? Lloyd's BS still high on Prozinc

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pinmel

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Lloyd is a 10 year old male feline recently (2 months ago) diagnosed with diabetes. He lost almost 8 lbs (down from 20 lbs) before we could figure out what he had. We put him on Prozinc, starting him very slowly at 1 u 2 x daily (every 12 hours) and then quickly raised him b/c his BSs were staying around 6-700. he is now on 7 units 2 x daily and his BS is around 3-400, still high. BS +6 is fluctuating from 188-287 at times. I feed him a combination of wet food (Fancy Feast) and dry food (Royal Canin glycobalance). He's always very hungry but has gained at least 5 lbs back so we know hes metabolizing the insulin. A couple of questions: the vet has asked me to take Lloyd's BS every 1-2 hours for the next 12 hrs which is going to make my cat freak.....he already hates the BS being done 2 x a day. He wants to know where Lloyd's BS is at the different postprandial times--which I get but is there another way to understand how he's metabolizing the insulin w/o sticking him so many times? Also, his stools are very soft, is there anything I can feed him that won't interfere with his BS but can bind him a bit more? Lastly, is it possible he is insulin-resistant?

Thanks for all your help,
Lisa/pinmel
 
pinmel said:
Lloyd is a 10 year old male feline recently (2 months ago) diagnosed with diabetes. He lost almost 8 lbs (down from 20 lbs) before we could figure out what he had. We put him on Prozinc, starting him very slowly at 1 u 2 x daily (every 12 hours) and then quickly raised him b/c his BSs were staying around 6-700. he is now on 7 units 2 x daily and his BS is around 3-400, still high. BS +6 is fluctuating from 188-287 at times. I feed him a combination of wet food (Fancy Feast) and dry food (Royal Canin glycobalance). He's always very hungry but has gained at least 5 lbs back so we know hes metabolizing the insulin. A couple of questions: the vet has asked me to take Lloyd's BS every 1-2 hours for the next 12 hrs which is going to make my cat freak.....he already hates the BS being done 2 x a day. He wants to know where Lloyd's BS is at the different postprandial times--which I get but is there another way to understand how he's metabolizing the insulin w/o sticking him so many times? Also, his stools are very soft, is there anything I can feed him that won't interfere with his BS but can bind him a bit more? Lastly, is it possible he is insulin-resistant?

Thanks for all your help,
Lisa/pinmel
Click to expand...

Hi Lisa, it sounds like you and Pinmel have had quite a journey. One thing I would consider Is getting rid of the dry food. I don't see your specific flavor of Royal Canin on our food chart, but the majority of their brand is in the 20/40% carbs range. The food chart is here:

http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

Royal Canin is toward the very bottom under Vet prescribed foods. I'm not sure about your wet food but you might see where it falls on the charts. We try to stay under 8% carbs. When we switched from our dry food (40% carbs ) to wet, Oliver dropped 100 points overnight.

If you decide to switch to all wet, be sure it is a cycle you can monitor in case Pinmel's levels drop.

As far as loose stools, many people start wet with one flavor, see how that goes and then offer another. FortiFlora also helps some kitties; it's a probiotic.

Are you giving Pinmel a favorite treat each time you do a test? That is usually the secret to this thing, so he is wanting the treat more than worrying about the poke. Some people use PureBites; Oliver loved Bonito Flakes. Both are low carb. Maybe if you describe your poking routine, we'd have some ideas.

Your vet is asking for a curve, every 2 hours. If this seems impossible, you might split it into 2 days - getting a +2/6 one day and the 3/5 the next? Then you have lots of info, just poking a little less frequently.

Your vet seems to be very Fd friendly - good insulin, encouraging home testing. I would just argue with the food choices.

He could have a high dose condition, but I would definitely ditch the dry first. If the insulin is dropping him from 400 to 188, it is working. BTW, that probably feels really crummy, dropping that far. At least human diabetics say it does. So that may be why he isn't feeling so perky.

If you use the Search function for diarrhea, you can find lots of threads with ideas from Miralax to Pumpkin.

The protocol we put together for ProZinc is in my signature in blue. Also you can gleam lots of good info looking through the threads here. You're not alone!
 
Until his glucose is better regulated, he's going to feel hungry; that's just how it is when treatment is first started. You haven't said what Lloyd's breed is, but unless he's something like a Maine Coon, 20 pounds is way overweight! (I say this only because my Bat-Bat had gone up to 20 lbs. after a urinary tract infection. Had been given high carb canned & dry Science Diet by the vet's office while treating it - and I've no doubt that this was one of the primary factors in her developing diabetes back in 2013. And I didn't know back in those days that feeding dry food was making things worse for her. She is same age as as Lloyd, btw.)

It is not uncommon for your cat to lose weight rapidly when the diabetes really kicks in, as the imbalance of glucose to insulin causes them to start burning up muscle and fat. That said, unless your cat is a giant breed (as mentioned above), you probably want to aim for a weight of about 11-12 lbs. anyway. So you'll need to start thinking in terms of Lloyd being a more slender kitty.

And a cat who really, really loves his chow & has been overweight for quite a while is naturally going to feel really hungry until he gets used to being on a closely-controlled diet.

Need you to answer some questions before we can get a better picture of the way things are (and soft stools are not uncommon with dietary changes):

1) Which Fancy Feast formula(s) are you feeding? (As they can vary greatly in carb content.)
2) How much food is Lloyd getting per day, and in how many feedings per day? (We do not recommend feeding ANY dry kibble foods; these are simply too high in carbs for "sugar cats.")
3) Is yours a single cat household, or do you have others? (As this can make things complicated as relates to maintaining his diet.)
4) Can you provide the blood glucose #s (with time of testing) that you've gotten so far?

Amounts/ type of food and when you're feeding can all significantly impact the BG numbers you're getting when you test. And yes, you really do need to test more than twice daily right now. There's really not any better way for you to have enough data to know what kinds of dosage adjustments you'll need to make during treatment. Perhaps do your BG curve this way: testing every 2 hours over that 12-hour period, starting with the morning test (right before feeding and dosing), then at 2 hours after the dose (+2), then four hrs (+4), and every 2 hrs. up to next pre-shot test time. Alternating the ear you stick each test will make it a bit easier for Lloyd. They really don't have that many nerve endings at the edges of their ears, btw - it's just that it takes a while for them to get used to you doing it.

I know this probably feels pretty overwhelming to you right now, but it WILL get better! Looking forward to the additional info from you.
Cheers - Robin
 
Welcome Lisa and Lloyd. You have come to the right place. This message board is awesome. If you have time, take a look at the Health Forum too. There you will find a bunch of different subjects and conversations. You (I) learn so much. Robin and Sue has some great questions. I would like to add a few more.
1) Could you provide your process of testing and shots? Where do you test and shoot?
2) When do you feed? What time?
3) What time do you give shots?
4) What meter are you using?

Keep track of all of your testing; dates, time, numbers, etc. because soon you will want to enter all that information into a spreadsheet. Collecting data is key to living and overcoming diabetes and we don't want you losing all that valuable information.

Your vet does sound pretty informed. Most are not, just due to all the other things they need to know. It is refreshing to hear a vet requesting a home test curve. Most vets will ask you to come in to the vet's office so they can perform a "fructosamine" test which is basically a curve that you can do at home. You are saving money! When the cat is taken to the vet, their blood glucose (BG) number is typically high due to stress. So performing curves at home provides you with the best information and more accurate numbers.
 
Hi Lisa - how is Lloyd or is it Pinmel doing? Just wandering if you would be interested in setting up a spreadsheet for him?
 
Sue and Oliver (GA) said:
Hi Lisa, it sounds like you and Pinmel have had quite a journey. One thing I would consider Is getting rid of the dry food. I don't see your specific flavor of Royal Canin on our food chart, but the majority of their brand is in the 20/40% carbs range. The food chart is here:

http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

Royal Canin is toward the very bottom under Vet prescribed foods. I'm not sure about your wet food but you might see where it falls on the charts. We try to stay under 8% carbs. When we switched from our dry food (40% carbs ) to wet, Oliver dropped 100 points overnight.

If you decide to switch to all wet, be sure it is a cycle you can monitor in case Pinmel's levels drop.

As far as loose stools, many people start wet with one flavor, see how that goes and then offer another. FortiFlora also helps some kitties; it's a probiotic.

Are you giving Pinmel a favorite treat each time you do a test? That is usually the secret to this thing, so he is wanting the treat more than worrying about the poke. Some people use PureBites; Oliver loved Bonito Flakes. Both are low carb. Maybe if you describe your poking routine, we'd have some ideas.

Your vet is asking for a curve, every 2 hours. If this seems impossible, you might split it into 2 days - getting a +2/6 one day and the 3/5 the next? Then you have lots of info, just poking a little less frequently.

Your vet seems to be very Fd friendly - good insulin, encouraging home testing. I would just argue with the food choices.

He could have a high dose condition, but I would definitely ditch the dry first. If the insulin is dropping him from 400 to 188, it is working. BTW, that probably feels really crummy, dropping that far. At least human diabetics say it does. So that may be why he isn't feeling so perky.

If you use the Search function for diarrhea, you can find lots of threads with ideas from Miralax to Pumpkin.

The protocol we put together for ProZinc is in my signature in blue. Also you can gleam lots of good info looking through the threads here. You're not alone!
Click to expand...
 
Hi there friends--

Thank you everyone for all the great/helpful recommendations. I put some of them into motion already and Lloyd is clearly doing better...I'm implementing a couple of things at a time versus trying too many changes and I believe his BS is already improving.......:) I've put him on one protein, eg chicken pieces from Fancy Feast. I also am giving him protein (chicken) treats when i stick him. This is working great. I've also pared down the dry food. His BS this morning was 285....but was coming down with every stick over the weekend so that tells me he's responding to the changes. He never was a "fat" cat even at 20 lbs...he is a big sinewy cat (has the body of a tiger really) and always very healthy. I don't know his breed as I got him and my other cat from an ASPCA (they were crate-mates, not litter mates). Also, he had an issue with crystals in his urine that caused a urethral blockage about 1 1/12 years ago and I have to agree that this could have contributed to pre-disposing him to diabetes condition. He had to be put on a urinary diet.

BTW, I have a journal which I log all the BS values, times, food and meds into so I track everything very closely

Very best to all of you for success with your felines!

Lisa and Lloyd
 
Lisa - That sounds like great news so. I am so happy that Lloyd is improving. It is great that you are logging all your information. If you are ever in trouble and need some eyes to take a look at his numbers, it would be so helpful if you could journal your numbers on a SS here. It really doesn't take too long to get it set up and it makes it so easy to pick out patterns, changes, etc. There are folks here that can help you set one up. You can check out Merlin's spreadsheet and all the others here. It is attached to our signatures.

Also, great to hear that you are getting rid of the dry food. That will help out soooo much.
 
All good news Lisa! It would be helpful to set up the spreadsheet. We're all used to looking at it, so if you needed help fast, we could glance at the SS and get an idea of what to tell you.

Glad to hear that things are going so well!
 
Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
 
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