Is it time to switch insulin or dosing problem?

[Melout311]

Hi All!

Bash was diagnosed with diabetes almost 5 months ago. At first he was responding really well to ProzInc and I thought we were going in the right direction to getting regulated. However, within the last couple of months his AMPS and PMPS have just keep going up. I have been gradually increasing the insulin. We started at .5 and now we are at 2 units twice a day. It seems like he barely responds to the insulin after the shot. Should I gradually increase his dose or do you think he is rebounding because I have been increasing it? Or do you think since he is so unresponsive to it he has developed a tolerance and it is time to try a new insulin? I really want to see my baby back into the blues and greens. Any advise is appreciated. Thanks!

 

[FurBabiesMama]

Hi. I am a little confused by the dosing changes that have been done. It seems a bit of a 'zig zag' with up and down dosing. I have found that consistent dosing is important. It is usually best to hold a dose for at least a couple of days.. and with some cats (like mine), a 'few' days is even better. Also, mid-cycle tests are necessary to know how a dose is working, so without that data, you cannot really make a good call on dose changes. When you base a change only on pre-shot test results, you are missing a huge part of the picture. You cannot tell if the dose is too high or too low. Would you be able to do a curve (test before shot then every two hours until next pre-shot test) some time this weekend to get a fuller picture of how the 2u dose is working out?

Is he having any issue that could be causing him pain and impacting his numbers? Does he need dental work or have a UTI or anything like that? Have there been any food changes? Any things like these can impact his BG levels.

 

[Melout311]

Ocassionally when his numbers were lower I was too chicken to give him a higher dose and than when his numbers were a bit higher I would give him more. I know I need to just stick to a dose. I'm going to keep testing every two hours before I go to bed tonight and I'm planning on doing a curve tomorrow testing every two hours. I will keep him at two units. As far as any changes that would effect BG..nothing I can think of. He eats two cans of FF a day. He is still drinking and urinating a lot, but he does seem like he has put on some weight. 2 lbs since we started insulin. His coat still looks greasy though. His teeth look good, and he acts like he feels okay for the most part. He has changed sleeping spots. He now stays close to his food, but maybe it's because he is hungrier with higher BG?

 

[Rachel]

He now stays close to his food, but maybe it's because he is hungrier with higher BG?

Probably so. Most diabetic cats get hungrier when they're not regulated, so he probably is hungry right now and just wants to be close to his food.

A curve would be great. That could help us figure out what's going on with him hopefully. Don't worry...this happens sometimes, but with some work, we can figure out a good dose for him.

 

[FurBabiesMama]

I see on your spreadsheet that you gave his shot at +9. I am not sure why that was done, but please keep in mind that there is really only an hour of 'play' time with ProZinc. You want your shots to be 12 hours apart except when that is not possible - then, you want to move them no more than an hour. Any more than that, and you are overlapping the doses enough that it could cause problems. Again, consistency is so important.

UPDATE: Does that mean that when you put in a +11 test result, that was really 2 hours after the shot and +1 is really 4 hours after, and so on? When you adjust shot times, you still want to put the pre-shot test result in the AM or PMPS spot. You always want to record tests based on how many hours after the shot they were done - a test 2 hours after shot time goes in +2, 4 hours goes in +4, and so on. Otherwise, it is confusing and not giving a clear picture of insulin dose impact.