Is this remission?

Hello- Our kitty was hospitalized for six days recently and eventually given a diagnosis of diabetes along with mild pancreatitis. She was initially prescribed 2 units of Prozinc twice daily. After just a few days of testing her we determined that the dose was too high with her having some very low hypo episodes, including all the way down to 28 (very frightening). We are vigilant in testing her, and continued to be somewhat low even on giving her adjusted dosing according to her numbers, but it was really just a guess. I spoke to her vet and he wants her to be on 1 U twice daily, but even so our kitty continues to have very low numbers, so I have been giving her less. But, I find that we have to make the decision come injection time whether to give or not, which has been very stressful. Last night I decided to give her 1 Unit when he BG was 220, and this morning when I checked her she was down to 50. When this has been happening I have been too scared to give her any insulin, even though her vet says I need to keep the dose and schedule consistent. Even when she has not had insulin for 18 hours her numbers have been in the mid to high 200's, sometimes less. Is this remission, and how should I approach things. The vet refused to give me any cutoffs of when to not give insulin and refused to provide any sliding scale, so I have been going it alone, but would like advice because I don't feel comfortable with giving her insulin when her numbers are so low.

 

Well first off...WELCOME! Sorry you have to be here, but we're more than happy to help out.

Second, yes, it definitely sounds like your dose is too high. Our suggestion for new folks is to NOT shoot under 200. And ANY vet that would tell you to keep dosing even when your cat is at 50 preshot...well let's just say that makes me so angry. 50 is a normal BG number and giving insulin on that number would surely result in a severe hypo. So, if I was you, I would not shoot a preshot under 200.

If 1 unit on a 220 preshot gave you a 50 12 hours later, that's still way too high a dose. I'm thinking your kitty may just need something tiny, like 0.25. Do your needles have half unit markings? Do you think you could eyeball 0.25?

Generally speaking, for remission, we want the numbers to stay under 200 consistently. If you're getting 200s after roughly 18 hours or so, that means that your kitty probably just needs a really small dose...and it may be that he can go into remission with that.

We'd be happy help you figure out dosing as you go. A lot of people post here in the morning and evening with their preshot numbers and we help determine a good dose from there. If you'd like to try that, we will be happy to jump in!

I'm sorry your vet is not helpful...it sounds like he is really NOT a good vet overall.

 

Welcome!
Rachel has given some great advice, she is one of our mentors on the Prozinc forum . Would you be up to create and use the Spreadsheet we use here, so our experienced members can see the trends? Here is the link: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

2U was a slightly higher starting dose than most of us here.

Unfortunately, the most likely reason the Vet did not provide you with any sort of sliding scale dose because they cannot do so safely. Every cat is different (ECID). There aren't many generalizations (except maybe starting dose should be around 1.0U) for dosing kitties that work for everyone, just learning methods and getting lots of data .

We will gladly help you as best we can

 

Thank you so much for the advice. I will get the spreadsheet going. We do have a slight twist today. Last night she tested at 270 at 8pm, and was given 1U. This morning at 8am she was down to 50, and I did not give her any insulin. Then tonight at 8pm she was at 61, and again I did not give her insulin. This means that as of 8pm she has had 1U of insulin, which was at 8pm. We are now 24 hours without insulin needing to be given. Any thoughts???
BTW: she is still eating, drinking, and elimination is good.

 

It could mean that she's heading toward remission or needs only a tiny dose of insulin. Gathering data on the spreadsheet will be very useful in figuring this out.

 

Could be the tool to bump her into remission! *paws crossed*

 

Those low numbers are promising!

 

Our Oreo has now gone 4 days without insulin! We continue to check her twice a day to ensure that she continues to do well. I didn't use the spreadsheet because we haven't needed to give insulin, but here are her numbers!
3/24- 50 (7:41am), 61 (7:40pm) - had insulin 1 U at 8:18pm the night before
3/25- 105 (7:43am), 156 (8:05pm)
3/26- 127 (8:15am), 135 (8:24pm)
3/27- 128 (7:29am), 97 (7:40pm)

Her appetite has continued to be good. We feed her Fancy Feast beef original or Sheba chicken pate, and mixed sometimes with Trader Joe's tuna for cats. She likes it if I put some warm water mixed in to create somewhat of a gravy. We really don't have much of a feeding schedule yet because she is wants to eat when she is hungry so some numbers occurred sometime after eating and other times before.

 

Wow, some of those numbers are after eating? That's impressive. Adding the water is a great thing...all kitties can use more water, and it should help keep things healthy.

Those numbers are great! I'd definitely keep up the testing for awhile (we say a cat goes into remission after 14 days of no shots) and then spot check from there on out.

 

There are people on here who are experienced in guiding a kitty to remission. If you want to learn more you could post a question about it on the main health forum. Oreo is looking great!