New member Buddy says Hi

Hello to All! Gail & Buddy here. Buddy came to me 2 yr ago at age 10yr, weight 15lb. In July 2022 his labs were within normal limits, weight 15 lb. He was diagnosed in late Jan 2023 after rapid weight loss to 11.3 lb and polyuria, BG 501, and was started on PZI 1 unit q12hr the same day, incrementally increased by the PetVet based on BG results. As a rescue he ate only dry food, but has grudgingly accepted Purina DM pate if I make a pate milkshake in water. He eats two cans a day (total 320 kcal) divided in 4 doses... he is a grazer... and now weighs a stable 12.5 lb. Dry Purina DM is used sparingly only for treats and emergencies. Successive AlphaTrak BG curves at home always showed a drop of about 100 mg/dl with a nadir between 5-7 hours, regardless of PZI dose. PZI was increased up to 3 units q12hr, with BG improved but still above the normal range (100-250). After about a month on 3 units, his BG have started to suddenly drop without warning by 200-300 mg/dl from his pre-insulin levels, then up to 400-500 with Hypo treatment and holding insulin. Buddy does not exhibit any obvious warning signs even when he bottomed at 48, so we were cautious. The vet was out of town, so I backed his dose down to 2.5 and now 1.5 units.
Hopefully he can stop bouncing around and be stable enough on this dose for a few days so I can get another BG curve and see what is going on. Buddy has had a great attitude through losing his favorite tasty dry food, tolerating the ear sticks, and suffering through hi/low BGs, so we want to straighten this out soon. He still chases squirrels and climbs trees when feeling ok, and shows up at mealtimes.
My background is in medicine and human diabetes, but cats are definitely in a different category of treatment, so I need to rethink my pathophysiology models Yes, I do record BG at least 2x day, with some midpoint BGs, and have a HYPO kit ready. I just downloaded your spreadsheet and will get it set up asap. I'm guessing I should post on the PZI forum after this introduction.
Thanks for a helpful website and forum !

 

I can tag a prozinc user for you
@Suzanne & Darcy
See if she suggests to stay with posting on the Welcome forum

The Purina DM wet is 6% carbs which is fine . The dry is 18 carbs
No need for prescription foods
Most members feed Fancy Feast Classic Pates or Friskies Pate
They are around 2-3 % carbs
You want to feed around 6% carbs or less
Here is our food chart if you want to take a look at it,
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

We always add water to the food so that's great you're doing that
You might want to read about the 2 dosings methods and you can see which one you would like to follow, if you are feeding any dry food at all you would have to follow the SLGS which says if your kitty drops under 90 you need to decrease by 0.25 units
Do you have the syringes with half unit markings?
We don't base the number of units on the pre shots, we base them on how low the BG is dropping.

Instead of giving the DM dry for treats
You can give any freeze dried treats they are all low carb
Tap on this blue link and read post #64 the post numbers are to the right of each post and you can read about the freeze dried treats I listed

https://felinediabetes.com/FDMB/threads/new-to-this-i-need-advice.269452/#post-3007388

Once you fill in your SS I'm sure @Suzanne & Darcy can give you some advice

Here is the link for the dosing methods
https://felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/

 

Thanks for the welcome and information. I have some Fancy Feast and Friskies to try out once he is more stable… one variable at a time. I have 1/2 unit syringes. I agree about dose changes based on low BG; I just reviewed your methods. These hypos are very recent and came up suddenly so he is still bouncing a bit from a lower insulin dose. Thanks for the good link to the freeze dried treats. He only gets maybe ten pieces of dry DM a day as treats, but an alternative is certainly useful.

 

Hi and welcome Gail and Buddy.
Looking forward to seeing your data on the SS.
You can post on this page for a while if you like. You will get more eyes on you here.
If you are using an alphatrak meter and he dropped to 48 I’m glad you reduced the dose. If he drops under 68 on the alphatrak meter you need to give high carb food and test in 20 minutes to see he is on the way back up.

 

Welcome to FDMB!

You medical background will serve you well when it comes to managing Buddy's diabetes. To be honest, it's not all that different other than Buddy's metabolism being faster than a human's. The harder part is that it's your cat and it's far more likely that your more apprehensive when it's your family member than a patient!

Please let us know how we can help.

 

Actually, my human medical background has helped only with technique. Cat’s carnivore metabolism makes BG anticipation and response Very different for me than my usual clientele. Thankfully, Buddy has been an exceptional, and forgiving, patient.

 

It looks as if he is bouncing from the lower numbers that he is no longer used to.
The blue BG you have in the SS are not called extreme lows. The only one that is even in normal range is the 129@+5 on 3/22.
All the other BGs that are higher than that are above normal range.
We can see how the 1.25 U dose goes. Hopefully that will bring the BGs down a bit further.
I will tag @Suzanne & Darcy as she is a Prozinc user.
Here is information about bouncing from the Basics

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

 

Thanks. The extreme lows were at previous doses of 2-3 units, but he still had AMPS and PMPS that were high.