PZI Sensitive Kitty...Need Info

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kkoka1

kkoka1

Member Since 2013
Hi,

Sorry about the candle icon in the first post...

I consider you all far more experts than the vets. So, I need your help. This is our 2nd go around with diabetes. Our first time through we thought was a fluke (due to a severe anal gland abscess). But here we are again.

First go around, we almost lost her due to Hypo issues. Thankfully, a vet caught it, she went off insulin, and was great for about 4 months. Pancreas appeared to restart itself.

Jingle Bells (our girl) is about 13 years old. She has appeared fraile to us since the anal gland episode--drops weight rapidly [we have noticed that the DM food doesn't seem to give her the nutrients she needs...now on W/D for a try], has issues with her front leg joints [been doing laser therapy which seems to help], kidneys are slowing getting worse [so now battling kidneys versus diabetes], etc.

Here's all the info I can give so far this go around:
Blood work thru vet reveals glucose of 313 on day of draw; Fructosomine of 570; kidneys getting slightly worse
Utilizing Alpha Track as the meter

Day 1:
Blood Glucose 352 @ 6:15 am after eating at 6 am
Gave .5 units of PZI (per vet)
At 11:30 pm, seemed to be having some sort of reaction (biting--like fleas [but we have none]; compulsive grooming; hind end twitching)
=Gave her some food, as it seemed she was tanking to us around midnight (P.S. It is hell to get her blood--so stressful and traumatic for all of us)
At 6:15 am [next morning], blood glucose was 64 after eating!!!!! OMG! She appeared normal to us! Discontinued insulin for the night and called vet who of course was not in--got a surrogate vet's opinion who agreed.
Pee sticks = total dark brown in a second!
Seemed to take well over 24 ours to "get our cat back" (i.e.insulin out of her system)

Day 2: GAVE IT A GO AGAIN, AS THESE ARE OUR ONLY 2 DAYS OFF TO WATCH HER 24/7
Blood Glucose 339 @ 6:15 am after eating at 6 am
Gave .25 units of PZI (as best I could on that damn syringe--vets keep telling me you can't give lower than .5--I keep disagreeing; hence you all :)
At same time interval, seemed to be having reaction (biting/compulsive grooming, but much less and no twitching)
=Gave her food at 1:30 pm to counteract the reaction--seems to help
Seemed to tank at 3:50 pm; vet had told me to try to get blood then; to our surprise, it was 248--so, I think she was just tired from everything she's going through
Blood Glucose at 6:30 pm after eating was 245; administered another .25 (best I could) & watched her all night...fed a bit at 3 am due to wooziness
Pee stick @ end of night was bluish!!! Insulin seems to be helping--our first bright spot, even though these pee sticks aren't accurate, at least it isn't total brown. Still can't understand why she doesn't go in a gradual fashion--it seems to be all of nothing with her.

Day 3:
Blood Glucose 313 @ 6:15 am after eating at 6 am
Gave .25 units of PZI (again...best I could)
Seems to be "our cat" most of the day on this dose--reacts fairly well to us, etc. We just freak when she gets sleepy cuz that's the only clue we had when she had the hypo incident the first time.


nailbite_smile Here are a few things I need help with:
1. She seems super highly sensitive to insulin. She can tank to 60 easy (went from 325 at 6 am to 64 at 6 pm) on only .5 units of PZI. We are now down to .25 (as best I can on 40 syringes). I saw something about using 100 syringes for the 40 PZI. If I can get the 100 syringes, what mark do I take it down to for the .2 or .25 dosage of the 40 PZI? I really can't afford to overdose her on this, but feel that I am not being accurate enough using the 40 syringe guesstimates. :cry: I don't seem to know where to go for the conversion chart on this site.

2. What food have you all found that works the best for kitties facing diabetes and kidney issues? DM is just too lacking in nutrients for her. She doesn't seem to like the W/D consistency--spits out the chunks--that the vet thought would be a good medium ground for both issues.

3. My daughter and I both have to go back to work/school tomorrow. My elderly mom can come check on her once (probably at the 5-6 hour mark when she seems to have a reaction). Will she probably be okay tomorrow on this same dose (considering the past 2 days)? I freak out because she only needed insulin 4 days before and then her pancreas kicked back in. The insulin seems to stay in her system soooooooo long, I'm afraid of another hypo event, even though we are ear pricking before administering (oh how fun that is!).

4. Considering her sensitivity, when would you all say NOT to admin insulin? If 200 or under? Remember...352 to 64 in the span of 12 hours on .5 units. Ughhhhhhh!

Thanks everyone. Sorry this is so long. I just thought the full story would help. Can't thank you all enough--our vet not back for 3 more days.
 
Hello and welcome to the board

First please edit your original post and remove the candle icon - we reserve candles for kitties that have just passed away!!

When you were feeding DM was it wet or dry? Was she getting the DM when her diabetes came back?
Reason I ask is that the DM wet is only 3% carbs which is good but the w/d is 25% carbs which is way too high for a diabetic cat and can keep their blood sugar high. For diabetes you want the % of calories from carbs to be under 10%.

Given she is dropping to 60 on only 0.5 unit I wonder if you took the W/D away for a week and only gave her a low carb wet instead whether she would even need insulin at all - her diabetes could be transient. For cats with kidney issues you need foods with low phosphorous and in fact we have a long list of foods you can choose which are low carb so great for diabetes and low in phosphorous too so would help both conditions!! See here http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=94685

I would certainly give it a try! (Although I would try this only if she does not show ketones - did the vet mention this?)

Wendy
 
You can give lower doses. It requires U100 needles and the conversion chart (as you are using a U40 insulin with U40 insulin. If you want more info, let us know

Did she have a UTI and was treated for it? That can certainly elevate by levels and cause flaky numbers. When you say dark on the strips, did the vet think DKA or UTI?
 
Hi,

I heard about the candle...I am so sorry. I did go in and edit it, but I am not sure if it changed. nailbite_smile

We put her on wet food when I first heard of the elevated blood sugars (last December) and I did a lot of research. I started with over the counter foods (mostly Fancy Feast classic) until the vet put her on the DM. We stayed true to the DM until about 3 months ago when she started losing weight, almost getting skeletal. Our normal vet was out of town, so I hate to say it, but we did our best staying true to the <10% carbs, but did add in some Friskies Pate' varieties (again the ones under 10%). She seemed to do well (coat improved, flaky skin went away, seemed to get stronger). We mixed about 1/2 and 1/2. I will say the last few weeks we did more Friskies than the DM. We felt terrible when the diabetes came back. We felt like we caused it, but we were still giving under the 10% carb foods, so I am not sure if it is true or not. Either way, we see a distinct difference when she is on just DM--she drops weight like crazy, hair starts falling out, and skin gets very flaky.

They did think she is transient, but I am not sure now. She has only been on W/D for about 3 days. We did put her back on only the DM when we first noticed the pee stick. It didn't seem to change her readings, only her weight which plummeted.

She does not have ketones--in fact, since giving the .25 for two days, the pee stick is now blue (perfect--no spillage). Vet never said anything about a UTI, and I'm sorry but I don't know what a DKA is??? She does have kidney values that are getting worse in the last 3 months.

Re: lower dosage...called and asked my vet clinic today about the syringes (100's). A receptionist said she went back and asked but the vet she consulted said "absolutely they do not recommend that." My vet isn't back until Wednesday, so I will ask again. I would DEFINITELY like to know how to convert using the 100 syringes so that I can give that info to my vet (since they seem in the dark on this).

Just as an aside, do these PZI drugs cause other issues in our kitties?

Thank you everyone for your help. You don't know how much it means to us.
 
If you are using a U-40 insulin, it has 40 units in 1 mL.
If you are using a U-100 insulin, it has 100 units per mL.
Thus, a U-40 insulin is only 40% of the concentration of a U-100 insulin in a given volume.

If you use a U-100 syringe to measure an amount of a U-40 insulin, the syringe markings need to be adjusted that same 40%.

U-100 Syringe Mark * 0.4 = dose of U-40
0.5 * 0.4 = 0.2 units of U-40
1.0 * 0.4 = 0.4 units of U-40
And so on.
 
You might want to try a lower carb food again - many of the Friskies are up towards 9% but the Fancy feast classic pates are 3-4%.

She might lose weight on the DM because she doesnt eat it as much? Many cats get sick of the flavour. Also try and space the foods out through the day to take the stress off the pancreas with mini meals instead of a big one.

Are you measuring her blood every day? before every shot?

Wendy
 
Here is a link to the insulin syringe conversion chart. I suggest you print it and put on fridge - this way you don't have to memorize or try to remember and can easily refer to it, if you get the U100 syringes.

http://www.felinediabetes.com/insulin-conversions.htm

You may also want to consider changing insulins. I say this because she is biting herself at the injection area - yes? And possibly could be having an allergic reaction. There is another kitty here at the moment, that may be having a similar problem.

Just something to think about if you need to continue giving insulin. If you switch, there is lantus savings card available - so you pay $25 per pen and some pharmacies may sell one pen at a time to help keep costs down - you will need to call and ask. I have heard that hospital pharmacies may do this.

http://www.lantus.com/sign-up/offers.aspx
 
Many vets do not use the U100 needles and the conversion chart. I would guess it is one more thing for pet owners to have to absorb and they want to keep things easier. We have lots of people who use them with great success - giving doses in the .1/.2 range. You can buy them from ADW (the ad above) - I think without a prescription. You want the ones that have .5 measurement lines.

I would get some numbers and see where she ranges, on the lower Friskies food, without insulin. (if she doesn't do well on the DM, then don't feed it. Just tell the vet she wouldn't eat it.). If she is over 200, give a tiny amount (you can do that with U40 syringes. It is just harder to eyeball and not as accurate. Start with .5, squirt out all but a drop or two.) and monitor. She may go longer than 12 hours without going up to the 200s again, but with PZI, which doesn't build up a shed, that is okay. Just watch and shoot again when she is over 200. This may work, as long as she doesn't drop too low (under 40) mid cycle.
 
The Hill's W/D food is often prescribed for kitties that need to lose weight. So if your cat is already skinny, this may not be the best choice to feed.
 
You all are awesome. I am sorry I haven't answered. I have been so tired.

We gave her a shot of insulin the other night. Within an hour, she was spacing out, not opening her eyes, not caring about anything going on in the world, etc. We monitored her every hour through the night, gave her some food to try to perk her up, etc. We got a pee stick and thought we had some keytones, so rushed her to after hours clinic. Of course, not our normal doctor. That, it turned out, was a good thing for at least one reason. She did a urinalysis (not a culture...I don't think) and found out she has a UTI. You gals nailed that on the head! She was so out of it, that we decided to stop the PZI (per our vet). She was already on the injection antibiotic, but they put her on Baytril (that's been fun to try to get down her). Vet said it can elevate her glucose, so we are praying that this infection goes away and her numbers go down. That is what happened last time with the anal gland infection. Boy would that be a relief.

So we have enjoyed a few days of sleep and Jingle Bells is happier than a clam, bright-eyed and purring without the insulin. We have to prick her tonight to keep tabs on the numbers (HATE THIS WITH A PASSION) and give the antibiotic time to work, I guess.

Thank you for all the info. You can't know how grateful we are.

One last question...our pee sticks are like blue-green, then go to brown after awhile. We are wondering if they are being affected by our San Diego hot weather heatwave. Can the humidity and heat do this? The vet saw NO evidence of keytones the night we went in.

THANK YOU ALL!!!!
 
K/d Food contents

Hi,

Jingles is off the juice for the moment. We are trying to find a food that works for her both with the kidney issues and the high blood sugars. Fancy Feast is too strong--she usually throws it up. I just bought Wellness, Cowboy Cookout brand, and one other that had low phosphorus and low carb content. She loves everything, but we find that the w/d and k/d that the vet has suggested make her really skinny FAST--like within a day. We noticed increase thirst with the w/d, so we are throwing it out.

Can anyone give me some info on carb content on the k/d from Purina? We are wondering if we should mix two foods together.

Thank you!
 
From vet Dr. Lisa Pierson's food chart, the canned K/d is protein 22%, fat 50%, carb 27%, phosphorus 84

This shortcut list has all the low carb and low phosphorus (<250 mg/100 cals) from Dr. Pierson's list.

Shortcut shopping list <250 phosphorus. Adapted from Rhiannon & Shadow’s shortcut list
all values are from Dr. Pierson's updated list, September 2012

carbs in % . . last number is phosphorus (CKD, CRF cats need under 250 phosphorus)

5% - Friskies Special diet Beef and Liver entree 241
5% - Friskies Special diet Turkey and Giblets dinner pate 189
5% - Friskies Special diet Beef and Chicken Entree pate 242
7% - Friskies Special Diet with Salmon 228

3% Weruva Paw Lickin' chicken 196
9% Weruva Green Eggs & chicken 230
4% Weruva On the Cat Wok 163
5% Weruva Steak Frites 118
7% Weruva MidEast Feast 202

Weruva Cats in the Kitchen canned food
3% La Isla Bonita 166
8% Funk in the Trunk 250
4% Fowl Ball 180
8% Lamb Burger-ini 236
2% Chicken Frick 'A Zee 174
8% The Double Dip 248

5% - Merrick Cowboy cookout 202
8% - Merrick Grammy's pot pie 237
3% - Merrick Surf n Turf 229
9% -Merrick Turducken 219

1% - Merrick Before Grain cat 96% beef – 163
2% - Merrick Before Grain cat 96% turkey – 178

5% - Wellness Kitten 216
4% - Wellness chicken 219
4% - Wellness turkey 201
4% - Wellness Beef and chicken 226
6% - Wellness beef & salmon 207


8% - Wellness Core chicken/turkey/chicken liver 215
5% - Wellness Core Beef , Venison & Lamb 171

3% - Nature's Variety Instinct Grain free Beef – 248
1% - Nature's Variety Instinct Grain free Duck 191

2% - Natura Evo 95% chicken and turkey 155
4% - Natura Evo 95% beef – 234

2% Hounds & Gatos chicken 241
9% Hounds & Gatos Beef 250
3% Hounds & Gatos Lamb/chicken/salmon 225
3% Hounds & Gatos Lamb & Duck Liver 244

8% -Holistic Select chicken & lamb 222

3% Soulistic Polynesian Picnic 239
4% Soulistic Celestial Feast 250
7% Soulistic Upstream Dream 234
8% Soulistic Nautical Nirvana 228

9% Max Cat Chicken Supreme 173
8% Max Cat with savory duck 197
8% Max Cat with Savory Venison 214

8% Avoderm Chicken Chunks/gravy 234
2% Avoderm Tuna % chicken w/ veggies 241

9% Halo Succulent Salmon 227

1% Eukanuba adult Entree with gourmet chicken 239
8% Eukanuba adult Entree with Lamb and Rice 230
3% Eukanuba adult Entree with Pacific Salmon 241

7% Evolve -chicken 214
6% Evolve turkey 244

0% Natural Balance O'Fischally Scampi 244

5% Pinnacle Chicken and Ocean fish 175
5% Pinnacle Chicken and Tuna 221
4% Pinnacle Ocean Fish 231

3% Authority Chicken 238
7% Authority Turkey & Giblets 222
8% Authority Beef 249


BFF (Best Feline Friends ) also made by Weruva
BFF 2% Tuna and Chicken 234
BFF 2% Tuna and Salmon soulmates 236
BFF 2% Tuna and Shrimp Sweethearts 236
BFF 2% Tuna and Bonito Be Mine 240
BFF 2% Tuna & Tilapia Twosome 240
BFF 5% Tuna & Pumpkin Valentine 243
BFF 2% Tuna & Chicken Chuckles 234

8% Dr Fosters and Smiths Chicken 204

2% ZiwiPeak Lamb 224
Click to expand...
 
One last question...our pee sticks are like blue-green, then go to brown after awhile. We are wondering if they are being affected by our San Diego hot weather heatwave. Can the humidity and heat do this? The vet saw NO evidence of keytones the night we went in.
Click to expand...
Depends on the urine testing strips you are using. Do you have the ones that just test for Ketones? or do you have the ones that check for Ketones and blood glucose (like Ketodiastix).

The ketones must be read from the combined ketodiastix in 15 seconds, no more, no less. the glucose is then read 15 seconds later, for a total of 30 seconds.

Here is a link to a nice description of how to test with the ketodiastix.

With time, the urine test strips will darken in color. If you have left the cover of the vial loose, that could be affecting them. Sounds to me, like the color change is happening after the 30 second time limit.
 
Have you considered home testing her blood? Its cheaper and more accurate than at the vets, and it will keep her safe and give you a much better picture of whats going on

Wendy
 
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