The right dosage?

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Starla and Tigger

Starla and Tigger

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Hello Tigger and I are new here and Tigger was diagnosed back in June of this year.
We are still struggling so much with his glucose levels.
He started off with 2 units twice a day and was doing real well the first couple weeks, then gradually his blood sugar kept creeping back into the 300 and 400's
I test his blood at 6am and 6pm when we feed him and that is when he shows the 300 and 400 blood sugar levels.
He is at 6 units twice a day still and his diet is very regulated (eating 3 times a day 6am, 12pm, and 6pm) on M/D hills diet glucose management dry food and once a day a small amour of wet food is mixed with the diet food.
His weight is back to normal ( 11 pounds), but I cannot get his blood sugar to get lower.
How much higher can I take his dosage? My vet might think we need to move Tigger to human insulin but I hear that is hard to regulate.
What is considered too high of a dose for cats ?
Going to do another glucose curve this weekend. And does usually hit his low around 6hrs after morning shot ( 150).
Any advice on Tiggers high glucose even with higher doses of insulin?
Also he sad never gone Hypo, thank goodness, we only increase insulin 1/2 units at a time. ( usually one week waiting period to see how it reacts)
Thanks for any help!
 
Hey Starla! Welcome to the group. There are a few things that will help people here to give you the best advice: First, most of us have a google spreadsheet attached to our signatures. We use that to input the sugar kitties BG levels and dose, and then any mid-cycle numbers we get. Here is the link with the directions for setting that up. Please ask if you need help figuring it out as there are lots of people who can help you.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Next, what kind of insulin are you using now? Since you posted in the ProZinc group, I'm guessing that's what you're using, but want to make sure.

And finally, my vet gave us M/D hills as well. My cat's BG went from the 200's to the high 300's and was still rising. My vet insisted it couldn't be the "prescription" food, but when I pulled him off of it and put him on a better food, his numbers dropped right back down. I would recommend you transition your kitty to something else before you worry too much about the rest. I use Fance Feast Pate which is easy to find and inexpensive, but there are lots of other options as well. I'll look for the link to the food info and post it when I find it.

Or someone else might be able to chime in.
 
Welcome Starla and Tigger,

One things that jumps out at me is the diet. As Djamila said, wet low carb food is best for diabetics. A vet explains on her website here:

www.catinfo.org

We try to feed around 8% carbs. I can't find the Hills exact type on her food chart, but they run from 14 - 40% carbs (they are at the very end of the chart. ). When we switched Oliver from Science Diet, he dropped 100 points overnight.

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

Once you get the diet switched, you can see the change in levels and adjust accordingly. So you need to monitor carefully when changing.

The pre shot number is important but the mid cycle number tells you how low the insulin takes him. So, I'd try to get some tests in 5-7 hours after the shot.

We put together a protocol for ProZinc. It's in my signature in blue.
 
Thank you so much for the quick response.

I will get a chart set up as soon as I get a chance, we keep a paper one at home, so I do keep track as much as I can, especially since Tigger's glucose is still high.
Yes he is on Prozinc.
And I did find the Hill's diet M\D on the food chart link and yeah it is 14%....wow. And the canned food I have it apparently too high too. So I will get that switched out and see how he does. ( gradually switch, he has a sensitive stomach)

I will also try to get his chart posted with the glucose curve results I get this weekend.

Thanks again for all the help. Being worried all the time is not good for me or the cat! And I call the vet sometimes but it just seems like I'm being a crazy cat lady.
 
We're all crazy cat ladies (and gentlemen) here, so you have good company! ;) And you can ask as many questions as you need to. The folks on here have a tremendous amount of wisdom and experience!

Good idea to switch gradually and take care of Tigger's tummy. It definitely took me awhile to find the right food that was both healthy, and something my picky eater would actually eat. Once we got it right though, Sam's numbers came down really quickly.

I hope knowing that you're not alone, and having somewhere to ask all of your questions, will help you to relax and let go of some of the worry. You and Tigger are going to be okay! You can do this!
 
What meter are you using?

Lots of good information given to you already. A couple of things that I would add are:

Diabetic cats are susceptible to diabetic ketoacidosis (DKA). It is best to buy testing strips that will measure (if any) ketones in the urine. One brand is Ketostix which can be found at Walmart or any pharmacy. You will want to test periodically unless you continue to get high numbers, then it is suggested to test more frequently. Basically, all you do is hold the testing stick in Tigger's urine stream when he is in the litter box. Ketostix typically costs around $10.

Always good to be prepared for possible hypo events which means that your cat has reached dangerously low numbers. It can be fatal, hence, the importance of home testing and collecting data in a spreadsheet. In each of the Insulin Forums are stickie’s labeled Hypo Links. Please print and post on your refrigerator so everyone in your household is aware of hypo symptoms. You will want to create your hypo kit that would include and not limited to; extra testing strips, honey/karo/maple syrup, high carb food, medium carb food, vet information, etc.

Also, I can't emphasize enough to test while you are transitioning to the right low carb, wet food. As everyone has noted, BG numbers could drop drastically.
 
So much great info and advice! Again I can't thank everyone enough for the help and encouragement.

I indeed do have the necessary items for hypo, but posting the info on my fridge is a great idea.

I use a human glucose meter right now, the contour next EZ.

I will have to look into the ketostix.

I will have a chart up very soon I hope:cat:
 
I see you got your chart up! That'll be a huge help for us.

I think the next steps I see are: switching to a low carb, wet food (which you said you plan to do). Getting some mid-cycle numbers. ProZinc is dosed based on preshots AND mid cycle numbers...the mid cycles help us to see how low the insulin is taking Tigger. You said you're getting a curve this weekend? That'll help for sure!

I don't want to overwhelm ya, and you've already gotten good advice from everyone here. So with that, I'll just add, welcome! We're here for ya!
 
Thanks Rachel :)

Quick question to everyone, about how much can food do you give you cats for one meal? or even the day? one can per day depending on the size of the can. I think I am going to try the Fancy fest pate (classics) that Djamalia is using, according to the cat food chart that Sue provided a link too, it is pretty low in Carbs. Just unsure of serving size. Tigger is a about 11 pounds and vet says that is a healthy weight for him.
The can of 5.5 oz Friskies food I have right now, says 3/4 can or about 1 oz of food per pound of body weight, is that for the entire day?
 
We either give 2 cans of Fancy Feast pate or 1 can of Friskies pate daily. We only have a non diabetic cat now and we divide it into 2 meals, am and pm. Lots of people divide it into smaller, more frequent meals. It is up to you and may depend on your schedule. Many people feel the smaller, more frequent meals help their cat stay even.

I would print off the food chart page I wanted and take it to the store so I sure got the right flavors.
 
I feed the equivalent of about two cans to each cat. In the morning I put down a can of food and then a catsicle of the raw (a frozen chunk of Rad Cat Raw which thaws later so they can eat mid-day when I'm not home. In the evening I give another can and more raw. I feed them as much food as they want to eat, but neither of them are inclined to overeat, so it works. Sam started to overeat when his diabetes was developing (that was one of my clues that something was wrong), but now that his BG is better controlled he's gone back to a normal amount of food.
 
WOW I really have no clue how this happened so quick, but glucose was 66 this morning. I even lowered Tigger's dosage when I switch to all can food ( and the lower carb can food too) I have never gotten a reading that low, and I tested twice. I am going to pass on his morning shot.
 
Wow! That is a drastic change. Not only a poster child for food change, but one for testing. I shutter to think if you had given 5 units this am.

He is bound to be high tonight. Not only is the low number a shock to his pancreas which will likely release extra glucose, but also, he will have been 24 hours since the last shot. But I would still reduce the dose. My thinking is that you don't want to shoot the dose that gave you a 66 after 12 hours. And sometimes the food takes awhile to work - there can be fits and starts and he can continue to respond with lower ranges.
 
I was thinking he was maybe in shock as well, and do anticipate a high number tonight, but yes I think I will lower the dosage significantly depending on what reading I get tonight. I have to stay late at work so my boyfriend will be doing the testing and medication, but I can update when I get home from work. But at least this gives me a little hope that we will not have to switch him to human insulin and that Prozinc is working :)
 
We are still on a roller coaster apparently. I had no clue what dosage to give Tigger tonight so it was 1 unit at 7:30pm. He has been eating today but not like normal, little bit at a time and not finishing meals. Just took a reading at 10:15pm and he is high at 330. I guess better to be high than too low. Testing again in the morning,
 
Think of it as data gathering. So you know 6 units is too much. Tonight you'll see what one unit does for a 300. If it doesn't bring him down enough, then for the next 300, you increase that a bit.

And yes, better too high for a cycle (or more) than too low for a minute.
 
so Tigger has been in the high 200's. He does not have the same eating habits right now ( wont finish all his food and is not really really hungry at meal times like he was before) I am wondering is the food change and glucose change is causing him not to be hungry?
 
Good Morning ~ Wow, the 200's is a great place Pre Shot. About the not being as hungry and not finishing his food, it could be that he doesn't like the new food as much. Is he eating most of it? Also, with his numbers coming down, they usually aren't as hungry as they were when the numbers were higher. Could you get some more numbers on him today? Especially since his pre-shots are in the 200's. It would be helpful for the more experienced ones here to help you with dosing if they could see how the proZinc is working on him. Usually with ProZinc the nadir is around +4 -+7 , so if you could get some data during those times it would be helpful. Also, the same at the night cycle. What a difference the diet change has made in him! Good job mama!
 
Ditto. As Bobbie says, some numbers today/tomorrow will really help you figure out how this dose is working. As his pre shots are coming down, his dose may need to lower also. His eating less (and lower carb) can make the numbers lower too. But we do want him to eat enough - about 2 cans a day of the smaller Fancy Feast size or one can of Friskies, divided into two meals.

Sometimes they need a little extra help to be interested in the new food. Lots of people add a little warm water and stir in up so it is like a gravy. Other cats like theirs dressed with a favorite treat or Parmesan cheese. It is also likely as Bobbie said, that he needs like food because he is in lower ranges and his body is processing the food more efficiently.
 
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Good Morning! And thank you for the encouraging words. My only concern as he is acting more lethargic in the past 3 days too, just not himself. So I really hope it is just him trying to get adjusted to new food and his glucose level. I only gave him a little less than half a can of fancy feast this morning and he only ate half of that. I plan to take the glucose curve today, just tested again at 2 hours after, still looking ok in the 200's which again is way better the 300's and 400's he has been in for weeks. I have gone from 6 units twice a day to 1 to 2 units depending on what is going on with him. This morning I did 1 1/2 units. Thanks again for all the very helpful information and encouragement!
 
Not sure about the lethargic unless it is his body just getting used to lower numbers, lower insulin, and new food. How is he otherwise, peeing, pooping, preening, and purring? (the 4 P's) another indicator of how they are doing.
 
I'd like to ditto what everyone already said! :) I've always stirred warm water into my cats food...I started when Gypsy had her UTI because I wanted to ensure she got water. Now my cats won't eat unless I do it. I'm not sure whether it's because they like the consistency or because it's easier to eat (though I think it is easier). I've also heard that playing for about 15 minutes before meals can help trigger their hunt and eat cycle.

Let me ask this and I apologize if it's been answered, but I'm still on my first cup of coffee (LOL!). Do you leave the food out for Tigger to graze? Mine never eat it all at once. Only one shows up for every meal anyway. They usually come straggling in anywhere from 5 to 10 minutes after I put food down. Then they all eat some and leave...they usually finish the meal after 3 to 4 hours I think but they NEVER eat it all right away...
 
To my knowledge Tigger is pooping, peeing, purring but the preening has not been normal since he has had diabetes. We have to brush him take a wet wash cloth to him every so often. He is going to the bathroom, just less because he is eating less and drinking less. Sometimes it is hard to tell because we do have another cat.
I do leave the food out, however he has always eaten his food all at once and with the change this week he has not been as hungry and has not finished his meals. He perks right up for treats though, and eats them. Maybe it is the food, and he just needs to get use to it.
 
It could very well be he just doesn't like the food as much. As Sue mentioned, try sprinkling some parmesan cheese on this food, or crushing some treats that he likes and putting on top. Anything to get him to eat. And with another cat in the house it is hard to tell who is giving what sample in the box. It took a while for Bubba to start back preening himself after he was feeling better.
 
So I tried to put a little warm water and parm cheese and he looked like he was going to eat, took a couple licks and then went to lay back down again. But I do have my other cat intrigued lol. So he really needs to eat something so I ended up giving him a 1/4 part of a Starkist Chunk white albacore tuna in water and he is chowing down. The can says zero carbs and we usually give him a little tuna when we make it for ourselves anyway. I am so happy he is eating :)
 
That's good that he ate! And now you know the cheese trick for the other cats. :) The fish is okay to give only about once a week though because of the mercury. I know you are relieved that he ate! We all become like Italian Grand Moms when are kitties won't eat, " Mangia mangia!"
 
It's close to 200. What would you think about one unit or 1.25? 1.25 looks like it would be safe, but going into night, one unit may let you sleep?
 
So just wanted to update, Tigger is eating like normal again! I am thinking he just did not feel good after that 66 last Thursday and his body just didn't feel good. Had no issues eating his food this morning, afternoon and dinner. Trying 2 units with his eating habits and hopefully get a good reading as to what dosage he needs now.
 
Oh so glad that Tigger is back to his normal self. Any chance you can get some mid-cycle tests? It would be interesting to see how well your doses are performing.
 
It's possible that low number had him feeling a little under the weather. I'm glad he's feeling better!

I agree whenever you can get some mid cycle tests that will help. :)
 
I will try to get some mid numbers at night. I really cant come home during the day because of work. He is in 300's again so, going to try 2.5 units today.
 
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