Chuck's bouncy journey, part 14.

Old thread: http://www.felinediabetes.com/FDMB/threads/chucks-bouncy-journey-part-13.173168/#post-1906600

AMPS: 459
Fed 4.5oz (not sure if water was added) .8oz snack at +2.5. 1T YA @+6.
Gave 5.2 units. (DH eyeballs dose on u40 syringe which drives me insane. Why not just use the d*mn u100 syringes- that's what I bought them for!!!)
+2.5 397
+3.5 384
+6 370
I will try the old bottle again with a more aggressive dose tonight. If the results are the same I'll call the vet. I emailed the manufacturer of ProZinc and asked if they have any programs to help in my situation of damaged insulin from user error. Worth a shot. I also have a lead on possible replacement from CA. If all else fails I will call the vet and see if they will make an exception for a payment plan on half the cost.

 

I JUST remembered that I will have a $40 credit if they let me return the needles I bought with the insulin! I'm not above begging! LOL

 

PMPS (+11): 515
Fed 4.5 oz + 2 T water. .8oz pate +1T water @+2.5. 1T YA @+4.5.
Gave 5.8 units from old bottle.
Will monitor. Vet agreed to refill insulin early. Will be able to get it tomorrow.

 

+2 547

 

+3 502

 

+5 430
+6 410
He got a bite or two of Kitty's friskies pate. I have taken counter measures (at +5) to deal with the potential increase and to try to get his numbers lower.
I'm waiting for a urine sample. Smart little turd keeps digging up the plastic wrap and peeing under it.
Feel like I should add this: ***DO NOT COPY MY DOSING*** I am currently dosing with a damaged (from being out of the fridge) vial of insulin. The increase in recent dosing is from this. Getting a new bottle of insulin tomorrow.

 

+7 358

 

lol

 

+8 336

 

Finally! NEGATIVE KETONES!
+9 309

 

+10 289 Finally under 300... Getting +11 then off to bed. Dh is going to delay AMPS.

 

+11 310
PMPS (+12): 390
Fed 4.5oz not sure if water was added.
Gave 5 units.
Running in 400s up til +5... Updating SS later today.
Picking up new vial of insulin around 1230.

 

Good luck with the new bottle. Sorry you had to go that route

 

I got an email back from Boehringer Ingelheim Animal Health, people who make ProZinc. She wants me to call her. I will once I leave the garage.

 

Interesting ...

 

Hopefully something good

 

+12 318! Tested twice.

Stick with 5 units on the new insulin?

 

+11 310
PMPS (+12): 393
Fed 4.5oz not sure if water was added.
Gave 5 units.
+1 421
+2 462
+4 396
+5 410
+5.5 424
PMPS (+12): 318
Fed 4.5oz + 2T water. .8oz pate + 1T water at +2.5. 2 tsp YA @+5.5 2tsp YA@+9.
Gave 5 units. (new vial)
+1 536

 

+2 417

 

+3.5 347
+5 308

 

+7 358
+8 339
Not impressed with numbers tonight. We will see what tomorrow brings.

 

Lower dose though.

 

Yes and he dropped earlier than the last bottle.

 

I tried reaching the rep at Boehringer Ingelheim Animal Health. Then re-read the email and it clearly states she will be out of the office the rest of the day. *derp* It's been a very strange day.

 

AMPS (+11): 444
Fed 4.5oz pate + 2T water. .8oz + 1T water at +2.5. 1T YA at +5.5.
Gave 5.4 units.
Will monitor.

 

I just bought him some Zobaline for his legs. His back legs have been a bit shaky some days.
I also bought him some "PetAlive Pancreas Booster" http://www.onlynaturalpet.com/products/PetAlive-Pancreas-Booster/230076.aspx
Hopefully they will help move him along into better control.

 

+1 529

 

Let me know how the Zobaline works. Cliff's legs have gotten progressively worse since Dx, and when I asked the vet about it--she said to focus on getting his BG down, as that's the only thing that will help.

 

That's what mine said when I asked about B12 injections. Let me know too!

 

I will update on how it's working.
Unfortunately the new insulin doesn't seem to be working much better. I'll update the numbers and SS around 10pm. (1hr 45 mins from now)
Busy day.

 

+2.5 436
+4 393
+6 397
AMPS (+13.5): 518
Fed 4.5oz +2T water. .8oz + 1T water @+2.5. 1T YA @+5.5
Gave 5.8 units
+1 "HI"
+2 425
+6 358
+7 378

What the h*ll is going on?! I just don't get it!

 

+7.75 382

 

Could something else be effecting?

 

I can't recall, Steph, did you get tests done for high dose conditions?

 

I'm not sure. What else could it be? There's no contraband available. He's getting better hydrated but I don't see how that would hurt his numbers. I'm just at a loss. Maybe he's got a bit of glucose toxicity? And I need to find his breakthrough dose again? We got a yellow this morning but it's a high yellow so it could technically be a pink.
I'm bummed he's been high and flat. Wondered if dose was too high but we see some movements in numbers this morning so I think we are going in the right direction.

 

No I haven't had him tested because we found a dose around 6 that worked.

 

I know you just got a new bottle of Prozinc, so if you don't see some improvement by the time it's almost used, you should consider getting him tested. Even if he's stable at 6-7 u, that's considered a high dose. Hopefully it is just toxicity and you break through and your dose comes down soon!

 

AMPS: 381
Fed 4.5o +2T water. .8oz pate +1T water@+2.5. 1tsp YA @+5.
Gave 5.6 units
+1 487
+2.25 483
+4 377
+5 287 Happy to see the yellow. Won't be home to test again today. DH is feeding and shooting this afternoon and I'll be home at pmps+4... DH can test at +2.75 before leaving for work...

 

I will keep it in mind. It's been almost 8 months since his last bloodwork so I've been thinking about getting some done at 12 months but if we need it sooner that will be done.
I had hope because we were seeing blues on a 5 unit dose then it all got messed up. I was thinking we were starting to see some help from Mr P...

 

The high dose tests are separate from regular bloodwork and can only be run by Michigan State University. Your vet will have to contact them for info if/when you decide to have them run. One thing you could try is a switch to Lantus or Lev. If it's toxicity or resistance sometimes a switch can help. Let's hope he finds his dose soon and you won't need any of the above ideas!

 

I just thought of this: I'll have to go back and see when I started the glucosamine/chondroitin supplement. I wonder if that might have some effect on his numbers. I'll get back on a bit later to search my posts... For now I have to make breakfast for two little ones.
Thanks for the input.

 

I vote for some glucose toxicity from being high, Steph. I think some kitties get it quite quickly, Teasel being one, and you know the drill - increases until you break through.

 

I agree. Looks like we are back to the same dosing as he had in December and January. So I will be more aggressive with dosing on pm and weekend doses. DH has vacation coming up too so hopefully we will get him closer to regulation numbers soon.

 

Hi Steph--how much does Chuck weigh now-a-days? My vet had given me a # of 8 units that we could go up to (based on Cliff's weight of around 12lbs) before he was considered insulin resistant to ProZinc. Perhaps Chuck needs a little increase to get him back down in the blues? Don't give up!

 

He's up to 10.8 pounds and gets a total of one can of 9 lives meaty pate and 1-2 tablespoons of Young again zero mature per cycle.

 

DH just called said
PMPS: 324
Fed 4.5oz +2T water.
Gave 5.6 units. I should be home around +2.5, earlier than I expected so I'll be there to monitor. I might try YA in place of the usual .8oz pate snack of his numbers are dropping at a normal pace.

 

Yeah, I don't know how the weight translates to units, but it would seem to me that you have a little more room to go up before looking into other options (switching insulion, etc..)

 

He should be 12 pounds. I'd be happy with 11.5 pounds too. I'm hoping he starts getting some muscle mass back. I try to get him to play for a bit every night to get his muscles moving. He loves the laser dot but so does the drooler! She's OBSESSIVE over it. To the point that she's not allowed to see it or she'll drive me INSANE for 2 hours searching the house for it. DH tries to get some play out of him too while April is in bed with me.

 

Sounds like you guys are really good to your cats!

 

GOOD news is we are seeing some movement in numbers after adding a micro dose. AND we didn't see a huge spike after his meal. I feel like we are starting to get somewhere.
PMPS: 324
Fed 4.5oz +2T water. 1 tsp YA at +3 and +5.
Gave 5.6 units.
+3 342
+4.5 306 .1u given. DO NOT COPY MY DOSING!
+5.75 254

 

We sure do try. They are our "kids". We never wanted human kids but are crazy about our furbabies.

 

Those of us who didn't want human kids (and I'm one of them!) do spoil our furbabies!

 

+6.5 218

I do know some people with human kids that still spoil their furbabies but I know for a fact we wouldn't have much money to spend on them if we had human kids! I get my human kid "fix" by babysitting my friend's children. I get to leave them with their parents when they get too much to handle. LOL it's the awesome part about babysitting... of course teaching them the basics and watching them grow and learn is amazing too. The little one I've watched for about 3 years now is starting Kindergarten this year! His sister starts next year! Their mommy is due with #3 in August! It's like starting all over again! I told her she's nuts. lol

 

Yes!!!

 

+7.75 239
+9 221
+10 299

 

When do you sleep?!?

 

HAHA. At first I was sleeping in 1 hour naps. Now DH helps monitor over night. I usually am in bed by 3am. On days I have to get up early I go to bed around 11 or midnight and am up again at 6am. Dh gets home around 1am and monitors until around 5am. Usually longer on the weekends. then I try to get up mid cycle for am cycle but lately I haven't had to because of his high numbers.
I have been trying to feed and shoot once I know his numbers are rising even if it's early. I have a TON of data so it's better than letting him get to 500+
DH is going to take over and he will message me his readings and if I can't fall back asleep I get on here and see what's going on. (I have no life lol)

 

AMPS (+11): 377
Fed 4.5oz pate + 2 T water. .8oz pate + 1T water @+3 and 1T YA @+5.5.
Gave 5.8 units.
Hope to see some BLUE this cycle.

 

+1 482

 

+3 404

 

Huzzah for data! One of my Aunt's almost made me feel bad when I told her I like to try and test Maury 4 times a day. But how else am I going to learn how he's doing? So I made my argument and didn't feel guilty at all

 

Ah! Two people testing makes sense! I was wondering if you had some super power that allowed you to go without sleep

 

+4.5 433
PMPS: 417
Fed usual with usual snacks.
Gave 5.8 units
+1 515
+3 351
+4.5 275
Won't be home til AMPS. Glad to see numbers falling!

 

AMPS (+13): 460
Fed 4.5oz pate + 2T water. .8oz pate + 1 T water @ +3 and 1T YA @ +5.5.
Gave 6 units.
DH will monitor.
Looking for BLUES today!

 

My baby boy.

 

He's awesome looking.

 

OMG - Mr. Personality is written all over his face, Steph! Such handsome, distinctive boy!

 

He's like a little white tiger!

 

What a handsome guy!

 

I've been thinking a lot about the acromegaly. Can he be an acro cat if he's not gaining weight? He's still under weight at 10.8 pounds and it's taking a long time to get him to gain. Googling pictures of acro cats he doesn't seem to look like one to me. But his recent dosing is driving me nuts.
AMPS (+13): 460
Fed 4.5oz pate + 2T water. .8oz pate + 1 T water @ +3 and 1T YA @ +5.5.
Gave 6 units.
+1 HI
+3 397
+4 354
PMPS (+11): 416
Fed 4.5oz pate + 2T water. .8oz pate + 1 T water @ +3 and 1T YA @ +5.5.
+3 385
+5 404 .4u given *DO NOT COPY MY DOSING!*
+6 331
I was also wondering about Vetsulin... That is the one that is a mix of a quicker acting and loner acting right? So he wouldn't get such a food spike after eating and maybe surf longer? I know prozinc is a favorite for some vets along with lantus. I haven't talked to his Vet about any of this yet. Just trying to get some input from you all so I don't go in blind/deaf/dumb. Someone also suggested an R insulin for meal time. I know that's a very fast acting and can be dangerous so it kinda scares me but I wonder if it would help with his mealtime spikes in a micro dose amount? I don't plan on making any changes soon. I want to finish out this bottle of prozinc at least. DH used the "warmed" bottle the other day. I'm going to mark that on his SS. Just found out today.

 

Not sure about the acro...could ask in Health maybe and someone can give you some insight?

Vetsulin is much harsher I believe so it would drop him faster...but I don't believe it's longer acting. I think it's more like 8 hours.

As for R, I know it's been used in conjuction with Lantus, but never with Prozinc that I know of. @Bobbie And Bubba didn't you use R at one point?

 

If you choose to switch insulins, I'd recommend either Lantus or Levemir. They are both long lasting and give a smoother curve. With a higher dose kitty most will recommend Lev because at higher doses Lantus can sting some cats. The physical signs of acro don't always show early on. My vet kept insisting Colin didn't have it because of having no outward signs. I had to insist on the test. He was very surprised at the result. He still hasn't gained the weight, holding steady at 12# and the only thing I can see is his lower jaw is a little longer than it used to be. If you'd like, I can tag Wendy and Julie who are the acro gurus in L&L and they can give you more info.

 

Sure the more info the better! I will look up Levemir. I have been following Kris & Teasel and it gives me increased anxiety to see the same dose on such a lower number. I'm sure it's because I'm accustomed to the prozinc and lantus is different. I will keep your experience with Colin and his acro test in mind if my vet isn't willing to test. I mean if it's a blood test and I'm paying- why wouldn't she want to? But I have had my fair share of vets that couldn't be wrong. haha.

 

Yes, Steph, dosing on those low numbers takes some getting used to. The time it really gave me the jitters was on 02/25. For blues, I'm OK. There's no sliding scale dosing though with the Ls.

It's a no shot for Teasel tonight because he's far too low. I'll be reducing his dose a little tomorrow AM. This was a nail biter number.

 

Yes there is definitely a difference in Prozinc dosing and depot insulin dosing, but there are a lot of folks on the L&L forum to guide you. @Wendy&Neko and @julie & punkin (ga) are two of the best and know their high dose kitty stuff! They will give you some info on acro and IAA and be glad to answer any questions you have.

 

It is my understanding that Vetsulin is a fast acting, with harsher drops and not the duration of Lantus or even Prozinc.

I did use R with Bubba along with Lantus and I do believe I read on the boards that it has been used in adjunct to ProZinc but I am not positive who it was that said that or who has the knowledge to use the two together . If not used carefully, it could make bouncing worst.

 

Yes! I would be a mess. I am quick to panic and steer but was getting better about not getting to ahead of myself but lately it hasn't mattered since he's been so high. I like the progress you're making though!

The R would be scary for me because some days, usually mid pinks or lower, he doesn't spike much after his meal. Other days he spikes hard. I would be hesitant to give it until I saw how big the spike was which would kinda defeat the purpose of it. I read a bit about lev and think it sounds like it could be a possibility in the future if we decide we need to change.

 

I don't think I could handle giving R insulin myself. Tricky kitties will still be tricky on an L insulin but you can see that Teasel has done his version of levelling out. I hope to see more of that.

 

If it turns out you need R, there are several pros in L& L that will guide you. I've never used it, but many high dose people do and it can help.

 

Yes, especially if he's poorly regulated. Remember ECID -well, the same for acros. Neko had acromegaly for 5.5 years and never got above 15 lbs. The vet thought she was a good weight (part Maine Coon). We've also had some petite acros that weighed a lot less. The other thing to consider is IAA or insulin auto antibodies. It's less common condition but we do see it around. Neko had both. A recent study at Royal Veterinary College in the UK showed that 1 in 4 diabetic cats had acromegaly. The cats in their study (over 1000 cats) had doses ranging from 1 to 32 units, with an average of 7. Neko's vet originally thought she had to get to 10 units (for her size) before testing for acromegaly. We never got that high.

Only 35% of acros show clinical signs on diagnosis. Neko's only signs were a tearing eye (which I found out much later was due to soft tissue growth in her tear duct), her dose, and an obsession with bread products. A lot of cats don't show physical signs until much later on in the disease.

I wouldn't go there. We were on Vetsulin first (properly called Caninsulin for canine insulin in Canada). For cats with a high dose condition, if he has that, the longer lasting L insulins are better. If your kitty is a high doser, I would in fact recommend Levemir, as Lantus can sting at higher doses. And yes, R is an option used by some people with acrocats (or IAA) but my experience is only with the L insulins. The later onset in Levemir also makes R use easier cause you have quite a bit of time after shot time where the L insulin is still wearing off and the R can do it's work.

I've seen a lot of vets relunctant to do the test. Mine was as I said. I asked her to humour me. Boy did I earn points when both tests came back positive. Depending on the age of the vet, a lot of them were taught "this is acromegaly, you'll never see it, it's so rare". The research on it being more common is fairly new. Neko's vet diagnosed another in her practise a few months after Neko's results came in. Now she knows what to look for. And remember, you want the IAA and the acro test. Some are one or the other or both. Dosing strategies can change based on results.

Feel free to ask questions - here's a place to start if you like to read.

 

Teasel is keeping you on your toes! He sensed you were relaxing . Although I do feel like Maury sense this and then throws me a bounce

 

Wow. Chuck's right eye tears up and gets more gunk than his left eye. Thanks for the info and I'm off to read it now! I will call my vet and see what she thinks about the two tests. Is there a way to test if the pancreas is producing insulin at all? Or is it more of a rule out other conditions first type thing?

 

Not to my knowledge. Acros generally have working pancreases. And the rest of the sugar cats have pancreases that sputter and produce some insulin. Usually we suggest that if people have increased safely to dose of 6 units (or there abouts), the cat has no infection/inflammation (ie, such as dental needed), and are eating low carb wet or raw food, then it's time for the high dose tests. There are other conditions that can cause some insulin resistance, like hyperthyroidism, heart conditions, pancreatitis, kidney disease, but not usually to that high a dose.

 

He has been unofficially diagnosed with IBD. Never treated with anything other than fortiflora. Maybe I should start there?

 

+7 316
+8 332
+ 10 223
+11 341
AMPS: 341
Fed 4.5oz pate + 2T water. .8oz pate + 1 T water @ +3 and 1T YA @ +5.5.
Gave 6 units. I was going to increase to 6.2 units but because of the extra at +4 I decided I would wait til tomorrow PM to increase the dose.

 

Still complicated times with Chuck, I see. Hopefully you can get your vet to do some more testing that might give you some answers!

 

+1 356

 

Awesome! Nice to see no immediate huge food spike Keep it going, Chuck!

 

DH thinks the micro at +4 or +6 is a good idea to get rid of the food spike but it's not practical for us.

 

+2 301

 

+3 185 Just got his .8oz snack. I'll test again in 15 minutes

 

Wow that's a surprise! Hope he levels out some and has a nice surf there for you!

 

+3.5 163 gave him .5oz pate. It's early in the cycle so I expect him to go down more.

 

+4 124 gave .8oz pate

 

+4.5 138 no food

 

+5 147
Think I gave too much food. Hopefully he won't bounce from the "lower numbers" and big drop. We will see. I'm off to bed for a couple hours.

 

Chuck heard about the possibility of tests and said NOOOOOO!

When is the last time Chuck had a good vet work up? I tend to think of high dose conditions because you've been trying with small increases for awhile, but it's true that other things could cause it...

 

Last bloodwork was 8/2016. Results are on my SS labs page. He was looked over when we switched our vet in October I think, maybe November. Oy, my memory is so awful. If have to look at the stack of vet papers to see for sure.
I might have to take my dog in so if I do I'll book a double appt and take him too. April had too much of a treat that disagreed with her belly and is going on 72+ hrs of GI upset.

 

PMPS: 451
Fed the usual. Snacks at +2 and +5
Gave 6.2 units
Will monitor.

 

+3 425
+4 386
+7 353