Can't seem to get my little man regulated :(

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suwannee79

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My cat George has been diabetic for about 5 months now. Although he was very sick initially once we started getting him under control he seemed to be getting better....then he had two hypo seizures. We weren't checking his BG at home but as soon as he had the seizures we started. The vets we were seeing at the time had him on 5 units of PZI 2x a day which we think is what led to the seizures. We switched vets two days after the seizures and basically started over on his dosage.

The new vet is a cat-only clinic that has experience with diabetic cats so I like to think they know what they're doing, but my cat seems to be getting progressively worse. They immediately dropped his dosage to .5 units of PZI 2x a day and at first he seemed fine with that but then his BG began going up so we compensated and have kept compensating - we are now at 2.5 units 2x a day and his numbers are all over the place, recently getting into the 500s! He has dropped to 10.5 lbs (he was 16 before being diagnosed) and he seems hungry ALL the time. It's heartbreaking to hear him crying and feeling his bones but not wanting to feed him so I can keep him on his schedule.

He does have a UTI right now which we're treating with 2 Clavamox pills a day so I know that could also be playing havoc with his numbers but the hunger and weight loss are really starting to weigh on me. I would love for anyone to look at his chart and give me any opinions or advice they have. I know part of the problem with his numbers is that at one pre-shot he'll be super low so we don't give him insulin and then he's super high at the next pre-shot check - a few times we gave more insulin to try and compensate and maybe that was wrong bc that may have led to the low numbers the next time. I'm so confused about his dose right now because when he's high I feel like I need to give a little more but then when he's low and can't have insulin I feel like I'm just messing him up for later.

His diet right now is 2 1/2 cans of BFF wet food over 24 hours (I usually give 3/4 of a can before his shot and then another 1/2 between shots so he doesn't go 12 hours without eating). The BFF main ingredient is Tuna mixed with either chicken or other fish, I've tried giving him EVO, Friskie's, Fancy Feast and another brand I can't remember to try and give him some non-fish options but the BFF is the only wet food he'll eat. I've also tried sprinkling FortiFlora over some of the other brands and he'll sniff like he's interested but then won't eat the food.

Once he's finished with the antibiotics I plan on doing another curve - the last one was crazy, he was in every range but the 500s.

I'm just at a loss right now and don't know what to do :sad:
 
It does look like everytime you have gotten a high reading, there has been a complicating factor - a vet visit, getting into dry food, an infection. All things that raise bg levels.

And you have gotten some nice numbers in there too. Yes, every time he throws a low ps and you skip, it's a set back. So if we can find a way to avoid that by manipulating the dose, it will be good.

My advice is to breathe. :mrgreen: He is doing well, considering all the other factors you are fighting. I would make a plan to eliminate the dry food. For some people, that means feeding the other cat (s) their dry in another room while you stand over everyone and then pulling it up until the next meal. The other cats won't like it but your job is to get George regulated. The infection can raise the numbers, but we can dose around it. Is there a snack George likes that you can mix into the wet? Some cats love Bonito flakes sprinkled on.

Get a curve again and let's look at what you get. I think you may be close to a good dose and just need some tweaking. If you post here daily with your numbers, we will get familiar with you and George and be able to offer suggestions daily.

And do that breathing thing whenever possible. :mrgreen:
 
Thanks S & O :smile: I swear I'm normally breathing but my little skeleton is howling at me non-stop right now and we're an hour from feeding time and it's just starting to really wear on me.

As for the dry food - we do pull the other cat's food up, the times George has gotten into it is when we've turned our backs for like a minute and the next thing we know he's wolfed his food down and snuck over to the other cat's food. We're trying to get our non-diabetic cat off dry food but she's being just as picky as George even with the FortiFlora. We're giving her grain free dry food and she's adapted to eating when George eats, just gotta get her over her pickiness with wet!

Goerge's next shot is in about an hour and a half so I'll make sure to post his pre-shot number on here, curious what it will be after his 540 reading last night :?
 
Have you tried mixing warm water into the wet food? Sometimes it tricks them into thinking they are getting more, and they like the texture. I also wonder if he needs more food. Here is Carl's handy dandy way to determine how much to feed: 20-30 calories per pound of ideal body weight, per day. That will keep a healthy cat at its ideal weight. The range of calories is dependent upon a few factors, one of which would be level of activity. Since George is ranging from the blacks to the blues, maybe a little more food wouldn't be a bad idea until he is more regulated.

PZI is not very busy during the middle of the day - busiest at early am and pm east coast time. If you ever have an emergency, post on Health. If you post here during the day, it may take a while to get an answer, but someone will help eventually. I will try to be around in 1.5 hours when you get a number.
 
I haven't tried the warm water method but I will definitely give it a shot!

I've been debating giving George more food but I wasn't sure if that would mess up his numbers even more? The cans say to feed around 1oz per lb of the ideal weight - we think George's healthy weight is around 12lbs and the cans are 5.5ozs so giving him 2 1/2 cans a day = almost 14ozs of food which seems like it should be enough. However, I've been reading that BFF is a lower calorie wet food so is there a chance that even though we're technically feeding George more than he needs bc it's lower calorie it's not filling him up enough? I can't seem to find an actual calorie count on the food so it's all just guessing at this point.

Oh and thanks for the info on the various board traffic!
 
There's a wonderful lady named Suze who has been doing a ton of work putting together a new food chart. She has all the data from BFF including calorie numbers. PM her and she can link you to it.
Her user name is Pumbaa.
Carl
 
Thanks Carl!!

George's AMPS BG is 415, gave 2.5 units PZI. It's sad when 415 seems good compared to some of his other numbers from the past few days/weeks :?
 
Not sure if the total calories on the amounts you have been feeding will be the right amount but at least you'll have a number we can look at and go from there. My guess is he needs at least 300 or more if you are trying to get him to gain.
You can space the food out during the day or night to keep him happy, as long as he doesn't eat in the 2-3 hour time frame leading up to a shot.
Will you be able to get tests in today? A +3 and +6 can be helpful to figure out how the dose is working.
Carl
 
So are your normal shot hours about this time and then 12 hours from now? Where are you located? (Just wondering if we will have people around at your normal shot times...)

Agree with Carl that midcycle numbers will be very helpful. It is possible that he dips low midcycle and that is why his preshots are higher. In that case, we'd want to lower the dose, not raise it. If the dose is wearing out before the 12 hours are up, there are ways to adjust for that too. Any numbers you can get will be helpful for us to see what is going on.
 
Not sure about the +3 but I should be able to get a +6.

I'm in Georgia but I work the night shift so his shots are at 12p and 12a, actually heading to bed now :smile:
 
Well, sweet dreams then! I should be online for your midnite test and shot.
Whereabouts in Georgia?
Carl
 
I'm in Marietta just outside Atlanta. George's +6 AMPS is 149 - I'm giving him the rest of his food now but bc of our earlier discussion am debating giving him an extra 1/4 of a can so he'll have had 1 1/2 cans instead of 1 1/14 - his levels are good right now so I hope the extra 1/4 can won't mess him up too much but as he's so skinny I guess this is the route I should go on for right now.

I was wondering, what is a..."normal" starting BG reading before shots when a cat is regulated? Are 400s normal or are regulated cats usually lower?
 
That's a nice drop and low enough that he could be bouncing at preshot. (more midcycle numbers will make that picture clearer)

You can spread the food out so he feels like he is getting more, if you want. (just stay away from the 2 hours before the next shot)Many of us freeze the food and leave it out to thaw. I love my PetSafe automatic feeder. It will feed 5 separate meals whenever I program it to.
 
I'm assuming you use wet food, if so how does the feeder separate the feedings? Very intrigued but worried our other cat would eat his food.

Edit: Just read the product description and reviews and I have a question - I typically refrigerate the uneaten portion of wet food until it's time to feed,is it safe/sanitary to leave it in the compartment all day? Also, read some reviews that said if the cat is determined and still hungry they can figure out how to move the inside tray to get more food if they smell it's there, I'm worried George would do that in a heartbeat!
 
Google it to see a picture. It's a five compartment round feeder with pie shaped sections. I had several before it that my cats were always able to break into. With this one, the bottom moves, not the lid, so they can't pry it open. You set the program to feed at 6 am, then 8:30 etc - whatever fits.

It is harder with two cats (I only have one) but people here have tricks to do it. And it sounds like George might hold his own fighting for it. :-D Also might be a good way to get your other cat interested in wet?
 
He had a nice cycle today at 2.5, but that was starting with a preshot in the 400s. If you get a preshot in the 250 range, I would be conservative and shoot less. The other question is whether you can monitor for a number midcycle.

It's hard because you have so little data to base the dose on. The other thing we want to avoid is a cycle that gives you a preshot tomorrow that is too low to shoot.

What do you think about 1.5 if he is in the 300s? One unit if just above 200?

Carl said he'd be around before your shot. Let's see what he says.
 
If at all possible, test him at +11, then again at +12 because we want to see how much and how fast he comes up.
I'm thinking like Sue...if the number is a lot lower than it was this morning, then the 2.5 would probably be "too much". He went from 414 to 149 on that dose, and while there's no way to know if that is "normal" for him yet, it at least gives us an idea what that dose will do. You still had 100 points to spare that he could have gone safely lower to.

I'll make sure and check back in around 11 and before midnight to see any numbers you can get.

Carl
 
He is having a long surf - usually happens when the dose is too high. Hope he goes up to 200 by pmps so you can give him some insulin.

PS this is good news. :mrgreen: The insulin is definitely working - just need to reduce the dose some.
 
....but this is "good" confusing. I'd much rather be confused about blue numbers than red ones. :smile:

From what I have seen, when a dose of Prozinc is possibly too high, it will do one of two things. It will either give you a very low nadir in the +5 - +7 hours time frame, or it will last a lot longer than normal, and give you a really lower number late in the cycle than you expect to see. That's what this looks like.
The "too low at nadir" ones are much easier to deal with, I think, because it seems pretty obvious that you should reduce, and you can look back on the spread sheet and make some sort of logical decision as to how much to reduce.
The "long cycles" are more difficult to determine, at least for me. Sometimes the instinct is to just skip a dose, or to wait a while until you see a higher number, and shoot late. Neither are really terrific options, because with skipping, you pretty much guarantee a higher number for the next shot. And waiting messes up your schedule going forward.

I'm thinking you want to shoot something at +12, but not sure how much yet..., or you can stall without feeding, but hopefully not stall for too long.

Carl
 
I'd stall on the food but I think he'll eat my leg if he doesn't get fed shortly ;-)

I'm going to go ahead and start feeding him and then I'll check again a little before midnight - if he's still around these numbers is .5 units safe to shoot?
 
Yes, I think .5 would be safe on any number around 200, especially if you feed him first because then you'll know he's got food on board.

Carl
 
He was at 198 so I went ahead and did .5 units. For future posts should I start a new topic with his daily numbers?

Thanks so much S & O and Carl, you guys have been awesome!!!
 
Starting a new post every day isn't required, we sort of all just wing it here! But, when threads start to get long, it's a lot for someone new to the thread to get through before seeing the important/recent stuff at the bottom. You'll notice many people do start a new one each day, and generally, that does make it easier on everyone, including you. Some people will put a link to "yesterday's thread" in their first post on a new thread, in case people want or need to go back a day to catch up. There are forums, like Lantus TR and Health, where threads can get buried under all the traffic, because there are a bunch of new ones every day. Not so much of a problem in PZI. Basically whatever works best for you is okay by me. :smile:

Don't expect super action from the .5 dose overnight, and don't be surprised by a 300 in the morning. But I believe that shooting a reduced dose on time was a better option than skipping or stalling, so you did well with this tonight!

Carl
 
Thanks Carl! I might start a new thread tmw, if I do I'll link to this one for sure :smile:

Update: George is at 245 +3 PMPS
 
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