New Member with Newly Dx Kitty -- Williamsburg, VA

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Avery

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Hi,

I would like to introduce myself and my Kitty, Turtle!

She's 16 years old, with Hypertrophic Cardiomyopathy for which she's been on Beta Blockers for many years. She takes high blood pressure medicine also, and 1/4 baby aspirin twice a week. Last year she was diagnosed with an Osteosarcoma tumor in her leg. I didn't want to put her through a biopsy and possible amputation, so I decided to enjoy my last days with her. However, over a year later she is still here and her tumor does not seem to have spread, though her right leg is huge compared to her left. Did I mention she has Arthritis too?!

Anyway, I found out about her diabetes in a terrible way. My husband and I went on vacation for 4 days around Halloween, and we returned to discover that there had been a devastating miscommunication between our cat sitter and her boss. The result was that no one came to care for Turtle the whole time we were away, and she had not had any food or medications for 3 1/2 days. She seemed OK the night we returned, though very hungry, but the following night we found her lying on the floor, crying. She couldn't get up...her back legs didn't seem to work, and she seemed blind. We rushed her to the Emergency Clinic, and during the trip she had a seizure in her carrier.It turned out that her glucose numbers were so high they wouldn't even read on the Clinic's equipment. She was hospitalized for a couple of days, then placed on two units of PZI twice a day and given Hills M/D food to eat.

Five days after being on the insulin she went to the Vet for a glucose curve. They did two readings on her and decided that they were so high that she needed her insulin dosage doubled ASAP, over a period of two days. I had bought a Freestyle Lite meter and had been doing my own readings on Turtle during the previous several days and had never gotten any readings that high (the Vet was comparing my meter's results to her results at my request). Plus she was doing so much better -- she'd perked up and was drinking and urinating less. I talked the Vet out of increasing her dose. When I took her home that night her BG readings started dropping and over the next two days were back to the range of numbers I had been getting before taking her to the Vets'. So I really think those high numbers were due to stress and am terrified at trusting any measurements I would get at the Animal Hospital.

She seems to feel better every day. I have the day off today and am doing a full Glucose curve at home. I may try to find another Vet, too. It's not just her wantiing to double her dose so rapidly based on two glucose readings and not taking into account her clinical signs...she always seems so rushed, and the Clinic hours aren't too flexible for someone who works full time. I just don't think they are equipped to handle her condition (and my perhaps annoying questions and second-guessing) long-term.

So this is Turtle's background. I have a few questions....

About 6 months before all this happened, I took Turtle off of dry food completely, and changed the canned food I was supplementing that with to a lower-carb variety. She was having diarrhea regularly, and my Vet thought it might be dietary. I looked at Dr. Lisa's Cat Nutrition page and thought that the dry food/high carbs might be causing her diarrhea. I switched her over to Natural Balance canned Venison & Green Pea. Frankly I didn't know how much to feed her - I'd always free-fed Turtle dry food and added a large dollop of canned to it twice a day. I went by the can label and began feeding her a can a day, divided into two portions. About six weeks ago, I did notice that her water bowl needed filling up more often and that the urine clumps in her litter box were growing. I made a mental note to have this investigated at her next checkup. (I feel pretty stupid now for not taking action sooner). I did weigh her and she seemed to be holding at 10 lbs, her normal weight. Plus her GI issues had really improved.

But now I'm afraid I was under-feeding her. If she was on this improved diet, why did she start having these symptoms? I wonder now if I have been starving her all this time. She is now on the M/D canned, also a can a day. Now I'm dividing it into three portions per day to make sure she has food available when her glucose level is lowest. The vet says to just weigh her to see if she's getting enough. Between not eating while we were away to seizing, vomiting and defecating everywhere, her weight has dropped to 8 lbs. I'm not sure what to shoot for -- maintaining her present 8lbs or trying to gain back some weight? A lot of folks posting here seem to feed much more, maybe two or even three cans a day. If I've been starving her all this time, I'm going to feel terrible.

A second question is, she takes a potassium glucomate supplement, a teaspon a day divided into two portions per day. How might this affect her BGs and fit in with her diabetes?

Last Question, about Insulin. The PZI is $96 per 5mm vial. My Vet gets it from Veterinary Pharmacies of America (VPA). I've read that you can work directly with BCP directly (with your Vet's Rx) to get this insulin and avoid potential price markup from the Vet. Has anyone worked with VPA in this way? If I can get my Vet to work with me to get the insulin from BCP instead, is it the same insulin as from VPA (100% bovine PZI)?

Thanks so much for reading (if you've gotten this far without falling asleep!). I've gotten so much info and reassurance from the FD site and message board over the last week. I couldn't have dealt with all of this otherwise. Thanks for being here.

-Avery
 
Re: New Member with Newly Diagnosed Kitty

Bless you for caring for sweet Turtle. With another parent and her multiple issues and without such superior care, she would have most likely left us long ago.

Yes, you can use BCP PZI. It is a compounded insulin that is generally less expensive. It works very well in some cats, as does ProZinc. You might take a look at our PZI support group: viewforum.php?f=24 There are several kitties on both insulins. And this general information on PZI: viewtopic.php?f=24&t=32799

Your curve today should give you some good information that may clear up the picture. Because of the stress at the vet, your numbers will be much more accurate.

It did seem like stress could have caused the initial diagnosis. But it does seem like the diabetes is back. A wet lo carb diet will definitely help. Every cat is different. In some, the diet makes all the difference and they rapidly go off insulin. With some, their numbers improve but insulin is still needed.

If you want to post your city and state, it may be that we have a member nearby who knows a good FD vet.
 
Re: New Member with Newly Diagnosed Kitty

Avery:

Welcome to you and your kitty to the best site on the internet dealing with Feline Diabetes. These wonderful people saved my cat and saved my sanity and gave me good, solid advice. While I am not knowledgeable to give medical advice or opinions, I can, however, send you a big smile and take comfort in the fact that you and your kitty will be well taken care of here to the best of everyone's ability.

As I was told: Breathe!!!

I am positive someone (or several people) in the know will come along soon and help you out.

Kindest regards,
Cheryl
 
Re: New Member with Newly Diagnosed Kitty

I see Sue has posted a reply while I was typing mine.

Smile Avery, you are in good hands.

:)
 
Re: New Member with Newly Diagnosed Kitty

Avery,

Last Question, about Insulin. The PZI is $96 per 5mm vial. My Vet gets it from Veterinary Pharmacies of America (VPA). I've read that you can work directly with BCP directly (with your Vet's Rx) to get this insulin and avoid potential price markup from the Vet. Has anyone worked with VPA in this way? If I can get my Vet to work with me to get the insulin from BCP instead, is it the same insulin as from VPA (100% bovine PZI)?

You can absolutely buy it from VPA directly. My vet called the 'scrip into the VPA located in Houston TX. After she did that, all I had to do was call them up, they verified the prescription, asked my kitty's name (I guess for a 2nd verification?), and I paid over the phone for it. When it came time for a refill, I just called them up and gave them my name, they had me in the computer, and they sent it out.
Your vet is ripping you off with that price. I received 10ml vials both times, of VPA PZI 40u. The cost for each, including shipping overnight, was $51.90. I got 20ml for about the same cost as you paid for 5ml. Somebody is making some money on that deal....
I really don't think that there is a difference between BCP and VPA PZI. Just the lab that makes them. Both are located in Houston.

Carl in SC
 
Re: New Member with Newly Diagnosed Kitty

Thanks, Carl...I will definitely try to have my Vet let me work directly with AVP. I should have said that this is the 100 UL, not the 40 UL, so that could explain why it's so much more expensive perhaps? I still think I can do better going directly thru AVP.

Someone suggested I should give my location in case there is a FD Vet nearby - I live in the Williamsburg, VA area.

Thanks!
Avery
 
Re: New Member with Newly Diagnosed Kitty

If it is U100, then that could be the main reason for the price difference. But hopefully you can cut out the middle man and save a few dollars.

Best thing to do if looking for a vet or another member who lives close by is to edit your "subject" line on this thread to include "Williamsburg VA". I know we have other members in that general vicinity, and using the subject line is the best way to catch the right "eyes". Just go back to your original posting, hit the "edit" button, and you can make changes to the subject line.

Carl
 
Hi Avery,

I'm in Hampton, about 30 - 45 mins from you. I was just up by W&M last Thursday, but don't really get up there much. I'm not going to have much good news for you in the way of vets though. I could not recommend mine for diabetes treatment plus they are too far for you to come anyway. Which emergency clinic did you go to? There is one in Newport News that I didn't have good luck with when my diabetic Thumper was having some problems. I have done a bit of research & found a couple of vets in Newport News, Kiln Creek area I might try if you are interested in those. Let me know & I can get the names for you. Again it might be a bit of a drive for you though.

It's great you are getting a curve today and I would not double the dose. Post your readings from today & someone can help with the dose. It would be great if you could set up a spreadsheet also. Try posting over on the PZI board.
 
I did a glucose curve on Turtle today and I am completely baffled by the numbers I'm getting.

*Last* Sunday I did a curve, with these numbers resulting (she had been on insulin for two days at that point):

7:00am 285
7:00am food
7:15 shot (2 units 100UL PZI)
9:15 265
1:00pm 143
1:00pm food
3:15pm 145
6:00pm 133
7:00pm food
7:15 shot (2 units 100UL PZI)
9:30 pm 219

This had a noticeable curve to it and the numbers seemed like they were in a good range (this was why I was reluctant to double her dose from 4 units/day to 8 units/day). Thursday and Friday her pre-shot numbers were all between 174 and 218.

Today, everything's higher and flatter:

7:00am 178
7:00am food
7:15am shot
9:45em 262
11:30am 195
1:00pm 254
1:00pm food
3:00pm 270
5:00pm 285
7:00pm 278
7:00pm food
7:15 shot
9:30pm 301

I don't know what to make of these numbers. Perhaps now that her body is getting used to the insulin it is deciding that it needs more? Why did the dose seem so effective so early on? I know, I know....welcome to the world of FD!!! :)

I'm having a talk with a potential new Vet tomorrow...if he suggests increasing the dose I'm still going to be a bit uncomfortable unless it's a very small increase.

Thanks!!
 
I just couldn't get my head around your numbers. I went ahead and made up a spreadsheet for you. I hope I got the numbers right.

https://docs.google.com/spreadsheet/ccc ... lZQMjk0TXc

Your numbers do seem to be going up, but they are all over the place. The shot into the 133 was a very scary move. We really urge newbies not to shoot under 200. I wonder if he went down really low over night.

Let's see if others can help you figure it out. I definitely would not raise the dose but would get more preshot and mid cycle numbers. And please don't feed lower carb food until you reduce the dose.

If you want a copy of this spreadsheet, send me a pm (button in lower left hand corner of the page) tonight. I can give you permission to edit and you can share it in your signature. (just copy and paste the url above into your signature)

Normally I would offer to help you set it on your own, but I am leaving town tomorrow and won't have time.
 
Thanks so much Sue and Oliver! The two curves were done a week apart, not a day apart, but the numbers are exactly right.

I was concerned about that pre-shot 133 number too. Things I read seemed to differ on whether this was too low to shoot, and I was going to ask my Vet about it -- but then she sprung on me her intention to *double* her insulin dose because two readings at the Vet were high! I was so relieved that I was able to talk her out of it that I didn't pursue it. Telling her about the low pre-shot numbers was what made her back off, but she didn't indicate that she thought it was *too* low, so I thought I'd go with it.

Thanks for all these suggestions and help. I'm almost wondering if I shouldn't "start over" at a lower dose and go from there. I'll ask my (potential) new Vet tomorrow and pray he doesn't want to double the dose like the other Dr. did. I just have a gut feeling that she could possibly be getting too much insulin, and fear there's no way to find out for sure!

Good night...time to dream about drops of blood and numbers!
 
Hi Avery,
Those numbers look like "too much insulin" to me. It's what we call an inverse curve, actually not a curve at all because the numbers were either rising or flat all day long.

The numbers a week ago may have looked good on 2u. But when too much insulin is used, the effect is cumulative. A week later on that dose, and you aren't getting much action from the insulin.

My suggestion would be for you to cut back to 1 unit, twice a day, and try that for at least 3 or 4 days, unless of course his numbers just keep going up. If so, then we can reevaluate the dose.

Does that sound like a good plan?

Best thing to do would be to post your next thread in the PZI forum, since everyone there is familiar with the insulin you are using. I am sure that when the PZI users see it, they'll all have some advice to help you out.

Carl
 
Thanks so much, Carl. I will pose this issue on the PZI forum as you suggest, and during the night I had decided I wanted to cut back to 1 unit twice a day, so I'm relieved to see that you think it's a good idea. I think this is a good opportunity to put her back on her old food, which is lower carb and she likes better anyway.

Apparently this is the kind of stuff that Vets hate-- people adjusting dosages on their own -- but I feel very comfortable going with my gut on this one. I wish she had started with a lower dose to begin with.

I'll head over to the PZI forum...thanks millions and millions to everyone for their suggestions and support.
 
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