Unregulated Kitty on ProZinc

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crazycatlady18

crazycatlady18

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Hi all,

I'm a newbie on here and this is my first post. I've read through some of the forums and you guys seem like a great group of people! We took in a neighborhood kitty who had crappy owners and found out that he was diabetic. He's been on ProZinc for several months now and we can't get him regulated, despite the vet slowly increasing his dose. He's also had several UTI's, which I guess cause the blood sugar to rise. He's been treated a couple times but they always come back, so after x-raying for kidney stones (none found, thank God!), he's on week 5 of antibiotics to hopefully get rid of this thing for good. The vet thought that once we got the UTI under control, the blood sugar would follow, but he's now up to 4 units 2x day and he's still reading "high" (over 500) on their animal glucose meter. I also just bought a ReliOn human meter tonight to test him and he shows "high" on that one also (over 600). He's still drinking a lot and peeing like crazy, so we know he's not controlled, even without seeing the readings. Today though, I noticed very mild twitching in his face/ears, and in his paws and belly. It's similar to the severity you'd see when they have sleep twitches, but only 1 about every 30-60 seconds, when I'm staring at him. I freaked out and googled it and found that twitching could be low blood sugar (this was this morning before I bought my own meter) so I skipped his morning insulin and called the vet. They agreed that it's better to be safe than sorry and assume it's low blood sugar. Doc said to give him half a dose, but he was still having mild twitches when I came home from work a couple hours later, so I didn't do it. He's spending the day at the vet tomorrow so they can do a curve on him (though I'm not sure how great that will work, given the stress increase I've read about). This evening, I stared him down some more and saw it was still happening. I called the vet 15 minutes before closing for advice, and they said, "better too high than too low". I decided I didn't want to assume things, so I went out and got a meter. It read high, so I checked again and same thing. Now I'm on the fence about giving him any insulin tonight or just waiting until I take him to the vet tomorrow morning. I feel horrible knowing that his level is so high :( but I have to go to bed (should be there already) and am afraid to dose him without him being monitored at all. Sorry for the VERY long post here! Doc things that we need to switch to a different type of insulin, which I'm all for. I just want him to be healthy. Any advice you have would be appreciated! Thank you :)
 
Good morning and welcome to you and your sugar kitty! Could you introduce us to yourself and your cat?

First off, I'm so glad to hear that you are home testing. That's super important. How often do you test? We recommend at least 3-4 tests a day if you can. We ALWAYS test before shooting. The order for ProZinc is to test, feed, and shoot, all in about 15 minutes. If you get a number below 200, we recommend stalling without food for half an hour and then testing to see what the number is and if it's rising. If you can't do that (I know work makes things tougher!) we don't recommend shooting under that number at all until you have data. We also try to test at nadir (the +5 to +7 range...that means 5 to 7 hours after your shot) and a test before bed to see where your kitty is headed at night. I know these are not all possible every day. When my Gypsy was on insulin, we tested before every shot and before bed...and I tested nadir on the weekends and occasionally in the middle of the night if I just woke on my own.

With these kinds of consistent tests, we can help advise on dose and help you decide if you need to switch to another insulin. Without that information, we just don't know. Setting up a spreadsheet will help. You'll see that most of us have spreadsheets in our signatures (mine is kind of old). Instructions are here: http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/ It's not that hard, I promise! Once it is set up, you just have to fill in the numbers on it when you test. If it's linked to your signature, we can see it and help you out more.

Can I ask what you are feeding? We recommend low carb, wet food (like fancy feast classics or friskies pate). However, since you are giving insulin, ONLY CHANGE FOOD IF YOU ARE HOME TESTING. If you change food without home testing consistently, it can cause a hypo as this can drop your cats numbers over 100 points overnight, I can tell you, I've seen the food change cause a kitty to go into remission. Most cats need insulin and food change, but it can hugely change the numbers. This would be recommended no matter what insulin you use. You don't need any of that prescription diet the vets push. It won't help.

My suggestion for you is to make sure your kitty is on an appropriate diet first. Get that spreadsheet and testing going. It's possible that your kitty actually needs less insulin. We change doses in small increments because you really can skip over the perfect dose. 4 units is really high.

As a side note, this forum is mostly active in the mornings and evenings (testing times!). If you have an emergency, I suggest posting on health as more eyes are there. However, if you post your numbers here, we can help guide you on dosing.

Let us know some of the info I mentioned here and we'll be glad to do what we can. Remember, we are all paying it forward for the help we received when our kitties were first sugar kitties. All will be well! :D
 
Changing to a low carb, over the counter, canned or raw diet may reduce the glucose from 100-200 mg/dL. It may reduce the corresponding insulin dose from 1-2 units. This is why you must be home testing if you change the food.

Dose adjustments of insulin are based on the nadir, the lowest glucose between shots. This most often happens between +5 to +7 hours post-shot. That is the key period to watch for low numbers.

See my signature link Glucometer notes for more details on glucometer tests and reference ranges for cats when using various meter types.
 
Hello! Thank you both for your responses. My name is Gina and my kitty is Grover. He's a 16 year old Ragdoll. We started taking care of him about 6 months ago when he showed up on our doorstep (literally) and upon contacting his owners, realized that they didn't care and were neglecting his health. He's been on insulin for about 4 months (we waited a couple months before taking him to the vet to see if his people were actually going to take him to the vet, as I suggested) and we can't seem to get him regulated. We don't know how long he was actually diabetic before we got him. He started on a very low dose - 1/2 unit - and seemed to respond to that by not eating ravenously and drinking water like crazy. But, when tested at the vet his glucose level always just reads "high", even after we slowly got him up to 4 units, 2x daily. Their meter is actually a pet meter and anything over 500 is high. I know now that the stress of being at the vet can bring the numbers up. He only eats Fancy Feast, and I buy the classic or chunky versions only. I'm strongly considering a home cooked diet for all of our "kids", though in researching diabetic cat foods, Fancy Feast seems to be universally OK, so I'm not sure the home cooked diet will help :( I haven't been regularly testing him yet, just periodically. Every time it comes back high, with the exception of getting 517 yesterday at nadir (+6 hours). That's the first time I've had an actual number. I'm going to be doing a glucose curve this weekend when I'm off work, and reporting it to the vet. I feel horrible that his glucose is so high :( He had a UTI that we had trouble getting rid of, so we just completed a 6 week course of antibiotics and found out yesterday that he's all cleared up. I'm very happy about that, but the doc had thought the infection was affecting the glucose and once it was gone, he'd regulate. I'm disappointed to find that isn't the case. Now I don't know what to do. I don't expect his glucose curve on Saturday to give us any good numbers because he's still drinking water like crazy and peeing a huge amount. He's been back down to 2 units for about a week.
 
An update - I tested Grover before feeding him lunch (+5 hours) and he was 417. I know this number is still off the charts, but it's the lowest number I've seen in the handful of tests I've done on him. After reading through some threads, I feel like I should be testing for ketones now, too. He doesn't have any symptoms but after having such high BG for months now, I'm worried :( I read a bit about testing, but I'm still confused. Can I test his urine with the strip right after he pees on clumping litter, or does the litter mess up the results? I'm really glad to have found this site and thank you in advance for any other info.
 
The classics (pates) are good. I think the chunky types may be higher carb. You stick the ketone strip into his urine stream, IF he will let you. Oliver would never pee if we were in the room. We put aquarium gravel into a clean litter box. He'd have to christen the clean box and we could get the sample because it wouldn't be absorbed.

It looks like his numbers are quite high. I think it could be a number of things. It might be that he was diabetic for a long time before he started insulin and so will take a long time to break that resistance. So, depending on what kind of numbers you get on your curve, you might need to start a pretty aggressive protocol: 3 cycles with numbers too high, then increase by .5, increasing until you get some better numbers. It could be that he needs very low carb food, in the 3-5% range. He may need a different insulin. He may be an high dose kitty.

I'd say the first step is to get some data and start a safe increase in doses. Have you seen the spreadsheet we use? If you need help setting it up, let me know.
 
It's a good idea to check for ketones when you're in such high numbers even if there are no symptoms. Even after that, testing occasionally is a good idea. There are plenty of different methods if you can't just stick the strip in the stream. Sue's method is probably easiest, honestly. Gypsy didn't even care that I would walk up behind her in the litter box and test her...I was lucky there!
 
Check my signature link Glucometer Notes for information on glucose blood testing and Secondary Monitoring Tools for some tips on urine testing plus some additional assessments you may wish to make.
 
Hi all! Thank you so much for your responses. I'm really overwhelmed right now :( I did Grover's first curve yesterday and his numbers are sky high. Every day that he's unregulated, I feel like I'm killing him :( Here is the link to his spreadsheet. Any help you can give is much appreciated. I'm going to post this on a new thread also, to get more visibility.
https://docs.google.com/spreadsheets/d/1cYXffzL7_fpvVWSPOEPiVL8WUeXfSdy_elFf5fqQLK0/pubhtml

I really want to start all of our kids on a raw or home cooked diet. Our 3 other cats have health issues also - hyperthyroid, pancreatitis (and borderline hyperthyroid), and remission from small cell intestinal lymphoma. I've tried to get help from the holistic vet that works at the office but all I got were recipes and no return call after several attempts. I'm super frustrated and not sure what to do. I'm nervous to start making food without someone to guide me in the beginning stages so I don't screw anything up and make them sick, or not get the nutritional balance right.

Our vet asked me to do this curve and report thenumbers to her, so I will be doing that today. Though I am lacking confidence that she'll know what to do. He's been high for months now :(
 
Hi Gina

Here is our protocol for working with ProZinc which you might find helpful to read over. With the data you have so far, it suggests that a dose increase of 0.5 units may be helpful. Then use that dose for the next 3 shots, and evaluate in the +5 to +7 hours post-shot to see how low he goes.
 
Thank you! I'll start doing this with tonight's injection.

I'm faxing my numbers to the vet now and she'll be in tomorrow to discuss them. She knows I've been doing research, so I'm sure she will be on board with following the recommendations I get on here. From what I've been reading, it seems like most vets aren't great at treating diabetes, for lack of knowledge on the subject.
 
Also, if you haven't been there before, pop over to Cat Info to read about feline nutrition and to get the food chart for shopping.

It may be that you can select some over the counter foods which are lower carb than what you have been feeding. And there is a recipe for raw food at Cat Info, too.
 
I'm with BJ. I'd start being more agressive: raise by .5, hold for three cycles, if no big response, raise again. There is something called insulin toxicity. If they sit in high numbers for an extended time, it takes more insulin to break through. Here's an article on it.

http://www.felinediabetes.com/FDMB/threads/feline-diabetes-and-glucose-toxicity-links.62960/

As long as you can get a test each pre test and somewhere in the middle of the cycle, you can catch a lower number if it comes. For now, I'd systematically start raising the dose. If you get to 4 units and see no movement, then it's time to look at something else. But my guess is that, right now, his body is just used to higher numbers.
 
I am sorry. I replied on Health, not realizing I was telling you the same thing twice. If you want, you might just post here when you want to get dose advice. People who don't use ProZinc are unlikely to give dose advice. If no one is around (it is a much smaller forum) and you need immediate help, definitely go to Health and post.
 
Welcome to FDMB!

BJM beat me to it about having you check out catinfo.org.

For diabetic cats, any wet food 10% or less in carbs is good for them.

At the beginning of the food chart Lisa explains the columns for chart. The third column, C, is the carb column that you want to look at.

Since the chart is 37 pages long, I printed out only pages of food that I was interested in buying at the store. I printed Fancy Feast, Friskies and 9 Lives brands.

I did settle on feeding Hank the 9 Lives flavors that are 2-5% carbs. That keeps his numbers lower.

Before I got Hank on wet food his numbers were very high too. Take a look at Hanks SS before 10/25/14. It takes patience and testing to get data to get the numbers down.

Hang in there!

You're doing great!

Anymore questions, just ask away.

Kimmie
 
Morning! What is the carb count for what you are feeding? I had to switch my girl to Friskies special diet which was around 5% carbs because quite frankly, 10% was too high for her. She was pretty carb sensitive. It helped us some (and my other kitties lost some weight on it too...thankfully!). Just a thought. Going to a lower carb food might be a good option to try for now.

I'm interested in making raw food myself, but haven't got the time to do all the necessary research yet. I know Dr. Lisa Pierson has some info about it on her site...you might also check in health to see if anyone there has done it. I'd maybe hold off on it for a bit. I'm not saying you shouldn't do it, but if you're feeling overwhelmed now, maybe give yourself a little time to breathe. Try lower carb food first and if that doesn't help, you can always move to a raw diet, or move to it when you have a bit more time.

I'm with Sue and BJ. I'd be pretty aggressive on the dose. Getting him out of those higher numbers will help him feel better, and will also hopefully help the pancreas heal some.

Don't let this get you down! I know it's a super steep learning curve at the beginning, but we've all been there. We're here to pass on what we know to help you out and one day you can help someone else out! You'll get there!
 
It also is possible you have a high dose cat, with another condition causing those high glucose levels. Hyperthyroidism, acromegaly, insulin autoantibodies, and Cushings are 4 conditions which may result in high glucose (or low insulin) levels. They are not common tests on blood panels. Vets do them when trying to problem solve. If the dose gets up to 6 units, twice a day, you may want to explore them.
 
Thanks BJ & Rachel :) I just updated his spreadsheet. I've been sick for the past few days, so it's not completely filled in, but it does show his numbers going down! :) I'm feeding Fancy Feast, classic and chunky flavors. If he is being finicky, I keep some of the FF flaked fish & shrimp and tuna on hand also. According to the cat food chart on Dr. Pierson's website, the classics are all under 5 carbs, the chunky are 5-7 and the fish & shrimp flaked is actually 0. Maybe I should feed him more of that one! I talked to our vet on Tuesday and she is in agreement with the protocol :) She said if he is still high once we get to 5 units, that's when we should look at other tests (I mentioned acromegaly to her). I feel really good about his numbers coming down now in nadir!!! Unfortunately, Grover hates getting his BG test, no matter if he's sitting up, laying down, etc. He does do better laying down, but it's not always possible to get him then - especially at AMPS and PMPS when he's hanging around the kitchen waiting for food. So, his high numbers might not be accurate. Any suggestions there? I give him some pets for a minute before I test him but I'm not sure what else to do. My husband is not always home when I test him, so that makes it harder to try and do it alone, especially when he's not laying down.

BJ, he's actually gained a couple of pounds since we took him in so I don't think he's hyperthyroid (we have 2 other kitties who are, so unfortunately I'm pretty familiar with it). Hopefully he keeps going down and no tests will be needed. It's been a very expensive year for us at the vet!
 
You might work on general positive reinforcement / treat training.
Pick a desired activity - going to the testing spot, for example.
Using a desirable low carb treat, lure him to do the activity (no testing), then treat.
Repeat several times a day with time between the activities.
 
Fish is the lowest carb but generally it is advised to feed it only a couple times a week, mostly because of the Mercury.

When you can, how about a curve (test every 2-3 hours) Sure would be nice to know when that number is lowest. He is dropping 50% which is good, but probably means he is bouncing back up. If the blue number today is as low as he goes, you can up the dose a little. If he is lower than that, before or after +6, you might be more cautious with an increase.
 
Do you always test in the same place? Gypsy got to the point where she knew when we sat down in our testing spot, she had to get tested. She didn't love it (she loved to make annoyed meows at me) but she didn't move. She knew she got her treat after! Try using the same place maybe so he knows that when you are there, testing will happen. And give bribes...er...treats after!
 
Good morning all! Well, I think we may have had a breakthrough. Grover had been improving for several days, and then yesterday he was testing really high so I was disappointed. But, this morning before his shot for the first time he had a low number - 261!!! I went up to 4.5 units last night, but noticed that a little bit leaked from the syringe before I shot so I figured he probably got about 4.25. I went ahead and gave him 4.5 this morning. Do you think that was okay? I'm sort of worried that I should go home and check his BS every couple of hours, which isn't really feasible because I'm at work. But I was hesitant to back off because I think maybe we are breaking through the high numbers finally!!! His spreadsheet is updated now :)
 
Hurray! Did you leave him some food? If so, I would think he'd be okay. You've been increasing slowly so there is less likely to be a big surprise. If you have someone who could just look in on him around+6, it'd likely ease your mind.

The process should be that this dose will finally give you some better numbers - discounting any bounces, of course. And then, hopefully, good enough numbers that you can start decreasing, not increasing. (Anti jinx)
 
Hi Sue :) I didn't leave food out, but I always go home at lunch and test him so hopefully he'll be fine. We have 2 dogs so the kitties eat on the kitchen counter and Grover can't jump up there (he's an old man). I'm actually looking at having my dad build a carpeted ramp for them to climb up and down, but steep enough that the dogs can't scale it. Our dog Rocky is crazy and he WILL find a way to get to the cat food if its possible LOL!

Thanks for your response! I'm finally feeling better about his numbers. Praying that he keeps doing good on this dose (or lower!).
 
Go Grover! Sending good vibes that the lower numbers continue, and gives me hope that I will finally stumble on the right dose for Bud.
 
I'm so excited today. Grover was 261 this morning, 255 at +5 and 129 at +7!!! We have NEVER seen anything below 195!!! I just updated his spreadsheet :)

Stacy,
It has been so frustrating to get him regulated, and I'm not even sure we are there completely, but I feel so much better this past week. Everyone on here has been so nice and helpful. Hang in there and keep trying! I hope Bud gets regulated soon, too. Praying for all our sugar kitties!
 
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