Need some hope

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Ashley82

Ashley82

Member Since 2015
My 9 year old cat Citrus (orange tabby) weighed about 18 lbs and then suddenly dropped it all and started with the polyuria, polydipsia that diabetes is known for. This was about September. February it was confirmed and on Feb 20th we started with once a day insulin shots (ProZinc).
His behaviour has been atrocious. He is urinated on the furniture- despite a clean litter being about 10 feet away. Even with new litters throughout the house (including one right beside the couch), deterrent spray etc the peeing on the furniture continues. This is a new problem (probably around Jan) that went unnoticed because the urine doesn't smell like normal cat urine with all the sugar in it. I have cleaned the couch several times with the dual action urine eliminator stuff from the vet. Is this normal for a cat who is sick?
Now about this insulin. Because I am out of town half of the month and I can't afford to pay some one to come in twice a day Citrus is getting once a day insulin (ProZinc). Started at 2 units Feb 20th and have been monitoring his blood sugar at home. His sugar continued around the 20mmol/l even after 15 days (goal 4-9.5). Up to 3 units for 12 days, blood sugar came down to about 16mmol/l and he seemed to be putting on weight (yuppy!) Vet says still too high- increase the dose. 4 units for the last 9 days-- now he is back up to the 27mmol/l WTF? Why is he getting worse and not better? It would be assumed that if he was doing well and going in the right direction with 3 units a day then 4 would be better-- and yet it is worse.
Am I feeding him wrong? He is getting 1/2 can of the diabetic prescription food in the morning and half with his insulin in the evening. There is some dry kibble available during the day (also the prescription food) since some times he is so hungry that he literally climbs my leg.
How long does this take?
I love my cat but am not sure how much longer I can keep up with his messes, especially when I am not here.
Any hope? Suggestions?
 
Hi Ashley,

First off, take a very deep breath. And now another one...
Many of us felt overwhelmed at first, but it does get easier, honestly.

Some of the behaviour you're seeing is not at all uncommon for a recently diagnosed diabetic cat.

As you know, cats with high blood glucose pee a lot. And the need to pee can be urgent. They don't always make it to the litter box. My cat peed everywhere at first. It wasn't 'bad behaviour' - the poor thing just couldn't help it. He even peed in his sleep, which wasn't great because he often sleeps on my pillow (so I've woken up more than once to find my hair soaked in cat pee...)
Diabetic cats are also very prone to UTI's (urinary tract infections), and if a cat has a UTI the situation can become worse. (You mentioned that your cat's pee now smells different; what kind of smell does it have?)
The peeing will return to normal as the blood glucose levels get better.

Citrus's appetite should also return to normal once his blood glucose levels get under better control. He's ravenous because his body can't utilise the food he's eating. He needs the insulin to help him do that.

The vast majority of cats need two insulin shots a day. If only one shot is given then it may be that the cat only has insulin in it's system for half the time. Therefore the blood glucose levels aren't going to be kept under control.
Here is the link to the FDMB Prozinc User Guide:
Protocol for ProZinc/PZI

If it is the case that Citrus's blood glucose levels increased after the dose was raised to 4 units then it may be that the dose is actually too high.
It may be that the higher dose is causing the blood glucose to drop too low, and the body is responding to this 'threat' by releasing stored glucose into the bloodstream. It's a protection mechanism. It can be triggered when the blood glucose drops toward dangerous 'hypo' numbers, but can also be triggered when the blood glucose just drops lower than the cat is comfortable with (diabetic cats get used to high blood glucose levels and can need to relearn what is normal). This is a common phenomenon, and we call it rebound or 'bouncing'.

You say that you are testing Citrus's blood glucose at home. When are you actually doing the tests?
Are you testing before each insulin shot?
And have you tested during the insulin cycle to see how low his blood glucose is dropping at the peak of the cycle?

Regarding food; most of us don't feed prescription food. We feed our cats ordinary low carb wet food. But this is lower in carbohydrate than the prescription and dry food. Reducing the carb content of the diet can reduce the blood glucose levels quite a bit, and that means that the insulin dose may also need to be reduced in order to prevent hypoglycemia. We recommend that folks only lower the carb content of their cat's diet if they are comfortable with hometesting and can monitor the effect of the diet change.

I would recommend, given those high blood glucose levels, that you monitor Citrus's pee for ketones. You should be able to get Ketodiastix (or equivalent) test strips from most pharmacies.

You ask if there is 'any hope?' and the answer is 'yes', there absolutely is hope.
With the right care there is every possibility that Citrus may return to normal health soon. :bighug:

Eliz
 
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Most of use here record our BG value and does and other information is a spreadsheet which then can be viewed by other caretakers in this forum. Here is how to setup the spreadsheet.
http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/
With a filled in spreadsheet of your past data we can them be able to make suggestions on dose.
A better insulin if you have to go to once a day dosing would be Lantus or Levemir although both of those are twice a day insulins normally.
 
He is jumping over the litter to pee on the couch. I feel like I have to follow him through the house. Then he uses the litter box.
So he knows that he is doing something wrong. Yet does it any ways.
 
First, check him out for a UTI. If it hurts to pee, they start associating the box with the pain and avoid the box.

Second, the odds are you will never have control of any of this if you are only giving him insulin once a day. It just doesn't work to double the one dose. He may well be going way to low then bouncing up high because his dose is too high. And he feels rotten when he is both high and low. If he is going very low while you are gone, the dry food (which is probably higher carbs) might well be saving him. And he is ravenous because diabetes prevents food from being metabolized properly.

Take some time and read some of the stickies here to learn more about best treatment protocols. The more you learn, the better he will feel and the happier you will be.
 
I am new to all this myself, but his system is probably out of whack since the insulin isn't being administered around the clock. If I understand properly, insulin lowers the blood sugar for x hours after it is administered, and then begins to wear off and the blood sugar begins to rise again until the next time a shot is administered. If Citrus is getting the injection at night, then I am assuming by morning and then throughout the entire day his sugar will be quite high since he is not receiving a morning shot as well (you'd have to check how your brand of insulin is meant to effect the cat's system over the course of a day for a better estimate/perspective). If Citrus's sugar is high during the day, then he will probably be quite thirsty and seem ravenous since he is not receiving much if any benefit of the insulin at that point. The frequency and volume of urination will be high as well. Also, as Debby just mentioned, higher doses could be causing more extreme high/low swings in his body, especially if they are being given once a day and the insulin is meant to be given twice.

Hopefully your vet can help you get Citrus on a schedule and type of insulin that can accommodate both of your needs.
 
Ashley82 said:
Because I am out of town half of the month and I can't afford to pay some one to come in twice a day Citrus is getting once a day insulin (ProZinc).QUOTE]
Hi Ashley, Where do you live? I ask because I'd be happy to meet you and if you agree come in to give Citrus his shots, if you live in my city.
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PMLOC said:
:(I'm in Calgary. I'd hate to see you give up on Citrus...
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I am so upset. But I think that is where this is going. I can't afford more help. He wont be full time with me for another few months. And even then every time I need to do anything I am going to have to get other help.
Thank you for being so kind as to offer.
 
I don't know anything about ProZinc, but is there a reason it has to be administered at night as opposed to the morning? Just thinking that an AM injection might help keep his system in check during most of the day (assuming that is when he is most active), and then if for whatever reason the insulin is not lasting as long as it needs to for him then perhaps with it being night he might sleep during some of that time despite his sugar being high.
 
Romeo's Dad said:
I don't know anything about ProZinc, but is there a reason it has to be administered at night as opposed to the morning? Just thinking that an AM injection might help keep his system in check during most of the day (assuming that is when he is most active), and then if for whatever reason the insulin is not lasting as long as it needs to for him then perhaps with it being night he might sleep during some of that time despite his sugar being high.
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It's more of a timing thing for the person who is coming in to help me. They work during the day so come by when they are done.
 
I think we have some members around Toronto. How close it that? Maybe start a new thread with something like "Regular cat sitting help needed in Brampton". Be sure to include a link to this thread.
 
Maggies Mom Debby said:
I think we have some members around Toronto. How close it that? Maybe start a new thread with something like "Regular cat sitting help needed in Brampton". Be sure to include a link to this thread.
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How do I link to this thread? What would be the best forum for the new thread?
 
Ashley82 said:
How do I link to this thread? What would be the best forum for the new thread?
Click to expand...
Hi Ashley,

This forum (main health forum) gets most 'eyes', so you'll be most likely to get results by posting here.
If you look at the bottom right hand corner of your first post in this thread you'll see a faint '#1'. If you click on that you'll get a pop up box that will give you the URL address to the post (in two versions). The first link is the long-winded version, the second is the concise version, but either version is fine. Just copy and paste the link into any post you make.

Wishing well for you and your boy,

Eliz
 
Hi Ashley,
I don't have anything to add to the already excellent advice you've received here except to say that, emphatically YES--there is hope. My Noodle exhibited so many of the signs you've mentioned when he was first diagnosed and while he is not fully regulated yet, he is MUCH better and the out-of-box peeing, etc. has stopped. So please hang on if you can--it really does get better!

Hugs to you both,
Christi
 
I would switch to Levemir if I could afford it, I think in most cats you will see some effect for most of the day after it builds in the system, if you cannot afford Levemir I would at least give the Prozinc twice a day on the days you are there and I hope maybe you can find someone in your city to help.
 
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