New to FDMB- Prozinc User- High BG & Neuropathy :-(

Discussion in 'Prozinc / PZI' started by Leigh B, Dec 23, 2018.

  1. Leigh B

    Leigh B Member

    Joined:
    Dec 22, 2018
    We discovered my boy, Murphy, was diabetic in May this year. We started him on Lantus for several months and his results were not getting better. He was hanging 300-400's. I went to a new vet, and learned that some cats respond better to Prozinc. He IMMEDIATELY responded when we changed him to the new insulin. However, during this time, he started showing signs of neuropathy. It is not getting better. He is able to come up steps and jump on the couch, but it seems to be worsening. I have purchased Zobaline. I gave him one pill a day for a week, and have been doing 2 pills a day for the last week. (Two weeks total on the Zobaline). I keep hoping it will get better.
    I know that having his BG under control is the most important factor.
    I had stopped charting and tracking b/c he seemed to be leveled out in the 190-200 range. Yesterday, his neuropathy was really bad and I could tell he was in a bad BG range.
    Yesterday I started to chart again. He was at 485 before food and 1st shot!! UGH. I feel like we take one step forward and 2 steps back. I tested at 6 hours and it was 347. I “upped” his pm dose to 3 units. At about the 3 ½ hour post dose point, his BG was at 183. In the middle of the night, I tested again and he was at 121.
    I'm a little confused about what may be causing his sudden high numbers. I have not changed anything...just maybe food? I've transitioned from the Purina wet DM to Friskies pate. I've done a TON of research and have seen all of the charts posted here. I'm feeding him the classic blends that are recommended on the charts. Otherwise, I'm doing 2 1/2 units of the Prozinc twice a day....just added the Zobaline for his neuropathy. I can always tell when his BG is not good b/c his mood is so obvious. It breaks my heart.
    I'm looking for help/support regarding the neuropathy AND any thoughts/tips on Prozinc. I am thinking there might have been an accidental fur shot that caused his high numbers?
    When his numbers have gotten high in the past, he's been obvious at the water bowl. He's NOT been drinking much water at all. I have assumed it was because he was not needing it, due in part to the moisture in the food.
    Help! I was in tears last night...I do not want to put him down. But, if he can't walk...I don't know if I'll have a choice in the end.... :-( :-( :-(
    I have started a chart in my signature (hoping I did it correctly)
    Thank you! So glad to have found this site...people who understand!! <3
     
  2. Candy&Company

    Candy&Company Member

    Joined:
    Sep 12, 2018
    Noooo, you won't have to put him down, I doubt it - not looking at your post and your chart. The Zobaline WILL help, as will trying to get a grip on his insulin dose, not to worry. My Fena presented horrible, and she's her old self now.

    As for water, think about adding some tablespoons of hot water to his wet food, every feeding - to keep him better hydrated. How much does your baby weigh, what breed, age?

    Those blue numbers are VERY positive - don't be sad, please, this board is AMAZING.

    Get his PMPS tonight, and post here - and any other numbers you might get before then, ok?

    This board CAN help your baby. :bighug:

    PS - getting to low carb food is EXCELLENT but monitor him close, sometimes that can really drop the numbers.
     
  3. Candy&Company

    Candy&Company Member

    Joined:
    Sep 12, 2018
    PS - Try to keep your baby as happy and calm as possible. If YOU'RE stressed/emotional, they'll pick up on it.

    I think the 2.5 dose is doing good for him for now, if his numbers keep up good, for awhile you should be great. It seems like he's responding well so far - but you wanna watch in case he need a lower dose. Those blues on your chart? EXCELLENT. *high 5's*

    Zobaline can take up to a week sometimes to show it's working, so help your baby as best you can. Breathe... everyone tells me to do that and it's important, believe me, LOL. Your angel has SUCH a sweet face, aww.. we'll help him and you. *nods*
     
  4. Candy&Company

    Candy&Company Member

    Joined:
    Sep 12, 2018
    PPS - this might not be the best advice, but with Fena at her worst, I had this one old gardening glove. She knew when I put it on, it was "play time" - it went almost to my elbow and was leather-ish. I'd play at her chest/tummy to MAKE her use her back legs, which was sad at first but slowly... she got A LOT better. Exercise, if walking/stairs/etc. can't do it. For Fena, anything that got her back legs working I supported. Might be something for your baby?
     
  5. Lisa and little

    Lisa and little Well-Known Member

    Joined:
    Sep 24, 2018
    Hi Leigh... don’t freak out. Just look at my SS and you’ll feel better. Lol. I know the stress and I am not qualified to comment on dosing as I am still trying to figure it out myself but the people here are awesome and I could not have gotten this far without them. One thing I can comment on is the Zobaline. I am into my second month a 2x a day. When I started Little was having a hard time jumping up on the bed, couch etc and would have some swings and misses. She is much better now although still walking a bit “drunk”. Give it all time. Rome was not built in a day and as the members here have told me many times- this is not a sprint it’s a dance. Patience is necessary... keep watching BG levels and giving zobaline.. many member a have said it can take quite some time. Thoughts are with you and beautiful Murphy!!
     
  6. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    First of all, Candy and Lisa have given you some great advice already about patience and zobaline and exercise. It can take some time, but you will see progress. Remember that Murphy didn't get here overnight, and he isn't going to heal overnight.

    As far as the dose, with only two days of data, it's too early to say much, except that it will be important to keep the dose the same both am and pm for a few cycles and continue testing before each shot and a couple of mid-cycle tests when you can so we can see the insulin response. And keep posting so we can help get Murphy into better numbers.

    Great job getting onto a low carb wet food. What are you giving for treats? Are there any other pets in the house on different food? You'd be surprised how much impact even a single high carb treat or one little bite of the dog's food can have on a diabetic cat. So look around carefully if three might be any other source of carbs that Murphy is getting into you. He'll make the best progress with an appropriate dose of insulin (we can help you get there), and a carefully controlled diet.

    Hugs to you. and Welcome. I'm sorry you have to be here, but glad you have found us!
     
  7. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    Leigh, I just wanted to suggest that you be patient and wait for the ProZinc experienced members to read this thread and offer some advice. @Rachel and @Djamila are two that I know of with a great deal of knowledge and experience with this insulin.
    I have also read that the treatment for neuropathy can take a long time, so please don't despair. Here is some information on that subject http://www.felinediabetes.com/FDMB/threads/feline-diabetic-neuropathy-weak-back-legs.178252/
    Please make your signature so that the advising members can see Murphy's pertinent info right away, it will display with each of your posts and is a complement to the spreadsheet you have already set up. Here is a link on how to do that: SIGNATURE
    Best wishes to you and Murphy going forward. :cat::bighug:
     
  8. Candy&Company

    Candy&Company Member

    Joined:
    Sep 12, 2018
    See? This board is AMAZING - you and Murphy are in EXCELLENT hands, just be patient please.. I know it's hard, believe me! But it pays off - and don't neglect yourself either! Snuggle your baby alot, do what's fun... play with toys, etc. Yourself, eat good, sleep good...

    Took me awhile to realize I was neglecting myself to care for my babies but they NEED you at your best. Don't neglect, no matter how hard it might seem. :bighug:
     
  9. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Welcome! We can help. :)
     
  10. Leigh B

    Leigh B Member

    Joined:
    Dec 22, 2018
    Wow!! What a blessing you all are! Thanks for the kind words and advice. I am blessed to have a friend staying with my fur babies while I see family Christmas Eve and Day. I'll be charting and updating as soon as I can get to my computer.
    Murphy is such a sweet boy. And, he's not very old. I rescued him, so I'm not exactly his age, but it is about 6 years old.
    He had gotten up to 22 pounds but is at 17 now. That's still alot, but he's a larger sized cat, too.
    I'll update numbers soon...and will have many more questions, I'm sure!
    Thanks again for all of the great responses & feedback.
    Hope you all have a very happy holiday!
     
    Kris & Teasel likes this.
  11. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    We'll be here when you're ready to start. :)
     
  12. Leigh B

    Leigh B Member

    Joined:
    Dec 22, 2018
    For the record....he IS getting his shots while I am gone. Just not getting his BG monitered.
    Also, I've been dealing with this since May, so I am going to try to update his signature chart on here when I have it all in front of me.
    I'm SO ready to have him stabilized.
     
    Last edited: Dec 25, 2018
  13. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    It can be frustrating for sure...we're here and happy to help you get him stabilized! We've helped tons of people with their cats, so I'm sure we can help with Murphy too. :)
     
  14. Leigh B

    Leigh B Member

    Joined:
    Dec 22, 2018
    Hey there...I am trying to update Murphy's chart under my signature, and I can't access it to make changes. I'm not the best on computer graphs, etc...I was able to start it, but can't update it. Should I be allowed to access it from my profile/signature page? If not, what am I doing wrong? I can start all over, since I only have a few days logged, but will need to know how to update for the future.

    My boy is not looking so great today. He is showing 385 4 hours after 2.5 units. He isn't eating much breakfast (enough to give shot)...and is not drinking much water. Could/does this mean he might be having renal issues**? In his early stages, he'd be drinking tons of water if his BG was high...
    I am home and watching him closely. Going to go to 3 units in the am and 3 in the pm and continue to test his BG.
    So tired of seeing him sick! His eyes look sunken today.
    Also, so tired of having to stick this poor boy to get BG. I have PAGES and PAGES of numbers going back to August....and he's still in the 300's.
    Is there a chance this is a much larger problem than just the diabetes? **I have had 2 panels run on him this year, at 2 different vets, and they both said the only issue they found in his blood work was the diabetes. WHY can't I get this boy better? 3 units twice a day seems like so much...
    Again- I'll update his chart with the history since I started him on the Prozinc, so you guys can see a better idea of his progress/lack thereof.
    Thanks for the tips and help....worst case, I'll start the spreadsheet all over...
     
  15. Leigh B

    Leigh B Member

    Joined:
    Dec 22, 2018
    Figured out how to update spreadsheet!!
    Any thoughts/ideas/experience with the other issues mentioned in my previous thread post? :-( Thanks!
     
  16. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Great job getting the spreadsheet sorted!

    Do you have ketone strips so you can test at home? You can buy them at any human pharmacy for around $15. You stick the test strip into his pee while he's using the LB (if he won't let you near him when he's peeing let us know and we have some other tricks that make it possible). If he isn't eating, that would be my first concern. Ketones can be quite serious, so I urge you to get a test as soon as possible if he isn't eating, and especially if he seems lethargic as well. If you can't get a test soon, I would suggest a vet visit as they can do a quick blood test in office to check quickly and easily.

    Don't worry about how high his dose is. A kitty needs what he needs. While many cats never use more than 2u, other cats get upwards of 10, 20, 30 units. Just think about the blood glucose numbers, and don't worry about how much insulin it takes to get there. If he gets to six units, you can start considering switching insulin since Prozinc starts to get expensive at that point. I know you've already tried Lantus, but my hunch is that the problem with it was more due to poor vet advice than to the insulin itself. I've noticed that kitties who are diagnosed when they are quite young, as Murphy is, do tend towards the higher doses at least for awhile. That's just anecdotal, there isn't any research I know of to back that observation.

    A couple of suggestions: first, have you considered using a human meter instead of a pet meter? The numbers read lower on a human meter, so they just automatically make you feel better. And they still give the information you/we need to adjust the dose. Plus, they are way cheaper.

    Second, while I know you don't like testing (none of us do), it really is the best tool you have for getting him better control. As I look at the data you have, I'm unclear why he's getting two different doses AM and PM? Now that you're back in town, I would suggest holding the doses you have regardless and posting your data from today and tonight. Then let's take a look tomorrow and see if we can't start helping you get some more appropriate dosing to help him start feeling better.
     
  17. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Djamila has given you great advice. We can help you get your kitty feeling better. :)
     
    Leigh B likes this.
  18. Leigh B

    Leigh B Member

    Joined:
    Dec 22, 2018
    THANK YOU!!! I am not testing for ketones. I will go get a test today! Quick question...how do you treat when there are high ketones? Is there something different/additional to add to the routine? I have done tons of research on diabetes, glucose and neuropathy, but not high ketones, specifically.
     
  19. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    The best treatment for ketones (anything above a trace amount) is a vet stay as they require fluids and fast acting insulin that must be closely monitored. If it's just a trace, you add water to the food at home and monitor closely as they can progress rapidly. @Kris & Teasel is our ketone expert since she's had to deal with them a couple of times with her kitty.

    Ketones are caused by insufficient insulin + not enough calories + some sort of infection/inflammation. Often times that last one is something like a UTI, a dental issue, or some other thing that is not detected until after the ketones appear.

    Anytime we see a cat in high numbers who stops eating, we get worried about this.
     
  20. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Djamila is correct. I've had unpleasant experience with ketones. Testing urine for ketones is wise and easy to do. Anything above "trace" warrants a vet visit. Here are some ways to get it done:
    • put the end of the test strip right in his urine stream as he's peeing
    • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
    • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
    Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.
     
  21. Leigh B

    Leigh B Member

    Joined:
    Dec 22, 2018
    Murphy was initially diagnosed b/c of dental issues (in May). We had some of his teeth extracted, and he has a healthy mouth now. At the time of his surgery, they did a blood panel before the procedure (standard protocol stuff), and discovered his elevated BG. He DID have ketones in his urine at the time. That was one of the final indicators to the vet that it was diabetes, and not just stress due to being at the vet and having oral infection.
    I will hit the pharmacy on my way home, and see about getting him tested as soon as I get home.
    Stay tuned...
     
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  22. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    What Kris just said is important - make sure to read the directions on the strips you get and check it in bright light at the correct time. The color will continue to darken as time passes, so if you check it late, it will look worse than it is. The colors can also be hard to discern (at least on the strips I use), so good lighting is important.
     
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  23. Leigh B

    Leigh B Member

    Joined:
    Dec 22, 2018
    Sooo....good news (I think)....his ketone level met the "trace" indication on the chart. I was afraid it would be dark purple/high. I'll keep checking it. Also, tested BG again (last test was at 12:30 and was 359) and he's at 387. That's still too high, but I was worried it would be higher.
    He is super lethargic still :-( I am going to get him on a constant 3 units for tonight & tomorrow. Hoping for stability. His neuropathy is so bad that he can hardly walk. Still giving him Zobaline. My poor boy :-( :-(
     
    Djamila likes this.
  24. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I'm glad you got the ketone test strips. Test for those as often as you can right now. Stick to the same dose tonight and we can start working with you tomorrow. Those pre shot tests are important.
     
  25. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    It can take a couple of months of good numbers and zobaline to heal from the neuropathy. I'm glad his ketones were low! Make sure to add in a few tablespoons of water to the pate to help keep him hydrated. This is important for all cats, but especially since he's shown ketones before. My guy didn't like the added water at first, so I had to start with a teaspoon of water stirred in, and gradually work him up. Now he gets a hearty 3T per small can sized portion of food, and laps it right up.
     
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  26. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Yes, to water added to all wet food meals. Teasel is very tolerant of these things and gets 3 to 4 T added to his meals that are 1/3 of a 5.5 oz can of food each. Definitely soup but he laps it right up. He's had DKA twice so I make sure he's well hydrated all the time.
     
  27. Leigh B

    Leigh B Member

    Joined:
    Dec 22, 2018
    Thank you! I updated his chart. His neuropathy is killing me! Poor thing can't take more than a few steps at a time. I've been putting him in the litter box b/c I feel like he doesn't go because it is too difficult for him.
    I am keeping him as comfortable as possible, giving him Zobaline twice a day, shots twice a day...food that is "diabetes approved"....
    His eyes are looking sunken and he's not really eating much anymore. I am sure that he eats enough to get his dose, but it does worry me.
    I keep telling myself I'm doing all that I possibly can. I am starting to prepare for the worst, though. If he gets to the point he can't walk at all, I am not sure what else I can do? I want to keep him as comfortable as possible for as long as possible, but I feel like he's starting to suffer more. I can just tell...even if I can't figure it out obviously with ketone or BG readings.
    Does this sound familiar to anyone you've come across on this board? I'm afraid the neuropathy is going to be the ultimate issue. I picked him up to take him to his box this morning and his front paws were shaky. :-( :-( :-(
     
  28. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    That's a risk factor for hepatic lipidosis and ketone development. He might need antinausea meds and appetite stimulant meds.
     

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