Help with numbers and PZI dosing for snowball

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muestafa1

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Hello all, this is my second post and first on the PZI forum.

My wife and I are new to home testing but have embraced it after our poor little guy went hypo over a week ago. During the week he was diagnosed with pancreatitis and put on steroids and antibiotics.

Before all this started Snowball was on 2 units of ProZinc twice daily. Our vet recommended dropping his dosage down to 1 unit twice daily following the hypo incident just to be safe. After testing for a few days I could really use some advice reading the numbers. Based on what I've seen, I've upped his dosage to 1.5 units twice daily, and then most recently back to 2.0 units for his last shot. His AMPS numbers seem to be climbing day over day and his PMPS numbers do as well. Today we did testing every two hours. He was fed after the first shot and was allowed to graze. Additionally we gave him a treat after each test (we haven't given him low carb treats yet, we're using pounce treats to hide his pills)

I believe the steroids are supposed to cause insulin resistance, so I wonder if that's why we're seeing the rise in his numbers.

His numbers should be available in the spreadsheet in my signature. If there is any issue getting to it, or if I should put them here, please let me know. Any suggestions as to how to interpret the numbers and dose accordingly would be greatly appreciated! Also, if anyone has experience with dosing a kitty on steroids, that'd be helpful as well. Thanks so much!

(first post w/ full background is here: viewtopic.php?f=28&t=38062)
 
Welcome! This forum has people using your insulin and will be good support for you. It is busiest at in the am and pm. If you ever need help quickly, be sure to post on Health also.

It looks like you got better numbers on one unit. Was that before the antibiotics and steroids (which can really change your levels upward). We suggest increasing by .25 units and holding the dose several days. To do this with U40 insulin, we use a conversion chart and U100 needles. If you want to consider this, use this chart.


http://www.felinediabetes.com/insulin-c ... rinter.htm

Your numbers now are really high and flat , which sometimes can mean too much insulin, but it is complicated by the infection.

I would be testing for ketones with your numbers and I think I would be tempted to try 1.25 units.
 
I'd ditch the pounce treats. They're not low carb and if your cat is as carb sensitive as mine, even a small amount can mess with their sugar. Also, to really see what a dose is doing, you need to stick with it for at least 3 cycles (my vet prefers 7 days). Sticking with a dose will let the body adjust and settle into it.

It's hard to be patient and not want instant results - we all want that - but as many have reminded me, this is a marathon, not a sprint. Hang in there.
 
I'm a newbie and don't have experience with steroids and pancreatitis, but you've come to a good place. I've received a lot of advice and encouragement that really helped me with treating my kitty Max. Not sure what diet Snowball is on, but Max is very carb sensitive like Kristen mentioned about her kitty. I would try for a low carb wet diet (you may already be doing this) and maybe see if you can hide the pills in a chicken treat. Paws crossed that you'll start seeing better numbers for Snowball.
 
Welcome to you and Snowball! Looks like you are off to a good start. We're a small and friendly group. I too am a newbie, "a micro-dose maven" so I'm afraid I don't have much dosing experience to offer except to echo to please test for ketones on a daily basis. Ketostix are very inexpensive at any drugstore and well worth the money.
 
Thanks for the responses everyone! I'll go to 1.25 (or as close as I can get until we get u100 needles) and try it for a few days. I got nervous because the values kept going up. The good numbers at 1.0 were the first day he was given the steroids so I don't know if they had really had a chance to have a negative impact. I'll be buying low carb kitty treats tomorrow. We'll buy the sticks for ketones as well, although I'm not sure how I'm going to catch him in the act :shock:
 
Good work on the home testing and getting the SS up.

Are you still doing steroids? If you decide to stop them it is important to taper them off and not just go cold turkey on them.

H had pancreatitis too. It is a pretty crazy thing. Hopefully your vet gave you Sub Q fluids/LRS [and the how to lesson] to administer and pain meds [like buprenorphine] at home as needed? The LRS can really help when they go into food protest because that's where they get the majority of their water from - their food. With the pancreatitis you will need to stay on your toes about the food and the dose. Remember: less food in = less insulin needed. So you can go from needing a good amount of insulin to needing very little in just a cycle or two when a P flare happens. Sometimes it can look a little like the P trying to kick in and do it's thing or the kitty going into remission but really the cat is just eating [much] less. Careful observation of the food intake and how much it varies from day to day will help you put together less food in = less insulin need. I used to weigh all of H's food so it was pretty obvious to me when he was doing the P flare thing. But I'm a "detail" oriented and I do not expect anyone else to be weighing their cat's food [but it really does help IMHO]. Usually the food would drop first then about a cycle later the BGs would really start to drop. It's also thought that a medium fat low carb diet can help with the pancreatitis. I believe the medium fat thing lessened the severity of H's P flares. Pancreatitis tends to wax and wane. So you'll go several days of very little food then it will just break and they'll be back to the races. The LRS can really help them though that and is important IMHO.

If you or anyone else starts to see a rapid drop in the food intake or the BG numbers, make sure to take note.

http://petdiabetes.wikia.com/wiki/Pancreatitis
 
For the ketones, lots of people can catch the cat going and stick in a ladle :mrgreen: or the strip. Once they start, they can't stop. But Oliver wouldn't even get in the box if we were around, so we bought some aquarium gravel, put it in a litter box and left him with it with some water and food until he went. I have heard others say you can use lentils also -something the pee won't stick to. You want to compare the strip you get with a clear strip from the box and then compare it to the samples.

I have never dealt with pancreatitis but here is some info on diet: Pancreatitis diet : Pancreatitis Diet

I know it sounds like a lot, but until you get the infection settled, you will need to do a lot of monitoring. As Gator says, on food intake and signs of pain. On numbers so you can adjust the insulin as needed. And on ketones. The good news is that you should be looking at a different picture as soon as the infection clears, and things should be easier to manage.
 
In testing for ketones, I removed the kitty litter and put in cut up pieces of newspaper. Would watch till kitty went to pee, because you need fresh urine. Then would stick the ketostrip into the urine in the pan. Good luck and keep posting!
 
Just checked, and the pill pockets are Greenies, allery duck and pea flavored, can be found all over, including Amazon.com and most pets supply places.
It would be great to remove the treats with high carbs.
 
judy and squamee(GA) said:
Just checked, and the pill pockets are Greenies, allery duck and pea flavored, can be found all over, including Amazon.com and most pets supply places.
It would be great to remove the treats with high carbs.

Thank you so much! We're picking them up in a few minutes. Will be much healthier alternative than the pounce treats for hiding pills! Hopefully this helps his levels!
 
Bad evening reading. His number was too high to be read by the tester. Just displayed "HI" :YMSIGH: We did give him his meds using the new pill pockets and we're feeding him less tonight to try to reduce the amount of glucose going in. We called the vet and they suggested going back up to two units for tonight.

He's on the steroids for another two weeks although the dosage starts to go down starting Wed.
 
I am not understanding. Why would feeding less affect the glucose? In general, you feed frequent small meals to diabetics to support their pancreas and keep the numbers steadier during the cycle. New diabetics do not process their food well so we suggest feeding them more, not less, as they can be literally starving.

Have you posted on Health for specific help with pancreatitis?

BTW, what are you feeding? Have you seen this site? Pancreatitis diet : Pancreatitis Diet
 
Sue and Oliver said:
I am not understanding. Why would feeding less affect the glucose? In general, you feed frequent small meals to diabetics to support their pancreas and keep the numbers steadier during the cycle. New diabetics do not process their food well so we suggest feeding them more, not less, as they can be literally starving.

Have you posted on Health for specific help with pancreatitis?

BTW, what are you feeding? Have you seen this site? Pancreatitis diet : Pancreatitis Diet

Hi, I was under the impression that when a cat was fed their glucose level increased as a result of the feeding and then eventually comes back down. My fear was that Snowball's glucose level was so high pre feeding that if he eats too much he'll hit some magic high glucose number and something bad will happen. (I know what happens if a cat goes Hypo, but is their a bad event when their glucose gets too high?) I'm sure this is all wrong, but we're in panic mode here as his numbers have climbed past what the meter is capable of displaying. As for diet, Snowball is fed ff wet food twice daily and evo dry food through the day. I just did a ketone test and it came back closest to the negative color so that's something positive. Also, Snowball seems to be acting fairly normal. His appetite has returned since going on the meds and he seems to be doing ok energy wise. The only thing that's troubling are what i'm interpreting as high glucose numbers. We are at the very bottom of his Prozinc vial and need to purchase another vial tomorrow. Can the "last drops" be less potent than what was in the vial just a few days ago?
 
Hi there, just wanted to say hello. Don't get yourself freaked out over specific high #s - yes high #s are bad, but it's more in a longer-term sense, or if combined with other problems like if they aren't eating or have an infection. It's not like hypo though where a specific high # will cause them to go into crisis (at least not that I've ever heard of before). Most meters I think have a HI reading that is over 500 or over 600 or something. It's not something you want, but don't let it freak you out.

The best thing for their pancreas is to eat several small meals. That keeps them from having such a big food spike, and helps stimulate their pancreas to produce it's own insulin, as eating is what triggers insulin production in a healthy pancreas.

Is it possible to eliminate the EVO dry, and maybe feed him more FF instead? One thing I have learned here is that it's ok to leave canned food out for several hours, and/or people have lots of tricks - timed feeders, freezing portions of the food that then keep them fresher longer, etc. You can get lots of tips on how to handle stuff like that, and I think you will find with the dry out of the picture you will be MUCH happier.

If you do keep the dry in the picture I would guess you will need more insulin. I haven't looked at the #s too closely or read others' advice, too tired tonight, but often with dry food they will need more insulin. We went from over 4u on the lower carb dry foods to more like 1.5u LC canned. If your #s are higher overall and you are feeding dry (of any kind, even the ones with lower carbs) IMO your best bet is to get rid of the dry (and monitor the #s to be sure their BG doesn't go too low, and/or reduce the dose down to 1u as a re-start point for LC canned only food). Next best bet if you can't is to raise the insulin, but it can be a lot harder, especially if their eating patterns are uneven.
 
p.s. I found the dregs of insulin (PZI Vet though, different insulin though similar) to be duds. If you are getting a new vial tomorrow, that is a good thing! Just hold the dose steady and monitor to see if you get a better response. I would guess though with dry in the picture that this dose is too low. (but I wouldn't try raising a dose on the first day of a new vial)
 
I agree your numbers are high. Rather than limit the food, I think the best thing you could do is get rid of the dry. Even tho it's the lowest carb dry, it's still dry. Dry food is 7-10% water while wet is 78% water. Wet has to be more hydrating for cats than dry and hydration is vital for cats - especially kitties with pancreatitis. (catinfo.org)

When we switched from Oliver from dry to wet, his levels went down 100 points overnight. He had been on a higher carb dry than Evo, but I was overwhelmed by the difference.

Food does raise bg levels. But it doesn't make sense to me to limit food. Your supporting Snowball's health and specifically his pancreas is more important than the few points the food might raise his levels.

Have you asked on Health about the specific steroid and whether there are non steroid options? The steroids are pushing your numbers higher while you are trying to bring them down with insulin. A complicated issue.

You have lots of things going on. If you could change some of the things that have the potential to raise the bg levels while still supporting the infection and pancreatitis, it might be helpful. Those things are diet and the steroid, I think.
 
Oh yes, and if there is an infection suspected, you definitely don't want to withhold food. It's not eating & infection combined with high #s that can cause crisis. The FF (assuming it's LC flavors) will cause a minimal food spike, I wouldn't even worry about that at all. It's the dry that will drive the #s up into the 300s & 400s from eating. But even so, that is preferable if they won't eat anything else.
 
Joanna & Bix (GA) said:
Oh yes, and if there is an infection suspected, you definitely don't want to withhold food. It's not eating & infection combined with high #s that can cause crisis. The FF (assuming it's LC flavors) will cause a minimal food spike, I wouldn't even worry about that at all. It's the dry that will drive the #s up into the 300s & 400s from eating. But even so, that is preferable if they won't eat anything else.

I gave more wet food. Snowball will eat anything, he's not fussy at all :) Trying to keep the other four cats in the house fed is the challenge if we totally withold dry food. I'm going to look into timers or freezing/refrigerating some of the wet food so it's still safe to be eaten later in tthe day. Tomorrow we'll be getting a new vial of prozinc, which may help if the solution left in this vial isn't as potent. We eliminated the pounce treats that we were using to hide his meds in, and switched to the hypo allergenic pill pockets, so there should be some carb savings there. Thanks for the support everyone!
 
It sounds like you are making a lot of positive steps. Paws and fingers crossed for better numbers tomorrow!

As Joanna said, if you get a new vial, please start with a lower dose than 2 units. If your previous vial was petering out, it may be the reason that the one unit wasn't working after the first day. I would try the 1 unit (no matter the ps number. It is the result of virtually no insulin if the PZI hasn't been working.) You can always raise the dose. The change in food can also lower the amount of insulin needed.

Come and tell us what the ps number is and what numbers you are seeing, after your first shot with the new vial.
 
Keep us posted. Like Sue said, you are making positive changes where you can and that's good. Saw you were able to grab a +4 test today and got a blue. Yeah! Don't mean to be a broken record, but I'll add my two cents, since I newbie me was surprised at the difference the diet made. In the beginning, Max was on a mix of low carb dry and low carb wet and still testing in the 450's :-(. Once I made the switch to only low carb wet, his numbers and dose dropped literally overnight. I didn't think it would have that big an affect since Max was already eating some wet, but it did. Anyway, you've got to do what's right for you and your cats and feeding changes may not be an easy thing when your a multi cat household. I add a little water to Max's food to help keep it fresh during the day when I'm gone.
 
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