HELP ALL AROUND PLEASE

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Hadaza

Hadaza

Member Since 2023
On Sunday July 16th we will switch from Prozinc to Glargine. Our vet has advised beginning at 1 unit. Does this sound correct? We are currently at 2.5 units with Prozinc and we can't seem to get Calcifur to stop bouncing. What do I do about this? Does the bounce ever stop? Is switching insulin the correct thing to do? Will Glargine help to stop bouncing?
 
I'm not sure as I am new here but there are a lot of people with excellent knowledge on the subject. I'm still a rooker and seem to make a mistake everyday, but I'm trying my best and O.P.F seems to be doing better and his neuropathy seems to be getting better as well. Someone will come along with some advice but sorry, all I can do is offer moral support.
Jim
 
Years ago when I switched insulins with Spot I started over with a lower dose. Since a cat can respond differently to different types of insulin both the vet and I agreed this would be the best way to find the optimal dose fore the new insulin
 
Hi @Hadaza I switched from prozinc to glargine. I am happy with the switch. The bounces are not so extreme in my kitty's case. I really suggest you read this sticky note https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/ and also read up on the TR dosing protocol if it's something you're interested in.
As for the starting dose @Wendy&Neko @Bron and Sheba (GA) guided me on what the starting glargine dose should be by looking how my cat Cleo was doing on Prozinc.
Hope to see you and Calcifur around the forums.
 
When swapping from one insulin to another, we look at what the cat has already been on. Looking at Calcifur’s spreadsheet, i can see that the 2.5 U Prozinc has only once got him down as far as 192. I would start at 2.5 U of Lantus and keep the dose at 2.5 U for 5 to 7 days to let the depot fill, unless he drops under 90.
If you start at 1 unit as the vet suggests, Calcifur will be in high numbers unnecessarily and it will take longer for him to get back to where he is now.
You might like to look at the two dosing methods which Angela has linked for you. You are testing enough for TR which should get him into better numbers sooner.
 
This is very helpful. Thank you. I’m basically with him all the time. The few times I’m not, he has a cat sitter.
 
I agree with Bron on the dose suggestion. Going back to the beginning (1 unit) will just cost you time getting up to where he needs to be.
 
I will start him tomorrow on Lantus now that I feel a little more comfortable making the switch. I’ll post in the Lantus forum for more help. He has elevated ketones in his blood so I will need guidance being more aggressive with his treatment. Thank you all
 
@Hadaza
If he has ketones in the urine / blood, please put that into your signature and also the subject line when you post tomorrow on the Lantus page.
Please tell us how many ketones are in the urine.?
Are you testing for them every day? If not, please do test every day at the moment. If you don’t have a blood ketone meter, you can buy some Ketostix from a pharmacy and test the urine. It is very important we get rid of those ketones as they can develop fast into DKA which is very serious for a cat. Please put any results of the ketone tests into the remarks column of the SS.
That is another reason to definitely NOT to go back in dose.
If there are ketones in the urine you need to be feeding Calcifur more food than you normally do. So as well as the 2 main meals, please give at least 3 or 4 snacks every cycle.
Also offer some warm water in the food, about a teaspoon every snack as fluids are also important in getting fours of ketones.
 
Actually after thinking about it, it might be better to stay with Prozinc until we get rid of the ketones. This is because Prozinc is an ‘in and out’ insulin and Lantus is a depot insulin and Lantus takes a few days in the beginning to have the full effect of the dose felt.
I would increase the dose of the Prozinc tomorrow to 2.75 units
@Wendy&Neko
 
He is showing trace ketons in urine, according to Ketodiastix. I test him frequently. Every 3 days. I will test daily now. I will post his vet records tomorrow as they told me he had ketons in his blood (1.7mmol/l) I believe and said 2.4mmol/l is the danger zone. This number puts him at risk for DKA. That was approximately 2 weeks ago.

So I should stick to the Prozinc and increase by only .25 not .5 ? I’m with him all the time so I can test all day and night.

How does giving snacks help and how much of a snack would you recommend? Is plain chicken broth good for hydration?
 
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Yes, I think over 2.4 on the blood ketone meter is cause for concern. When is the AM shot due? If you increase to 3U, can you monitor closely?

Hadaza said:
How does giving snacks help and how much of a snack would you recommend? Is plain chicken broth good for hydration?
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The recipe for ketones to develop is not enough food + water + insulin. Which is why cats with ketones are fed more and also given more water in food (and subq fluids, if necessary).
 
Morning, his shot is at 9am. I can monitor closely today. Friday and Saturday evening he will have a pet sitter for about 10 hrs. I’ll do the 2.75 units then on Sunday when I can be with him all day I will increase to 3units.

He cannot have fluids because he has advanced cardiomyopathy. His heart could not withstand treatment for DKA.

I’m going to post for help in the Lantus group once my vet send all medical records this morning. Please keep a look out for me. I desperately need help with eliminating ketones from blood. Thank you for all the assistance.
 
Hadaza said:
Is plain chicken broth good for hydration?
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Check the ingredients for a broth with no salt or spices (such as garlic). I made my own by poaching either chicken or turkey. You could either add to his food or serve separately. Neko couldn't have fluids either once she got her CHF diagnosis, but she also had kidney issues so I added as much water as I could to her food. There are bone broths available in pet food store now that might be suitable. Bone broth was too high phosphorus for Neko but might work for your kitty.
 
Wendy&Neko said:
Check the ingredients for a broth with no salt or spices (such as garlic). I made my own by poaching either chicken or turkey. You could either add to his food or serve separately. Neko couldn't have fluids either once she got her CHF diagnosis, but she also had kidney issues so I added as much water as I could to her food. There are bone broths available in pet food store now that might be suitable. Bone broth was too high phosphorus for Neko but might work for your kitty.
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I do prepare his broth by boiling plain organic chicken legs. I could administer broth throughout the day. I portion out 4 tsp bags and freeze. How much broth would you recommend he gets daily?

Our vet wants Calcifur to eat only two meals a day (125 cal per meal) but she also wants him to go back to one unit when starting Lantus. VERY FRUSTRATING considering he has elevated Ketones. Would it be better for a cat with ketones to eat smaller meals throughout the day? If so, do you know why food helps with ketones? I want to take every measure to get Calcifur to a safe place.
 
Your vet is clearly out of date with feline diabetes. Two shots a day and smaller meals throughout the day are better. Especially with ketones in the picture! Here is a post with some descriptions of what is happening. Make sure to check out the links too: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters He needs enough food and insulin. And not all at once.

I can't suggest how much broth to give. Do you know how much water he drinks on his own? Bron suggested a tsp with each meal. That's a good place to start.
 
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