Had our first hypo episode; also looking for advice on a difficult work schedule

Hi all! My 12 year old cat Kira was diagnosed a few months ago with diabetes--her sugar was up around 230 when diagnosed. I had been feeding her Merrick dry food and switching to ProPlan DM* didn't help--if anything her sugar tended a little higher, right around 260-280.

We've been easing her onto ProZinc and last week switched her to two units on a U-40 syringe. On Saturday, 12 hours after her last dose, her sugar had actually hit a record high of 300! The vet had us switch to 3 units. We skipped that morning dose, but Sunday night she had a hypoglycemic episode an hour or two after her evening shot. We don't have a meter (which is, I am learning, a no-no) so I don't know her numbers, but her gums were pale, she was a little unsteady on her paws, and she was definitely lethargic. I got most of a can of Fancy Feast pate into her, mixed with some tuna, and when that wasn't helping much, gave her some karo syrup. Probably should've done that the opposite way around.

Anyway, within four hours she was back to her normal behavior. We skipped the morning dose and now I'm not sure how to proceed. She bled a little from the injection site--could I have hit a vein or something? Would it take three doses for a clear episode to occur if 3 units is too much? I mean, she could also just have not eaten enough; I free-feed dry since I'm not home during the day.

The more general question I have is figuring out a dosing schedule. I leave the house at 7:00AM and don't get back until 7:00-8:00PM, depending on work. In the morning I've been putting food out at 5:00 and dosing her at 6:30, if I see that she's eaten, but what's the best way to proceed in the evenings?

*She's a gravy-licker--I've never had much luck getting her to eat pate, or even Tiki succulent chicken. I'm debating trying Northwest Naturals Freeze-Dried Raw or Young Again Zero Carb Mature after I get a meter.

 

Hello. Welcome
Yes you are correct that the only way to keep her safe and know what is going on (how an insulin dose is affecting her) is to home test. There is a lot of great advise on the forum for tips, tricks, and step by step instructions. My own cat purrs while he is being tested.
As to her numbers, my vet told me that the BG numbers are often inflated at the vet clinic because of the stress the cat is feeling. If the amount of insulin is based on these artificially raised numbers then there can be a problem.
When you dose ProZinc insulin (and my apologies if you already know this) two doses are given 12 hours apart. The am dose for example will start to lower the BG approx. 4 hours after injection. Roughly 5-7 hours into the cycle Kira's BG will be at the lowest. The cycle (the 12 hour period between injections) thus resembles a smile curve.
If during this lowest "drop" (nadir) Kira's BG drops too low or even lower than she is used to, her liver will release glycogen to try to come to her rescue. This will result in a high BG, called bouncing. It is for this reason that you will read "that too much insulin can look the same as too little insulin". The only way to know if this is happening is to home test.
Generally we test before each injection (AMPS - am preshot and PMPS). If possible it is good to test mid cycle. When work prevents this, people test mid cycle on weekends or their days off. A test before bed is useful information as well.
Generally any dosage changes are when you are able to test mid cycle. They are usually in .25 increases/decreases.
As to food, if you continue to feed her higher carb food she will require more insulin to compensate. If you decide to switch her to a low carb food you will need to do it gradually and be home testing. A change to a lower carb food can drop BG as much as 100 points. Some people have had their cats diabetes controlled strictly by diet.

 

Pati has given you some great info. One thing I wanted to add is that your kitty may be careening from lows to highs and as Pati said, home testing will help you see that. When a cat's body perceives a glucose level that feels too low, it releases extra glucose to compensate. So the next level can be high because of the bounce caused by the extra glucose. Adding more insulin at that point can make the problem worse, causing lower lows and higher highs. Giving a dose and then getting a level around 5-7 hours later can show you whether that is what is happening.

2/3 units is a high starting dose. We suggest 0.5 to one unit and increasing slowly based on home testing. If you are not home during the day, you might try getting a mid cycle number at night to see some patterns. And then on your first day off, get a curve - levels every 2/3 hours to see how the insulin is working.

 

They can be more sensitive to the insulin after a hypo event too. I would start with getting some tests done (sounds difficult to some but it gets easier with each test) and if insulin is needed start lower, like Sue and Oliver said.
My cat has a tiny bit of blood after his shots. Not every shot. I chalked it up to more "movement" with the needle trying to push the insulin. I have a slight tremor in my hands and I feel awful when I'm extra Shakey some days.

 

Hi Mom & Kira, I am new to FDMB, joined 1/2/17. I do not have enough experience to give advise, but I would like to tell you what happened to me. I read a few post from members and realized they all test at home (the vet taking care of my cat told me most do not test cats). My cat Buddy was started on 3u of ProZinc. When at Wal-Mart I decided to look at BG monitors. While looking I saw one that I had seen mentioned, it was a Reli-On Micro Meter. The cost of the meter was 14.99 & I could get 20 test strips for 8.99, it contained lancets, so that was all I needed. When I got home with the meter I had problems getting blood from my cat's ear, so I did not use it like I should. Buddy went in to the vet for his first curve, the kept him 3days and 2 nights. When I picked him up, the vet told me that Buddy was on 5u of ProZinc, I thought boy was that an increase. For some reason I decided that I was going to test Buddy, he decided I was not going to test him. When I finally did the test it came back at 41, I thought the meter was broke. I called the number on the box and they ran me through some test on the meter & strips, they said nothing wrong with strips or meter that was the correct reading. As soon as I got off the phone I took another reading, this time it was at 35. Buddy did not have any insulin that night. If I had gave him the 5u that night, with him already being HYPO, their would have been no bringing him back. I also had a HYPO incident today with Buddy. Buddy shows no sign of being HYPO, you can only tell by taking a BG reading.