High starting dose - newly diagnosed

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Linda and Lacey

Linda and Lacey

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Hi - Lacey was just diagnosed last week and her untreated blood glucose was about 450. The vet put her on 3 units of PZI every 12 hours. From what I read, that's a pretty high dose, but also her blood sugar was pretty high. We are not testing right now, just following the vet's directions until we take her back for the vet to see how her prescribed dose/schedule is doing. (I know everyone here recommends testing, but we are hoping to avoid that, if her response is good and consistent.) Lacey may be a little overweight but not much, and she's 12 or 13 years old. We're taking her for a weigh-in next week. So far, except for today, Lacey's eating/drinking/peeing has calmed down to normal levels and her activity is up dramatically. Today she got a "fur shot" in the morning and has been hungrier and thirstier.

My question is more about feeding. The vet has us giving the shot 15 minutes after she finishes eating. I like to pick up all the food a 2-3 hours before shot time, to ensure that she will be hungry at mealtime. But the vet did say she could have a mid-day snack. She was already eating Friskies and 9-Lives Tuna, and I'm trying to sway her toward the lowest carb flavors of Friskies. She also has taken a liking to the W/D dry food the vet wanted us to try, but she really only has that as a between-meals snack. We have 4 other cats that are used to eating free-choice, so it's hard to pick up all the food all the time, but to me the main thing is that she eat a full meal before she gets the shot. Does that sound like a good "minimum" requirement? Am I worrying too much about that? My husband tends to want to leave her snacks down all the time, and just "hope" she has eaten enough before the shot.
 
With ProZinc, it isn't terribly important to feed before shooting the insulin. It tends to be a mild insulin that doesn't have a harsh onset. Some people feed mini meals during the day; others feed twice daily with maybe a snack mid day.

I'd really urge you to home test. Our suggested starting dose is one unit so she is on a fairly high dose. And very often the kitty is stressed at the vet, and we know stress raises blood glucose levels. So a dose based on vet numbers can be too high once the cat gets home. FD is a dynamic situation. If you look at other people's threads, you can see that often a cat has an unusually low or high preshot. It is easy to adjust for that, if you have home numbers. As a vet who posts here said " treating FD without home testing is like driving down the freeway with a bag over your head." An apt analogy.
 
Welcome to our forum. Yep, totally agree with you that 3 u is a lot of insulin to start out with especially since you are not home testing. Hopefully, for the safety of Lacey, we will be able to persuade you to home test. It is not bad at all and it helps to get the most optimal use of your insulin while also keeping Lacey safe. Also, your vet will want you to come in periodically to perform a fructosamine test. If you are home testing, you will not need to go to the vet. Rather, you can record your numbers on a spreadsheet that we all use here and send it to your vet.

Regarding feeding, I typically test, feed and shoot all in about 10 minutes. I just make sure that Merlin gets about a tablespoon in him before I shoot.

I am going to give you a few links for you to read.

1) Prozinc protocol - This is a guideline that we use here. http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/
2) Cat food information - This article is 18 pages long. Please read it all. It is written by a well known vet that specializes in feline diabetes. It also has a list of wet, low carb food. You will want to make sure that you are feeding under 10% carbs and if you can get under 6%, the better. www.catinfo.org By the way, your dry food that your vet prescribed is 37% carbs.

Here is some on what you need in case you experience a hypo event.

Hypo Kit: Always good to be prepared for possible hypo events which means that your cat has reached dangerously low numbers. It can be fatal, hence, the importance of home testing and collecting data in a spreadsheet. In each of the Insulin Forums are stickie’s labeled Hypo Links. Here is one: How to Handle a Hypo You will want to create your hypo kit that would include and not limited to; extra testing strips, honey/karo/maple syrup, high carb food, medium carb food, vet information, etc.Please print and post on your refrigerator so everyone in your household is aware of hypo symptoms.

Hopefully, you will decide to test. Just a little food for thought, that people test themselves when they have diabetes. Why wouldn't kitties be tested too? We have some other information to give you regarding testing, meters, spreadsheet, etc. if you need it.
 
Good to hear that she likes wet food already and you are steering her towards the low carb ones! Most of us would not feed her any of the dry food, too many carbs. There is one called Young Again Zero Carbs dry food that you could try. Her food intake would be based on her ideal weight and calories needed to obtain that. There are tables, etc. on the forum to help figure this out, or ask your vet for advice. You can shot 15 mins after feeding, some of us even shoot while eating, but I usually give half of Rupert's food first, wait about 10 minutes and give the rest when I shoot. He holds still and doesn't even notice the shot! You are off to a good start, there are many more qualified people on here to give you advice and help, I just wanted to say "welcome" and I know it's all a bit overwhelming at first, you are doing a lot of the right things already, the rest will come. Best of luck to you! :bighug:
 
Thanks for the info - I've been on the site a few days and have already checked out the cat food list, put together a hypo kit, read the protocol, etc. This is a great site with lots of good information and support. I know the w/d dry is high in carbs, but the "treats" it is replacing for her (Party Mix) is probably higher and unhealthier, and we have this bag of food that none of our cats except her will eat, so we're just going to make sure we give them in moderation. (She would eat 9-Lives Tuna each and every time if we let her, and we got her back hooked on it trying to make sure she ate before she went to the vet for her curve, so the main focus now is to get her back on Friskies or FF lower-carb varieties.)

Thanks especially for the info about shooting less than 15 minutes after eating being okay. This morning she took off for her nap before the 15 minutes were up, and I had to drag her out of her hidey-hole. Hate doing that!
 
We actually did test her the other day, 2 hours after her shot, because we were worried she was walking funny. We used my husband's glucometer which hasn't been calibrated - we're going to buy one of the recommended human glucometers and get it calibrated after next Friday (payday).

Anyway, her BG 2 hours after 3 units was 423, so I'm confident the value at the vet wasn't too far off.

Turns out her hips were just bothering her because of the struggling she did on the way to the vet (she hates the carrier).
 
Glad Lacey was ok! So great you are testing already, it is so important. If I remember correctly, the 9 Lives Tuna was pretty low in carbs, I know it isn't recommended to feed fish more than 2 or 3 times a week, but if that is the only wet food she will eat right not, that is ok. My cats love the 9 Lives tuna also, what I did to tempt them to eat the chicken, etc. was mix some of the tuna with it and gradually phase it out. I still feed it to them, just not as often. A lot of the 9 Lives is low in carbs, lower than a lot of the Friskies. FF is good for sure, but more expensive. I know it's hard to cut out all the dry kibble, even as treats, but you could replace those treats with boiled chicken or some of the freeze dried chicken or salmon treats. I hated to waste my dry cat food, so I gave it to someone who could use it. I did warn them it is not the food to feed and to consider feeding wet, canned, low carb instead. :rolleyes: It's a lot to take in all at once, you are doing great!
 
I just want to jump in also and urge you to test before you shoot. I'd hate for a hypo situation to arise because she had already been in the double digits and then got 3 units of insulin. I almost had that happen..thank heavens I was testing, because Gypsy would have died since I headed to work after that.

That one test you got sounds about right. Generally, they're going to be higher around 2 hours after a shot since the food is still onboard at that point. :)

My cats hate the carrier too! The funny thing is I leave it out constantly for them to hang out in (and they enjoy spending time in it). I thought if they could hang out some they would see how non scary it was...but every time I try to get them in it to go somewhere, they fight!
 
It is great you were able to test! What kind of meter is your husband's? You might be able to use it. If he gets strips with his insurance, they could share and save you money.

We suggest testing before every shot (to be sure the dose you are planning to give is safe) and then 5-7 hours after the shot) to see how low the insulin takes them.

The protocol we put together for ProZinc is in my signature in blue. It might be helpful.
 
Thanks - we're not sure if his meter is reliable (he never uses it himself) so tomorrow we're going to pick up one of the Relion ones and also a scale so we can weigh her. I'm really not that worried right now about her being low; I really think she is still very high because she's still drinking and peeing a lot But I guess we'll find out for sure. She's eating several snacks throughout the day, plus a good meal right before each shot. The vet put her on 3 units instead of the 4 her curve indicated just to be on the safe side. Lacey is more active and playful than before she started the PZI though, and she is being a sweetheart about getting her shots.
 
Check my signature link Secondary Monitoring Tools for some additional assessments you may find helpful to evaluate your cat while you work on home testing, plus some notes on glucometers, and useful links.
 
I second the cautions about high doses of Prozinc! My cat started at one unit and was increased, after a curve at the vet, by one unit about every 10 days, until he reached 5 units. He appeared not to be responding--UNTIL the morning I found him unable to stand, with BG of 26! It took several hours to stabilize him enough to get to a specialty hospital. He is now doing well on 2 units--we had to begin at the beginning again, and proceed much more slowly. I heard one vet I respect remark that a cat rarely needs more than 2 units of Prozinc. The lesson I learned is, you must go more slowly. Since my cat has had two episodes of ketoacidosis, I got a meter that lets you test for ketones--Precision Xtra, on Amazon, special test strips for this. It gives me a lot of peace of mind.

I have found it most useful to "curve" him at home every few weeks. I do every three hours and send results to the vet. Otherwise, I don't test unless I think he is not feeling well. My vet recommended this approach, and it is certainly less stressful.
 
Bgenick, you do test before each shot, right? Just on this page, there are a dozen beans whose cats surprised them with a lower preshot than they were expecting.
 
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