Newly diagnosed - insulin dose too high?

Hi all:

I've been reading the forum since late January when my kitty Leroy was diagnosed.

Leroy is 11 years old, had lost weight and started having incontinence issues when we took him in.

Unfortunately, I do not have his initial readings but below is the overall data I have.

Insulin: Prozinc
Weight: 8.0lbs
2/9 - start
Dosage: 2units
Feeding 3oz fancy feast (flaked tuna&shrimp) with each shot 12 hrs apart
-continue this for 3 days until I realize (after reading here) that his food consumption is likely too low as he was a grazer and up his food to 6oz at each feeding.

During the first two weeks his weight fluctuates, lowest being 7.7 and upon his first BG curve at the doctor he weighs 8.1 lb

Noticeable changes: decreased water intake, less urine in litter box, still having incontinence issues. Improved gait.

2/23
Weight:8.1 lbs
BG Curve
AM shot: 7:30
8:15a - 678
10:15a - 374
12:15p - 645

Vet calls to say they are going to stop the curve because his levels were all over the place. Dosage increased to 3u

2/23 - 3/9
Weight increases, now at 9.1lbs. The overall change in personality is outstanding. 2/23 - 3/2, still having incontinence issues but starting 3/3, completely stops!

3/9
Weight: 9.1lbs
BG Curve
AM shot: 7:20
7:50a - 474
9:40a - 498
11:50a - 244
1:55p - 261
3:50p - 344

Dosage increased to 4u. (Little surprised, I expected to stay the same or a very slight increase)

Gave Leroy his PM shot at 4u, and I feel like he is doing worse. His stride is slower, he seems a little lethargic, almost like prior to being diagnosed. I've been monitoring him and gave him a bit of his old (high carb) dry food we had left over just incase. I don't think he is hypoglycemic...but I'm concerned that we've increased his dose too quickly in this 1mo time frame.

Thoughts or insights? I think it might be time I start monitoring his BG at home as well.

Apologies of the format is wonky... I am posting from my cell.

Thanks!

 

Hi and welcome!

Hard thing in this case is that the sypthoms you are describing could be both too low or too high is hard to tell, with out a test right now, specially since you changed the dose in his PM shoot so the numbers you have from the curve are probably totally different now that what he had

I'm guessing that you are not home testing, and that the values you have were taken at the vet, I would suggest you try to start home testing in my experience is the only way to know wht is really going on and that would help him and you ( it would give you peace of mind ) in cases like this, we can help you.

So far what you did giving him some high carb was a good idea better for him to be high than too low but I do suggest you keep an eye on him and maybe give him a little bit more food around +5 or +6 ( that would be five or six hours after you gave the shoot) just to be safe

It was a very big increase it is recomended to increase in 0.25 units increments to avoid missing the good dose, cats are actually very sensitive to the smallest amout of insulin

 

Ok what you need to do is go back to 3 units.... I think your vet is raising the dose too fast, and sometimes too much insulin can look like not enough because of bouncing. He may be dropping too low. We recommend raising doses in 0.25-0.5 unit increments.

Curves at vets are not usually accurate because stress can raise the numbers 100 points or more.

The best thing I can suggest is to test at home.

Head over to Walmart and get

1. Relion micro or confirm meter
2. Box of 100 extra test strips
3. Box of 26 or 28 gauge lancets
4. Cotton cosmetic rounds
5. Neosporin ointment with pain relief
6. A treat for you

I have a video in my signature showing how I test my cat CC at home.

 

And you can wander on over to the ProZinc forum for insulin specific advice.

 

Definitely start testing so you can see what is really going on. Sometimes doses get raised too fast and go past the correct dose.

 

I have to agree to start home testing. My Smokey was on too high of a dose, but the vet only saw the high bounce cycle and wanted to increase his dose. I had seen nearly hypo the day before, then again the day after, and decided to lower it at home with the help of people here. When you’re home testing you’ll be able to see multiple cycles in a row and know for sure what’s really going on. You really can’t base it on one day, especially at the vet where stress is a factor.