New member - high sugars prozinc stopped working?

nerominka

nerominka

Member
My almost 13 yo male diagnosed with diabetes 2019, has been on prozinc and was up to 4 units recently. Last week started refusing his usual food and peeing outside the box (as he does when he has high sugar) and sugars were 380 pre-dose and 350 throughout day. The prozinc seems to have stopped working or I am suspicious that he has been having high sugars for a while and now is resistant? The vet told me to increase to 5 units and dont check his blood sugar for a week. I have been checking it when curious and it is still 350 at the peak of insulin...I have been feeding meat baby food and low carb foods (whatever he will eat)
This was a new bottle of prozinc, so it should be more potent. I read on the forum about glucose toxicity and also question if the new bottle of insulin is bad, although this seems unlikely. Do I need to slowly increase the dose by .25 - .5 units every 6 cycles? Is 5 units a large dose for a cat?
 
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Hello and welcome to the FDMB. So your kitty has been on ProZinc since 2019? I really need to see some more information on him. Do you keep records of his blood glucose? It’s okay if you don’t, but in order to help you, it would be beneficial if you could start keeping records and start a spreadsheet. We need to see what his preshot BGs are and to see what his nadir is (lowest point in the cycle.)

What is his diet like? You say you are feeding low carb wet food? Have you been doing this all along. I’m concerned about the change in his behavior. Is he lethargic? And his appetite is diminished? Any vomiting? Have you been testing for ketones — either with a blood ketone meter or using urine ketone tests strips?
 
Here is a link to some helpful information. It talks about how to create a spreadsheet. But if you have any trouble, please let me know because we can get it all set up for you. It’s much very easy to use once you get started. We would really like to help out! Talk to you tomorrow.
 
Yes he has been on Prozinc since 2009. I think we started with 1 unit but settled on dose of 2.5 then 3 over time and then 4 for the last year or more. He does sometimes dip down randomly low (in the past) and his blood sugars responded to the insulin. Now it seems like his levels are not changing even with 4-5 units. I dont keep long records of his blood glucose. I usually only test when I suspect an issue based on symptoms. I have been testing this past week and the levels are all in the 300s, mid to high 300s. This is with him eating less.

He has been on low carb wet food since diagnosis. He still wants to eat but was not eating his usual foods, I bought some others and he is eating them now, along with baby food. He is sleeping most of the time, but it is rainy and he usually does that during the winter. He still wants me to pet him and will get up for a bit to get attention. He did vomit a few times last week but not lately. I don't have ketone test strips, but I can get some. I will work on the spreadsheet.
Thank you for your help!
 
I see your spreadsheet! That is fantastic. Would you please try to get a test in the middle of the cycle to see what his nadir is? I would recommend getting a +4 test one day and a +5 test another day and a +6 test on the next day. In a few days, we will have a good idea of where and what his nadir is on this dose. Please don't change the dose unless it is warranted because of a very low preshot number. So this morning, you shot 4.5 units. Can you please stick with that dose unless he has a very low preshot and you have to reduce? We won't be able to get a very good picture of what's going on unless there's some consistency in the dose.

I would also recommend that you feed most of his low carb wet food in the early portion of each cycle (before his nadir and since we don't know what that is yet, I'd say before +6.) I hope he will eat. It worries me when they won't eat.

Has he been to the vet recently for any bloodwork? For him to go off his food could be from a lot of things, such as an infection. He is also peeing outside the box you said, so a urinalysis would be a good idea. The problem is that if you combine infection with high blood glucose numbers -- that's a recipe for a cat to go into DKA, which is life threatening. I'm concerned about the lethargy. I definitely would recommend trying to test for ketones. If they are high, then he definitely would need to go to the vet.

I really will try to help you with his dosing and BG numbers.
 
Oh, one more thing, please be sure to always get a preshot test to make sure it is safe to shoot insulin. Perhaps you already do this, but it really is important. Also, we need to see where he started from before the insulin and then where he goes and how fast he gets there! :-) so that's why we need those mid-cycle tests as well.
 
I had to order more supplies to test and should be able to do more testing tomorrow throughout the day. I am happy to see some numbers in the 200s even if they are still too high. It was worrying me that he was stuck in the high 300s and 400s. He also seems to be eating now, which is also better. He did just go to the vet last month for checkup, although no bloodwork as we weren't having issues. I may take him back in. Thank you
 
Fantastic! I’m excited to see the yellows too. Today if you can check him at +6 it would be so good. In a few days we will have a better picture.

As long as he keeps eating and drinking normally (and hopefully not going outside of the litter box) and you can check his ketones I think he will be okay. You can also add some water to his wet food to keep him well-hydrated. If he is really lethargic that would be a warning sign. How does he seem?
 
This pre shot today was 350 - high, my fault because I was an hour late (13 hours after last dose). I had the chance to give him food and shot an hour and a half early but no time to pre test and didn't want to do it too early - in hindsight, I should have probably done early rather than late. I can definitely tell when he goes over 300 he doesn't feel so good and he wants to eat but doesn't eat much, and just mostly sits around. He is very big (22 pounds) and seems bloated and uncomfortable to me sometimes. He has long hair and his coat seems a little dingey and has dandruff. Last night he was rolling over and wanting me to pet him, seemed to feel better - I hope I can get his glucose under control. My other cat (his lifelong friend) died in June this past year after long suffering with intestinal lymphoma. It's hard to care for these cats with high needs, I know you all understand. Thank you
 
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Hello there. I keep peeking at his spreadsheet hoping to see if there is another test on there. I'm very sorry about the loss of your other cat who was Nero's friend. That's very sad for all of you, I know. I have had cats with intestinal lymphoma before as well. We have had good results with chlorambucil (Leukeran) and Prednisolone, but in the end the cancer always wins. Having a diabetic cat is very time consuming as well. Nero certainly is a big boy! 22 lbs. Is he overweight or is he just a large cat? Is he a particular breed that is known to be large, like a Maine Coon?
 
Could you do me a favor and write in the comments/notes section of your spreadsheet that his shot this morning was an hour late. That way we can look back and see why perhaps the preshot number was a little high.
 
Hi there, he is overweight but he is also a big cat. I'm not sure if he is part Maine coon, I always thought he could be but I found him on the street when he was a kitten so no way of knowing. His blood sugar was lower preshot tonight 114, he didn't snack during the day today and was sleeping comfortably on the bed (maybe because he felt better), but I only gave him 3 units for PM dose. I have the same issue when we leave him with a cat sitter, I don't want his numbers to get too low if I am not there monitoring him and feeding him throughout the day so I have her give him a lower dose usually. But I feel like thats probably another reason why his numbers aren't very controlled. Maybe I need to get his diet better controlled. He can be very picky but also loves to eat. He is also hard to administer the shot to - because he is so big I think its hard to get the skin tent, and Im not sure if I am putting it under his skin adequately. Would this affect the effectiveness of the insulin? I'm sure it alters the absorption but not sure how exactly. I also don't like poking his ear so much, I use the softclix lancets, are there better ones I can buy? Aside from the lower 114 tonight, based on his tracking I don't see that he gets much of a nadir or insulin peak. He used to in the past get a low number in the middle about 6 hours after giving insulin. Does this mean the insulin is no longer working for him? It's been 4 years on it and he is now at a higher dose. Are some cats on insulin for much longer than that? Thank you
 
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Hello there, I cant figure out how to update his spreadsheet, but
I have been testing and keeping track offline. Nero got sick 3 weeks ago and we ended up the ER as I was worried about dehydration he was not eating or drinking. Lab work was all okay - showed dehydration and WBC a little high and was given fluids. They did not have staff to hospitalize him and I took him home to care for with fluids to give and antibiotic. He recovered in a few days slowly. Now last Friday he escaped outside or an hour and I found him at neighbors. That night he came down with diarrhea and his appetite slowly diminished over the weekend. Now he has been refusing to eat or drink for last 3-4 days. Took him to vet on Tuesday and was given fluids, flagyl for intestinal inflammation and cerenia injection. I have cerenia at home to give and today I got mirtazapine and gabapentin from vet to give for pain at home. Just wondering is this pancreatitis? Why is he getting sick so often. He always has a huge appetite and is over 20 pounds so it is very unlike him to refuse eating and have diarrhea. Is this common for diabetic older cats to get sick often? I hate forcing him to eat via syringe and forcing fluids. And giving all these medications - seems like theres a reason he does not want to eat and I don't know the root cause. His BG numbers have been up and down. They were actually pretty good and then jumped down to 50-60 and I skipped dose and it went back up to 400. Its hard to give him fluids at home as he doesn't have extra skin to tent up and put the needle in.
 
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