Insulin resistance?

Jamie N Gizmo

Jamie N Gizmo

Member
My kitty went into remission in 2014 and i havent been around. January he popped out of remission. Vet at the time refused to give me prozinc and had him on novolin. He was otherwise healthy, no infections.
The novolin was not working well, so i went to a different vet last week to finally get prozinc for him. He was 420 at the vet, and 1 unit seemed ok until i could get more test strips in the mail. I gave him his PM shot at 430, and his BG was 454 on alphatrak. At 830pm, its 461 still...as if he never got insulin? Ive been giving 1 unit twice a day.
he's still on the fancy feast pate's. I'll be doing a curve tomorrow. Recent blood work revealed no infection and otherwise healthy.
Any opinions?
 
Sorry you've found yourself doing the sugar dance again.

Based on 2 BG readings, it's impossible to say what is happening although my first thought would be to ask whether it's possible you gave a fur shot? It happens.

I take it this is the first testing you've done since switching to the ProZinc. I know it's not what you want to hear but until you get a few days of data, no one can know what is going on. It would also be helpful to see what was happening with the Novolin if you were testing at that time.
 
here are the numbers from January. The insulin itself was working, but didn't really seem to be lasting, as he was still throwing high numbers here and there, which could be bouncing i suppose. Prozinc was the insulin he went into remission on, but again this morning it seems as if it's not having any effect. No fur shot. You have to scroll down a bit, as the numbers from 2014 are also listed here.
https://docs.google.com/spreadsheets/d/1HjWVyVC2aeDCB6c2QrqRs7HspqZ1DUWN67HseRKc_r8/edit?usp=sharing
 
Can someone take another look see? The first day he was already one the prozinc 1 unit before i could order test strips. The 26th, he was still high 3 hours after prozinc. I gave novolin too thinking the prozinc may not be working at all for some reason. He did dip down after that..but the novolin seems to be too harsh and dipping him too quick. Without insulin treatment he was around 350..now he's hitting in the 500s from bouncing >_<; I restarted the prozinc, but i still think the dosing is way too little considering the nadir. I'm going to give it a couple days to adjust i guess..
https://docs.google.com/spreadsheets/d/14PPcQ8mKEEk-KkJk_wlACcyQWs3Lg28oGxx7EwyU7b0/edit?usp=sharing
 
I'm confused. You seem to be seeking dosing advice for ProZinc because you don't think it's working but you also seem to have been dosing with both Novolin and ProZinc. Just to summarize my understanding....

26/9 - you gave 1u of ProZinc at AMPS and then 2.5u of Novolin at +3 of that day cycle? PMPS - 1u Novolin at +3?
27/9 - AMPS - given 1u Novolin and PMPS one hour early - given 2u of Novolin (assume no ProZinc)
28/9 - AMPS 2u of what? PMPS 1u of what?
29/9 - AMPS 1u of what? PMPS 1u of what and then 1.5u of ProZinc at +7
30/9 - AMPS 1u of ProZInc? Was this given 12 hours after the last shot of ProZinc or 12 hours post PMPS last night?

Using ProZinc and Novolin together can be an effective technique in some rare cases where a high dose condition is involved, in cases where ketones/DKA are an issue or if BG is extremely high however there is a technique to using two different insulins and doing so without knowing how to do so effectively is extremely dangerous and it appears to me that this may be at least partly responsible for the numbers you are seeing. It doesn't appear to me that there is any need to employ this advanced technique at this point in time. Has Gizmo had ketones in the past or does he have them now? Has he tested positive for some high dose condition i.e. acromegaly, IAA or Cushings?
 
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Hi Jamie - I'm one of the people on the FB group that asked if you'd been posting in this forum. I agree with @MrWorfMen's Mom, you shouldn't be going back and forth between the 2 types of insulin. I was also confused as to which insulin was given when. Please read the stickys at the top of this forum. It's best to start low and go slow.
 
Sorry. I updated the notes on the spread sheet and looked up the day i actually had him at the vet. I started prozinc that night(He tested i think 420 at the vet?somewhere around there). I had an issue getting the strips from ebay and never received them, so there was a delay. Got them from chewy and started testing that PM. Our am and pm shots are administered at 430am and 430pm. Sometimes hes been getting angry and banging on our baby gate(i keep him confined to a certain area because he behavior pees in the house), so i gave him food an hour early. It doesn't seem to matter at the moment since he's high and all over the place. I know i have to start sticking to it..i'm a bad fur mom i guess. Like right now its 230pm here and he's banging 2 hours earlier than he should for food.

Thanks for any input. The novolin was given in a slightly higher dose by accident on 9/26 because i used the u-40 by accident..i was half asleep. Converting it over to u-100, it measures 2.5 units instead of 1. He threw nice numbers with both insulins and lasted through the next morning. I'd rather not use both. It just appeared on 9/26, i had given the prozinc that AM and his number was still climbing 3 hours later.
 
So the last time you used the Novolin was the AMPS of the 28th?
Am I correct to assume that you gave the ProZinc this morning 5 hours after previous shot of ProZinc (given at +7 last night)?

Given the use of 2 insulins and the timing of some of the shots, it's not clear what is going on. If you gave two doses of ProZinc 7 hours apart last night then 5 hours later for this morning's dose, that is going to cause BG numbers to be all over the map. You don't need to react to each and every BG reading you get. You need to look at the BG pattern over a period of time and then make dosing adjustments in a consistent, incremental fashion using one insulin only.

ProZinc usually lasts at least 10-12 hours and sometimes 14 hours so if you double dosed last night and dosed early this morning, you may now be seeing the result of too much insulin and colliding onsets/nadirs/overlap. This is a marathon not a sprint and it takes patience.

I suggest you give Gizmo 1u twice daily 12 hours apart as long as BG is over 225 on the AT2 meter. If BG at pre-shot is lower than 225, post for assistance. We can lower the no shot limit/nadir limit,. later but right now, we have no idea how he reacts to normal dosing with 1u of ProZinc alone over the course of a few cycles. I'd hold the dose for a period of 3 days unless Gizmo's BG drops below 90. If he drops below 90, then a dose decrease may be needed.

If necessary you can give insulin 1 hour early but don't give another shot part way through a cycle because you think BG is too high.

After 3 days of consistent dosing, we can re-evaluate whether a dose increase is needed or not.
 
I restarted the prozinc last night 9/29. I started on 9/19 from the vet, but didn't get test strips until 9/25, so i was shooting blind. I gave prozinc the morning of 9/26, but by +3, he had risen to 433 from 365. At +3 is when i gave the novolin 2.5 units to bring it down, as i thought the prozinc wasn't working. I types 9/28 i restarted prozinc, but was my mistake and was 9/29(last night.)
I know its very confusing..so i'm just going to call the last week a bust and start over. I have todays readings in so far. Haven't been under 400 all day, but atleast it came down 100 points in 12 hours..I can tell he's not feeling well, he's not being cooperative today.
 
I think Gizmo will feel better in a day or so and is more under the weather right now due to his body fighting the extra doses of insulin. I know how hard it is to be patient and even more so when kitty was previously in remission, but taking this one step at a time will ensure Gizmo starts feeling better and stays safe.
 
Hey Jamie!! Glad to see you over here from the Facebook group and getting some good advice from Linda!!

We ALL want our kitties cured yesterday, but as you've heard before, this is a marathon, not a sprint, so try not to overthink it when you see numbers that don't really make sense to you right now. Cats are experts at driving us crazy!

Are you trying to only feed Gizmo twice a day? If so, there's no reason you can't give him more food! Most cats here do better when they are fed more frequent, smaller meals (and it keeps them from driving the humans nuts too!) The only time we don't want to feed is the 2 hours immediately before shot times so that when you test, you get a number that's not influenced by food. Other than those times, it's fine to give him small snacks throughout the cycle.

Some cats do better if they get most of their food before nadir, and some cats can be fed right up until +10 without any problem, but by gathering data and keeping good records, you'll find out about how Gizmo reacts! A lot of people will put an * in the cells when they feed

You can do this!! And there's lots of people here that want to help. If you're not getting replies here in the ProZinc forum, you can also post in the Main Health forum. Just put the link to your post here into that post so people can quickly find your threads here.

Hang in there!! Gizmo didn't develop diabetes overnight and he can't be cured overnight either....Darn-it!!
 
Thanks chris! you and donna helped me get him into remission the first time around. Once we found the bouncing after a hypo he had it was almost like over-night he went into remission. This time isn't going as well. I think the prozinc is slowly working today. The novolin was dropping him too quickly. Still not in great numbers, but ya know..Hopefully he'll settle the next couple days.
The food i've been trying to remove it as a variable for now. When i go back to work mid october, he'll be alone from 6am-4p. They usually have a bit to snack on(even though i know youre not supposed to leave it out) They eat dinner, then 10 mins later will go back and take some nibbles, then again in another 20. It's usually completely gone within 2-3 hours.
 
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