTY'S NAME????) - & we'll look forward to seeing his #s in that spreadsheet soon!
 
I am in AZ. He weighs 15 lbs, but is a very big cat. He was 18.4 before the diabetes started. I did not test before feeding and dose this morning.

How does your kitty's body condition look compared to this body condition chart?


EDITED TO ADD:

Please be sure to get a preshot BG before his insulin this evening and post it here. Also, at +2hrs after injection to see where his BG might be heading.

It is only with mid-cycle readings that you stand a chance of understanding better what is happening on a given dose. Part of the problem with insulin is that too high a dose can look like too little a dose. I'm not saying that your cat is on too high a dose - we don't have enough information. I am concerned that he's on a significant dose, that he may be going quite low early in the cycle and then 'rebounding' from a low, producing a high number in response. The only way to determine what's happening is to test.

As mentioned above, I'm not familiar with Prozinc other than that I know it's an in-out insulin (once the dose wears off, it's out of the cat's system). I think it was a smart move to reduce the dose. Your cat is still getting some insulin (so important at such high numbers), but I think you should let your vet know about the strange behaviour. (Insulin and the BG changes can affect a cat's behaviour.)

I hope that members with more experience of Prozinc will be along soon to help you further. I'm sorry that I don't know enough about your insulin type to help more.

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Last edited:
I am in AZ. He weighs 15 lbs, but is a very big cat. He was 18.4 before the diabetes started. I did not test before feeding and dose this morning.
(Oh, goodie - we're in same time zone!)
Protocol for insulin is: Test, feed then shoot, BUT ... (for now), if pre-shot # is under 200: wait 15 minutes, retest (to see if it's risen to safe range), THEN feed & shoot (try to shoot within 10-15 min. of his meal). I have had to do multiple AMPS/PMPS tests (withholding food until BG rises) on Bat-Bat multiple times during treatment.
 
How does your kitty's body condition look compared to this body condition chart?
To give you some added perspective, here are a couple of before/after photos of Bat-Bat's transformation:
2012 Bat 18 lbs!.JPG

BEFORE: At 18 lbs. above in 2012 (1 yr pre-diagnosis: Free-fed, mostly kibble (ack!) - with kibble ball (was trying to slow down her gorping to get her wt. down).

AFTER: Taken yesterday @ a svelte & healthy 11 lbs, (strict diet controls!) at her shoebox "raised feeding station" (helps control that scarf & barf problem).
2015 Bat 11 lbs.jpg
 
Feeding Fancy Feast pate 90% of the time. The other 10% Fancy Feast medleys. He still eats a couple teaspoons of dry at night as we have two other cats. His behavior did subside later. I use the Relion meter. Thanks!

Fancy Feast Medleys are 12-15% carbs. That's too high for a diabetic cat. You want to aim for carbs under 10%.

See Cat Food Nutritional Chart in my signature line.

See catinfo.org and look at the link in the right hand column for transitioning a kibble addict off dry food. Dry food isn't recommended for sugar cats.
 
I'm not a techy type, but was able to do my own spreadsheet. Try the directions here, Ron.

I've just skimmed your thread and am not a pro on ProZinc, but I would comment on just a couple of general things.

Dry food isn't good for diabetic cats - it's too dehydrated for a cat that's already dehydrated. It's too high in carbs for a diabetic cat as well. There are some lower carb dry foods but I'm unconvinced that they are good for diabetic cats. A cat's natural prey is a mouse or a bird - lots of moisture in those.

The FF medleys are also too high in carbs - stick to the classic pates. As you change him to all low carb, he may need less insulin, so testing and making gradual food changes will help you respond with his insulin dose. You do want to have a hypo kit that includes high carb gravy cat food, karo/corn syrup, maple syrup or honey to raise his blood sugar if he goes too low.

I wouldn't limit a diabetic cat to 2 meals per day. Grazing is ok for a diabetic cat as long as they are not overeating. If your guy needs to lose weight, however, that must be done very slowly. Cats losing weight too fast can actually have their livers clog with fat - a crisis called Feline Hepatic Lipidosis and it can be fatal. On the link that Cat Ma gave you above to catinfo.org (run by a vet) she has great nutritional & health information that will help you.

I fed my diabetic cat 4x per day - feeding more than twice a day can help even out blood sugar fluctuations. He weighed about 13-14lbs and he got one can of FF at preshot and 1/2 can 3 hours later, both am and pm. Other than that, I agree with the suggestions on feeding that you've had here. Feed your diabetic kitty in his own room. Everybody's dish gets picked up after 15 minutes. Your non-diabetic cats can eat just twice a day.

One thing we've seen demonstrated by more than one member here is that for some kitties, even 3 pieces of dry crunchies (cat or dog food) can increase their blood sugar by 100's of points and keep it there for another day. High blood sugar is damaging, so if you can transition your kitty to lower carb canned food you'll be helping his body out.
 
NB - if you do change to a lower carb diet, you need to monitor blood glucose closely during the transition, Ron, because the insulin dose may end up too high for your cat's needs and may need adjusting downwards.
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I'm not a techy type, but was able to do my own spreadsheet. Try the directions here, Ron.

I've just skimmed your thread and am not a pro on ProZinc, but I would comment on just a couple of general things.

I wouldn't limit a diabetic cat to 2 meals per day. Grazing is ok for a diabetic cat as long as they are not overeating. If your guy needs to lose weight, however, that must be done very slowly. Cats losing weight too fast can actually have their livers clog with fat - a crisis called Feline Hepatic Lipidosis and it can be fatal. On the link that Cat Ma gave you above to catinfo.org (run by a vet) she has great nutritional & health information that will help you.

I fed my diabetic cat 4x per day - feeding more than twice a day can help even out blood sugar fluctuations. He weighed about 13-14lbs and he got one can of FF at preshot and 1/2 can 3 hours later, both am and pm. Other than that, I agree with the suggestions on feeding that you've had here. Feed your diabetic kitty in his own room. Everybody's dish gets picked up after 15 minutes. Your non-diabetic cats can eat just twice a day.
@julie & punkin (ga)
As mentioned in my earlier posts, twice-a-day feedings may not work for some ... However, I believe that when BG #s are all over the map & generally high overall @ in early stages of treatment with ProZinc AND if someone is available to monitor kitty's BG levels, trying 2 meals/day until there's a clear idea of when that kitty nadirs on-insulin (without the complication of BG spikes in a 12-hr cycle due to multiple mini-meals) can be quite helpful in establishing some kind of baseline from which to work (i.e., knowing how kitty's body reacts to insulin overall during a 12-hr cycle), whether the choice is made later to go with multiple feedings or not.
Clearly, grazing & multiple meals have not been working for Ron's cat to date. He reports that his cat has no other health complications, so it might be worth him giving a more structured plan a try for a little while ... (Obviously, if he has to work long hours outside the home & no one can be around to do BG testing for/near nadir, I can certainly understand that a timed feeder & mini-meals can be the difference between safety & a hypo event.) Ron will just need to discover whatever way works best for getting his cat under better glycemic control, given that he has the added conundrum of more than one kitty at home. :)
 
Ron, I would be glad to set up a spreadsheet for you. Check your private conversation as I need some info. It would be very helpful to see how his numbers range and when you get certain numbers.

I think there are two possibilities:

He needs more insulin. Some times you have to reach a break through dose. BUT, I think a change to wet low carb may help in this regard so I would work on that first

He needs less insulin. He might be bouncing around because you passed over a good dose. We suggest starting at one unit. I wonder because you started at two, if he would do better at a lower dose.
 
Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning, pre-shot, test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening, pre-shot, test)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

The nadir is the lowest glucose between shots. There is a general period when it will happen which is specific to the insulin being used and testing then helps make sure your cat doesn't go too low.

It is merely a grid for storing the info; no math required.
 
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