8 units and no improvement

Discussion in 'Prozinc / PZI' started by Dawnmc, Feb 17, 2019.

  1. Dawnmc

    Dawnmc New Member

    Joined:
    Feb 17, 2019
    My almost 15 year old cat was diagnosed with diabetes the end of December. My vet prescribed prozinc insulin, starting with 2 units. Right off the bat I screwed that up, as I've never used a syringe before and I thought I was giving 2 units, but was actually only giving 1. This went on for at least the first week, before I realized it. I then adjusted the dose to 2 units. She continued to drink like a horse and peed a lot. After a week the vet said to increase to 3 units....another week, same thing....vet said increase to 4 units....this went on, up to 8 units.......2 days ago, she started having a hard time walking....having a weird thing going on with her hind legs....called the vet....he said he thought she might be getting too much insulin.( I called the vet at 4:30 pm. her last injection was at 6 am.)he said not to give her any insulin that night and she should be better by morning and if she was better to cut her back to 6 units. if she was not better , to not give her any insulin and bring her in to be checked. She was not better. Took her in, her blood sugar was 540. When she was diagnosed in December, it was 567. He still thinks she's getting too much insulin and I think he's wrong. He took blood to to a total workup to rule out any other problems, which we should have the results tomorrow. She had been on dry food all her life until recently when I began switching her over to fancy feast....as of today she is on fancy feast only. Oh and after the appointment yesterday, he had me cut her back to 5 units. Which I did and she is still drinking like a horse and walking like a lame rabbit......any help will be greatly appreciated!
     
  2. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Hi Dawn, and welcome! It sounds like you guys have really been through it lately!

    Has your vet talked to you about home testing? I'm guessing as you've been reading on here, you've already seen that we place a pretty high value on it. Is it something you would consider doing? We can help you get started (I promise it's not as difficult or scary as it sounds) and that will help you get your kitty into a better place.

    It's possible your vet is right and the dose is too high. It's also possible that you have a high dose cat and the back leg weakness is neuropathy caused by the high numbers. So two opposite possibilities - and the only way to know is to monitor the blood glucose and let the numbers tell us.

    If you're willing to give it a try, let me know and we can help you get started. :)
     
    Rachel likes this.
  3. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    Welcome Dawn! Well gosh, it's been a tough journey for you so far. You actually went up in doses fairly fast. We never increase by full units since we can skip right over the ideal dose. We raise by .25 or .5 at the most, so it is possible that she is getting too much and you just happened to skip over the ideal dose. It's also possible that she really does need a lot of insulin...we've seen that plenty of times too.

    As Djamila said, we really need to see more home testing numbers to help you figure this out. The reason is that we want to see what the BG is BEFORE giving insulin....then see how far down it takes your cat...then see what it goes back up to. This way, we know how the insulin is affecting your cat. We can see if what is happening is that your cat is in high numbers before the shot then plummeting down to really low numbers that cause them to go back up high or if they are staying high all throughout the cycle. That helps you figure out if you need to increase or not.

    If you're willing to home test we can totally teach you. We've taught plenty of pet parents how to do this over the internet and that's how I learned too! Check out some videos on youtube and you'll see that it's really not traumatic for most cats. They don't all LIKE it, but they usually tolerate it well. My cat used to make an annoyed noise when I did it, but she never ran...I think she was just tired of sitting in one spot and wanted to go!
     
    Djamila likes this.
  4. Lisa and little

    Lisa and little Well-Known Member

    Joined:
    Sep 24, 2018
    Hello and welcome. We have all been where you are so you’ve come to the right place. All good advice here and without home testing it’s tough to tell if dose is too high or too low. The back legs sounds like diabetic neuropathy. Check out Zobaline for cats... it’s a B12 for diabetic kitties... no sugar or sugar substitutes. I have my girl on it and her legs are much better however not sure if it’s due to the insulin and the Zobaline together it what. I just know many here recommended it so I have it a try. She used to have a hard time jumping up on stuff and now she doesn’t skip a beat but could also be due to the fact that she is a “bit” more regulated with insulin. Worth a try!
     
  5. Dawnmc

    Dawnmc New Member

    Joined:
    Feb 17, 2019
    I've read that the methylcobalamin needs to be injected in order for it to help with neuropathy, but it sounds like others are having luck using it orally....Also, I did buy a Relion monitor, but have only been able to get enough blood from her ear once to test her. This was just before feeding her and her bg was 134. Is that what it should be? also my vet has concerns that it's a monitor for people and not cats.....that it won't read properly, but I have an appointment for her on Wednesday so i'll take the monitor with me to compare...I've been reading about glucose curves and am somewhat confused...as to what to do if and when I'm ever able to get enough blood on a regular basis to do one....as in, when I get these number, then what do I do.???
     
    Last edited: Feb 24, 2019
  6. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Was the 134 right before you gave the shot? If so, I'm afraid your cat is being overdosed. That number is much too low to be giving such a large dose.

    We have lots of tricks for helping you get the tests.
    1. Make sure her ear is warm. Put some uncooked rice or uncooked oatmeal in a small sock, or any small bit of fabric - I made one using a square from an old T-shirt that I tied into a pouch. I've also made on by sewing two pieces of felt together - anything you have an hand that can go in the microwave will work. Put it in the microwave for 20-30 seconds depending on how big you make it and how strong your microwave is - you want it to be warm, but not hot enough to hurt her ears. Hold it gently against her ear until the ear is warm. You'll likely need to distract her at the same time - chin/head scratches, brushing, talking quietly, whatever will keep her there helps.
    2. Use a large lancet. In the beginning lancets sized around 26-28 are good. If you have 30's or 33's (which usually come with the meters), those are much too small when you're starting out.
    3. Make sure she's hydrated. Cats are naturally dehydrated, especially if they've been getting any dry food, so that makes it difficult to get any blood. Add extra water to her wet food, and make sure she isn't eating dry food. The extra water mixed into the food will help improve her hydration.
    4. Try making two pokes together instead of just one
    5. "milk" the ear after the pokes - gently press on both sides of the poke to help the blood come out
    6. (should have put this one earlier in the list) - after warming the ear, spread a very thin layer of neosporin or vaseline over the fur where you are going to poke. This helps the blood to bead up instead of getting spread out into the fur.

    It's a lot to figure out all at once, but we have no end of tricks to help make it work, so if you try all of that and still struggle, let us know what's going on and we can help.

    As for the accuracy of the meter - no, it's not as accurate as the lab tests or the pet meter. However, it gives you the information you need: too low, just right, too high. Whether they are too low to shoot at 134 or at 142 doesn't matter. Whether they are too high at 276 or 358 doesn't matter. It's still too low or too high. The human meter is "close enough" to keep our kitties healthy and safe, and given that they are much easier to access, and much less expensive, it's a reasonable trade off.

    I am very concerned about that number you got and the current dose, so please do keep working on those tests, and let us know what questions you have and how we can help!
     
    Kris & Teasel likes this.
  7. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I agree with Djamila about the dose - especially giving the full dose on a BG of 134. Getting home testing conquered is the very best thing you can do for your kitty.
     
  8. Dawnmc

    Dawnmc New Member

    Joined:
    Feb 17, 2019
    I just tested her again! 3 hours after feeding her, and giving her 4.5 units of insulin, her bg was 300. Comments welcome please....
     
    Djamila likes this.
  9. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I’m glad she didn’t drop too low. Unfortunately it’s almost impossible to give useful feedback without seeing more BG data and how these two numbers appear in context. What came before is very important in determining the effectiveness of a dose. Please work at your testing routine and set up the spreadsheet we use here.
     
    Last edited: Feb 24, 2019
  10. Dawnmc

    Dawnmc New Member

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    Feb 17, 2019
    `Where can i find the blank spreadsheet?
     
  11. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
  12. Dawnmc

    Dawnmc New Member

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    Feb 17, 2019
    Thank you!!!
     
  13. Dawnmc

    Dawnmc New Member

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    Feb 17, 2019
    WootWoot! Just got in another test! 276......
     
  14. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    Great job! The more you test, the easier it will get for both of you. Your cat's ears really do "learn to bleed" as you test more, making it much easier.
     
  15. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Setting up your signature would help us:
    • click on your name in the upper right corner of this page
    • click on "signature" in the men that drops down
    • type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.
     

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