Need advice - high BGs x5mos, mom & tomcat distressed

Discussion in 'Prozinc / PZI' started by Amy & Tommy, Mar 4, 2018.

  1. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    Hello all, I am glad to have found this site while browsing for information about my Tommy's lack of reaction to ProZinc. He was just diagnosed Oct-2017 after sudden weight loss - used to be about a 14lb boy, but was down to 11 over a span of less than 3 months. When he was first diagnosed, we visited the vet five weeks in a row, starting with 1 unit twice a day and quickly worked up to 4 units twice a day. I took away the dry food immediately after diagnosis and fed only friskies pate (previously he received 1/2 can of friskies ~2.25oz in the morning and evening and always had dry food available to snack on).
    I got an AlphaTrak2 from adw diabetes, but our vet still wanted to do fructosamine tests every few weeks-these have always been in the 400s as well. During these few months, we tested at home every few days just before the PM meal and shot, and we graduated over to Fancy Feast since the classics usually have lower carb %s. Other than the weight slowing coming back (vet and I agree he's good at 12lbs), none of the other symptoms have gone away. He drinks alot. He pees alot. He is hangry all the time. His front legs twitch when i pet him. His hind legs are looking weaker all the time. I have communicated with her intermittently with the alpha trak log results as i see her pretty often (i have another kitty and two chihuahuas-basically 4 cats).
    Tommy had pancreatitus about 3 weeks ago after another fructosamine test where we upped to 5units twice a day - always in the 400s. He received subcutaneous fluids two days in a row, and a 5-day treatment of cerenia and buprenex. His vet told me to feed him anything he wanted just to get him to eat since he was down to 10lbs and had been vomiting; and since his sugar was still so high to go ahead and give him now 5units of insulin twice daily - maybe adjust-down the dose a little if he wouldn't eat. After the first two days of getting the fluids he seemed to be doing better and we continued the cerenia and buprenex until the regimen was finished. This last week he was sick again (15 days later). I rushed him back to the vet with the same symptoms of pancreatitus not eating, not feeling good (no vomiting this second time). Vet says i overfed him, his belly is too tight and full, now he should only have 6oz per day. He received fluids one-time, a shot of cerenia at the vet, and came home with 2 cerenia to be given 1/2 pill once every 24 hours. He just finished those last night. We limited him to the 6oz per day for those 2-3 days and he was not at all happy about it! I am ashamed to say he has had about 9oz today and his sugar was actually in the 500s at the PM after 2 hours of fasting.
    I feel as though i keep getting different messages from the vet - make sure he always has food available, oh you're overfeeding him, let's increase his insulin. In her defense, we did remain at 2.5 units for maybe 3 weeks to see if he would respond, but that was the only time we used 1/2 units until this pancreatitus up to 5.5 (which was only 3 days after the fructosamine). She is always referencing him being stressed after we see BG results. I am unsure about that, he is the king of the castle here and he has a wonderful personality! I asked if she thought it was time to try another type of insulin but no we should just keep increasing. ugh!
    I need the link to your spreadsheet seen in other posts. I purchased some ketone sticks today from walmart (hoping to try the saran wrap in the litter box since we have a hooded large box and i don't think he will go for me hovering). I had no idea we should be testing before every meal, we have no problem doing this. Our vet was saying every couple of days when feasible. I am hoping that we have just missed his optimal dose with fast, whole increases - similar to what I've read in other posts. Please advise, you all seem so knowledgeable about this. I am so sad I've waited this long to try to educate myself more about feline diabetes and relied on the vet too much.
     
  2. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Wow! You have clearly been doing a lot of reading since yesterday!!!

    Welcome Amy and Tommy! I'm so sorry you both have to be here, and have had such a tough road so far. Pancreatitis is the worst. Far too many of us around here have kitties with both issues.

    It sounds like while your vet has made a couple of mis-steps, overall she's given you some good advice along the way. And we can help straighten out the less-than-good things.

    Here is the spreadsheet: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

    And nice job already getting a start on your signature!

    Pancreatitis does increase blood glucose, so the dose may not be inappropriate. That will be easier to say once you are able to input some data and we can see the data you've collected.

    We recommend testing before every shot time, and getting mid-cycles whenever you can, especially in the +4 to +7 range (four hours to seven hours after injection). That can get super expensive with an AT2, so you may find it helpful to switch to a human meter. The test strips are much cheaper, and while they don't give the actual BG number, they give a close enough reading to make dosing decisions. If you're interested in that, we can share some links to an ADW meter, or give you info on the WalMart meters that many folks around here use.

    Let us know what questions you have, and if you have any trouble with the spreadsheet just ask and we can have someone help you get it set up.
     
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  3. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    Thank you for responding Djamila!
    I have to say I do believe our vet cares for Tom and wants him to be well. Of course it has just been frustrating to follow instructions to the letter and not see results. We are ready to go hard with the testing, whatever it takes :cat:
    I am interested in a human meter. I saw the ReliOn at Walmart when I got the ReliOn Ketone Reagent strips - it was maybe $10? I saw the 100 strips for $1-something - someone mentioned this on another post. I watched someone's video earlier about the lancets and not using the tool for them so not necessary to get those specific to the AT2 kit either. Also saw a post regarding the 1/2 unit marked U40 syringes at about $14 - have been paying the vet $28 for the 100 box. I really appreciate the information I've found here, looking forward to not only managing Tom's diabetes but the associated costs as well!
    I will work on the spreadsheet as time permits, it's late now and hoping to catch a test at the +4 before bed. He is stalking for his wet food nightcap but will break to play with his mouse a little (good sign).
     
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  4. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    If you really want to get fancy with Tommy's care, while you're at WalMart, you can also pick up u100 syringes for about $12-13. Then you can use this conversion chart http://www.felinediabetes.com/insulin-conversions.htm to convert the dose from u40 to u100. This also allows you to make very precise changes to the dose.

    If that feels like one too many complications though, you can order u40's with half-unit marks from ADW diabetes for a reasonable price. You can also get lancets on there for $2-3 dollars (or I'm sure you can buy those at WalMart as well).

    Yes, feline diabetes is an expensive thing to manage, but once you get away from the vet-specific products it becomes more reasonable!
     
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  5. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    I see the spreadsheet linked in your signature, so great job with that. Right now it doesn't look like anything is entered yet. Is that correct? If so, then you've done it and can start entering data whenever you're ready. The easiest way for you to access it right now is probably to click on the link your signature, and then bookmark it. If that doesn't work to find it, let me know :)

    As far as how far back to go.... Do you have data all the way back to October? If you're bored while watching TV some night, it would probably be helpful to have it all in your spreadsheet at some point, but for now I'd say just go back about 10-14 days and enter whatever you have, then go forward with your more current numbers.

    Do make sure you're logged into your google account - if you aren't logged in it won't let you enter numbers.
     
  6. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    Thank you for responding. I actually deleted my question post once I found the answer - the link on my signature wouldn't allow me to edit the sheet of course like when I view your Sam's spreadsheet but I found it logging into Google. I will begin entering most recent data first and as you said add the history when possible. It looks like an amazing tool, excited to use it.
    Tommy is not so excited - about the more frequent pokes. We are not using the lancet clicker only the little gauge and obviously still needing practice there. He is even hissing after his insulin shots. I just keep reassuring him we will get his treatment fixed up.
    I read your Sam's profile, he sounds wonderful- glad to have connected with you and see that you've been successful in managing his changing needs.
    I will definitely some data in tomorrow and reach out so Tom's updates can be seen- another day gone by too quickly!
     
  7. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Does he get a treat after the tests and the shots? Giving a little love and a treat goes a long way toward settling down the hisses and bites. (not sure if he's biting too, but mine sure did!).

    It's okay to leave your posts even if you've found an answer. you can just add a quick reply saying you've found it. As you're on here for awhile you'll find how helpful it is to search through other people's threads and find information you need, and see that other people struggle with similar things. You're definitely not the only person who has had that question, so leaving it for someone else to find may be helpful.

    Sam is pretty great. Like most cats, he's a bit of a character and keeps me laughing. :cat:

    You're absolutely right that Tommy will like this all a lot more as it starts to make him feel better. Looking forward to seeing your data and figuring out what's up with Tommy and his high dose/high numbers!
     
  8. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Djamila has given you great advice. Her Sam has been (and can still be) a handful. Persistence and positive reinforcement while you try hard to be as calm as you can will get you there. At the start our anxiety over poking them and maybe causing a momentary pinch just oozes out of us and kitty picks up on that. A little bit of calm and clinical businesslike action is good to cultivate. :)
     
  9. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    One thing to try is to take Tommy to the test or shot spot off and on during the day but don’t test, just pet and treat then let him go. I find that helps to relax everyone.
     
  10. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    Good evening Djamila, Kris, and Sharon,

    I've just powered through Tom's spreadsheet for 2018 to date. Please take a look and tell me what you think. I worry about him always extremely hungry and showing the signs-thirst, urinating, neuropathy. He cleans himself alot less frequently now as well, so i know when his eyes are clean he is probably feeling better than other days. I wonder if his immune system is attacking the insulin or depleting his fat reserves making him feel weak and hungry even though his BG is still way too high. The vet keeps saying as long as he is holding his weight we should not be too alarmed, but of course it still bothers me.

    I have neglected to mention that Tom began taking Glycoflex maybe a year ago for a shoulder click that he constantly had. The glycoflex took care of that, but after the diabetes diagnosis and constant high numbers the vet did recommend cosequin saying the glycoflex could affect his BG. I never picked up the cosequin but took him off the glycoflex for about two week. We did not see any results in his numbers and he seemed to be in pain (I read somewhere that if you start meds for arthritis that you could not stop). The vet said we have to remember we are treating the whole Tommy not just the diabetes so we are still taking the glycoflex chewable - this is Tom's treat after his PM shot and he does love them.

    Tom is not feeling good today. I caught him gobbling up dry dog kibble last night and again this morning after his breakfast and AM shot. Both times I have taken the dogs' food up and locked in the pantry. For his AM shot, he bolted out of my leg-circle with the syringe still in his scruff and insulin not injected - I feel like he is smart enough to know that the insulin is not making him feel good. He did not eat for 8 hours after his breakfast and AM shot. He had a small 1/4 of 3oz can of fancy feast classic at the 8-hour mark (no one was home to feed him). For the PM he was hangry again and ate 3/4 of a 3oz can of fancy feast classic. Then he made the strange meow noise that cats do sounds like a strange baby or animal (I'm sure you all know this sound), and I looked for him knowing that is the pre-vomit noise. He emptied his stomach and right back to begging for food. I just gave him 1/2 of the fancy feast broths packet and he is calming down once he knows he is denied being a glutton (tough love for Tom?)

    I will take your advice Kris and Sharon. I do find as I am calmer so will he be, although there is no more purring during the pre-poke/injection petting :(
     
  11. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Hi Amy!

    First to the food. The dog food will spike the BG, so good catch on that. It does mean that the numbers aren't necessarily a reflection of how Tommy is doing so much as they are a reflection of eating too much carbs. I'm sure you already know this, but you'll have to be super vigilant about keeping him way from it, and making sure there aren't any little kibbles hiding under the stove. Even one can make a difference.

    That being said, I see possible evidence of bouncing in the numbers. Which means that it's possible Tommy is going too low in the middle of the cycle and then bouncing high. That may be why he's seemed ravenous at times - he's trying to raise his blood glucose to avoid doing hypo. The other reason is that when a kitty's BG isn't regulated, they cannot efficiently absorb nutrients from the food and they are quite literally starving. They really do need more food than normal to try to compensate for that. And the third reason for the hunger may be going too long without food. If a kitty is only fed two meals/day they will have trouble eating when it is time to eat and will "scarf and barf" which is what it sounds like happened tonight. If you can't leave food out for him during the day, you might consider getting a timed feeder that will open periodically and give him access to more food at a few intervals during the day. It's okay to put wet food in those and we have some tricks on how to help it last longer if you're interested in trying that route.

    Now for the dose. The numbers indicate that it's possible there is some bouncing going on. Do you work during the week (forgive me if you're already told us that - I have a terrible memory)? If so, will you be around this weekend to get some mid-cycle tests? I know testing is still a little difficult, but I'm a bit concerned what might be happening around his nadir right now and think we really need some mid-cycle numbers to know if this dose is really okay for him.

    finally the arthritis - inflammation raises blood glucose, so getting an anti-inflammatory is going to be important for him. Your vet is correct that you have to treat the whole Tommy, but also in doing that, you help the diabetes. Adequan is often used with our diabetic kitties to help with arthritis. I'm not familiar with the meds you're currently using. It might be helpful to post out on the main forum to see what other folks think might be the most helpful to Tommy to ease his pain and also help his BG at the same time.

    Hang in there and hugs to you! This is a lot to learn and manage all at once. I promise it gets easier as time goes on. Just take things one stet at a time, and keep asking questions, clarifications, or help on any or all of this!
     
  12. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    I have to say i just knew it! When he was diagnosed beginning October, his glucose was 406 and we started on (i believe) 2units 2x daily. Once i called the vet after home testing a bit to ask if we should raise the dose as no results other than almost no vomiting (Tom had always been a glutton scarf & barf kitty pre-diabetes when he had constant access to dry and 1/2 can friskies pate 2x daily.) Our usual vet was on vacation so one of her partners said only feed when giving the shot every 12 hours. This went over horribly! We fasted (starved) him every 12 hours, taking his BG for about a week and it was higher than than before - i will add the Oct-Dec data asap but it's relative the same #s. When our regular vet returned and we visited, she said keep feeding whenever he wants to keep his weight, let him always have wet food available. So, we started giving 1/2 can in AM and PM with shots, and 1/4 can roughly every 2 hours to keep him satisfied. When he had the pancreatitis the first time 2/12/18 he was so sick, vet said give him anything he wants (I even gave him some leftover cat dry kibble i was going to put out for the ferals) because his digestive enzymes were flowing through his system instead of stomach because stomach was empty. Then when we returned 2 weeks later pancreatitis again, she said he's too full, keep him at 6oz per day. This was after a weekend and i admit i fed him more often than a newborn baby. All the while i have kept thinking how is this not too much insulin? Something else has to be going on if his numbers have never improved, yet we took away the dry food immediately upon diagnosis and only fed wet low carb (Friskies pate at first now Fancy Feast classic). I am so disheartened and worried that he will have a hypo attack, time is of such importance now, but there is never enough!

    I know the dog dry food is an issue, we had been taking it up constantly but after he was sick he seemed uninterested so we left it out. Agreed-now we see we have to remain vigilant there, no slacking! He does generally get fed a good portion-1/2 to 3/4 of a 3oz can around 6-6:30AM and 6-6:30PM now. I do work M-F and am gone about 12hrs each day due to a long commute, but i have adult kids home in the day that will feed him 1/4 of 3oz can around 10am and again 2pm. I will give him a nightcap 1/4-1/2 of 3oz can about 10:30pm. So it is unusual and unexpected that he had a long fast today. When i have left wet food out for him he will scarf it, so will think about that timed feeder. It's a good idea in case of an emergent situation like today-adding to my list of things we need (human meter, 1/2-marked syringes).

    I will ask the vet about adequan, and post on the message board about the Glycoflex we are using. We are actually travelling this weekend saturday through wednesday - 4.5hour one-way cartrip with Tommy. We have gotten some Gabapentin from the vet to sedate him for the rides to and from, and will be picking up some Cerenia on the way out for just in case he gets sick while at family's house. Of course i am worried sick about this as well, but we must take Tom to care for him while with us. I would be able to do the mid-cycle tests on Sunday. What time span do you think? Every 4 hours including just before feeding on the 2hour feeds? Oh! almost forgot, i have tried to get a urine sample in saran wrap for at least the last 3 evenings with no success - have ketone sticks, no Tom urine. I have thought this also may be easier at our family's house as we do have another 9y/o female cat that has grown up with Tommy and they share a large hooded bathroom (cleaned nightly).

    I wanted to ask you since Sam also has pancreatitis according to your signature - is cerenia something i should think about keeping on hand since Tom has had trouble with it twice already? Is this something that can always come and go again? Please let me know whenever you can, it is late again, another day gone by. I must enjoy relaxing with Tom now that he has calmed down.
     
  13. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    I do keep cerenia at home. I bought a whole little stack of it from allivet awhile back since Sam seems to just go from one flare to the next. I also keep some bupe at home to help with his pain level. Unfortunately, pancreatitis can be/become chronic, though there are many cats that just have one or two flares and never again.

    A full curve is testing every two hours. You feed any snacks like usual and just test when it's time - not worrying about if they have eaten recently or not. The only time we withold food the two hours before the AMPS and the PMPS. Since you'll be traveling, I'm guessing this weekend might not be the best time for a full curve. A typical nadir is between +4 and +7 with prozinc. Of course every cat is different, but if you get a couple of tests in that range, it will give us a start. Also, because of the inconsistency in his numbers, it's going to take a few days of mid-cycle data to really get a sense of what is happening, so any days during vacation you can get tests - even in the +3 to +8 range, it will be helpful. You don't need every hour in there, but if one day you could get a +3 and a +5, and another day a +4 and a +6, etc. that will help to fill in a picture of what might be going on here.

    It's entirely possible that he really does need this much insulin. There are kitties on here who need as much as 20+ units twice/day. We just want to be sure that the bouncing in the numbers is safe bouncing before making any suggestions about possible dose changes.

    That's great that you have kids who can help with snacks during the day. The other thing you can do when there is a long fast like today is to just give him 1/4 can, wait 10-20 minutes, give him the next quarter can, etc. That slows him down and will hopefully avoid the reflux.
     
  14. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    Ok i need to check into getting a supply of the cerenia (assuming another item cheaper online than at the vet)' and you say bupe is that the same as the buprenex that Tom had? I will ask the vet for pain meds as well for the trip, since i did read online that pancreatitis is very very painful. The vet said her cat had it 3-4 times also. We didn't receive anything for pain on the second attack (maybe the vet took me serious when i joked that i don't want Tom to be addicted to pain stuff because you could really tell he was kind of high when he had gotten it, the kids nicknamed him Pupils). Do i need to get a script from the vet to order on allivet?

    Agreed this trip will not be a good time for a full curve (where i have read other people getting up every two hours) so the curve must be every 2 hours for 24? I can definitely do the mid-range tests and post results while we are there. The vet did also say and i have read when reading about the acro cats that some kitties are just high dose kitties, although the thought of 20+ units scares me financially. I feel bad that we haven't gotten Tommy fixed up yet prior to the trip but going to visit my father, haven't seen him since last July after surgery, he is preparing to return for more cancer treatment, so it really is important to us to visit or i wouldn't put Tom through the stress (apologies if this is too personal, but want you to know Tom is truly a priority to me, just that we still have other family priorities as well).

    I was going to ask if you think giving the 5.5 units now while we are still collecting data is ok, but realizing that without more data to analyze, it really is our only option for now. As always, thank you Djamila. Hopefully tomorrow i will have some time to look around the forum and/or post about the glucosamine. Good night to you and Sam.
     
  15. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    Hi Amy, the curve is every two hours for one cycle, so twelve hours. My cat has acro and is on 9u Levimir. There is also a high dose condition called IAA, Insulin Auto Antibodies, which usually corrects itself in about a year. Right now I wouldn’t worry about either of those, just concentrate on making sure Tommy has no access to any high carb foods. Be sure that there are no spilled dog kibbles when you pick up the dog food (that happened to me, spilled kibbles that had rolled in spots I didn’t see but Colin sure did!). As for midcycle tests, could your kids learn to get them? That would tell us so much, but if not try to get them when you can and we’ll try to figure Sweet Tommy out!
     
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  16. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    Hi Amy!

    Yes, bupe and buprenex are the same. I use it for my Tigress during cystitis flares, and it really helps. If it makes him kind of high and spacey, you could try giving half a dose? I think Djamila has done that before...and I accidentally gave half a dose once (because the other half got spilled on the floor lol). Funny thing was it still seemed to help just fine. Sometimes you have to push the vet a bit for those pain meds, but just let them know firmly that you know he is in pain and you want to help that. I order it from my vet, but you could order it online as well...I think 1-800-petmeds has it as well as other places. It is a controlled substance, so you won't be able to get a whole lot at any one time (I get 6 doses at once) but it's better than nothing. I don't know for SURE but I don't think kitties actually get addicted to bupe...I want to say I looked it up once because I had some concerns and I read somewhere that's unlikely. I'll try to find that info for you later.

    As for getting too personal...this is the place for it! We do that all the time...I've shared my family and life concerns as well as other things here. We KNOW Tom is a priority, but your family has to be as well! You do the best you can to manage it...and we're here for you. :bighug::bighug::bighug:
     
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  17. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    You are not alone in bringing your kitty along for the ride when other life needs arise. I even took mine on vacation with me last summer. I wouldn't say they loved the car rides, but they were fine the rest of the time.

    Sharon and Rachel have responded to your other questions, so I just wanted to add that when kitties get to a really high dose we recommend moving to Levemir - it seems to work better for high dose kitties, and it's cheaper than Prozinc so the cost isn't as much of an issue. Figuring all of that out will come later if it needs to. For now I hope you all have a good trip and enjoy the time with your dad. It might turn out that Tommy thinks road trips are fun!

    Here is a thread about traveling with a diabetic kitty - well, the thread is about a crate, but Yong posted a link to a great document with a whole list of things to consider in packing. It is very thorough, so don't feel like you need to do all of that, but when we took our road trip I found it helpful. http://www.felinediabetes.com/FDMB/threads/traveling-question.176085/#post-1936399

    :bighug:
     
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  18. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    Hi Sharon, Rachel, and Djamila,

    You are so right! i have made everyone in the house aware of the dog kibble now - poor doggies are dieting as they can only eat if someone is watching LOL. Unfortunately no one else will poke Tom for a test. Teenager would use the clicker if i held Tom, but we have stopped that. Teenager will inject insult. Adult kids will only feed and love (which is ok). I am looking forward to getting Tom to dad's house to get more data. I can easily do every 2 hours for 12, and reassuring to know that there is high-dose-needed insulin.

    Good to know about the bupe/buprenex, we can try half a dose. I think maybe he didn't have to finish the whole treatment and i should have stopped giving it when he looked better. So this is a plan for any future attacks. We can tell when he's not feeling good, he gets very in-your-face always laying close by, as though he's saying i'm sick, please take me to the doctor. Normally he has always been a low-maintenance kitty, he will come to you if he wants attention but then he's off again. I will call the vet tomorrow for addition of pain med to our pickup order for Saturday morning.

    Thank you for the traveling document, bookmarking now, and must find time to check it out before we leave so do not miss anything.. I've been rushing around in preparation, got some Friskies with gravy in case of emergency and more of the Fancy Feast broths in case of loss of appetite (Tom really likes these and will at least drink the broth). I'm planning on a small insulated lunch sack with the freezer packs from the vet to keep the insulin cold.

    Tom has eaten alot today and even though we've spaced out the in-between shot feedings, he just puked again and front legs shaking when loving him after. Now he's relaxing taking a nap. Same thing happened last night. I'm not sure why after he vomits and is denied food he gets very calm and not frantic. His poor ears look like someone tattood them. Although i saw on the video not to poke the vein i have trouble getting a droplet if not poking close to the vein, been poking up to 4 times while massaging ears to get it flowing. Once poked through and the droplet formed underneath which i didn't notice until after poking again for a drop on top. I know this will get better with practice and Tom is responding to the calmness of the routine. Also i'm not sure if he has had a BM in the last couple of days but belly is not protruding. I just constantly worry and hope that the high numbers/diabetes is not damaging him too much in the interim, feel slightly guilty without more time to dedicate to getting his treatment right. I appreciate each of you very much for sharing with us and reassuring us!

    Thank you for the well wishes. Tomorrow night Tom will get a dose of gabapentin and again Saturday morning. Trying not to stress too much, it's only a 4.5hr drive and we can find anything we need when we get there. Dad has a good vet (VCA hospital?) as he has a dog also going through chemotherapy so I have to remind myself Tom will be ok.
     
  19. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Good luck on your trip! :) You've been given good advice about meds, etc. I'm glad you've found FDMB and this forum to help you with your handsome kitty.
     
  20. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
     
  21. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    Thank you Kris!

    I have a quick question for all of you - just got in and Tom's PM BG is only 211. He has had small portions spaced out today since overindulging and vomiting the last two nights. Should I still give him the 5.5u when he is low like this? Or is it a possible false reading? Sometimes the alpha trak 2 times out before we can get the sample. If you pull the strip out and re-insert it just says ERR. So we get a new strip for our reading. But i had put 3 unused/ERR strips in the side pack of the alpha trak case (not back in the bottle). Is this bad? I don't think they've been contaminated.
     
  22. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    oops, PMPS is 207 not 211
     
  23. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    You gave him this dose in the AM of Mar 06 when his BG was 195. Tonight's PS BG is in a similar range so I think you can give the same dose. We always suggest a BG test at +2 in these situations to see where he's heading. If the +2 test BG is similar or higher than the PS test the cycle will likely be uneventful (ie., no big drop). If it's significantly lower (50+ points) more testing is in order because there could be some drama.

    Re meter timing out: I always put the test strip part way in - not enough to trigger a reading. Then I get the poke done and when I have a decent blood drop I push the strip the rest of the way in to turn the meter on. This prevents the timing out error.
     
  24. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    You are right, i realized that had previously had the 195 but good to know we should get a +2 tonight. What would i do if by some miracle it was -50 lower?

    Good tip about the test strip. I had been not pushing it in until after the poke but sometimes it looks like a droplet is forming then it doesn't form so i have to be mindful about being less anxious.

    Thank you Kris and Teasel!:)
     
  25. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    If BG is quite a bit lower at +2 test again at +3, +4, etc. to track its descent. If it’s falling fast five a small snack of low carb food to slow the drop.
     
  26. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Oh boy we do not have to worry about dropping low, 517 just now! How is this possible?
     
  27. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Unfortunately, without mid-cycle tests, there's no way to know for sure why he's at 517.

    It could be that he dropped low during the cycle and this is a bounce.
    It could be that he hit nadir really late and the previous dose just wore off before the new dose kicked in.
    It could be that he's figured out y'all are about to leave on a road trip and he's having anticipatory stress.
    It could be that he saw a squirrel outside the window. ;)

    Mid-cycle tests are the secret decoder ring of all of this :D, so hopefully this weekend will give us some clues about what's going on for Tommy. When are you leaving? Are you all packed?
     
  28. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Hahaha thanks for the laugh Djamila :D I did think bounce but you are right we need more data to be more certain-so many variables. Of course Tom is smart enough to know when we're leaving, we used to go once a month but he never saw His supplies getting packed up - only the bubbas' (doggies who are also aware and curious why they're not going on vacay too). Still wonder if the test strip was bad somehow, not sure. Looking at our alpha trak test strip supply we may switch to a human meter soon but we can get through a cycle. Hopefully we can make some determinations before switching since the human meters register a little higher (if i remember correctly). I was very calm and did not rush the strip into the tester at the +2 test.

    He is on the gabapentin now so very very calm, no frantic begging which is nice. Teenager reviewed that travel list also, we have everything laid out ready for packup in the morning. E-mailed his spreadsheet to his vet today and she has included the bupe with the cerenia. So up at 6, poke, feed with magic dust, inject, take inventory again, packup, quick stop at vet to pickup at 8 and on the road! :rb_icon:
     
  29. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    I'm a huge fan of using the human meters. They are just so much less $$$ than the AT2! I'd rather spend my cat budget on toys and treats :cat::cat::cat:. Human meters run lower than the AT2 which also makes your spreadsheet look prettier. :D You'll be much less likely to see a black number. Of course his BG is still the same, but I think the psychology for us caregivers is helpful!

    Have a great trip! I got all excited for you just reading that. I love the day before travel! I hope you all have a calm, uneventful drive and a good visit with your family!
     
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  30. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    We made it! It was stressful for Tom. He didn't want to eat the magic dust this morning and cried a lot and scratched around inside his taxi. His BG was 300s this am and when we finally got here, but the PMPS was 623! :nailbiting:
     
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  31. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Travel stress - he’ll settle. :)
     
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  32. Djamila

    Djamila Well-Known Member

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    Ouch! Guess he doesn't love long car rides? ;) How is he settling in? Hopefully he had a good night's rest and is feeling a little better this morning.
     
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  33. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Dang! Well that's too bad, but hopefully he'll feel better once settled in some. Stress happens!
     
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  34. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Good morning everyone. We got one cycle done yesterday. I think these numbers look like Tom's nadir is exactly halfway, which would suggest he needs higher dosing? I would rather not increase at this time -only because we are away from home and stress could still be a factor. What do you think? Tom is settling more all the while, he knows ur family and their pooch from visits at our house so he is venturing farther into dad's house everyday but also comfortable with being in the large den where his stuff is.

    Great news! Teenager has started helping with testing. :) Tom is still hangry all day, his back legs still looking weak. He ate 1/4 of 3oz can after every poke and his usual 1/2 of 3oz can at AM and PM shots, so 7.5-8oz total yesterday. He vomited last night after gobbling up his glycoflex (glucosamine). We hadn't given it to him for the few days since he last vomited 2 days prior, but this is his evening treat he loves. I've got to ask the vet about that adequan! And make time to look around the site for arthritis treatment info. Maybe just too much at the PM shot? Have you ever had to deny your kitty food during testing or other times? Tom sometimes acts out when denied. Yesterday he dug his remaining nails (had broken at least 8 inside the taxi on the way here) in dad's sliding door screen. :oops:

    Thinking ahead to the return trip, hoping for no traffic issues as we're returning home on a weekday/Thursday. We could do another cycle on Saturday after he's been home a day to de-stress. I put some Neosporin with pain relief on his tattered ears, which look like a war zone. He has one blood circle accumulation where I may have poked through a small vein so bleeding under the skin which should reabsorb? Also thinking about a harness and seatbelt clip. He is a large cat and even the large pet taxi we have is cramped for him. This can't be helping his travel stress. All in all, he is ok, and his behavior and symptoms are the same as at home.
     
  35. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Also should plan for an evening test cycle to see how numbers are when Tom's resting? I realize cats are nocturnal but he will settle and nap at our bedtime-always up before mom though, of course.

    Also again- I probably said this before that I did research the glycoflex/glucosamine and found both sides of its affecting diabetes numbers- some sites said it could affect numbers, some said no evidence to support its affecting numbers. Tom's vet had said it could and try the consequin, which we didn't do, we only kept him off for about two weeks and still saw high numbers. I realize pain can affect the numbers so must get something done about this asap to rule it out of the dosing /high numbers issue.
     
  36. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Ideally the nadir is at the midway point but it often moves around. When you’re back home and settled I recommend an increase of at least 0.25 u. Once you’re past 5 u you increase by 0.5 u until you start seeing blue or dark green.

    If he does better grazing, let him graze as long as it’s low carb food. Just take it away 2 hours prior to the pre shot test.

    It’s great you’ll have help with testing, etc. :)

    I can’t advise on glucosamine - no experience.
     
  37. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Hi Kris, I'm confused when you say recommend +0.25 and over 5u increase is usually 0.5. Tom is at 5.5u. :confused:

    I don't think grazing will work for Tom. There was a point at the first pancreatitis attack, his vet said make sure he has (wet) food available at all times since he lost weight. Next time pancreatitis flared up 2 weeks later his vet said I over fed. If I leave food out for him chances are he will gobble it all up and vomit. He has rarely walked away from a plate of wet food.
     
  38. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Also let me ask this - I've read dose increases "after a few cycles"... Does this mean after a few days since a cycle is 12hrs? You may be right about the dose increase, Tom has been at 5.5u for two weeks now no real changes in his AM &PMPS numbers. But I don't have syringes with half marks marked yet, have been eyeballing the 5.5, should I eyeball the +0.25 increase as well?
     
  39. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    That's why many people like an automatic feeder.

    A slightly larger dose increase after you reach 5 u is suggested because we consider the % increase. An increase of 0.5 u on a dose of 5.5 u is only a 9.1% increase. A quarter unit dose change would be only half of that.
     
  40. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Syringes with half unit marks are ideal. You can find them on www.adwdiabetes.com. An alternative is to buy U100 syringes with half unit marks and use them in conjunction with this conversion chart: http://www.felinediabetes.com/insulin-conversions.htm
    This allows a lot more fractional dosing options.
     
  41. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Argh! Someone said that already, automatic feeder! I will see how expensive and if feasible. Thank you Kris :)
     
  42. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Ok so how does this sound: keep feeding spaced out for Tom's constant hunger, look at auto feeder options, order the half marked syringes now so hopefully will be home when we get home Thursday, and start with 5.75u @2x daily beginning Friday AM, and do another 12hr cycle curve on Saturday ?
    Admit the options are many and trying to focus on immediate needs where auto feeder and supplies are concerned. We are also running low on the AT2 and understand we can switch to cheaper human tester, but not sure if we should at this point when his numbers aren't very controlled yet ?
    Teenager says Tom is urinating a lot this morning, we did bring the keystone strips, maybe give try this test while here as well, we had planned to since at home another feline makes more difficult.
     
  43. Sharon14

    Sharon14 Well-Known Member

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    Aug 16, 2015
    THIS is the autofeeder many of us use
     
  44. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Ok wow I didn't realize it was affordable, thanks Kris! :bighug:

    I guess what I was thinking is since the animal and human testers have different spreadsheets, we shouldn't change now, but is that an issue? I could go to Walmart and get a Reli-on with 100 test strips way cheaper than ordering another 50 AT2 strips for $50. I could also pickup the u100 syringes and printout the conversion chart to keep handy.
     
  45. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    You could start a human meter spreadsheet now if you're going to switch.

    Re syringes: if you switch to U100s with thew conversion chart, put the U40 syringes away where you won't accidentally grab those.
     
  46. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Hi all, just checking in. We are returning home tomorrow morning.

    Tom's vet called Monday after reviewing his spreadsheet that I guess was printed as of the 9th so she did not see the curve we did here at dad's on the 11th. She says he wants him in for a curve within a week -obviously we had some miscommunication as she didn't have the data showing we are now equipped at home, but we have agreed that I will do another curve Saturday and email Tom's spreadsheet so she can review and call back next Monday.

    She said she had discussed Tom's numbers with one of the other vets who responded "raise the insulin", but she doesn't want to do that, we have raised. I let her know my concerns about the too much too soon raises and that I learned good increase is 0.25 to 0.50. She says well we have been increasing by halves... No we have not. We have increased by half only 2x now- from 2.0 to 2.5 and from 5.0 to 5.5. I don't want to complain on his vet's sometimes too busy treatment of Tom where I've had to remind her of things, but it would be nice if I didn't have to. Anyway, during the call she had the same suggestions that I'd had when we saw her last 2/26. Now she says maybe we should try another insulin, two available, one is much more expensive but another might work for Tom-she spoke so fast can't remember if there were two names but she did mention Lantus?

    I have yet to increase Tom to the 5.75. Was planning on doing another curve this Saturday. Have not picked up a human meter yet. Ordered AT2 strips with rush shipping Tuesday night, but doesn't look like they'll be delivered by Saturday - was hoping to see if results will vary or remain similar using same meter type, but plan B is will still do the curve using human meter on Saturday.

    I would like to give it another shot with the +0.25 increase to 5.75 , would that be ok to increase on Saturday while doing curve with new human meter? Or do you think it's too late for PZI to still work for him? Tom has been on the 5.5 for a little over 2 weeks and results look the same, always high. :(
     
  47. Shawnee

    Shawnee New Member

    Joined:
    Mar 16, 2018
    Hi Amy and Tommy,
    I too have a large 17 lb tomcat, momma’s boy! (he weighed 9 oz when we found him). He has been battling diabetes and also pancreatitis on and off for over a year! We have the pancreatitis finally in check, but it took b12 shots, first weekly, than bi- monthly than monthly! Combined w the insulin it worked wonders! He was in remission, but got a tooth abscess, and he is back on insulin. The first time on pro zinc we worked up to 3 units. but combined w the b12 shots, he went into remission within a few months! This time we are using Lantus, and it has not worked as welll for him! I can tell you for certain, if not for the b12 *****, we would have never got his numbers down the first time they were in the 400s. Ask for the shots, it will help his intestines to heal!
     
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  48. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Thank you Shawnee! 17lbs oh my! Did your tomcat lose weight with the uncontrolled diabetes too? I love Tom's big boned frame but he is still looking so thin the last few months. I will ask his vet about the B12 when speaking to her again. This might be a great idea since he is often energy-less, which I assume he just doesn't feel good a lot of the time. :(

    Received the AT2 test strips today-just in time for curve tomorrow. Still plan on getting a human meter soon, but planning the +o.25 increase/up to 5.75 as @Kris & Teasel suggested while still on the AT2 (hopefully results will look more positive, I don't want to guess if it's the meter making results look better or the dose). Wish us luck!
     
  49. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Amy- I might go with the 0.5u increase at this point - first because he's over 5 units, but even at smaller doses we say if the nadir is above 200 to increase by 0.5u instead of 0.25 units. Especially because you are limited on mid-cycle testing during the week so your dose changes can't be as often as might be ideal, you might want to take advantage of the time to monitor this weekend and do a larger increase.
     
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  50. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    The timed feeder might be the perfect thing - it would help him not "scarf and barf" but still give him access to regular snacks throughout the day. Cats do need a lot of extra calories when they are in high numbers to try to hold off the weight loss, so keep feeding him lots, but as you mentioned, he needs it slowed down a bit so he doesn't get sick from it.

    Great job getting that curve in. It shows that he is responding to the insulin which is great, so it's just a matter of getting in some more increases. Also, as you're about to hit six units, it might be worth considering the IAA/Acro testing to figure out which condition(s) you're dealing with. Have you had a chance to do any reading about those? There is an ISG for that here: http://www.felinediabetes.com/FDMB/forums/acromegaly-iaa-cushings-cats.12/ but it's not very active. It's a good place to read and maybe do an initial post depending on your test results. Most folks who deal with those conditions are over in the Lantus/Levemir group (usually using Levemir). You could stay with Prozinc, but as you've noticed, it gets expensive at higher doses.

    Good luck with the increase (whichever amount you choose) and the curve today!

    How was your time at home?
     
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  51. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Very good, understanding the reasoning you explained, as well as the % of increase that Kris stated -I am not an educator (accountant), but so very glad that many of you are! :cat:
    Tom was 451 at AMPS and received the 6.0 units, hoping for good #s today.
     
  52. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Still thinking about the timed feeder, hoping our other Kitty won't gobble up Tom's in between portions - Tom will Bogarde his way over to her plate (so that she'll leave) when he hasn't finished his- smart Tom, not so polite though.

    I will read up at the link today-thank you. Will have to make a list for the vet, hopefully she'll be ready for all of our questions!

    Tommy rode home in the harness and seatbelt tether next to the teenager. He had the gabapentin at breakfast but we noticed him facing rear staring at the seat. Our chihuahua does this when he's carsick so we gave Tom cerenia about +2. He was high the rest of the way home, poor baby, but was happy to get home. He went in the closet twice last night, laid down and came back out. He went through the house laying down for a bit then moving. I assume he was still a bit groggy from the ride and magic dust.

    We've noticed some dandruff on his backside near tail and assumed because he's not cleaning himself so much with not feeling good and that's ok, he loves to be brushed, but I did see him giving Kitty a bath last night? I know he is happy to be home, he's been very mellow which is not unusual for his personality, just hoping it's the meds and traveling, not that he doesn't feel good. Let's see what numbers the day brings!
     
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  53. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Like you said, most likely woozy from the drugs and the car ride. Make sure he doesn't go off his food though - stress and insufficient calories can trigger ketones so it's something to watch for until he's feeling better.

    Sam likes the tethered harness option in the car too. He looks much more comfortable just sitting on the seat instead of caged. Atticus is the opposite though - he feels safer in his carrier. Ah kitties...always have to be opposites!
     
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  54. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    OMG @Djamila @Kris & Teasel - just opened the new AT2 test strips and when putting the empty container into the recycle, realized these different codes. We initially had our AT2 meter set to 22 CAT as that is what came with our starter kit. I'm trying to insert a pic from this iPad, but the 2nd bottle we've used all 50 strips at 22 instead of 8 CAT. Now the new 3rd bottle says 7 CAT. Has this affected our numbers? :nailbiting:

    I did notice diff numbers on the video I watched about poking with just the lancet /without the clicker, but that was about all I did was notice. Teenager programmed the AT2 when we got it for the accompanying 22. I'm assuming this is something I need to check and learn myself to program the meter every new bottle of strips.

    Tommy's +2 looked good coming down to 274 but now the +4 is 353.
     
  55. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
  56. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    It's possible that using the wrong cat code can affect the BG values. All you can do now is input the proper code and go from there. Lesson learned! ;)
     
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  57. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    I found this on the main forum, saying the code should be checked every time a new bottle of strips is opened, and also that a control test should be done:

    http://www.felinediabetes.com/FDMB/...phatrak-help-needed-asap.153275/#post-1612789

    I did the control test mentioned in the thread and it was in the acceptable range. So unfortunately it probably hasn't affected Tommy's numbers. You're right, it did give the learning opportunity to flip through the "long version" of the instructions instead of the "quick start" guide. I remember we were excited to use it after 5 weekly Vet payments for accucheks (ouch).
     
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  58. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Glad to hear you got safely home! Tommy probably just needs some time to relax and get used to his home surroundings again. Keep an eye on him, but don't worry too much (easy for me to say!).
     
  59. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Thank you Rachel, I'm sure you are right. Mom needs a rest now too, even though I wasn't he one getting poked 87times today o_O
     
  60. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    We are done with today's curve with the +0.50 dose increase, yahoo! I think I received hisses every other poke and not the PM injection. Tommy slept a lot today. It seemed like he only woke up every two hours for a poke and snack, but he ate well and no vomiting so far :cat:

    Please have a look at his updated spreadsheet and let me know what you think. I think it looks like he still needs more insulin. I also entered the data from 2017 albeit is sporadic. I still need to enter labs.
     
  61. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Yes, I think his dose will have to go up.
     
  62. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    We could do more. Does it look like any progress with the yellows? How much increase after how many cycles? I will be working from home Wednesday and could get some mid-cycle tests, but that is 6 cycles from now.
    Will hopefully communicate with Tom's vet on Monday. Now that I think back about our convo this last Monday, I believe she is leaning more towards changing insulin. I was hopeful today's curve would show some improvement that prozinc could still work for him, but still worried.
     
  63. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    You can typically increase every three cycles, but there should be more than one cycle of data in those three since sometimes the kitty won't respond much the first cycle, but will on the 2nd or 3rd cycle. Or sometimes they'll respond on the first and then less on the next couple, or high and flat on the next couple. So ideally if you could get a +6 or +7 (it looks like his lowest number was on the later side of the +6 time) today, that would be great.

    Since you're still well over 200 on the nadir (your lowest number), I would say to do another 0.5u increase. You could do it tonight if you can get a mid-cycle test tonight. If you can't, then wait until Wednesday when you can.
     
  64. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    How much Prozinc do you have left in your vial? Any idea when you'll be needing a new one?
     
  65. srk4cats

    srk4cats Well-Known Member

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    Jan 19, 2017
    There are even lancets at the supermarkets for under $2. Just don't get the 33-gauge micro-thins even though they come in pretty colors. I have a hard time getting a blood drop from them and have wasted test strips because of it.
     
  66. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    Now also remember vet said if he went under 300 to test every hour, probably to nail down that nadir. I can get a +6 and +7 today but he will want a reward after the +6.
    I'm not positive that I can get a mid-cycle tonight if we increase.
     
  67. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Almost half in the current vial, then have two more vials - one has at least two doses and the other probably has 2 days' doses. I think if we continue with the increases and not seeing significant response at the end of the main vial, we will have to try something else. These high #s can't have been good for his body this long.
     
  68. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    I was contemplating getting the higher gauge #, smaller gauge because I can hardly get a sample from Tom's capillaries after a few pokes I end up poking the vein and have overflow! :(
     
  69. srk4cats

    srk4cats Well-Known Member

    Joined:
    Jan 19, 2017
    me, too.
     
  70. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    It might be worth starting the conversation with your vet about Levemir so you have time to order it and learn about it before you run out of Prozinc. Most folks with higher dose cats prefer it because it stings less than Lantus when given in larger amounts.

    Of course it's always possible that Tommy will surprise us, 6.5u will be his magic dose, and he'll start to come down, but better to start planning under the assumption that he's going to need more insulin still.
     
  71. Amy & Tommy

    Amy & Tommy Member

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    Mar 3, 2018
    Good idea Djamila, thank you again. It's good to know the Lantus stings at higher amounts, making a note for discussion with vet hopefully tomorrow.

    Tom was 262 at +6 and 297 at +7 with no food between, so mid-cycle definitely seems to be his nadir (please correct if wrong). He is still sleeping a lot today, but was playing with his mouse last night so no concerns about his activity. I will get a +4 or +5 tonight but that may be as late as I can push myself, maybe I can up to the 6.5 Tuesday evening, we will see.
     
  72. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    Tom's vet called today after I emailed his spreadsheet. She did not mention noticing that I increased him to 6u, but discussed changing his insulin to Vetsulin and starting off with 1u twice daily. She said we need to him regulated and/so we can get him in for a dental cleaning. I am all for that after reading about the effect bad dental can have on the BG. She said yes we know he has the pancreatitis that can affect his BG. I asked what she thought about testing for acromegaly and IAA. She said if we can't get him regulated on the Vetsulin then we can consider that as the tests are very expensive. She is just out of the Vetsulin but will receive more by the weekend. I need to pop over to the Vetsulin forum and do some reading. Should I continue with another +0.5 increase to the 6.5u on Wednesday?

    Tom vomited this morning at +5 (I believe) because adult kids were not up to feed him - definitely ordering the auto feeder this Friday as we are not going to make this a habit! He had some fancy feast broth and then some cod/sole/shrimp to be sure he ate. Next he had some constipation and was actually grunting to poop which the poop was very large I was told. What could cause this? Did I supposedly over feed him again on Saturday's curve?
     
  73. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Did she explain her reasoning for putting him on Vetsulin? And on a much lower dose? Yes, do go read the yellow info stickies on the Caninsulin/Vetsulin forum. Some cats do well on it but there are some important differences between it and ProZinc:
    • it tends to be faster in onset and can drop BG down more strongly (that might be where she's coming from)
    • it can have shorter duration than ProZinc - 8 to 10 hours as opposed to 10 to 12 hours
    • it can increase bouncing in bounce prone kitties because the BG can drop quickly and fairly low as a result of its stronger action.
     
  74. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    If the constipation continues, try miralax 1/8-1/4 tsp once or twice a day. Put it in his food and add water. My cat has recently started having the same problem and that seems to work best.
     
  75. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    No she really didn't. I said I thought we were talking about the lantus or levemir but I don't remember her response ...always quick conversation or visit, I tried to take a note (lucky I got down the name vetsulin). I called back to inquire about the cost since she last week she had said one of the other options was much more expensive. The tech said vetsulin is $58, I am paying $150 for the prozinc. I asked if it would be the same 40u needles but she didn't know. I really am trying to avoid unnecessary paid visits, but we are obviously going to have to talk longer and hopefully slower. I am gone from home approximate 12 hrs on weekdays so not sure how that 8-10 hr time frame could work. She did say we would need to take a curve at the start and when # drops below 300 to test every hour - I did neglect to do this on Saturdays curve.

    Tom just vomited again :( we are at +1. Should I take his BG and/or give him a half a cerenia? I need to look to see if constipation is a side effect of cerenia.
     
  76. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I’d give him the Cerenia.
     
  77. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    Thank you Sharon, making a note to pickup some miralax. It really is a strange thing, I kept asking the kid how was he grunting?
     
  78. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    I'm going to. And if he asks for food I will feed. He is very calm now but obviously stomach is upset. Thanks Kris.
     
    Kris & Teasel likes this.
  79. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    My cat grunts when he’s constipated too. The miralax has helped him. Unfortunately for my kitty I think he’s developing magacolon which many cats with acromegaly develop.:(
     
  80. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    Aww poor Colin! I saw on the MSU form that the acro test was $58 but am assuming since the sample has to be sent cold that is why Tom's vet says it's very expensive?
    also I saw your post on the caninsulin thread for the Abyssinian about the zobaline. Of course I forgot to ask the vet today about B12 shots, but is this relatively the same thing? Tom is not up on his toes as much lately, I know that with his breed his front legs are shorter than hind, but I keep thinking his hind feet are going down. Shawnee had said above that the B12 helped her kitty with the pancreatitis /intestines healing and with the BG regulation with prozinc. I'm sure it has multiple benefits, just have to remember everything sheesh.
     
  81. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    Yes the cost of the acro test comes from the overnight cold shipping + whatever your vet charges to draw the sample. For neuropathy, the methyl B12 and folic acid to aid absorption is supposed to be best. You can find cheaper options, but be careful that there are no sugars (including artificial). Zobaline is easy because it’s made for diabetic cats, so no worries about ingredients or dosage, and it’s easily crushed and mixed in food. My vet recommended shots too, but I didn’t want to stick Colin any more than I had to.
     
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  82. Amy & Tommy

    Amy & Tommy Member

    Joined:
    Mar 3, 2018
    Good morning everyone! Its been a long week and today could be the start of really regulating Tom's diabetes, we are hopeful! I spoke with his vet on Thursday after emailing his spreadsheet. She said don't increase Tom to 6.5, I said too late I did on Wednesday in hopes of a change (we didn't really see any). She advised on our starting the vetsulin at 1u twice daily and to let it get into his system for about two weeks, then we will need to get a curve on him. I let her know that I will still be doing AMPS & PMPS testing as well as mid cycle checks due to the fast onset of the vetsulin, she said if he will let me. :rolleyes: I am going to pickup a Relion confirm or prime this weekend and use both it and the AT2 for a couple of tests just to compare and have the data. We are also still thinking about the arthritis/joint treatment, maybe will try some cosequin capsules since he scarfs & barfs the glycoflex treats.

    @Kris & Teasel i read the the yellow sticky on the vetsulin forum, good information! Also read the whole manufacturer insert... Scary stuff when they're talking about hypos in their clinical trials. We have compiled our hypo supplies in case *crossing fingers we don't have to use them*

    @Djamila i ordered the timed feeder, it will be here tomorrow. I am excited to set it up so that Tom will not have to rely on the kids, and also so that he could eat during the night as he is usually so hangry in the AM. Do you have any tricks for keeping wet food portions cold until dispersion?

    @Sharon14 i ordered the zobaline, vet had not heard of it but said ok if made for diabetic cats. Also have been giving the miralax at AMPS & PMPS feelings since Thursday pm. Tom had a few large hard pebbles in the litterbox last night but is still tight in the abdomen. It says it works in 1-3 days, this AM was 4th dose, so hoping to see softer stool soon.

    I guess we will be heading over to the vetsulin forum, but want to thank all of you again for your help and advice in our journey to controlling Tom's DM :bighug:
     
  83. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    If you lower the dose that much when you switch, please be sure to check daily for ketones. Also, add plenty water to his food as the miralax works by drawing water into the intestines. Good luck with the vetsulin.
     
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