How to know when you need a med change?

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myboo99

Member Since 2011
My 13yo has been dx'd diabetic since Dec 11 so almost 2yrs. He was a hard cat food water even though we offered both being we have 4 cats. We immediately took away all hard & converted to can only. I've played with all the low carb wets suggested here & his numbers will get better but eventually rise again so we change. But the pattern repeats after a couple months. I've now gone back to friskies/ff just b/c they offer more variety & they got tired of wellness.

So he actually gets very lil insulin actually, on the 40 conversion he gets on average .7u of Prozinc which keeps him on average 350 or under after the 12hr shed. The last visit to the vet (which she is not good at diabetes & I struggle to find 1 who is) she mentioned maybe if I got more fiber in his meals he could get off. However she didn't have a suggestion of how to do that other than adding can green beans to their food? Yea they wouldn't eat that! So if anyone thinks that would actually help & has a suggestion for that I'd love it!

Ok so original question. He's been on Prozinc this entire time, in the past when we had rising numbers out of him we'd increase 12hr dose & it seemed to work fine although sometimes he would bounce just a bit. He's never gotten more than 1U as he's never required more. Now though he's creeping higher & higher (400-500's) no matter what we give him dose wise. I thought maybe he was bouncing so I started testing him at 6hrs (what I thought was when Prozinc kicked in?) and he's running anywhere from 250-300 still. So if I give him an additional token dose at that time of .2-.4 his 12hr numbers are in the 300's. if I don't give him a token dose he's way high. So since the Prozinc is not holding him over the full 12hrs does this mean we need an insulin change? Surely its not the food right? It's really hard with me working to give him an extra dose at 6hrs. I'm having a baby in a few weeks & will be able to then but right now I can't. This morning the meter read high but I wasn't able to do his 6hr token last night. I've got to get this under control soon cuz he doesn't feel well most of the time & I can tell that. Any help greatly appreciated!!
 
Firstly, let me say I am NOT an expert..... only just started this sugardance with my kitty six months or so ago.

I am unclear on why your vet thinks additional fiber will 'get him off'...... I assume you meant off of insulin? Fiber is helpful for a number of reasons, but I'm not really clear on how it would accomplish that particular thing. As for adding fiber, many cats like canned pumpkin (pure pumpkin, not pie mix) or you could add tiny bits of psyllium powder (Metamucil)...I give my cats extra catnip towards this goal, it does seem to help... But if you are going to add fiber do it very slowly, to avoid tummy problems.

As for your insulin problems, again, I am NOT an expert... however, I am thinking you need to get more mid-cycle tests, because your cat could easily be getting too much, and based on the ONLY mid cycle test you have I would not be confident that he is not bouncing from too much insulin every time... I'm not nearly as diligent as I should be in this regard myself, but I still do try to get random checks in as often as my cat (and my availability) allows... and my cat is on a teeeeeeeeeny dose himself, much less than your kitty (.1 most of the time)

Eta: Oh and..... I am pretty sure you are NOT supposed to give insulin again mid cycle... there are probably circumstances or protocols where you could/should but I suspect those would entail a great deal more testing.
 
Without having your spreadsheet updated, it's really impossible to say if you need to give more insulin, less or possibly change to another type than Pro Zinc. Can you update his numbers for at least the last several weeks?

It may be a good idea to try Lantus or Levemir since they work a little differently, but again, without seeing his numbers, it's just guesswork. I know you shouldn't need to give a "token" dose during the cycle to keep him in lower numbers though

Sorry I can't be of more help at this point, but I wish you and Bitty's the best and congratulations on the new baby!!
 
Hello and welcome to the board!

I hope we can help you - its great you are testing too!

What kind of FF/friskies are you feeding? Is it the pates? Some of the other flavours are too high. For diabetic cats you want a low carb diet where the % calories from carbs is under 10% - see this list : http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=94685

Can you update the SS at least for the last 2-3 weeks? That would help a lot to see whats going on.

Let me know
Wendy
 
Well she said fiber helps them digest carbs better so they don't spike all the time when eating them. Apparently it slows down the breakdown of carbs? Which I do somewhat understand as I have gestational diabetes myself & they taught me to deduct fiber count from my carb count b/c it breaks it down differently. I can try the pumpkin & see if they eat it for sure. She did mention psyllium husks but said the research wasn't strong enough to suggest whether it actually made a difference or not.

As for mid cycle numbers I've tried everything, we give him less he's high, we give him more he's high. When he gets above 450 I try to give him turkey & drop down .1 since it has no carbs & it'll get him down quicker than the others. They only get pâtés & I only buy the ones with 10% or less. I did all my research here when we 1st got dx'd on food types. I avoid all of them with liver as well so mainly they get turkey, chicken, ocean whitefish (occasionally), tuna & beef (only if he's lower since its high carb). It's just almost like his body doesn't break it down anymore it's weird. But I do understand it's hard to know w/o doing more testings, it's just hard for us to do when we aren't home. But like I said now that I'm getting close to maternity leave I'll have more time to sort this out.

My lab top was down & doing google docs on my phone/iPad is a nightmare lol! But I've gotten it back now so I'll work on getting those in for you guys to look at. Thanks again & I'll update when I've got those loaded.

PS-what dose mid dosing do? I assumed him getting so high would be more dangerous to his organs than mid cycle dosing. Since I've tried both ways more/less I'm not sure what else to do.
 
Never heard of that helping but as long as there isn't carbs in it then it doesn't do any harm. Plain canned pumpkin though, not the pie filling.

That's good on the foods, what are you using for treats. Is he on steroids? When did he last have his teeth checked?

I can't say more though without seeing some numbers

Wendy
 
Let's start by clearing up the nutrition stuff. Cats have no need for carbohydrates in their diet, per Dr Lisa Pierson, DVM of Cat Info. You might share that link with your vet.

The cat is able to break down protein and fat and convert parts of them into glucose as needed. All fiber would do is possibly slow down the digestion of carbohydrates ... which should be limited to under 10% of the calories (not the weight).

As it happens, there is a wonderful printable list on the site which may be printed out to use for shopping. Most of the Friskies pates and the Fancy Feast Classic pates have under 10% calories from carbohydrates.
 
Ugh ok I somehow got locked out of my account so I had to open a new 1 b/c I haven't heard from administrator.

I've updated his chart so can someone please look at it for me? Tonight we had our neighbor come do his shot & he was 490 pmps with no mid cycle token today. She gave him .9u that we had pre loaded for her & I just checked him at +4, 450!!! What gives?! Maybe she got a fur shot or something idk but he looks like he feels terrible so I gave him another .4u & fed again. He gets freeze dried chicken treats so no carbs there. I'm at a loss & got to get this figured out. Please help!
 
Also no he is not on steroids & we just had his teeth checked out like 2mths ago. She did give a round of antibiotics to clear up some gingivitis but I notice the bad breath slowly creeping back. Would that effect something?
 
You shouldn't be giving shots mid-cycle. It should only be given every 12 hours.

I'm NO expert in any of the insulin dosing, especially Pro Zinc, but it seems to me if you're not getting better numbers than you are, you either need to give more at PS times, or try changing insulins to see if you can get better control

Here's her Spreadsheet for anyone else that wants to look https://docs.google.com/spreadsheet/pub ... utput=html
 
Yea I figured that wasn't the best thing to do but I'm not sure what else to do with them so high. The vet stinks at diabetes & I haven't found 1 that's any good. He dropped down to 40 once pmps which made him lethargic, I called to ask & she said give him 3u b/c he's due for a shot. Had I not asked on here she would have killed him! So I'm not sure she's equipped to handle fixing this or directing me what to do.

I know we're waiting for someone to help with dosing but do I jump .2u & test every couple hours tomorrow? How much should I increase over 1u to see if that helps? I'll be home all day tomorrow & will test every 2hrs after dosing to see what we're looking at.
 
I'll agree your numbers are all over the place, but with you dosing multiple times it's bound to be confusing, there is no real nadir to look at with you dosing that way. I honestly think, if it were my kitty, I would go a day or two without insulin to clear his system out and see where his numbers fall before making any decision on dose... possibly as long as 72 hours just to be certain he isn't bouncing.

Please bear in mind, as I said I am NOT an expert so what I would do may not necessarily be the right thing... and also bear in mind that MY experience has been with tiny doses lately, so that probably is coloring my opinions. It seems to me that if your kitty is not bouncing that something else must almost certainly be going on (infection, etc)

How old is the insulin, any chance it's gone bad or something? I'm just not real sure what else to suggest. The only other thing that comes to mind at all is perhaps he is reacting/responding to some particular ingredient in his food, but that's a whole 'nother ball of wax.
 
PZi is an "in and out" insulin - it doesnt need days to clear. So I would start again today - but only dose every 12 hours - and hold the same dose ie 0.7. And try and get some more tests in so we can look and see if its a bounce.
I usually recommend 4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

Do that for a few days and we will see better whats going on.

Wendy
 
It's not old insulin, we just bought it in Feb this year & it's never been left out or anything. I'm leery on the food idea just b/c we alternate 1 meal friskies & the other FF on a daily basis. As far as I know those aren't really the same ingredient wise but could be I suppose.

He tested 231 this morning & I gave him .6u, started at +4 & testing every 2hrs. It's not a bounce by his numbers already. I've updated today's so far if anyone wants to look. His ears feel feverish & being lazy today. His nose is cold/wet but ears are warm. Idk if it's the high bg level or maybe there is an infection. I'm going to see if I can research another vet to check him out in the next couple days. We have 1 of the "supposed" best vet schools in the country here but I'm not sure about a school as it is students doing the care. Thanks!
 
Which Friskies and which Fancy Feast foods are you feeding? Hopefully, the low carb pate style ones.

They do have different carb percentages, usually the Friskies pates run around 8-11% and the Fancy Feast classic pates run around 3-5%. Maybe mix a bit of each of the two foods together, to even out the carb percent?
 
Thats great to see the SS> I am looking forward to seeing numbers without the triple dosing. Also I believe even with PZI you need to hold the same dose for a few days to let it settle.


let us know on the foods

Wendy
 
As far as food goes he only gets the 10% or less pates. Friskies- chicken, tuna, turkey, ocean whitefish (only on occasion) & FF- chicken, turkey & rarely if he's low I'll give him a beef & chicken but these are all the classic pates. I researched all the food when we 1st got dx'd so I know which ones are lower. Honestly none of them make a difference in numbers now except for the turkey b/c it's no carb. I'll usually drop down 0.1 u when I give turkey so he doesn't get too low.

His numbers last night were close to 500 after +4 I think I'd rather hold him at 0.9u instead, I think 0.7u is too low. Do you think 0.9u would be ok for a few days if I kept it consistent? Those 500's scare me!
 
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