Our 10 year old cat was diagnosed this summer with diabetes. He started at 3 units twice a day of ProZinc. He moved up to 4 units twice a day about 2 months ago. A month ago his kidneys started failing and was placed on a k/d diet. Which he loves. Last week he got bumped up to 6 units twice a day. Today we went in again and his glucose level was 356 by his was 1 1/2 after his morning dose. So he was bumped again to 8 units twice a day!!! The vet said he might not be responding to insulin anymore. He goes back next week and we will see how he responds to the increase. I am so surprised how quickly he is failing. He sleeps all the time. He eats and uses the litter box. Then goes back to sleep. Does anyone have any suggestions to help him? We love him dearly and don't want him to suffer. confused_cat
Not responding to insulin
- Thread starter Freond
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Elizabeth and Bertie
Member Since 2010
Hello and welcome to FDMB,
Please forgive this short message but I'm about to go out. Others will respond shortly.
I am so sorry that your kitty is feeling poorly. But please do take heart. This site is a fantastic resource for help with managing feline diabetes. You are among friends here.
What leaps out at me most from your message is the fast rate at which your kitty's insulin dosage was increased.
I have a couple of questions for you;
How did your vet determine that 3 units was the correct starting dose?
How were the increases determined..?
Was the dose increased by whole units of insulin, or more gradually (ie, .25 unit , or .5 unit increments?)
And another question:
Are you willing to learn to test your kitty's blood glucose at home? It's not difficult to learn, it won't hurt your cat (or your wallet), and will give you much better control and understanding of your kitty's diabetes.
So sorry for this brief message, but did want to respond to you ASAP.
Eliz
Please forgive this short message but I'm about to go out. Others will respond shortly.
I am so sorry that your kitty is feeling poorly. But please do take heart. This site is a fantastic resource for help with managing feline diabetes. You are among friends here.
What leaps out at me most from your message is the fast rate at which your kitty's insulin dosage was increased.
I have a couple of questions for you;
How did your vet determine that 3 units was the correct starting dose?
How were the increases determined..?
Was the dose increased by whole units of insulin, or more gradually (ie, .25 unit , or .5 unit increments?)
And another question:
Are you willing to learn to test your kitty's blood glucose at home? It's not difficult to learn, it won't hurt your cat (or your wallet), and will give you much better control and understanding of your kitty's diabetes.
So sorry for this brief message, but did want to respond to you ASAP.
Eliz
Sue and Oliver (GA)
Member Since 2009
That is certainly a large dose of ProZinc. Most cats here get one unit and under. It may be that he is over his ideal dose and bouncing from lows to highs. The only way to find out if this is the case is to give some midcycle numbers over a few cycles. This is best done at home as cats are stressed at the vet and stress raises blood glucose levels. Then doses based on those elevated numbers may be too high once the cat gets home. The falling asleep could be a sign that he is dropping low midcyle - sleeping or unconsciousness is a sign of hypo.
We have taught hundreds of people how to hometest. No only will it keep your cat safe by knowing whether the dose you are planning to give is safe, and how the insulin is working, it is much less expensive than getting tests done at the vet.
Would you like us to help you hometest?
There are high dose conditions that do require large doses of insulin. But finding out exactly what is happening with his numbers is the first step.
We have taught hundreds of people how to hometest. No only will it keep your cat safe by knowing whether the dose you are planning to give is safe, and how the insulin is working, it is much less expensive than getting tests done at the vet.
Would you like us to help you hometest?
There are high dose conditions that do require large doses of insulin. But finding out exactly what is happening with his numbers is the first step.
I have no idea how the vet determined that 3 units was a good starting number. He ran a bunch of tests at the first cist and when he diagnosed the kidney failure. He increased by 1 unit. Then 2 last week and 2 today. Never in small doses. Freond did good with 3 units for a while. We took him in after getting sick and/or behavior changes each time. We are quickly drowning in the cost of all the tests, insulin, and special food. However, we do NOT ever want to put him down because of money. So I am trying to learn anything I can. I know about home testing. It is super easy. Our vet thought it would be stressful on Freond to home test. confused_cat We have 4 very young kids and another cat so he is used to chaos. He loves our vet and is super happy to go there. Probably a nice break from the kids. 
Sue and Oliver (GA)
Member Since 2009
So you are testing him at home? fantastic! Can you give us some recent numbers - preshot and midcycle? That might really help us see what is going on.
C
Carl & Polly & Bob (GA)
Is the k/d food dry or canned?
Sue and Oliver (GA)
Member Since 2009
You might be a little stressed till you get the routine down, but your cat is likely to be much less stressed than at the vet. Our idea is that we wouldn't get insulin for our 2 legged children, shoot blind for 2 weeks and then go back to the doctor- we'd test before each shot. We do the same for our 4 legged kids. 
It is fairly easy. Here is a video that shows how we do it.
http://www.sugarcats.net/sites/harry/bgtest.htm
It is fairly easy. Here is a video that shows how we do it.
http://www.sugarcats.net/sites/harry/bgtest.htm
nancy and payne
Member Since 2010
Just a thought but that's a LOT of insulin! I use PZI and my cat uses high doses of insulin. I
shoot 3x a day and test before each shot. You need to know his #s before you shoot or a some point
he will go low and you will shoot .....
He needs to be on a low carb wet food like Fancy Feast pates or Friskies, there are lists, that should
help the #s . No more dry, sorry it's like crack to a diabetic cat. Also,
unless you have #s daily, how will you know what dose he really needs, my bet is you've gone past
it and is is reacting to TOO much insulin. Please don't up it anymore.
It is difficult in the beginning but you can do it. I have been shooting insulin 3x a day for three yrs.
and unless I had reams of #s and tests showing the need I would never shoot that much insulin into
one cat.
Start testing, and change his diet. I would lower his dose.
Nancy and Payne
shoot 3x a day and test before each shot. You need to know his #s before you shoot or a some point
he will go low and you will shoot .....
He needs to be on a low carb wet food like Fancy Feast pates or Friskies, there are lists, that should
help the #s . No more dry, sorry it's like crack to a diabetic cat. Also,
unless you have #s daily, how will you know what dose he really needs, my bet is you've gone past
it and is is reacting to TOO much insulin. Please don't up it anymore.
It is difficult in the beginning but you can do it. I have been shooting insulin 3x a day for three yrs.
and unless I had reams of #s and tests showing the need I would never shoot that much insulin into
one cat.
Start testing, and change his diet. I would lower his dose.
Nancy and Payne
Hello!
Sad your kitty is so ill. I don't know about kidney failure in kitties, but I'd get a copy of the actual tests from the vet & post the information here. Your vet appears to be quite lacking in FD knowledge, so please check up on his knowledge of kidney failure.
How much does Freond weigh? My Pudge weighed 18 lbs (but his ideal weight was 14 or 15 lbs) at the time of his FD Rx & was placed on 4 units X2 of ProZinc by his vet. I didn't know about testing at home until some 2 weeks later when my daughter found this site. I almost killed my Pudge. I started home testing & lowered the dose to 1 unit. Today, Pudge is OTJ due, in my opinion, to the advice of the wonderful people on this board. Please do not shoot 8 units! It's very dangerous.
Best wishes,
Sophie
Sad your kitty is so ill. I don't know about kidney failure in kitties, but I'd get a copy of the actual tests from the vet & post the information here. Your vet appears to be quite lacking in FD knowledge, so please check up on his knowledge of kidney failure.
How much does Freond weigh? My Pudge weighed 18 lbs (but his ideal weight was 14 or 15 lbs) at the time of his FD Rx & was placed on 4 units X2 of ProZinc by his vet. I didn't know about testing at home until some 2 weeks later when my daughter found this site. I almost killed my Pudge. I started home testing & lowered the dose to 1 unit. Today, Pudge is OTJ due, in my opinion, to the advice of the wonderful people on this board. Please do not shoot 8 units! It's very dangerous.
Best wishes,
Sophie
Wendy&Tiggy(GA)
Member Since 2011
Hello there
Since your kitty has diabetes and kidney disease you want a low carb canned food that is also good for the kidneys. But you want to be testing first since his insulin needs will drop and you don't want him to have a hypo.
Here is a list of foods that are good for diabetic cats but note the last number is phosphorus - and your cat needs under 250 phosphorus cos if his kidneys- http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=94685
And here is a testing shopping list - let us know when you get the stuff and we can give testing tips.
1. Meter ie Walmart Relion Confirm or Micro.
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
4. Cotton balls to stem the blood
5. Neosporin or Polysporin ointment with pain relief to heal the wound
6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
7. Ketone urine test strips ie ketodiastix - Important to check ketones when blood is high
8. Sharps container - to dispose of waste syringes and lancets.
9. Treats for the cat - like freeze dried chicken
10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast
Wendy
Since your kitty has diabetes and kidney disease you want a low carb canned food that is also good for the kidneys. But you want to be testing first since his insulin needs will drop and you don't want him to have a hypo.
Here is a list of foods that are good for diabetic cats but note the last number is phosphorus - and your cat needs under 250 phosphorus cos if his kidneys- http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=94685
And here is a testing shopping list - let us know when you get the stuff and we can give testing tips.
1. Meter ie Walmart Relion Confirm or Micro.
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
4. Cotton balls to stem the blood
5. Neosporin or Polysporin ointment with pain relief to heal the wound
6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
7. Ketone urine test strips ie ketodiastix - Important to check ketones when blood is high
8. Sharps container - to dispose of waste syringes and lancets.
9. Treats for the cat - like freeze dried chicken
10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast
Wendy
Care4Sparks
Member Since 2011
Hi,
I'm no expert but to share my situation -
like you, my cat was getting a high dose. I was doing home testing and the dose seemed to have no effect. I kept moving it up... no improvement, more insulin, and still no improvement.
It seemed like it wasn't doing anything.
but I got advice to go against intuition and 'restart'
That scared me, to drop so fast with numbers so high, so
Over time we have been lowering the dose.
Sparks now gets 2.5u twice per day. His BG isn't any worse than when he was getting a lot more, and actually we aren't seeing numbers in the 400s.
Others suggested we shot past the correct dose.
2.5 might still be too high or low. It is a thing you have to consider over time.
But I feel better giving him this lower dose and Sparks seems to like it, too.
Again, I am no expert but I didn't feel ok dropping to 1u twice per day, after having him at 4u three times a day. His numbers were really high, persistently.
But over weeks we dropped a half unit here, then a few weeks and another half unit, then a change in number of shots per day...
And, surprisingly, he not only adapted but has seemed to improve.
I think we really did overshoot out of fear from his high numbers and lack of patience (sense of urgency).
You already know about kidney problems, so that is a special consideration I don't know much about. Maybe your vet or others will know more about whether a quick drop in dosage or small adjustments are best but my novice perspective is that overshooting is a reality and isn't always measureable with low BG readings - sometimes it's just persistently high BG readings (because the body is trying to counteract the insulin 'overdose' I guess).
Good luck with everything and I hope the more experienced here and with your vet your kitty will feel better soon!
I'm no expert but to share my situation -
like you, my cat was getting a high dose. I was doing home testing and the dose seemed to have no effect. I kept moving it up... no improvement, more insulin, and still no improvement.
It seemed like it wasn't doing anything.
but I got advice to go against intuition and 'restart'
That scared me, to drop so fast with numbers so high, so
Over time we have been lowering the dose.
Sparks now gets 2.5u twice per day. His BG isn't any worse than when he was getting a lot more, and actually we aren't seeing numbers in the 400s.
Others suggested we shot past the correct dose.
2.5 might still be too high or low. It is a thing you have to consider over time.
But I feel better giving him this lower dose and Sparks seems to like it, too.
Again, I am no expert but I didn't feel ok dropping to 1u twice per day, after having him at 4u three times a day. His numbers were really high, persistently.
But over weeks we dropped a half unit here, then a few weeks and another half unit, then a change in number of shots per day...
And, surprisingly, he not only adapted but has seemed to improve.
I think we really did overshoot out of fear from his high numbers and lack of patience (sense of urgency).
You already know about kidney problems, so that is a special consideration I don't know much about. Maybe your vet or others will know more about whether a quick drop in dosage or small adjustments are best but my novice perspective is that overshooting is a reality and isn't always measureable with low BG readings - sometimes it's just persistently high BG readings (because the body is trying to counteract the insulin 'overdose' I guess).
Good luck with everything and I hope the more experienced here and with your vet your kitty will feel better soon!
Deb & Wink
Member Since 2013
Prozinc does not work well with every cat. You might consider a different insulin like Lantus or Levimir.
Sue and Oliver (GA)
Member Since 2009
If I were you, I would start testing at home and get some levels to see how Freond is really responding to the insulin. Then you can see whether he is bouncing from highs to lows and needs less insulin or whether he is just generally high. If he is high overall, then you might consider looking into trying another insulin or looking at high dose conditions.
I would also switch over to completely wet (and perhaps a lower carb food) BUT not until you are testing at home.
Can we help you learn to home test?
I would also switch over to completely wet (and perhaps a lower carb food) BUT not until you are testing at home.
Can we help you learn to home test?
BJM
Member Since 2010
For more info on renal disease, go to Tanya's Feline CRF site
Sue and Oliver (GA)
Member Since 2009
Gosh, yes! I'll go back and change it.
Jess and MrCat
Member Since 2013
Wendy&Tiggy said:
I agree with Wendy. It is important to switch to low-carb canned food that is low phosphorus. The k/d food you are giving is definitely not low carb. It probably contributed to the higher BG. But like Wendy said, you need to home test before you switch to a low-carb diet. The BG will come down with low carbs and you will need to adjust the insulin as a result. There are many folks on this site who can guide you once you switch to the new low-carb canned food. Best wishes!
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