On PZI having Hypo like symptoms with BG over 20 MMOL/L

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StanleyM

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I am in the UK and have a diabetic cat called Stanley, he has been diabetic since January 2015,he started on Caninsulin, and had brief remission in August 2015, we were unable to get him under control and he suffered Hypos regularly. He started on Pro-Zinc in mid June, and we started to get better control, he had a hypo around 2.00pm on the 31st Aug 2016 lasting a few hours, so insulin reduced, however over the last 2 weeks, he is suffering mini hypo like symptoms sometimes after injection, but it seems to be at differing times and last from 1/2 hour to 10 hours . On the 21st September, we started home testing, insulin dose just 3 units in the morning for 2 days, levels in high 20's and 30's, agreed with vet to go back on twice daily 2 & 1/2 units, on 23rd September, then at 6.50pm had another mini hypo, did BG test 29.6, did not give insulin on vet advice, hypo symptoms lasted until 5.00am. No insulin on 24th September, 3 BG tests, levels high. levels started to decrease with a normal curve, and levels dropping to low 20s.Then on 23rd September at 6.50pm , mini hypo started. On 26th September at 12.45pm he had another mini hypo - BG at the time 22.8, symptoms - head bobbing, circling, seems blind, then laid down, he was back to normal after half an hour. Advised vet, she advised no insulin for the evening. Had another again at 9.00pm for an hour, then fine again. Advised vet today, 27th September before insulin shot, advised no insulin. BG today 8.13am - 25.1 mmol/l - 12.15pm - 30.3 - 3.20pm - 31.1. No mini hypo like symptoms today, so far, now 6.04pm, will test BG at 8.00pm. It's like he is having some sort of allergic reaction to insulin???? He also has glaucoma in left eye for which he has regular eye drops for, pressure is high. Just wanted to see if anyone has had similar symptoms with their cat, as both us his owners and the vet, who has never used Prozinc before are not sure why this is happening when his BG is still high.
Thank you in advance for any help or information you can provide.
Stacey


 
I am going to assume that since you are in the UK the readings you are giving are in mmol/L, which is what I also use in Canada. The numbers you are quoting are no where close to hypo numbers. Hypo numbers would be more in the range of under 5 mmol/L . I would be concerned about possible ketones with the numbers that high. Also the circling and head bobbing and the such could indicate a neurological problem. I would suggest taking a video of your kitty and going to the vet and having testing done to see if there are other conditions that could be causing these symptoms. Again, if you are quoting numbers in mmol/L these numbers on no way indicate a hypo.
 
Hi Stacey and welcome to FDMB. Stanley's symptoms and his numbers certainly are not telling the same story. I had an experience recently with my human meter where the readings were suddenly quite wonky. I knew they were off because I was cross checking with a pet meter. After trouble shooting a bit, I realized that the battery indicator was showing low. It can be hard to catch the notification when you are rushing to test kitty. The meter was still working...just not correctly. I got one readings way higher than expected and one much lower. I recall seeing someone else mention having a similar experience in the past. So my suggestion would be to change the battery in the meter first and foremost to ensure it is reading accurately.

As Mary Ann says, those numbers are no where near hypo and this could be a neurological issue but if your meter behaves like mine did, Stanley's BG could be much lower than you think.
 
This does seem confusing, Stacey. If there are Uk numbers and not US numbers, those levels are not hypo levels - they are in fact quite high. Can you confirm if they are mmol/l levels? If US numbers, then yes, they are very low.

Our general guidelines for a regulated cat (on insulin) are mid 200s for preshot (US numbers) around 11-14 in UK if my conversions are close ) with the lowest mid cycle numbers 5.5 - 9. And not below 3.8- 5 which is hypo range. Those levels are for human meters. If you are using a pet meter, they should be a little higher, but not approaching the 20/30 range, which is quite high.

I wonder too if he is possibly in diabetic ketoacidosis: https://en.m.wikipedia.org/wiki/Diabetic_ketoacidosis. This would be a dangerous situation. But more likely, like Mary Ann, I wonder about an issue with his Glaucoma/blood pressure. Or as Linda suggests, a problem with your meter.

Regardless, if you are using UK ranges, and the meter is working correctly, he doesn't seem to be getting enough insulin to bring him down into safer, lower ranges.

Is there a Vet school or another vet who specializes in cats that you might get a second opinion from? It concerns me that your vet doesn't realize the numbers he is getting are high, not low.
 
These hypo like symptoms seem not to occur when he is off PZI. No PZI today, and no hypo like symptoms, if neurological it will probably be all the time. He has had hypos, and symptoms are the same, it's just the reading is not showing low.

My vet does know the values are high, and is checking with specialists as to what could be the problem, with whom she has communicated with previously. Unfortunately, all the info online is from the United States, unless anyone knows any specialist in the UK!!

I will change the battery, good suggestion you never know or I may try another meter.

Measurements are UK mmol/l.
 
What part of the UK are you in? There are a number of specialist vets around who only take referrals from other vets, 'the' place for feline diabetes is the Royal Veterinary College who train many of the UK specialists. My local specialist trained there.
 
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