Newbie - Need Help Understanding BG Numbers

[Nancey]

I have read so much on this website and it is fantastic, so happy I found it. My Frodo was diagnosed last February and was on Lantus 1 unit BID. He went into remission and was managing well until I had to take him to the vet for peeing outside the litterbox and his hide legs were trembling, that was March 29th. It is a different vet and he has put him on Prozinc 1 unit BID. He told me to give him the dosage for one week taking his BG in the evening before food and insulin, then call him with results. I called him and he told me to keep giving the same dosage and as long as he stayed under 300 he would be fine, didn't say anything about calling him back, doing a curve or another appointment in the future. Not happy with this vet, looking for another one. I stopped going to the other vet due to their rise in prices, CBC with T4, Urinalysis and yearly shots was running me $330. And I have 6 cats plus a dog. This vet was suppose to be a good vet and as long as there are no issues he seems okay, but I am not happy with basically being blown off on Frodo's diabeties.

Here are his stats: At the vet BG was 404, Glucose from blood test was 392, no ketones in urine. So we started the Prozinc 1.0 units BID. His diet before this was Canned Core - Chicken & Turkey; EVO 95% Chicken & Turkey & the dry EVO chicken & turkey. Since the dry was low carb my vet at that time thought it would be okay for him to continue to nibble on it.

Current diet (as of 3 days ago), Canned (all of it is Chicken & Turkey based):
EVO 95%
Merrick B4 Grain
Wellness Core
Treats - Freeze dried Salmon and Chicken

My concern is it seems this insulin is not leveling him out like the Lantus did. He starts off high then comes down and then goes right back up. Now I do admit since I have totally stopped all dry food, not even one kibble piece (4/21), his BG seems lower. I have done 2 curves, one testing every 2 hours and one basically every 3 hours. I am attaching my spreadsheet. But here are his numbers for the past few days, BG's done before food and insulin:

4/20 - AMPS 186 PMPS 191
4/21 - AMPS 234 PMPS 219
4/22 - AMPS 219 PMPS 192
4/23 - AMPS 174 PMPS 175
4/24 - AMPS 167

4/15 Curve - 150, 193, 181, 173, 175, 180, 169
4/21 Curve - 234, 178, 158, 219

I am feeding him 2 cans a day, giving him 1/2 a can when after his shot about 5:30am and then putting the rest in his bowl before I leave for work at 6. He gets 1/2 a can after his evening shot and then the rest when it is all gone. Seems as I have gotten him eating better without the dry food his numbers seem better. But not sure since the first curve was not that bad and he was eating about 1/4 cup a dry in a 24 hour period.

Any help on understanding these numbers is greatly appreciated. Also has anyone had luck with the B12 with the trembling hocks? Poor thing seems like he waits until he really has to go pee before going because it is a big puddle, and he almost sits in it by the time he is finished. And if he has to poop afterwards the trembling really bad.

Thanks for any and all help,
Nancey - Frodo's mom confused_cat

 

[MikeysMom]

Welcome to the board, Nancey! I've never used PZI, so I can't comment specifically on how that works, but those numbers aren't really terrible at all...I worried all the time when my cat was in the 200's and was given the advice to relax, because lots of people would love to see those numbers! Which is true!

Remember that the stress of being at the vet can have a big impact on BG! I test at home just before we leave and he's always much higher at the vet's than at home from the stress! Also, a human meter will read a bit lower than a vet meter like the Alpha Trak, so if the vet is using one of those, it will be a bit higher (seems like around 30 higher is the norm) as well.

I'm sure some of the PZI folks can give you dose advice to bring the numbers down further, and you will probably need more data as you go...if you can get some mid-cycle tests every day or evening, it would be great. But really, those numbers are pretty good...they're below the renal threshold for the most part, and if you check for ketones, I'd say you're on the right track so far, especially after just a few days on the PZI.

 

[Carl & Polly & Bob (GA)]

Hi Nancey,
How long was Frodo on Lantus? At the beginning of the Lantus treatment, did you see curves that were up, down, and up? And then as time went by, they pretty much flattened out?

My concern is it seems this insulin is not leveling him out like the Lantus did. He starts off high then comes down and then goes right back up.

What you are describing is the difference in the way the two insulins work. A normal Prozinc curve looks like a smile, with the PS numbers about equal, and the dip in the middle at nadir being the low point. Actually from the curves you ran, his curves are flatter than most Prozinc curves especially at the start of treatment. Prozinc doesn't have a "shed/depot" like lantus has. It is more of a "in the body for 12 hours" type of thing.
The good thing is that Frodo's numbers are really good at this point, nothing really high. Getting rid of the dry food completely has helped, IMO. And the canned food you are giving him is good too.
When you brought him in when you noticed the excessive peeing and legs shaking, did the vet run a full panel, or just a glucose check? Just wondering if the vet has ruled out anything else going on beyond diabetes.
I don't have any B-12 experience but a lot of people here have, and hopefully they'll see this soon and give you some input.

Carl

 

[Nancey]

Hi Carl,

On the spreadsheet the second tab shows the Lantus curves that were done, I will post them here:

2011 BG Curves (Lantus)
Time 11-Feb 16-Apr 25-Apr
7:30 151 154 159
10:30 167 155 205
1:30 173 162 197
4:30 194 155 196
7:30 166 164 165
1 unit 1 unit .5 unit

He started the Lantus first of February 2011 and was on thru the end of April after stopping the Lantus his numbers were staying in line with the April 16th curve. So yes they were jumping up and down and then flattened out in the end. The Prozinc is doing as you stated the smile effect. So maybe what I am seeing is the difference how the insulin works in the body.
The vet ran a full panel, I had him run a geriatric profile with a T4. He said typically you see electorlytes out of balance like the potassium but he didn't see anything out of line so said it was probably his diabetes that caused it. His choloestrol was a little high, can't think of anything else being out of the normal range, will have to look at them again this evening when I get home from work. Will the trembling eventually go away with his diabetes being regulated?

Thanks for the help...

 

[MommaOfMuse]

Maxwell's front legs tremble when he really concentrates on something, but for him it is an old skull fracture that has caused some minor brain damage, our best guess is that it was when he survived hurricane Katrina...I have also seen where it can come from early onset of arthritis. Is it possible that he could have a slight touch of arthritis and squatting to potty is causing him some discomfort from it?

Because his numbers really don't look all that bad, and I would think if it was neuropathy he would have been much worse when first dxed and walking on his hocks or nearly so. WIth those numbers I wouldn't think his would be neuropathy unless he was worse earlier. How long has his legs done this?

Mel, Maxwell, Musette & The Fur Gang

 

[Nancey]

Because his numbers really don't look all that bad, and I would think if it was neuropathy he would have been much worse when first dxed and walking on his hocks or nearly so. WIth those numbers I wouldn't think his would be neuropathy unless he was worse earlier. How long has his legs done this?

Due to my current living arrangements I just noticed it the weekend before I took him to the vet. He has always been very sensitive about brushing or petting him on the back end, which I mentioned to the vet. He always has been what I call a "sitter", he walks a little bit and then sits down, doesn't walk a distance like the others do. And he will jump on the bed, but come to think of it he has been meowing at me in the middle of the night to pick him up on the bed. He has never walked on his hocks or any where close to them, he really walks normal except for the trembling, which varies day to day. So maybe I should try the glucosamine instead of the MeB12. I just feel so bad for him when I see him potting and trembline like that, especially since it seems he is holding his pee until he just has to go.