Kitty was just diagnosed today by our GREEDY vet.

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karenkarma

Member Since 2013
My Tommy The Cat was just diagnosed with cat-a-betes today.
He was never fat and is only 1.5 years old. So, I assume he has the cat version of what I have. (Type 1)
I am bothered by the fact that my vet did not even know what Lantus is and insisted that I HAD to use this kind called ProZinc which cost me $135.
I have more Lantus insulin and syringes than I know what to do with.
The very worst part though is that my cat will have to have 2 shots a day instead of 1 on the ProZinc and the way I understand it, only 1 shot of Lantus.

I don't know whether to change it myself or what.
GRRR!!!
 
Hello Karen and extra sweet Tommy, and welcome to the FDMB!!

Pro Zinc is an excellent insulin and used by a lot of people here. It's a good choice for Tommy. Lantus and Levemir are also good insulins for cats.

All insulins need to be given every 12 hours, so the part about only giving Lantus once/day is incorrect. It's given every 12 hours too.

What are you feeding Tommy? If it's dry food, you need to get him off that and onto a low carb wet food (less than 10%). We have an excellent Food Chart that shows you the carb percentage in pretty much any food you can buy. If you're already giving insulin, it's important for you to change to low carb foods slowly though.

Next important thing is to learn to test Tommy at home. You wouldn't give an infant insulin without first knowing what their blood glucose was and it's the same with our kitties. You can get a human glucometer at WalMart for about $15 (but if you're already testing your own blood glucose, and can afford the strips, there's no reason you can't use it)

We can teach you how to test Tommy, as well as help you learn the things you'll need to learn to keep Tommy safe, as well as working towards regulation.

Here's a little something for you to read...I hope you like it..I got a giggle out of it when I was new! A message from your cat

Again, welcome, and we'll be here for you!
 
karenkarma said:
My Tommy The Cat was just diagnosed with cat-a-betes today.
He was never fat and is only 1.5 years old. So, I assume he has the cat version of what I have. (Type 1)
I am bothered by the fact that my vet did not even know what Lantus is and insisted that I HAD to use this kind called ProZinc which cost me $135.
I have more Lantus insulin and syringes than I know what to do with.
The very worst part though is that my cat will have to have 2 shots a day instead of 1 on the ProZinc and the way I understand it, only 1 shot of Lantus.

I don't know whether to change it myself or what.
GRRR!!!
Click to expand...

ProZinc is an animal insulin so that's likely why your vet said to use it.
Lantus and Levemir are better insulins for cats, but they are human ones so maybe some vets just aren't up on all kinds.

Now, there is no insulin made that lasts 24hrs for cats; sorry. Cats have a much faster metabolism and Lantus will last about 12-14hrs in the cat, so it's perfect. I prefer Levemir, but since you already have Lantus and syringes at home, then you are set.
No, you do not have to use the animal insulins if you don't want.

I am guessing you also test your own blood sugar, so you will have no problem testing your cat on the tip of the ears.
What meter are you using for yourself? I will say that the FreeStyle meters with the butterfly strips are not good for the upper range with cats, but the Relion meters are all just fine and very economical.

Gayle
 
Thank you so much for replying.
His royal catness was in DKA when we took him to the doctor today.
I kind of knew what was wrong all along because he was acting too much like me when I have blood sugar issues. The doctor was quite shocked because he is so young.
I was worried because she does not know what lantus is and of course, I am worrying that she isn't giving my baby the very best care.
I am glad to know that the ProZinc is effective.
I opted to watch Tommy after he received Sub Q fluids and was checked out. They said hospitalization was the best option, but he was still eating his food and is gladly drinking unflavored pedialyte now.
I have to get a knack for finding the vein in his ear so that I can test his sugar. Luckily, I get enough test strips for 4 tests a day, but I only do 3 unless it's an emergency.

I believe he went into DKA because he was given a steroid shot for a gum infection. If i look at steroids wrong my blood sugar runs 500.

You know how they say that cats take on their owner's traits?
I don't think they mean health traits, but when he had a panic attack in the Vet's office I was like... That is certainly my cat.

Then he promptly peed on the floor... He didn't get that from me.
 
There are many cats who are steroid-induced diabetics and may not be truly a diabetic.

You may want to test more often than 3 times a day; it's good to be doing a curve once a week to see how the insulin and the dose are working. Also, you can easily give fluids at home and save the expense of going to the vet.
You do want to have the cat stay at the vet office until the DKA issue is fully cleared.

Gayle
 
He has been losing weight and got the gum infection twice already in a few months. We thought he was somehow not eating enough because of the gum infection though it looked like he was.
He already has dropped hocks and was unwell and sluggish before the steroids. We were just attributing it to his infections until the vet saw the dropped hocks.
They are going to do the curve to start with. I guess it's kind of like an HBa1c test for cats.
Either way I know he will be o.k. if we take good care of him.
 
You have already gotten good advice. Agree with everyone - ProZinc is a good insulin. (Lantus also works well but since it is a human insulin, it may be that your vet is unaware it can be used for cats. That puts him a little behind the times, but ProZinc is marketed for cats only so it may be what he knows).

Glad you already are ready to home test. Two things that might help. Warm the ear. You can fill a small sock and heat it in the microwave or fill a pill bottle with very warm water. Also, the 30-31 gauge lancets for humans are often too small for cats at first. You might try some 25-27 gauge ones.

It sounds like you are well versed in diabetes. Although ProZinc(PZI) has been around a long time, there are few vet studies and no established protocol. We are developing one:

There is no established protocol for ProZinc. Dose is determined by looking at the history of the kitty – his doses and how he has responded including preshot numbers and midcycle numbers.

Starting Doses
The recommended starting dose for ProZinc or BCPPZI is .5 units or one unit twice daily. It is suggested that if the initial numbers are high, doses can be changed every three cycles, increasing by .5 at a time. If the initial numbers are in the 200-300 range at preshot and midcycle (nadir) numbers are not too low (not 50 and under), increases can be made .25 units at a time. During this early period, especially if wet low carb food is replacing higher carb dry, monitoring is very important. Insulin plus a diet change can result in sudden low numbers or in a gradual lowering of numbers overall, depending on the cat.

Over time, as data is collected and nadir numbers are available, doses can be adjusted more confidently.
If the cat is in the 250+ range at preshot and does not drop 50% or more for nadir, a small adjustment could be considered, if monitoring is possible.
If the cat is in the 250+ range at preshot and drops below 50% at nadir, bouncing is a possibility (bouncing occurs when the cat’s body perceives a drop that is below what has been occurring and releases extra glucose, resulting in an “artificial” rise in numbers) Bouncing most often involves a lower midcycle number than the cat has experienced previously. If bouncing is suspected, any increases in doses should be tiny and monitored carefully.
If the cat is high and flat during the entire cycle, the dose could be raised .5 units, as long as monitoring is possible.

ProZinc and PZI are unique in that they can be dosed in two ways, depending on how the car responds. Some cats seem to do best if a specific dose is held for several cycles. It seems to take that long for their numbers to really change. Some cats respond to a sliding scale, getting a different dose for different preshot numbers. Collecting data will help you see which regiment works best for your cat. If you need help with a sliding scale, ask people on the PZI forum to guide you.

Low Preshot Numbers
The general recommendation for new diabetics is not to shoot a preshot under 200, but to wait 20 minutes (without feeding as food raises blood glucose levels) and retest. If the number is rising and above 200, then a shot can be given with perhaps a little less insulin given.

If midcycle (nadir) numbers are in the 40-50 range, the cat should be carefully monitored for the next couple of hours with tests given every 30 minutes as long as the cat stays low. First small amounts of low carb food can be given to raise the blood glucose levels. If that doesn’t raise the levels, higher carb food should be given. If the levels are dropping and below 40, then honey can be put directly on the cat’s gums. If the numbers still aren’t rising, a trip to an emergency vet is probably necessary.

If one preshot is above 200 and shootable, and one preshot is too low to shoot, it probably means the dose is a little too high and lasting more than the usual 12 hours. Try reducing by at least .25 to see if you get two shootable preshot numbers (ideal) rather than one that is too high and one that is too low to shoot (not ideal)

If you are using U40 syringes and find yourself trying to eyeball doses under .5, you may want to consider using U100 needles and the conversion chart. (Conversion chart) This will allow you to give mini doses.

It is important to test for ketones regularly, at least once weekly even if the cat is eating well and has no infection present. Test daily if any infection is present, the cat is not eating well and/or is in higher ranges. Testing for ketones can catch DKA early. Cats with DKA should be seen immediately by a vet.

Data Collection
Until the bean gets data on their cat’s responses to the insulin, advice on dose changes can be gotten on the forum or from the vet. Using a spreadsheet to record data is the best way to share this data with forum members and the vet.

 
When I first mentioned Lantus to my vet, she looked confused. Then she said "oh, you mean Glargine?". What we call Lantus and Levemir (both are brand names), she may know as glargine and detemir.

Prozinc can also work well, but if you already have Lantus and syringes for it... Unfortunately, your vet probably won't refund the cost if it is "opened".
 
I am having trouble getting him to be still enough to test his little ear =(. But, I am glad to see him scramble around and be a butthole like normal at least.
He enjoyed Thanksgiving dinner with my mother. I think that perked him up. Right now I am taking him everywhere I go, not that I mind. He is a great car cat.
He is very good about his shot. I am going to get the vet to help me learn to test him. I already have a Reli On blood glucose meter. It's $16.99 for the meter and $9.99 for 50 strips (Compared to some that are over $50 for the same amount!!!)

He is being a little trooper.

Oh, I was going to go ahead and ask. Is it safe to give him meat or a little treat between meals? He is used to eating a little all day and now is on a schedule.
 
Yeah...we all love our Relion Prime meters! The "pet only" meter, the AlphaTrak, has test strips that are about $1 each...no way could most people afford to do 6-8 tests per day (or more) at that price!

I started with the Confirm because it takes the tiniest sample size, but now that China's ears have "learned to bleed", I'm using the Prime to save on strip costs.

The trick to testing is conditioning. Decide where you want to be your special "testing" spot. Several times a day, take Tommy there and just rub his ears (that was China's problem..she hated having her ears touched)...even if only for a split second, give Tommy a treat. Lots of us use freeze dried chicken, or you can boil a piece of chicken, chop it up into small pieces and use that. Here's a list of Low carb treats for you to look at too. As he gets used to the routine, it'll get better. The edge of the ears have few pain receptors so most of them just don't like having their ears played with more than any reaction to pain. If you do try to poke and after 3 tries aren't successful, give it a break and always end the session with a treat...whether you poke or not. China now comes when she's called to get her tests because she knows if she sits still for a few seconds, a yummy piece of chicken will appear :-D

What size lancets are you using? The 26 or 28 gauge are bigger than the 30/31's and are better for new kitties. Once Tommy's ears "learn to bleed", you can go back to the tinier 30/31's. Look for "Alternate Site test" lancets

It's fine for Tommy to snack during the day...actually, several small meals are easier on a healing pancreas than 2 huge ones, but for the 2 hours prior to your Pre-shot tests, take the food up so you know the number you're getting at AMPS and PMPS isn't food enhanced.
 
I had a very rough time getting blood sugar tests done. Listen and follow Chris's instructions above, I did and with time she purring and accepting of it.
I am also a type 1. I was upset that I couldn't use my freestyle strips because that is what I use. But the Relion is great. From what I am reading it sounds like you are on Lantus yourself. It would make more sense to me to start her on the Lantus and share your prescription with her and that will save you money. If I were on Lantus that is what I would do. I wish that were the case but I am on Novolog via insulin pump. Also the curve or what you are calling eqivulent of A1c is probably flucosamine test. Waste of money. It shows where her numbers have been in the past few weeks, well we both know if she is DKA then her numbers in the past few weeks have been HIGH. I wasted money on that same test and also 30 dollars for them to test her sugar a week later. After being skilled, coached, cheered on by this board, I do my own curves, with the help of this wonderful board we figure out the dosage. You and I both know that we make more day to day decisions on our treatment than our doctors, right? We live this disease, our doctors don't. You have all the tools, the medicine and more support than you could ever imagine from this board. You can do this! From one diabetic T1 to another... BIG HUGS
Sending healing vines to kitty. Hospital is where he needs to be until DKA clears.
 
You guys are so helpful!
I will get used to testing him I am sure. I will read up on how to dose the lantus until the prozinc is gone. I hope my vet knows it as Glargine.
I will have to learn to do the curve as above. That's more complicated than anything ever done with MY diabetes!
 
Dosing with ProZinc is very different than the protocol for Lantus. You might want to wait to read about Lantus until you are actually ready to use it.

We used a kitty burrito until Oliver got used to the testing. We wrapped him up in a towel with his head showing. The other thing that it might help to know is that, if he is moving away, you can get the drop on your fingernail and test from there.

When you get some numbers (preshots and midcycle) let us know so we can help you figure out how the insulin is working.
 
Have you seen our testing tips? https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

I usually recommend 3-4 tests a day instead of a curve as it gives more data

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.


Also heres the spreadsheet we use - let me know if you need help setting it up: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
Wendy
 
Thank you so much for taking the time to give me tips.
Little Tommy is looking a lot better today. He actually ran around and enjoyed being around a bunch of people.
He is still sleepy and runs down but he is a world better than before.
I think with my hand problems I am going to have to get him a lancing device. I want him to have his own meter anyway so I am thinking I will get him his own arkray like mine. That way strips will always be plentiful. They are nice and cheap too. In my experience the arkray lancing device is one of the less scary ones. It doesn't click as loudly as others I have. (24 years of diabetes and it still makes me jump if it clicks too loud!) and it's very adjustable.


I looked for lancets at Walgreens today but the biggest gauge for lancets they have is 28. It looks like I can get everything I need at a reasonable price at this American Diabetes Wholesale place. Do any of you know somewhere cheaper?

Thanks so much!
 
ADW has some of the best prices, as well as if you get stuff through the link here on the message board, part of your purchase is donated to help with the board's bills

28 is probably good if that's the best you can find...that's what I used..it's just important not to use those really tiny 33's when you're first starting. It's easier to poke once and get blood than having to poke several times..until their ears learn to bleed..then you can go to the smaller ones

When you have a minute, would you add some information to your signature? It'll help everyone since they won't have to keep asking the same questions over and over.

Just go to the User Control Panel (top left side of the page) and then go to "Profile"...If you want to add information in that part (like your location..and any other you want) that'll let us know where you are anyway.

Then go to "Edit Signature" and in the box, put your name and your cats name, date of diagnosis, what insulin you're using, what meter you're using, any other health problems, plus anything else you feel will be helpful, that would be great!

Then, once you're testing, we have a spreadsheet that you can use..you'd add the link to your spreadsheet to your signature when it's done too..that way we can see what numbers you're getting before we try to advise you on dosage. Here's How to get your spreadsheet and link in your signature

Good luck on this new adventure! We understand the learning curve is steep, so ask any questions you have, and if you read others posts too, you'll see answers to questions you didn't think to ask yet!
 
I use the rebranded Arkarys from Walmart (ReliOn) and they're great, inexpensive meters. The strips are also interchangeable so if you ever run out of strips between shipments, you can always pick up more. The Arkray Glucocard 01 is the same as the ReliOn Confirm/Micro.

For lancing devices, I've used quite a few and my absolute favorite is the Accu-Chek FastClix. I like it so much, I even bought a second one for my upstairs "testing station." :lol: It's super quiet and works like a click-pen. The hole where the lancet comes through is off-center, which does take some getting used to, but it actually makes it easier to always hit the right spot once you get the hang of it because you can do it by touch instead of by sight.
 
I added a bit of information about Tommy to my signature.
I have a reli on prime and had no clue the other reli on was interchangeable with the arkray!!!

Another question. Is Tommy in pain because of the dropped hocks?
 
Eats: We have food for diabetic cats, but are thinking about a meat diet.
Click to expand...

What food are you currently feeding Karen? Most of the diets that are advertised as "diabetic foods" are really too high in carbs (and except for 1 or 2, there are NO dry foods that are low carb)

Pretty much any food you can buy is listed on this Food Chart. You want to keep it under 10% carbs. Fancy Feast Classics and Friskies pate's are both reasonably priced and under 10% carbs.

Some cats only need to change to a low carb diet and they can be controlled without insulin, so switching over to low carb food is the first step in handling this disease
 
The vet gave me this Hill's Prescription diet dry junk.
I didn't think that was right either. It might be good for my overweight cat, but I know how beneficial a low carb diet can be to a diabetic.
I actually bought him a few friskies pates when his gum infection came back. He loves them!
Wet food will probably make him eat more properly at mealtime too.

Oh, yet ANOTHER question. Where is a good place to find U30 Needles?
 
Oh, yet ANOTHER question. Where is a good place to find U30 Needles?
Click to expand...

I have no idea to tell you the absolute truth...I've never seen anyone use U30 syringes! Everyone here I've seen using Pro Zinc uses U40 syringes

I'll try to find someone with experience with Pro Zinc to see if they've ever heard of them
 
If Tommy is walking on his hocks, yes that can be painful. Just ask any human with diabetic neuropathy. It can be greatly improved when you get the BG (blood glucose) numbers regulated and more under control.

Wink had horrible neuropathy when he first came to live with me back in January. It took a couple of months, but with the BG's under control and the help of the methyl B-12, he is nearly back to normal. He used to only be able to walk 3-4 steps and then stop, could not jump, didn't play. He is now a champion jumper, walks up on his tippy toes again albeit with a bit of a splayed waddle and plays like a maniac.

Tommy will get better too. It takes time, but you will see his old playful self as time goes by.

How are the 5 P's today? peeing, pooping, playing, purring, preening and his appetite?

ETA: The vet and shelter had Wink on this horrible high carb Hill's W/d prescription dry (37% carbs). Once I got him off that terrible high carb food, onto the low carb Fancy Feast pates, he went into remission in a couple of months. It would have been sooner if he had not been a dry food addict. It took time, patience and persistence to convince Wink that the canned food was edible and yummy.

Which specific food does your vet have you feeding?
 
There is no such thing as U30 syringes.
U40 syringes are used with U40 insulins such as ProZinc. U40 means 40 units of insulin per ml. U100 is 100 units per ml. However, one can use U100 syringes for a U 40 insulin but yo have to convert to get the right dose.
 
Do you mean 30 gauge lancets? The 28 you got are probably a good choice until the capillaries start fattening up and he starts bleeding consistently.

Your insulin should say U40 on it and the needles should match - U40. Unless you are using compounded BCP PZI. It comes in both U40 and U100 strengths. If you are still wondering, let us know exactly what it says on the insulin and needle packages.
 
You might mean 30 gauge lancets as Sue mentioned above.

If you use a conversion chart, you might also mean 30 gauge syringe needles, which can be 3/10 mL (or cc)
 
So is he just eating the Friskies pates right now? no more dry? If so, his blood glucose may start dropping. Hopefully you can start testing soon.

Wendy
 
karenkarma said:
The vet gave me this Hill's Prescription diet dry junk.
I didn't think that was right either. It might be good for my overweight cat, but I know how beneficial a low carb diet can be to a diabetic.
Click to expand...

Actually, your overweight cat would also do better on a wet, low carb diet. Oftentimes, cats are overweight because they overeat on bad quality food simply because they're trying to get the right nutrients out of it. High carb food is too low in fat and protein for them so they eat more of it, trying to get more fat and protein into their diet. You remove the bulk of junk from their diet and they no longer have to keep trying to compensate for it.

I feed both Mikey (diabetic) and Henry (non-diabetic) the same food. There's nothin special about low carb, wet food except it being good for all cats.
 
My vet made a stink about me using a "human" glucometers, but I ignored her, and continued on with the support of this board. It sounds like your vet may be stuck in the same mindset with the insulin situation.

As for lancets, I have found my cat dose best with 28-30 gauge. Warming his ears with the rice filled sock is crucial to the process for us, and he always gets some freeze dried chicken when we are done. It took time, but now he meets me at his testing chair in time every morning and every evening. If we leave the chair out, he will even jump in it hopefully during the day, looking for a treat. :lol:

It looks like you are well equipped and guided by all these great people, you will do fine!
 
Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- no shot limit for ProZinc, PZI, or other non-depot insulins

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mg/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
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