Numbers going up not down with insulin

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Ambermom

Ambermom

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My cat has been on 7.5 units of prozinc for three days from 7 units. This morning she was at 524 and tonight 404. Her numbers are going up instead of down. Could this be the Somalgi effect? How do I know? I feel like she is starving all the time and is eating 3 -4 cans of FFa day. Please help!
 
Hi @Ambermom

We use the "911" when a cat is having a life threatening situation. Would you mind taking that off of your title so people don't panic when they see it?

As for your question, You know if it's bouncing by looking at the data you've collected. Have you had a chance to start your spreadsheet? As soon as you post it, we can take a look and try to help you figure out what might be going on.
 
Djamila said:
Hi @Ambermom

We use the "911" when a cat is having a life threatening situation. Would you mind taking that off of your title so people don't panic when they see it?

As for your question, You know if it's bouncing by looking at the data you've collected. Have you had a chance to start your spreadsheet? As soon as you post it, we can take a look and try to help you figure out what might be going on.
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Sorry
 
Too much insulin can look like not enough. The more data - especially mid-cycle - the better the good folks around here can advise you on dosing.
 
Mid cycle is in the 28os 7-8 hrs post shot. Then it jumps to 363 2 hrs later. I test her 12 hrs apart, more often on Sat. She is fed two meals in between because she is starving all the time. Literally-she wants food every time someone is in the kitchen. She is still losing weight. I feel terrible for her.
 
Hi Ambermom, like mentioned above, the spreadsheet will help us see if bouncing is in play (if you need help setting it up like I did, let us know and we’ll do it for you). If bouncing isn’t happening, there are conditions that require higher doses and we can help with that too. My cat has acromegaly and is one of those high dose cats. At one point he needed 17u BID.
 
Hi Everyone:
Amber had another vet visit with everyone scratching their heads. She is now on DM food vs. Fancy Feast. Still on 7 units of Prozinc. Vet wants her fed 2x a day for a total of 1.5 cans of DM per day. She is starving, don't know if she will tolerate only being fed 2x a day. Has anyone had a case like this where the Vet doesn't even know what to do? The vet is adamant about not increasing her insulin due to somogyi effect. I have her SS in my signature. The numbers are frightening... :(
she is on 12.5 mg Furosemide, 1.25 Vetmedin, 5 mg benazepril
 
Ambermom said:
Vet wants her fed 2x a day for a total of 1.5 cans of DM per day. She is starving, don't know if she will tolerate only being fed 2x a day.
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Many of us have been told to feed only twice a day but most of us don't follow that and kitty is happier for it. Some of us feed several scheduled meals a day and some of us allow our kitty to graze. The important thing is to remove all food for at least 2 hours before doing the pre shot BG test so it's not food influenced.

Ambermom said:
Has anyone had a case like this where the Vet doesn't even know what to do?
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YES!!!!! My vet was stumped at my cat's refusal to follow all the rules. He's not a high dose cat but his BG is erratic and my vet had no clue how to advise me. I decided to take things into my own hands, came here to FDMB over a year ago, learned a lot about my cat's responses to insulin and have gotten him better (if not perfectly) regulated.

Ambermom said:
The vet is adamant about not increasing her insulin due to somogyi effect.
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Without testing you don't know if she has a high dose condition like acromegaly or insulin antibodies. Some people can't afford to do these tests but proceed with dose increases as though the kitty has one or both of those.

BTW - I can't open your SS. You have to "share" it with us.
 
Ambermom said:
Hi Everyone:
Amber had another vet visit with everyone scratching their heads. She is now on DM food vs. Fancy Feast. Still on 7 units of Prozinc. Vet wants her fed 2x a day for a total of 1.5 cans of DM per day. She is starving, don't know if she will tolerate only being fed 2x a day. Has anyone had a case like this where the Vet doesn't even know what to do? The vet is adamant about not increasing her insulin due to somogyi effect. I have her SS in my signature. The numbers are frightening... :(
she is on 12.5 mg Furosemide, 1.25 Vetmedin, 5 mg benazepril
Click to expand...

Yes, I think almost all of us have had vets that don't know how to treat feline diabetes. There is a LOT to learn about it, and vets have to know some of everything for every kind of animal they treat, so they don't becomes specialists in what is a very complex disease. Feline diabetes is all we do around here, so most of us, even though we are not experts, have "seen" more diabetic cats than any vet ever will. That's why I rely so much on the expertise in the forum. My vet is a kind, wonderful person, and I'm so glad that he takes care of my kitties in other things, but this is where I look for knowledge and wisdom about treating diabetes (and related issues).

Please don't feel like you need to limit your cat to twice/day feeding. You and your kitty will both just be unhappy, plus depending on your cat, it may make her numbers worse. If my kitty doesn't eat regularly, his numbers go much higher. If he snacks throughout the cycle, he stays pretty flat. Every cat has their own patterns, and the data will help you learn Amber's, but I think most cats do better with at least a few snacks.

The data will pretty quickly show if your kitty's numbers are somogyi, or just that she is a high dose kitty, and as Kris mentioned, you may also consider getting the testing done to solve the mystery once and for all. Great job setting up a spreadsheet by the way. In the top right corner, there is a blue button that says "share" click on that, make sure it's set to "anyone with a link can view" and then we should be able to see it.
 
Djamila said:
Yes, I think almost all of us have had vets that don't know how to treat feline diabetes. There is a LOT to learn about it, and vets have to know some of everything for every kind of animal they treat, so they don't becomes specialists in what is a very complex disease. Feline diabetes is all we do around here, so most of us, even though we are not experts, have "seen" more diabetic cats than any vet ever will. That's why I rely so much on the expertise in the forum. My vet is a kind, wonderful person, and I'm so glad that he takes care of my kitties in other things, but this is where I look for knowledge and wisdom about treating diabetes (and related issues).

Please don't feel like you need to limit your cat to twice/day feeding. You and your kitty will both just be unhappy, plus depending on your cat, it may make her numbers worse. If my kitty doesn't eat regularly, his numbers go much higher. If he snacks throughout the cycle, he stays pretty flat. Every cat has their own patterns, and the data will help you learn Amber's, but I think most cats do better with at least a few snacks.

The data will pretty quickly show if your kitty's numbers are somogyi, or just that she is a high dose kitty, and as Kris mentioned, you may also consider getting the testing done to solve the mystery once and for all. Great job setting up a spreadsheet by the way. In the top right corner, there is a blue button that says "share" click on that, make sure it's set to "anyone with a link can view" and then we should be able to see it.
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Thank goodness other people have heard the same information I am hearing from my vet. More than likely she will be fed four times a day, but try to stick to 2 cans of DM a day for the rest of the week and see what happens.
PS. I believe my SS link should work now.
 
Yes, spreadsheet works. Hooray! You work during the week, right? So mid-cycles just on the weekends? How many hours between PM shot and bedtime?
 
One other thing about the food: I don't know how big a can of DM is or how big your cat is, but if she doesn't need to lose weight, I would recommend feeding her however much she wants right now. You're right that her numbers are quite high, and when a kitty is in high numbers, they can't use all of the nutrients in food the way a healthy cat can. That means that they really do need more food than a healthy cat at the same weight. As Kris mentioned, you want to withdraw food two hours before test/feed/shoot time so that the BG number isn't food inflated, but the rest of the time she can eat if she wants. I think you mentioned she's still losing weight which indicates that she needs more food, not less.

High numbers and not enough calories are two of the three "ingredients" for ketones, so I would hesitate to keep her from eating if she's hungry.

If she needs to lose weight, or if two cans is enough to keep her happy, then ignore all of that. I was just thinking from your comment that she might be asking for more?
 
Update-since starting on DM wet food one week ago, Amber’s numbers are finally coming down! They are still high, but no 500s...I am feeding her larger portions 3x a day. Just praying for weight to stabilize. The Vet said to keep her on 7 units prozinc and regroup in two weeks.
 
Crap! Numbers are going up again for no reason.
She is on DM and her numbers were going down. What is happening, my poor cat is wasting away
 
Hi Ambermom, there are a couple high dose conditions you may want to look into getting tested for. IAA, which is insulin auto antibodies, and Acromegaly which is a high dose condition caused by a benign pituitary tumor. My cat tested positive for acromegaly and a change in insulin and dosing advice from other acro cat owners has helped him significantly. In case you’d like more info on these conditions, I’ll tag @Wendy&Neko to help. I remember he also has a heart condition, if you would, list those heart drugs in your signature in case any of them have a bearing on his dose.
 
Hello Ambermom. I agree with others that you might want to approach your vet about testing for high dose condition. Yes, my vet was clueless about that too and thought I had to wait until we got a much higher dose. I had to walk my vet through what to do - we learned together with the help of FDMB. On this board, we suggest cats on low carb food that get to 6 units be tested for IAA and acromegaly. My girl had both. One in 4 diabetic cats has acromegaly, according to recent research, though not all of them need larger doses. Typically if a cat is on higher doses, one or other of the tests is likely to be positive. Acromegaly is caused by a benign tumour on the pituitary that sends out excess growth hormone. Other signs of acromegaly are "starving" due to the excess growth hormone (think growing teenagers) and some get heart conditions caused by organmegaly, or growth of the heart.

If Amber has a high dose condition, holding the dose any length of time will let insulin resistance get hold and the numbers will get worse.
 
Hi Saron- Vet is now considering changing insulin to Lantus/Glargine. Does anyone know anything about this insulin?
Amber was 525 first thing this morning. Yikes!! As a side note, she has a referral for internal medicine specialist at NC state vet school-but it takes weeks to het an appointment.
 
Ambermom said:
Hi Saron- Vet is now considering changing insulin to Lantus/Glargine. Does anyone know anything about this insulin?
Amber was 525 first thing this morning. Yikes!! As a side note, she has a referral for internal medicine specialist at NC state vet school-but it takes weeks to het an appointment.
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Lantus works very well for many kitties. Your best bet is to go post on that forum to ask all of your questions about it. :)
 
I agree with Sharon, Levemir can be a better insulin for higher dose kitties. In addition to the sting factor, Lev seems to have a bit better duration.
 
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