Kitty is at the VET...questions

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kse

kse

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Once again, let me Thank everyone who responded to my post yesterday.

A little brief history again--My Kitty, 15.5 yrs, was dx with Diabetes last week with a blood sugar of 435 and all the classic symptoms (including weight loss of 1.5lbs in 3 months). I took Kitty to the Vet this morning for additional testing--her blood glucose level was 352 today. She also had lost an additional 6 onces and is down to 8 lbs. I have been feeding FF low carb for a week and attribute the blood glucose decline to that. The Vet started PZI this morning. I have a great deal of respect for my Vet and she knows I will go to all limits to help my Kitty.

After reading this board, I am happy PZI is the insulin of choice--but, I have a question. My Vet suggested a 2 unit dose once a day, instead of a one unit dose twice a day. Is this acceptable a two dose only once a day? She said there was a less likelyhood of having a hypo incident with once a day dosing. Is this correct?

I plan on doing home testing once she comes home tomorrow--but I just want some feedback on the once a day dose.

Thanks to all, I am sure I will have many questions and always know I am appreciative of all feedback.
 
Sorry but your vet's reasoning is completely incorrect. PZI is a twice a day insulin in almost all cats, with a very few exceptions.

So, your vet wants to start with 2 units which is a bit high, especially if the diet has been changed. So your cat has a chance at becoming hypoglycemic from that dose, then, the dose will wear off and your cat will run high for half the day. Not exactly the best approach for managing diabetes..

Do you like your vet? If so, I'd strongly suggest a talk about this. We can even point you to articles that talk about PZI being twice a day...

Jen
 
Can you please point me to the articles?

I am calling my Vet this afternoon and would love to have the information.

Thanks.
 
I know it is hard to get advice from strangers on the Internet that conflicts with your vet. But, no, insulin only lasts 12 hours in cats. So a once a day dose would mean that your cat would get a dose in the am, go slowly down for about 6 hours, then slowly back up for 6 more hours. From that 12 hour point on, she would continue up in high numbers until the shot 24 hours later.

You could prove this to yourself easily by doing one shot for 24 hours, testing at the 6, 12, 18 and 24 hour points. it isn't a great way to start your kitty on insulin but you would have the numbers to show your vet. Or you can go over to the PZI forum and look at the spreadsheets in the posts.
viewforum.php?f=24

PZI is a good insulin but it won't work once a day. I would start on unit twice daily.
 
This is from the FAQs on the ProZinc website:

Is it possible to use PROZINC once a day?
Historically, protamine zinc insulins were administered once daily to diabetic cats, a protocol based more on clinical perceptions of response to treatment than on results of absorption of kinetic studies. Studies show that absorption of protamine zinc insulins in cats can be quite variable.

In the field studies, mean time of the blood glucose nadir was between 5 and 7 hours, and subsequent blood glucose concentrations were increasing in most cats by 9 hours after administration of PROZINC. These results suggest that PROZINC should be administered twice daily in most diabetic cats to maintain glycemic control.
 
I am new at this and have no idea what type of PZI the Vet is using.

You all have convinced me to ask my vet about the once a day dosing.

Is there any valididty to her earlier response that once a day dosing of PZI will decrease the chances of hypo incidents?

I am leaving Kitty at the Vet tonight for continued monitoring. Like I said yesteday--I'm really scared and want to do what is correct for my Kitty.

Thanks
 
Like I said in my response, there is zero validity in the idea that once a day dosing reduces the chances of hypo. Further, the 2 units your vet is suggesting has more of a chance of taking your cat too low.

Why is your cat staying over night? There is absolutely no need to do this and I cannot imagine the cost. Are they monitoring her or is she left alone?

Honestly, I know this is totally overwhelming but I'd be asking why.
 
I know this is hard because you need to have a vet and you want to trust her. All I can say is that we all have or had diabetic cats and successfully treated them. We volunteer time on this website as a labor of love to help other diabetic cats, often because we had bad beginning experiences with this disease.

The 2 units once a day will take your cat down low and then way back up. Truth is, it will probably be okay at the vet. Cats are stressed there with strange noises and smells and lots of people who are "not the mommy". Stress raises bg levels. So if her level is high, one dose of 2 units while there won't hurt for a one time dose. It won't help but it probably won't hurt until you get her home.

If I were you, when I get her home, I would just say you were scared to start with 2 units so you started with one. Your vet doesn't hold the syringe. You will probably not communicate with her for several weeks, and by then you will have a spreadsheet full of great numbers! :razz:
 
Scared is putting it mildly!

The Vet is open tomorrow and they are planning to check her numbers in the moring and administer the insulin again. So,there is a chance she will get two units again in the morning. Scarey, I guess...

I might go pick her up tonight and bring her home--- I am trying so hard to do what is correct and totally overwhelmed. If I bring her home I am certain I will not sleep for looking at her to be sure she is okay. So stessful.

Thanks for the help---I need it!
 
I know it is stressful. Once you start taking her blood glucose levels at home, you will feel so much more in control.

Unless your vet is a 24 hour vet with someone there at night monitoring, I think you certainly could tell them you don't want her there alone on her first time with insulin. They can't argue with that.
 
One more question....since she received the insulin this morning and they are not planning on giving it again today--will her glucose levels continue to drop during the night or would the "big" drop happen during the day? I hope this makes sense. I am just wondering about the danger in leaving her unattended tonight.
 
Her drop will happen today, not while she is at the vet over night.

Please, ask them why you are paying for her to stay overnight when they aren't giving insulin and they aren't monitoring. It doesn't make sense. She will be stressed and they aren't doing anything that you cannot do.

I KNOW this is tough. But you can be an informed client and play a role in the decision making process. It is YOUR cat.
 
Well, normally the big drop would be 6 hours after the shot. But you just can't predict, especially in the beginning, how your kitty will react to the insulin. They all react differently. That is a huge part of the reason we stresss testing. You can't look at other cats and predict what yours will do. You can't even look at your cat's past patterns and be sure they will react the same way the next time. You test so you know.

What will be the value of her staying there alone if no one is around to monitor? If you get her, you can give the dose in the morning (and you can pick the amount....)
 
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