Newbie needing guidance/suggestions

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Frankie Bear

Frankie Bear

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Hello there, this is my first post besides my intro. My name is Rhonda, my sugar cat is Frank. It's only been 3 months since diagnosis and he's gone from Lantus to Prozinc while very obviously deteriorating somewhat - he used to be a big, strong, muscular cat with beautiful fur who now looks a bit like a stray - he's lost weight, looks scrappy and can't jump like he used to. I love our vet but I feel that no-one will care about him like I do, and I fear that of course, she has other patients and therefore isn't that interested in pursuing this treatment with much zeal.

In early November we ceased all access to dry food. He hates it. He enjoyed canned food for breakfast previously but getting it all day every day leads to protests and hunger strikes. We stick to our guns but it's hard. (There are 6 other cats who get kibble so Frank wants it, too.) We have other special needs fur babies including 1 with no teeth, 1 with kidney disease, 1 with pemphigus (an auto-immune disorder), plus a kitten so this kibble battle is a big deal. It's like one of us has to be home and watching to see who's hungry all the time.

We finally got Frank down into a normal range a few times on Lantus but then I guess he was bouncing? His BG would skyrocket back into the 20s (mmol/L, we're in Canada). We had almost daily contact with the vet, trying to stabilize him but to no avail. He was switched to Prozinc 9 days ago. The vet sold me a bag of Purina ProPlan kibble, said it was <8% carbs so it would be ok for Frank to have. I am skeptical, and have read from others' responses to my intro that it's not possible for a kibble to be ok for sugar cats. I thought it was a godsend but if it's true, we'll have to take it away.

I guess this is the place for newbies to post so that's all I can think of at the moment. Frank's spreadsheet will be in my signature. Any advice anyone can give would be greatly appreciated!
 
Welcome to the land of Prozinc users. You will definitely find some amazing, helpful people here. I feel like I'm too much of a newbie to give dosing advice but I'm here to support you on this journey. I know that someone already said this on your other thread but take the ProPlan back to your vet. It is way to high in carbs. For a kibble addict there is only Evo and Young Again. I leave YA out for my sugar cat to snack on and feed him FF classics twice a day.

BTW, you sound like an amazing person with all your special needs kitties. The world could use more caring people like you.
 
Welcome to the forum! My cat is still fairly newly diagnosed as well. She was diagnosed at the very end of August. You'll find some extremely helpful and knowledgeable people here on the board.

Canned food is an absolute plus. Just make sure it's low carb. There is a link on the site to a chart which has the contents for different types of foods in case you need it. Some cats, like mine, can't do dry food no matter what the carb % is while some are fine. You may have to play with that a bit. The general consensus is that low carb, wet is usually the gold standard but sometimes that's not always possible so lots of people make it work.

It'll probably be a bit slow on the responses here with the holidays but there are some people that are always available to help. Bear in mind that I am no expert because I'm still getting my cat regulated and the people on here have seen pretty much everything but from Frank's SS it looks he may be bouncing. Normally when we increase insulin its in small amounts and its held for a few cycles to see if the cat settles in, bounces or needs to have another increase. The absolute first step everyone would recommend though is to get as many tests as possible. The more AMPS/PMPS tests the better and as many mid cycles as you can get to see where his nadir lands. That'll give you and the forum members a clear picture of where he starts, how the curve progresses and ends up at the second dose. I know it's hard and takes awhile to get used to but that'll really help get him on the right dose.

Don't worry though. You'll find a ton of help and resources here and they'll get you headed in the right direction :)
 
Welcome Rhonda and Frank,

It does look like Frank is needing quite a bit of insulin. That may partly be due to the dry food. I am not aware of any Purina dry food in the 8% carb range. You can check the food chart that a vet put together on her website here:

http://www.catinfo.org/

If you can't find it on the chart, you might check the ingredients. If there is any meal in the food, it is not low carb.

She explains why wet low carb is best for all cats. One thing you might consider is switching all your cats; it is a better diet, helps prevent kidney and urinary track issues and could keep away any future diabetics in your house. She also has great ideas for converting reluctant eaters. She is a big fan of Forti Flora which has the animal digest that makes dry food so irresistible. You sprinkle it on top of the wet food. Another thing that is popular at my house is to add warm water to the pate and make a gravy; sometimes the texture of the pate is what they don't like.

It looks like you got some decent numbers with Lantus every so often. It is dosed by using the nadir and the dose is held, not switching from higher to lower doses based on the preshot. Alternating the dose and not raising or lowering the dose based on the nadir may have been your issue with it.

You are getting a nice drop from ProZinc on 5 units, but his numbers are still pretty high. Generally we consider a cat regulated if they are in the lower 200s at preshot and double digits at nadir (5-7 hours after the shot) but not below 50 which is approaching hypo territory.

If he were mine, I would get rid of the dry and make sure the wet I am feeding is under 8% carbs. Always get a preshot number and a nadir whenever possible to see if the diet change helps. I don't see any numbers low enough to bounce from since you started ProZinc unless he has a late nadir. Getting a test in around 8-10 hours after the shot will tell you if he is dropping late. And I think you need to get a test in at pmps regularly. You are only seeing half the picture.
 
Hi Rhonda and Frank! Welcome to our forum!

I agree with Sue. I think you might want to make sure you're giving a low carb food, and make sure you get tests every PMPS. Without that, you don't know for sure if Frank ever drops super low, making it unsafe to give insulin.

The more tests you can get, the better off we'll be. Especially in the beginning, lots of data is needed to help us figure out what Frank is up to. Any possibility of maybe getting a curve in sometime soon? That's where you take a day and test every 2 hours or so...helps determine when nadir is and also see how the insulin works in him all day.
 
Thanks everyone! So, dumb question... what's a 'nadir'? And if I do a curve, I thought I was only supposed to test until the BG started to come back up? I meant to do a curve on him today, actually, but somehow my day got away from me. I'll try again tomorrow.

Someone posted above that if the dry food has any sort of 'meal' in it, that it'll be too high in carbs. I just looked at the ingredients and the very first ingredient is corn gluten meal! Wth? Is it true that vets are selling this junk because they really don't know? I'm astounded!

My boy has been really loving the leftover turkey today so we've given him lots - absolutely no trace of gravy, of course, just turkey - I assume that's ok? It wasn't even cooked with potatoes in the pan.

Thanks!
Rhonda
 
A nadir is the lowest point of the cycle. With ProZinc, it's usually 5-7 hours after the shot.

The dry food sounds like it would be very high carb.

Turkey is fine as a snack, but not a complete diet. You could add some shreds of turkey on top of the wet food to see if it would get him interested in eating it.
 
Thanks, Sue, that helps. He's eating Friskies and Fancy Feast as well as turkey today so he's doing alright in that area too. I'm doubting everything lately... I've used that Fortiflora before and all the kitties liked it so if it's safe for diabetics too, I'll get some on Monday for sure... maybe - somehow - I could get everyone eating only canned, would make my life soooo much easier!
 
One more question: what's the point of the PMPS if his BG is consistently high? If it's 12 hours after the last dose, won't it still be high?
Thanks!
 
it's important to get the whole picture. Sometimes the levels go down at the end of the cycle; sometimes they surf along to the pmps; sometimes they jump up fast at the end signaling too little insulin. Sometimes people are surprised and get a lower pmps than they expect and need to lower the dose for that shot. And sometimes the night time 12 hours are very different than the daytime. All this info is important and helps you decide how to treat him.
 
Rhonda don't worry. You will spend a lot of time doubting yourself and questioning everything and that's ok. I've posted several threads where I said I felt like a bad parent because I can't regulate Nala but don't ever think that. You're here, you're trying and you're doing your best to take care of your little one. That's what really matters and you'll get the support and guidance you need here. Stay positive :)
 
Hi Rhonda - welcome to our little forum!! regarding the dry food -the only ones considered marginally acceptable for sugar cats are 1) Young Again zero carbs (can only get on-line); 2) Evo and a third one that isn't well known yet, but has gotten good reviews from some on-line postings and that is Wysong Epigen 90. It's a long story, but I need to feed my cat mostly dry - I have found that Young Again gives Murphy excellent numbers (but he won't eat at the present time); many people get good results with Evo although it definitely shoots up Murphy's numbers and I am feeding Epigen 90 at the current time with so-so results. We are all here to help each other, so please post and ask ask ask ask questions. We all look forward to learning more about Frank
welcome again!!
 
Welcome to the PZI forum, Rhonda and Frank! I used to give my cat ProZinc, but recently switched to Levemir, but this was my first "home" and I check back regularly. You are doing a good job and never feel stupid about asking questions. I have been doing this for over 5 months and still have questions! We have all been there, done that and yes, the vets do give bad advice sometimes. You will find there are very experienced people on FDMB, who can help you get your Frank feeling more like his old self. I had to switch all my kitties to wet also, it took a little time, but they are all eating it now. It is more expensive, but as Sue pointed out, there will be less health issues in the long run. Also there are some links here for different low carb wet foods to choose from, some of us have to buy the cheaper brands, but they usually work just fine for most cats. I use 9 Lives pates and Special Kitty (Walmart) pates, many use Friskies pates also. Just be sure to only get the ones on the lists, no gravies! The Evo and Young Again dry food is okay and might work well for you.

Keep up the good work and best of luck to you and Frank! :bighug:
 
Hello Rhonda and Frankie! I am pretty new, too... and not where I need to be yet, with my boy Wynken, but I do want to say this is a terrific forum, and we have already received a lot of help here. :) Welcome!
 
One thing very different with ProZinc - once you have mid-cycle data to know how doses affect him, you can develop a sliding scale and 'shoot what you see', ie adjust the dose based on that knowledge and the pre-shot tests. Also, if tests in the +9 or later time show a lack of duration, you could see if a TID schedule (every 8 hours) might work better for him.
 
Frankie Bear said:
Someone posted above that if the dry food has any sort of 'meal' in it, that it'll be too high in carbs. I just looked at the ingredients and the very first ingredient is corn gluten meal! Wth? Is it true that vets are selling this junk because they really don't know? I'm astounded!
Click to expand...

I think that most vets offices are just not well versed in feline diabetes. For example, during Ben's recent pancreatitis scare, the vet tech compounded some meds for him in strawberry syrup. ;) Lucky for me, my regular vet admits that she doesn't know a lot about the disease and is okay with me getting my dosing advise here instead. And she is willing to learn from me. And best of all, she got information about this board and passes it on to her other sugar cat patients
 
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Sue and Oliver (GA) said:
If he were mine, I would get rid of the dry and make sure the wet I am feeding is under 8% carbs. Always get a preshot number and a nadir whenever possible to see if the diet change helps. I don't see any numbers low enough to bounce from since you started ProZinc unless he has a late nadir. Getting a test in around 8-10 hours after the shot will tell you if he is dropping late. And I think you need to get a test in at pmps regularly. You are only seeing half the picture.
Click to expand...

Thanks for this! I did my first PMPS last night and it was almost the same as the AMPS which leads me to think that maybe he doesn't have a late nadir? But maybe it's too soon to tell? What are your thoughts on dosing - we increased him fairly quickly with the change to Prozinc... should we leave him at 5 for another day or 2 now that we've taken all kibble away, and keep a close eye on him?

We unfortunately tried again to do a curve on him and the glucometer died right after I took the +4 test. Thought it needed new batteries but no so didn't get a +4 # on him today but did get back in time with a new meter to do +6.
 
Mancat said:
Rhonda don't worry. You will spend a lot of time doubting yourself and questioning everything and that's ok. I've posted several threads where I said I felt like a bad parent because I can't regulate Nala but don't ever think that. You're here, you're trying and you're doing your best to take care of your little one. That's what really matters and you'll get the support and guidance you need here. Stay positive :)
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Thanks! This diabetes thing is hard on my heart, hard on his ears, it's just hard... thanks for the support!
 
BJM said:
One thing very different with ProZinc - once you have mid-cycle data to know how doses affect him, you can develop a sliding scale and 'shoot what you see', ie adjust the dose based on that knowledge and the pre-shot tests. Also, if tests in the +9 or later time show a lack of duration, you could see if a TID schedule (every 8 hours) might work better for him.
Click to expand...
Wow, good to know, thanks!
 
Yes, I wo
Frankie Bear said:
Thanks for this! I did my first PMPS last night and it was almost the same as the AMPS which leads me to think that maybe he doesn't have a late nadir? But maybe it's too soon to tell? What are your thoughts on dosing - we increased him fairly quickly with the change to Prozinc... should we leave him at 5 for another day or 2 now that we've taken all kibble away, and keep a close eye on him?

We unfortunately tried again to do a curve on him and the glucometer died right after I took the +4 test. Thought it needed new batteries but no so didn't get a +4 # on him today but did get back in time with a new meter to do +6.
Click to expand...

Yes, I would hold the dose and be sure to test before each shot, just in case he drops lower (with the food change).
 
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