Is this dosage too high . . . ?

[vstarjewel]

My cat Max was diagnosed with diabetes end of April. He had full bloodwork panel done, sugar was 521. Vet recommended Prozinc, started us with 2 u twice a day (before meals). 10 days later 2nd check up came down to 313, vet upped it to 3 u twice a day (before meals). 2 weeks later number was 475; vet said to give Max 4 u morn and 3 u night. Just in general, from what I've read, that seems like A LOT of insulin? I KNOW it's impossible to say for sure if it is a lot without info, but it just seems like too much.

I just started to check Max BG, had to get a meter and supplies. I started a spreadsheet on May 24th, but I can't say it's accurate. We have 3 cats, and my husband (whether he does it on purpose or not) argues with me on everything with Max and "forgets" to put the food bowls up (which do have dry food for the 2 other cats). So once I get ALL the cat food hidden from EVERYONE and can get reliable numbers, I will post his stats. Any thoughts would be GREATLY appreciated!

 

[Karen&Rocket]

I can't help unfortunately, but just wanted to say I'm in a similar situation. Rocket's weight is stable, but we've gone from 2U twice a day in Feb, to 2.5, and now 3U at our vet's recommendation starting yesterday . I've just started home testing a couple days ago, but strangely Rocket's numbers were better yesterday before his shot, and went up pretty high a few hours later. Which is the opposite of what's supposed to happen, right? I'm so confused and don't want to contradict our vet, but this doesn't seem right. I'm not trying to hijack your thread, but our situations seem pretty similar.

 

[vstarjewel]

Yeppers . . . I thought it weird that his sugar went up when the insulin was increased . . .? But as I mentioned, I can't say for sure that the readings I have are indicative of Max getting into the wrong food. I'm getting no help or cooperation from my husband . . . which is infuriating me. At this point I'd happily put him down and keep the cats.

I digress LOL. A friend of mine that had a diabetic cat for 3 years directed me here, saying it was the very best source of info she found. A few things that she has told me have really stuck (I'm sure a few of them are on here, but still wanted to share)

First: the vet is only going to have readings every 2 weeks, and is assuming the cat hasn't had any food 6 hours prior to checking BG. They have NO idea what is happening on a day to day basis. So take their recommendations with a grain of salt, and research EVERYTHING.

Second: if you feel like you can't talk or ask questions of your vet, get another vet. It's like human kids . . . if their doctor suddenly declared they had diabetes and want to shoot them up, wouldn't you question it? Same thing.

Third: you have to give the body time to adjust itself. The only way to gauge any changes is regular testing. I think I was under the impression that once the insulin was regulated it was just feed and shoot twice a day, end of story. Yeah . . . no. It's all in for the whole enchilada for the rest of Max's life, including regular testing, time tables, insulin shots. It is the commitment I made when Max became part of our family . . . same thing as I would do for my children.

I am kinda not happy with my vet right now. I think it's because the vet techs that would do Max's draw would return, say "up the insulin", and leave. I do get that the techs need to utilized (I work in the dental field, not every appt needs a doctor), but I feel that if the insulin needs to be increased it should come from the vet, and he/she should be present to answer questions. I also wasn't happy that the tech informed me that they won't give a prescription for Prozinc; we could only get it there. At our initial visit we were told that we could get the insulin at a pharmacy, probably for a lesser cost. When I told her that I was informed differently, she said it was office policy because they can't verify that the insulin could be a knock off. If we got it filled at another vet they would give us a script. That ticked me off, but I said nothing. I will approach them again about the script, but if they don't issue one then I may consider going elsewhere. Just don't have a lot of trust there at this moment.

 

[Sharon14]

I’ll let the experienced prozinc users advise on the dose, but I will recommend that you go ahead and post the spreadsheet. Even if Max has been eating high carb food, the numbers may show some trends, just write in the comment section that hi carb food may have been involved. As for the other cats food, can they be changed to the same low carb food that Max is eating? That would be easiest, No more worries about DH feeding or Max eating inappropriately.

 

[vstarjewel]

I will probably put my SS up in the next day or two. I have a few AMPS PMPS numbers, but nothing in the middle. I started home testing May 24th (ish), so I should have SOMETHING more to report.

One of my other kitties, Chloe, will ONLY eat canned food. Heaven forbid you run out . . . boy, will she let you know it! She is 18 and ornery . . . now that I think about it, she DOES take after her mom .

It's our third one, Bailey, that is the "interesting one". He will NOT eat canned food or fresh meat. This we learned when my daughter was kitty sitting for us and ran out of hard food. Long story short, she found canned food in the cupboard, figured it was ok to feed to the cats (true). Bailey went 2 and half days without eating. Daughter went to store to get cat food, didn't know what to get, so she tried to get Bailey to eat the canned stuff. Nope. Offered him chicken, tuna, roast beef lunch meat (not the best, but worth a shot). Nothing. We came home to a meowing, starving cat and distraught kitty sitter. I've had people tell me that he will eat what we give him if he is hungry enough . . . I really don't want to chance that idea again. Side note: daughter won't kitty sit for us anymore, said something about PTSD . . . .

 

[Sharon14]

Some kibble addicts can be taught to eat wet food, maybe even most, but I have one like Bailey. After 4 years of trying, he now eats wet food sometimes....
If you’re in the US, there are a couple low carb dry foods available. They are pricey, but because they are so dense, cats tend to eat less. One is Young Again Zero Mature and the other is Dr Elseys clean Protein

 

[vstarjewel]

I just found that on the forums! I'm off to check those out now. Thank you!!!!!

 

[vstarjewel]

I can't help unfortunately, but just wanted to say I'm in a similar situation. Rocket's weight is stable, but we've gone from 2U twice a day in Feb, to 2.5, and now 3U at our vet's recommendation starting yesterday . I've just started home testing a couple days ago, but strangely Rocket's numbers were better yesterday before his shot, and went up pretty high a few hours later. Which is the opposite of what's supposed to happen, right? I'm so confused and don't want to contradict our vet, but this doesn't seem right. I'm not trying to hijack your thread, but our situations seem pretty similar.

This morning I finally got an accurate reading for Max. It was over 600 and he hadn't eaten all night. Tested, fed and shot him. Came home on my lunch hour about six hours later and his blood sugar was 128 . He was so lethargic he just kind of sat there while I checked his sugar . Immediately gave kits lunch,, and he seems to have perked up a bit. So glad I came home!

 

[Sharon14]

Wow that’s a big drop! What meter are you using?

 

[Karen&Rocket]

First: the vet is only going to have readings every 2 weeks, and is assuming the cat hasn't had any food 6 hours prior to checking BG. They have NO idea what is happening on a day to day basis. So take their recommendations with a grain of salt, and research EVERYTHING.

Second: if you feel like you can't talk or ask questions of your vet, get another vet. It's like human kids . . . if their doctor suddenly declared they had diabetes and want to shoot them up, wouldn't you question it? Same thing.

Third: you have to give the body time to adjust itself. The only way to gauge any changes is regular testing. I think I was under the impression that once the insulin was regulated it was just feed and shoot twice a day, end of story. Yeah . . . no. It's all in for the whole enchilada for the rest of Max's life, including regular testing, time tables, insulin shots. It is the commitment I made when Max became part of our family . . . same thing as I would do for my children.

I am kinda not happy with my vet right now. I think it's because the vet techs that would do Max's draw would return, say "up the insulin", and leave. I do get that the techs need to utilized (I work in the dental field, not every appt needs a doctor), but I feel that if the insulin needs to be increased it should come from the vet, and he/she should be present to answer questions. I also wasn't happy that the tech informed me that they won't give a prescription for Prozinc; we could only get it there. At our initial visit we were told that we could get the insulin at a pharmacy, probably for a lesser cost. When I told her that I was informed differently, she said it was office policy because they can't verify that the insulin could be a knock off. If we got it filled at another vet they would give us a script. That ticked me off, but I said nothing. I will approach them again about the script, but if they don't issue one then I may consider going elsewhere. Just don't have a lot of trust there at this moment.

This morning I finally got an accurate reading for Max. It was over 600 and he hadn't eaten all night. Tested, fed and shot him. Came home on my lunch hour about six hours later and his blood sugar was 128 . He was so lethargic he just kind of sat there while I checked his sugar . Immediately gave kits lunch,, and he seems to have perked up a bit. So glad I came home!

This is all so much to think about, isn't it? Mind boggling. I totally agree with what you're saying, and I hope I get used to the home testing enough that I get accurate numbers. I've gotten numbers over 600 and as low as 153 this week too. My vet suggested I might be getting higher numbers right now because my cat isn't used to it... is that a thing? I mean maybe a little, but can the numbers be affected that much? We caught the diabetes fairly early, and I was so hopeful with the ProZinc that we might be one of the lucky ones whose cat goes into remission... but the longer this goes on the less hopeful I am. Anyway best of luck to you, and I'll keep my eyes on this thread.

 

[Daddy Jack's Mommy (GA)]

I'm not terribly experienced, as I've only been here a few months, but that's too high of a starting dose, especially if you're also changing his food to a low carb wet. Prozinc (which I use) protocol suggests beginning with 1U, getting data on his BG numbers between doses (testing), and then raising or lowering the dose based on the numbers between doses. Testing him before his dose lets you know if it's safe to dose him at all. It's easy to believe that his dose has been too high causing him to go too low and then to bounce up high again. Stating with too high a dose doesn't give you the opportunity to find what dose really works for Max, as too high a dose can look like too low a dose if you don't have data on how he responded.

As far as your vet... I don't know what to suggest. It's ridiculous that he won't provide a script for prozinc, forcing you to buy it from his office. I think I would have to look for a more caring/less money driven place to bring Max.

And I agree with @Sharon14 to go ahead and post the SS, even if you don't have much data there right now. It still helps to be able to see what numbers you do have.

How is Max right now? Have you tested him since the 128 reading? What is his BG the last time that you checked? Is he eating? Is he still lethargic? Please let us know how he's doing. We worry...

 

[Jenna Josie]

Yes to what Carolyn said, and just adding that 120s are perfectly safe, but they are low *for him* right now, and so his little body may be overreacting to the perceived low BG and compensating by dumping stored glucose into his system.

It's all only an hypothesis, however, without the data, so it's great that you got a mid-day test! Please do try for more of those and to post your spreadsheet so that we can see what patterns may be emerging. While a +6 is great, other tests are good, too, so whatever you can get will be helpful. Cats typically nadir anywhere between +4 and +7 (don't look at my cat's chart though; she's weird!), so that's a good range to test to see how low they may be going. Many of us (not being able to stay up all night to test our cats ) try to get a +2 or +3 in the evening (the "before bedtime" test) to get an idea of where the cycle may be going. Typically cats will have a "food spike," and so their numbers will be up after they eat but before the onset of the Prozinc (probably about +3). If the +2 is flat/lower, then you know you're probably going to have an active cycle and need to monitor a little more.

 

[vstarjewel]

Got spreadsheet up!! Mine looks different than the one posted, it was easier for me to read shortening it up.

Wow that’s a big drop! What meter are you using?

I'm using a TruTrack meter. I am ASSUMING the readings are correct . . . it's brand new and the strips are good. Will see if the wonky numbers continue (though I've read here that wonky numbers are kinda normal when first starting out, esp with Prozinc . . ?)

This is all so much to think about, isn't it? Mind boggling. I totally agree with what you're saying, and I hope I get used to the home testing enough that I get accurate numbers. I've gotten numbers over 600 and as low as 153 this week too. My vet suggested I might be getting higher numbers right now because my cat isn't used to it... is that a thing? I mean maybe a little, but can the numbers be affected that much? We caught the diabetes fairly early, and I was so hopeful with the ProZinc that we might be one of the lucky ones whose cat goes into remission... but the longer this goes on the less hopeful I am. Anyway best of luck to you, and I'll keep my eyes on this thread.

I don't get the swings either . . . they don't make sense. Then again, the body is a touchy machine; reminds me of trying to fix a carburetor on a car. There is no set number or guide, you tune it as you go along. I'll follow along on your SS, maybe we will see something between the 2 of them

I'm not terribly experienced, as I've only been here a few months, but that's too high of a starting dose, especially if you're also changing his food to a low carb wet. Prozinc (which I use) protocol suggests beginning with 1U, getting data on his BG numbers between doses (testing), and then raising or lowering the dose based on the numbers between doses.

And I agree with @Sharon14 to go ahead and post the SS, even if you don't have much data there right now. It still helps to be able to see what numbers you do have.

How is Max right now? Have you tested him since the 128 reading? What is his BG the last time that you checked? Is he eating? Is he still lethargic? Please let us know how he's doing. We worry...

Thank you for expressing your concern!! He was much more alert when I got home this evening. He pigged out at dinner, which I thought was a good sign. I think the dosage is way high, taking in consideration everything I've learned about ProZinc. But I am not a Dr, so I will keep him where he is, unless his numbers indicate differently. I hate taking him to the vet, it stresses him out so much that he premeds before appointments. I am going to give a week of monitoring and getting data, and will call the vet. If they give me a hard time I will find another vet. I do like the office we go to, they take very good care of my bunny (exotic pet category). But for the reasons I cited above, I may have to take him elsewhere.

Yes to what Carolyn said, and just adding that 120s are perfectly safe, but they are low *for him* right now, and so his little body may be overreacting to the perceived low BG and compensating by dumping stored glucose into his system.

It's all only an hypothesis, however, without the data, so it's great that you got a mid-day test! Please do try for more of those and to post your spreadsheet so that we can see what patterns may be emerging. While a +6 is great, other tests are good, too, so whatever you can get will be helpful. Cats typically nadir anywhere between +4 and +7 (don't look at my cat's chart though; she's weird!), so that's a good range to test to see how low they may be going. Many of us (not being able to stay up all night to test our cats ) try to get a +2 or +3 in the evening (the "before bedtime" test) to get an idea of where the cycle may be going. Typically cats will have a "food spike," and so their numbers will be up after they eat but before the onset of the Prozinc (probably about +3). If the +2 is flat/lower, then you know you're probably going to have an active cycle and need to monitor a little more.

I planned on doing the q6h for the next 4 or 5 days, then doing a q3h testing day to get a better curve. I just started working part time vs full time . . . about a week before Max was diagnosed. In an odd way, Max and I are fortunate that he was diagnosed when he was . . . I would NEVER be able to keep up a regular schedule for him otherwise!

 

[Jenna Josie]

I planned on doing the q6h for the next 4 or 5 days, then doing a q3h testing day to get a better curve.

I have no idea what this means, but it sounds *awesome*! Very sciencey.

(I assume it’s Latin abbreviation for every 6 hours and then every 3 hours, but my catholic schoolgirl Latin is long forgotten ... and I’m too lazy to google right now, lol).

 

[vstarjewel]

Oh oops... I guess I was so tired yesterday it reverted back to work verbage. Yeah that is every 6 hours or every 3 hours. Sorry about that LOL. So if you ever see that on a prescription you know exactly what it means. Just for giggles and kicks if you see PRN stands for as needed for. And I can assure you I am not a good Catholic school girl LMAO