? 911 Trying to get regulated in NC...!! Help! :)

So grateful I found this forum. We are using Vetsulin, which I'm understanding now is not necessarily the best insulin for cats. I'm trying to decide between PZI/Prozinc and Lantus/glargine...but Jeez, why so much more expensive that Vetsulin!!!?? I also believe we've been dosing her too high and just learned about Somogyi effect causing hyperglycemia. Her BG is 600-700+ when we measure 2x per day for over a week. We give 6.5u Vetsulin around 10am with first meal and again same dose in the evening around 5-7pm with 2nd meal. We started w/1U 2x/day w/o testing BG (no meter yet) but after reading about tight regulation, started increasing the dose to match the BG using our new AT2 meter. But now I feel we've created Somogyi and hyperglycemia. She definitely has neuropathy, weak back legs, and drinking too much, not eating enough...but this has been the case since before we started insulin. I'm currently using Solid Gold Indigo Moon dry food and add water to make gravy. It has 42% protein and 20% fat...carbs not listed. Only added carbs are potato and peas. No grains. I've looked at a lot of "wet" canned foods and find many are the same ingredients as dry food, even with grain, but just have huge water contents...70-80 %. Protein is 10% highest. If I'm going to go wet, I want a healthy food with no crap that is affordable. She's been on dry all her life. Please help w/suggestions! As far as insulin, please recommend. As far as dosing, say I start her on 1u 2x/day with PZI or Lantus, how long do I leave that dose where it is with BG unregulated (say over 150) until I start increasing the dose? Do I go up by 1/2 u or 1 u 1x or 2x/day? How long do I stay at that dose before going up again? Please post guidelines for that process. Thanks SO much for your help...I don't want to kill my kitty!!!

 

Good morning and welcome to FDMB.

I agree that your current dose is probably too high. Most cats do not respond well to Vetsulin. PZI, Prozinc, Lantus and Levemir are longer acting insulins. If your vet prescribes BCP PZI, you vet can order the first vial from BCP for free. At the bottom of this page on their site, there is a link for the form that needs to be completed by your vet. http://www.bcpvetpharm.com/products_bovine.htm

If you use either Lantus or Levemir, get the prescription for the pens instead of a vial. The pens are more economical since you should be able to use almost every drop. With the vial, the insulin starts to become ineffective long before you can use all of it. So you end up throwing a lot of money away. Depending on your dose, one package of pens could last 8 months or more. You will use the pen the same way as a vial by using a syringe to withdraw the insulin. If needed, you should be able to buy one pen at a time from your pharmacy, or I believe that you can order it from a Canadian pharmacy to help save some money.

Starting over at 1 unit is the best way to determine your optimal dose. We recommend that you wait a week before increasing it if needed. Only increase by 1/2 unit and wait another week before determining if it needs to be increased again. Using this method you help you find the dose that works best for your cat.

If you are changing food, do not remove the dry until you lower the dose. You do not want to risky hypoglycemia.

 

Hi Ken. Welcome to FDMB. You've already received some great info from Lisa. I see you have already set up a spreadsheet for Ginger however I cannot view it. Your share settings need to be changed so that anyone with the link can view the document. Good job setting that up as it will help the folks here help you get Ginger on the road to better health.

You have a lot of questions and this is the welcome forum. I would suggest you re-post your questions over on the Health forum HERE to get more opinions/suggestions as that board gets far more traffic from folks with experience with all the different types of insulin.

Rest assured, you have come the right place and help is at hand. I'll be watching for you over on Health.

 

Hi Ken. The food is a tough one. Nature Variety wet is a decent food. It on the dry side so adding water helps. Ziwipeak is a good one though must be ordered. I just found some ProPlan True Nature the carb calculator says is fine for diabetes but waiting to hear from Purina for the as Fed values.

Most people here use Fancy Feast classic/pate. It's important Ginger eats so finding a low carb she will accept should be goal. Being on dry food there are 2 that come to mind that is lower carb Young Again which is only ordered from manufacturers, they will send free sample. And EVO cat/kitten.

Also I personally stay away from food that has carrageenans in it. It is a known intestinal irritant and carcinogenic.

The insulin your are thinking are all good ones. It's a matter of finding the one that works for Ginger. Lantus can be ordered from marks marine pharmacy in Canada. It is so much less expensive than in the States. Script is needed and can take 7-10 days to get it. Order the pens, don't need pen needles we use insulin needles and draw it like the vials. The pens last longer than vials if stored properly. Vials can break if you drop or bang them.

Feel free to ask any question.

 

Thank you all for your suggestions and support! I stayed up most of last night doing more research. Here is where I'm at right now:
1. I've decided to change vets to a feline specialist in my area endorsed by the AAFP; both she and her clinic have high ratings.
2. I'm going to request that we go off of Vetsulin and go onto either PZI or Lantus. I have found another post where I can get PZI/bovine from a compounding pharmacy in the US for $44 for 10ml/40u, and that bovine is better used by gets than porcine (Vetsulin) or even Lantus which is human recombinant (so are some forms of PZI). Bovine is only 1 amino acid away from feline; porcine is 3 and human is 4. I'll also listen to the vet's input.
3. We will continue to monitor her BG 2x/day during feeding, and I will try for a 3rd reading midway between meals when BG should be lowest.
4. We will change insulin dosing to every 12 hours!
5. I have reduced insulin to 1u per dose to account for possible Somogyi "bounce" effect for at least 3 days, depending on the vet's input as well.
6. I will plan to raise insulin by 1/2u per dose per day for 3-day stints until we find a level that controls the BG, then keep it there and hopefully step down once she begins to recover her own insulin production and reduces her insulin resistance.
7. I will change to a different food. I will definitely opt for less than 20% carbs and will discuss going less than 10% with the vet. I am considering both wet/canned food and soft/pouch type food. I personally think/feel that wet food is nasty and don't know if I can take it or if she can transition to it after 13 years of dry food. Whatever food we go to, it will be MUCH lower in carbs and likely not hard/dry. I will say that with the current food, I've been reducing the amount and adding significant amounts of water to soften it and make it easier for her to absorb the nutrition, though I realize it's still relatively high in carbs.
8. I am aware of the risks of hypoglycemia and will monitor for that.

I also would like input on "tight regulation," meaning in my understanding, adjusting each insulin dose to the measured BG level. I've found a chart by a Dr. Elizabeth Hodgkins that increases insulin by 0.5u steps depending on the BG; that's where I got the 4+u idea. I feel like the strategy I suggested above has the advantage of being more protective against hypo-g and finding the lowest effective insulin dose. She feels this shouldn't be an issue w/wet food and measuring BG 3-4x/day and will control the BG faster. What do you all think?

 

I've moved this thread over to the main health forum...please visit it HERE, thanks!!: http://www.felinediabetes.com/FDMB/...ated-sick-kitty-please-help-thank-you.156623/