Hello there,
I’m wondering if someone can help me with a question. I haven’t filled out a spreadsheet, I don’t need dosing advice or anything like that, just more of a general question about blood glucose trends. My cat, Sam, came out of remission in August 2021. He needed to have several teeth removed, and we assumed that he would go back into remission fairly easily after he was all healed up, but he hasn’t. He’s a big guy naturally (16 lbs on a raw diet) and he’s receiving a fairly high dose of insulin. He has no other underlying health conditions and his mouth healed great with no issues. My question, though, is that on a very regular basis, he will be within normal BG range at nadir, and then will stay that way until his next dose. So, for example, at nadir last night, he was 5.9 mmol/L and then this morning before his meal and shot, he was 4.6 mmol/L. He currently receives 5 U and 4 U of Prozinc. I’ll explain the different doses. We had a very difficult time regulating him and he’s bounced all over the place number-wise the entire time, until recently when we discovered this dose combination; 5 U brings him down to normal range, but if he receives 5 U when he’s low, it shoots him back to to higher numbers almost immediately (22-24mmol-ish) because it seems to be too much, where 4 U will raise it gradually and he stays at around 12-15 mmol/L. It’s almost like his curve is over 24 hours instead of 12, so he’ll go from 12-15 mmol/L to 3-8 mmol/L and stay there for the remainder of the 12 hour cycle, then goes back up to 12-15 mmol/L with the 4 U shot. This is the only dose combination we’ve been able to find that keeps him in good numbers. The caveat to this is that he needs the 5U followed by the 4U; if the dose is changed at all, his numbers go right back up. So for example, on the 9th, he was at 12.4 before his PM dose, received 5 U, was at 7.5 at nadir, and 4.4 before his AM shot on the 10th. He received 4 U, was at 4.6 at nadir, but instead of the gradual increase we usually see, he was at 3.4 before he received his PM shot. From experience 5 seemed to be too much when he’s this low, so he received 4 U, and then went back up to 16 before his AM shot the next morning. He stayed between 16-18 for his next dose cycle, before coming back down to the lower numbers. I hope this is making some kind of sense. My question is, if he’s able to stay low when his dose should be wearing off, why is he not going into remission? At that point, is it not his own body taking over and doing the work? I apologize, I know you prefer the US mg/DL but the conversion confuses me a little bit. I know you also prefer a spreadsheet to be filled out but it’s a lot of work to transfer the data in my own spreadsheet and I’ll be honest in that I really don’t want to, though I can if you absolutely need to see it.
To summarize, he’s 9 years old, he is on a raw diet, he receives 5 and 4 U of Prozinc insulin daily, the treats he receives when he’s tested are just dehydrated meat, and the only other thing he receives is a digestive aid (Optagest Digestive Aid) to help with the constipation that sometimes accompanies a raw diet. He was initially diagnosed in May 2020 and went into remission fairly quickly after we changed his diet; he never received more than 1.5 U then, but he was also very sick and had lost a lot of weight. This wasn’t the case this time as we caught it very quickly. The amazing vet we had the first time around retired before he came out of remission, and the new one hasn’t been all that helpful. Outside of ensuring he doesn’t have any other underlying conditions, she isn’t receptive to questions and told us to stop daily testing because she seems to think it’s obsessive. When I explained that we test regularly to ensure he’s safe and responding to his insulin and that this was the advice we received from our previous vet who worked at her clinic, she just didn’t respond. He’s symptom-free and hasn’t needed to see her, but when he does need to go, we’ll be seeing someone else. Please let me know if you need anymore info, but all I’m really wanting to know is if anyone has seen BG trends like this and why he’ll stay low when his dose should be wearing off but won’t go into remission.
I’m wondering if someone can help me with a question. I haven’t filled out a spreadsheet, I don’t need dosing advice or anything like that, just more of a general question about blood glucose trends. My cat, Sam, came out of remission in August 2021. He needed to have several teeth removed, and we assumed that he would go back into remission fairly easily after he was all healed up, but he hasn’t. He’s a big guy naturally (16 lbs on a raw diet) and he’s receiving a fairly high dose of insulin. He has no other underlying health conditions and his mouth healed great with no issues. My question, though, is that on a very regular basis, he will be within normal BG range at nadir, and then will stay that way until his next dose. So, for example, at nadir last night, he was 5.9 mmol/L and then this morning before his meal and shot, he was 4.6 mmol/L. He currently receives 5 U and 4 U of Prozinc. I’ll explain the different doses. We had a very difficult time regulating him and he’s bounced all over the place number-wise the entire time, until recently when we discovered this dose combination; 5 U brings him down to normal range, but if he receives 5 U when he’s low, it shoots him back to to higher numbers almost immediately (22-24mmol-ish) because it seems to be too much, where 4 U will raise it gradually and he stays at around 12-15 mmol/L. It’s almost like his curve is over 24 hours instead of 12, so he’ll go from 12-15 mmol/L to 3-8 mmol/L and stay there for the remainder of the 12 hour cycle, then goes back up to 12-15 mmol/L with the 4 U shot. This is the only dose combination we’ve been able to find that keeps him in good numbers. The caveat to this is that he needs the 5U followed by the 4U; if the dose is changed at all, his numbers go right back up. So for example, on the 9th, he was at 12.4 before his PM dose, received 5 U, was at 7.5 at nadir, and 4.4 before his AM shot on the 10th. He received 4 U, was at 4.6 at nadir, but instead of the gradual increase we usually see, he was at 3.4 before he received his PM shot. From experience 5 seemed to be too much when he’s this low, so he received 4 U, and then went back up to 16 before his AM shot the next morning. He stayed between 16-18 for his next dose cycle, before coming back down to the lower numbers. I hope this is making some kind of sense. My question is, if he’s able to stay low when his dose should be wearing off, why is he not going into remission? At that point, is it not his own body taking over and doing the work? I apologize, I know you prefer the US mg/DL but the conversion confuses me a little bit. I know you also prefer a spreadsheet to be filled out but it’s a lot of work to transfer the data in my own spreadsheet and I’ll be honest in that I really don’t want to, though I can if you absolutely need to see it.
To summarize, he’s 9 years old, he is on a raw diet, he receives 5 and 4 U of Prozinc insulin daily, the treats he receives when he’s tested are just dehydrated meat, and the only other thing he receives is a digestive aid (Optagest Digestive Aid) to help with the constipation that sometimes accompanies a raw diet. He was initially diagnosed in May 2020 and went into remission fairly quickly after we changed his diet; he never received more than 1.5 U then, but he was also very sick and had lost a lot of weight. This wasn’t the case this time as we caught it very quickly. The amazing vet we had the first time around retired before he came out of remission, and the new one hasn’t been all that helpful. Outside of ensuring he doesn’t have any other underlying conditions, she isn’t receptive to questions and told us to stop daily testing because she seems to think it’s obsessive. When I explained that we test regularly to ensure he’s safe and responding to his insulin and that this was the advice we received from our previous vet who worked at her clinic, she just didn’t respond. He’s symptom-free and hasn’t needed to see her, but when he does need to go, we’ll be seeing someone else. Please let me know if you need anymore info, but all I’m really wanting to know is if anyone has seen BG trends like this and why he’ll stay low when his dose should be wearing off but won’t go into remission.
Last edited:
