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Hello Cindy and Butter. So glad you found FDMB.

I know this is going to sound totally backwards but it sounds highly likely that you need to reduce the dose of insulin immediately. Changing insulin with the dosing method your vet is using is not going to make any difference whatsoever. This is all too common and you are not alone in this experience. Many of the folks who find us are here for exactly the same reason.

The starting dose of insulin would normally be around 1u twice daily so your vet prescribed double the usual. We recommend dose increases be done in 0.25u increments and definitely no more than 0.5u. So again, your vet has been increasing the dose at least twice as quickly as we recommend. Our kitties are small creatures and 1u increases are huge making it highly likely that the best dose for Butter has been totally missed.

Insulin is not a medicine like Aspirin where if one tablet doesn't work you take two the next time. It's a hormone that triggers other processes in the body and what is happening with Butter is perfectly natural. When the BG starts to drop too fast and/or too much, all mammals have a defence system that triggers various processes in the body to spill stored glucagon into the bloodstream and bring the BG back up to safe levels. In Butters case, his body has become used to higher than normal BG and so his defence system gets triggered prematurely and panics raising his BG up even higher than what has become normal for him.

Now that you are home testing (KUDOS to you for that!) you can gain much better control over Butters than the vet ever could because the other problem at play here is that our kitties are usually stressed out at the vet and this causes temporary elevation of BG. Some cats will have a BG 100 or more points higher than their norm. This of course leads the vet to think kitty's BG is far worse than it is and they end up prescribing too much insulin.

Now that you are home testing, it would be very helpful if you would set up one of our spreadsheets to track Butters BG. The spreadsheet is viewable by members here who can help you get Butter on a better path and on the road to feeling and acting much more like his old self. If you can plot in the readings you have taken at home so far, it will give folks here some data on which to offer more specific opinions/suggestions. Here is a link to the Spreadsheet Instructions and another link to how to use the spreadsheet. If you need any assistance setting up the spreadsheet, just holler and someone will help you out.
 
Mr wolf did a great job of explaining what needs to be done. Your insulin is good.... The dosing is terrible. We will get you there.

Well done for home testing!

Get that spreadsheet going so we can see more clearly what's going on.

We are going to have you back that dose way down to 1 or 2, test, and then have you SLOWLY raise as needed by no more than 0.5 units at a time. I'm fairly certain your ideal dose was skipped. Too much insulin can look like not enough. @Cindy Lamy
 
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Hi Cindy and Butter! Welcome to ProZinc! I'm so glad that you're home testing and it definitely sounds like you need to reduce the dose. 5 units is a lot to give and you probably missed the ideal dose (which happens a lot to newer members!). I don't want to overwhelm ya and since Linda give you great information already, I will just add to please ask any questions you have! We're happy to help!
 
Hello Cindy & Butter!! :bighug:

I'm only two months in and your are so in the right place. The way I felt on day one and today are night and day. It really does get easier. I so wish I could offer advise but I'm still learning but what I will offer is comfort knowing you're getting the best advise. My Beenie is slowly going in the right direction thanks to the help/direction I get here!!!!! Its essential to test at home. I honestly don't know how kitties make it based on vet direction alone. I haven't reached out to my vet, who by the way I LOVE, because we've got it handle here!! You AND Butter will be fine.

Feel free to ask away; the folks here are AMAZING!! :cat:
 
Beenie said:
Hello Cindy & Butter!! :bighug:

I'm only two months in and your are so in the right place. The way I felt on day one and today are night and day. It really does get easier. I so wish I could offer advise but I'm still learning but what I will offer is comfort knowing you're getting the best advise. My Beenie is slowly going in the right direction thanks to the help/direction I get here!!!!! Its essential to test at home. I honestly don't know how kitties make it based on vet direction alone. I haven't reached out to my vet, who by the way I LOVE, because we've got it handle here!! You AND Butter will be fine.

Feel free to ask away; the folks here are AMAZING!! :cat:
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Thank you! :)
 
JanetNJ said:
Mr wolf did a great job of explaining what needs to be done. Your insulin is good.... The dosing is terrible. We will get you there.

Well done for home testing!

Get that spreadsheet going so we can see more clearly what's going on.

We are going to have you back that dose way down to 1 or 2, test, and then have you SLOWLY raise as needed by no more than 0.5 units at a time. I'm fairly certain your ideal dose was skipped. Too much insulin can look like not enough. @Cindy Lamy
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Thank you Janet!
 
MrWorfMen's Mom said:
Hello Cindy and Butter. So glad you found FDMB.

I know this is going to sound totally backwards but it sounds highly likely that you need to reduce the dose of insulin immediately. Changing insulin with the dosing method your vet is using is not going to make any difference whatsoever. This is all too common and you are not alone in this experience. Many of the folks who find us are here for exactly the same reason.

The starting dose of insulin would normally be around 1u twice daily so your vet prescribed double the usual. We recommend dose increases be done in 0.25u increments and definitely no more than 0.5u. So again, your vet has been increasing the dose at least twice as quickly as we recommend. Our kitties are small creatures and 1u increases are huge making it highly likely that the best dose for Butter has been totally missed.

Insulin is not a medicine like Aspirin where if one tablet doesn't work you take two the next time. It's a hormone that triggers other processes in the body and what is happening with Butter is perfectly natural. When the BG starts to drop too fast and/or too much, all mammals have a defence system that triggers various processes in the body to spill stored glucagon into the bloodstream and bring the BG back up to safe levels. In Butters case, his body has become used to higher than normal BG and so his defence system gets triggered prematurely and panics raising his BG up even higher than what has become normal for him.

Now that you are home testing (KUDOS to you for that!) you can gain much better control over Butters than the vet ever could because the other problem at play here is that our kitties are usually stressed out at the vet and this causes temporary elevation of BG. Some cats will have a BG 100 or more points higher than their norm. This of course leads the vet to think kitty's BG is far worse than it is and they end up prescribing too much insulin.

Now that you are home testing, it would be very helpful if you would set up one of our spreadsheets to track Butters BG. The spreadsheet is viewable by members here who can help you get Butter on a better path and on the road to feeling and acting much more like his old self. If you can plot in the readings you have taken at home so far, it will give folks here some data on which to offer more specific opinions/suggestions. Here is a link to the Spreadsheet Instructions and another link to how to use the spreadsheet. If you need any assistance setting up the spreadsheet, just holler and someone will help you out.
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So in the meantime what dose should I drop down to? He has been getting 5 units every 12 hours for over a week. We started out at 2 units, then the vet increased it after a month to 3, then the next week it was 4 now we are on 5.
 
I don't mean to be disrespectful but for the life of me I cannot get a grip on the fact that everyone says vets do not know what they are doing when it comes to this. It amazes me. He had me buy the Hills W/D dry food. He is such a nice vet and loves cats. He calls me at home all the time. It is just so strange!
 
Cindy Lamy said:
I don't mean to be disrespectful but for the life of me I cannot get a grip on the fact that everyone says vets do not know what they are doing when it comes to this. It amazes me. He had me buy the Hills W/D dry food. He is such a nice vet and loves cats. He calls me at home all the time. It is just so strange!
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The truth is most vets just don't get enough training in this area, or they dose a cat like they would a dog and they are not the same. I'm sure your vet is well meaning.

The hills W/d is a high carb food! Like 33% carb! Well the mystery of the high numbers is solved. Even the diabetic m/d food is too high at 14% carb. Diabetic cats need a diet of foods less then 10% carb. Basically you've been feeding her donuts. Will she eat wet food? Most of us feed fancy feast classic or Friskies pate. Choose food under 10 carb from this list. http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

This is important! Before you switch her food to low carb you must drop that dose way down because her numbers are going to drop. If you change food without lowering the dose she could hypo.
 
Cindy Lamy said:
I don't mean to be disrespectful but for the life of me I cannot get a grip on the fact that everyone says vets do not know what they are doing when it comes to this. It amazes me.
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It amazes us too but as mentioned, vets are not given much training on diabetes and those hours cover all species. When you think about it, the vet is like a family physician for humans. They know a little about a lot of things and in the case of vets, they are also faced with understanding different species of animals. A human doctor would likely send a diabetic patient to an endocrinologist/diabetic specialist. That option for our cats is more problematic and very expensive. Diabetic control is very much a hands on proposition and when your vet sees your cat periodically in what, for the cat, is a stressful environment, they don't get an accurate view of the situation. Most vets have not treated that many diabetic cats so they don't get the experience that those of us who deal with it 24/7 have.

The same holds true for diet. Most vets get their nutritional education from representatives of the big name pet food companies like Hill's, Purina and Royal Canin. They are essentially brain washed into thinking the food these companies are promoting is the best and they end up peddling it to their patients.

Your vet sounds like a wonderful vet for many things, truly interested in you and your kitty but if you were to ask him how many diabetic cats he has treated/is treating, I'm betting it's a pretty small number. Hopefully he will work with you as a partner and learn from your hands on experience.
 
A couple of questions:
Does Butter have any history of ketones or DKA?
Have you started switching diet or is Butter still eating the W/D?

These are important bits of info along with any home testing BG levels that you can provide, will give folks here some data on which to base dose recommendations. While we're confident the dose is too high and should be reduced, deciding what to recommend that reduction should be depends on these factors.
 
I'll jump in and agree with the others on what's been said about vets. I don't fault them for not knowing all the nuances of feline diabetes. They might not treat many diabetic cats and they also have clients who can't/won't cope with being hands on with a pet. We don't see this side of a vet practice. I think they don't want to have more pets euthanized so they put forward the simplest possible treatment plan once there's a diagnosis of diabetes on the table. People who come here to FDMB already have the mind set of wanting to learn more and do more.

If you like your vet - and many are absolutely wonderful, caring people - keep him! A good relationship with the person who looks after our treasured fur kids is essential. But - make it your mission to learn as much as you can about treating FD yourself and if you can get your vet on board as a partner rather than a director, that's ideal. A bad vet is one who won't listen, gets on his/her high horse if you want to try something different, isn't willing to give you the time of day if you question him/her, etc. That's how you judge whether a vet is good or bad.
 
To add to that, my vet was actually mostly really great at diabetes. She suggested home testing (though she didn't push it...the folks here convinced me) and she was the one who told me from the beginning that pet meters weren't necessary and I could use a human one just as easily (and much more cheaply!). She did try to push prescription food, but I just refused it. When I brought my SS in to show her, she actually said that I was handling it perfectly and to let her know what I needed...and she was fine with me just handling it myself rather than asking her!

I think there are a lot of great vets out there, but as others have said, they just don't get the training they need...and that isn't surprising since they have to treat ALL animals for ALL diseases. And also remember the info they get about prescription food is usually from the company that makes it. And sure they could do research on their own but what vet has time for that?
 
Rachel said:
When I brought my SS in to show her, she actually said that I was handling it perfectly and to let her know what I needed...and she was fine with me just handling it myself rather than asking her!
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I can't add much more to what the other's have said :). The important thing is similar to Rachel's Vet, one that will be on your team and work WITH you. I've gotten rid of 2 Vets because they kept opposing my research and caring method for Maury's diabetes. Everything I was doing, to them, was wrong :(. I recently found a new Vet who is on my side and I will take him there for any other issues. She's fine that I just keep her updated on what I'm doing with Maury's FD and interested in seeing his progress with our method :bookworm:.

I'm glad you really like your Vet and he loves cats but I, and I'm sure others who have joined here, have always loved kitties but didn't know very much about feline diabetes. We're also just saying more Vets than less, do not seem to understand the condition. It's not their fault; they have to know a little bit about many things. There are many threads to back that up here too. These sort of Vet's tend to think their way is the only correct way and everyone else is wrong. The key, again, is to have one that is more open and able to admit they were wrong or misinformed. We're definitely not trying to turn you on your Vet, as we are not professionals :bighug:. We want what's best for every kitty and to help their beans
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Linda probably said all of this much better in her post #14 :smuggrin:
 
This all makes sense to me. Thank you all so much for helping to clarify this. My vet encouraged me to home test. He said he doesn't really bring it up as the majority of people do not want to home test and some don't even want t o treat. When he initially did his blood work he said his liver numbers were fine. Pancreas was high. Ketones ok. He thinks there might be an underlying issue like pancreatitus because he is not responding to insulin but now I think it is because I am leaving out the Hills W/D and he eats that everyday along with 2-3 cans of wet food (FF Classics Pate). I am scared to pull the dry foot away totally as the vet has me on 5 units of Prozinc every 12 hours. Should I slowly wean him off the dry food and lower the does slowly. Last night I dropped it to 4. Today, I am not sure what to do. My cat does not like to be tested and when I give him his shot he turns around and sometimes runs. So, I need my husband to help me with the testing which makes it hard as he works a lot. I guess I need how to figure out how to test him myself.
 
Pancreatitis is common in diabetic cats and it can raise the insulin needs to some degree so while I still think your vet has gone overboard on dosing, there was at least some justification for him to think a higher dose might be needed. If you can confirm that Butter has never had ketones or DKA and give us some data from the readings you have been taking, we'd be in a far better position to suggest dose adjustments. Sometimes folks take the dose right back to 1u and work back up as needed....others reduce gradually. It's ultimately up to you how you wish to proceed. We can give you suggestions but we need more info to do so safely and safety is our number one priority.
 
Okay. Thanks so much! I will get the numbers and then post back. I really appreciate all your help. I lost my dad 9 months ago and my father in law a week ago. It's been such a hard stressful year for me and Butter's diagnosis has been difficult but I love my boy and want to get him better and I think with all the help here I will be able to figure this out!
 
Make sure to have some low carb treats, like PureBites freeze dried, and give Butter's a reward after each attempt: successful or unsuccessful. If he's not big on treats, doing anything positive after the test attempt will help him associate it with a positive experience :).

Never hesitate to ask us questions :bighug:
 
I'm so sorry to hear about your Dad and FIL. I know all too well how difficult it is to lose loved ones and especially so close together. Having Butter diagnosed added to that emotional upheaval is more than anyone deserves. We will do all we can to make your journey as smooth as possible. Right now it's looking pretty promising that Butter's story may ultimately be a happy tale! :bighug:
 
Cindy Lamy said:
Okay. Thanks so much! I will get the numbers and then post back. I really appreciate all your help. I lost my dad 9 months ago and my father in law a week ago. It's been such a hard stressful year for me and Butter's diagnosis has been difficult but I love my boy and want to get him better and I think with all the help here I will be able to figure this out!
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:bighug::bighug: We're here to help you with your lovely kitty.
 
Aw Cindy, that's a tough year for you! If it helps, know that you'e got a super supportive community here. :bighug::bighug::bighug::bighug:
 
MrWorfMen's Mom said:
I'm so sorry to hear about your Dad and FIL. I know all too well how difficult it is to lose loved ones and especially so close together. Having Butter diagnosed added to that emotional upheaval is more than anyone deserves. We will do all we can to make your journey as smooth as possible. Right now it's looking pretty promising that Butter's story may ultimately be a happy tale! :bighug:
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Thank you! I feel so much better. I dropped the dose last night and this morning to 4 units from 5. We just tested him 2 hours after his shot and it was 361. Do you suggest that I keep dropping the dose and take away the Hills W/D completely? When is the best time to test? He really hates getting tested! I bought Fancy Feast Hand Selected Chicken Treats. It says one ingredient on the cover. He loves them!
 
Cindy Lamy said:
Thank you! I feel so much better. I dropped the dose last night and this morning to 4 units from 5. We just tested him 2 hours after his shot and it was 361. Do you suggest that I keep dropping the dose and take away the Hills W/D completely? When is the best time to test? He really hates getting tested! I bought Fancy Feast Hand Selected Chicken Treats. It says one ingredient on the cover. He loves them!
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good treat. Did you buy any fancy feast classic? I think I would drop the wd completely, go to 1 or 2 units and feed fancy feast and get a bunch of tests in over the next few days. it may take a little while for the numbers to start coming down but we will get there.
 
Cindy Lamy said:
When is the best time to test? He really hates getting tested!
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The best time to test is right before you give the shot, so that you know your kitty is high enough to safely receive insulin (over 200), and then if you can, again sometime between +4 and +7. If you look at the spreadsheets most of us have attached to our signatures (the light gray text below each post), you can see that many of us test quite a lot. We really do try to keep the kitties safe and healthy around here!

My kitty hates getting tested too. It has definitely gotten easier with time and practice, but it was super difficult at first. Let us know if there is anything in particular that seems to be causing the trouble. We all have lots of little tricks we've learned along the way to make it a bit easier.
 
It's definitely a good idea to get rid of the WD but you want to make SURE you're getting some tests in when you drop it since it could drop him a lot!

We'd like to get you a spreadsheet set up if you're open to that? It's a really great tool to help you figure out what dose to give your kitty...and as a bonus is a great tool to share with your vet! Then as you get some tests in we can help you figure out a good dose for your kitty for sure. :)
 
Cindy Lamy said:
Okay. Thanks so much! I will get the numbers and then post back. I really appreciate all your help. I lost my dad 9 months ago and my father in law a week ago. It's been such a hard stressful year for me and Butter's diagnosis has been difficult but I love my boy and want to get him better and I think with all the help here I will be able to figure this out!
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Hi Cindy and Butters,

I am a new member as well just shy of a month since my cat started treatment. This place is awesome and everybody here is very knowledgeable and so eager to help. You can see from my spreadsheet that my cat's numbers were crazy in the first 3 weeks but it has gotten better. So don't get discouraged and panic when BG numbers are up and down once you start from the low dose. It will get better!

Also, I understand how hard it is to deal with losing loved ones. I lost my dad last year, hugs to you and Butters! You have tons of support here!!!

:bighug::bighug::bighug:
 
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