Request for advice on Dyson's situation

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kthondragon

kthondragon

Member Since 2024
Our cat, Dyson, has been on insulin now for around a month, give or take. Here is a link to my initial thread, for some background info: Previous Thread

He's been at 3u of Vetsulin for about two weeks and he has had a few days where he got better numbers, but in general it seems like we cannot get him out of the 400-500+ range (on human Relion meter). He has been to the vet for a follow up, and again for an Ultrasound because they wanted to look into possible Pancreatitis. The result showed that he either has a mild or chronic case so he has been put on a course of an antibiotic to hopefully calm that down. They also saw some abnormality with his biliary system and liver, but liver panel bloodwork showed nothing of note. So they decided to also put him on Ursodiol, which he's been taking once every 24 hours, along with the antibiotic.

We have periodically tested him for ketones and he comes up negative for those, so that is good at least. He is eating a low carb diet still of mostly Fancy Feast pates, and sometimes Weruva Pate, plus freeze dried chicken and freeze dried beef for snacks...feeding him at least a snack or more whenever he seems like he is hungry, as per the advice given.

We've spoken to the vet about changing insulin and she was willing to consider Prozinc, but said she's never prescribed Lantus for a cat and that she wouldn't be comfortable doing so. We, of course, would prefer Lantus since it is so commonly mentioned on here and is really inexpensive. I'm going to be gathering sources (AAHA, NIH, etc.) to bring to her regarding Lantus, but I am not hopeful.

First questions: Is Prozinc an acceptable option? Should I push harder for Lantus? Or continue on Vetsulin?

Second questions: Looking at the numbers and the curve bounce that we are seeing, would it be worthwhile to reduce the insulin to 2.5 or 2.75 to see if we are contributing to the bounce with too high a dose? Or are we better off increasing it to 3.25 or 3.5?

Thanks for any help you can provide!
 
kthondragon said:
Our cat, Dyson, has been on insulin now for around a month, give or take. Here is a link to my initial thread, for some background info: Previous Thread

He's been at 3u of Vetsulin for about two weeks and he has had a few days where he got better numbers, but in general it seems like we cannot get him out of the 400-500+ range (on human Relion meter). He has been to the vet for a follow up, and again for an Ultrasound because they wanted to look into possible Pancreatitis. The result showed that he either has a mild or chronic case so he has been put on a course of an antibiotic to hopefully calm that down. They also saw some abnormality with his biliary system and liver, but liver panel bloodwork showed nothing of note. So they decided to also put him on Ursodiol, which he's been taking once every 24 hours, along with the antibiotic.

We have periodically tested him for ketones and he comes up negative for those, so that is good at least. He is eating a low carb diet still of mostly Fancy Feast pates, and sometimes Weruva Pate, plus freeze dried chicken and freeze dried beef for snacks...feeding him at least a snack or more whenever he seems like he is hungry, as per the advice given.

We've spoken to the vet about changing insulin and she was willing to consider Prozinc, but said she's never prescribed Lantus for a cat and that she wouldn't be comfortable doing so. We, of course, would prefer Lantus since it is so commonly mentioned on here and is really inexpensive. I'm going to be gathering sources (AAHA, NIH, etc.) to bring to her regarding Lantus, but I am not hopeful.

First questions: Is Prozinc an acceptable option? Should I push harder for Lantus? Or continue on Vetsulin?

Second questions: Looking at the numbers and the curve bounce that we are seeing, would it be worthwhile to reduce the insulin to 2.5 or 2.75 to see if we are contributing to the bounce with too high a dose? Or are we better off increasing it to 3.25 or 3.5?

Thanks for any help you can provide!
Click to expand...
Tagging Suzanne she's familiar with Vetsulin, but we can't see your spreadsheet again
@Suzanne & Darcy

We cannot see your spredsheet
To set spreadsheet sharing permission:
* At the top right of the spreadsheet screen click on Share.

* In the pop-up dialog box click on the Get Link section.

* Change link access from 'Restricted' to 'Anyone with the link' and make sure that the permission on the right hand side is set to 'Viewer'.

* Click Done to save the changes.
 
*sigh* How did I miss this setting AGAIN lol.
(I created a new spreadsheet with just the human meter's information since it's been a few weeks now.)
 
Did you start out with three units? He was never on a lower dose? ProZinc would be a much better option than Vetsulin since the duration of Vetsulin is so poor. Lantus would be even better. If you have to, start with ProZinc and switch to Lantus when you can. It’s definitely one of the insulins recommended by AAHA (but so is ProZinc and some cats do very well on it.)
 
How is his appetite? How is his energy level? Did he have bloodwork done at diagnosis or subsequently? Is it attached to your spreadsheet? Any elevated white count? Was the Spec Feline Pancreatic Lipase test done for pancreatitis?
 
Suzanne & Darcy said:
Did you start out with three units? He was never on a lower dose? ProZinc would be a much better option than Vetsulin since the duration of Vetsulin is so poor. Lantus would be even better. If you have to, start with ProZinc and switch to Lantus when you can. It’s definitely one of the insulins recommended by AAHA (but so is ProZinc and some cats do very well on it.)
Click to expand...
We originally started at 2, but his numbers weren't ever showing anything other than "HI" on his home glucose tests... so the vet and we decided to move him up to 3 and he's been on that for two weeks now.

I'll talk to the vet about getting the ProZinc order in... hopefully that will help. She really is digging her heels in about switching to Lantus. And I hate going to her with "So, I read this online and..."

His appetite is enormous. He's hungry all day, and is still drinking a lot of water. He did have bloodwork done at the ER vet, but I don't have those numbers. I do have the numbers from two days before his DKA, which I can add to the spreadsheet Labs tab. They tested his liver since then, but that's about it. At his original test, his white count was middle of range(3.5 - 16) at 10.5. I don't believe they did a Spec Feline Pancreatic Lipase test... but in the results I do see a Precision PSL test, that was shown to be 35 (normal range is apparently 8-26.)
 
Well, although there are a discouraging number or reds and blacks on his spreadsheet, there are also some yellows recently so he is responding to the insulin. The 3 unit dose has been held too long. He needs an increase of .25 units. Honestly, he probably could use a larger increase, but since he’s not producing ketones at this time we can go with a .25 unit increase. You are testing for ketones daily? And he has been negative? Am I getting that right?

He’s been on this dose long enough that if he were being overdosed, he would have dropped too low at some point — and you test a lot, thankfully, so you would have caught a low.

Holding doses for too long risks glucose toxicity where it’s harder to bring their numbers down because their bodies are just used to being in those high numbers.

We should know after a few days if the 3.25 is helping. If ketones are in the picture then we may need to increase sooner rather than later.
 
Suzanne & Darcy said:
Well, although there are a discouraging number or reds and blacks on his spreadsheet, there are also some yellows recently so he is responding to the insulin. The 3 unit dose has been held too long. He needs an increase of .25 units. Honestly, he probably could use a larger increase, but since he’s not producing ketones at this time we can go with a .25 unit increase. You are testing for ketones daily? And he has been negative? Am I getting that right?

He’s been on this dose long enough that if he were being overdosed, he would have dropped too low at some point — and you test a lot, thankfully, so you would have caught a low.

Holding doses for too long risks glucose toxicity where it’s harder to bring their numbers down because their bodies are just used to being in those high numbers.

We should know after a few days if the 3.25 is helping. If ketones are in the picture then we may need to increase sooner rather than later.
Click to expand...

Thanks! We will transition him to 3.25u. We haven't tested for ketones daily, as it's really hard to catch him when he goes to the bathroom, and we have three other cats so can't be sure who uses the litter boxes at what times. But we have checked at least every couple of days and since he left the hospital, it's been negative every time.

I added his lab results from his original intake on the lab tab of the spreadsheet. Will add his more recent results when I have a minute (though they were focused mostly on his liver.)
 
kthondragon said:
Thanks! We will transition him to 3.25u. We haven't tested for ketones daily, as it's really hard to catch him when he goes to the bathroom, and we have three other cats so can't be sure who uses the litter boxes at what times. But we have checked at least every couple of days and since he left the hospital, it's been negative every time.

I added his lab results from his original intake on the lab tab of the spreadsheet. Will add his more recent results when I have a minute (though they were focused mostly on his liver.)
Click to expand...
I understand about multiple cats! I bought a Nova Max Plus blood ketone meter due to that problem after my cat’s DKA. But I am happy he’s not had any more. How many more days of antibiotics does he have? Regarding his liver, you said the liver enzymes were all in the normal range so that’s a plus.
 
Suzanne & Darcy said:
I understand about multiple cats! I bought a Nova Max Plus blood ketone meter due to that problem after my cat’s DKA. But I am happy he’s not had any more. How many more days of antibiotics does he have? Regarding his liver, you said the liver enzymes were all in the normal range so that’s a plus.
Click to expand...
Correct! All his liver enzymes were in the normal range, so they weren't worried about his liver so much anymore. He has 9 more days of his antibiotic, including tonight.
 
Suzanne & Darcy said:
I am hoping for a bit better numbers today. When do you think you’ll be able to switch insulin?
Click to expand...
His numbers weren't great starting out the day... but I got good news.
When I called the vet and asked to switch insulin, before I even named anything, she said she'd put in an order for Lantus! So I get to pick that up today, though we won't start the Lantus until after the U-100 syringes arrive tomorrow.
We are starting on a 1u dose.
She did say we should probably stop testing him as much and that we should get rid of the human meter and switch to a pet meter... but I am choosing to ignore that part :)
We are going to be closely monitoring him after the switchover, but may eventually drop to just testing AMPS and +4, PMPS and +4(depending on what we determine is his nadir.)
 
That’s great. Your perseverance paid off! It’s pretty silly about the meters. Before these per meters were invented all vets used human glucometers because that’s what was available. In fact, a lot of vets still use them (mine does.) I also don’t understand why not to test. The thing may be that a lot of vets will tell you to keep your cat in the 200-300 range. They have no chance of pancreatic healing in that range which is nowhere near normal for a cat and is very hard on their kidneys as well since they’re above the renal threshold so much of the time. But it will prevent a hypo, right!
 
Suzanne & Darcy said:
That’s great. Your perseverance paid off! It’s pretty silly about the meters. Before these per meters were invented all vets used human glucometers because that’s what was available. In fact, a lot of vets still use them (mine does.) I also don’t understand why not to test. The thing may be that a lot of vets will tell you to keep your cat in the 200-300 range. They have no chance of pancreatic healing in that range which is nowhere near normal for a cat and is very hard on their kidneys as well since they’re above the renal threshold so much of the time. But it will prevent a hypo, right!
Click to expand...

Good thing is... we already own a pet meter, just had to get some more strips. So we will keep using the human meter and filling in the spreadsheet with that, but if the vet asks for a reading, we'll just use the pet one for that. Gotta play the game, I guess. But yeah, I would much rather he drop to more normal numbers... would love to someday see him in the sub-200s definitely. Poor boy's been through the ringer. Just hoping he can start feeling better soon.
Thanks for the help/advice!
 
Diane Tyler's Mom said:
@kthondragon
That's great you got the Lantus!
Yes if your vet wants a curve done just use the pet meter for that
Do you or der the U-100 syringes with the half unit markings since we adjust the doses by 0.25 units at a time. These make it easier to do.
Click to expand...
Yeah I was pretty happy she went for the Lantus. And I grabbed the U-100s with the .5 doses listed on it. I figured they would be the right choice.
 
I wonder if your vet called in the vials or the pens,
@kthondragon[/USER
Tyler has been in remission for 3 yrs and 3 months now so I don't use lantus anymore, he's food controlled. A lot of members even use the generic lantus
I found this posted by one of our members if you need it for the future
I followed this prescription info exactly and it workedperfectly. Hope this helps!
Then go to the Lantus site to generate the coupon as in second image.
[IMG]https://felinediabetes.com/FDMB/attachments/upload_2023-12-1_6-57-52-png.68163/[/IMG]
[IMG]https://felinediabetes.com/FDMB/attachments/upload_2023-12-1_6-59-16-png.68164/[/IMG]


If you get the pens or a vial and the pharmacy tells you they are only good for 28 days that's not true
The pens are good for much longer than the 28 days. That number is for people who carry the pens around with them everywhere, like at work, in the car, in their purse, etc.
5 pens should last about a year ,you can use each pen or vial until the last drop.They are all good until the expiration date on the pens . Keep them on the middle shelf in the fridge

Just a Heads up when you do start the lantus please note that in your signature you can put that after you have Vetsulin just put a / after it and put Lantus and the date.
Also on your spreadsheet up top.
When switching insulin we like you to put a blank line above the date you start lantus and just type Switch to Lantus and highlight it
 
Last edited:
Diane Tyler's Mom said:
I wonder if your vet called in the vials or the pens,
@kthondragon[/USER
Tyler has been in remission for 3 yrs and 3 months now so I don't use lantus anymore, he's food controlled. A lot of members even use the generic lantus
I found this posted by one of our members if you need it for the future
I followed this prescription info exactly and it workedperfectly. Hope this helps!
Then go to the Lantus site to generate the coupon as in second image.
Click to expand...
My wife actually did that a few weeks ago in the hope that we would need to use it :)
I don't know how the vet called it in... but I figure I'll pick it up tonight no matter what(and see if the card works) and if it is working to help control Dyson's numbers... when it comes time for a renewal of the prescription I'll ask her to send the script in according to the card for the proper savings :)
 
kthondragon said:
My wife actually did that a few weeks ago in the hope that we would need to use it :)
I don't know how the vet called it in... but I figure I'll pick it up tonight no matter what(and see if the card works) and if it is working to help control Dyson's numbers... when it comes time for a renewal of the prescription I'll ask her to send the script in according to the card for the proper savings :)
Click to expand...
Sounds good, I did add to my post above ,so I don't know if you saw it , just take a look :cat:
Good luck with the lantus , I loved it
@kthondragon
 
@kthondragon
Hi Mike and Erika ,one last thing
You have enough data on Dyson to start posting on the Lantus Forum when you start it. There are more eyes on it.
If you do we have a certain way to post there
Date Dyson AMPS# and any other tests after that, you can continue with his PMPS # also and any tests after that
To add the additional tests tap on the word Thread Tools to the right then tap on Edit Title add the other tests then tap save

When you switch to lantus I would try and get a +6 also besides the +4 only because lantus usually nadirs at +6 but not always
Sorry to be such a pain in the butt lol
 
Diane Tyler's Mom said:
@kthondragon
Hi Mike and Erika ,one last thing
You have enough data on Dyson to start posting on the Lantus Forum when you start it. There are more eyes on it.
If you do we have a certain way to post there
Date Dyson AMPS# and any other tests after that, you can continue with his PMPS # also and any tests after that
To add the additional tests tap on the word Thread Tools to the right then tap on Edit Title add the other tests then tap save

When you switch to lantus I would try and get a +6 also besides the +4 only because lantus usually nadirs at +6 but not always
Sorry to be such a pain in the butt lol
Click to expand...
Not at all a pain in the butt in any way shape or form. We welcome the help :)
 
Saw this pic of Dyson on your previous post
IollHyQ.jpeg


He is adorable why not put his pic as his avatar

go to the top of your name and tap on it ,a drop down will appear ,tap on Avatar and add his pic

If you look under your user name at the top right of this page you will see avatar. Click on that and it will give you instructions.
@kthondragon
Forgot to mention when you start posting on the Lantus forum always link your previous days post to your new Post. Try to post everyday
 
Diane Tyler's Mom said:
I wonder if your vet called in the vials or the pens,
@kthondragon[/USER
Tyler has been in remission for 3 yrs and 3 months now so I don't use lantus anymore, he's food controlled. A lot of members even use the generic lantus
I found this posted by one of our members if you need it for the future
I followed this prescription info exactly and it workedperfectly. Hope this helps!
Then go to the Lantus site to generate the coupon as in second image.
[IMG]https://felinediabetes.com/FDMB/attachments/upload_2023-12-1_6-57-52-png.68163/[/IMG]
[IMG]https://felinediabetes.com/FDMB/attachments/upload_2023-12-1_6-59-16-png.68164/[/IMG]


If you get the pens or a vial and the pharmacy tells you they are only good for 28 days that's not true
The pens are good for much longer than the 28 days. That number is for people who carry the pens around with them everywhere, like at work, in the car, in their purse, etc.
5 pens should last about a year ,you can use each pen or vial until the last drop.They are all good until the expiration date on the pens . Keep them on the middle shelf in the fridge

Just a Heads up when you do start the lantus please note that in your signature you can put that after you have Vetsulin just put a / after it and put Lantus and the date.
Also on your spreadsheet up top.
When switching insulin we like you to put a blank line above the date you start lantus and just type Switch to Lantus and highlight it
Click to expand...
I wish I had that kind of price when Darcy was on over 40 units twice a day.
 
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