10 Units Twice Daily

Hi,

I have a diabetic overweight kitty.
I should mention right off that we also have 3 other kitties.

3 of the kitties all get along, and can eat together, 1 does not. They do not all eat at the same time, but they all eat the same food, Prescription W/D. Due to the dynamic, we need to keep food down all day.

We just had blood tests come back and we were told that our diabetic kitty needs 10 Units of insulin twice daily. Do we just take this advice and increase it? What can we do to get this number down?

Any advice would be appreciated.
Thanks,
Seena

 

Re: 10 Units Twice Dialy

Some questions:

1. What insulin are you using?

2. What dose are you presently on?

3. What test did the vet do to suggest raising the insulin dose to 10 units twice daily?

4. Do you home test? (If not, are you willing to learn?)

 

Re: 10 Units Twice Dialy

 

Re: 10 Units Twice Dialy

Did you start ProZinc at 1 unit twice daily? That's a standard starting dose.

The food you're feeding is dry?

Has your kitty had any curves done at the vet (where they test blood sugar -BG) every 2 hours)? Do you have those results and can you post them?

How long since kitty was diagnosed?

Has your kitty had any "crashes" since on the insulin?

 

Re: 10 Units Twice Dialy

 

Re: 10 Units Twice Dialy

ProZinc is a good insulin. We suggest starting at .5 - 1 unit twice daily and increasing by .5 units. How much did you kitty start on? (Weight is considered with diabetic kitties but not to the extent that it is with dogs. We rarely have even an overweight cat start at more than one unit)

WD is not a good food for any of your cats. This vet explains why: http://www.catinfo.org We suggest foods under 8%; WD is 37%. When we switched our Oliver from Science Diet Dry (ugh) to Fancy Feast, he dropped 100 points overnight. Lots of us let our cats graze; it is possible with wet food.

BUT you don't want to change the diet until you are testing at home. If we hadn't been testing and had given Oliver the usual dose, he would have hypoed. Especially at those doses, you don't want to change the diet without monitoring carefully. Here is a shopping list for testing:


A human glucometer. Any one that sips and takes a tiny sample is fine. Some members stay away from any meter with True in the name and the Freestyle meters. Some people think they are unreliable and read lower than other meters. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 26-28 gauge is good. Any brand will work as long as the lancets match your device.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking. You can also use a prescription bottle filled with very warm water. It provides a good surface to poke against.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats

How to get the cat ready for home testing

First pick a place where you want to test. Some people use the kitchen counter, a blanket on the floor, between your legs while sitting – whatever works for you. Take the kitty there and give him/her lots of praise while you play with his/her ears. Give a treat and release. Next time, add the rice sack (thin sock filled with raw rice, heated in the microwave until very warm but not hot) or a prescription pill bottle filled with very warm water. Lots of praise, treat and release. Finally add the lancet so he/she will get used to the noise. The hope is that when you finally poke, they will be used to the process and know a treat is coming!

There are high dose conditions. It is possible that your cat has one of those. But changing the diet and testing will help you see how the insulin is really working and you can go from there.

 

Re: 10 Units Twice Dialy

Hi Seena,

I'd love it if you could get some numbers from your vet, so we can understand what they are seeing that indicates the dose keeps going higher and higher.

There's the dry food, which is most likely keeping the numbers high, like others have said. But ten units BID is a really large dose unless there is some sort of "high dose condition" that hasn't been tested for and verified yet. Ihave only been around for a couple years, but I've never seen a dose of Prozinc that high that wasn't related to a high-dose condition.

You said that your diabetic kitty is overweight? How fat is fat? Have you been feeding the w/d the whole time? If so, it's odd because w/d is marketed as low-fat and supposed to be good for weight management... Plus, if the numbers are such that the vet keeps on raising the dose, then it would seem that the diabetes is not controlled or regulated, and that usually tends to make them lose weight no matter how much they eat. Has the vet ever found any other condition besides diabetes in the blood tests, like hypothyroid or something else that would cause slow metabolism?

I personally wouldn't raise the dose until two things happen...
1 - find out from the vet what the logic is behind raising the dose by 25% to 10u twice a day. What numbers have they seen?
2 - start home testing.

I wouldn't change the food until you start home testing either. Your cats might be unwilling or unable to switch to low carb canned food. It sounds like that might not be an easy option at least not short term. But you can find a dry food that is much lower in carbohydrates than that W/D is. The lower carbs should drop the blood glucose numbers, possible by a great deal. You wouldn't want to switch until you are able to see those numbers if they drop, on a day-to-day basis. And it's possible that at that time, the dose could be lower, also probably by a lot.

Another option might be to try a different insulin, but I'd try home testing and diet change to see if maybe the Prozinc will work better that it has been working.

 

Re: 10 Units Twice Dialy

I don't have any numbers, in fact the communications the vet has had was with my husband on the phone.
He is currently 23 lbs give or take, and has been maintaining that on WD for about 3 years now.

I think one of our first steps is to definitely look at getting a second opinion. Will keep you all posted!

 

Re: 10 Units Twice Dialy

If you want to start a new thread with your city/state, you could see if anyone lives nearby and knows a good vet.

I'd suggest you try testing at home in the meantime and see what the insulin is doing.

 

Re: 10 Units Twice Dialy

OK here we go with your answers.

1. That dose is VERY high and if your cat were eating a different diet, I would want to see your cat's blood glucose numbers. If your cat is not bottoming out, I would say you have yourself an acro cat.

2. Diet. Dry food should not be fed to a diabetic cat because many cats are VERY carb sensitive and the result would be a need for a higher dose of insulin.
There was once a cat who posted on this site that their cat was getting 20units of Caninsulin.... it turned out that the cat was being fed DRY food. Once the dry was replaced with low carb wet food, that cat needed only ONE unit of insulin twice a day.
Food makes a huge difference in dose needs for many cats, and several turn out to be DIET CONTROLLED.

3. Home testing is important because it may save your cat's life. If your cat is not acro, that dry food is saving your cat from hypo incidents and rushes to the ER to save the cat's life.

Here's what I suggest you do.
1. Pick up a human blood glucose meter, the test strips and lancets for the meter, and start to home test today or as soon as you can. You need to see what your cat's numbers are before making any changes to food or dose. If you are already home testing, please post the numbers you have.

2. Once you see your cat's numbers, I would suggest that you start to transition your cat from dry to wet food. Use Dr. Lisa's food list for choices, but most people feed fancy feast pates or Friskies pates. They are low carb and good to feed diabetics.
Depending what numbers you get from home testing, you will know how to make the changes in dosing and feeding. For all you know, your cat IS going very low in mid cycle but you just don't know it. Cats are very secretive.

There are videos on home testing, just a poke on the tip of the cat's ear to get a drop of blood, then sip the drop on a test strip on your meter. If you are in the US, you can pick up one of the Relion meters and supplies as they are quite fine and the most economical of the meters.... the strips are what cost you, so take a look at the cost of the strips for the various meters.
Do NOT get any of the Freestyle meters or ones like TRU2GO or others with True in the name as they are unreliable.

As soon as you have picked up some wet food and your meter and strips, post so that people can help you get going.
Testing
Testing on cat’s ear
Testing on cat’s ear Youtube
Food List
catinfo.org/docs/FoodChartPublic9-22-12.pdf

Gayle

 

Re: 10 Units Twice Dialy

Two of the ReliOn brand are the Confirm and Confirm Micro. The generic versions of these are made by Arkray USA and sold by our shopping partner ADW as the Glucocard 01 series.

Since you're already giving insulin, focus on learning home testing before making any changes to diet, for safety.

Once you are able to test easily, do gradual diet changes to reduce or avoid GI upsets. A shift of 20-25% different food per day may work.

Cat Info, written by a vet, has excellent information on healthy nutrition for cats.

 

Re: 10 Units Twice Dialy

Feline obesity can also cause insulin resistence.

What is the ideal weight your vet has told you your kitty should weigh?

How much food are you feeding per day? You said you were free feeding. You still need to portion control with the free feeding.

 

Re: 10 Units Twice Dialy

The vet said he is maintaining weight right now and he is fine with where he is.
Right now, we aren't home testing but looking into it.

We feed 2 cups in the morning and 2 cups at night between 4 cats. It never emptied between feedings meaning the kitties do not clear out the bowls.

 

Re: 10 Units Twice Dialy

Home testing will let you know where your cat's numbers are. With such a high dose that you are giving your cat, for his safety, testing before shots is advisable. My worry is one day he will not eat enough of the dry food to counter the insulin and he could drop too low.

I had asked about feeding the wet food as you have it mentioned in your signature... are you still feeding some wet or just dry now?

 

Re: 10 Units Twice Dialy

That's a lot of food, even between 4 cats! That's 1 cup of food per day per cat. If I fed my cats that much, they would be overweight very quickly.

 

Re: 10 Units Twice Dialy

We are following the Feeding guide as per the vet and as per the package.

Weight of Cat
Amount per Day

6 lb (2,7 kg)
1/2 cup (45 g) - 3/4 cup (65 g)

10 lb (4,5 kg)
3/4 cup (65 g) - 1 1/8 cups (100 g)

14 lb (6,4 kg)
1 cup (85 g) - 1 3/8 cups (120 g)

18 lb (8,2 kg)
1 1/4 cups (110 g) - 1 2/3 cups (145 g)

 

Re: 10 Units Twice Dialy

It's probably one of those ECID things, you know, Every Cat is Different.

My littlest kitty Delta, 7.3 pounds (3.31 kilo) gets 4 ounces of canned food a day.
My medium kitty and diet controlled sugar cat Wink, 10.2-10.4 pounds (4.63 kilo) gets 6-8 ounces of canned food a day.
My big kitty Monet 12 - 12.2 pounds (5.45 kilo), gets 6-7 ounces of canned food a day.

When Monet was on his diet, he only got 1/4 cup dry food and 1/4 can (1.4 ounces) of wet food a day. It's such a change to see him with a 'defined waist' as my vet calls it. No more bulges around the hips.

As long as your vet is telling you your cats are at their ideal weights, you should be fine.

Are you in Canada? I only ask because you gave the weights in kilos as well as pounds.

 

Re: 10 Units Twice Dialy

Before a cat is regulated, there is a larger appetite.
I owned two acro cats and their daily intake was 30oz and 24oz per day, but the dropped down to around 10oz and 5oz per day once they were regulated. Acro cats do gain weight.

As for going by what's on the packaging, those amounts are for normal healthy cats, and not for diabetics.

You do not put diabetic cats on diets if not regulated; I am not sure why you would want to give a cat less food if its body is already having troubles extracting the nutrients from the food it's fed.

Acro cats seldom have 'waists'; they most often have big pot bellies.

 

Re: 10 Units Twice Dialy

I've never heard of an acro kitty, so it's something I'm going to have to explore.
I'm actually a Canadian living in the US.

We are going to look at testing. I have a meter from when I was gestation diabetic but we don't have any strips so we have to order them from somewhere.

 

Re: 10 Units Twice Dialy

You can usually get the strips much cheaper on ebay. Be sure your meter sips and takes a tiny sample. Some of the older human ones take a large drop.

Here is some info on acro kitties:

http://felinediabetes.com/FDMB/viewtopic.php?f=12&t=375

You can't really decide whether the acro conditions are part of the picture until you know what kind of numbers he has, and then you start the wet low carb diet and see if things change. Then you will really know where he actually is in terms of the dose he needs.

 

Re: 10 Units Twice Dialy

I have a One Touch Ultra 2, which seems like a few people use here, although I understand it's not preferred because it's a bit higher cost, but it's the one I have right now.

Thanks for the link on acro kitties!

 

Re: 10 Units Twice Dialy

The meter you have is just fine and I liked it almost as much as the mini.... the mini just seemed to fit in my hand nicer, but all the OneTouch are good.

You should be able to pick up test strips from any pharmacy wherever you are.
Once you are testing the numbers, you will then be able to plan how to change foods, and adjust the dose down so you don't have a hypo from too much insulin.

If you switch to a low carb wet diet and your cat still needs a dose over 5units twice a day, you should look into testing your cat for acromegaly and IAA, both tests.

Gayle

 

Re: 10 Units Twice Dialy

I have the full report.
So the main numbers the vet was looking at were these 2.
Glucose, Serum 370
Fructosamine 629

 

Re: 10 Units Twice Dialy

OK good a fructosamine test was done and is high meaning the cat's not regulated at all.

Going to food now, are you feeding only dry food or some wet food as well?
If you are feeding both, there is no need for a gradual switch over to wet food ONLY....
Just drop the dose to 5u and switch to just wet food.

Be sure you are home testing at each shot time so you know it's safe to give a shot.
Once you are testing regularly, you will know how to proceed for example, drop the dose and remove all dry food.

When cats are not regulated, they do eat alot of food. Acros have pretty big appetites.
My two acros were eating 30oz and 24oz before regulated, but they ate less on their own once their numbers were better.... they dropped down to about 10oz and 5oz of wet food per day.

Gayle

 

Re: 10 Units Twice Dialy

While you work on blood glucose testing, see my signature link for urine ketone testing. Ketones form as a by-product of fat breakdown. Too many may indicate diabetic ketoacidosis (DKA), a potentially fatal, expensive to treat, complication of unregulated diabetes.

 

Re: 10 Units Twice Dialy

Just wanted to let everyone know we are grateful for your help, we have to delay all this for a bit, I jumped in forgetting that we will have to board him at the end of the month so we want to ensure we are 100% available when we start.
I will be back with more questions!

 

Re: 10 Units Twice Dialy

Where you board him
1) should test his glucose
2) give insulin
3) have written permission/authorization to take him in for emergency vet care if needed. If desired, put a financial limit or other limitations on treatment.
4) Have your emergency contact info.

 

Re: 10 Units Twice Dialy

Ok let us know when you are ready. With your kitty there is some work to be done and the sooner we can make some progress the better!

 

Re: 10 Units Twice Dialy

Oh we've done this many times before, we only board him with the vet. But thanks for the tips anyway!

 

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Thanks! I really do appreciate the help!

 

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Hows things going? Ready to get started?

 

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Just back from vacation.
I am going to talk to my vet to see if he is going to support us at all. We have an appointment this Friday.

 

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"Dr. does recommend a low calorie/ low fat food for Panya. This is the prescription food of the Purina DM or the Hills W/D food which we have prescribed Panya in the past. Dr. .... says that the dose increase for the insulin was because of Panya's weight gain, which lead to a "Poor glycemic control" in his body"

Got word back from an email I sent to the doctor.
So I know that the DM is
Calorie Content (Dry)
Metabolizable Energy (ME): 4118 kcal/kg, 592 kcal/cup
Crude Protein (Min) 51.0%
Crude Fat (Min) 15.0%
Crude Fiber (Max) 3.0%
Moisture (Max) 12.0%
Vitamin A (Min) 18,000 IU/kg
Vitamin E (Min) 100 IU/kg
Carbohydrate* (Max) 18.0%

Now I just have to find a wet food that matches it.

 

Re: 10 Units Twice Dialy

We recommend feeding 10 % calories from carbohydrates or less for our diabetics and it may not have to be prescription.

The food chart at Cat Info lists those values due to a lot of e-mails and calls Dr pierson made to get the info. She compiled the data and did the necessary calculations.

If it helps keep the insulin dose more reasonable, it may keep you from breaking your budget from high insulin use!

 

Re: 10 Units Twice Dialy

Many of us here feed our kitties the following wet foods as they are low carb and low price! fancy feast classic pates,friskies pates and wellness grain free,

What did your vet say about home testing?

Weny

 

Re: 10 Units Twice Dialy

First of all, thank you everyone that has stuck with me so far.
I want to get the strips this weekend, unfortunately we over extended ourselves and pay is coming in late so we have to wait until this weekend to get the strips.

I've actually taken the Cat Food spreadsheet linked here (thank you by the way!) and put it into a spreadsheet. I'm going to look at the foods suggested and especially at fancy feast classic pates, friskies pates and wellness grain free as suggested. It's a good place to start!

My vet didn't really say anything about the home testing, just to let them know the levels.
Here is a reply from a follow up email I sent.
Dr. does recommend a low calorie/ low fat food for Panya. This is the prescription food of the Purina DM or the Hills W/D food which we have prescribed Panya in the past. Dr. says that the dose increase for the insulin was because of Panya's weight gain, which lead to a "Poor glycemic control" in his body. If you would like a copy of his laboratory results for this information, you may pick up a copy.
At this point Dr. says that if there is an OTC food that you are considering to replace the prescription food he says to make sure that the caloric and fat contents are as low as the prescription food. This information should be listed on the food bag or on the Hills and Purina websites. Dr. wants to see Panya loose weight. We can always check his weight here if you ever want to stop by.
Blood work is the best way for us to give the most concrete answer to say how well Panya is doing with the increase. Or at home monitoring can be done either through a blood glucose monitor or in his urine via glucose monitoring urinary strips. If you decide to go either of these routes please be sure to keep track of his glucose levels and report back to us.

Here is a picture of my "little" guy.

http://imgur.com/wZWDK6E
http://imgur.com/3GukW

 

Re: 10 Units Twice Dialy

If you pop over to Cat Info, she discusses safe rates of weight loss and how to calculate what you should feed. She also recommends the low carbohydrate, low calorie foods. High carbohydrate food will make the diabetes worse, even if it is low calorie.

 

Re: 10 Units Twice Dialy

I don't even know where to start here. Guess I'll start with how your vet adjusts the insulin dose, by Panya's weight gain.

A weight gain does not necessarily mean poor glycemic control. It means the cat is eating too much. Too many calories. You free feed so there is no way to tell how much of the 4 cups of food a day you feed, are being eaten by Panya. The package directions on how much to feed your cat are always overstated. If you are still feeding these amounts, it will lead to obesity for all your cats. I recommend you cut back on the amounts immediately. You have also said the cats do not ever finish the amounts in their bowls before you refill them. This tells me you are feeding too much.

You told us earlier, your vet has never done a BG curve and you are not hometesting. Without knowing what the BG's are, raising the dose based on a single BG reading at the vet continues to put your cat in danger of an insulin overdose.

Back in May you said the BG reading was 392 for your cat Panya?
Is there a more recent BG test? If so, When was the last time this was done?
What was that reading?
When was the blood glucose reading taken in relationship to the insulin shot?
How often are BG readings done for Panya at the vet?

 

Re: 10 Units Twice Dialy

Well for the record, we have been feeding the same amount for years and the other 3 cats are not overweight at all.

Again, we are getting strips and will be home testing. We can arrange another test with the vet. Since they did not mention it, it was not something I thought of.

 

Re: 10 Units Twice Dialy

Great! Then your 3 normal weight cats look like these pictures and these descriptions? http://www.swaynevets.co.uk/downloads/catBodyConditionScoring.pdf "With ribs palpable without excess fat covering. Waist observed behind ribs when viewed from above. Abdomen tucked up when viewed."

Some cats regulate their food intake just fine and do not become overweight. Other cats, it seems as if the 'hunger switch" in their brains is not working right, and they overeat. ECID. Every Cat Is Different. I've had both kinds of cat.

So even though 3 of your cats are not overweight, and can limit their food intake, Panya does not seem to have that working "hunger switch" to tell him when he is full. If that is the case, then trying to change all your cats over to meal feeding would be one idea to help out Panya.

 

Re: 10 Units Twice Dialy

What dose are you giving now, is it still 10units twice a day of Prozinc?
What was your cat's weight before and how much has he gained?
What food have you been feeding now, fancy feast and friskies wet pate flavors are quite fine and better for your cat than any of the prescription food.

You do not put a cat on a diet because it's gaining weight while being treated with insulin ... cats with acromegaly quite often gain weight and many are quite muscular. Increasing / decreasing the dose is never based on weight fluctuation, but on the BG numbers from home testing.

With the dose you are giving, it's important that you start testing soon because the dose can drop quickly, and you need to know the numbers so you know if the insulin is needed or not.
If you already have your meter and are testing, please post the numbers you get, and what time you gave the shot, and what time you got the numbers. Be sure to test before every shot.

If you have the vet get the IGF-1 test done for acromegaly, don't forget to have the IAA test done as well; they are both done at MSU.

Gayle

 

Re: 10 Units Twice Dialy

Yes, he is still on 10 units of Prozinc.
We be getting strip this weekend, testing before that I'm afraid is not possible due to reasons I don't feel are relevant for this board.

He gained 2 lbs over the last year and has maintained that since the last veterinarian visit.
We haven't changed food due to not having the strips. We want to be testing before we change the food out.

Maybe we need a new vet, but in the interim I am working with I have have.

Thanks everyone!

 

Re: 10 Units Twice Dialy

There was an interesting discussion here several years ago, about feeding kitty as much as they want. Link here Feed kitty as much as he wants?

Vet, Dr. Lisa Pierson says

This discussion was so important, it was made part of one of the Stickies over in the Lantus TR forum.

So part of getting the BG numbers under control, is to put some limits on the food intake. To do that without changing the food you feed now, you need to feed less food. To do that with multiple cats in the home, the easiest way is to meal feed.

 

Re: 10 Units Twice Dialy

The AAHA Diabetes Management Guidelines for Dogs and Cats have some good information on when testing should be done, at home and in the vets office. It's good to print them out to refer to. Maybe even share a copy with your vet.

 

Re: 10 Units Twice Dialy

Getting the strips this weekend and the food.
We will be getting Friskies Cat Food Classic Pate, Special Diet Turkey & Giblets Dinner.. and since we are switching to the new food (gradually mixed in with the dry) we will be separating out the food for each kitty and then picking the food up after each eats.

Thanks!

 

Re: 10 Units Twice Dialy

Your plan sounds great. if you have any issues with testing, just post and people can help you.
I know you will feel much better once you know the numbers that are resulting from the dose you give and the food that is being fed.
You will feel in control.

Gayle

 

Re: 10 Units Twice Dialy

Well testing isn't going that well. Having trouble hitting the vein to get blood.
I used a flashlight to shine through, so I know where it is. We haven't started to mix in the wet until we can get some testing first to see where he is at.

I used a sock with rice to warm the ear up, even rubbed it. Kitty is being really good and patient with us. We wanted to get a few days worth of testing to see where he was at before we started to mix in the wet. So we will try again tonight!

 

Re: 10 Units Twice Dialy

you are not trying to hit the vein but between the vein and the outer edge of ear

 

Re: 10 Units Twice Dialy

Did that too.... many times.

 

Re: 10 Units Twice Dialy

If you hit the vein you usually get lots of blood.. so

1. what size lancets are you using?
2. what are you putting behind the ear to press against?
3. are you using the lancet tool or free handing?

We can give more tips based on those answers

Wendy

 

Re: 10 Units Twice Dialy

And don't forget about warming the ear first. That step is essential.

 

Re: 10 Units Twice Dialy

I also have a sock with rice that I nuked in the microwave that I used to warm the ear up and I also rubbed his ear with my fingers.
Thanks!

 

Re: 10 Units Twice Dialy

They are the lancets for the OneTouch Ultra, so 28G I believe.

Used a few things from my finger to a cotton ball.

We are using the lancet tool.

I also have a sock with rice that I nuked in the microwave that I used to warm the ear up and I also rubbed his ear with my fingers.
Thanks!

 

Re: 10 Units Twice Dialy

Ahaha!

First, the lancets that come with tools are often 33g which is too fine for a newbie.

Second you need something firm behind the ear to give you more traction, like a pill bottle lid

Third you might want to try freehanding the lancet, it gives you more control of pressure and depth and you can see better what you are doing . go in at a 45degree angle.


Wendy

 

Re: 10 Units Twice Dialy

Well the one touch ultra lancets are 28g, I double checked.

We did get a reading tonight however, it was 151.

We are going to check again in the morning.

Thanks!!

 

Re: 10 Units Twice Dialy

Fantastic! At what point did you get the 151? Remember the insulin works in a curve so the blood sugar starts high at preshot , then drops to a low, then back up again for the next shot ( generally). So we recommend four tests a day if you really want to know whats going on

- Always always test preshot - you dont want to shoot when too low
- mid cycle - 5-7 hours after morning shot if your schedule allows - you are trying to see here how low he goes because its the low number you base dose changes on
- before bed - 2-3 hours after nighttime preshot test to see what his nighttime plans are. If this number is same or less than the preshot test you may want to set the alarm for another test at +6 (6 hours after shot time) because this usually means an active cycle

Also its a good idea to track readings on a spreadsheet - this helps you track trends and us to advise you better: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

 

Re: 10 Units Twice Dialy

Great number, that 151. Now, you just need to post where, along the cycle, you got that number.
If you shoot at 8am and that number was at shot time, I would be worried about the amount of insulin you are giving. if that 151 was around mid-point in the cycle or hrs after the shot, it's a decent number.

Example of a typical curve:
+0 - PreShot number.
+1 – Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 – Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

Now, not all cats have that type of curve, but for now, since you are not regularly testing and have not done any curves, we'll use it.
One of my acros have nadir earlier, around +5; my other acro was closer to +10 or later.
The first curve looked like a valley; the second, like a mountain. Once you have done a few curves, you will be able to see where YOUR cat falls with a curve.

I have not seen any mention, but the ears truly do 'learn' to bleed. The healing after pokes for tests result in easier bleeding in time. You can also try the other side of the ear as well. One of mine was better on the underside of the ear tip; the other, on the upper, hairy side of the ear.
I should mention that I never warmed their ears, so you may find that step is not essential but rather just a bother.
For testing, I don't freehand because you cannot regulate your depth like you can with the lancet devise. Yes, some people may say it's better or easier, but it is never ever as consistent as when using the lancet device... the device is always the same angle and the same depth, and that's consistency.

I hope you will be able to set up a google spreadsheet because seeing the trends in your numbers are going to be quite important if you find your cat does have acromegaly because other acro owners will be able to help you with seeing where the numbers are headed.
The spreadsheet is good for normal diabetic cats too as you will be able to get some guidance from other diabetic cat owners.

I should mention that many cats, all acro cats, end up needing to switch to a longer lasting insulin like Lantus or Levemir, but once you are feeding a low carb wet food and doing curves, you will see how much insulin your cat truly needs, and if it is lasting most of the 12hrs.

Gayle

 

Re: 10 Units Twice Dialy

Thanks for the info!

The test was preshot. We gave him his shot right after.
I am keeping a spreadsheet to track his numbers.

We will be testing twice daily right now, preshot before the food switch. Once we switch his food, we will be changing the frequency of testing to include testing after food.

268 this morning.

Panya's Blood Glucose Testing

Edit Note: We give him his shot every 12 hours at 10am.

 

Re: 10 Units Twice Dialy

Thats great! I cant seem to see the readings though - did you "share" it for anyone with a link?

Also Can you add the link into your signature so we can find it easily?

thanks
Wendy

 

Re: 10 Units Twice Dialy

I redid the spreadsheet, it seems it would only open after about 5 minutes of waiting. Also I put it in my sig as per your request.

Thanks!

 

Please see my signature link Secondary Monitoring Tools for some additional assessments you may wish to make.

Urine ketone testing is particularly important while you are working on regulating his insulin dose. Ketones form from fat breakdown. Too many may indicate diabetic ketoacidosis, a potentially fatal, expensive to treat, complication of diabetes.

 

yay ! I can see it. Can you also add your and your cats name to your signature as well as the insulin /dose and meter so people can see it at a quick glance ie Seena and Panya, PZI 10 IU BID. One touch ultra.

Did you give Panya insulin this morning? the U column (cell C4) is empty where I would expect to see the dose ie 10IU?

Wendy

 

Ah I see, yes he got his shot this AM and last night. I've updated that column and my signature. Thanks!

 

Ok cool. Actually these BGs are pretty good considering the dry food.. he is still getting the dry w/d right?

However the key thing is how low is Panya going?.. Its the low number that you really need to know because if its too low (under 50) then a dose decrease is needed. So we need to get some tests around +5 to + 7 because thats the typical low time. And some cats go lower at night hence the request for a before bed test.

Wendy

 

Yes still only the Dry W/D.

I'll see if I can get a reading tomorrow.
Since we feed/give shots at 10am/pm, then go to work or go to bed, that's a little more to work in with us working, I will have to see if we can work in an afternoon shot though. We both work through the week so it might have to wait until this weekend.

I appreciate your help!!

 

what time is it there now? Did you get a PMPS? And can you fit in a before bed test? Seriously I cant emphasize enough how important it is , if you want to prevent a hypo and get him regulated.

Wendy

 

Would you change the date on your SS? It says month 6 and we are in month 7.

Getting those mid-day tests can be tricky when you work full time. Most people can only get those on a day off. That's why other testing can be useful.

Why did you pick 10 am/10 pm as your test/shoot/feed time? What is a typical day like for you?

I'm asking to see if we can try to figure out when else you might be able to some get other test data.

ETA: If you are willing to share the info, you could add your location to your user control panel, profile tab, edit profile that would answer Wendy's question and be there in the future. Country, state/province, city is nice to see. It's optional but helpful in the event of an emergency. So someone knows if they can stay up with you to support you through a hypo for instance.

 

We will be testing tonight before we give him his shot again, it's only 5:30pm here.

Whoops! Thanks for catching that. You'd think that someone who looks at spreadsheets all day wouldn't put that it's June when it's July!

10am was when the doctor first gave him his first shot, so we've stuck at that time every 12 hours. We are typically later risers anyway, for a later work schedule. Hubby gets home later from work, around 8pm.

Done!

 

You aren't stuck at that time, you can move the shot by 15 minutes each time or by half an hour a day. Comes in handy if you know you need to be out in a few days and might be home at a different time.

 

I have no idea why so much picky little useless info and details are being asked from you.
The most obvious detail is the dose in your signature! Take that out because who is going to have to waste the time to change their signature every time the dose changes! Ridiculous.

As for asking why you picked your shot time, it's none of anyone's business. if you want to change it, you don't have to piddle around with the 15min each shot for change; you can easily do 30min or more each shot.... hey, if you wanted to get creative, you could shoot 2hrs early if you want 8am/pm and just give a reduced dose like 8u or something.

Your signature is for the info that YOU want to share, not what others tell you to put there.
You do not need to put your country, state, city, or any other info if you don't want. Even time zones don't matter because your spreadsheet is based on your shot time and then the number of hours after the shot.

A great deal of people work or are away from home during the week, so there is no need to be stressed about getting mid cycle tests. For some cats, mid cycle tests mean nothing because their nadirs are much earlier or later. You will be just fine to do a curve or two on your weekend or day off, testing every 2 hours and that data will let you know how well and how long your insulin and dose are working. The curves will also tell you the effect that the dry food is having on the numbers. Just see if you can have all food removed 2hrs before shot times so that your pre shot test number will not be food influenced.

It's going to be important that you are able to test a fair amount when you do the food switch to wet because you may need to cut the insulin dose way down.

Gayle

 

Thank you everyone for help and feedback.

 

Now that we know your shot time was set by the vet, and the fact that you are late risers, it makes sense. PZI is more flexible on moving shot times around a bit. More so than Lantus.

Ask if you need more info on how much you can move your shot times around. 12/12 schedule is best, but there is some flexibility. We want you to have a life too! :lol: :lol: :lol:

Thanks for sharing your location. Now that I know where you live, in case of emergency I can go find other members that might be on-line and can commit to helping you in the wee hours of the morning. I know some of the folks that are on here late at night that live in those western time zones. Now that I know there is a 3 hour time difference in our locations, it means I probably could not be around to help you late at night. It's why I asked.

 

Hey there. Wow nice numbers. With that 50 the other night I would be inclined to reduce the dose a little - say to 9.5. Also you might want to get more tests in during the day etc as if she keeps doing that you can keep reducing. You dont want her going too low.

Wendy

 

Is your cat Panya ok? After seeing that 26 on your SS today, I got a little worried.

With that 26 today, you definitely want to reduce. By more than a tiny 0.5U. Think you may want to go back down to 9 or even lower. You know your cat better than we do. Think about how much you want to lower that dose.

Prozinc can be dosed on a sliding scale. That means, if the numbers fall in a particular range, you give one dose. If the numbers are in another higher range, you give a slightly higher dose.

This is an example of a sliding scale. Please, do not use this for Panya. It was developed specifically for another cat. It was based on sufficient test data and the ability of the caregiver to get at least 3-4 tests a day. She also knows this cat very well and can pick up on signs that she is feeling high or low.

Tiffy's sliding scale.
>550 - 3.5
>450 - 3.
>350 - 2.75
>250 - 2.25
>150 ONLY IF HOME TO MONITOR, STALLED 30 MINUTES TO MAKE SURE IT IS RISING AND SHE IS NOT ILL - 1.5

 

I just saw that 26.. I hope you gave syrup as that is WAY too low.. and you need to reduce the dose!!!!!

 

Hi all,

Thanks for checking in and for the feedback. My vet is a little more responsive, as per his instructions we did not give him his insulin last night, checked him again this morning and he's way high.
The vet wants us to take him in, but I have a feeling that if we do that, his numbers will be elevated. He really does not like the great big outdoors and would prefer to sit inside where there isn't so much hustle and bustle so it really stresses him out.

We are going to play it by ear, adjusting where we can.

Thanks again.

 

I am SO glad you didnt shoot last night - I never ever shoot under 50. plus again that 38 shows the 10 units is too high! PLEASE reduce the dose before he has a hypo. Try 9 units for a few days.

 

Just a little update.
Panya is doing well. He seems happier, his dandruff is lower and he is down a pound. We are managing the Prozinc and switched his glucose monitor to the Relion. We are doing meal feeding twice a day and we are sticking to the Friskies Special Turkey and Giblets.

We are a far cry from where we were a month ago, spending so much on prescription food and going through insulin like it was water. I couldn't have done it without the information and assistance from people here. We are still a work in progress, but today Panya jumped on to the kitchen counter, which is not something he has done a lot in the past due to his size.

But thanks for your help everyone!

 

The 2 units are looking good.

Be sure now to get some mid cycle tests - you might find the 2 units now are even too high! If you catch a number under 50 (most likely midday or more likely middle of the night) then reduce by 0.25 !

Wendy

 

Today we went to 1.5. I am going to try to get a midday test today.
He's definitely not feeling sick or ill effects, he's lying with me more and spending time with me, and he's chasing his sister. Being a bit of a bully to one of the others. I have been home to watch him. He's more alert and active then ever. It's nice to see.

 

ok good - hold that dose for 3 days unless he goes under 50 again.

 

All right! Panya's getting his energy back and chasing his sister. That's one way we know our kitties are doing better, playing.

How are the other 4 P's? peeing, pooping, purring, preening? Appetite still good?

In addition to that mid-day test today, a regular 'one last test before you go to bed' is a good one to get. If you aren't testing at night except for your PMPS, you're missing half your data.

 

Oh yeah the others are really happy about the wet food.They are unfazed by it all except now feeding time excites them more!

Good point, we will do that again.

Will do... he's 67 right now.