PZI not working

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DStreight

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My 15 year old cat was diagnosed last May 2010 and was put on Novulin. After glucose curves done every two weeks for months, the vet could not regulate his insulin. It rarely got below 300. She suggest PZI around January. It has had better results and she increased the dose until he is presently on 4.5 units/twice per day. His levels are not never below 250 and increasing to around 375. I have begun doing my own glucose tests at home because of the $55 every two weeks charged at the vet. I am really getting frustrated as he continues to go down hill. He begs for food constantly and drinks water at an alarming rate. He was supposed to go back to the Vet today, but I canceled. I don't have to have them tell me his glucose levels are high. I just don't know what to do with him to get his levels down. I tried cooking chicken and giving him that, but he's grown tired of it and I didn't notice a change in numbers. My Vet hasn't focused much on his diet, and has given hime the W/D prescription food, but I'm noticing on line that appears to be high carb. Any suggestions at what I can try on my own? The PZI is at a really high dose according to the package insert. Any suggestions would be appreciated!
 
That is a high dose. Some cats need that much insulin, but I am wondering if the dry food is the issue. You are right - WD is high in carbs (37%) When we changed Oliver over from dry to wet, he came down 100 points overnight. If I were you, I would change the diet to completely wet lo carb. We try to stay under 8-10% carbs, a food you can afford that your cat will eat. I feed gluten free Fancy Feast. Janet and Binky’s chart

If you do that, be very careful about monitoring. When Oliver gave us the 100 point lower amps, if we hadn't tested and had given him the regular dose, he would have hypoed.

Can you set up a spreadsheet for us? It will really help us see exactly what is going on. Setting up a spreadsheet If you have trouble, just ask for help. The template is not working for all computers.

Have you gotten any mid cycle numbers? You want to get some numbers 4-6 hours after the shot to find the nadir - or lowest point in the cycle. That will give you more information about whether the dose is too high or too low and how it is working.

I know it is frustrating when you are working so hard to help. You have already done the most important thing - hometesting. Now we need the data to help us see what is happening.
 
My cat Max was diagnosed in early January. For the next 4 weeks, he made little progress, testing in the 450's week after week on more and more insulin (PZI). Before I changed his diet, Max was on 3 units PZI twice a day and the vet had just upped that to 4 units cause he was #'s were still so high. I was increasingly discouraged, but then I found and followed the advice on FDMB (home testing and diet among other great advice). After reading about diet, I changed Max to only low carb wet. I had been feeding him a mix of Science Diet M/D dry recommended by my vet and some low carb wet. Max really turned a corner when I changed to the low carb wet diet. Like Sue said, you want to monitor closely cause the insulin needs can change over night. I gave Max his 4 units the day I changed his diet and the next day at shot time he was still really low (probably too low). After that, we went down to 1 unit and even lower doses. Every cat is different and I don't want to give false hope, but the diet change can really make a difference for some cats. Max eats Fancy Feast Classic, but if you look at Janet & Binky's chart, there are a lot of low carb options. If you do end up trying the diet change, you may want to reduce the insulin dose and test to be safe. The 4 units I gave Max was way too much the day I changed the diet.
 
My money is on the diet too as the culprit. When Bix was on the lower carb dry foods (around 13% if I recall) he needed over 4u and I still couldn't get him regulated. And W/D is a lot higher carb too. Your BG#s are actually better than I would expect on a food that high carb, so that's a good sign.

One choice is to drop back to 1u 2x/day and simultaneously switch quickly to LC canned foods. Another option is to switch foods more slowly and gradually reduce the dose if needed depending on the #s you get from home testing. For that route, you want to do a lot of testing to be sure the #s aren't going low. As others have said, the change can be pretty dramatic. When I switched Bix I was reducing the dose something like 0.5u on almost every shot, and I still put him in some scary low #s by accident. So if you can switch foods pretty fast, I think a 1u do-over might be in order, just makes it a little easier to manage I think.
 
Hi D,
Let me just 2nd what is being said about the low carb canned food. With Tom his diagnosis number was like 576 and it took about a week before we got the insulin but we immediatly switched from purina dry to all canned under 7carbs wet and just with that alone he was noticeably feeling better and his numbers dropped a couple, yes 2 hundred points.
Sooooo, be careful when and if you make the switch ok.
Keep us posted on all your changes.
I have'nt been around for a bit, What are you and your kitties names?
Lori
and tomtom too!
 
oh my, i just noticed you just registered here today! there is so much we want to know. it is entirely possible that your kitty is actually getting too much insulin causing the high numbers. are you testing before every shot? would you be willing to keep a spread sheet chart that we can help you set up so we can really track what's going on? Sue and Oliver are great at getting that set up.
How often during the day are you testing?
Since you are so new there is so much hope for improvement.
No offense to Veterinarians....but we just seem to know more about treating feline diabetes here than most vets.
Bravo to you for testing at home.
lori
and tomtom
 
I didn't get everyone's replies until late last night. I did check BJ's (Blackjack) blood sugar this morning and it was 320 prior to feeding. I did feed his regular canned food at 6:20 a.m and now have gone to the store and got the Fancy Feast Classic. At 10:00 a.m his glucose was 390 and I will take again soon. I will start tomorrow with a much smaller dose of PZI and start feeding only the low carb food. He has had no dry today. I will also do a glucose curve to be able to supply more information. Our situation is complicated by the fact that we have a 14 year old exotic shorthair who is blind and has high blood pressure! We also have a three year old deaf/crippled male cat that loves to get in the middle of it all. So basically my days are spend taking care of my cats. I will watch him carefully tomorrow with the change in diet, to make sure he doesn't get to much insulin. BJ has always had a lot of allergies in the spring and this really is bothering him this year. He has always taken medicine and usually had to take steroids and they will no longer give him those, so he's really suffering with running eyes and itching. He has gone from weighing 18 pounds last May to just under 12 now. I'll remain optimistic, but sometimes just wonder if he's just going to die from this disease! I'll post my result tomorrow.
 
Dearest Blackjacks Mom,
First what a wonderful caring individual you are to have these special needs kitties in your care. How lucky they are to have you! And please, no! to the idea that blackjack will not recover. I think his treatment plan has been poor at best with only haveing bi-monthy testing. No cat could have gotten better that way.
All your cats btw will benefit from eatting the exact same diet as Blackjack. It is the food they were meant to eat. high portien, low carb...like a mouse,bird or anything they would have caught in the wild. my tom eats raw rabbit that i found at a store called 'wilds'
blackjack WILL do better now that you are here with so many other diabetic kitty moms.
Lets get you spread sheet going ok.
I'll ask sue and oliver to help you as i am lame any thing computor.
Hugs,
lori and tomtom too!
 
Your kitties with special needs are so lucky to have you taking care of them. I had the same worries as you when Max kept having high #'s. Like you said, stay optimistic and remember to breathe. You're making some good changes (diet and testing at home really helps you be more proactive and saves money since you don't have to pay the vet). Paws crossed you start to see some progress soon. Keep us posted.
 
Did you make a change to the spreadsheet? The one in your spreadsheet now is your copy (it has a cc in it). You need the one you share with us - it has a pub in it. It was correct earlier.

The extra info in your signature is great.
 
Have we mentioned testing for ketones? It would be wise. Here is some info on it: ketones If you think he will let you, you stick the strip into his urine stream. We managed it by putting aquarium gravel in the litter box and leaving Oliver alone with it. (You can also use torn up paper or lentils) Oliver would not pee when others were watching. :mrgreen:
 
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