Just diagnosed, numbers not budging

[Helene and Santino]

Hi everyone.

My kitty's name is Santino and he is a sweet 19-year old tabby who has never been sick a day in his life until just now. He got diagnosed with diabetes a few weeks ago (was losing weight, peeing everywhere and getting wobbly on his legs). We started Prozinc insulin (2 units twice a day) about 10 days ago. He was initially at 660 at the vet's office, and at the recheck today he was at 700! The vet told me that he might have an infection we haven't found on urine culture or anywhere else on the labs, so they gave him an antibiotic, and told me that I can go up a half a unit on the insulin. They also scared me saying that causes for insulin not working can include things like undiagnosed cancer, or simply the fact that elderly kitties can take longer for their insulin receptors to come back.

That said, Santino's been acting a little better, though it might just be my imagination. He looks like he has more energy, is less off balance and wobbly while walking which my vet told me could have been a result of altered mental status due to high sugars, no longer has constipation, and doesn't seem to be drinking as much. He still has a lot of litterbox accidents, namely peeing all around the litter box and in it only about 20% of the time, but that might be a different issue entirely.

Now, I've got a couple questions.

1. They told me to come in an hour before his insulin shot was due. That kind of doesn't make sense to me. Prozinc tends to wear off after 8-10 hours, no? So if he's tested right before he's given his shot with his last shot 12 hours ago, of course he will be high. Or am I missing something here? When you start a cat on insulin, is their sugar pre-dose eventually supposed to go down? This is something I really want to know. I'm catastrophizing now -- wondering if Santino has acromegaly...
2. I've compiled a list of low carb dry foods, does it seem reasonable: Wellness Core, Nature's Variety Instinct, Evo/Innova, Dr. Elsey's, Before Grain. I'll get several kinds and see which one Santino likes best.
3. I did leave my Prozinc out for about 8 hours once while I was at work. Rookie mistake, I know. The vial still looks ok, no cloudiness or stringiness. How long is it supposed to be good out of the fridge?
4. Could I be administering the shots wrong somehow? Any common pitfalls, i.e. furshots, insulin coming back out again after the poke?
5. If a cat is insulin resistant for whatever reason, is that the end? Is there no hope of them getting better?

I have already learned a lot from this forum -- for instance, I had been feeding Santino FF with gravy, and then I read the label and guess what... the gravy is full of carbs. I've switched him back to FF classic pates today. Santino's also a kibble addict, but I will be transitioning him to a low-carb option. (I have Taste of the Wild Canyon River and an unknown type of Friskies that came from my mother in a bin, but neither of those seem like great options).

I am going to try the home testing soon, but I live alone right now and work crazy hours, 8 am to 6 pm, and some days actually 24 hours straight through, though if I play my cards right I can have an hour long window in the middle to run home and give a shot.

 

[Fluffles]

Ok so here goes, I am still pretty new to feline diabetes but you will get so much support and help from this message board. There are so many here with so much experience that can provide you with so much support advice. My first thought on your post is that with only 2 blood glucose tests 2 weeks apart at the vet is not necessarily a clear indicator of how your cat will respond to the insulin. I think you will gain invaluable information of how your cat is responding when you are able to start home testing. I have a kind of a crazy work schedule too (4 days a week 12 hours). Its still possible to get some great info that others on here can help you decipher. I think the sooner you can start testing at home the better for your cat. Even if you can just test before shooting and then maybe try to get a few extra tests in over the weekend to "fill in the blanks". If you need help deciding on a monitor or how to do it just ask and there is lots of advice available. I use the relion from walmart and would highly recommend.

Fluffles was also a "carb addict" but I have successfully to just the ff chicken pate and he's doing fine now. I feel like changing his diet was one of the biggest reasons he is headed for remission. The diet and the advice I received are what has brought Fluffles on the road to recovery. I hope the best for Santino! and the best advice I can give you is to keep posting and you will receive so much help. It's really overwhelming at first but you will learn so much about how to help Santino feel better!!

 

[Chris & China (GA)]

1. They told me to come in an hour before his insulin shot was due. That kind of doesn't make sense to me. Prozinc tends to wear off after 8-10 hours, no? So if he's tested right before he's given his shot with his last shot 12 hours ago, of course he will be high

You're right....that doesn't make a lot of sense to me either unless they're talking about keeping him all day to do a curve and giving him his insulin

2. Is insulin receptors "coming back" really a thing? The vet told me that in cats diabetes is usually an insulin resistance picture and that with time the receptors can recover function and result in remission. It's less often a matter of pancreas cells dying, although it can happen. Anyone aware of cases of receptors not "coming back"? I'm afraid they'll make me put my kitty down

Remission IS possible!! The earlier they are diagnosed and treated, the better the chances are!

And NOBODY can force you to put your kitty down....that's a decision for you to make!!

3. I get the vibe that my vet is being ageist in saying that at Santino's diabetes that is not getting better can be "anything," including an occult infection or cancer. Am I wrong? Keep in mind this is week two of treatment

It's way too early to know. What IS important is to learn to home test so you can really see how he's responding. A lot of vets won't mention home testing (or even actively discourage it) but you wouldn't give your human child insulin without knowing their blood glucose and it's the same for our furkids!!

4. I've compiled a list of low carb dry foods, does it seem reasonable: Wellness Core, Nature's Variety Instinct, Evo/Innova, Dr. Elsey's, Before Grain. I'll get several kinds and see which one Santino likes best.

The only dry foods that are OK are Dr. Elsey's, Evo Cat and Kitten and Young Again Zero.....but there are lots of good reasons to stay away from dry foods completely!! A cat's kidneys are it's weakest organ....a diabetic's kidneys are even weaker. The more water you can get into them, the better!! A good low carb canned diet is what we recommend. Fancy Feast Classics, Friskies pates and 9-Lives ground are all low carb and affordable and fine for sugarcats

The vet that occasionally posts here said it best in her "PLEASE consider more than just carbohydrate content" post

5. I did leave my Prozinc out for about 8 hours once while I was at work. Rookie mistake, I know. The vial still looks ok, no cloudiness or stringiness. How long is it supposed to be good out of the fridge?

It's fine.....all of us have left our insulin out at least a few times

6. Could I be administering the shots wrong somehow? Any common pitfalls, i.e. furshots, insulin coming back out again after the poke?

Did your vet have you come in to show you how to give insulin? As long as you're doing it the same, there's really no way to mess it up. We ALL give an occasional furshot, so if it happens, just remember to never shoot again (since there's no way to know how much actually got into the cat) and chalk it up to experience.

7. Will it get better???

There's no guarantees in life, but you're still very early in and it will take some time to see how he's going to do. It sounds like you're already starting to see some improvement. One thing to look for is how much litter you're having to scoop.....it should come down as well as you'll notice he's not drinking as much.

 

[Helene and Santino]

Did your vet have you come in to show you how to give insulin? As long as you're doing it the same, there's really no way to mess it up. We ALL give an occasional furshot, so if it happens, just remember to never shoot again (since there's no way to know how much actually got into the cat) and chalk it up to experience.

The vet showed me on a fake cat... And a real live cat is very different. They squirm and try to get away, although Santino's gotten better in that regard. For a while I think I might have been shooting too close to where I'm pinching so the pinch might have made it come out again, but I watched the vet give an antibiotic shot today, so I think I'll change my technique a bit.

There's no guarantees in life, but you're still very early in and it will take some time to see how he's going to do. It sounds like you're already starting to see some improvement. One thing to look for is how much litter you're having to scoop.....it should come down as well as you'll notice he's not drinking as much.

Lol, Santino's developed litter box problems for the last few months, so he only goes in the actual box every once in a while. I've decided to just grin and bear it and put down wee wee pads all around the box, which works well. I think once the diabetes gets better, I'll tackle the box -- one thing at a time. I think he may have developed litter box aversion as a side effect of the diabetes, too, or the constipation that comes with dehydration. But I think I'm changing the wee wee pads a little less often and the urine is less dilute from the looks of it.

 

[StephG]

You can trim or shave the area you give him the shot at. It makes it easier to see the needle go in and reduce the chances of a fur shot. I've been giving shots for over a year now and I still used a shaved area. I like to see that the needle is going in. Fur shots are still possible of course. Are you using the long needles? I personally like the short ones because it makes it less likely that I'll poke straight through like I have done before.
I think home testing will give you more answers that you need. Too much insulin can look like not enough too. Not saying he's on too much but you can find that out by testing at home.
My first car suggested putting my boy down at diagnosis. I was furious. Don't let anyone make that decision for you. Hang in there... You're in the best place for help, guidance, and support!