Introducting Lil - Insulin/FIP question

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kristinaroe

Member Since 2014
Hello Everyone,

My kitty is named Lil - she is a 16 year old domestic shorthair. She has diabetes, heart, liver and kidney disease, IBD and possible FIP. We were diagnosed a couple of months ago and it has been a roller coaster getting her BG down. She is currently on Prozinc, 4 units 2 x a day. Her numbers on her last curve started at 416 and dropped to 250 so the vet wanted to increase her to 5 units but the next morning she was 239 so on the advice of the vet we skipped the am to be over 750 by the time the second dose was due. Her brother passed away last Thursday and now her numbers have been around 295 so we haven't increased her to the 5 units. We have kept her at 4 or 4.25ish - we have to eyes hot since her syringes only have unit markings. Don't know why her numbers dropped not sure if it could be related to her brother passing but she is still eating and is more active than she has been in months. In addition to Prozinc she is on Prenisolone, metronidazole and proviable twice a day. First question is what to do on the days she is below 250 - vet has us skip but then she is through the roof - should be do a small shot? Second question is about FIP. The research I have done says that FIP is a quick fatal disease. She was diagnosed as possible about a month ago. Is there a point we can probably rule out FIP? She has improved greatly since the diagnoses so we are hoping she doesn't have it but can it lay dormant? At the time of diagnosis she had fluid in her abdomen - the vet sampled and said the protein level was consistent but the fluid itself really wasn't. Since then she has gotten rid of the fluid on her own - I am assuming she deposited it in the litter pan but the swelling has went down and doesn't outwardly appear to be building back up. Any suggestions on another cause for the fluid?
 
ProZinc is a U40 (40 units per ml) insulin and U40 insulins are only available with unit markings.
However, you can use human insulin syringes which are for the human U 100 (100 units per ml) insulin. You can get u100 syringes with 1.2 unit markings.
If you fill a U100 syringe to the 1/2 unit mark with ProZinc that is only 0.2 units of the ProZinc Insulin
to 1 unit marking is 0.4 units of ProZinc
to 1 1/2 unit marking is 0.6 units ProZinc
to 2 unit marking is 0.8 units ProZinc
2 1/2 unit markings is 1 unit ProZinc
 
I don't know about FIP or the fluid question, but maybe can help with ProZinc. Have you seen the protocol we put together?

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=109077

I would be cautious as she seems to be needing less insulin. Be sure to test before each shot. We urge new diabetics not to shoot under 200, but to stall: Wait 20 minutes without feeding and retest. You want to make sure she is rising, not falling and closer to 200. And then shoot a smidge less insulin. If she is 200+ and you are sure she is rising vs still falling at the end of the cycle, I would shoot - maybe trim the dose a little if you won't be around to monitor. If you skip, you lose ground. Being without insulin for an 12 hours after the first shot is gone means they jump up to higher levels. So she is on a constant roller coaster, with highs to lows and only one shot every 24 hours. Better to reduce the dose and get two shootable preshots daily.

Just for reference:

We generally consider a cat regulated if they are in mid to lower 200s at pre shot and in double digits at nadir (the lowest point of the cycle, usually 5-7 hours after the shot with ProZinc) but not below 40, which is approaching hypo territory.
 
Thank you so much for the protocol - that is what I needed. The vet has been good but when can't get information from her on the spot so the protocol helps a lot. We gave her 4.5 last night and she was 295 this morning so we gave her 4 and mid cycle she was 336 but honestly she seems to be at her lowest about 4 hours and then goes up and stays there till about two hours before next dose so she is probably going to be close to 400 tonight. I think we are going to try a couple of days with the 4.5 am/pm and try to get some 4/6 hour tests in addition to the pre-shot. She is a tricky one with all the other health stuff and meds she is on but we are definitely seeing improvement so we are hopeful we can get it under control. We started over 750 so to see anything below 300 has been a huge improvement. Now we just need to get her a little lower consistently.
 
We are doing fancy feast and boiled chicken. She was very underweight from IBD so we are on a high protein low carb trying to put some weight on her. She eats like 4 cans a day plus half a chicken breast daily so she eats a lot for a 6 lb cat.
 
We do a mix of classic, grilled, and the white meat chicken appetizers. She doesn't love the classic so we try to mix it up or add chicken breast to it. Vet was more concerned with getting the weight on her than a strict diet but we are trying to get her switched over as she gains a little. Actually the vet thought she had FIP so we were told to put her to sleep about a month ago. She was really sick from what we now think may have been the diabetes getting to her so the vet didn't really push us to change her diet. The last time she was there, about a month ago, the vet sent her home but didn't think she would make it through the night. We decided we would fight as long as she was fighting and she now looks the best she has in several months. Everyday is a gift.
 
You can take a stiff ruler with fine markings to approximate smaller doses. Line up the ruler 0 point with the syringe and count the number of tick marks in 1.0 units. It may not be a whole number n but that's OK. Its just to help you do consistent dosing.
 
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