PMPS 600+ Very Scared!

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Tamaraidic

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Did a curve today (haven't done a SS yet)
AMPS 310
5u PZI
+2 348
+4 271
+6 200
+7 225

PMPS 600+ (doesn't read past that so who knows)
That was an hr ago. Gave his prescribed 5u PZI
He hasn't see. The 200s since Dx so we were celebrating!

+45mins still 600+

I can't stop crying! Such a good day and now THIS?
 
Deanie and Boo (GA) said:
Tamaraidic said:
Gave his prescribed 5u PZI
Click to expand...

How in the world did you get up to a dose that high in just 4 weeks? Given the high numbers, he's probably getting too much insulin. How fast did you increase and what data was that based on?
Click to expand...

Deanie, here is the story from a previous post:
When Sonic was Dx he was 435 and was put on 1u PZI BID. We didn't home test during the 2 weeks he was on the 1u every 12 hrs. He went to vet for a curve and was 375 before his 9am shot. 2hrs later he was at 321 then 312 2 hrs after that. We were told to increase to 3G BID. That's when the home testing began. Didn't do any curves at home but was testing 350-370 just before shot and 300-320 an hr later. Two weeks later (4/13 the day after we lost our lady Spooky to bladder cancer) he was 435 before shot (3u). Then 365 2 hrs after shot and 320 2hrs after that (all at vet). We were told to increase to 5u PZI BID (that was 4 days ago) #s range from 321-420 before shot and 300-350 an hr after. Going to do a curve Thurs when we are home all day to do it (we both work full time). I am so scared for him that I am having nightmares :(
Click to expand...
http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=68868&p=749292#p749292
You'll see in that thread that the advice was to drop back to 1u...
Which I still think needs to be done. The dose advice from the vet defies logic (at least our logic).

Tami, have you had a chance to talk to the vet? Did you ask him the questions I suggested in that previous thread?
I think the 600 is another indication that the dose is too high and is causing radical reaction from Sonic's system to try to fight off the insulin doses.

Carl
 
Agree, agree, agree with what others have said so far. When on insulin 600s are typically a reaction to too much insulin.

I know it's very difficult to go against the advice of a licensed professional, but we have seen this here time and time again - cats prescribed too much insulin based on in-clinic curves which more than likely show values based on stress level BGs rather than non-stress BGs at home.

The testing you got at home was already revealing the effects of too much insulin by the time you started that's why the numbers don't appear to come down. Please see this link: http://petdiabetes.wikia.com/wiki/Rebound

I too had Gandalf up to 6U of PZI until I found this board. He did best on about 1.25U of PZI. That's a huge difference.

Someone recently posted about losing their cat to hypoglycemia on only 5U of Lantus. Though Lantus acts differently than PZI, improperly increasing doses of any insulin is dangerous.

I'm sorry if that scares you further, but I cannot emphasize enough that the advice of FDMB members overall in these cases usually proves correct.

Has anyone explained or helped you with ketone testing? That is something you need to be doing as well as home testing at this stage.

Relax and read. You are Sonic's best advocate and we can help you figure out how to help him.
 
Yes, Tami, breathe....When Harley was first dx, I had reading so high - all it said was HI. I rarely suggest going back to 1u from 6 but I don't use PZI. Experts will need to tell you what to dose. What I do know is make sure you are testing for ketones regularly. To begin with, I tested Harley every day since ketones develop quickly.

Pattie
 
Tami -

I'm one of the poster children for ketones. Can't stress it enough. A $6-10 bottle of strips can save you $2-4000 at the vet school/ER vet if ketones develop into DKA. On that high of a dose, they shouldn't, BUT, that's an extreme dose, and the numbers can be the basis for DKA.

Grayson was running long cycles at .2 and .4 units of ProZinc before he had a ketone scare. We jacked his insulin up over several weeks, .2 or .25 units at a time, before getting to 4.5 where we stayed 25 cycles, then continued to increase to 5 and 6 units. I've had THREE vets tell me to drop him back - two said drop to one unit; the third to reduce 1/3 to 1/2 and hold a week at a time to bring him down to normal dosing and see if (where) we missed the ideal dose - that we most likely passed right by in our hurry to keep the ketones away.

There are some cats that have Acromegaly and/or insulin resistence that require high doses. I'm having Grayson tested for them on Monday. But that's the exception rather than the rule. I would encourage you to post over in the PZI forum and take a look at some of our spreadsheets to see - but most of our folks have their kitties on .5u to 3 units - and several have gone off, or are in the process of going into remission, as their doses shrink and their numbers improve.

To quote my friend (the vet that suggested the 1/3-1/2 reduction - who also has a diabetic cat), "Most cats respond well to 1-2 units of PZI" - I think you too, have missed the dose.

Since I've reduced (~2 weeks now), Grayson is acting more normal, not continually ravenous, he's grooming, playing and acting like he used to. I know for him, the reduction was a good thing.

Good luck!

Lu-Ann
 
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