Dosing advise for Sienna

SiennaCat

SiennaCat

New Member
Hi, any help is appreciated! Sienna is 15 and has had diabetes for almost 4 years now. She was on Prozinc - 6 units twice a day for the last three years. Just recently the past 3 weeks, she started loosing weight and her sugar would get low to 46mg/dl. I have since reduced her to 2.5 units twice a day but her glucose never goes below 230 mg/dl and goes up to 400 mg/dl. If I raise her to 3 units she drops to 56mg/dl and her high is around 270mg/dl. What would you recommend as a good dose? Her diet and health/symptoms are the same. She does not show any signs of being too high or too low other than the blood tests.
Thanks!
 
Hi there. May I please ask, first, what is her feeding schedule like? What does she eat? What times does she get her main meals and snacks?
 
Also, when she has a lime green number you need to reduce her dose by .25 units each time. I see that sometimes this has been done and sometimes not. She is very bouncy and flies up high after the lime green numbers. I'm glad you have the spreadsheet to share with us; hopefully, we can soon get a good picture of what is happening. Excellent work in testing and catching those low numbers.
 
Suzanne & Darcy said:
Also, when she has a lime green number you need to reduce her dose by .25 units each time. I see that sometimes this has been done and sometimes not. She is very bouncy and flies up high after the lime green numbers. I'm glad you have the spreadsheet to share with us; hopefully, we can soon get a good picture of what is happening. Excellent work in testing and catching those low numbers.
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Thank you for answering, she eats 4 times a day right after I test her in the morning then she has a small snack at 4 hours after her injection and then she has another meal after I test her at night and then a snack after 6 hours. She refuses wet/canned food so her vet recommended the Hills prescription w/d. She has been on the same for the last few years. Thank you, I just read the part last night about dropping it .25 after a low reading. I currently am giving he 2.5 and her glucose was 430 this morning. Should I continue for a few days at 2.5 unless she has another low number?
 
If I were feeding dry food, I would make sure it was low carb which is appropriate for diabetic cats. The only low carb dry foods on the market that I am aware of that are low enough in carbs for a diabetic cat are Dr. Elsey’s Clean Protein and Young Again Zero Mature. That w/d appears to be full of corn, wheat, and rice in various forms and has little meat protein that cats need. I just looked it up on the catinfo food chart and the carbs are 25 percent. So that is incredibly high for a diabetic cat who should be eating at least less than 10 percent carbs. It will be much easier to control her BG levels if you can transition her over to a low carb food and it will be much better for her to eat something with a lot of meat protein. More on feeding schedules in a minute.
 
Thank you for the food recommendations. I had purchased what the vet had said was for diabetic cats. I had her on a blue buffalo blue wilderness before that was supposed to be high protein but he had me switch her to the prescription kind. I will look and see if I can get one of the two you recommended.
 
So if you look at her spreadsheet, do you see how she does these massive dives in the early portion of her cycle? That guarantees a bounce into high numbers later on. Whenever a cat drops into numbers that the body is not used to or perceives as a threat— and also when they drop very steeply (such as 100 points or more in an hour) they will bounce. Their body releases a bunch of stored glycogen from the liver as well as counteregulatory hormones that will drive the blood sugar up sharply.
In order to prevent these steep drops, I would recommend feeding her small snacks in the early portion of the cycle. This will smooth out her cycle. Looking at her spreadsheet, I would recommend small snacks at +1, +2, +3 and possibly +4. This is known as feeding the curve. Most members of this Board take the total amount that they want their cat to eat each day and divide it up into smaller portions to be given throughout the cycle. We just don’t recommend feeding after nadir (the lowest point in the cycle which can vary by cat but is around +6 for a lot of cats on ProZinc. Feeding after nadir can shorten the duration of the insulin and cause the numbers to rise prematurely. One other point about feeding that you probably already know is not to give food for two hours prior to your AMPS and PMPS preshot tests. This will prevent the preshot tests from being inflated by food (which certainly would be the case with high carb dry food.).
 
SiennaCat said:
Thank you for the food recommendations. I had purchased what the vet had said was for diabetic cats. I had her on a blue buffalo blue wilderness before that was supposed to be high protein but he had me switch her to the prescription kind. I will look and see if I can get one of the two you recommended.
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Dr. Elsey’s Clean Protein is readily available from places like Amazon and Chewy.com. I believe Young Again is available only by ordering from the company.
 
Thank you so much for all of the information! This will definitely help her and me. Would you recommend staying at 2.5 units while I adjust things diet wise?
 
Now as to her dose, there have been too many dose changes recently to get an accurate picture and make a recommendation- but we can try. I am not really comfortable recommending 2.5 at this time because what I see is that recently when she received 2.5 units was when she was starting from a very high number due to a bounce (April 3, 5, and 8) so I can’t say how low that dose would take her under more normal circumstances (i.e., when she isn’t in a bounce.). She already showed us that even on 2 units she hit lime green (April 2.) If you are able to give the small snacks that I suggested then she may be safe on a dose of 2 units. Then hold that dose for 7 days unless she drops below 90 or if she has a really low preshot where it may be unsafe to give her the full dose.

If you are able to make the switch to low carb food do it very gradually because it really can have a positive but downward affect on her blood glucose. So you will have to be very vigilant about testing during the transition so that you can keep her safe.
 
If you do transition to lower carb food, it is very likely that she will need less insulin.

Have you read through the information about how to handle lower than expected preshot numbers? One option is to stall without feeding and to retest in 20-30 minutes to see if the BG is rising on its own(without food.) Also a reduced dose can be given, and, some cases, it may be necessary to skip the shot entirely.
 
Thank you, I read that information last night. I can do the snacks and the vigilant testing during the week since I work from home. I just ordered the low carb and will introduce it gradually and test frequently. I really appreciate all of the help. The vet I found was better than the first but it seems there is still a lot I need to know.
 
The other thing that I would add is that many cats do tend to drop into lower numbers at night so it is important to get nighttime tests. It’s a good habit to get the “before bed” test. That way you can see if you may need to stay up and give food or to set an alarm and wake up to test.

Many people will use automatic feeders to dispense snacks at certain times during the night or daytime if they’re not at home.
 
You’re going to do great! She’s very beautiful, by the way. What are you giving her for a treat when you test her? A lot of cats like the Pure Bites freeze dried treats and they are basically no carbs.
 
Do you have a hypo kit? In most cases we would recommend high carb wet food like Fancy Feast Gravy Lovers or similar to bring up the blood glucose in case of hypo, but you can probably just give some of the w/d (although it takes dry food longer to raise BG). You should still have some Karo syrup or honey on hand in case you need it to bring blood sugar up rapidly and, of course, lots of test strips.
 
Be sure to post here whenever you want to with any questions. For this ProZinc forum, I should get an email sent directly my inbox to tell me there’s a message here and I will try to respond. That is how I saw your message. I would have responded yesterday, but I was talking to a friend of mine who had to euthanize her cat and I was really upset.
 
Finally, here’s something to read about dry food. I am not busting your chops about the dry food. I am sure you have tried before to get her to eat wet food. But the article explains a lot more about why dry food isn’t really good for cats in general. But we need to deal with things as they are for now, which is why I suggested the low carb dry foods that are good quality. She needs to eat and that is the most important thing.
https://felinediabetes.com/FDMB/thr...r-more-than-just-carbohydrate-content.175004/
 
Thank you so much for all of the information. I have started her on the CleanProtein and I can already see that her numbers are steadier. I do have a hypo kit. I really wish she would take wet food but she is really picky. I just give her a kibble of her food and lots of pets after each test. She is very motivated by praise. She learned to jump through a hoop just using claps and cheers. I really appreciate all of your help!
 
SiennaCat said:
Thank you so much for all of the information. I have started her on the CleanProtein and I can already see that her numbers are steadier. I do have a hypo kit. I really wish she would take wet food but she is really picky. I just give her a kibble of her food and lots of pets after each test. She is very motivated by praise. She learned to jump through a hoop just using claps and cheers. I really appreciate all of your help!
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That is really amazing. She must be a very clever cat!
 
I wish your spreadsheet was updated! I'm just checking in on y'all and I am excited to see smoother cycles without steep drops and those nice blues that you have been getting! So I'm just wondering what happened yesterday (4/13?) I'm excited about the positive changes for her. :cool:
 
Suzanne & Darcy said:
I wish your spreadsheet was updated! I'm just checking in on y'all and I am excited to see smoother cycles without steep drops and those nice blues that you have been getting! So I'm just wondering what happened yesterday (4/13?) I'm excited about the positive changes for her. :cool:
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Thanks for checking in! I just updated the spreadsheet. She has been having some pretty high numbers. I’m hoping once I completely transition to the high protein food she will even off again. I’ll try to keep the spreadsheet up to date. Thanks again.
 
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