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Bella & Puddin

Bella & Puddin

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My cat, Puddin (m, 6 yrs) was put on Prozinc caused (in our opinion) by a single steroid injection. He has ALWAYS been on a wet food, low carb diet since his birth (he was born under our bathroom sink), so I don't believe the issue was created by food.
The vet started him at 4 units of Prozinc...after about 3 checkup visits so far within the span of less than 2 months they have suggested an increase to 8 units of Prozinc.
I'm frustrated at this point for many reasons...I'm glad to have found this forum that teaches users to take matters into their own hands (vet told me it would be too hard for me to test my cat's levels at home...).
I dislike giving SO MUCH insulin especially after reading the suggested starting dosages on this forum for Prozinc!
My question for now is: in the interim (as I learn to test at home and gather supplies to do so) can I "restart" or go ahead and lower his units?
Additional info: despite varying dosages, his glucose levels at vet have varied...lower dosages even suggested BETTER levels than higher dosages.
 
Oh my goodness. I can’t say that I am not alarmed by the high doses. Sometimes they’re appropriate, but normally we would arrive at higher doses based upon home testing and seeing how low each dose takes the cat. The only safe way to dose the insulin is to find out what the nadir is (nadir is the lowest point in each cycle.). I would absolutely love to help you and Puddin. We need to get you set up with a spreadsheet and home testing if possible. Or a Freestyle Libre sensor, although those only last for 2 weeks. They can give you time to get your testing technique down. I have to run for a few minutes but will be back! Tell me what he eats. Has he ever had a glucose “curve” run at the vet?
 
Suzanne & Darcy said:
Oh my goodness. I can’t say that I am not alarmed by the high doses. Sometimes they’re appropriate, but normally we would arrive at higher doses based upon home testing and seeing how low each dose takes the cat. The only safe way to dose the insulin is to find out what the nadir is (nadir is the lowest point in each cycle.). I would absolutely love to help you and Puddin. We need to get you set up with a spreadsheet and home testing if possible. Or a Freestyle Libre sensor, although those only last for 2 weeks. They can give you time to get your testing technique down. I have to run for a few minutes but will be back! Tell me what he eats. Has he ever had a glucose “curve” run at the vet?
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I appreciate your desire to help us! I will provide you the information requested in a few hours.
 
It sounds like maybe you’ve been reading through some of the sticky notes at the top of this forum. That’s good if you have.
Did he just get increased from 4 to 8 units all at one time? Based on what numbers?. Small changes in insulin doses can make a real difference. Do you have any of his bloodwork? Is he eating well? Does he have normal activity level? No history of ketones (if you or the vet have tested for ketones) or hospitalization for DKA?
 
I've attached Puddin's history file; what is missing is the initial visit which I will request tomorrow.
In short he received a steroid shot in July or August due to a cough, after a few weeks he began to deteriorate, lost 7lbs, we brought him back to the vet and he was said to be diabetic. We THINK the initial glucose reading was 360; if this is true, it was lower than any reading AFTER insulin was started.
In the file you can see some of the blood glucose readings (curves) that have been done. On one occasion they only took one reading and said increase, without doing a curve.
The units went from an initial 4u to 5u to 6u to 8u (what we are at now). Without having done any blood glucose check at home, he is still thirsty, poops outside of the litter box, and isn't very playful. A couple of hours after his 8u insulin shot this morning he was restless and anxious and couldn't seem to quench his thirst. This evening I decided on my own to only give him 6u and he is not restless but rather a little lethargic, but, of course, this is without any testing.
He eats very well, almost too well! And is consistently thirsty.
His activity level is very low compared to before the steroid shot (the catalyst for his diabetes).
I am not aware if ketones were every checked by the vet and also no history of DKA.

Thank you for reading and input!
 

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Oh, I really feel for what you all are going through. We need to start tracking his blood glucose levels to see what is going on with your handsome boy. I am glad you shot a reduced dose tonight, but we still need to see where he goes on that dose. I hope you can start testing so we can see what is going on during each cycle.
 
Let me know if you can be around sometime this evening to “chat”. I’m wondering how your adorable Puddin is doing.
 
Hi! I'm just home from the vet. Puddin seemed to be feeling unwell so I wanted a new vet to look at him and even give a second opinion on the diabetes issue.
He was given an antibiotic for now and it was suggested to keep him at 8u (for now). I haven't been able to get the tools for testing at home yet, within the next few days I will get them.
At the vet they checked his current level and it was in the 380s (less than it has been lately from glucose curves done).
Once I get the hang of testing and have a decent source of data (IF I can get the hang of it!) I would love to dive into the data with you!
 
Okay. I do hope you can start getting tests done. Have you read through the tips on testing. Has anyone sent you the picture of the “sweet spot”? Tips about warming the ear? Etc?
 

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I would go to Walmart and buy a ReliOn Premier meter. It’s a good reliable meter. Strips are $17.88 for 100. You don’t have to worry about using strips at this cost.
 
Have they ever tested him for ketones? Today?
Why the antibiotics? Did he have a fever? A high white blood count? Did they give you the bloodwork results?

If he does have an infection, I am very glad they caught it. An infection combined with high BG is a recipe for DKA.

You should try to test him at home for ketones by getting some Keto stix that you need to put in his urine stream in the litter box. With his high numbers, it would be safest to test for ketones. I bought a Nova Max Plus blood ketone meter instead from ADW Diabetes Supply. It works the same as a blood glucose meter except with special strips to test for ketones.
 
They tested his urine and blood (only for glucose reading); would urine have been for ketones?
From previous yet recent bloodwork Puddin had elevated white blood cells...previous vet gave us antibiotics but either we didn't administer well enough or they weren't appropriate for his issue. No fever.

So far, even just 24 hours later, he seems to have perked up and isn't as crazy for water. I'm wondering if a major issue is this infection. I also haven't found any urine outside of the litter box today which is a big deal.

The 380 reading would've been about 9-10 hours after insulin had been administered.

I've gathered all of the glucose testing material; exactly the ones you mentioned. I'll watch some videos and see if I can try tomorrow!
 
BellaMills said:
They tested his urine and blood (only for glucose reading); would urine have been for ketones?
From previous yet recent bloodwork Puddin had elevated white blood cells...previous vet gave us antibiotics but either we didn't administer well enough or they weren't appropriate for his issue. No fever.

So far, even just 24 hours later, he seems to have perked up and isn't as crazy for water. I'm wondering if a major issue is this infection. I also haven't found any urine outside of the litter box today which is a big deal.

The 380 reading would've been about 9-10 hours after insulin had been administered.

I've gathered all of the glucose testing material; exactly the ones you mentioned. I'll watch some videos and see if I can try tomorrow!
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I’m really happy to hear he seems perked up. And going inside the litter box is huge! Do they suspect a UTI? Not sure about that because they would have noted that there was probably blood and white cells and also visible bacteria in his urine sample. What did they give you (antibiotic?)
 
Suzanne & Darcy said:
@Diane Tyler's Mom do you have a link to a good testing video?
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@BellaMills
Hi there first can you set up your signature we need some information about Puddin
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help

The blue link will also tell you how to set up your spreadsheet and explain how it works. If you have trouble setting it up just ask we have a member who can help you with that

Testing tips and videos
https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
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6. As the ears sugar

used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with
Here is a video one of our members made testing her kitty
She's using a pet meter that has to be coded ,with a human meter you don't have to code it.
So ignore that
I have always used a human meter
VIDEO: How to test your cat's blood sugar

I hope you bought one of the Relion human meters
 
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Hello! I'm having difficulty with the ear pricking. It's been a few days of trying at random times of day and only once was I able to get some blood to come.out, but his hair got in the way of the test strip and then I smudged the sample on my hand with no more left for testing!
We're going to keep trying.
I mentioned I was attempting testing to my vet and he said that cat blood glucose could read higher on a human meter because their blood makeup is different to a humans; is there a conversion factor we should use after obtaining the values from a human meter?
Thank you for the helpful information! I will fix my signature once I get on a physical computer. I will keep you all updated - thank you for checking on us!
 
That’s not true about the human meters. In fact, the numbers on a pet meter like the Alpha Trak tend to read higher. That is why we recommend that a cat not drop below 68 on a pet meter; whereas we don’t want a cat to drop below 50 when using a human meter. That’s really the only important point. There really is no conversion between the two. The strips for the AT are outrageously expensive as well. Think about this, many vets are recommending the use of Freestyle Libre glucose sensors for cats. This is a device invented for and used by humans.
 
Are you using something to warm his ear up prior to trying to get blood? Many people use a small sock filled with rice and microwave it. Others use a small bottle like a pill bottle and put warm water in it. I used a small glass bottle that I happened to have from a sample of olive oil. This was only in the beginning when I first started testing. After a while their ears bleed more easily. Warming the ear can really help. I cried a lot in frustration and defeat during my first weeks of trying to get blood.
 
I got one reading this morning! At 0840 his reading was 401. This was about 3 hours after receiving 8 units of Prozinc.
I'll do some more random testings and then start tracking better...I hope it stays as easy as it was this morning...wow...thank you, God!
 
Suzanne & Darcy said:
Awesome! That’s so great!
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If I'm still getting levels that are high (high 300s to almost 500) throughout the day, would the next step be to increase dosage units?

Also, I just tested the same prick point/sample of blood and got 2 different readings...431 and 398; what do I do with this information?
 
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BellaMills said:
If I'm still getting levels that are high (high 300s to almost 500) throughout the day, would the next step be to increase dosage units?

Also, I just tested the same prick point/sample of blood and got 2 different readings...431 and 398; what do I do with this information?
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Yes. The blood glucose meters are allowed to have up to a 20-25 percent “meter variance,” which means that you can test the same drop of blood and get a number that can vary by +/- 25 percent. It’s something we have to take into account, but sometimes we test the same blood and get virtually the same number- so it doesn’t happen all the time. We also always recommend — if you get a number that seems really off or unexpected — to retest to make sure you didn’t have a bad test strip. Let me look at the spreadsheet now and see what data you have
 
Great job with the testing! It is good to start seeing data filling in that spreadsheet. What we need is to see some tests around +6 (+5, 6, 7 perhaps— it doesn’t need to all be on the same day.). From the looks of things, I am not expecting dramatic nadirs, but we need to know before any dose changes can be safely considered.
 
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