Here we go again..

Dottie and I are playing a game of insulin tag. She's on Protamine Zinc Insulin, and we're in the first days of getting her regulated.

This is proving to be quite a challange. She's had dental surgery to remove all her teeth, and her mouth was severely infected before the dental work. (stomatitis). She had also been given prednisolone to try to control the inflammation. ALSO she does not react well to surgical anesthesia and it took her several days before the effects finally wore off.

NOW, suddenly she is feeling better, wants to play..but getting her numbers down is proving to be an issue.

Before her dental surgery her BG was at 445.

Here's her numbers for today.

12:30am 165
3:15am BG 206
4:45am BG 231
11:00am BG 248
3:15pm BG 274
7:30pm BG 204
9:45pm BG 105


Chris is helping me with Dottie's spreadsheet and I just sent her the BG numbers ( I have visual issues that make that Spreadsheet daunting..but I'm working to develop a workaround soon)..not sure if they'll be up on the SS yet.

Originally my vet started her off at 5 units. But he wants me to report problems, and yet when I do talk to him on the phone I am keenly aware that he's in a rushed state..he's between patients. And he can't hold everything in his head..he's not a computer..and he probably didn't have Dottie's record in his hands when I talked to him..the vet tech kind of just dragged him away from another patient.

So the 5 units wasn't enough at the time so the very next day he upped the dose to 7 units, and she had a bad crash. So he dropped back to 5 units..and she had a scary dive with that. This is when I started to really ask for help here, only on the main forum. Doc said divide the dose to 2.5 units BID...we did..and that seemed too strong as well. So I'm not sure if we now need to go back to once a day injections or not. I rather like the idea of BID because I feel we can get a better all even distribution of numbers, but for the past two days I have not been able to give two injections a day.

Today after her 11am test I tried a very small dose of insulin, .2 of a unit, Protamine Zinc, (100u/ml)..after the pretest. I also fed her 15 minutes after the pretest. As you can see, the insulin had little effect so tonight I want to try .5 of a unit.

As you can see, between 7:30 pm and 9:45pm there is a BG drop of 99 points. This has to be because she suddenly got taken by a fit of playing. She loves her little krinkleballs, (mylar crackly sounding toys), and batted them all over. After she played I even fed her a meal of Friskies Chicken & Tuna pate, to try to head off a BG drop...but her number went down anyway.

Looks like I'm going to be living A LOT in the Prozinc forum for at least a while. I need wiser heads who use Prozinc and are familiar with it's protocol.

What do I do when she wants to play? Banish her to another room without toys until we can get a better fix on what she needs as a dose?? The evening before was pretty much the same..when she plays her BG takes a nosedive.

My feeling is that her body is still adjusting to Life Without Infected Teeth And Gums, not being on prednisolone, and bad reactions to anesthesia during surgery. So her body is changing even as I try to anchor her with a good daily dose of insulin.

Help! I need help, from other Prozinc users.

 

Actually, exercise is good for her!! It makes insulin more available to the cells (which may be why her BG comes down after exercise)

I wouldn't increase her....I'd continue with the .25U dose and see if she can even out but let's see what the ProZinc people have to say @Sue and Oliver (GA) @Rachel

As for tonight, if you shot at 11 this morning, that means it's about time to shoot again...You might want to stall, don't feed her and test again in about 30 minutes and see if she's coming up

 

Yes I'm going to wait a little bit. Hopefully her numbers will rise.

On a good note: no more trouble getting a blood sample from her. Her ears are becoming quite cooperative in giving out drops.

 

Ok I just noticed something: There's a precautionary note in the PZI links...about ProZinc compounded by Wedgewood pharmacy. That is where my vet got Dottie's insulin.

"If you get from a pharmacy not listed here, make sure you are getting the real ProZinc in the green, blue and white bottle pictured here and not a compounded insulin like Wedgewood or others."


So what's the story about Wedgewood? Why is compounded ProZinc bad? This is probably where my vet will draw the line about getting insulin. He wants me to get it through him.

 

The issue with compounding pharmacies seems to consistency from batch to batch. I don't think you need to be worried about it right now. It might matter weeks or months from now if you need to get a new bottle.

 

Compounded isn't "bad". Lots of cats do well on compounded insulin. Mine did, he only needed it for 10 weeks and went into remission.

 

Like Chris said, playing and exercising are great things and help the body burn energy (from glucose) so seeing the numbers go down from activity is a nice thing to see.

Do you think your vet would be open to looking at your spreadsheet? That might be a way to keep him up to date while allowing him to do so on his own time when he isn't rushing from one case to another. You could just send him the link. I used to fax Bob's numbers to my vet every week.

 

Our vet seems a bit defensive. When he told us Dottie had diabetes we basically got the insulin and needles, told us to give x units, and call him in the morning if we had trouble. Didn't even suggest we look online for help, and didn't want to go into details. Just "do this" and good luck. If a doctor did that to a person with diabetes they'd lose their license.

I might mention that he is definitely a 'dog person'.

 

Annnnnd oookkk...Just did another BG and Dottie is down to BG 85

 

Looks like you'll be skipping again tonight!!

Don't feel bad....it could be that her pancreas is sputtering back to life and that's going to lead to some wonky numbers....but it's good news if it is!

 

Ok then I'll cross my fingers, hene..and I will feed her then.

 

85 is fine. But no insulin tonight. Way too low to give a shot.

 

Did she get the prednisolone before or after she was diagnosed with diabetes?

 

She was on prednisolone for about 12 months, off and on, before she was diagnosed. In fact it was the diabetes that caused the vet to stop her prednisolone.. Because of her problems with Anesthesia, the vet and we were quite worried she might not survive surgery, but the response to prednisolone kind of forced the issue for us. She had to have all those teeth out, because her mouth was so sore at times she couldn't bear to eat. She didn't have many teeth left, just her canines and a couple of molars, (stomatitis)...but what was in there, had to go.

Now her mouth has no odor at all. FINALLY. And she looks rather endearing, with her little pinched mug. Already I can see signs of her face changing because nothing is swollen and her teeth aren't there to fill out below her cheekbones. That's why I changed our avatar. This is how she looks now.

That's her little blankie in the pic. She's had that for at least half her life, and she sleeps beneath it. She thinks we can't see her when she hides.

 

Hi Jeanne!

I think you're right...she's getting used to life without infected teeth and being off the pred. The good news is, those low numbers are what you want!

I do think 2 shots a day generally works better than 1. As you say, it usually allows a more even distribution of insulin. I believe there has been one kitty who did well on 1 shot a day on this board...and that's definitely the exception. HOWEVER...if the numbers are too low to shoot, they are too low to shoot!

I think keeping the dose at .2 is a good plan. Honestly, if it continues to give you such low numbers at one preshot, we might have to go lower.

You're doing great!

 

If we go any lower I'll have to lean over Dottie and whisper "insulin!" Sort of like making a very dry martini, huh?

 

Maybe you can just hold the bottle near her and she'll manage to absorb what she needs!!

 

Hi Jeanne! Sorry I didn't see this thread sooner, rough day here. Actually the numbers I'm seeing are pretty good numbers. A few were maybe a little low considering that you're using a human meter.

Prozinc does work a little differently, in my experience, its a little bit slower acting and lasts longer. Goof was the exception to almost every rule regarding FD, my vet and I learned a lot from him. Lol

With Goof, who's bg was 652 at diagnosis, we started him on 1u, the highest he ever got was 3u. After a awhile, he only needed only one shot per day for about 3 weeks, then he went into remission.

He now needs a shot only on occasion. Don't know why that is, but if you look at his SS, but that's just his norm I guess. Every cat is different and it'll take a little time to find out what Dottie's "norm" is.

All of that stuff with her mouth can most certainly be causing the wonkiness in BGs. If you get a day where you can get a curve, that'll tell you more about how she's using the insulin. And by all means, let her play as much as she wants to as that'll help burn the excess sugar.

 

Welcome to the PZI forum, Jeanne. Glad you found your way over here. The forum is smaller than Health so it may take awhile to get a response (especially later at night). If you ever have an emergency, post here and on Health so you get more eyes.

As Mog and I were suggesting on Health, it might be good to practice measuring some drops with an old syringe and water. Once you are confident about giving a drop or two drops or whatever you choose, pick a target shoot number. With her volatility (recent drop from steroids and dental and food change, and the possibility of her pancreas helping out) I would be cautious.

One thing that some people have done when their cats are in low ranges and just needing a tiny dose is to "chase the dose". Here is the specifics:

When your cat is consistently in numbers too low to shoot at shot time and in numbers in the 100 range and below during the cycle, you can consider micro dosing. This process should be guided on the forum by experienced members and will require more frequent testing.

You may be shooting at times other than the 12/12 schedule, when the blood glucose levels rise enough to require a small dose of insulin. You will need to pick a number somewhere near the 150 range at which you will plan to shoot, being sure that the number is indeed rising. The dose at these low numbers will vary with each cat and its patterns, so advice should be solicited. But you may be considering doses below .25 and even considering a “drop” of insulin. At this point, U100 needles and the conversion chart will be necessary.

It is important during this period to offer small frequent meals. You may want to experiment with the lowest carb foods to help bring down the numbers, staying away from seafood more than once or twice a week.

 

Sue, the link is there at the end of her sig. I missed it the first time I looked.

 

Jeanne,
The reason I asked about the pred.... She may have what is called "steroid induced diabetes".
I am using my phone at the moment, and linking is a challege. But just Google "steroid induced diabetes in cats" to see what I'm talking about.

 

Jeanne, you are a hoot! And I love that she is coming down!!!!

 

You both are right on the money about dottie maybe just needing a drop. Right now he for her midnight shot is due she is at 145 and I think if I give her a micro dose of one drop she might actually have a lower numbers during the day. I am prepared to watch her very carefully all night to make sure she doesn't take a nosedive. Cross your fingers for me big hugs to you all

 

Hope you had a good night. I would be reluctant to shoot 145 when things are changing so fast, but hopefully a drop was safe.

Jeanne, how about starting a new thread every day (or night - I know you are awake at night while we are asleep) maybe with her current numbers and the date. With a topic like Dottie 1/21. Amps 159. With the two threads going now, I am not sure we are catching all you are saying on them both.

 

Good idea Sue. I keep worrying about hogging the board, Guess a thread a day isn't so bad, though. Especially since we're just starting to do this dance.
Going to new thread...