Too Much Food Causing High BG?

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firefly

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Could the reason Gracie's BG numbers remain so high is because she is eating too much? Or, could the reason be dosage and "bouncing?" Gracie will eat at least 12 oz. of cat food a day, if not more. Even though her litter box, and water intake is back to normal, her eating is not. She can't seem to get enough food. I weighed her yesterday (she weighs 10lbs.), and she has not gained, or lost any weight since starting on ProZinc. Her coat still doesn't look normal (only a little shine vs a shinny health coat before she got sick). Should I reduce her food to just 8 oz. a day? I have been afraid to not give her as much food as she wants knowing she isn't getting the nutrients that she needs because of the diabetes.

Also,she has been on ProZinc for 30 days, I have increased the dosage to 1.20 during that time, not to mention "adjusting" it a few times. Could the increase and the "adjusting" be contributing to the bouncing and not leveling off/stopping? I would think by 30 days, I would see a pattern of lower numbers by now. Any suggestions? One other thing....could someone look at Gracie SS on 12/14. It appears to me that "possibly" she was about to stop bouncing, and then I lowered the dosage to .75. Could this lowering, and then raising the next dosage have started the bouncing to begin all over again? Thanks

Linda
 
The high numbers can be from multiple things...

The dose might be too low.

The dose may be too high. And these could be "bounces" from low numbers in the middle of her cycles, but you would need to verify that with some tests around 5-7 hours after giving her shots.

It could also be food related, and it depends on when she eats in relation to when she gets insulin. Is she on a schedule with feedings, or does she free-feed? Any food eaten in the two hours prior to her shots might raise those rest numbers.

That is a good deal of food she's eating. Bob only ate about 8 to 10 oz of Fancy Feast and Friskees pates and he weighed between 12-13 pounds while on insulin.

There are other things that can cause weight loss or no weight gain beyond "just diabetes".
How old is she?
I think it is more common in senior males, but hyperthyroidism is one thing.
Do you have her lab results from her last blood work?
 
It's the weekend - could you get some midcycle numbers? It is impossible to guess what is happening until we see how low (or not) the insulin takes her.
 
Carl & Bob (GA) said:
The high numbers can be from multiple things...

The dose might be too low.

The dose may be too high. And these could be "bounces" from low numbers in the middle of her cycles, but you would need to verify that with some tests around 5-7 hours after giving her shots.

It could also be food related, and it depends on when she eats in relation to when she gets insulin. Is she on a schedule with feedings, or does she free-feed? Any food eaten in the two hours prior to her shots might raise those rest numbers.

That is a good deal of food she's eating. Bob only ate about 8 to 10 oz of Fancy Feast and Friskees pates and he weighed between 12-13 pounds while on insulin.

There are other things that can cause weight loss or no weight gain beyond "just diabetes".
How old is she?
I think it is more common in senior males, but hyperthyroidism is one thing.
Do you have her lab results from her last blood work?

Carl,

Gracie is 9 years old (will be 10 in May).

I put 8 oz. of food for her in a container for the next day (I weigh it) I will give her a little "snack" of her food when she is hungry before I give her the 2 oz every 3-4 hours or so. I will leave her, and my other cat whatever food is left from their container out for when she gets hungry in the middle of the night. Plus, if there isn't anything left in Gracie's container, I will put more food in her bowl (which means she gets around two more ounces on top of her 8oz.). She doesn't eat 2 hrs. before her shot.

All her lab work came back normal except her glucose.

Linda
 
Sue and Oliver (GA) said:
It's the weekend - could you get some midcycle numbers? It is impossible to guess what is happening until we see how low (or not) the insulin takes her.

Sue,

I will get midterm numbers today. I have a question, and please, I am not trying to be smart here. If her BG shows a pattern during midcycle (see previous BG curves), then why is it important to get one from time to time? Is it because of the change in dosages? Or could it beto look for something else? If so, what? Thanks.

Linda
 
It is important to get mid-cycle tests because the cat's body is constantly changing (as is ours).

Food consumption, activity levels, different food batches, illness, stress and so on may all affect the glucose numbers.

If the bloodwork did not specifically include tests for hyperthyroidism, see about having that done.
 
BJM said:
It is important to get mid-cycle tests because the cat's body is constantly changing (as is ours).

Food consumption, activity levels, different food batches, illness, stress and so on may all affect the glucose numbers.

Thanks. Would you recommend doing this once a week? I had thought that every 2- 3week, or maybe even a month if dosage didn't change, but I see what you are saying.

Linda
 
The reason I'd like to see a curve is that you are wondering about upping the dose. I think it's wise to see what's currently going on before changing.
 
Exactly what Sue said - you need to see what is going on currently before changing the dose.

As an FYI - in cats, it is possible for the pancreas to recover some, if not all, function. This too will alter your dosing.

There are a number of Secondary.Monitoring Tools in my signature link which supplement blood glucose testing. Regularly checking the 5 Ps (purring, preening, playing, pooping, peeing) are behaviors you often see improve as glucose control is established. Intake of food and water, plus elimination of those also give you clues, as will weekly checking the weight. Dehydration can be a warning sign that something requires a vet visit. Trace ketones are definitely cause for concern and more than a trace necessitate an emergency vet visit as they cannot be managed at home.
 
Sue and Oliver (GA) said:
The reason I'd like to see a curve is that you are wondering about upping the dose. I think it's wise to see what's currently going on before changing.


Sue,
I am doing her curve as we "speak." I have posted her numbers so far. I did not want to up her dosage (I do not know if it needs increased or not). I do not know what is causing her BG to stay high after 30 days of being on ProZinc. Is it because of the amount of food she is eating, bouncing, the increase/decrees in dosages or what? I have a feeling it has something to do with the amount of food she is eating. But, I am so afraid that reducing her food intake until I get her BG numbers under control will cause more problems for her. I will leave it to the experts here on FD to advise me, since I am new to this, and don't know what is causing her high numbers.
 
So I'd say she has more room to drop and that you could up the dose to 1.4 or 1.6 , where ever you feel comfortable and if you can monitor midcycle the first few cycles to make sure she doesn't drop low. She dropped midcycle but she certainly has room to drop more.

Have you seen the protocol for ProZinc? It will give you an idea how to change doses.


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

I don't think you need to feed less; I am thinking she just needs more insulin.

Just for reference, we generally consider a cat regulated if they are in the mid 200s at preshot and below 100 at nadir, but not under 40, which is hypo range. She is not terribly far from that.
 
Sue and Oliver (GA) said:
So I'd say she has more room to drop and that you could up the dose to 1.4 or 1.6 , where ever you feel comfortable and if you can monitor midcycle the first few cycles to make sure she doesn't drop low. She dropped midcycle but she certainly has room to drop more.

Have you seen the protocol for ProZinc? It will give you an idea how to change doses.


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

I don't think you need to feed less; I am thinking she just needs more insulin.

Just for reference, we generally consider a cat regulated if they are in the mid 200s at preshot and below 100 at nadir, but not under 40, which is hypo range. She is not terribly far from that.

Sue,

I did see the protocol for ProZinc. What does it mean when it states "no shot level for ProZin" in the 150 mg/dL range? Also, what does it mean in the 200 mg/dL range when it states, "no shot level for beginners; may slowly reduce 150mg/dL for long-acting insulin....?" Is the dosage based on nadir numbers, or the number at preshot? I assume it is at preshoot. I will increase her dosage to 1.4, and see what she does between tonight, and tomorrow night (that will be 3 cycle, is this correct?). Would this be enough time to see what the dosage is doing, and know whether I should increase it to 1.6 or keep it at 1.4?

Thanks again for all your help. You do not know just how much I appreciate your advice, as well as all the others.
Linda
 
I think you saw BJ's bg levels? This is the protocol:


There is no established protocol for ProZinc. Dose is determined by looking at the history of the kitty – his doses and how he has responded including preshot numbers and midcycle numbers.

Starting Doses
The recommended starting dose for ProZinc or BCP PZI is .5 units or one unit twice daily. It is suggested that if the initial numbers are high, doses can be changed every three cycles, increasing by .5 at a time. If the initial numbers are in the 200-300 range at preshot and midcycle (nadir) numbers are not too low (not 50 and under), increases can be made .25 units at a time. During this early period, especially if wet low carb food is replacing higher carb dry, monitoring is very important. Insulin plus a diet change can result in sudden low numbers or in a gradual lowering of numbers overall, depending on the cat.

Over time, as data is collected and nadir numbers are available, doses can be adjusted more confidently.
If the cat is in the 250+ range at preshot and does not drop 50% or more for nadir, a small adjustment could be considered, if monitoring is possible.
If the cat is in the 250+ range at preshot and drops below 50% at nadir, bouncing is a possibility (bouncing occurs when the cat’s body perceives a drop that is below what has been occurring and releases extra glucose, resulting in an “artificial” rise in numbers) Bouncing most often involves a lower midcycle number than the cat has experienced previously. If bouncing is suspected, any increases in doses should be tiny and monitored carefully.
If the cat is high and flat during the entire cycle, the dose could be raised .5 units, as long as monitoring is possible.

ProZinc and PZI are unique in that they can be dosed in two ways, depending on how the car responds. Some cats seem to do best if a specific dose is held for several cycles. It seems to take that long for their numbers to really change. Some cats respond to a sliding scale, getting a different dose for different preshot numbers. Collecting data will help you see which regiment works best for your cat. If you need help with a sliding scale, ask people on the PZI forum to guide you.

Low Preshot Numbers
The general recommendation for new diabetics is not to shoot a preshot under 200, but to wait 20 minutes (without feeding as food raises blood glucose levels) and retest. If the number is rising and above 200, then a shot can be given with perhaps a little less insulin given.

If midcycle (nadir) numbers are in the 40-50 range, the cat should be carefully monitored for the next couple of hours with tests given every 30 minutes as long as the cat stays low. First small amounts of low carb food can be given to raise the blood glucose levels. If that doesn’t raise the levels, higher carb food should be given. If the levels are dropping and below 40, then honey can be put directly on the cat’s gums. If the numbers still aren’t rising, a trip to an emergency vet is probably necessary.

If one preshot is above 200 and shootable, and one preshot is too low to shoot, it probably means the dose is a little too high and lasting more than the usual 12 hours. Try reducing by at least .25 to see if you get two shootable preshot numbers (ideal) rather than one that is too high and one that is too low to shoot (not ideal)

If you are using U40 syringes and find yourself trying to eyeball doses under .5, you may want to consider using U100 needles and the conversion chart. (Conversion chart) This will allow you to give mini doses.

It is important to test for ketones regularly, at least once weekly even if the cat is eating well and has no infection present. Test daily if any infection is present, the cat is not eating well and/or is in higher ranges. Testing for ketones can catch DKA early. Cats with DKA should be seen immediately by a vet.

Data Collection
Until the bean gets data on their cat’s responses to the insulin, advice on dose changes can be gotten on the forum or from the vet. Using a spreadsheet to record data is the best way to share this data with forum members and the vet.

_________________
 
Linda,
You are correct. The 150 or 200 is the suggested no-shoot level on the preshot tests. The longer you do this, and more "nadir data" you collect, the better feel you will have about the preshot number you feel comfortable shooting at.
Some people will even go below 150 once they have the data to consider it safe to do so. Even if that means adjusting the dose downward based on the lower preshot.
 
Sue and Oliver (GA) said:
I think you saw BJ's bg levels? This is the protocol:


It was the Glucose reference range I was looking at. I have seen the protocol, now that you posted it. I had forgotten about it. Thank you!
 
Carl & Bob (GA) said:
Linda,
You are correct. The 150 or 200 is the suggested no-shoot level on the preshot tests. The longer you do this, and more "nadir data" you collect, the better feel you will have about the preshot number you feel comfortable shooting at.
Some people will even go below 150 once they have the data to consider it safe to do so. Even if that means adjusting the dose downward based on the lower preshot.

Thank you Carl for this information. I appreciate it.
 
Is there any overlapping with ProZinc? Gracie's BG, last reading is 344, (two hours before this it was 277). She has two more hours to go before her next insulin shot. Can I give her the insulin now (two hours early)?

p.s. I went ahead and gave her the 1.4 insulin at 5:30 instead of 7:30.
 
There can be overlap, but in this case I think you're fine. The number looks like it was definitely rising like this morning's dose had worn .

Good call on your part.
 
Carl & Bob (GA) said:
There can be overlap, but in this case I think you're fine. The number looks like it was definitely rising like this morning's dose had worn .

Good call on your part.

Thank you Carl.

btw, lovely tributes to Bob and Mullet. I know you must miss them everyday. I dread the day when it will be time for my cats to go.
 
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