Diabetes and Chronic Pancreatitis

Status
Not open for further replies.
Frankie619

Frankie619

Member Since 2017
Hello everyone! My cat Frankie was diagnosed with diabetes and chronic pancreatitis in January and I have had difficulties regulating him since. He is currently on 5 units prozinc once a day with levels ranging in the 400s. His diet right now is ID wet food. The vet just wants to increase insulin and I'm not convinced that will regulate him.

I test at home and the one successful glucose curve I've had was a couple weeks after a teeth cleaning in May. His curve was nearly perfect but has since gotten worse. He is always hungry and thirsty and has lately been going number 2 twice or three times a day. He's dropped from 10 lbs to 8 lbs. I've been feeling discouraged lately so any suggestions are welcome! Thanks!
 
Welcome Frankie and his Mum!
Glad to hear you home test. Would you be interested in setting up a Spreadsheet like most of us here use? Maybe we can see something with Frankie's numbers once you fill it in :)
Spreadsheet: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Understanding SS: http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

Setting up your Signature will help too: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/
Since you're a new member here, I'll also give you this to read ahead of time but hope you'll never need: http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

It is possible he's on too high of a dose. What increments were his increases done in? Many vets tend to do whole units, while this works well for people, it doesn't work so well for kitties. What is ID wet food? A prescription one? Many of us feed Fancy Feast classics or Friskies pate (non indoor formulas) that are low carb foods, less than 10%. Are you testing Frankie for ketones?

We'd love to help you help Frankie feel better :bighug:
 
Yong, ID is a script for for sensitive stomach among other things.

My cat Max had chronic pancreatitis for several years which I believe caused him to become diabetic. I fed him fancy feast classics until he developed kidney disease. How are you treating the pancreatitis? Max mostly got nausea medication when he had flares. It does make diabetes more challenging. Have you considered a different insulin?
 
tiffmaxee said:
Yong, ID is a script for for sensitive stomach among other things.

My cat Max had chronic pancreatitis for several years which I believe caused him to become diabetic. I fed him fancy feast classics until he developed kidney disease. How are you treating the pancreatitis? Max mostly got nausea medication when he had flares. It does make diabetes more challenging. Have you considered a different insulin?
Click to expand...
We are treating the pancreatitis with the ID food to the best of my knowledge. He is only on insulin and that special food. How did your vet treat the pancreatitis?
 
Yong said:
Welcome Frankie and his Mum!
Glad to hear you home test. Would you be interested in setting up a Spreadsheet like most of us here use? Maybe we can see something with Frankie's numbers once you fill it in :)
Spreadsheet: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Understanding SS: http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

Setting up your Signature will help too: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/
Since you're a new member here, I'll also give you this to read ahead of time but hope you'll never need: http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

It is possible he's on too high of a dose. What increments were his increases done in? Many vets tend to do whole units, while this works well for people, it doesn't work so well for kitties. What is ID wet food? A prescription one? Many of us feed Fancy Feast classics or Friskies pate (non indoor formulas) that are low carb foods, less than 10%. Are you testing Frankie for ketones?

We'd love to help you help Frankie feel better :bighug:
Click to expand...

Thanks for your help, it's so nice to have support here! I filled out a spreadsheet on the numbers i have for him, give it a look and let me know what you think. I increased his doses in 1 unit increments and use a U-40 needle.
 
From that data, what I'm seeing is his working dose was between 2.0 and 3.0U. Did the Vet instruct you just to give 5.0U once a day? Kitties metabolism is usually too fast to make insulin last 24 hours, that's why we do twice a day dosing, 12 hours apart.

For my boy's pancreatitis flare it was about managing pain and nausea. And of course making sure he ate so he could receive his insulin. I did have to use an appetite stimulant a few times. With that, my boy was caught pretty early so we treated conservatively. :cat:

Definitely try to focus on getting those PS numbers (preshot test) and ideally with Frankie not having eaten anything 2 hours prior;) . If you have a full time job, getting a before bed test in the evening can help shed light on where he's going overnight. Most kitties tend to run lower over night for an idiopathic reason :rolleyes:.

Don't forge to add some more information to your Signature, at least insulin type and meter you are using. :)
 
Yong said:
From that data, what I'm seeing is his working dose was between 2.0 and 3.0U. Did the Vet instruct you just to give 5.0U once a day? Kitties metabolism is usually too fast to make insulin last 24 hours, that's why we do twice a day dosing, 12 hours apart.

For my boy's pancreatitis flare it was about managing pain and nausea. And of course making sure he ate so he could receive his insulin. I did have to use an appetite stimulant a few times. With that, my boy was caught pretty early so we treated conservatively. :cat:

Definitely try to focus on getting those PS numbers (preshot test) and ideally with Frankie not having eaten anything 2 hours prior;) . If you have a full time job, getting a before bed test in the evening can help shed light on where he's going overnight. Most kitties tend to run lower over night for an idiopathic reason :rolleyes:.

Don't forge to add some more information to your Signature, at least insulin type and meter you are using. :)
Click to expand...
My vet recommended the once a day based on where his numbers were at the lowest. My cat has never had any issues with nausea or not wanting to eat. He is always hungry and always begging for food (associated with his high BG levels I'm sure). I'll definitely keep trying to get the AMPS and before bed numbers. What food is your cat on?
 
We were on Friskies but he was getting bored and there aren't many low carb options that aren't pate so I'm using Fancy Feast right now :).

Yup focus on AMPS, PMPS, and before bed tests. Whenever you are off, grab some mid cycle tests, like anything between +4 and +8 ;)

Would you be open to dosing suggestions from us? I'll tag some of the fellow prozinc veterans. I'm thinking you should drop back to 2.5U and go back to two shots a day, every 12 hours.
@Kris & Teasel @Rachel @Djamila @StephG @Sharon14
 
Wow! Our kitties looks so much alike! Cross-eyed and all! :cat:
I agree that going back to insulin twice a day would be best. Prozinc is an "in and out" insulin so after about 12 hours it's gone.
I think Yong's suggestion of 2.5 units twice a day is a good place to start and move up from there in half unit increments or .25 unit increments if possible. It really is best to give two shots a day. Giving one shot is only giving him about 8-12 hours a day that his pancreas isn't being stressed to make as much insulin as it can.
I believe it's typical to see better numbers after a dental. I have seen it many times on here but I could be wrong. Every cat is different.
Are you testing for ketones? It's important to test especially when they have another issue like pancreatitis going on and still in high numbers. A number of things can cause DKA but testing for ketones helps catch it early.
 
I agree with dropping back to 2.5u twice/day. However, you should be prepared to increase by 0.25 or 0.5 (we can coach you around that once we see what numbers you're getting) fairly quickly as I don't think that will be enough insulin and we don't want him dawdling at a low dose. So pretty please keep posting so we can help you make some progress here.

I'd also add that you don't need to be doing full curves very often at all, but what we'll really need to see is the pre-shot tests both AM and PM right before you give a dose, and then if your schedule allows, grabbing mid-cycle tests sometime between +4 and +7. Right now it's looking like he has a later nadir, but that may be because the dose is so high and concentrated just in the AM cycle.

Also, since your kitty has both kidney disease and diabetes, here is a list of foods that work for both conditions: https://docs.google.com/spreadsheets/d/112NvvzgxEBOtkb42rA0XR8GeShw9xXs9kccf9-olK7I/pubhtml

That can be tricky to manage both at the same time. I've also had some good luck with Primal frozen or freeze-dried (make sure you rehydrate it with LOTS of water) Turkey which is low in carbs and phosphorus and has a good CA:Phosphorus ratio.

I realize that it can be hard to go against vet instructions, especially when they are coming from strangers on the internet, so please ask any questions you have. We are always more than happy to explain our thinking/reasoning on things!
 
LOL! I cannot stop that pink face from showing up! Apparently if you type a colon and a P right after each other, that's what you get. I'm trying to say the ratio between Calcium and Phosphorus :)
 
Frankie619 said:
We are treating the pancreatitis with the ID food to the best of my knowledge. He is only on insulin and that special food. How did your vet treat the pancreatitis?
Click to expand...

It's really a matter of treating the symptoms. Most get nauseous and that happened to Max with every episode. I mostly gave him ondansetron but sometimes cerenia. Buprenex was given for pain. Sometimes he got fluids. Diet was not changed. Here's a good article on pancreatitis.

Here's a good article.

http://www.idexx.es/pdf/es_es/small...pec-fpl-treatment-for-feline-pancreatitis.pdf
 
I agree to dropping back down. Going to 2.5 twice a day will be the same amount of insulin you're giving now, but it will be spread out to give you much more steady and consistent coverage. It's hard to say for sure what's going on without more data on your SS...the tests you and Yong suggested will help! I think dropping back to 2.5 and getting those tests and being ready for increases will help you get things under control. :)

One more thing...are you testing for ketones?
 
Lantus works best when dosed every 12 hours. Max was a bouncer his first year so I had to feed the curve to keep him in safe numbers. He like many would drop lower at night. I agree with the others that you need to find a dose you can feed every 12 hours.

His was the pancreatitis diagnosed? What are the symptoms?
 
StephG said:
Wow! Our kitties looks so much alike! Cross-eyed and all! :cat:
I agree that going back to insulin twice a day would be best. Prozinc is an "in and out" insulin so after about 12 hours it's gone.
I think Yong's suggestion of 2.5 units twice a day is a good place to start and move up from there in half unit increments or .25 unit increments if possible. It really is best to give two shots a day. Giving one shot is only giving him about 8-12 hours a day that his pancreas isn't being stressed to make as much insulin as it can.
I believe it's typical to see better numbers after a dental. I have seen it many times on here but I could be wrong. Every cat is different.
Are you testing for ketones? It's important to test especially when they have another issue like pancreatitis going on and still in high numbers. A number of things can cause DKA but testing for ketones helps catch it early.
Click to expand...
Our cats really do look alike, that's crazy! Sometimes i wonder if his pancreatitis is a predisposition of his breed. I am not testing for keytones, how do i do that? Since he is on 5 units in the morning should i drop a unit in the morning and add 1 in the evening to work up to the 2.5 u twice a day? Thanks!
 
tiffmaxee said:
Lantus works best when dosed every 12 hours. Max was a bouncer his first year so I had to feed the curve to keep him in safe numbers. He like many would drop lower at night. I agree with the others that you need to find a dose you can feed every 12 hours.

His was the pancreatitis diagnosed? What are the symptoms?
Click to expand...
The pancreatitis was diagnosed by an ultrasound. The ultrasound was requested because we found the diabetes first and he's fairly young and thin so the diagnosis didn't make much sense. His only symptoms are rapid weight loss, extreme hunger, and extreme thirst. He now has diarrhea so i'm hoping if he gets regulated that will go away.
 
Frankie619 said:
Our cats really do look alike, that's crazy! Sometimes i wonder if his pancreatitis is a predisposition of his breed. I am not testing for keytones, how do i do that? Since he is on 5 units in the morning should i drop a unit in the morning and add 1 in the evening to work up to the 2.5 u twice a day? Thanks!
Click to expand...
Hmm that's a good question. I think if you start in the morning you could just give the 2.5 units and then give the next dose 12 hours later.
Let's see what the others say before you decide.
 
I agree that you can just switch to 2.5 in the morning and then dose 2.5 again in the evening. ProZinc doesn't have a depot, so you don't have to worry about it getting messed up when you change doses. :)

Ketone tests can be done using human ketone strips. They're urine test strips, so you just get some urine on it and follow the directions. You can get them at any pharmacy. If you need tips on getting urine for the test, we have lots of them, though some of us just stick it in the stream while they are using the box!
 
I think you're OK to just drop to 2.5U in the morning as well since Prozinc is an in-and-out insulin :). Just do your best to make sure he does not eat 2 hours prior to PS time.

For ketones, I use the suggestion given to me by Kris&Teasel. A long handled spoon to slip under my boy when he's peeing, just need to catch a little bit to dip the test strip in. First time I did it he gave me a look like "What are you doing?o_O" Note: His spoon is clearly labeled and sits on the litter box :smuggrin:.
Just make sure to read the strip as soon as it says, most are 15 seconds. If you look at it a minute later it might be a false reading because the strip does get darker as it sits ;).
 
I am not so sure he has pancreatitis based on the lack of symptoms. It's unusual to be starving. Was the ultrasound done by a boarded radiologist? UsysllybggecSpwc fPL test is run to diagnose. If diarrhea persists a round of flagyl might help. I'd ask your vet. It's super bitter so if you do get it from your vet I'd put it in gelcaps. Hoping it won't be needed.
 
Hi everyone, I've gone back to insulin twice a day and trying to do more testing (having a full time job that wants overtime plus a diabetic kitty is hard!). I've been thinking more and more about switching food. Any recommendations on what kind and how to switch in a safe way? Thanks!
 
Many of us feed Friskies pate (non indoor formulas) or Fancy Feast Classics (pate). Add 1-2 Tablespoons of water to meals to make them sort of stew consistency. Depending on how sensitive a tummy Frankie might have a general rule of thumb is 25% new food to 75% old/current food for a few days, then go to 50/50 for a few days, then 75% new and 25% old/current food next few days, and then 100% on new food. Sometimes wet food transitions between brands isn't as big a shock on their system as dry foods can be. If I/D is dry, ideally you'll want to get Frankie off. Obviously there are some kitties who are sort of dry food addicts. My boy is one of these where sometimes he won't touch his wet food until he gets a couple bites of his YAZ dry :rolleyes:.

General guidelines, go slow and keep an eye on the litter box and poo inspections :D. Keep in mind these are probably going to be much less carb content than the I/D so you may want to stick with the lower dose and do it consistently. Might want to start doing weekly ketone tests too on Frankie, just to be safe :). I know we previous mentioned dropping him back to 2.5U twice a day but with diet change you may want to go lower to 2.0U twice a day. Try your best to always get the PS (preshot) number with no food eaten 2 hours prior and a before bed test. Other mid cycles can be taken on your days off. Let us know if you have any other questions :cat:
 
Status
Not open for further replies.
Back
Top