New member- steep drops on both caninsulin & prozinc?

Baileycat

Baileycat

New Member
Bailey was only diagnosed last month. Apologies I haven’t got a spreadsheet sorted yet- converting everything into American units would take a while.

He started on caninsulin but I was worried about steep drops even on 1 unit, he was also bouncing so we changed to prozinc a week ago, also because it’s got a higher rate of remission. Took a while to talk the vet round. His initial sugars on caninsulin 1.5 units were 33 (600), dropping steeply to 4.4 (79) at nadir (6hrs) & making him lethargic & he lost his appetite. On prozinc we’re still stuck in high numbers preshot but slightly better in low 20s (400), dropping to 6-7 (100) at nadir but only not lower at nadir because we’ve started allowing him to free feed for the first 6hrs of the day. We’ve also changed his food to very low carb wet food twice daily but he does get to have a very small amount of diabetic dry food to free feed on between shots for half the day- he’s 16 & has always had dry food so weighing up his quality of life vs tight control I feel this is a reasonable balance.

Am I just being impatient to want to get the preshot sugars & his symptoms better controlled? He’s my second diabetic cat hence had an Alphatrak already & knew how to test but my first diabetic cat didn’t live very long after diagnosis (for other reasons not diabetes) so I don’t want to push too hard for tight control and make him unhappy when he’s fairly old already.
 
Okay. I’m back. I would like to try and help you and your Bailey. Caninsulin is not a good insulin for cats. It is very harsh and I am not surprised that you had steep drops on it. ProZinc is a better insulin for cats, although it can still hit a bit hard in some cats.
We really need to get you a spreadsheet set up so we can look at what is happening. If you set up the world spreadsheet, it will automatically convert the numbers that you input into the world sheet into U.S. numbers. There will be a tab for World units and a tab for U.S. units. If you need help setting it up, we have a person who can get one set up in a jiffy.
 
As for feeding, I would like to talk about his feeding schedule. If you can, I would like to get some tests in at +2 after the shot and maybe +3. If you can get the spreadsheet set up, we will see how fast he’s dropping. It sounds like it will be important to feed him about a teaspoon or two of wet low carb food at +2 and +3 or maybe after. This will help stabilize his blood sugar and prevent steep drops. When we get more data, we can customize his feeding schedule.

You are not impatient for wanting to help get him better regulated, by the way! Not at all. You are simply trying to help him. That’s natural. Let’s get to work!
 
Where do you live? I mean, what time zone? Are you in Canada or the UK? I’m just trying to figure out what your time is. I am on Eastern time in the U.S. (in Georgia.)
 
Im in the UK.
Suzanne & Darcy said:
Where do you live? I mean, what time zone? Are you in Canada or the UK? I’m just trying to figure out what your time is. I am on Eastern time in the U.S. (in Georgia.)
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I’ll work on the spreadsheet. We did 3 full (home) curves on caninsulin and I’ve done some random spot checks at different times on prozinc so far awaiting a full curve next weekend as advised by vet. I’m out at work a lot of days between 7-7 and he is the most fussy cat ever with food hence us allowing him some dry (diabetic) food via timer to keep the sugars up halfway through the day. started katkin 2 weeks ago which is zerograin fresh meat with just the nutritional additives so zero carb which made a massive difference overnight to his numbers. Overall his carb intake is under 10% with the mix. Normal wet cat food he just licks and doesn’t eat- been the same for the past 16 years.

We wanted to have him on lantus but vets here won’t as not licensed in cats unless you can prove that licensed things don’t work first. Guidelines via the royal vet college are to start a ‘longer acting’ insulin first line in newly diagnosed cats though so that’s how I won the vet around to prescribe him prozinc.
 
Baileycat said:
Im in the UK.


I’ll work on the spreadsheet. We did 3 full (home) curves on caninsulin and I’ve done some random spot checks at different times on prozinc so far awaiting a full curve next weekend as advised by vet. I’m out at work a lot of days between 7-7 and he is the most fussy cat ever with food hence us allowing him some dry (diabetic) food via timer to keep the sugars up halfway through the day. started katkin 2 weeks ago which is zerograin fresh meat with just the nutritional additives so zero carb which made a massive difference overnight to his numbers. Overall his carb intake is under 10% with the mix. Normal wet cat food he just licks and doesn’t eat- been the same for the past 16 years.

We wanted to have him on lantus but vets here won’t as not licensed in cats unless you can prove that licensed things don’t work first. Guidelines via the royal vet college are to start a ‘longer acting’ insulin first line in newly diagnosed cats though so that’s how I won the vet around to prescribe him prozinc.
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Funny, The depot insulins like Lantus and Levemir are the longest lasting insulins that are the most gentle and give the flatter curves without all the hard drops and high preshots. The preshots tend to be low (kept low by the depot) so the overall “curve” tends to not be that curvy. Pretty flat. But we need to give the ProZinc a try. I started with Caninsulin, moved to ProZinc, then to Lantus, then to Levemir. Have used them all.
 
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I’ve got a spreadsheet up now. Not a huge amount of data yet as he’s only been on prozinc for just under 2 weeks now but got most of a curve done today. The low 56 is when the clocks changed forward- we didn’t even register it but obviously my phone updated automatically & as a result he got his breakfast & insulin an hour earlier than usual. Will be sending the curve to the vet to look at.
 
I would back that dose down. He's had a 56 on that dose and that would have earned him a reduction to 1.75 units. Then he's had a 68 and a 95 on an Alpha Trak meter. 68 is the "take action" number on an alpha trak meter (feed higher carb food and monitor frequently to make sure BG is rising and staying up.) If he were my cat, I would reduce to 1.5 units and continue to monitor and let the dose settle in for 7 days (per SLGS protocol) and see how he does. Obviously, if he has an unusually low preshot, you may need to further adjust the dose for that cycle. Great job on the testing :) keep up the good work.
 
Also, I would like to see how fast he is dropping at +1. He seems to be having pretty good drop by +2. I encourage you to feed him at +1 and +2, small spoons of low carb. If you are at home and this is possible? Too rapid of a drop can trigger a bounce just like a "number that is lower than what his body is used to" can do. I'm not saying this is so, but I would like to see. You are making progress :-)
 
Another thing, many cats do drop into lower BG at night. It is always a good idea to get a "before bed test" to see where he is. For a lot of people that is a +2 or a +3. Then they can see if they need to intervene with higher carb food and/or if they need to set alarms to get up and test to make sure their cat is safe overnight.
 
Suzanne & Darcy said:
How are things going for you and Bailey? Just checking in on you…
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Ok thanks, haven’t heard back from the vet but reduced down to 1.5 units. Currently struggling to get him to eat at the same times every day- last resort is purina diabetic dry food which at least if he eats it means it’s fine to give him the insulin, but frustrating because it pushes the numbers up higher than the low carb wet food so haven’t done that many extra tests because it would be almost pointless. Trying to get his routine back on track…I’m hoping the numbers are nearly good enough for the vet that he can have some dental work he needs as that may be making the numbers worse and causing the pickiness when trying to feed him, or then again that might just be him being picky ‍
 
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