Question as I Rebegin with Robbie's relapse

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RobbiesMom

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Once again this forum has proven to be an amazing resource. As my dc Robbie and I begin the journey down this road again I am reminding myself of all the information available here and printed out all the helpful guidelines.

Last night at approx. 10:45pm Robbie's BG was 345, after some chicken to help get him to drink water it dropped down to 245 by 2:45am. At 7am this morning Robbie was again 245 and ate most of his breakfast. At 11:30 today Robbie's BG was read at the Vets and registered as 311. The Vet Tech administered 4U's of Prozinc. At 1:30 he was happy and playing with the dog and ate some more of his breakfast which he had not finished (unusual for him). At 5:30 he was crying for dinner and jumped right up on the feeding area and ate 1/2 his dinner (he doesn't always finish dinner until about 8pm and than often starts crying for more food at 10-11pm). We feed him chopped grill feast which we found as a low carb choice on the Janet and Binky site - we sometimes switch it up for one of the other ones on the list but after checking today I see this "flavor" is not on the new list. So I'll be looking into that now too - although it's still, according to the can, a low carb, lower calorie choice. He also gets metimucil in his food 2x a day for his constipation problems. At 7:30 pm I tested him at home and his BG was 213. He's sleeping (but not in his normal spots - in his "I don't feel well" spot which makes me uneasy). I gave him a bit of chicken after the test since he does hate the ear pricking so much.
My concern is that this "relapse" was caused by my foolish thought that after 19 months of being fine without insulin I could give Robbie a tablespoon full of a high calorie/carb food he LOVES in order to get him to ingest Cosquine for his arthritis. This went on for about a month (3.5 weeks) before I noticed he was drinking a lot more water and his pee clumbs in the LB were HUGE. I stopped immediately and hoped he'd bounce back, but he just kept slipping down until last night it was clear he was feeling pretty awful and I finally tested him.
According to the Vet he should be getting 4u's again at 11:30 - in order to start adjusting him to a 8am/8pm schedule I'm going to give it to him at 10pm. I am strongly feeling I could give him 2u's as I feel 4 is just a tad high but since he didn't drop too much from this morning I'm truly not sure. Any thoughts would be appreciated.
 
Considering his size, his high numbers and his experience with other diabetic cats he treats that was what my Vet felt comfortable with. Just tested Robbie again at 10:10pm and he's at 210 - an hour and 15 minutes short of 12 hours between doses and his numbers have only moved from 311 to 211 which is the same amount they moved last night just drinking some water and eating some chicken. I'm debating what to give him as a dose now.
 
HI Ellen, I think 4 units is a pretty high dose too - wouldn't it be better to start lower and work up? Otherwise you might run into rebound issues. Going up would be much better then dealing with a hypo situation in my book. Jan
 
Did you test him in the middle of those 12 hours? He may not look like he moved very far, but usually cats go in a curve and the middle is the lowest point, that is what the concerning time would be starting out at such a high dose. He could look like he just move a little when he was at 40 at +6. I don't know Prozinc or most of the particulars of your guy, but that is a lot of insulin to start at.
 
Not sure if you used PZI/Prozinc before, but my vet told me the standard starting dose was 2 units. We agreed to start at 1 unit instead. The first several weeks, we had marathon long cycles that lasted 24 hours. We cut the dose considerably.

You may want to re-think even the 2 units. His numbers seem low enough to see what the insulin will do for him. And if it's not making much difference, then you can increase.

You may want to come over to the PZI board where there are folks with more than my 2.5 months experience.

Lu-Ann
 
From the AAHA guidelines p. 4 (218):
The panel recommends a starting dose of 0.25U/kg q 12hours, based on an estimate of the cat’s lean body weight.This equates to 1U q 12 hours in an average cat. Even in a very large cat,the starting dose of insulin should not exceed 2U per cat q 12hours.
 
Thanks everyone - I emailed this info to our vet today - told him I have been doing 3 not 4 and asked for a re-evaluation from him and his exact reasons for starting at 4. I know he's not the MOST experienced with diabetic cats but after our first round with this I sent him tons of info and he really did take it all in and now has been treating several more cats so he has some experience now. However, I'm not adverse to pushing him to expand more on his reasons and also not adverse to going with my gut and the info gained here. I love this Vet for a variety of reasons - not the least of which is I have a revolving account with him which considering how often we are there with one of the 2 cats or the dog is very good for us as we almost always have a balance with him. However, I don't want to put Robbie in danger - and the last time thru this we started at 8u's which EVERYONE here went nuts over and I ended up with 3 "crashes" with Robbie as we adjusted down. Right now about an hour after dinner he's at 341 - I would have liked to see something lower and this scares me but I'm taking a deep breath and at 9pm will give him probably 3u's again - but I would appreciate thoughts on this as well.

thank you all for your time and help here.
 
I've got his numbers posted under my signature via google docs - I think I've listed all the numbers I've tested. I won't be able to get a really good curve type of testing until Saturday as I can't get home from work mid day very easily.
 
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