I don't know what to do anymore

Hello, I posted last week about my 14 year old dipping into the 20 range when she should have been in the 200s. My cat has been a known diabetic for the last two years. She has been on ProZinc for about four months now after the vet was unable to obtain anymore PZI in the surrounding area. The vet has had her on 5 units twice a day for the last four months. With the advice of this board, last Saturday I moved her down to 1 unit twice a day.

She has been peeing around my bed (the usual place she sleeps) on and off for the past week, but I've been chalking it up to being mad about so many ear pricks last week since she's moving around just fine.

So, tonight I was inspired to test her sugar and found her to be at 56. She is usually 200+ a couple hours after eating. I'm heart-sick with grief since I don't know how to manage her diabetes at all anymore. I've paid the vet $1000+ in the last three months for them to tell me they don't know what's wrong. They're wanting her to come in for a $210 ultrasound (then charge me to read the ultrasound) and I simply cannot afford paying a month's rent every couple of weeks. With this in mind, I'm going to type up her chart that I've been keeping after finding you guys back in February. I'm praying that someone has some insight into what is going on here. Please keep in mind that most of these reading dates were at the recommendation of the vet, hence why they aren't more frequent. Also, I have no idea how often I should be testing her...

Key:
ABBS = after breakfast immediately before shot
ADBS = after dinner immediately before shot
AD = after dinner
The first column is ABBS, the second column is four hours later, the third is two after that, and the final one is ADBS.

Insulin:
2 units/2 day....................Feb. 14...............................496 ADBS
2 units/2 day....................Feb. 15.....335....335....273
(Unknown: New amount).......Feb. 26.....133.....55......69.....191 ADBS
No insulin last night............Feb. 27..... 460
(Unknown).......................Mar. 09.....427....142......99
3 units/2 day....................Apr. 14.....409....319.....288
4 units/2 day....................Apr. 30.....342....309.....220
5 units/2 day....................May 12.....314.....66.....111
5 units/2 day....................May 21.....321.....56.....147
5 units/2 day....................Jun. 01......270....115....130
Sugar drops to 40 on Jul. 20 at 6:30pm
No insulin last night.............Jul. 21......198....181....202
No insulin last night.............Jul. 22......279..................... 26 ADBS
1 units/2 day.................... Jul. 29.................................56 ADBS

Please help us.

 

That drop to 1u on Sat was good advice, but it looks to me that your cat is simply needing even less insulin. Maybe the pancreas is starting to kick in. Since 1u Prozinc is taking your cat too low, try .5u twice a day. Be sure to test and post your results, daily if at all possible.

I also posted a link to this thread in the PZI group so hopefully some of them will stop by and review your situation.

laur

 

Thank you so much.

I'm terrified of giving her any insulin tonight since I don't want to drop her any lower.

 

sure, you can skip tonight. I've heard it said many times here that a cat is more sensitive to insulin after dropping low. Also, you should have a number in mind, below which you don't shoot -- until you have carefully amassed data before gradually working your way down. THis might be 200 to start and again you may lower the don't-shoot-below number as you gather more data and learn about your cat's response to the insulin.

Will you be able to get midcycle tests tomorrow, if you give .5 in the morning? You really need to be testing before every shot, and getting mid cycle readings. THis is the best way to keep the cat safe, and identify the need for dose changes. if your cat's pancreas is healing, then the need for insulin may continue to drop.

laur

 

Is the pancreas healing sorta like going into remission? I'll only be able to do a midcycle if I give her the shot early---but I'm sure she'll be needing it after going 18 hours without it. I need to learn how to test her glucose from her paws to give her ears a break.

 

You mentioned in another thread that your cat has gained 4 pounds over her healthy weight of 10 lbs. What are you feeding?

You also mentioned $1000 in vet bills over the last few months. What were the symptoms or reasons that your cat was vetted? What exactly did they want to ultrasound, and why? Did the vet have any reason why she would be eating/gaining so much?

wondering what else may be going on,
laur

 

Dollbaby eats half a can of Friskies twice a day and then has free access to dry food (she likes to nibble every couple hours).

She went to vet in May the day before I left for a weeklong trip because she was dripping watery-blood from her genitals. The vet charged $350 and told me they didn't know why or where it was coming from. Then this month (7/11) I was charged $710 when I took her to the vet for being extremely disoriented as her blood sugar had dropped too low (which has never happened before and I had never seen it before either, which is why I took her in). Last Thursday (7/22) I found her again with the low blood sugar but this time the vet told me to stay home with her and watch her.

Last Friday I caught her urinating on my bed and there were a few drops of blood in her urine. Her blood tests keep coming back as fine so they don't know why she has blood in her urine. The drops in blood sugar also comes with a fever which only alleviates when she comes back up again. So, the reason they want an ultrasound is to see if there is anything else going on with her. She doesn't seem to be in any pain as she goes about her usual routine of eating, sleeping, and being grumpy with her younger sisters.

 

Hi,
It late, but i have a lot of questions for you, and I'm sorry if they have been answered before.
What can we call you?
Can you tell us a little bit about your kitty weight history and general size, (anything unusual about paws, face, belly?)
Which PZI were you switching from?
what is your schedule/do you work?
Did the vet do a urine culture or urine analysis since the "accidents". In a culture they stick a needle into the bladder and get a clean sample to grow in a culture dish to see if any bacteria grow, and which AB it might respond to. Some vets aren't able to do them...
Did they tell you what they hope to find by doing an US?
I assume you are using red capped u40 syringes with your Prozinc. Yes?
did your "Prozinc" come in a light green box
Other furkids in the house? Dry food around ?

I'm sorry I didn't read all of your first post because its late, but I understand folks suggested you drop back to 1u, and you did, and you had a 2nd hypo experience after that. and now you are afraid to give insulin. And that you are trying to stop feeding dry food, but she still gets some. Am I close?

Did you know there is a subgroup of the FDMB of folks who use PZI insulins, that can help you understand what others have seen and fine tune the dosing with Prozinc, and make other suggestions that might help you. For example it seems maybe a very small dose of insulin is all your kitty needs (less than 1u) Many, if not most of the low dose Prozinc moms here, use u100 syringes (with half unit markings) with u40 insulin (Prozinc) in order to get very precise quantity of Prozinc such as .2u, .4u, .6u, .8u . There is a conversion chart which tells you how to precisely dose kitty. If you ask for help on this topic, you will get pictures and the whole explanation until you are comfortable with it.
Heres a link to PZI forum: viewforum.php?f=24

Also, I can't help but wonder if your cat is one of those that will go off the juice when dry food is removed- wouldn't that be cool?
Heres a link about feeding felines by a vet who pops in here from time to time : http://catinfo.org/ It is excellent.


Usually folks try to test first, then feed, then shoot.
eating first will affect the numbers almost immediately.
feeding after test is a reward
shooting last once you know its safe- like above 200 until you get more data on how she responds.

When my cat pees out of the LB - it usually means infection - but then every cat is different.

the lingo for bg readings which helps since we are all in differnet times zones, is
AMPS AM preshot
PMPS PM " "
+1 1 hour after the shot
+2 2 '' ''' '' '
+3 etc

Welcome

 

Hi & welcome!!!

The BG #s do look to me as well as a sign she is needing less insulin, which is AWESOME!!! If you got a # that low on the 1u, I agree to reduce the dose, and skip tonights shot.

With PZI we usually have a no-shoot # where we don't give insulin if the PS (we use AMPS & PMPS for the a.m. & p.m. pre-shot tests) is below a certain #. The lowest # generally used is 150, but if you are still collecting data and not exactly sure what is going on, it's recommended to set the no-shoot a little higher than that, like 180 or 200.

So if you got that # at shot time, you would wait and retest in 30 minutes or an hour, and once it's high enough, then you give the insulin. That helps to protect from unexpected low #s. Or if it is really far from a shootable #, like tonight's 56, you may want to skip the shot rather than retest. Some cats will jump 100 points by the next hour, but some don't, so that's sort of a cat-by-cat decision. You are absolutely right though not to give a shot on a # like that, with PZI in most cases you do not want to give insulin on a BG # under 150.

It would be ideal if you can test before each shot, so then you better know if it's safe to give insulin or not (especially with her history!). Since her ears are tired, I would focus on getting those 2 tests a day, and then maybe every other day try to get the test that you've been doing 6 hours after the shot.

I would try to eliminate the dry food - my suspicion is she may not need insulin at all if she didn't have any access to dry food. I wouldn't want you to withhold insulin though if she does need it. The advice to cut her dose back to 0.5u makes sense to me, and if you can test before each shot and get in a mid-cycle test here & there (not needed every cycle, especially if her ears need a break), that will help you be able to determine if the 0.5 is a good dose for her or not. The dry food can really raise their BGs a lot.

HOWEVER, if you are not able to test and have given insulin, I would let her have whatever her usual amount of dry is - if the dose is still too high, that will protect her from low #s. If you can test to be sure she isn't going low, then I would get the dry food out of the picture, assuming she is eating well on low-carb canned.

Overall, even though her #s are a bit scary in spots I think it is all a good sign that her pancreas is working, and that is really good news!

 

Hi,

I'm not a user of Prozinc.

Looksas if kittys body was protecting itself from the high doses of insulin and then got to a point it couldn't cope anymore. I can't see any explanation for why you went on to insulin in the first place. Did kitty lose weight and increase water?

Dry food can have as much as 50-60% carbs-this makes bg's rocket. Wet food (Friskies is excellent) is (following the ones on Janet and Binkys charts)under 10%, hence much less insulin needed.

I wouldn't mess around with Dollaby's shot times, just try and get +1,2, maybe a 4 (6 is approx the lowest number in the 12 hour cycle)and then your next preshot number.
The +1 will give you an idea of how carb sensitive Dollaby is. This number is usually higher than your preshot (AMPS)
The +2 will show you how quick the insulin is kicking in.
+4 is to let you know kitty isn't going to low
+6 Nadir (lowest number usually) this is geerally the number you base your dosing on. You don't want kitties going under 40 (50 really in newly diagnosed which I know Dollaby isn't)
Just to say you would always also look at your preshot numbers before administering a shot as well (as has been discussed by others here on this thread)

Post the numbers you get for more thoughts and cross post in PZI forum.


I have read some positive stuff about Prozinc, relatively new to the market (Nov 09 I beleieve)


I would suggest you post a new thread in health 'watery blood from genitals-thoughts?' There may be others here who have experience of this.

The peeing around the bed could be a sign of infection and Dollaby associates the litter box with the pain she gets when she pees (she? He? sorry not sure)

Last thing-not all kitties will thank you for trying to take blood from their paw pads,depends on their temperament. If Dollaby is getting sore ears, get some neosporin. Also when you have pricked and got your blood, hold piece tissue over it and press gently,not toolight but not too hard. This will help prevent bruising. Lucky's ears were always a mess when she came back from the vets as they just didn't get this basic piece of info!!I also swapped between the ears each day.

Good luck :mrgreen:

 

I would like to comment on t dry food.

I have one civvie and she eats ONLY dry. Long story but she will NOT switch, and is stubborn enough to starve if she does not get a certain type of dry food. I think she would die if I did not give it to her.

Anyways, I have to cover it when not around because if my FD kitty Shadoe gets even a mouthful of 3 or 6 little pieces, her numbers go through the roof! She cannot eat dry at all without her BG numbers being extremely influenced.

There was another fellow who was giving his kitty 20u of insulin and was feeding dry. He switched to wet and had to drop down to 1u within days! Food can make a HUGE difference so it could be that you may well have a lucky kitty who may be diet controlled.
Maybe trying just the friskies, and leaving extra out in case of going low and needing to feed the low.

 

Wow, so many things to answer! I'll try to keep the answers short and separate my response to each poster in a different paragraph. I'll copy and paste some parts.
Her reading this morning was 259, 18 hours since her last shot. I gave 1/2 unit. Dollbaby: http://farm5.static.flickr.com/4064/4526887431_391d70464a_o.jpg

Nancy and Cody:
Hello, I'm Amanda. It is nice to meet you.
Dollbaby actually has a very delicate build, but (from what I strongly believe is caused by ProZinc) has gained weight so she's at that heavy point right before she becomes obese. Her neck is still slender but her belly is soft and low to the ground. Most of her teeth were removed last November because they had rotted. Her face stopped being puffy almost immediately afterwards! As soon as I got her home, she shoved her face in the dry food and ate for 10 minutes straight she was so hungry! If you clicked on the photo, you'll see that her eyes are no longer as reflective as they once were.
I...don't remember which PZI but it was in a blue box with a gray and white (I think) kitten. The ProZinc is in a green box.
I go to school full-time, work for the school 20 hours a week (both from home and there), and this summer I have two internships so I'm not home a lot. Currently, I live alone so I don't have a back up person to keep an eye on her.
I haven't taken her back to the vet yet for the accidents. She had a urine culture done on the 11th which found nothing.
The vet wants to do the ultrasound because they don't know why she's all over the board with her glucose levels.
Yes, I use these little red capped needles. http://www.americandiabeteswholesal...are-Ulti-dsh-Fine-Insulin-Syringes/Detail.bok
There are two younger females (8 and almost 7 years of age).
Dry food is kept out because there are three of them. They're just like humans with different hunger levels, so they don't always finish their can food immediately and may want more later. Or one is greedy so the other doesn't get enough to eat. Since I'm not home a lot, I hate the idea of them sitting here hungry because there is no one to make sure there is something for them to eat, hence the dry food. Also the 8 year old has a tendency to binge eat wet food and then throw up so I can't leave an extra can sitting out when I leave for the day. She won't binge on dry food though.

Joanna & Bix
See, this is the information that the vet should have given me! I have a strong suspicion that they want me completely reliant on them for even the smallest thing ($$$), which is why I've been kept in the dark on what to do for Dollbaby's diabetes. I thought we were doing okay because she had gained weight back and was more active, but the last month has revealed that to not be the case at all!
There are two younger females (8 and almost 7 years of age).
Dry food is kept out because there are three of them. They're just like humans with different hunger levels, so they don't always finish their can food immediately and may want more later. Or one is greedy so the other doesn't get enough to eat. Since I'm not home a lot, I hate the idea of them sitting here hungry because there is no one to make sure there is something for them to eat, hence the dry food. Also the 8 year old has a tendency to binge eat wet food and then throw up so I can't leave an extra can sitting out when I leave for the day. She won't binge on dry food though.

kate and lucky
Yes, she lost a great deal of weight which is how I realized something was terribly wrong with her. My dad and I fought a lot about the issue since he claimed it was old age (she was 12!) that had ripped all the flesh from her. When she was diagnosed, the vet said that if she had remained untreated, she would have been dead within six weeks. That was two years ago!

Lisa and Witn (GA)
There are two younger females (8 and almost 7 years of age).
Dry food is kept out because there are three of them. They're just like humans with different hunger levels, so they don't always finish their can food immediately and may want more later. Or one is greedy so the other doesn't get enough to eat. Since I'm not home a lot, I hate the idea of them sitting here hungry because there is no one to make sure there is something for them to eat, hence the dry food. Also the 8 year old has a tendency to binge eat wet food and then throw up so I can't leave an extra can sitting out when I leave for the day. She won't binge on dry food though.
I'd like to leave off the dry food, but I haven't figured out a way to circumvent these issues. :-(

Gayle and Shadoe
Dollbaby looooves her dry food too. There are issues with food since there are two younger cats so it's hard to regulate the food.

Thank you everyone for your support during this very stressful time.

 

One thing that might work for you are automatic feeders. They will allow you to feed smaller more frequent meals of wet food. They might stop the bingeing and still alllow everyone to eat? We use the PetSmart5 which we love, but we only have one cat. You might do better with 2 feeders if two of your cats will share. We freeze the wet food and then he can eat it at his leisure, or we can put it in and leave for a day. Wet food will not go bad during the day unless you live in a very hot climate; it gets crusty but most kitties don't care.

The dry food makes such a difference. When we switched from dry to wet, Oliver's numbers came down 100 points overnight. We never looked back and wouldn't consider feeding any of our cats dry now.

 

another point i haven't seen mentioned is that it is possible your cat gained weight because she was on too high a dose. it happens sometimes.

the bloody pee thing worries me. would you be able to see a different vet for this? this kind of thing should not be hard to diagnose. i'd first suspect some kind of urinary tract infection, which could be traced by getting urine from the cat's bladder via cystocentesis and then doing a culture and sensitivity test (C&S) on it. an ultrasound or xray could also be warranted. did they do a cystocentesis or did they get you to collect the urine at home?

 

I just wanted to comment on the dry food situation. I also have 3 that would just wolf soft food because that had always been their treat and Smokey adored her hard food. When we first switched we did have binging and purging and sometimes Peanut would be really hungry when we come home because Smokey hogged most of the food during the day. That settled down and now they only eat enough to satisfy themselves and won't even touch the food if they aren'y hungry. Smokey will occassionally get possessive of the feeders, but the other two have learned to just take what they need. Most cats can transition to wet. Some take a while, but they get there.

We still put hard out for Peanut on a rare occassion when she seems to be hungrier than normal, Smokey leaves it alone for the most part. It seems like she's made a connection to the hard food disappearing and her feeling better.

We do have 2 of the 5 compartment auto feeders and 2 of the 2 compartment. Since the cats no longer binge, we leave them open most of the time, only close them when we will be gone for a while and need to make sure they don't eat it too early. The 5 compartment feeders aren't cheap, but if hard food may be the only thing keeping you on insulin, it may be money very well spent.

Good luck and even though those lows are scary, it may be a good sign that Dollbaby is healing.

 

Amanda,

that is excellent news. 259 after 18 hours is very promising. Try and get the suggested spot checks in, especially around +6 so we can see how well .5u works on Dollaby's numbers.

Gradually dumoing the dry is really the best way forward. See if you can have a go at some of the suggestions offered. I was similar to Chris-In a week from complete dry diet 457 to no dry at all, wet 3.4% 254 (and no insulin either). Will save a lot of money if thats all that's needed, not to mention time and possible worry on your part.

I'm still worried about this watery blood from her genitals. It could be very serious. Has she been neutered? No chance she could be pregnant? Can you give a bit more specific info on where it's coming from, amount and frequency?

Would still suggest you create a new thread about this issue too. It could be Feline Lower Urinary tract disease (of which there are a number of different things that could be wrong.
Does she strain to urinate?
Crying when she goes?
excessive licking ofher genitals?
Goes to pee frequently (or frequent attempts)?


There is no definitive cure for FLUTD, possibly why vets are clueless and generally throw all sorts at it (x-ray, cultures etc)

You could try adding extra water to what wet food you do give. Also consider buying a water fountain or leave a tap dripping. Cats have a very low natural thirst drive, but a ot of people have found that seeing/hearing running water, cats can and do drink more. If they eat a pure wet food diet they shoud hardly ever drnk from a fountain.I always added water to Luckys food despite a 100% wet food diet and she needed it.

 

I agree the binging might settle down if you try leaving wet food out, more than they need. I learned here it is ok to leave the canned food out for a few hours - some people freeze it in small portions and then set those out, so it will be fresher later in the day. I leave canned out for my cats, and yes, when I first started leaving food out they went crazy for it, but once they realized it is always there, they turned into nibblers, who tend to just eat a few bites every few hours.

At one point when I had Bix on too much insulin, he gained something like 3 pounds in 3 days. I didn't realize til hindsight that was what was going on, but it does sound like that might be the case with her too. If she is gaining weight and still eating like there is no tomorrow, could be she has been balancing out the extra insulin by overeating. Hopefully that will settle down now that she is on a low dose.

 

since it sounds like your schedule is very busy, it sure would be great to get her off the juice so you don't need to worry about getting home for a shot, or hypo while you are gone. No insulin means no chance of hypo...

A timed feeder might really help you make the switch to wet food. I use my timed feeder everyday, and I'm home most of the time. Heres a link to the 2 petsafe brands. If you don't have anyone who's super aggressive, the 2 meal feeder might work well.(although my guy was able to break into it early, so I got the 5 meal feeder)
Heres a link http://www.google.com/search?client=saf ... 8&oe=UTF-8

I freeze wet food into muffin tins, make up a ton of them at once and then store them in a bag in the freezer. Cody gets 1 every night at 4AM or whenever I need to leave for the day.

I have 2 cats and i've tried so hard to separate them when dry is down, but invariably, as careful as I try to be, Cody would get into it and have a terrible couple days. So now I just don't even try- wet food is all we serve!

 

Hello LGoddess,

I am in the same place you are with my cat Xena. Xena was on ProZinc for 45 days and she kept bottoming out. The vet took Xena down to 1 unit and she still bottomed out at 40. So scary! Our vet called it "somogyi effect", but now that she's been off of insulin for two weeks, her levels are way up again. My vet recommended the same thing (MRI, etc.). But I've already spent around $1000 too. I don't have the resources to do the MRI, etc. I only started reading this website today and already I've seen several people with the same problem using ProZinc. Does anyone think another insulin is worth another try? Thanks Emma

 

Emma - the first question is are you home testing? This is key if you are to get any control on what's going on with your cat. It's not hard to do and is easy to learn.

What kind of food are you feeding your cat? dry? wet? prescription? This is another area to address - the best foods are low carb wet foods.

I see you posted in two other threads and in order to get direct attention - may I suggest that you start a new post of your own, this way you will get direct responses that won't be buried in other posts and you will have everything in one place.

 

I am so sorry that you have so many problems. I came to this board to ask about my Greylie when he started being a diabetic. The vet put him on PZI and I was very insecure about it.

I was told not to give a shot when he was 180// I also had changed him from dry urinary to wet food. I was quite happy to see that his pancreas started working again and that he did not not any insulin anymore.

I don't know if you can do the same thing but I would be very careful with the dosage when the numbers are lower because they can be too low.

My heart goes out to you.,.... I know how I felt first my Sophia was sick then my Greylie it is quite a worry I know.