Hello, this forum has been a wealth of knowledge but I'd like a little more advice to my situation, as I am not convinced my vet is doing the right thing. Background: Cat (7 years, very big Siamese mix who is overweight) was drinking large amounts of water and peeing an abnormal amount. Took to vet who weighed him and found he lost two pounds. Initial blood sugar measured there was 400, no ketones found in urine. Doc said he was diabetic and prescribed ProZinc at 2 U morning and night. We were supposed to come back the next day to learn about how to do the injections. In the meantime I read nonstop about this disease and switched him off his dry kibble to the low carb classic pates. The next day I express my concern to the vet about switching diet and starting insulin at same time and she said don't worry this is an underdose. She measured glucose again and this time it was 500 so we figured ok no problem. Fast forward three days later our new home blood glucose meter comes and we try it out in middle of day and it's reading mid 60s. PMPS that night was 120, we decide no shot. AMPS next day 80's, no shot, PMPS 190 we figure give a shot because it went up. Long story short after that shot we've never seen an AMPS or PMPS above 120. This is only a week after diagnoses at the vet. I think switching food helped immensely, but our vet thinks we should keep doing the insulin twice a day until we do a curve in her office in another week. Is this bad advice? I feel like the food switch has almost immediately caused remission. I am extremely hesitant to administer more medication when I don't think he needs it. What should I do? Continue to monitor AMPS and PMPS and show the vet in a week? She doesn't seem to think that elevated numbers at the office were due to stress and the poor diet.
I never used ProZinc and there's only a few things I can comment on, more help will come. If your cat likes his new food I would stick with a low carb diet but continue to monitor his weight. What was his weight before he lost two pounds? Yes you should continue to monitor AMPS and PMPS and show the vet in a week along with getting his weight checked. That would also be a good time to have his teeth checked even though seven years old seems young. Do NOT give insulin to a cat with blood sugar as low as 60. The starting dose is just a suggestion and should be changed according to his numbers. No two cats are ever the same or require the same dose of insulin. For now it's much easier to withhold insulin and deal with a higher number than give insulin to a cat that doesn't need it. Does he have any other medical history that might be relevant? If you're just starting out more members would have seen this if you had posted this in General Health. It's just a little oops, if you don't get the answers you need feel free to post the same question again. Good luck.
What meter are you using? It takes awhile for the high carb foods to get out of the cats system, so as long as no ketones are present, just Keep monitoring. With numbers under 120, I’d say things are looking good and even if insulin is needed, 2u is too much to start (the more experienced prozinc users will be along to advise soon).
We had a short bought with prozinc before our guy recently went into remission. The more people I see come to the forum, the more I feel like vets seem to think 2u is a 'standard' starting dose, when the reality is that it is far too high in most cases. You mentioned your preshots have been under 120 recently, are they still above 100? Also curious to know if there have been any underlying causes for elevated BG identified. Lots of sugarcats have dental issues, and the infection can certainly elevate it.
Followup: Expressed concern to my vet. She was skeptical that the numbers I was getting on my (Relion Premiere) monitor were the same as the vet supplied one. She offered to have me come in and compare numbers with theirs. So I brought Mittens in and we ran the test on our monitors from the same drop of blood, right at the scheduled PMPS time. She got 145 on her meter, I got 115 on mine. The vet was extremely surprised that the numbers have dropped so dramatically so quickly. Basically, for a cat to come in to her, with all the clinical signs we diagnosed (weight loss, extreme thirst, big litter clumps), with also a BG of 500, it's almost unheard of for the BG to drop to 145 in 7 days by just a diet change. We have not given Insulin since 5/26 (it's 5/28 as of this post). She told us that our monitors aren't that far apart and its fine to use ours. She also said again how surprised she is by this, and that we should cease all insulin for the next 10 days. She wants to continue on the diet we have him on, and then do the fructosamine test on him to see where the BG is truly at. So this is good! Now you guys are bringing up dental checks, I don't think they ever looked at his teeth, but I was not there at his initial appointment. I do know that my wife mentioned to me that his blood/urine showed that there were no infections. Does that rule out something with his teeth causing the high BG? The cat is very big, 26 lbs 2 months ago, 24 now, and should ideally weigh probably around 19-20 lbs. He really is just a tiger! So I think we will continue to due spot BG checks every other day or so, but for now we must have gotten extremely lucky in that his BG being so high was an anomoly, or just switching to wet food essentially caused his pancreas to start working again. Thank you for your advice!
Our vet was also surprised by how quickly our boy dropped. If you stick around on the forums you'll see that this isn't actually terribly uncommon when you make the right food changes, but every cat is different. Our vet also recommended going a few weeks off and seeing how he did, but we found his numbers were still somewhat higher than ideal and warranted some microdosing support until his dental and subsequent healing. I would wager that vets often see people who don't follow instructions to change up food, or people who feed the hills/purina food which is actually fairly high carb. As such I think their dosing recommendations are unfortunately usually off. Go with your best judgement and research plenty yourself. I would still recommend getting daily tests to see how her numbers are presenting as it will inform you and us here on the board the best way to move forward.
Don't worry too much about the meter thing. No two meters will ever get exactly the same reading (they're legally allowed to be off by quite a bit) and even the same meter will get different numbers just minutes apart.
I think food change alone has caused remission in my cat too.. My cat Buddy was diagnosed 5/20/19 so I'm new to this as well.. His BG was 498 and the vet gave him 4U of prozinc that morning which I found out was a very high dose starting out. They tried to get me to put him on Purina D/M dry food (which I will not do!) and to give him 4U of insulin 2 times a day (never had to do) and gave me no way of checking his glucose. Thankfully on that first day I found a facebook group which led me to this forum. I started checking his glucose the first day and learned about the low carb wet foods and put Buddy on it right away. Since then his numbers have dropped with the food change alone and I didn't have to give him any insulin. He is like a new cat. More alert, more energy, softer fur, litter box changes for the better and he stopped drinking large amounts of water. I will keep him on the low carb wet food and I'll keep check on his Blood Glucose too.. I wish your boy the best!
Buddy wouldn't be the first cat to go into remission so quickly. For lots of us it's a dream that never comes true. You did the right thing with the food, I say nuts to Purina D/M and double nuts to vets who don't advise using a meter. Would they be doing that to their kids?
