New here. Diabetic since May 2015 Need Advice

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Damsel said:
The weight loss has me very upset. He's been great up until lately
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I am glad you brought the weight subject up again as I meant to say to please check for ketones as Bubba started losing weight when he was throwing ketones and he was only in the 200 range when that happened.

What in a good weight for Morgan? And I am not sure why he gained weight while on Lantus unless you were feeding more? How much are you feeding? There is a formula for calories which is the ideal weight times 13.5 add 70. Using a 10 lb cat as an example: 10 X 13.5 = 135 + 70= 205 calories a day. then just divide up the amount of calories into the amount of feedings you are doing a day. ( I give Bubba 6 little meals a day but, I am home all the time and can do that and I have an autofeeder to use if I go out)

Use Morgan's idea weight into the formula so if you would like to see him back at 15 lbs use that number.

Yes, the R insulin in adunct to the Lantus helped us tremendously. It broke through the resistance and got rid of the ketones and gave the Lantus something to grab onto and started to get him into better numbers. This all happened in December of 2015 . But, again, careful guidance when using the R insulin in adjunct to the ProZinc under your vets guidance.

Yes,stay positive, get more test at night, and let's review the amount of calories he is getting and rule out ketones and go from there . :cat:
 
Thank you for the information. Very encouraging that the dual insulins got Bubba into better numbers.
Morgan was good around 15 pounds. I have two cats, so it's difficult to tell how much food he's eating.

My day is crazy, so I'll respond better later to your questions. Just wanted to quick go on line to check some other cat foods to try at the pet store. Still hoping to find some canned food Morgan will really like.
 
It's been a little while since I posted. A lot is going on with work and computer problems, not much extra "living" time right now. Also, must admit, I feel like I'm cheating on my Vet too by coming here for advice.
The update is that we were raising Morgan's units because of his high numbers. We got up to 5 units. Obtained a new bottle of Prozinc on 11/8 and gave Morgan his shot that evening. He was at 409 in AM, 411 PM.
11/9/2016 I tested before his AM shot ---34! I tested again thinking it was wrong --38. Contacted the Vet; tested almost every hour. I updated his chart - he stayed low almost all day. I had a meeting in the evening, so last test was at 4:40 pm - 89- no shots on 11/9/2016.
11/10/2016; 452; 330; 342. I wanted to lower his units to 2, but my Vet said 3 so he got 3 units in the AM & PM
11/11/2016 - This morning -- 66. Contacted the Vet. He said to keep checking and when he gets to 100 give him 3 units.
Either something is going on with Morgan, or this bottle is more potent for some reason. My Vet said a new bottle wouldn't do this, but????
Anyway; I have a very busy day today. I wanted to quickly get this on the board; I'll check him again in the next few minutes. I'm praying he doesn't go over 100 because I cannot give him 3 units.
He is eating and drinking like his usual crazy diabetic self when his numbers are high. His fur actually looks better than it has in weeks. It was beginning to look more oily than usual. He was perfectly normal on Nov. 10 also when his numbers were so low; eating and drinking like a mad mad. If anything, I'm feeling light headed.....
 
I would definitely not to give 3 units if he gets to 100. I would suggest not shooting under 180 and then I think reducing to 2 is a much better plan - if you can be there to get a nadir. If not, I might be tempted to dose lower.

Several hypo episodes may have lowered his numbers more than usual. Or it may be the new vial. Or he may have reached his threshold and be requiring less insulin. Or he may be overdosed Any of those is possible. But the response is all cases is to proceed carefully and monitor and lower the dose.

I know it is hard to go against your vet's advice, but your vet is not there to monitor him during the day. And I always think your gut is a good guide. Vets do find it hard to argue with " I was scared to give him more insulin".
 
Thank you Sue. I just tested again and he's at 63. Don't believe its a good approach to chase very low numbers; it concerns me for his health. I'm trying so hard to get him regulated so he can live and be healthy!!
Morgan's ears are starting to look a little sore at some of the test sites. I was hoping to give it a rest and just do pre shot numbers for a couple of days, but I know I can't now. I'll test a little later and update the sheet.

My Vet is very nice and has understood my fears. He believes the high bouncing indicates too low a dose so he wants to stay steady with 3 units for a week to let it even out. My non medical educated or experienced gut definately feels differently.
Thank you again for your advise.
 
Damsel said:
He believes the high bouncing indicates too low a dose so he wants to stay steady with 3 units for a week to let it even out.
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This makes no sense to me. I know bouncing is a difficult and maybe disputed concept, but his explanation seems exactly backwards. If the dose is low, the numbers can be high and then the dose may need to be increased. But if the dose is too high, then the numbers drop low at the lowest point and bounce back up (because the body senses a lower number than it is used to and releases extra glucose) The difference can be seen in the cycle. A low nadir can cause a bounce; a higher, flat cycle can be too little insulin. Clearly Morgan is having lows and then bounces from those. But regardless, if a kitty drops into the 30s and 40s, the clear indication is that the dose is too high and sending him into dangerously low levels. MHO.
 
Sue has given you excellent information on how too high a dose can cause low numbers and then a bounce into high numbers. Just to throw something else in here..you said you changed vials of insulin on Novemebr 8. That was right when the numbers started dropping very low. It is quite likely that the old vial had lost its effectiveness and was not giving the full effect. If this is the case then shooting the same dose on the new vial could very well out your kitty into a serious hypo. This is one of the first things the vet should have considered and the dose should have been lowered substantially. If the old insulin was losing its effectiveness you could have been only getting a small % of what the dose should have been.


ETA Until it is known whether the new insulin is more potent the dose should be very conservative and then raised back up as necessary.
 
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I truly understand that you feel like you're cheating on your vet, especially if you like him/her. I felt the same way. I can tell you that my vet, who's excellent and is very willing to work in partnership with her clients, had no clue about bouncing happening merely because of a kitty body's "perceived" low BG or rapid drop in BG. She mentioned the Somogyi effect but thought that all overly elevated numbers came about because of a very low BG at some moment during a cycle. She was very much on board with doing a BG curve at home and stressed the importance of canned low carb food but never once mentioned testing before injecting.

I've since had a long discussion with her about how I do things now, emailed her the spreadsheet and have her endorsement to keep doing what I'm doing. She's willing to order in ProZinc for me without seeing Teasel in the clinic and is there as a resource if I need her advice. Would your vet be open to a discussion about how you feel? It might set your mind at rest.
 
Tuxedo Mom said:
Sue has given you excellent information on how too high a dose can cause low numbers and then a bounce into high numbers. Just to throw something else in here..you said you changed vials of insulin on Novemebr 8. That was tight when the numbers started dropping very low. It is quite likely that the old vial had lost its effectiveness and was not giving the full effect. If this is the case then shooting the same dose on the new vial could very well out your kitty into a serious hypo. This is one of the first things the vet should have considered and the dose should have been lowered substantially. If the old insulin was losing its effectiveness you could have been only getting a small % of what the dose should have been.


ETA Until it is known whether the new insulin is more potent the dose should be very conservative and then raised back up as necessary.
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I agree. I approach a new vial with caution and only start it when I can monitor.
 
I agree with Kris. Have you tried just having a chat with your vet about this board? Some vets are actually really open to this board and to you controlling things more at home. My vet mentioned home testing to me in passing...never encouraged it really. But when I came back and showed my chart and said I was home testing, she was all for it. Told me the only reason she doesn't press it is because most owners are so scared of the shots and so overwhelmed that she doesn't want to add more. :)
 
Thank you all for your input! Very busy day today, just got a break from work now to check him again. He is at 140 so, being almost 2:30, I feel justified in telling my Vet that #1 I missed when he hit "100" and #2 At 2:30 (he gets his shots at 7:00) I think it's too late in the day so I waited until the evening. Of course I'll test, but I don't care if he goes to 500, I'm not giving him 3 units.
My Vet is very nice. These last few days we have corresponded via e-mail only, which means he is really, really busy. He is very good about calling me to check in; I'm hoping he'll call me so we can converse and get a feel for how set he is on my following his advice. Bad thing is he has been taking off on Fridays. Most likely he was not at the office when he responsed to my SOS e-mail this morning.
We just started Prozinc on August 29th so that bottle was only 2 months; 9 days old! I always wonder about a new bottle and its potency.
From my Vet's one comment on his e-mail when I said it seemed like the new bottle made a difference, he responded "the new bottle should not make a difference".
I'm starting to think I should go back to 1 unit again depending on if he even goes up anymore tonight.
I'll post my PM Preshot number later.
Thanks again!!!!!!
 
It is shot time and Morgan is at 193. My Vet did not contact me to see how things are going which makes me believe he is out of the office today.
As you know, he wanted me to give 3 units once Morgan reached 100. Now he is at 193; should I skip tonight? Just give 1 unit or 1/2 unit? I'm not really sure what to do.

Hi Rachel; I have not discussed this board with my Vet. He is actually "new" for me; but was highly recommended and a very popular Vet in our area. The Vet I had before pointed me to Binky's list and all the information that came with that. This Vet is very nice and down to earth, but somehow I'm not quite comfortable yet telling him I'm seeking advice elsewhere! I've gotta work on that....
 
He is close to 200 which is usually our no shoot number, although with a pet meter, we usually look a little higher. Can you monitor tonight - maybe +2 to see if he is headed down and then around 5-7 hours after the shot to see how low he might be going. Do you have some gravy food in case he'd drop low?

I think I might try 0.5 but plan to monitor. It is hard to decide how much to cut - much easier to increase based on your data. If it makes you uncomfortable to give any, skip and plan to figure out a dose in the am.
 
I can check at +2, and then around +4 tonight, but I have to get up early so off to bed after +4. I think I feel comfortable with .5 units tonight and then see where he is tomorrow. Most likely he will be high tomorrow and then I'm thinking 1 unit to see where that puts him for the day after?

Thanks again!
 
If he is above 200 - especially nearer 300- one unit sounds good. If he is closer to 200, maybe stick with 0.5, since it will have worked well?
 
Agreed; I feel comfortable with that. There is a caveat; however, at the last minute I drew .25 units. Couldn't shake the question "how potent IS this new bottle"? So, maybe that was worthless, but it was a compromise between .5 and skipping his pm dose. Guess we'll see! I'll post his numbers after I do them, but I won't post on anything here unless I have a concern. Thanks again.
 
Absolutely! So; you may not be up anymore tonight, but I just tested at +4 and he is at 328. Now I'm regretting the .25 ; that it will just sky rocket until tomorrow....
 
Damsel said:
Absolutely! So; you may not be up anymore tonight, but I just tested at +4 and he is at 328. Now I'm regretting the .25 ; that it will just sky rocket until tomorrow....
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Just another data point for your SS. You can get back on track. :)
 
So, if he is high today, I would still consider being somewhat conservative. Maybe one/1.5? My thinking is that you can move back up, if needed, based on the levels you get. But guessing how much less to give on a lower number is so much more tricky.
 
Just updated the spreadsheet so you can see how we transitioned. Yesterday started with 2 units because he was staying high. This morning preshot was 336; just now, his preshot is 130. I hate to lose the momentum with getting some low numbers. Maybe I'll check again before I go to bed and if he goes over 180, then give 1 or 1.5?
 
You could try this but will it mess up your overall schedule? If you have the freedom to chase the number and dose when he is high enough, that'd be good.
 
I have no life lately! :D I'll check again around 10:30. If he's still not up to 180, then no shot tonight and I'll stick with 2 units for tomorrow (assuming it will be high).
Thank you!
 
Last night I checked at 11:00 pm which is +4; he was 249 so I gave 1.5 units. This morning, AM Test was 63; apparently I guessed too high.
I see what you're saying about chasing the numbers and I really don't want to change his schedule or incorrectly guess a dose. It appears from looking at other spreadsheets, staying with the schedule means if his pre-shot is too low; then just no shot and leave it be (other than monitoring). Something is definately happening since starting the new bottle!
 
So is this morning's number 12 hours from last night's shot? If not, your real amps will be 12 hours from that shot. If it is, then yes, a clear signal to reduce the dose.

Just keep muttering "gathering data, gathering data". The good news is that the data has good numbers.
 
You are correct; that was not an actual 12 hour snapshot since the previous night he got his shot at 11:00 pm instead of 7:00. So yesterday was No AM Shot; 63; 183 (at +2) 432 - Gave 2 units at PM shot.
This morning, amps 243; gave 2 units. Quite surprised with the 243. This morning I started new bottle of test strips for Alpha Track - the code was 92, which I have not had a 92 bottle before, but I made sure I adjusted the code on the meter to 92. (Just talking out loud. Anytime something is new, it makes me a little paranoid that I may do something wrong).

Yes; I will mutter "gathering data"; common theme here; thank you for the good advice!!!!
 
Today: 243 amps - gave 2 units. +6; 105. Had to go out of town at 3:00 which meant I would miss his 7:00 shot (never did that intentionally before). Tested him as soon as I got home which is +4. His pmps is 117! These numbers are very surprising but I'm confused as to why he is drinking like crazy. I thought if his numbers would be lower than his symptoms would ease up?
 
Just updated my spreadsheet. His bounces are now going in the 500's!! Should I stay at 2 units? I was thinking with some of the lows he's had this month, that perhaps 1.5 units would be better but these bounces are higher than ever!
I pulled my back giving him his shot this wonderful holiday season, so I haven't been able to get additional tests; it's a challenge just doing the standard right now...
 
It looks to me like several things are muddying the waters. It looks like the .5 on197 was too little a dose. Then the skipped shot for the 118 created some higher numbers - likely both a bounce from that low and just going 24 hours between shots. If possible, next time, stall when you get a preshot too low to shoot. Wait 20 minutes without feeding - both to be sure the number is rising and nearer your target 200.

If he were mine, I think I might drop to 1.5 and hold the dose several cycles (unless he is too low to shoot) to see if he settles down and has fewer highs and lows. If you can, post more often with your numbers and get advice.

Ouch - back issues are the worst!
 
I second-guessed that .5 dose at 197. My thought was that he was close to the "no shot" number and I didn't want to skip it all together.
I like that plan to go to 1.5 for a few cycles.
The back, yes. Trying to work today, but not very comfortable... I'll post more often; definately need the help! Thank you!
 
My Vet happened to call after I posted the above post. He wants me to stick with 2 units and when I am tempted to skip a dose when he is under 100, I should give 1 unit. :nailbiting:
Today, Morgan was at 377; 435 (got an extra one in) and 458. Unfortunately, he is not feeling well. Not sure what is going on. He had runny poop this afternoon and has tried to throw up a few times, with only a little liquid coming out.
We are 1 hour after our shot time. I did not give him his shot because he has not eaten.
He's sleeping right now; I'm hoping he'll feel better and then maybe eat a little, but only time will tell.
Now what shall I do?
 
It "sounds" like you are unsure about that advice. I think your instincts are good. 100is a normal number and giving one unit would certainly make me nervous. He would only have 50 points to drop before he was in hypo territory.

I would see if he will eat - maybe make the food smell "good" by heating it up in the microwave, offering some off your finger, add a little of his favorite snack crushed on top. Also baby food without any spices can sometimes help their appetite. Did you change flavors recently? Maybe they didn't agree with him? Any other issues - different med?
 
Have you changed food recently? Is he getting Fancy Feast Turkey and Giblets? Some people are finding doesn't it agree with their kitties after an apparent reformulation. His recent numbers suggest bouncing is going on. Maybe give him a smaller dose if he decides to eat a little? You don't want too many missed shots when BG is high. Do you test for urine ketones?
 
I do agree with Kris - he's high enough that I would be tempted, if he were mine, to give at least half his dose. Also agree to test his urine for ketones.
Has he done this before (acted sick and not eaten or had diarrhea)?
 
He doesn't take any meds. I didn't change food and he only licks the wet food. He only loves his dry food which is Young Again Zero, so i can't heat that! I tried giving him a treat; no interest. The wet I put out was the same for my other cat and he is fine. Thanks for the info on the Fancy Feasts Turkey though; I have a few cans of that here. He turned his nose up at the baby food the last time I tried. He's been eating like crazy lately and especially if I sprinkle FortiFlora so I sprinkled some on his food tonight and he walked away. I'll keep trying to get him to eat so I can hopefully give him at least 1 unit tonight.

He has not been sick; however, he has been eating so much that occassionally he has partial softer stools. Today was outright liquid.

I'm running out of Vets in my area! This Vet calls me and checks on Morgan's results which shows he cares. He's understanding my refusal to give 3 units as he recommended, but when I suggested 1.5 units he was pretty firm about 2 units when high and then 1 under 100, but to stop skipping shots under 100. I am not happy at all about being told to give a shot under 100.

On a side note; I was watching my other cat, Reilly trying to clean Morgan earlier. He was cleaning Morgan's ears and it got me thinking. Since Morgan has been on insulin, Reilly got vicious toward Morgan and now Reilly gets Amitriptyline rubbed in his ear every morning. Morgan RARELY cleans Reilly, but what if he licked Reilly's ear with the Amitriptyline?
 
Thought I should post that since my last post on Monday, around 10:30 pm (+4 PMPS), Morgan started perking up a little. He actually ate quite a few pieces of kibble so I gave him 1 unit at 10:30 since I couldn't shoot at his regular scheduled time. He woke up on Tuesday acting perfectly normal. He has been sneaking a little of his brother's fancy feasts chicken so I'm wondering if that was the problem. Kris mentioned a problem with the turkey, but I have the chicken opened. Maybe same problem? Always something to worry about! My spread sheet is updated.
Also, I never responded to Kris' question about testing for urine ketones. I have not done that and honestly, it's not on my list right now. Some days it takes a lot of self encouragement to get me through all the cat issues here. I won't bore you with details, but suffice it to say that between Morgan's diabetes procedures and Reilly's behavior and poop problems (which I think is from the Amitriptyline), I'm working really hard to try to keep a good, happy disposition!
 
Yes! Thank you!!!! Just wanted to give an update on his health issue and went into a vent. Thank you for understanding. I'm hoping to keep my hair in tact!
 
I updated my spreadsheet. His numbers are high and haven't been dropping anymore. Can't help but wonder if we should renew the ProZinc bottle every month. Tomorrow is one month since we started this latest bottle. My Vet charges $89 which isn't bad. I was paying $280 for the Lantus, so I would be willing to buy a new bottle every month if it helps keep his numbers down. Do you know if there are potency issues with bottles over 30 days old?
Some good news; Morgan has been chowing down more wet food than usual. I've perused this website for food suggestions and tried Sheba Chicken Pate and a few Weruva seafoods (which he really likes, but I only give a little seafood) and now the Nine Lives chicken pate. He still eats mostly the Young Again Zero dry.
 
Glad he is eating better! There is no way to know whether Lantus will work better or not. It is dosed completely different and will require nadirs frequently as the dose is based on the nadir not the preshot and the nadir like ProZinc, so be sure you get advice if you change. It will be very hard to work with if you can't get nadirs - I seem to remember you have trouble getting midcycle numbers?

I think more data would help - curves when you can, nadirs whenever possible. It is very hard to know what is really going on. I think raising from 2 to 2.5 is a big jump, especially without knowing what is happening between preshot tests. I wonder if 2 wasn't working better in late November/early December and maybe a raise to 2.25 might have been a good idea.
 
I think I worded that incorrectly. I don't want to go back to Lantus. It just seemed that a fresh bottle of ProZinc keeps his numbers down better and as I use the bottle and the days go on, the potency lessens and his numbers are higher. On November 9th, when I started the new ProZinc bottle, his numbers were going lower (although, out of the gate too low because the dose was too high). I'm wondering if it would be better to get a new bottle of ProZinc every month even though we don't use the entire bottle in a month's time.

About the mid day numbers; I was running out of test strips AND pulled my back so I wasn't getting mid numbers. The back still hurts, but getting better. I will try to do more mid day tests. Can't do a curve yet, but will try to do one very soon. I get what you're saying. The mid day number could be lower than I realize so it's important to do the tests.

Thank you!!!!!!!!!
 
Sorry, I misread it. ProZinc should definitely last longer than 30 days, if kept in the refrigerator and rolled before giving. I would guess a new bottle might be a little more potent than an old one (3-6 months old maybe) but I wonder if the dosing is the issue rather than the insulin?
 
He's in hiding this afternoon, so I was unable to do an afternoon test which probably is what you need before can answer my question, what dose you recommend?
 
Damsel said:
I updated my spreadsheet. His numbers are high and haven't been dropping anymore. Can't help but wonder if we should renew the ProZinc bottle every month. Tomorrow is one month since we started this latest bottle. My Vet charges $89 which isn't bad. I was paying $280 for the Lantus, so I would be willing to buy a new bottle every month if it helps keep his numbers down. Do you know if there are potency issues with bottles over 30 days old?
Some good news; Morgan has been chowing down more wet food than usual. I've perused this website for food suggestions and tried Sheba Chicken Pate and a few Weruva seafoods (which he really likes, but I only give a little seafood) and now the Nine Lives chicken pate. He still eats mostly the Young Again Zero dry.
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My ProZinc lasts 2 months no problem. I'm careful storing and handling it of course. Your vet is charging a really good price for it.
 
Damsel said:
He's in hiding this afternoon, so I was unable to do an afternoon test which probably is what you need before can answer my question, what dose you recommend?
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I agree with Sue that you might need a higher dose to get better numbers. Quite likely the ProZinc is still potent enough. You were way up at 5 u when you had the hypo run of numbers. After that, he might have remained insulin sensitive for a period of time, hence the better numbers on a lower dose. Recently, 2.5 u has left him in red for AM/PMPS. I suggest raising to 2.75u for a few (3 - 4?) cycles to see how he does. You'll probably have to get at or above 3 u to see more blues.
 
Thank you. Yes; I thought $89 seemed very fair. What a relief after the Lantus cost. I'll try to get a mid test today and then raise to 2.75. I didn't get to update the spreadsheet yet, but he was in the 400's yesterday and today at AM/PMPS.
Also, I am very cautious about keeping the insulin in the refrigerator; however, one day last week I realized I left it on the counter for 4 hours! It was not near heat though.
 
Damsel said:
Since Morgan has been on insulin, Reilly got vicious toward Morgan and now Reilly gets Amitriptyline rubbed in his ear every morning.
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The aggression may have been due to Reilly detecting that Morgan's got an illness (e.g. Morgan may have a different scent). I had a similar issue and I had to keep my civvie in a different part of the house otherwise she would attack Saoirse.

Good sites for research on meds include drugs.com, marvistavet.com, and peteducation.com. Here are some links:

https://www.drugs.com/sfx/amitriptyline-side-effects.html (even though it's written for humans it can be a help in identifying med-related problems in pets, too - especially if they're very med-sensitive).

http://marvistavet.com/amitriptyline.pml

http://www.peteducation.com/category.cfm?c=2 1457

It might be worth your checking out a new product - Feliway Friends diffuser; it's supposed to help reduce aggression, etc. I used it in combination with the regular Feliway diffuser for Saoirse and the combo was very calming and reassuring to her.


Mogs
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Just posting that I updated the spreadsheet. Had a shocking high number last night; increased to 2.75.

Mogs, thanks for the links for meds for Reilly. I just received three new Amitrptyline pens but have been wondering if we should try something else. I think his poop problem is from the Amitriptyline. Also, it seems to work better some days than others. We have peace and quiet for several days and nights in a row and then he starts stalking and attacking again. Although it is no longer vicious attacks and I can easily break it up and separate them for a while. For that, I am thankful and so is Morgan.

I have some Feliway spray, and considered the diffuser; however, I seem to get an allergic reaction to it. I am not really allergic to anything so it's strange, but it gives me coughing fits and I can't breath so I decided the diffuser probably wouldn't be a good idea. Who would take care of Morgan? :woot: Thank you, very much. I will check these links out for a possible change! Love this forum. All of you are so nice, infomative, encouraging and full of great advice and information!!!!!!!
 
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