New insulin user, please advice

Aili

Aili

Member
Hi, I commented on the forum before, asking for help with syringes.
I have started to give insulin to my cat, I started longer than I would have liked because I have and unknown health problem and I'm going through a lot of testing.

My cat was diagnosed at the end of February, I noticed he was drinking more than the previous week, so I had him examined by the vet, everything was well except his glucose which was at 360.

My cat has stomatitis he had been treated with prednisolone for 2 months, didn't know what the vet prescribed since he told me it was for inflammation and I thought they were anti-inflammatories, so when I found out it was prednisolone, I stopped giving him injections and just added a couple of drops of prednisolone into his toothpaste and cleaned him, with it, turns out, it has worked and he's good now, with some red gums that can't be eliminated.

My cat is a very picky eater, there's no way to make him eat wet food, I've literally tried more than 30 different kinds in the 10 years I had him, and only found one brand he eats, but only for a while, then he stops eating.

I'm going to try to give him less quantity so at least he can skip a meal of dry.

I started giving him insulin last friday, I followed the SLGS, but I was getting impatient for the lack of change in his glucose levels and upped the dose a few times, I don't want to rush, so I decided to seek help from you guys, to see how I'm doing and when to up the dose.

If you guys would be so kind as to look at the spreadsheet and tell me, how I'm doing, I would be very grateful, since I'm very anxious and pretty lost.

thanks for your help.
 
Hello and welcome. I'm sorry you've been going through all of this with your handsome Nyan. Did the vet do a fructosamine test, or just a one-time glucose test. Have you seen the results? A fructosamine test would give you a single number that is an average blood glucose over the last few weeks. Is the meter that you are using a human glucometer or one designed for pets (I hope it's a human meter.) Do you have any idea of the carbohydrate percentage for the dry food that you are feeding Nyan?

The good news is that you are doing a fantastic job of home testing, which puts you in control. Do you have a hypo kit put together. In your case if he won't eat any wet food or the gravy from high carb wet food, the most important thing in there would be karo syrup (corn syrup) and/or honey. This is for when you need to bring his blood glucose level up quickly.
 
Hi, thanks for your help, my vet did a glucose test, I'm Spanish so the test and the names are different, he did a biochemic test and a hemogram the results that had the same name in Spanish and English I added the to my spreadsheet, labs tab.

From his diagnosis to now that I started insulin, I have been checking his glucose, the maximum glucose he has had is 450 one time, he usually is between 385 and 360, and twice 280 when he accepted one meal of wet, before I started insulin he usually would be around 330 to 350 during the afternoon to the time I went to sleep and in the morning at 7 he would be 380 to 412.

he is using a human glucometer, I have some high carb treats, pancake syrup and honey all prepared in case of an emergency, but I don't see him stop eating unless he get sicker, he has had stomatitis for 11 years and that has never stopped him from eating dry, unlucky for me, since wet food would be better for him.

the carbohydrates for his diabetic dry food is 15.5 is the lowest carbohydrate food that I could find, and that he likes.
 
Okay, thank you for the information. That is quite a lot of carbohydrates for a diabetic cat. Oh well... he has to eat, right? And maybe you can keep trying. You can already tell that a low carb wet diet would reduce his glucose because his numbers went lower when he at some low carb wet food. The stomatitis isn't helping either (since it's inflammation.) Does he still have all of his teeth? Sometimes a full mouth extraction is the best way to go for stomatitis cats. So he was on prednisolone (or was it Depo-Medrol injections) for two months? Well, as you know that will raise blood glucose, but he's still diabetic now without the steroids. I'm sorry that this is happening. I'm happy that he still has a good appetite though. I wish that you could obtain some lower carb dry food there. There are only a few low-carb options for dry food here in the U.S. and I do not know if any are available in Spain. They are Dr. Elsley's Clean Protein kibble (chicken is the lowest in carbs, but there is duck and rabbit and salmon, although those have been out of stock for months). Then there's another brand called Young Again that has very low carb kibble, but I also don't know if they sell overseas.
 
He's has some teeth left, extracted some of them, a full extraction is not an option, he's old and he has a very hard time traveling he was hyperventilating the last time I took him at the specialized vet, he didn't give me the option to extract all his teeth, and was very annoyed I wanted to take x rays after his extractions to make sure he had taken out the roots, last time I went because he was in a lot of pain when yawning, he said he had just gotten a extraction a few months before and he couldn't do anything else for him, he didn't even let me enter his consultation told me in the hall, turned around and left.

That is when I talked to a vet near my house and he started on prednisolone, but he has a small town office, not even has xray's, and he's a bit brutish in his methods, he wanted to put my other cat in high doses of prednisolone for a little cough once in a while and he wanted to give nyan 3 units of caninsulin to start with, luckily he listens to me, knows I research a lot and let's me do whatever if it's reasonable, so now my other cat uses and inhaler instead of prednisolone shots and Nyan is using prozinc at the dose I choose, hopefully with your help.

about the dry food, I looked at the list you have here, but none of those are sold here, I haven't found a food with less carbs I was giving him aplaws senior that mentioned low carbs, by using the carbs calculator it gave me a 26 of carbs, on top of that, I also have to find one he likes, Iv'e have given to pet shelters a lot of dry food over the years that my cats didn't like.
 
I will get back with you shortly about dosing. I've got several people pulling me in several different directions right now! And my kids are too.
 
I would have started at one unit, as recommended by SLGS for a new insulin user and held the dose for one week. As it is, you have increased the dose a few times. Let's at least hold this current dose for a full 14 cycles. It does take time for cats to adjust to insulin and frequently takes time to see movement and to break through any glucose toxicity that they may have. If you increase too quickly, you may go right past the kitty's best dose. Consistency is best. I know how hard it is to wait when you want to get them into healthier numbers.

If Nyan drops below 90 then it would be an automatic dose reduction of .25 units. I don't see that happening right now, but you never know.
 
Well at least he still eats well. I'm happy for that. I seems like your veterinary options are limited. We can help you here with the insulin and blood glucose.

You are using U-40 syringes, right? With half unit markings (makes small dose changes much easier.)
 
Hi, I will do as you say, It's frustrating to see insuling doing nothing and then when it does, glucose rising again in just an hour, but a the same time I don't want to rush either.

yeah I'm using the U-40 Syringes with half unit markings, but they are no longer selling them, so I will either have to shipp them from the US in amazon, or change to the u-100 0.3 syringes, or change insulin to lantus, for now I'll see if the shipping from the US works properly and the syringes are of acceptable quality since some people complain.

that veterinary is a jerk, the bad thing is that he's one of the most known and prestigious around here, he was usually nice, might have caught him in a bad day, the veterinary near my house is very nice and very easy to talk to, but a bit harsh in his methods, he wanted to give me random 1ml syringes the same I used for prednisolone, I told him, it would be impossible to give a 0.5 U of prozinc on those, and he said I shouldn't worry cats are very resistant to insulin so making a mistake wouldn't put my cat in hypo, since he has other people who has given their cats 5 times the dose by mistake and the cat was well, I guess he hasn't thought of recommending the right syringes so people don't make mistakes.

so I can't trust him much, but at least he gives me the prescriptions I ask for.


Thanks a lot for helping me, I appreciate it, I hope everything is well in your end, have a good rest of the day.
 
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Aili said:
yeah I'm using the U-40 Syringes with half unit markings, but they are no longer selling them, so I will either have to shipp them from the US in amazon, or change to the u-100 0.3 syringes, or change insulin to lantus, for now I'll see if the shipping from the US works properly and the syringes are of acceptable quality since some people complain.
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I was asking because I wanted to make sure that you have the correct syringes for ProZinc (we've had cats overdosed using the wrong syringes) and also because I've been helping a new member from Portugal and she can't find U-40 syringes anywhere.
 
Aili said:
and he said I shouldn't worry cats are very resistant to insulin so making a mistake wouldn't put my cat in hypo, since he has other people who has given their cats 5 times the dose by mistake and the cat was well, I guess he hasn't thought of recommending the right syringes so people don't make mistakes.
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Oh my! This is incredible. So wrong. We've had cats here who were overdosed and required 24 hour intervention with food/honey, etc. from a hypo. Without that, I hate to think what would have happened. Hypos can kill.
 
Suzanne & Darcy said:
I was asking because I wanted to make sure that you have the correct syringes for ProZinc (we've had cats overdosed using the wrong syringes) and also because I've been helping a new member from Portugal and she can't find U-40 syringes anywhere.
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there's u-40 syringes in amazon, I wonder if she can buy them there, looking in amazon site they are available to ship to Portugal, I'll post the links, It's worth giving them a look.

https://www.amazon.com/-/es/Brandzi...BRANDZIG&qid=1684618321&sr=8-2&language=en_US

Oh, sorry forget shipping costs are 14 $ it would cost her 32$ for 100 syringes, don't know if it's worth it.

Anyway, thanks again, we will be in touch
 
I see you had a blue number today and then a bounce began.

And yesterday where it says zero insulin was given... was that the fur shot? Can you write FS in the cell instead of 0.00. That way we know it wasn't just a skipped shot, but it was a fur shot. Okay?
 
Hi, thanks for keeping watch on my spreadsheet, yes it was a fur shot, I wrote on mobile and it doesn't let me write letters just numbers, that is why I wrote 0 and mentioned fur shot in the remarks.

I"ll see if I can fix it, when I'm in PC, thanks.

take care!
 
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Hi, Suzanne, When you have a moment, could you look at Nyan's spreadsheet ? I think tomorrow would be the day to give him more insulin, unless you tell me otherwise, it seems is not doing much anymore, not even eating wet food for most of the day.

I would appreciate your help, but no hurry.

at a different topic, I will have to buy sooner or later U-100 syringes, they are no longer selling them and buying them abroad costs the double as the U-100 syringe.

I would like to give the appropriate insulin according to the syringes, to avoid accidents and to know exactly what I give him specially with in between doses, do you think I could change insulin to lantus? it would be in a month or more, I started the insulin when I started the spreadsheet.

thanks for you help, hope everything is well.:kiss:
[QUOTE="Suzanne & Darcy[/QUOTE]
 
Hi there! I definitely think that you have the wiggle room to do the increase to 1.75 units. You did have one blue nadir (but just barely blue) and that was three days ago. The rest of your nadirs have been over 200. You have been doing such a fantastic job of testing so we can increase with confidence and know that Nyan will be safe.
 
Now, on the topic of syringes…. You are using the U-40 syringes right now for the ProZinc dosing. And you are telling me that they will no longer sell U-40 syringes in Spain? And you will only be able to obtain U-100 syringes? Well, we do have a conversion chart for that, but I totally understand about wanting to use the syringes that are designed to go with the insulin that you are using. I’m a fan of the depot insulins like Lantus and Levemir. I have used all of them: ProZinc, Lantus, and Levemir. I’m happy that we can continue to work with the ProZinc for another month though— to see how things will progress.
 
Great, I'll start with 1.75 on his morning shot.

I may have talked too soon about changing insulin, I was just reading about lantus and I read that one dose affects the next, and that, It can go on for days, so it's a bit unpredictable, I don't know if that's a good idea, since I don't know if I will be hospitalized again for tests and whatnot and won't be able to keep close watch on him or give him shots.

Wednesday I have a doctor's appointment hopefully after my last bout of tests, they know what is wrong with me and I can finally have treatment, if not, I don't know if it's better to stick with prozinc until everything settles down.

thanks again for you help, I'm off to sleep wanted to test him to see when his bg would raise and it's 4am, take care!.
 
Wow. You have a lot going on. I’m sorry. Let’s talk about this later. You have time. We can talk about the differences between the depot insulins and ProZinc. The depot is not bad (as in dangerous), but it does help to create nice flat cycles - and it can help carry a kitty for a little bit after a reduced dose or a skipped shot. It’s a little bit like having a storage tank of insulin to be released later. Sleep well!
 
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