Hey all,
I've recently taken in a foster/rescue from a situation where the family was not able to properly monitor his diabetes despite a lot of guidance from their veterinarian. He is 4 year old newly diagnosed diabetic (April of this year) and has been through 3 DKA episodes with the previous family when proper insulin doses were not given, insulin was still being given despite concerning behaviours at home which were later revealed (was hospitalized and re-stabilized on IV fluids each time). His story is long one but basically through my veterinary clinic he has landed in my home as a foster as the veterinarian did not feel this poor boy should be euthanized given the family could no longer cope - I have no experience with a diabetic cat but I felt his best chance at getting back to a normal life in a home as opposed to in a busy animal hospital. I have done a lot of reading and am quickly learning that this is not an easy fix but I'm willing to give him the love and patience he needs right now.
His kidney values had been normal up until 1 week ago, although his BG levels have never seem to normalize even on the Hills canned M/D diet. He was feeling much more himself despite the bounces between 100's to 400's until 1 week ago when he had an accident on the carpet and was not himself that night (drinking and peeing like a racehorse and quieter then usual - BG values had been in 300's and 400's all day despite no change in regime and more consistent lower values the previous few days). Given his history his renal threshold seems to be when levels are above 300-400 for longer then 24 hours as it is clear there is some remaining damage to his kidneys from the DKA episodes. I had blood work done the next morning following the accident on the carpet as I knew this was out of character for him. UREA 25.7, SDMA 17, Phos 2.2, Creatinine - Normal. Given these values he is considered to be Stage 2. Was started on Azodyl to lower UREA, Phos binder, switched to Hills Prescription K/D Early Support canned (slighter higher protein then regular k/d). However it is clear the higher carbs are not agreeing with him as his numbers are higher then ever despite being on 4 units of Prozinc twice daily (12 hours apart).
This evening I decided to try him back onto a lower carb, moderate high quality protein, low phos canned food as it is clear the unregulated diabetes is causing episodes where he is not feeling himself - Organix Chicken and Chicken Liver pate is what I chose and added in 25% new diet to 75% k/d renal diet.
Here are his values the past few days:
Friday June 8th - eating only renal k/d 4x day
Pre-shot am: 446
+7 : 270
Pre-shot pm: 464
Saturday June 9th - eating only renal k/d 4x day
Pre-shot am: 259
+9 : 243
Pre-shot pm: 374
Sunday June 10th- eating only renal k/d 4x day
Pre-shot am: 217
+6 : 151
Pre-shot pm: HI
Monday June 11th TODAY:
Pre-shot am: 442
+6 : 270
Pre-shot pm: HI (had accident in the basement which I noticed shortly after giving insulin) - I had made the decision earlier in the day to go out to get the Organix canned so this is when I added in the new food at 25% to 75% renal
I just took a reading now +3 and he is at 390, will try to get another one at +7 as well.
What I'm stuck on is how much to reduce Prozinc dose when transitioning onto a lower carb, higher protein, low phos diet. I don't want to miss the ideal dosing and accidentally overdo it with his insulin and drop his numbers too low causing a bounce back up. Given my work schedule I can only get readings pre-shot both am and pm and around +6 or +7 during the day (3 readings total).
Help would be much appreciated as I know many of the users in this forum have experience with Prozinc, this is a first time using this insulin given our veterinarians had been using Caninsulin with success with the other diabetic cases however it was what he was started on and caused too many bounces (was up and down throughout the day), he is certainly doing better on the longer lasting Prozinc insulin.
I've recently taken in a foster/rescue from a situation where the family was not able to properly monitor his diabetes despite a lot of guidance from their veterinarian. He is 4 year old newly diagnosed diabetic (April of this year) and has been through 3 DKA episodes with the previous family when proper insulin doses were not given, insulin was still being given despite concerning behaviours at home which were later revealed (was hospitalized and re-stabilized on IV fluids each time). His story is long one but basically through my veterinary clinic he has landed in my home as a foster as the veterinarian did not feel this poor boy should be euthanized given the family could no longer cope - I have no experience with a diabetic cat but I felt his best chance at getting back to a normal life in a home as opposed to in a busy animal hospital. I have done a lot of reading and am quickly learning that this is not an easy fix but I'm willing to give him the love and patience he needs right now.
His kidney values had been normal up until 1 week ago, although his BG levels have never seem to normalize even on the Hills canned M/D diet. He was feeling much more himself despite the bounces between 100's to 400's until 1 week ago when he had an accident on the carpet and was not himself that night (drinking and peeing like a racehorse and quieter then usual - BG values had been in 300's and 400's all day despite no change in regime and more consistent lower values the previous few days). Given his history his renal threshold seems to be when levels are above 300-400 for longer then 24 hours as it is clear there is some remaining damage to his kidneys from the DKA episodes. I had blood work done the next morning following the accident on the carpet as I knew this was out of character for him. UREA 25.7, SDMA 17, Phos 2.2, Creatinine - Normal. Given these values he is considered to be Stage 2. Was started on Azodyl to lower UREA, Phos binder, switched to Hills Prescription K/D Early Support canned (slighter higher protein then regular k/d). However it is clear the higher carbs are not agreeing with him as his numbers are higher then ever despite being on 4 units of Prozinc twice daily (12 hours apart).
This evening I decided to try him back onto a lower carb, moderate high quality protein, low phos canned food as it is clear the unregulated diabetes is causing episodes where he is not feeling himself - Organix Chicken and Chicken Liver pate is what I chose and added in 25% new diet to 75% k/d renal diet.
Here are his values the past few days:
Friday June 8th - eating only renal k/d 4x day
Pre-shot am: 446
+7 : 270
Pre-shot pm: 464
Saturday June 9th - eating only renal k/d 4x day
Pre-shot am: 259
+9 : 243
Pre-shot pm: 374
Sunday June 10th- eating only renal k/d 4x day
Pre-shot am: 217
+6 : 151
Pre-shot pm: HI
Monday June 11th TODAY:
Pre-shot am: 442
+6 : 270
Pre-shot pm: HI (had accident in the basement which I noticed shortly after giving insulin) - I had made the decision earlier in the day to go out to get the Organix canned so this is when I added in the new food at 25% to 75% renal
I just took a reading now +3 and he is at 390, will try to get another one at +7 as well.
What I'm stuck on is how much to reduce Prozinc dose when transitioning onto a lower carb, higher protein, low phos diet. I don't want to miss the ideal dosing and accidentally overdo it with his insulin and drop his numbers too low causing a bounce back up. Given my work schedule I can only get readings pre-shot both am and pm and around +6 or +7 during the day (3 readings total).
Help would be much appreciated as I know many of the users in this forum have experience with Prozinc, this is a first time using this insulin given our veterinarians had been using Caninsulin with success with the other diabetic cases however it was what he was started on and caused too many bounces (was up and down throughout the day), he is certainly doing better on the longer lasting Prozinc insulin.
