Is it too soon to think about changing insulin?

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Since early May, Buffy's numbers have been steadily increasing. Took her to the vet and while her white blood count was normal, there was something else (sorry I don't have her results in front of me) that the vet said indicates that something might be brewing. He put her on a ten day course of Clavamox and sure enough her numbers started coming down again nicely. Four to five days later, they went back up. Long story short, after 2 courses of Clavamox, 1 course of Batytil and then another course of Clavamox, the vet and I both feel this isn't from an infection. Her numbers are up and just aren't coming down. He doesn't suspect pancreatitis because she has no symptoms. In fact she shows no symptoms of anything other than she seem hungrier than my other cats at feeding time.

He increased her dosage of Lantus but that didn't seem to work either. At 4 units we both felt that maybe the Lantus simply wasn't working for her any longer. So we switched to ProZinc. To me, her numbers look worse than when she was on Lantus. I'm wondering if trying BCP-PZI would be the next step. I'm guessing that a fructosamine test would be beneficial at this point as well.

I'd appreciate it if the pros here could take a look at her SS and give me your opinion.

Note:
the numbers you'll see after starting the ProZinc are the converted number for the U-100 needle. Based on the U-40 needle she started at 1 unit and is now on 3 units, the proper amount for her weight according to the ProZinc dosing recommendations.
 
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Hi Cindee,

She did seem to do well on Lantus at first. You might post on that forum also and ask for input on the Lantus part of her spreadsheet. I would not change to PZI BCP. In my experience, which is fairly limited as we don't see many beans on it, I have not seen much difference between the two insulins (except cost)

I think I might consider switching to Levemir. Many of the higher dose kitties here use it as it is thought to sting less at high doses.

I would also post on Health about the infection issue explaining that there does seem to be something but she has been on several rounds of different antibiotics. Has she had her teeth checked? That is one place an infection can hide.

Last possibility in my mind: Is she solely eating wet low carb food?

I am sure you are discouraged and disheartened. You have done right by her and certainly collected the data that should give clues to her issues. It is possible she is a high dose cat but she didn't look like that in the beginning. Have you looked at the info we have on high dose cats to see if any of the symptoms jump out?

http://www.felinediabetes.com/FDMB/...-other-high-dose-conditions-what-we-know.375/
 
Thanks Sue.

Buffy has never been a dry food cat, strictly canned (Wellness) or raw (Rad Cat) both low carb. She gets a small treat of dehydrated chicken, about 3-4 chunks (¼” x ¼”) after I test her so that she associates the test with something good afterward. Teeth are perfect.

Thank you for the link to the “other conditions” page. I read it thoroughly, but she doesn’t show any symptoms of any of these diseases. She has no symptoms at all. Initially she was peeing outside the box and she was always hungry. Both of those symptoms went away as soon as she was put on the insulin and I’m happy to say haven’t returned. Between meals she doesn’t act like she starving, however at meal times she’s ready to eat, I’d say a bit more than my other cats, but not like she’s starving. Other than that she looks and acts completely normal.

What’s so strange to me is that she was doing so well then wham…almost overnight, the numbers started going up they just continue. Her Dr. doesn’t quite know what to make of it either. The one thing I’ve noticed is that even though her numbers are high, she’s leveled out. There are no highs and lows, before she was like a zig zag stich.

I’ll look into Levemir, I don’t know anything about it. I was leaning toward the BCP-PZI because of it being made with bovine and that being closest to feline insulin, more so than human recombinant.
 
/There have been a few people who have switched between BCP PZI and ProZinc but no one has seen any radical difference that I can remember.

I am guessing it is some kind of medical issue rather than insulin issue? Wish they could talk!

There is something called insulin toxicity that causes higher doses until you "break through". It doesn't seem to fit her because you started low with the Lantus and increased slowly. But here's the info:

http://www.felinediabetes.com/FDMB/threads/feline-diabetes-and-glucose-toxicity-links.62960/
 
Insulin auto-antibodies (IAA) don't show any outward signs; you only know if you test.
 
/There have been a few people who have switched between BCP PZI and ProZinc but no one has seen any radical difference that I can remember.

I am guessing it is some kind of medical issue rather than insulin issue? Wish they could talk!

There is something called insulin toxicity that causes higher doses until you "break through". It doesn't seem to fit her because you started low with the Lantus and increased slowly. But here's the info:

http://www.felinediabetes.com/FDMB/threads/feline-diabetes-and-glucose-toxicity-links.62960/
/There have been a few people who have switched between BCP PZI and ProZinc but no one has seen any radical difference that I can remember.

I am guessing it is some kind of medical issue rather than insulin issue? Wish they could talk!

There is something called insulin toxicity that causes higher doses until you "break through". It doesn't seem to fit her because you started low with the Lantus and increased slowly. But here's the info:

http://www.felinediabetes.com/FDMB/threads/feline-diabetes-and-glucose-toxicity-links.62960/

Wouldn't that be nice if they could talk...for many reasons. ;-) You're right she doesn't fit into the glucose toxicity either. If she just had some sort of symptom that would give us a hint but nothin'.

We did have a little breakthrough last night. I tested her before I went to bed and she finally dropped to 341. That was a pleasant surprise. The only thing different is that she ate Rad Cat instead of Wellness. I'm wondering if even the small amount of carbs in Wellness are too much for her. Rad Cat has zero. I'm going to feed her strictly Rad Cat and see if that's what has really made a difference or not. Fingers crossed.
 
The body reacts to the insulin as if it were a foreign intruder and makes antibodies which attack and degrade the insulin.
The only thing you'll see is needing a continuously increasing dose of insulin until you finally break through the antibodies and the insulin can work. It is described in our high dose forum.
 
The body reacts to the insulin as if it were a foreign intruder and makes antibodies which attack and degrade the insulin.
The only thing you'll see is needing a continuously increasing dose of insulin until you finally break through the antibodies and the insulin can work. It is described in our high dose forum.
Thank you! I'll check that out. :-)
 
I read the "high" dose forum. I think you may haven not caught my note that the numbers on Buffy's chart are "converted numbers". Not converted, she'd getting 3 units which is the correct dose for her weight. It was good to read though.

I made the decision today to switch to BCP-PZI. The ProZinc is not doing as good a job as the Lantus did and the thing both the Lantus and ProZinc have in common is the human recombinant so I'm just going on woman's intuition and hoping that the bovine recombinant will work better for her. Friday she's having a fructosimine test so we'll see how that goes. In the mean time, outwardly she's fine but I am concerned that damage is being done internally with those high numbers. I'll keep you updated on her progress with the BCP-PZI.
 
I'm confused about the "converted" numbers. Does that mean you've added to the ReliOn numbers or are they AlphaTrak numbers? What is the 8 units if she is only getting 3? U100s?

If she is only getting 3 units, then I would start upping the dose every 3 days by .5, monitoring and ketone testing. If she has insulin toxicity, you need to find the break through spot when she starts to drop.
 
The converted numbers are the U-40 converted to U-100. If I was using the U-40 needles, her "units" would be 3.0.

The vet told me to increase it this afternoon to 4.0 (converted to to the U-100 needle is 10.0). I was more cautious this morning and only increased it to 3.4 (converted is 8.0) The conversion is in .2 increments that's why I chose 3.4. I'll up it to 4.0 tonight and tomorrow morning but will test her more often to see how she responds. I'm thankful that even with the high numbers, clinically, she's doing well.

Tomorrow night she'll be getting the BCP-PZI and the starting dose is 1 unit (u-100). I won't wait a full week on this one. I'll take your advice and adjust it every three days. I'll be very surprised if she responds to 1 unit but we'll just have to see how it pans out. My fingers are crossed.

I'm sorry about the confusion on her SS regarding the ReliOn and Alpha Tracker. I was testing using both to see the difference. I'm using only the ReliOn now.
 
Aha. I get it. We really encourage people to use U40 numbers on their spreadsheets even when using U100 needles. Not only does they save people time having to do the conversion each time, but looking at your spreadsheet, I certainly assumed you were giving 8 units of insulin. Since everyone either uses U40 needles or makes the conversion to the U40 amounts on their spreadsheet, it gives us a common language. Which can be important in an emergency.

Yes, I'd move up fast with the BCP. I hope it makes a huge difference for her.
 
I understand. I'll see if I can come up with a way to include both to make it easier for all to understand. Since I enter the info daily, but only occasionally post here, I felt it was more important that I not confuse myself. ;-)
 
Basically, every half unit tick mark on a U-100 syringe equals 0.2 units of ProZinc.
I just count tick marks as 0.2, 0.4. 0.6 ...
 
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