My cat is yo-yoing...

Silverado was doing so well. I thought for a few days that he was going into remission. Then, all of a sudden, his numbers shot up, for no reason. In fact he is now strictly an indoor kitty so that I can control his food intake. I don't understand why this has happened. He is back to wanting to eat everything in sight, and peeing like niagara falls. What happened? Is it possible that the ProZinc PZI is failing him and I should look at something else?

Jane & Silverado

 

Hello

His bgl could be climbing for a lot of reasons; a few are:
infection somewhere in the body
sneaking high carb food (bread, dog kibble, etc)
stress

What is Silverado getting to eat daily for his normal diet? Lo-carb wet food, I hope.
Is he behaving normally other than wanting to eat more and peeing more?
And lastly, how much insulin does he get now and how long at this current dose?

~M

 

He certainly was doing well, wasn't he? I see your note about the bagel bag; is it possible he is somehow getting carb-y food? He could have an infection of some kind. Even just inflammation of the gums can cause BGs to spike.

How old is your PZI? I know it can't be that old because I remember you starting it, just not exactly when. Does it look okay? No floaties in it?

 

Hi Jane - I'm going to cross post for you on the PZI forum to get more eyes on your post... Sorry to hear his #s have gone up again.

 

I do not see any recent BGs in your spreadsheet except for preshot BGs. I recommend doing a curve to see what is happening to the BG between shots.

 

Hi Jane,

I just switched to ProZinc too. And to be honest with you I'm still sorting things out with it. You can read the little I've posted in the PZI group here:
viewtopic.php?f=24&t=1817
I've not heard back from BIV yet so I haven't updated the post. I do have a "ProZinc" spreadsheet to add to that. There are also a couple other posts I've made in PZI Land that you can read.

Anyway, as others here have suggested, you may need to investigate sources of infection, including UTI potentially. Several kitties in PZI land are going though this or are just getting over it. As mentioned too dental is another common issue.

As far as ProZinc goes, I called BIV to ask and they said switching on a 1:1 basis from PZI Vet was "safe." Anyway, my experience has been that for probably a combo of reasons the ProZinc did not act just like the old bottle of PZI Vet I was using. So it's been back to the drawing boards for us and I've had to nearly start from scratch on the testing. I've not had too many strips to work with, but more are on the way now so we will be having more data come in. Notably the nadir can shift [potentially more than once if you are switching]. The bottom line to all of this is you need to be testing. I would not take for granted that your old numbers on PZI Vet will translate to ProZinc. I have not noticed H losing sensitivity to ProZinc, maybe a little of the opposite when we first switched. I do not know how you dose, but since I discovered that I would have to get the numbers dialed back in I've been less aggressive with the sliding scale type dosing I've used in the past. When you say "yo-yo"ing do you mean that or just high numbers? Because at first I noticed that too a little and got a little concerned and got serious about testing again [and chilled out the "sliding" bit].

I think another factor in this for H has been that the old bottle was maybe starting to poop out a little so when I switched it made the strength of it potentially a little greater. Add that in with a change of the insulin and potentially how the kitty has to metabolize it and you are working with a bunch of different variables.

I have no magic arrows for you unfortunately - I hope this helps though.

EDIT - I looked at your spreadsheet and you have some dosing changes that are really up and down. My experience so with it far has been rewarded by taking things slow and as consistent as possible [at least while we are collecting new data]. If you need help with your spreadsheet, I would suggest posting in the PZI group.

 

He has been getting low-carb wet food since his diagnosis. All high carb foods have been locked away since the last bagel episode on Dec. 31. He doesn't act like he's sick (other than the expected diabetic symptoms). Nothing has been going on to cause him any stress. I realize that cats hide ailments well, so I plan to take him to the vet as soon as I can get an appointment. I had him on 1.0 unit, BID for 4 days. On two of those days his PMPS BG was at 124 and 128. On those two occasions I opted to lower the dose to .3 units. As of 2 days ago, I have bumped him up to 1.5 Units, BID. I'll go with that for another 3 or 4 days and see how that goes (unless, advised otherwise).

This bottle of PZI was started on Nov. 21, 2009. It looks fine. No floaties. How long does it typically remain viable?

I will get +5 and +6 BGs this weekend.

Thanks for all of the feed back. All suggestions and advice are welcome.

Jane & Silverado

 

As to how long PZI typically remains viable: I used mine for 5 months with no problems. Cindy (of Cindy and Mousie) has said that she has gotten 9 months out of hers. With yours not even being two months old, unless it has been stored or handled improperly, viability should not be an issue.

ETA: Mine did not go bad after 5 months; Buzz went OTJ so I had no need to use it anymore.

 

I have gotten over a year out of PZI Vet.

 

The Prozinc site says that, basically, the insulin will not poop out, but to look for cloudiness, floaters, etc...

I am wondering if he needs just a tiny, tiny amount of insulin and the increasing doses are actually inducing rebound highs? The .3u you shot at the beginning of this seemed to do ok, but then he was higher the next evening. Maybe he needs only .2u or even .1u?

You have u100 syringes and this is a u40 insulin if I am understanding correctly, so the small doses shouldn't be a problem.

I know it is a different insulin, with different action, but Beau needed sporadic mico doses of Lev when he was headed OTJ - I was shooting 0.05u sid or every 36-48 hours (Sep if you want to look at his numbers/shots). Recently, he got into some bread and could not get back under control himself, so he got that same dose, basically sid for about 5 days, but (knock wood) seems to be back on track now (OTJ).

 

Actually, I'm still using U40 Syringes. When I say I am shooting .3 and .5, I'm eyeballing this.

So, when his numbers jumped up into the upper 200's and 300's, after having been in the normal range for several days, should I have not reacted with a 1Unit dose? My vet told me that if he was between 200 & 300 to shoot 1unit, if over 300 to shoot 2units. Since this looks like a restart of the whole process, I thought it best to start out at 1unit for a few days and slowly work up to 2units if his BGs warrant it.

Am trying to get to the vet tomorrow.... hoping for a cancellation to get me in so I don't have to wait till next week. Hopefully this is a minor infection and we can get back on the OTJ track.

I'll get some more tests over the weekend to add to the spreadsheet.

Thanks to all for being there.

Jane & Silverado

 

Have you had any recent bloodwork done on him?

I cannot comment about the insulin as I used Lantus.

But I do wonder if something may be going on, such as hyper T.

Hyper T cats can show similar symptoms to diabetes.

The only way to know if this is an issue is by getting a blood test done. You need to ask the vet to run T4 and Free T4 tests. The T4 is usually part of a regular blood work up, the free T4 is an extra test (and extra cost), but in order to rule out hyper T, both of these tests are needed.

Just a suggestion if you are going to vet anyway and haven't had bloodwork done in a while.

 

Jane,

There is a sticky in the PZI forum that contains info about using U-100 syringes with U-40 PZI. This is something you may want to give a shot with. H has been sensitive to very small changes in the amount of ProZinc I've given. There's no good way to eyeball a 0.1U dose with a U-40 syringe. A switch to U-100 syringes may help you a lot.

 

He had a complete blood panel done back in October. It included T-4. He is fine there. I went through the hyperthyroid condition with one of my babies (GA) back in the 90's. So as soon as one of the "kids" reaches the age of 10, I start insisting on full blood panels to check for anything and everything (including T-4) and to establish a base line for any future changes that indicate an upcoming problem.

Gator, I was going to start with U100 syringes last month, but Silverado appeared to be going into remission, so I didn't get them. I'll go ahead and get them now that I know that this isn't going to be a short lived disorder. Once I switch over, I'll visit the conversion chart and go on from there. And you're right... eyeballing .1 is impossible.

I was not able to get in to see my vet on Saturday. It may not be necessary though because I'm seeing some improvement in Silverado's numbers. So, either the insulin is starting to work, or whatever was ailing him is resolving itself.

I remembered someone here at the forum saying that they had success with providing smaller meals more frequently, so I've started that with Silverado. (Which may have something to do with his improved numbers.) My big problem will be during the work day. Setting out frozen chunks to thaw will be the easy part. During the day there are at least 3 and as many as 7 civvies in the house with Silverado. It's anyone's guess who will actually get the food as it thaws and what they will do with it before it thaws. I have visions of them using them as hockey pucks and finding them scattered around the house. I think I'll set up a webcam to see what goes on. Webcamming these guys is always a hoot. :mrgreen:

I plan to get some +5, +6, +7 GB tests done later today and posting them. All 3 of those tests will be before he gets his afternoon feeding. Feedback from the test results will be appreciated.

Jane & Silverado

 

Yes, as was discussed in another recent topic. With PZI, free feeding is the best policy [unless they are overweight]. Normal cats eat 10-20 times thought the day and night. And even if they are overweight then, one can give smaller portions frequently.