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FurballLover

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Hello, my name is Jen and my fat cat Charlie was dx with diabetes on 9-10-09. Charlie is a large orange tabby who was always overweight (largest was high end of 18lbs) At the end of last summer we started having issues.
Charlie has always loved cold water and ice, running to take a drink every time I filled the drooler's water dish with fresh h20. (he also licks the condensation off the side of any cold drink he can get his paws on!) But suddenly he became obsessed--he would jump up on the vanity every time I was brushing my teeth and lap up the water from the faucet. This was a bit annoying but I didn't think much of it until the litter box issue. On several occasions, he had large clumps of liter stuck to his back paws and I would have to give him a bath (which I'm sure everyone here knows is one hell of a feat! :) One day I picked him up and he was all skin and bones. I had noticed he was losing some weight and was grateful b/c the vet always lectured me on this issue when we had his checkups. But one day, he was just too thin.
We got him to the vet to find out what was wrong. I was a wreck when I saw that he only weighed 9.14lbs (from 17.6 in feb when he had dental cleaning) I felt like the worst mommy in world--how did I let him get this sick? Our vet told me he was probably diabetic and that they would check for any other possible conditions/infections.
She had warned me of this possibility for a few years because he was overweight. The problem we always had with feeding is that his 'big sis' would starve when we decreased their food. Charlie is a piggy with food and Molly is the 'scarf and barf' type. We switched their food to science diet light and a can of 9lives chicken & tuna with dinner several years ago and Charlie still stayed portly.
I spent the entire night after our possible dx scouring the web for everything on the disease and returned to the vet's office the next day feeling overwhelmed and scared. After she showed me the correct injection technique and I practiced a few times, we discussed diet. She recommended hill's d/m and I bought a bag to supplement their new FF low carb canned food.
I had read quite a bit on the fdmb website and talked to her about home bg testing. She said she wasn't sure that it was feasible for cats and said we should do a curve at her office in a few weeks to see how his initial dose was working. I have to admit that the idea of injections was more than I could handle at the time, so I decided not to try bg testing at first. We discussed insulin and agreed to start with vetsulin until I could get a vial of PZI from another pharmacy.
The next couple weeks were full of tears and sleepless nights. The first injections I gave were not welcome by my C, but I persevered and we settled into a routine. After a few weeks there was a significant change. Charlie was playing, purring, and grooming again!! I was so relieved that he hadn't began hating me for poking him, and that he was frisky again!!

The weeks went by without incident. We had a curve done at the vet's 10-20-09 and his numbers were: +2=83, +4=111, +6=128, +8=98. Taking into account he only ate 1/2 his normal daytime food, (the kitties graze on a set amount thru the day) we felt pretty good about his numbers. Our vet told me to be cautious about hypo because the numbers were so low; but that if he normally eats more we should be fine.
Things went right along for a few months, Charlie became his old self and didn't seem to mind the injections (I sneak them in while he's eating). He gained back most of his weight and was doing very well on 3-3.25 u bid. Even my DH learned to do injects as a back-up for times I would be late getting home. (which was sweet bc charlie is a momma's boy and runs from DH anytime he comes near)

Things were great until two saturdays ago--Charlie had a hypo. I had been decreasing his kibble because he was getting fat again (stupid me-didn't decrease his insulin). Thankfully, I was home and noticed the signs. He vomited as soon as I gave him karo and then panted and was completely limp. We rushed to the vet and she saved his life. It was very serious--his heart rate and body temp dropped and he was having seizures. After 45 min of our vet frantically working, he started to come around. A few hours later we were able to take him home where I hovered over him all night. I was instructed to feed him every hour, keep him warm (his temp was still a little low) and not to give him insulin until we came back the next morning to check his bg. CBC confirmed no infections and the next day his bg was high (I think it was in the 300's?) so we resumed 1/2 his insulin that night and slowly brought it back up over the next few days. We resumed the kibble and the highest I am comfortable with giving him now is 2.5u.

I have spent all my freetime since the hypo on this board. Lurking and learning--what a great community! Cindy is sending a bg tester so I will start as soon as it arrives. Not sure how it will go, but I am determined to make sure Charlie never gets that sick again!! We will figure it out (I have to keep telling myself that :)

Sorry about the length of this post, but I wanted to introduce myself and give as much background as possible. I have set up a spreadsheet for C and included an extra sheet for his pre-bg testing info. It's listed as 'sheet 6' (can't figure out how to rename it yet--only used excel before yesterday)

My plan is to start testing--I will need a couple weeks to get C into a new routine. In the meantime I want to continue the d/m until I get the hang of testing and get some numbers compiled.

Once I get the hang of testing, it seems there are two options:

1 eliminate the kibble and start over with a small dose to work our way back to a proper number
2 slowly decrease both the kibble and the insulin

I would love any feedback on the issue--is there an option 3 that I haven't thought of?

I also have to figure out a suitable canned food. They don't like the new FF pink label chicken (they loved it before the label/formula was changed). They only eat it when the kibble is gone. I even tried mixing in some warm h20 and C just snubbed it off (too bad-saw someone post this idea and I thought it was a neat trick!) I live in a small town with only store of walmart so our choices are limited. I can stock up whenever I am near petsmart, but need a local backup. Plus the FF gets expensive at 5 cans a day!! Am I calculating that amount (without kibble) right? Charlie is 15lbs (should be 13-14) Molly is 9lbs?

The other big question I have right now is about C's insulin. I thought it was PZI, but was apparently wrong. I am so confused.
On the invoice they list it as:
PROZINC-Protamine Zinc Insulin Susp 100 Units/ml 5ml Inj
The vial says:
Protamine Zinc Insulin
PZI

I called the pharmacy today and they told me it's compounded with Humilin N

What does that mean? Can anyone help explain that?

There is so much I need to learn-thank you to everyone for reading this very long post! I hope with your help I can get Charlie on the right track! This is such a wonderful site!

btw charlie is very healthy otherwise; fat, but good!
 
Hi Jen and Charlie and welcome to the board.
It's great that you have been trying to learn as much as you can.
We use Lantus so I really could not help with PZI.
I will say though that there are a lot of canned food options besides FF to chose from that are high protein, low carb. Friskies is one, wellness grain free, EVO 95%.
Please review the Janet & Binky food guide to help you make some choices. Get a few different ones and see what Charlie might like.
I can tell you that dry food is the worst thing for Diabetics so you really need to consider changing to complete wet. Dr. Lisa site also has ways to switch over.
The board seems a bit quiet tonight.
I wanted to stop by and someone should be around to help and ask all of the right questions.
 
Welcome Jen and Charlie,

Great that you have decided to take charge. One caution: DO NOT change over to wet lo carb food until you are hometesting. The diet change can make a real difference (in Oliver 100 points overnight) and you want to be hometesting so you know when and if to change the insulin dosage.

Both of your options are possibilities. We always advise newbies to start low (1 unit 2X day) and go slow. 2.5 units is a pretty high dose; if it were me, I would start over at 1 unit with the low carb.

ProZinc is the new PZI. If you go to the Insulin Support groups and pick PZI, you can read the stickies and the posts and see how others are dealing with your insulin.

When you get your meter, try it on yourself first. You can make your rice sock now, and be messing around with Charlie's ears so he will be used to it. Put a flashlight behind his ear so you can see the capillaries that run off the vein along the side of the ear. That is where you will be aiming.

Glad you are here and working for Charlie!
 
Re: hypo two weeks ago. If you haven't already, go to the Health Links forum and read Melissa's post on recognising and treating hypos. Print it out and tape it to the side of the fridge; when you suspect a hypo is not the time to find that your internet connection is down. While you're there, read Jojo's post on stocking your hypo toolkit.

Remember that, anytime a cat hypos, they're likely to be more sensitive to insulin for a few days; you should give them a reduced dose.


> Once I get the hang of testing, it seems there are two options:
> 1 eliminate the kibble and start over with a small dose to work our way
> back to a proper number

This would be my choice.


> I live in a small town with only store of walmart so our choices
> are limited.

Depending on where you live, you might try some of the online pet food stores (a lot of folks like PetFoodDirect's discounts, some of which are periodically posted in Supply Cabinet). Depending on shipping and discounts, it may open up some options for you.


> The other big question I have right now is about C's insulin. I thought
> it was PZI, but was apparently wrong. I am so confused.
> On the invoice they list it as:
> PROZINC-Protamine Zinc Insulin Susp 100 Units/ml 5ml Inj

PZI-Vet by Idexx was discontinued a little under two years ago. BIV bought the rights to PZI-Vet from Idexx and, in November, started selling their 'replacement' insulin, ProZinc. They claim that it's an almost exact replacement for PZI-Vet. There have been some folks who have tried it, most without a problem, but I know there was one person who did have some sort of moderately severe problem with the new insulin and was pretty upset about BIV's claims.


> I called the pharmacy today and they told me it's compounded with Humilin N

1. AFAIK, ProZinc isn't combined with any other insulin.
2. Are you sure you were talking to the pharmacy about ProZinc? Because some pharmacies can make insulin on-site in a process that's called compounding, and it's possible that your local pharmacy's home-made version of PZI is combined with Humulin N. (Not sure why they'd do that, but it's possible.)
 
FurballLover said:
The other big question I have right now is about C's insulin. I thought it was PZI, but was apparently wrong. I am so confused.
On the invoice they list it as:
PROZINC-Protamine Zinc Insulin Susp 100 Units/ml 5ml Inj
The vial says:
Protamine Zinc Insulin
PZI

I called the pharmacy today and they told me it's compounded with Humilin N

What does that mean? Can anyone help explain that?

OK what I'm seeing needs to be figured out and caution needs be applied here.

If this is compounded then it looks like they are just calling it "PROZINC" and it is not the real ProZinc. Also it seems to be compounded in the U-100 strength!!!! This make it 2.5x more in concentration than the normal U-40 PZI strength. Also real ProZinc ONLY comes in 10ml bottles. And that pharmacy need to be notified that they are infringing on a Trademarked product. This can be very dangerous if you are not using the right needles. Did you get u-100 needles or u-40 needles?

If you can, you want to order the REAL ProZinc from a place like Allivet.com. There are reasons why compounded is not ideal [but OK if no other options].
http://www.allivet.com/ProZinc-Cat-Insulin-p/32212.htm

Your bottle should be green, blue and white. There is a picture on that Allivet webpage or one here:
http://petdiabetes.wikia.com/wiki/PZI#ProZinc.E2.84.A2
 
JJ & Gwyn said:
but I know there was one person who did have some sort of moderately severe problem with the new insulin and was pretty upset about BIV's claims.
Who was this? Do you know how I can find their posts? They didn't post in PZI Land as far as I know. I'm interested to know the circumstances of this.
 
Thank You!!

JJ--
luckily I read all about hypos when C was first dx--had all the supplies ready. I did try to feed him at first, but he wouldn't even sniff the food--the info on fdmb saved Charlie's life bc we knew what to do!!

Gator--
I thought something seemed wrong with what I have been reading this week-couldn't figure it out, though!
Not sure what to do.
I will call the pharmacy again tomorrow. If he is getting an ultra concentrated dose--I'm gonna be really upset!!

So, I just peeled the pharmacy's label off the old back-up insulin bottle and it looks like they print their own label and put it on an empty sterile vial before filling it. What is this stuff!?!?
 
FurballLover said:
Gator--
I thought something seemed wrong with what I have been reading this week-couldn't figure it out, though!
Not sure what to do.
I will call the pharmacy again tomorrow. If he is getting an ultra concentrated dose--I'm gonna be really upset!!

Do your needles have an orange cap or a red cap?

IMHO, the thing to do [if you can] is to get the REAL ProZinc ASAP. The link I provided is for $90 [for 10ml] which just about any pharmacy will price match or you can order from Allivet - I've been happy with Allivet's service.

Also perhaps read our sticky over in PZI Land
viewtopic.php?f=24&t=1979
Feel free to post over there too anytime.

Good luck and welcome!
 
>> but I know there was one person who did have some
>> sort of moderately severe problem with the new insulin
>> and was pretty upset about BIV's claims.
> Who was this? Do you know how I can find their posts? They
> didn't post in PZI Land as far as I know.

I don't remember who it was. I *think* it was on the old board, and I'm fairly certain it was on Health as I rarely visit the PZI forum (though it could also have been a Health post that linked to the PZI forum). From what I remember, they tried ProZinc, had some sort of anomaly, and ended up calling BIV who confirmed that that anomaly did occur in some tiny percentage of the trial subjects. But I don't remember anything beyond that -- I just made a mental note that most of folks seemed to be transitioning well and one person had a problem.
 
The syringes I use are u100 with 1/2u markings and the vial says u100, I always cross check when a new shipment arrives. Definitely have to check out other forms of juice, not sure I feel comfortable with using this one anymore.
 
Hi Jen,

As I explained to you a couple of days ago, the protamine zinc insulin sold by Wedgewood Pharmacy is not PZI. Glad you were able to confirm that information for yourself. I know we've had other folks who purchased what they thought was PZI from Wedgewood, but I don't remember who specifically.

My recommendation is to ask your vet to call around town and get some true PZI (ProZinc) or to call in a prescription to BCP Pharmacy in Texas. I know you're only paying $30 for a vial, but the BCP PZI won't be too much more. The ProZinc will be much more expensive ($90-$120 per vial).

In the meantime, here's some information on hometesting:
viewtopic.php?f=14&t=287

Terri
 
FurballLover said:
The syringes I use are u100 with 1/2u markings and the vial says u100, I always cross check when a new shipment arrives. Definitely have to check out other forms of juice, not sure I feel comfortable with using this one anymore.

Whew - that's good news. So one unit marked on your U-100 syringes and using U-100 insul is actually 1u. You should be OK until you can transition out. But hold onto those U-100 syringes as you may want to use them with the ProZinc if you get it [but you will have to do the conversion which you can read about in the PZI sticky].
 
We have only used Vetsulin, so I can't really help you with your insulin questions.

Regarding food, our cats are similar in size to yours (Sebastian is 16-17 pounds, Chloe-- non-diabetic-- is about 9). At first the transition from dry to wet was really difficult, but eventually they learned to deal with it and it hasn't been so bad.

Unfortunately, they both seem to get bored with the same food over and over. Like, they will LOOOOOVE Friskies Turkey and Giblets one day, but if they get more than three cans of it in a week, they refuse to eat it anymore! :shock: We feed them three of the 5.5 ounce cans a day, to share. (Sebastian ends up eating more than Chloe). If we go for the smaller 3 oz Fancy Feast, they have to have one each, which gets expensive. We feed in the morning, around 7am, then when I get home at 5pm, then again at bedtime, usually around 11.

I use Janet and Binky's food list and buy a wide variety of stuff each week. A couple of cans of each of their favorites-- that way they don't get bored. I buy a mix of the cheap (Friskies, 9 Lives) with the better quality (Wellness, Merrick, EVO). They like the cheap stuff better.

Good luck!
 
Thanks to everyone who responded to my questions!

I'm going to call the vet and get a different rx for Charlie's insulin. Since we're starting testing, I would like to do it right with a better insulin.

Charlie ate his breakfast with much gusto this morning--and then puked it all up. I'm worried about leaving for work because he already got his shot this morning. I'm going to leave work early, so he will only be alone for a few hours--still nervous though. He doesn't typically vomit, but he did scarf his food down earlier. :?
 
I would leave some food down for him so he can snack during the day. If his blood sugar should dip, the food can help bring it up and soften the roller coaster.

You might freeze some wet lo carb for the future. I use a Smartware cupcake pan. The cupcakes are the size of a Fancy Feast can and just pop out of the pan when frozen. Then I put them in a ziplock bag in the freezer and use as needed. Others just plop the food on a cookie sheet and let it freeze, or freeze it in a baggie. Then Charlie can snack on it during the day, but not eat it all at once.

Glad you are getting your insulin straightened out.
 
Charlie ate more this afternoon while I was at work--I think. We have a civie who might have eaten it! He was 'leading' me to his food dishes for the last 1/2hr, even though there's wet left. Since I don't yet have a meter, I gave him the tiniest bit of d/m kibble (barely enough to cover the bottom of a 1c measure) He promptly scarfed it down. I think we're OK, it was just a fluke that he puked this morning.

Getting him ready for bg testing with warm rice socks and pinching his ear a little. I bought some FF appetizers for treats. Found some treats at petco has anyone used these? Are they OK?

http://www.petco.com/product/105062..._3-_-Halo Liv-a-Littles Protein Treats-105062

Went to talk to our vet today. We are switching C's insulin to an actual prozinc label one. She wasn't aware of the problems as most of her patients use humilin n. I will be emailing her Charlie's spreadsheet weekly so she can monitor his progress. I told her we would be starting home bg testing and she is worried only bc she thinks the results can be as much as 30% off. They have a personal bg tester in their office and have noticed discrepancies. Does anyone have any hard data to disprove this? I'm only concerned about this because I don't want him to go too low again. Definitely going to do the hometesting for C because I can tell from all the otj kitties on this board that it can do wonders for our furbabies!

Thanks for everyone's support--it helps so much to know there are peeps out there who have 'been there done that'!
 
Jen -

Those treats are fine - since they're all protein, they won't spike his BG like some others can. I give Porky the chicken ones - he INHALES them! Through Amazon, I found them for $6 per jar, the cheapest I've seen (they're around $12 at Petco).

About the meters - perhaps the vet is talking about the difference between the Alphatrak (used for animals) and other meters used conventionally on humans? I know someone has posted about the difference in the readings....but any meter will give you valid readings, as long as you are using it correctly.

I'm glad you're getting the new insulin for Charlie - good luck with your sugar dance!
 
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