Need some suggestions

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raysofhope

raysofhope

Member Since 2012
Hi every one,
I have been pretty much on my own with my 15yr. Old cat who was diagnose with diabetes last June. I have had her on canned food. Friskies turkey and giblets. A little fancy feast sometimes when she isn't feeling to good. Halo dried chicken and salmon for treats. She seems To want food about every 3-4 hours!! even at night i have to get up and feed her..she has lost some weight since Ive gotten her on all canned food. she weighs about 11 lbs she used to weigh 14lbs.I've got her on about 1 u of prozinc 2xs day I have to monitor her every day, she changes on me if I give her a drop too much she drops like a rock ,then sometimes she gets up about 400 at the end of a dose usually she averages 270-320 at the end of a dose. Anyway she seems to get bouts of cystitis does anyone have any suggestions as to what may help her with this? I am pretty sure they are idiopathic. As when she calms down by the next morning she is fine. Also any ideas on a vitamin supplement ? I also give her zobiline. Thanks for any suggestions
 
Hi and welcome to the board. What is your first name and your cats name?

I'm Deb and my sugardude is Wink, that tuxie pictured to the right.

You might want to consider a different insulin like Lantus or Levimir or a different dose of the Prozinc you are using. Those numbers you gave us
are a bit too high. It's sounding to me like the Prozinc isn't lasting long enough. You want her in the low 200's at preshot and dropping lower during the middle of the cycle, just not below 50.

When are you testing?

No ideas on the cause of the cystitis. You might want to add extra water to the canned food, a tablespoon or so until the consistency of applesauce. How do you know it's cystitis? Are you taking her to the vet for testing?

No ideas here on the vitamins. I don't use a vitamin supplement for any of my cats. Personally, I don't think it's necessary.
 
if you can fit it into your schedule, another option would be to dose every 8 hours. To do that, take the total daily insulin and divide in thirds.

Might see if there is a bladder infection. If it is idiopathic cystitis (no infection), some cats have benefitted from glucosamine. Something to check with your vet.

A thought - Has she been tested for hyperthyroidism? The body runs on high and may use the insulin and glucose faster.
 
Hi thank you both, Iam Diana and my cat is Angel, anyway our vet isn't the greatest person to ask about this, as my cat would have been dead by now if I followed his directions.. He wanted her on 4 u 2xs a day!! He has a poor diabetic cat at the clinic that gets 8u 2xs a day!!! Yes she does go thought the insulin quickly sometimes it seems, I had taken her to the vet and he told me that he thought it was idiopathic, because it clears up by the next day, I have done some research online and her symtoms are of cystitis . Also I have done a few curves on her and she seems To go lower at 3 hrs and then at 6 hrs. Then she starts to rise again. If I try to keep her below 200 she gets sickly and throws up. She seems to function best in the low 200 range. I check her in the morning and evening. Like for instance if she is 348 in the morning she will usuall be anywhere from 270-318 in the evening. Now if she is 270 in the evening I can't give her a usual dose of 1 u or she will drop way off by 3:00am in the low 100's or so and then get sick and have the runs ect. She will be sickly until her number comes back up..I have had complete blood work done on her a few times as I was afraid of CRF or hyperthyroidism , I've lost 3 cats to that in the past couple of years and her sister died of a hyperthyroid Because she had bad reactions to the methmazole.The vet said Angel is in pretty good health for. Being 15yrs old
And her ketone levels were good. I am thinking maybe the 3 times a day might do the trick for her. Does that mean I have to test her 3 times to?? What are your thoughts? Also I thought prozinc was the best insulin for cats?? Thanks
 
ProZinc is one of several insulins which may work well for a cat - Lantus, Levemir, and PZI are 3 others.

Yes, if you went to TID dosing, every 8 hours, you would still need to test before shots, and during the estimated mid-point, for safety.

It would be really helpful if you would set up a spreadsheet on Google Docs (must create a free account first.) The instructions are here. Then we can see what is going on during the cycle between shots.

AMPS = morning pre-shot
MDPS = mid-day pre-shot, if you're shooting 3 times a day (I have a template I can give you if you decide to do this.
PMPS = evening pre-shot
_1, +2,...+11 = record any tests done at those times since a shot - 1 hour after, 2 after, etc.
U = units of insulin.
 
It would be easier for us to see what is happening if you could give us some numbers. For instance:

9/20
Amps 400. 1 unit
+6 80. (not your real numbers - just an example for a mid cycle number, 6 hours after the shot )
PMPS. 300

Amps is morning preshot number, before food and insulin. Pmps is evening.

If she is dropping low midcycle, your higher preshot numbers could be bounces. If their body senses a low number, it releases extra sugar. That can mean at she is higher than the insulin took her for the next preshot - she has bounced into higher numbers because of her body's reaction to a low number. If that is what is happening, she could be on a roller coaster between highs and lows. In that case, you reduce the dose.

It may be that PZI is not the best insulin for her. But some numbers would help us figure that out better.
 
Hi yes I am aware of the bounces ,that's what I try to avoid, I cannot always get a true reading before food as she eats every 3-4 hours!!!sometimes she eats 2hrs before her tests so I have to take into consideration for this. If I don't give her any food say at 3 hrs, she will get sick on me. Like throw up or look lethargic. I am not giving her hardly any insulin as it is and it's very hard to figure on tiny doses less than 1 u
Anyway here are a few numbers now remember she is getting canned food about every 3-4 hours.

Am.-318 give .90u. Pm 271
That evening give .90 by morn. -358

Am 368 give1.0 u pm reading 343 give1.0 by morn read 218 feeling sick wont eat.

Am 431 give1.1 u pm read 339 give.90 by morning359

Am 382 give 1.1u pm read 270 give.90 by morn 368

She is all over ,no consistency, I am going to try 1 u morn and 1 u evening see how that goes

I used to have her pretty well regulated but then she started bouncing and my vet told me to increase her dosage? That was a mistake!! I figured out that she did better if I reduced it. The main problem is with only 1 u there isn't much wiggle room. The reason I was giving her less at night is because she was getting very low and bounceing up higher in the am.
 
How low is she going? Midcycle numbers will let you see if she is dropping low. About 5-7 hours after the shot may be the lowest point of the cycle. I usually suggest that you reduce the dose with a bounce.

Lots of PZI users give less than .5 units using U100 needles and a conversion chart (because PZI is a U40 insulin). Then you can dose .2/.4 easier. You can also mark a sample syringe eyeballing .5 - tape or a marker. Use it as a guide when you want to dose .5 so it is more consistent.
 
You want to try to get her below renal threshold which is 180-280 depending on what source you check. When the BG's are above renal threshold, that dumps the excess glucose into the kidneys and urinary system, creating a sugar rich environment for bacteria to grow. Wink had frequent (monthly) UTI's when his BG's were over the renal threshold. Once we got those numbers consistently under 200, he has not had a UTI since.

Here are some BG reference numbers.

Reference ranges for decision making
BJM said:
Conceptually, it is somewhat like reading a thermometer in Celsius vs Fahrenheit. Freezing, for example, is 0 degrees Celsius and 32 degrees Fahrenheit.

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}
- 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.
Click to expand...
Click to expand...

PZI and Prozinc are both in and out insulins, so it's easy to change the dose amount based on the pre-shot BG reading.

Remember, glucometers are allowed to vary by +/-20% so some of those readings are basically the same number. Like the 382 and the 368 are within 4% of each other, so we consider those numbers equivalent.

You might want to try to get some mid-cycle numbers, to see how low the dose is dropping your cat.
 
I am going to get some 7-8 hr readings .she was 302 last night , and didn't feel well ,so she didn't eat much, I gave her .90 u of insulin a little less than 1 u and this morning she was 402 "!!! I gave her approximate 1.2 u this morning and am going to check at 4:30pm. Will let you know what that is..
Thanks
 
Hi ,I've been meaning to ask also any suggestions on the testing site? I've been doing her ears I move to a different ear and spot each time ,is this ok? For instance outside left right ear, then outside left ear ,then inside right etc. or should I use the same ear all the time?? Just wondering my vet didn't even know about this method..
 
I always use the same ear as the ears learn to bleed over time and its easier to get blood from them. I also tend to use the same spot (outside) but if it starts to bruise or look sore I may move it a little.

Wendy
 
Any method that allows you to get the blood you need is fine. If switching up works best for you, go for it, if staying on one ear/spot works, that's fine too.
 
Duh! I was thinking that,. thanks for letting me know,
any way checked Angel at 4:30 she was 250 ,I know this is high, but she did eat canned food at 2:30 she was starving . And today's reading really can't count as she is,rarely 400 which she was this morning, she may have snuck a few pieces of dried food. I have other cats that eat dry. Usually I keep the bowl coverecd but this morning it was open, my husband forgot to check it, so I quess today is a total bust.. I'll try again tomorrow, maybe she will be more in her normal range.
 
Just wanted to let you know ,I just checked her at 8:30 pm and she was 290!! That's about right for her . So now what do we have? This is why I get confused with her readings..thanks for all the help. Diana confused_cat
 
Hi I will look into the spreadsheet thing. But really I am so pressed for time it's not funny..
This morning she was 439!!! That is high even for her. I think she is bouncing on me again last night I gave her .90 of a u my instincts told me to give. Her .75 but I thought MAYBE she would be in the 200's again by morning.. No such luck.

I keep a journal and write down the time date her numbers and how much ins. I give her..
Some days I haven't checked her 2xs I am trying to give her ears a rest..
 
It is a valuable tool. For example, this am we need to look back through your post to see where she has been. With the spreadsheet, it is all there in one place.

Without a few midcycle numbers, it's hard to see a pattern and see whether she is bouncing. Any time you can get some midcycle numbers, it's real valuable info and helps fill out the whole picture.
 
Hi again,

dont want to sound dumb.. But I am a bit confused by the template. what do all the plus marks mean?
 
Also I checked her at 3:00pm and she was 330, so my theory of her being lower at 6hrs. went out the window too.. This is a bit frustrating at this point. She is not following her usual patterns at all! I will test her at 5:00 too..
 
Its a good question

AMPS = a.m. Pre Shot which is the reading you get just before you give your a.m. shot
U= dose you gave
+ 1, +2 +3 etc is the tests taken at 1 , 2 ,3 hours after the shot
PMPS = p.m. Pre shot

So I think you got 330 at +6? ie 6 hours after the shot?

Wendy
 
Ok checked -Angel at 8:30pmshe was down to 221! I thinks she is rebounding after looking at her numbers fro the past few weeks ,I am going to cut her back in the dosage tonight I gave her only .50 u so we will see what happens tomorrow. Also she did t want to,eat I gave her a little baby food w syringe then about 15mins later she ate about 10 pieces of dried chicken meat. Then I gave her the shot.
 
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