Hi Heather,
Sue asked me to drop in and take a look..... Spreadsheet is very interesting...
OK, I think, unfortunately, that your vet started you and Sneakers off on the wrong foot, and it's been getting worse ever since. The first problem (which you have corrected) was starting with Humulin. What worries me after that is the vet raised the dose to quickly, and too often, and using increments that were too large. 4 units of Humulin is a pretty large dose for a cat, no matter what sort of numbers the vet was seeing.
It is great that you switched to PZI, which is an insulin made specifically for cats. What I think the vet should have had you do when you switched was start over at 1 unit twice a day. My guess is that somewhere in between the day Sneakers first got insulin of any type, and that increase to 4 units, the vet missed the "right dose". One that would help your kitty, and keep him safe at the same time.
What worries me the most is what you say about Sneakers not wanting to eat much. I think that is due mainly to the fact that he feels like crap, and the reason he feels that way is because he goes from really high numbers to numbers that are too low for his body to deal with properly, then he shoots right back up to those really high numbers. It has to be confusing the heck out of his system. Today for instance, in six hours he dropped maybe 400 points, and then shot right back up. I think the dose is far too high.
Bright side - you are feeding him a good diet using Dr. Lisa's recipe. I'm a little bit confused about his feeding schedule. From reading your first post on the board, it sounds like he eats a couple hours prior to the AM shot ,and then you feed him again when you give him his insulin? If that is still the way you are doing it, it could be that the morning reading is "boosted" by that food he's eating in the two hour period before the AMPS test and shot.
Can you lay out his feeding schedule in this thread so we have a better understanding of it?
This is just my opinion, and hopefully others will chime in, but I think you should cut the dose back to 1u, twice a day. More or less "start over". I feel that at even the 3u dose, his numbers are dropping too far too fast, and it is causing his liver to "panic", which causes it to release glucogon (sugar) into the bloodstream as a self-preservation mechanism, and then causes the high numbers at the next test.
If you cut back to 1 unit, and try that for three days or so, it might help that to stop happening, and you'll know what 1u will do for Sneakers. After that, we can help you evaluate the data you get, and see about increasing the dose if needed. When you increase an insulin dose, you should never bump it up by more than .5u at a time. Some people increase by .25, some even less than that. It could very well be that Sneakers ends up at 2u or higher until he starts to improve, but if you don't go slow on the increases, you can miss the "right dose", which is what I think happened with the adjustments your vet suggested.
The other very disturbing thing in your other thread was the vet saying "don't shoot under 75", which actually is extremely good advice. Most new members here are encouraged to not shoot anything under 200. With PZI, there's no need to shoot insulin into a number that falls within the "normal" range (50-120), and even if you were to do that, you would shoot really tiny doses, like .25u or less, and only into numbers at the top end of that range. What is scary is that he didn't suggest what you should do on a number over 75 (like 100, for instance). He didn't caution you that 2, 3 or 4 units into a fairly low number could be deadly, literally. I'm glad that you haven't had any really low preshot numbers so far, because you may have unknowingly given a dose to Sneakers that could have caused some serious hypoglycemia. It just sounds to me like your vet is not "current" on feline diabetes treatments or protocols. Do you have any idea how often he sees a diabetic cat, or how often those cats end up getting better or going into remission?
Yesterday she did get a small portion of my turkey from McAllisters Deli- maybe 1/2 teaspoon when I got home at 330- this was after her 3:30 testing (and after finding half a mouse next to the fridge door- back half) so I wasn't surprised at the black. But she didn't eat much of anything later- I have to wet her food down so it is like gravy. At 3+ her numbers looked better.
That small amount of turkey, unless it had some weird additives to "sweeten it" should not have been a problem. Turkey is very low in carbs. And the mouse? I don't think that would cause a problem. If I've read correctly here, "mouse" is the best food for a cat, a great nutritionally balanced food for them.
Last thing - Kim asked if you were checking for ketones in Sneakers' urine.... have you done that yet? With really high BG numbers, ketones are a definite concern. If they appear, then can go out of control fairly quickly, so it is something you should really try to keep an eye out for. Her kitty, and mine, and too many others around here, have experienced "DKA", which can be life threatening and requires emergency care. My cat, Bob, nearly died when he was DKA. He make it after spending 3 nights in the ER. He was diagnosed in May, used the same insulin you are using on Sneakers, and went into remission in July. Today he is fat (but not as fat as he used to be!), happy, and purring in my lap as I type this. Not every cat does that well, especially that quickly. But it does happen.
I hope all of that makes sense and is helpful,
Carl
