Insulin stopped working

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amandazzle

amandazzle

Member Since 2013
I have a newly diagnosed sugar cat and thanks to the good people on this forum, I have made major changes in both Foster's (the diabetic), Nelson's, and even my own life. Both cats are on a homemade mostly raw turkey (with some supplements) diet, occasionally mixed with low carb canned foods or tuna (to get the stubborn one to eat it). That is a big deal, as I am vegan and have no idea how to cook turkey, no less grind and prepare it for cats. Foster was started on 1 unit of Prozinc, but I would like to switch him to Lantis after all the positive reviews I have read.

In the meantime, since I have Prozinc, I figured it would be good to see if that worked for him. Right after starting the insulin, he urinated and drank noticeably less. After reading some information on this forum I went out and bought the ReliOn glucose meter and strips and started to testing his glucose levels. Sure enough, he displayed a beautiful curve, just as predicted. The nadir was still a bit high (barely below 200), but I figured I could show my spreadsheet to the vet and we could make some adjustments to the dose.

HOWEVER, about a week ago, his glucose readings just skyrocketed. He is so high right before the shot that the meter won't display the number. He used to be around 400 at his highest. And the lowest his insulin seems to get is now 300 after about two hours. Then is shoots back up.

Is this normal? I have not changed the dosage or the way I have been injecting it. I am trying to avoid the vet (because of financial concerns and the cost of the intial appointment), but certainly don't want him to die because I can't afford to take him.

Can someone please give me advice?

Thanks,
Amanda
 
Hi Amanda,
It sounds like you are testing regularly, which is a good thing. Since you use prozine (PZI), you may want to post over in the PZI insulin support group to get more information and a faster response on dosing. The people over there use it on a daily basis. I use Lantus with Clyde and the Lantus dose is based on the low point in the cycle. I'm not sure how PZI is dosed when compared to Lantus and do not want to give you incorrect information.

Remember ECID, some cats need more insulin to get properly regulated and others less. This amount can change over time due to a number of factors, such as the food, the strength/age of the insulin, weight/activity level of the cat, etc and is a perfectly normal for the amount to change over time. It is not normal for BG levels to jump suddenly without something else going on.

The other thing that would help would be to put your spreadsheet into Google Docs and put a link in your signature so whoever is helping you can see what is going on based on his testing. Instructions can be found: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=50130. Please let me know if you need help setting it up and I will be more then happy to attempt to help you.

You may want to look at: http://www.catinfo.org/?link=makingcatfood Dr. Pierson, DVM has some information on making cat food, including some recipes. I've never made it but it looks pretty straight forward.

As a guide here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- the lowest level pre-shot for ProZinc, PZI, or other non-depot insulins.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.

If he has been over 280 consistently since the start of when his BG skyrocketed for most of the time each cycle, I would test for ketones to make sure he doesn't have any while we work on getting his BG down. If he does have ketones, then he needs to see the vet ASAP. This is done using ketone urine test strips such as ketodiastix.

Will
 
It would be helpful to see some recent numbers. A spreadsheet would be great, but if you want, just give us some data like this:

Amps
+6 (or however many hours after the shot)
Pmps

Any midcycle number is helpful to see if he is possibly bouncing.

No, it is not normal to suddenly jump in levels. Any chance he has a UTI or infection - teeth? How old is the insulin? Have you been refrigerating it and rolling it before injection?
 
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