Recent diagnosis, lost more weight after 3 weeks!

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Betsey & Whitey

Betsey & Whitey

Member Since 2014
This is my 1st post. My 10-11 year old cat was diagnosed with diabetes on June 15th. In March, for his regular checkup he was 11lbs 15 oz. Now only 8.5 lbs. All other lab work normal, kidneys, liver, etc.... No signs of infection or masses. Glucose was 379. Poor appetite, lethargic. We started him on 1 unit of prozinc 2x/day. Tried the prescription science diet M/D hard and canned b/c he is used to kibble in the morning & canned at night. Typically when he was well, he would like snacks mid-afternoon. Initially ate it, and seemed to get his appetite back, looking for afternoon snacks again, but his activity level is not baseline yet. After about 2 weeks, started to just eat a nibble. Tried Fancy Feast cause someone said they did well with that. (So many to chose from and I don't know which ones are ok for him). He has been finicky, eating very little. Still have lots of prescription food! He used to eat 1/2 of a 5.5 oz can of soft food. Now just a few bites. He had been getting his insulin. After almost 3 weeks, he appears very weak, still drinking a lot. Still lethargic. He is just not himself. My husband has been giving him deli turkey just to have him eat something! I have been away. Went home because my son said he was weak and not eating, and falling over. He was due for his 3 week fructosamine level anyway. A couple of doses of insulin were skipped, cause he wasn't eating. Now down to 7.9lbs!!!! Glucose was 423. Only can get him to eat human tuna. Nothing else. Vet gave him fluid cause he was dehydrated, Pepcid for his tummy just to try, and mirtazepine as an appetite stimulant. Doctor said to give him his insulin, b/c clearly his sugar was up. Trying Purina D/M hard and canned food now. This was July 7th. Fructosamine came back the following day at 457, which is apparently "good" and they don't recommend changing the dose of insulin. He does seem to be eating a little more, I guess because of the stimulant. Looking for advice. I was kind of hoping the fructosamine level would have been up, giving me a reason perhaps as to why he isn't improving. Any info will be helpful. Anyone else out there with a cat who doesn't want to eat, is on insulin,and still losing weight? I am very worried about him! Btw, no ketones in his urine!
 
Welcome to a good place.
I recommend that you, like most of us here, test your cat's (name?) BG using a human meter. That way you can find out what is going on and adjust the dose as necessary.
Something has to be done because of the weight loss.. It seems the dose is too low.
Right now I would feed anything he will eat.
If you give the general location of where you are located they maybe someone is near yo and can help you learn how to test BG. It can be intimidating at first.
 
A diabetic kitty with poor appetite usually means there is something else going on. Unregulated diabetic cats are normally ravenous.
 
Larry and Kitties said:
Welcome to a good place.
I recommend that you, like most of us here, test your cat's (name?) BG using a human meter. That way you can find out what is going on and adjust the dose as necessary.
Something has to be done because of the weight loss.. It seems the dose is too low.
Right now I would feed anything he will eat.
If you give the general location of where you are located they maybe someone is near yo and can help you learn how to test BG. It can be intimidating at first.
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His name is Whitey, and we live in eastern Massachusetts, near the NH border. I was looking at the fact that everyone tests. Any recommendation on the Glucometers? I am a nurse, and so is my husband so I am familiar with doing BS on humans... Would just need to learn on fur-baby! I thought a Glucometer would be very very expensive, but I was looking at them, and it is not as bad as I thought. It is all overwhelming, and like the other post below, I am now afraid that there is something else going on. I have spent so much money, and my husband is not working. It is scary!
 
My diabetic boy Wink and I live in eastern Massachusetts too. We're up by the NH border as well, around Newburyport. How about yourself?

Human glucometers are used by most people here to test their cats. They are inexpensive and best of all, some have test strip costs that are very low. Some people do use the Alphatrak pet specific meter, but the meter itself can cost anywhere from $100-200 depending on your vet markup and test strips run $1-2 a piece. On the flip side, test strips for the Relion Confirm or Relion Micro, available from Wal-Mart are only about 36 cents each. So you can get 3 or more tests a day for the cost of one Alphatrak test strip.

If you do not like Wal-Mart, you can order the equivalent meter from our shopping partner ADWdiabetes (formerly known as American Diabetes Wholesale). The Glucocard 01 is equivalent to the Relion Confirm and the Glucocard Mini is equivalent to the Relion Micro. Same manufacturer, they are just branded with the Relion brand for Wal-Mart. These meters all take a tiny 0.3 microliter blood drop.

If you are looking for a lower test strip cost, the Relion Prime would be an option, but that needs a larger 0.5-0.6 microliter blood drop. It can be a bit tricky at first to get that blood, but the ears do learn to bleed and you will get more skilled at poking and testing.

ETA: Fixed decimal point.
 
Whitey and I live near Salem, NH. Thanks for the info. I have been away, hubby back home with him. I asked him to weigh him today. If our scale is anything like the vets, than he has gained some weight since Monday. Approx. 7 oz. he has been looking for food, but that may just be the appetite stimulant working. Whatever it takes right now! I will look into some stuff. It is pretty overwhelming! Easier on a human! And much more expensive on my feline friend! confused_cat
 
See my signature link Secondary Monitoring Tools for a number of assessments you can make to evaluate how its going. Weight is just one of them.
 
Betseyrn said:
Larry and Kitties said:
Welcome to a good place.
I recommend that you, like most of us here, test your cat's (name?) BG using a human meter. That way you can find out what is going on and adjust the dose as necessary.
Something has to be done because of the weight loss.. It seems the dose is too low.
Right now I would feed anything he will eat.
If you give the general location of where you are located they maybe someone is near yo and can help you learn how to test BG. It can be intimidating at first.
Click to expand...

His name is Whitey, and we live in eastern Massachusetts, near the NH border. I was looking at the fact that everyone tests. Any recommendation on the Glucometers? I am a nurse, and so is my husband so I am familiar with doing BS on humans... Would just need to learn on fur-baby! I thought a Glucometer would be very very expensive, but I was looking at them, and it is not as bad as I thought. It is all overwhelming, and like the other post below, I am now afraid that there is something else going on. I have spent so much money, and my husband is not working. It is scary!
Click to expand...

So I took the advise of everyone here and purchased a glucometer last Thursday. It has been about 7 weeks since diagnosis. 1st sugar was 308, next morning he was 394, so I increased him to 2 units. (Prozinc). Clearly to me, his sugars have not been in control on the 1 unit, with continued weight loss (down to 7.6 lbs!) and drinking lots of water. His appetite is better now thankfully, but now he is wanting to eat all the time. Another sign that his sugar is not in control! The Fructosamine level that was supposedly ok, was when he was not eating well at all. Anyway, the next sugar that afternoon was 287 at dinner time, so I gave 2 units again. Next morning he was 104!!! I gave him 2 units again, but got scared that I shouldn't have given so much, and called my husband to make sure he ate more, but guess he over did it cause his BG was 511 at dinnertime!!! Continued with the 2 units and was away over the weekend. Next sugar on Sunday dinner time was 338, following morning, I just feel I'm going in circles. I am working on getting the hard food gone, but have not completed the transition. It has been difficult, but he had almost all canned food today. Just a few pieces of prescription hard food as one snack. Should i be withholding snacks?? I want him to put some weight back on, but if his sugar is high, that won't happen. I am still overwhelmed with all of this, but he is now eating better. He is also acting better, not quite to baseline, but improved except that he is quite bony. A few days ago, I weighed him again and he is up to 8lbs!! Yay. 1st bit of hopefulness. Should I increase the insulin again? I found some Fancy Feast canned food today that was a minimum of 17.5% protein, and I think 2% crude fat. He loved it and ate 2 cans of it! I work full-time so it is difficult to do several glucose tests in a day. It has been a difficult summer. 1 week before he was diagnosed I had to put down a 4 year old kitty with cardiomyopathy that I had been giving 3 pills, 2 times a day to! Then thought I would be ok this summer with out the worry of her, and then Bang, 1 week later I have a diabetic cat which has been even more difficult to regulate. At least he has a better prognosis, if i can get him under control. I've had so many cats over the years, but never had any chronic illness ever on any of the others! So this is my dilemma sugars not controlled yet, wants to eat all the time. Not sure where to go from here. Snacks or no snacks on underweight kitty. Remember, 11.15 ounces in March! Advice?? confused_cat
 
It sounds like you are gaining ground! The low preshot and then high evening pre shot likely represents a bounce. When the body senses a lower than usual bg level, it releases extra glucose and then the next number is higher. I would not raise the dose yet, but would get some midcycle numbers to see how low the insulin is taking him. That may tell you if he is dropping lower and bouncing up. We have put together a protocol for ProZinc that may be good info:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=109077

It would be very helpful for us, your vet and you to put your numbers in a spreadsheet. We have a color coded one that makes it very easy to see trends and patterns. Here are the directions:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

It's a little tricky to set up, so ask if you need help.

Here is a list of low carb treats: Lo carb treats

Keep up the good work. Congrats on getting tests in - that is the most difficult part of this sugar dance for many people. And if you can continue to get rid of the dry, his numbers will likely continue to drop.
 
As a new member, please do not shoot under 200 mg/dL until you have MID-cycle data showing it is safe to do so. How low the insulin takes the glucose is a key factor in dose adjustment.

We suggest using an inexpensive human glucometer with pet-specific reference numbers (which your vet may not know about). One many of us use is the WalMart Relion Confirm, or Confirm Micro, which is also sold at American Diabetes Wholesale as as the Arkray USA Glucocard 01 or 01 Mini (same manufacturer - Arkray USA). It uses a tiny blood droplet and the cost is significantly lower for test strips (like $0.36 each). In Canada or other countries, you'll need to look for one you can afford, and easily obtain test strips to use.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


* * * * * * * * * * * * * * *​
Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
Sue and Oliver (GA) said:
It sounds like you are gaining ground! The low preshot and then high evening pre shot likely represents a bounce. When the body senses a lower than usual bg level, it releases extra glucose and then the next number is higher. I would not raise the dose yet, but would get some midcycle numbers to see how low the insulin is taking him. That may tell you if he is dropping lower and bouncing up. We have put together a protocol for ProZinc that may be good info:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=109077

It would be very helpful for us, your vet and you to put your numbers in a spreadsheet. We have a color coded one that makes it very easy to see trends and patterns. Here are the directions:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

It's a little tricky to set up, so ask if you need help.

Here is a list of low carb treats: Lo carb treats

Keep up the good work. Congrats on getting tests in - that is the most difficult part of this sugar dance for many people. And if you can continue to get rid of the dry, his numbers will likely continue to drop.
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HELP! I am going in circles. I am so distraught now. My Husband and I are fighting about it. He says I am "starving" the cat because his sugars are still so high. (he is a nurse too, so he is wanting to treat him like a human. I am trying to follow the advice on this forum, so I came down on the insulin because of the possible "bounce" that you suggested. I was away the weekend, and had my daughter give 1.5 units. SO he had that dose for 3 days. One of them ended up going thru to her, so I think he probably missed that one. Anyway, checked him this morning, 352. Tonight about 30 to 40 minutes after dinner, 552!!! That was highest ever! They had fed him before I could get home from work, but did not give insulin. (canned food) I gave it as soon as I had tested him, right when I go home after that. Not sure how quickly the BS can rise after a meal Any idea?? I am using "ReliOn Confirm" Is it possible that if there isn't a lot of blood on the test strip that it can test high?? Sometimes there is barely enough, but it still beeps like it is ok and doesn't give an error code. I am grasping at straws! My husband is out of work, we are really short on the $$ right now. So I am trying to avoid the $100 fructosamine! MY husband says we don't have the $$ to do that right now. But I know his body is starving....He wants to eat constantly and I don't know what to do. He is Soooooo skinny. Tonight the tears came. :sad: I have downloaded the spreadsheet, but am not sure how it works. What is AMPS PMPS? I figure it is AM & PM something, but not sure what the PS is. Also, all the +1 +2 etc.... I am really getting worried. I am the animal person in the house, my husband has just adapted. He WILL give the insulin, but not test his blood sugar. I work full-time, so the "curve" has not been attempted. I am working overtime these days to make ends meet, and have not had a day off just to test blood sugars.. PLEASE somebody HELP me! I am getting scared now, afraid that he can't hold on much longer the way he is going!! He is becoming concave!!!
 
Hello Whitey's caretaker! (we'd love to know what to call you too!)

Just some quick answers for you so you can get your spreadsheet filled out

AMPS and PMPS are AM Pre-Shot and PM Pre-shot....tests you get in the morning (AM) and evening(PM) prior to shooting. You should always test before shooting to make sure it's safe to give insulin.

The + system is just our easy way to know how long it's been since the last shot. Since we live all over the world, it's really hard for us to convert everyone's time zones, so we use the + system..+1 is 1 hour after shot, +3 is 3 hours after shot, +6 is 6 hours after shot..etc., etc.....so if you shoot at 6am, at 9am that's +3, 12 noon would be +6, 3pm would be +9........there are 2 cycles every day, the AM and PM cycle, so the "+ clock" restarts after each shot.

Hunger...there could be several reasons for the continued hunger. Uncontrolled diabetics aren't able to use the glucose from the food they eat because they need insulin to "unlock the door" to the cells to let the glucose get in...therefore they eat a lot, but continue to lose weight. They try to eat more because their cells are basically starving for glucose, but without insulin, the glucose just stays in the bloodstream instead of going into the cells to nourish them.

The other big reason for hunger is if they go too low. Just as with humans who's blood glucose goes too low go looking for a Coke and a candy bar, our cats do the same....if the BG goes low, they get hungry. It's their natural way of protecting themselves. I can always tell when my China's blood glucose is running a little too low...she becomes REALLY annoying and wants food!

We all know how frustrating this all is, especially at first when nothing seems to make sense, but if you continue with appropriate treatment, you'll start to see improvements in your kitty's quality of life soon.
 
Chris & China said:
Hello Whitey's caretaker! (we'd love to know what to call you too!)

Just some quick answers for you so you can get your spreadsheet filled out

AMPS and PMPS are AM Pre-Shot and PM Pre-shot....tests you get in the morning (AM) and evening(PM) prior to shooting. You should always test before shooting to make sure it's safe to give insulin.

The + system is just our easy way to know how long it's been since the last shot. Since we live all over the world, it's really hard for us to convert everyone's time zones, so we use the + system..+1 is 1 hour after shot, +3 is 3 hours after shot, +6 is 6 hours after shot..etc., etc.....so if you shoot at 6am, at 9am that's +3, 12 noon would be +6, 3pm would be +9........there are 2 cycles every day, the AM and PM cycle, so the "+ clock" restarts after each shot.

Hunger...there could be several reasons for the continued hunger. Uncontrolled diabetics aren't able to use the glucose from the food they eat because they need insulin to "unlock the door" to the cells to let the glucose get in...therefore they eat a lot, but continue to lose weight. They try to eat more because their cells are basically starving for glucose, but without insulin, the glucose just stays in the bloodstream instead of going into the cells to nourish them.

The other big reason for hunger is if they go too low. Just as with humans who's blood glucose goes too low go looking for a Coke and a candy bar, our cats do the same....if the BG goes low, they get hungry. It's their natural way of protecting themselves. I can always tell when my China's blood glucose is running a little too low...she becomes REALLY annoying and wants food!

We all know how frustrating this all is, especially at first when nothing seems to make sense, but if you continue with appropriate treatment, you'll start to see improvements in your kitty's quality of life soon.
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Hello, My name is Betsey... Thanks for asking. I just went back to this original post. Ive been working off a different post. I thank you for your input. I did figure out the spreadsheet and have been checking his numbers. Still too high. I am gradually making changes, but it is very, very frustrating because he IS still starved, has continued to lose weight and generally looks bad, because he is Sooooo thin. He lost more weight after I thought he had somewhat stabilized. It is a bit frightening to say the least. I just don't know how low he can go before getting complications from that issue! He is acting more himself, but he sure doesn't look like himself! I made the mistake of going up too fast, and learned about the "bounce" problem. So I cut back, and am now trying to make changes slowly. I hope he can turn around soon. He is on Prozinc. Thanks for your encouragement!
 
You have upped his food intake some? Unregulated diabetics can't utilize their food well and usually need a little extra. You can also look for foods that are low carb (under that 8% range) but that are a little higher in calories.

It looks like you are varying the dose quite a bit. You can vary the dose with ProZinc but maybe a sliding scale would help make the dosing easier. How about 2.5 400+, 2 for 300+ and 1.5 for under 300. If you get a 200 or so for a preshot, maybe one unit?

Sliding scales are helpful to figure dosing but if the numbers change, need tweaking. We still don't know if Whitey does well with changing the dose or if he'd respond better holding the dose a few cycles. Doing one or the other for a few cycles should help you figure that out.

Good job getting that testing in.
 
Sue and Oliver (GA) said:
You have upped his food intake some? Unregulated diabetics can't utilize their food well and usually need a little extra. You can also look for foods that are low carb (under that 8% range) but that are a little higher in calories.

It looks like you are varying the dose quite a bit. You can vary the dose with ProZinc but maybe a sliding scale would help make the dosing easier. How about 2.5 400+, 2 for 300+ and 1.5 for under 300. If you get a 200 or so for a preshot, maybe one unit?

Sliding scales are helpful to figure dosing but if the numbers change, need tweaking. We still don't know if Whitey does well with changing the dose or if he'd respond better holding the dose a few cycles. Doing one or the other for a few cycles should help you figure that out.

Good job getting that testing in.
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Yes, He eats all the time during the day, but not at night. I have tried to stay on the same dose for 3 cycles as that was what I believe I read somewhere.Which I thought meant 3 days?? Maybe that is not what a cycle consists of?? Is it weeks?? I believe it was the prozinc forum. What is your recommendation, sliding scale or stable doses? And as I went to bed last night after I posted, or messaged, that what I need to know is should he BE getting at least 8-10% carbs, but not MORE than that amount per day? And is that per meal or per day Also, what numbers am i really striving for realistically? At nadir and pre-shots? Sorry for so many questions!!! Thank you Sue! confused_cat
 
One cycle is from amps to pmps. The change up in dosing I see are your morning and evening shots. It seemed to vary most cycles and didn't always fit your pattern from the cycle before. For instance, on 8/21 for an amps of 415, you gave 2.25 which seemed like a good choice. That night, on an pmps of 463, you gave 1.5. It seems like the same amount you gave in the am would have been a good idea?

A sliding scale gives you a dose for each range. So on 8/21 if your sliding scale was 2.25 for numbers over 400, you'd give 2.25 for both amps and pmps that day. Does that make sense? (I know this is complicated :cry: )

Since you are doing a modified sliding scale any way, I think I would try it for a while. (there is no way to know which way - sliding scale or constant dose - your cat will do best with until you try one for a week or so) Does the scale I gave you seem logical?

Can you leave out some food overnight? That could help even things out. Lots of use an automatic feeder for that. Then you can set it to open during the night, but go to a empty slot 2 hours before the next shot. I love my PetSafe 5. We suggest staying under 8-10% carbs per can. Our Oliver ate 2.5 cans of the small Fancy Feast pate cans daily while he was unregulated, spread out among several meals. Once he was regulated, he went back to 2 cans a day. Some new diabetics eat more that that.

After that, it is up to you. You want a food he will eat. If he likes some 5% brands and some 8% brands, I'd go with both. Some people try to stay very low at 1-2% carbs, but it is hard to find flavors in that category. Fish tends to be the lowest low carb but we try to limit it to a couple times a week, because of the mercury in fish and because some cats get hooked on it and will want to eat fish exclusively. Having a couple flavors he likes makes your life easier.

Let's review. Maybe we have missed something. You are feeding low carb wet. You test first and feed after? For the morning and evening test, he hasn't eaten 2 hours before the test? Any treats are low carb? What size needles and what insulin? (If you are using U40 insulin, you should be using U40 needles unless you use the conversion chart)

It would be nice to have yellow preshots and some blues mid cycle for now. You are striving for regulation first. That would be 200 - 250 for a preshot and double digits for a nadir, but not below 40 which is approaching hypo territory. He has a lot of pinks and reds and we would like to get him to have lower preshot and lower nadirs, but it does take time.

The questions are fine! This stuff is complicated and the only way you can figure it out is to read and absorb and ask questions.
 
So if you look at this food chart,

http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

Look at the column C for carbohydrate and stay under 8-10% For the same food, look at kcal and aim for the higher calories. Some foods are 60 calories per can. Some are 90. I'd try the 90 range for awhile.

If he is too skinny on 2 cans a day, up it to 3. Spread the meals out over day and night. You can add water to the food to make a kind of gravy that may taste good to him.
 
Sue and Oliver (GA) said:
One cycle is from amps to pmps. The change up in dosing I see are your morning and evening shots. It seemed to vary most cycles and didn't always fit your pattern from the cycle before. For instance, on 8/21 for an amps of 415, you gave 2.25 which seemed like a good choice. That night, on an pmps of 463, you gave 1.5. It seems like the same amount you gave in the am would have been a good idea?

A sliding scale gives you a dose for each range. So on 8/21 if your sliding scale was 2.25 for numbers over 400, you'd give 2.25 for both amps and pmps that day. Does that make sense? (I know this is complicated :cry: )

Since you are doing a modified sliding scale any way, I think I would try it for a while. (there is no way to know which way - sliding scale or constant dose - your cat will do best with until you try one for a week or so) Does the scale I gave you seem logical?

Can you leave out some food overnight? That could help even things out. Lots of use an automatic feeder for that. Then you can set it to open during the night, but go to a empty slot 2 hours before the next shot. I love my PetSafe 5. We suggest staying under 8-10% carbs per can. Our Oliver ate 2.5 cans of the small Fancy Feast pate cans daily while he was unregulated, spread out among several meals. Once he was regulated, he went back to 2 cans a day. Some new diabetics eat more that that.

After that, it is up to you. You want a food he will eat. If he likes some 5% brands and some 8% brands, I'd go with both. Some people try to stay very low at 1-2% carbs, but it is hard to find flavors in that category. Fish tends to be the lowest low carb but we try to limit it to a couple times a week, because of the mercury in fish and because some cats get hooked on it and will want to eat fish exclusively. Having a couple flavors he likes makes your life easier.

Let's review. Maybe we have missed something. You are feeding low carb wet. You test first and feed after? For the morning and evening test, he hasn't eaten 2 hours before the test? Any treats are low carb? What size needles and what insulin? (If you are using U40 insulin, you should be using U40 needles unless you use the conversion chart)

It would be nice to have yellow preshots and some blues mid cycle for now. You are striving for regulation first. That would be 200 - 250 for a preshot and double digits for a nadir, but not below 40 which is approaching hypo territory. He has a lot of pinks and reds and we would like to get him to have lower preshot and lower nadirs, but it does take time.

The questions are fine! This stuff is complicated and the only way you can figure it out is to read and absorb and ask questions.
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Hi Sue, I believe that one of your posts suggested to go lower in the evening, cause he seemed to have such a spike. That's why I cut back. MAybe it was a suggestion from someone else. Regardless, that is why I did that. Mainly because he isn't eating overnight like he does during the day. My problem with leaving food out overnight is my other 2 cats! One of them is 20 lbs at least. (the one I thought would more likely be prone to diabetes LOL!!) I was researching the auto feeders, but some apparently cats can manipulate and open before they are supposed to. That would be my 20 lb cat!! He gets into the strangest things! I will look into them again though. Trying to keep Whitey in a room by himself, is tuff. He is an outdoor cat, and would tend to scratch things up trying to get out of the room, and pee where he shouldn't! Like beds!!! :YMSIGH: He is difficult with this. (we found him as a stray, and he hates litter boxes!!) Other suggestions for multiple cat households?
To re-cap, yes, I am feeding only wet, but till now, mainly the lowest carb ones, 0% to1%, with a couple of Stella & Chewy seafood dog treats, and Lil Bits dehydrated beef as snacks. I have purchased a couple different ones today with higher carbs. I will check out the link again that you gave me. He is using u40 syringes, for u40 prozinc.
So to be sure, if he is over 400 for AMPS, try the 2.5 units and again at night if PMPS is still over is 400. But at night if he is in the 300's, I would give 2 units. I guess the problem came from him "bouncing" overnight, and winding up with 500's in the morning, when I gave the same dose. I will see what I can do about giving him something overnight to eat. Thanks again!
 
Yes, you understand the sliding scale....Some cats do better on the sliding scale on Prozinc...some do better with consistent dosing...the same dose every 12 hours and changing only after several days if necessary

If numbers are:
400+ give 2.5 units (whether AM or PM)
300+ give 2 units
200+ give 1.5 units
If under 200, give 1 unit

Make sure to get tests in on that PM cycle too. A lot of cats go lower at night and the only way to know is to catch them by testing. Usually if you get at least a "before bed" test in, that's good, but once in awhile, it's really helpful to set an alarm and get a test at a later time

"Bouncing" happens when they go lower than their body is used to (and this often happens at night)...then their liver releases hormones and stored sugar to bring them back up to where it's gotten used to living at. Then you get a really high AMPS! The more time we can get him into those lower (and normal) numbers, the more his liver should get accustomed to those numbers again and hopefully stop reacting so badly!

See how Whitey does for the next several days on the sliding scale and then we'll see where he's at
 
Chris & China said:
Yes, you understand the sliding scale....Some cats do better on the sliding scale on Prozinc...some do better with consistent dosing...the same dose every 12 hours and changing only after several days if necessary

If numbers are:
400+ give 2.5 units (whether AM or PM)
300+ give 2 units
200+ give 1.5 units
If under 200, give 1 unit

Make sure to get tests in on that PM cycle too. A lot of cats go lower at night and the only way to know is to catch them by testing. Usually if you get at least a "before bed" test in, that's good, but once in awhile, it's really helpful to set an alarm and get a test at a later time

"Bouncing" happens when they go lower than their body is used to (and this often happens at night)...then their liver releases hormones and stored sugar to bring them back up to where it's gotten used to living at. Then you get a really high AMPS! The more time we can get him into those lower (and normal) numbers, the more his liver should get accustomed to those numbers again and hopefully stop reacting so badly!

See how Whitey does for the next several days on the sliding scale and then we'll see where he's at
Click to expand...

Hello Chris and China....It's been a struggle, the summer has been totally consumed by this whole thing. Whitey is still doing poorly weight-wise, down to 6 lbs today at the vet!!! That is 1/2 his body weight since March!!! I can't believe he can even still be alive like this! Anyway, his lab work was not too concerning to the vet. 1 isolated liver enzyme up slightly, BS of course and BUN, which is because he is soooo dehydrated. He was given fluid today, and i will repeat that every 2-3 days for awhile IF I can find some skin to give it in! He is so emaciated! Still not absolutely sure there is not something else going on, but his lab work certainly didn't show anything major! He has been having some bowel issues, the consistency is better, but light in color, foul smelling, and he has been extremely gassy. Waiting for the stool sample final results, but he was started on FLagyl anyway. I am so hoping this helps. He still eats like crazy, and has no vomiting issues. I was almost ready to put him down, :cry: , but decided to just see if things were not as grave as I felt they were. So I am back to trying to get these sugars better, although the Vet was not really concerned and felt the #'s were not all that bad! :o He says they do not try to regulate like a human! But I would still like them to be lower...looking for advice again on his spreadsheet. Thx...Hopefully "Sue and Oliver" sees this too and anyone else who has advised on this post. Not sure how the posts work, but you have all been very helpful! Also can you tell me the difference b/t PZI and Prozinc? Is PZI just a compounded prozinc? Someone was looking to get rid of her PZI that she is no longer using, but I wasn't sure they could be used interchangeably. Thanks! Betsey
 
BCP PZI is not identical to ProZinc. It can be used following the same protocol, though.

Light, "fluffy", and foul smelling feces suggest exocrine pancreatic insufficiency. It happens when the enzyme-producing cells in the pancreas are damaged. Digestion is impaired, so there is weight loss. The treatment for that is supplemental digestive enzymes. Discuss this with your vet. You might consider empirical treatment. That is, treat as if that were the diagnosis without doing testing.
 
I think I'd up the scale - even if you are not sure what is going on with his intestines, you want to keep his numbers in a safe range. (The first range we look for is mid to lower 200s at pre shot and double digits at nadir, but not below 40, which is hypo territory. We generally consider thatrange as regulated. We think the renal threshold is around 250-270 and we'd like to see cats generally in or under that range.)


400+ give 3 units (whether AM or PM)
300+ give 2.5 units
200+ give 2 units
If under 200, give 1.5 unit

Most cats do not generally need this much insulin unless there is something else going on. I am concerned that your vet doesn't seem particularly concerned. Are you testing regularly for ketones?

He could be a high dose kitty, although it really doesn't sound like it. Here is a thread of the high dose conditions. Do any of the symptoms sound like him?

http://www.felinediabetes.com/FDMB/viewtopic.php?f=12&t=375

I would guess he has something intestinal going on. If there is an infection or other issue, that could certainly require extra insulin. Here are a couple websites about the exocrine pancreatic insufficiency:

http://veterinarynews.dvm360.com/ex...terinarians-think?id=&sk=&date=& &pageID=2 A vet site that seems pretty good.

http://www.peteducation.com/article.cfm?c=1+2135&aid=330 Good info, symptoms etc. Not sure about their "solutions"

You might want to start a new topic and ask for help with weight loss and diabetes. I know we have had lots of people with similar issues.
 
Thank you Sue! The Vet did call today, and he has Hook Worms!!! This might be my answer! I am more hopeful. It may have been going on for awhile! Could be why he is requiring so much!!! I am so hoping that this is the break-thru that I need. Will be heading to the vet to get the anti-worm for him. Will keep an eye on his blood sugar should he start feeling better and his sugar lowers!! :-D Betsey
 
If he is allowed outside, you may want to make worming a regularly scheduled treatment.
 
Just got an 8 hour BS...194!! I had given him 2.5 units this morning before I saw your message. Just gave him a snack, and his first dose of Panacur! Keeping my fingers crossed!
 
BJM said:
If he is allowed outside, you may want to make worming a regularly scheduled treatment.
Click to expand...

Yes, we used to do that...not sure what happened, but supposedly he had a neg. stool in late May. Now I am beginning to wonder about the sample I brought to my vet that day...It was tiny, and they didn't get my message that it i had left one there, so it was not too fresh. Maybe it just didn't show up that day, cause he clearly had loose stools then! Then they started him on the probiotics, which didn't really change things... That was the beginning of everything! After I got that news that it was negative for everything they tested, I worried more, and brought him to the vet again. He had just been seen 2 months before for his reg. check-up! So began my roller-coaster summer! It's been a short summer totally consumed by this whole diabetic thing! Now, I am hoping for a real recovery! Thanks to all of you for your advise and assistance. What a wonderful "place" I have found! :smile: Betsey
 
Boo on the hookworms, but I guess it's better than having nothing new to try! Hopefully treating them will do the trick!

A lot of us try to not feed after +6...you don't indicate on your spreadsheet when you feed, but sometimes it can make a difference in their BG numbers since after nadir, the insulin is wearing off

And WOO HOO on the Blue! That's a NICE surprise!!
 
Chris & China said:
Boo on the hookworms, but I guess it's better than having nothing new to try! Hopefully treating them will do the trick!

A lot of us try to not feed after +6...you don't indicate on your spreadsheet when you feed, but sometimes it can make a difference in their BG numbers since after nadir, the insulin is wearing off

And WOO HOO on the Blue! That's a NICE surprise!!
Click to expand...

Yes, I was excited to see the blue... but then yes, he had a snack, as he is ALWAYS hungry! We feed him and do all his medicines in the bathroom, away from the other 2 civies, so he is used to that. Problem is, if anyone needs to use the bathroom for it's intended purpose, he wants food! Since he is so starved, I give in! As you can see, his sugar went way up after that. I have been making sure the PMPS is at least 2 hours without food. Right now, it would be hard to not feed him after 6 hours, cause I give him his insulin generally at 5 am and 5-6pm. 11 am is early to stop, but maybe after 8 hours. He seems to often have a snack around 1pm, and 1am! I am long gone to work after 5am, and there are still people in the house, that he hounds! I am hoping, maybe if this whole worm thing is the culprit, that I can cut down on the food. He is eating me out of house and home!!! LAst weekend, I really thought I was going to have to put him down. I figured there was really something bad going on. I am so hopeful that this is what has been keeping him from gaining weight. Then who knows, maybe we CAN get into a remission! :smile: Thanks for your help! Betsey
 
BJM said:
BCP PZI is not identical to ProZinc. It can be used following the same protocol, though.

Light, "fluffy", and foul smelling feces suggest exocrine pancreatic insufficiency. It happens when the enzyme-producing cells in the pancreas are damaged. Digestion is impaired, so there is weight loss. The treatment for that is supplemental digestive enzymes. Discuss this with your vet. You might consider empirical treatment. That is, treat as if that were the diagnosis without doing testing.
Click to expand...

Thank you for this info, as well as the links that "Sue & Oliver" sent me about this. It really seems like it could be!I am not sure that it can come on so acutely, but I am going to ask the Vet about this. Whitey has not significantly improved since de-worming unfortunately, and since yesterday his appetite has decreased. Not sure that is a good thing. He seemed weak, BS still higher till today, since he has not eaten as much. I feel i am going in circles! nailbite_smile I gave him some SQ fluids and now def. thinking about this EPI. I know you mentioned treating empirically. Do you think there is harm in trying it without an official diagnosis? This gu is really costing me a lot of $$! I am just wondering if it would hurt a cat if they didn't really have it. I can order a sample size for $14.99 from "enzymeDiane" an online place that has a generic form of the prescription drug. It was recommended by the EPI forum. Thanks, Betsey
 
I do not know if external enzymes could cause a problem.

If I were going to try them, I would start low and go slowly, so I could monitor output for issues. If you chose to do that, taking serial pictures for comparison may be helpful, as well as noting frequency, volume, and consistency.
 
BJM said:
I do not know if external enzymes could cause a problem.

If I were going to try them, I would start low and go slowly, so I could monitor output for issues. If you chose to do that, taking serial pictures for comparison may be helpful, as well as noting frequency, volume, and consistency.
Click to expand...

Thx, I am going to call the Vet tomorrow, I guess, to see what he thinks. Thanks for your input! Sincerely, Betsey
 
Sue and Oliver (GA) said:
I think I'd up the scale - even if you are not sure what is going on with his intestines, you want to keep his numbers in a safe range. (The first range we look for is mid to lower 200s at pre shot and double digits at nadir, but not below 40, which is hypo territory. We generally consider thatrange as regulated. We think the renal threshold is around 250-270 and we'd like to see cats generally in or under that range.)


400+ give 3 units (whether AM or PM)
300+ give 2.5 units
200+ give 2 units
If under 200, give 1.5 unit

Most cats do not generally need this much insulin unless there is something else going on. I am concerned that your vet doesn't seem particularly concerned. Are you testing regularly for ketones?

He could be a high dose kitty, although it really doesn't sound like it. Here is a thread of the high dose conditions. Do any of the symptoms sound like him?

http://www.felinediabetes.com/FDMB/viewtopic.php?f=12&t=375

I would guess he has something intestinal going on. If there is an infection or other issue, that could certainly require extra insulin. Here are a couple websites about the exocrine pancreatic insufficiency:

http://veterinarynews.dvm360.com/ex...terinarians-think?id=&sk=&date=& &pageID=2 A vet site that seems pretty good.

http://www.peteducation.com/article.cfm?c=1+2135&aid=330 Good info, symptoms etc. Not sure about their "solutions"

You might want to start a new topic and ask for help with weight loss and diabetes. I know we have had lots of people with similar issues.
Click to expand...
on the forum

Hi Sue, It has been awhile since I posted about Whitey's sugars. Just when I think I am making headway, He throws me a curve with a huge spike at the pre-shots. So I was looking on the prozinc (PZI) forum and saw info about dosing in between, possibly 3 times/day or varying the time schedule. I have been so crazy trying to keep him on the 12 hour schedule, but he has huge spikes earlier than that. What do you think?? I did go a while without doing mid-cycle readings, just got more bad news on my 4 year old cat, that she has the same cardiac problem that her sister died from this June. :sad: (hoping to get a couple of years like we did with her sister...) :YMSIGH: I have also been focusing more on Whitey's diet and loose stools.(Empirically treating him with digestive enzymes. Stools better, but not sugars) (see my post from last night about EPI and IBD) Really hard to keep up with all this, but I hate to see the sharp rises on him. Anyway, looking for further advice. His pre-shots are at 5am and 5-6 pm....That's my work schedule. Also, was finding that every time I increased his doses he would have the "Bounce" SO I continued on one dose, thinking that maybe he was better on a stable dose and not sliding scale. But as you see, I gave the same 3 unit dose for a pre-shot in the 200's which gave me a green at 5 hours.(which I was happy about that. I fed him at that point thinking that would be enough, but the AMPS was super high again. His seems to have stopped losing weight, but has not really gained much and has lost a lot of muscle mass. Finding skin to give him insulin has been difficult. I think he might have been getting some "fur-shots" I have found the needle out of his skin frequently, and have to re-adjust to get it back
under the skin before shooting. Thanks, in advance to anyone who responds to this post. Betsey
 
OK, when you say wet food, what wet food? Some wet food is high carbohydrate. Lets make sure the foods you are using are, in fact, low carb.

You may be having an issue with duration; if that is the case, you could total the daily shots, divide by 3, and shoot about every 8 hours. Would that work for your schedule to at least try it? If not, a better option is to switch to a depot insulin which has an overlap in duration that is enough to reduce most glucose spikes at the end of one period and the beginning of the next.

There is another option besides TID dosing and switching, but it requires ruling out other issues first. And we'd want you to be testing regularly in mid-cycle and recording the numbers in your spreadsheet, because without that, it could be dangerous to your cat.
 
It's hard to tell what is going on, Betsy. I read your other post, and with the possibilty of IBD or EPI or pancreatitis, it really complicates the dosing. Last pmps was great and so was the nadir, but he probably bounced today. (A bounce can look like a jump up right away or it can be a higher cycle the next time.)

ProZinc can be given 3 times a day, every 8 hours or you can vary the schedule to 11/13 instead of 12/12, but I think you'd need more data before deciding to do either. Dosing 3x a day works for a cat whose levels start up by +8 but he isn't there consistently. If he had one preshot lower and one preshot higher, the 11/12 might work but he doesn't do that consistently either.

I think maybe I'd try the sliding scale. The 3 looks like too much for the yellow and pink preshots; it drops him more than 50% and then he bounces. If you could get his cycles to flatten out a little and stop bouncing, those blacks might go away. Even if he is not in great numbers, if you can get rid of the big drops and rises, he should feel better.

The more data you can get, the better you figure out what dose would be best.

While you aren't sure what else is going on, I'd also get ketone tests regularly.
 
Thank you Sue again! So I will go back to the sliding scale. This morning he was only 144! :o Wow, but he started out at PMPS 525. Such highs and lows! Not sure how low it went overnight. I gave him just 1 unit this morning looking back at your sliding scale you had suggested a while ago. I am home today, so I can try to get some other tests in during the day. Betsey
 
oops...just noticed a different scale you had given me, more recently. I guess I should have given 1.5 units this morning. :-| I will go by that one from now on and will see how it goes. Thanks again.. Betsey
 
BJM, I have been feeding EVO 95% chicken and turkey, or beef. I think they are around 3% carbs if I remember correctly! I have been calculating so many different foods, my head is spinning. Last night at snack time, (which would be all the time if we let him!) 3 hours post injection, he had 1/2 of a 5.5 oz can of Hounds and Gatos pork, which according to the calculator I am using it is less than 2%. So he HAS been eating the lower carb options. But he eats a lot thru the day. I believe it was you who had mentioned to try not to feed after 6 hours post shot. We do try that, but sometimes he just won't stop hounding us. Then he goes out and hunts, like yesterday, when he brought home a live critter. I couldn't get it out of his mouth, and he took off with it, and then I had the unfortunate experience of viewing him pretty much swallowing it whole!!! :o Hoping critters are 0 carbs! :lol: I am trying some different foods for his belly problem. We shall see. Thank you for your input. Betsey
 
Well, that's a lower amps. Now if we knew why. I think the one unit is good. When you get a number that far below 200, you do want to make sure it is rising, not falling, before shooting. And lower is better. (I'll need to go back and look at the scale. I rarely suggest a dose to be given under 180) I am glad you are watching his numbers today so he doesn't go too low.

never heard of Hounds and Gatos. Is it on any of the charts? If not, what are the ingredients? If he eats outside the house, any chance he ate something he shouldn't that could have caused his intestinal issues? Could he have worms? Could he be stealing dry food from a neighbor's dog or cat? Might be questions for the vet?
 
Perhaps you might note the low carb-ness or brand in your signature.

If he is still losing weight and needs to gain it back, you can increase the amount he is eating a bit.
 
Well, just checked him 4 hours post shot and already he is up to 368! He had been outside for those 4 hours. (his ears were cold, took me awhile to get the sample, even with heating up the ear!! Haha) don't think he gets into other neighbors stuff, have not seen him do that. We don't have neighbors in the area with stuff outside that I know of. He HUNTS and is more active than he had been all summer, where he would just go outside and sit under the the bushes.
So it IS nice to see him a little more like himself. (other than being a skeleton!!)
The Hounds & Gatos is on the list I printed from somewhere on the forum. The pork is 2% carbs and higher in calories than some of the others. The ingredients are Pork, Water and and multiple other minerals and vitamins. 10.5% protein, 10% fat, 0.5% fiber, 78% moisture, 0.025% magnesium on the nutrition facts. 100% animal protein! Less expensive than some of the other grain-free cans. This is a 5.5oz can. At the store I paid $1.59. I live in the northeast. I am going to look for it online and see if I can get it any lower.
His stool sample from last Sunday was negative for any parasites. He had been treated for hookworms 1 month ago and that was the follow-up sample.
The roller-coater continues! confused_cat Thanks as always! You are all wonderful!
 
:sad: rb_icon wings_cat rb_icon It is with heavy heart today that I write this. Today I put 2 cats to eternal rest. Whitey and Blossom. Whitey was my "sugar-cat" Blossom was diagnosed with Cardiomyopathy 2 months ago, but never improved with medication. It was only this past June, that I had to put her biological sister to sleep with the same problem, only she survived 2 years on medication, not 2 months. Blossom was only 4 1/2 years old, and Whitey approximately 11 years old. Whitey continued to be out of control with his sugars, never gained back weight, and continued to eat ravenously. (he went from 12 lbs to 6.5 lbs!) There was clearly something else wrong with him and he was not going to improve. He lived only to eat, and did nothing else except lie and wait for his next meal, and it would basically go right thru him with no nutritional benefit even with the pancreatic enzymes. He was not the loving kitty I once knew. The quality of life was not there for either cat. It has been a difficult year, dealing with 3 ill cats and putting all 3 to sleep. Thankfully I still have 1 kitty left, who at this time appears healthy. He is a 19 lb ball of fun! Thank you to the Feline diabetic forum for helping me during the early diagnosis stages. Your advice was all very helpful. I hope that I never have to deal with this disease again with another cat, but at least I know where to go to get help and advice. I know that I am not alone. I have some supplies left, Prozinc U40 syringes, some enzymes, and some other meds that my little calico cat was on for her heart. (Vetmedin, Enalapril) If anyone is interested in these let me know. Thank you for all your support.......Sincerely, Betsey
 
So sorry to hear this news Betsey!

Fly free Whitey and Blossom and land softly...there are many at the Bridge to welcome you and show you around wings_cat

When you feel like it, I hope you'll read this fable. It's official title is "The Loving Ones", but I've always like to call it You have Chosen Tears. It will probably make you cry, but in tears there is healing.

:YMHUG: Betsey
 
Chris & China said:
So sorry to hear this news Betsey!

Fly free Whitey and Blossom and land softly...there are many at the Bridge to welcome you and show you around wings_cat

When you feel like it, I hope you'll read this fable. It's official title is "The Loving Ones", but I've always like to call it You have Chosen Tears. It will probably make you cry, but in tears there is healing.

:YMHUG: Betsey
Click to expand...
Thank you Chris, I am sitting here full of those tears, but what a lovely story and so very true....I knew about the Rainbow bridge, but had never heard that fable. Thank you and everyone else for your notes of support and sympathy.... You all are a great group of people. Happy Holidays to you all..... Betsey
 
My deepest sympathies on the loss of your two cats, Whitey and Blossom. You were both deeply loved.

You might want to post over in the Supply Closet forum about any medications and such you have available to pass on to another person. Hopefully, someone can use these supplies in memory of your beloved cats.
 
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