New to forum, and so confused

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sofietca

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Hello,
Sorry, I don't have all my readings in a spreadsheet yet, but I will as soon as I have a chance! I do have everything entered into a diabetes application though so I am attaching a graph of her readings.

My kitty Trouble, who is about 10 years old, was diagnosed with diabetes about mid-April of this year and I have been having trouble getting her blood sugar regulated. Her bg was around 350 when she was diagnosed and the vet started her on 1 unit of ProZinc twice a day and Hill's W/D. It took me a while to get a glucometer with reliable readings (my first one gave wildly different readings than the one at the vet's office), but after a couple weeks with that treatment regimen she was still mostly in the 300s and was even getting readings in the low 400s. Gradually the vet moved her dose up to 2 units twice a day, but it honestly didn't seem to have much effect. I think her lows dipped into the mid-200s but she still had highs in the 400s. I switched her food to canned Evo 95% chicken about a month ago, which she devours, and she actually did get some lows in the mid-100 range, but still had highs in the 400s.

For the past week or so she was getting 1.5 units twice a day, and for a couple days she seemed to be doing better with her highs being right around 300 and her lows being about 180. Suddenly though she started having spikes where the high was up at 420+, and then when I gave her 1.5 unit shot she would tumble down to 180 again in a matter of hours. And then after 12 hours when it was time for her next shot, she'd still be hovering around 200 and I would be afraid to give 1.5 units again. I gave a smaller dose then, and at her next shot time she was again over 400. I don't understand what was happening (and you can see from the graph that her glucose has been so erratic). The huge spikes and falls worried me and I assume they can't be good for her. I did some reading and saw that some people had better luck when the shots are given more often so that they overlap more, so I tried dividing her doses up and have been giving at about 6 hour intervals. Starting on July 1, she's been getting .5 units (or thereabouts since my u-40 needles don't have increments like that) 4 times a day. That has seemed to help with the spikes and falls because she's been generally between 350 and 220 for the past 2.5 days, but I'm still not sure if I'm getting good results and whether I should keep going with this or not. I feel like I should maybe keep going with this and let her get used to it for a week maybe, and then increase each shot slightly so that I can bring this range down so her highs are closer to 200 rather than 300. But everytime I see a reading near 300 I get so upset and I feel like everything I'm doing must be wrong and I panic and want to try something different. I think I am mostly worried that I am somehow overdosing her and that she is having a rebound - does it look like that at all? The fear of that is making me so hesitant and worried and all I want to do is make her better. It's really wearing me down!

My cat has a 9 year old son who was diagnosed right after she was, and he had glucose highs close to 600 and had stopped eating and was having some liver failure... that kitty also switched to Evo (and Fancy Feast) canned food and his owner also did the 4 times a day shots, though I think she was more aggressive in the dosage than I am being, and he went into remission after a couple weeks of that and has stayed that way for over a week now. I just wish that the same treatment would work for his mother!

I almost forgot - I took her to the vet on Friday because she had soft stool with bright red blood in it and now she's on Metronidazole. I wasn't sure if whatever was causing the intestinal problems could have affected her blood sugar or not but thought it could be relevant.

I'd appreciate any advice or (gentle please!) criticism if I'm doing something wrong. Thank you!
Sarah

p.s. the high (358) reading in the middle of July 2 was right after a trip to the vet...
 

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It is hard to help with doseage advice without a clearer idea of your numbers. Could you do something like this for the last few days to help us out?

Date
amps (morning before shot) bg number, amount of insulin given
+3 (number 3 hours after shot) Or any variation thereof
+6 (number 6 hours after shot)
pmps (evening before shot) bg numbe, amount of insulin given

If you are giving insulin 3 times daily, you can alter this to reflect the shots given.

ProZinc is flexible in that you can shoot 3 times daily, and can alter the 12/12 schedule. It is frustrating in that there is no exact protocol and it does seem to work differently in each cat. Have you seen the PZI forum? viewforum.php?f=24 Everyone there uses or has used PZI or ProZinc. I would post there also, with your numbers. You can read recent threads and see what others are doing by checking out their spreadsheets. We do have people who have minimized the steep drops by altering the schedule of shots.
 
Looks like you are off to a good start! What kind of meter did you end up going with? Congrats on the hometesting - that is a HUGE part of regulation and getting a cat off insulin!

Your lows aren't really all that low all considering. Especially if you will be around to test, I'd advocate going more aggressive with the dosing. A spreadsheet will help us see patterns a little more easily. How often do you do dose increases? Giving shots every 6-8 hours is a good way to overcome a kitty that experiences short durations with insulin.
 
Ok, I tried to do what you said with the amps, +3, etc. It was a little tricky with the different interval of shots but I hope it makes sense...

****it looks like it compresses my layout, so I'll post a screenshot of how it should look!

july 1,
amps 317, .5 unit
+7 309
+8 313, shot .25 unit
+6 305, shot .5 unit
+3 283
+5 221
+7 268, shot .25 unit
july 2 +5 300, shot .25 unit
+8 358, shot .5 unit
+6 264, shot .5 unit
+3 277
+5 261
+7 273, shot .5 unit
july 3 +3 292
+6 300, shot .5 unit
+7 358, shot .5 unit
+2 338
+5 289
 

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Welcome to the forum! The people here are the best and helped me tremendously last year when I got started with Prozinc. It really took almost 2 months to start getting steady numbers for Jimmy. Now most of the time he's right on scheldule. To answer your question about the intestional issue, imo I believe it could affect the BG. Hang in there, and always ask this board anything you need advice on.
 
Dearest Sarah, and, especially you, sweet Trouble,

I am gentle. Please don't give Trouble PZI/ProZinc four times a day. Promise me. Promise us all. Trust me, Sarah, we can help you help Trouble and still have a life...

I was trained by a wondrous cat named Gizmo. She could have easily been named Trouble...

Welcome to the place you never wanted to be; but, will be blessed for having found.

Love and encouraging hugs,
Deb and Nikki -- and, Giz, forever dancing in my heart...
 
From the looks of the numbers you just posted, it looks like the 0.5u dose isn't doing much at all. Usually when you transition from twice a day dosing to three times a day dosing, you take the total number of units usually given in a twice a day dosing schedule (1.5u x 2 = 3u in your case) and divide by 3 to get your dose for TID dosing (which would be 1u three times a day/every 8 hours in your case). So right now it looks like you went from giving 3u a day total and getting decent dips to giving 1.5u a day total and pretty much getting a flat line.

As long as you are able to be home, try splitting your original 1.5u BID dose into a 1u TID dose and give it every 8 hours and see where that gets you. After a day or so, you will probably start getting lower numbers hopefully.
 
Thank you for the replies! I read over them and some of the other materials and decided I did feel better with a three times a day dosage, so I will switch to that. I'm not sure what to do right now though, because her last .5 unit shot was at 11:40 a.m. and I just tested her at 8pm and she's at 189 (down from 358, +2 338, +5 289, +8 189). Should I give 1 unit now? It seems like too much if she is starting at 189. I'm going to feed her now and then test again in 1-2 hours...

I really want to move her bg range down so that her lows are in the 100s, but I've just been so nervous that I'll cause a rebound situation that I opted for just achieving a even, albeit high, range. I thought if I did that I could then gradually increase her dose and move her bg down slowly, and that would be less stressful for her.
 
If I read right that's the lowest she's been in a while - they always like to throw random curve balls! Since it is a still dropping number, and below 200, you made the right call to wait. Definitely wait for a rising number! How is she doing today?
 
I waited for 2 hours and retested and she had gone up just a bit to 197. I gave .5 units but I wonder if it was too much because 3 hours afterwards she was up at 279 and her amps was 370. :( poor kitty!
 
I just wanted to welcome you to the FDMB! Cedric used Lantus for the month he was on insulin, so I am not familiar with your insulin. I am sure the folks here and in that forum will greatly assist you.

Good luck and I hope you get your baby's numbers under control quickly! :-D
 
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