Newly Diagnosed BG's HI HI HI HI

Previous thread http://www.felinediabetes.com/FDMB/threads/suspected-possible-diabetes.225637/
Please take a look see at Tiger's ss, I'm freaking out. I'm not new to feline diabetes Jazz Man has had it for 5yrs now. Tiger's BG is scaring me.

 

BG numbers for last night and this morning? SS not updated for the last couple of cycles.
Did you already increase to the 1.5U suggested in the previous thread?

Looks like 1U is not enough.
Either 1.25 U Prozinc or 1.5U Prozinc.
You risk bypassing a good dose for Tiger with the larger increase. But it's your choice for the dose increase.

On the other hand, Tiger is really high. If you are around to monitor Tiger, you may want to increase by the 0.5U amount.

Pre-shot tests are the last BG levels to come down when using Prozinc.

 

Can you get him to a vet soon? Not for a diabetes diagnosis, but to check to see if there's something else going on like a UTI or something

 

If it's a Uti the Amoxi will clear it up.

 

The SS is accurate as of 4pm CST. Yes, 1.5u 2 cycles. I need to figure out where to add the time's. Basically a 2nd shift schedule...AM=Noon and Pm=Midnight

 

UGH I just checked the ss. Why didn't the link update when I added the other readings?

 

Oh yeah, I forgot about him already being treated...but it's also possible the Amoxi isn't doing the job. Without a culture & sensitivity, there's no way to know for sure.

How old is your ProZinc?

 

Were you signed in?

 

UGH!!! Until I figure out why the SS is updating here is a snapshot

yes

 

Ya know I started using a donated bottle it expires next month. HMMM maybe thats the problem. I started out using a bottle that expires in Oct. I think thats when the readings where pinkish

 

Ok ss is working again. The link got goofed up somehow

 

Ok. Do you want to try 1.75U dose for PM cycle?

 

If the insulin was too old wouldn't that be too big of a jump? From 1u(when he had pink readings) to 1.75?

 

I think I'd get a new vial ASAP. I think that one's toast

 

If the Prozinc insulin is old, it is less effective. If the insulin has not been stored properly or mixed thoroughly before each and every use, it will be less effective. If the insulin has been open a long time, it can be less effective with age. Sometimes, as little as 60 days. If the Prozinc insulin has not been protected from light, it degrades over time. Keep it in the original box or a dark opaque container.

You can try to keep Tiger at the 1.5U dose for 1 more cycle if you want.

You've gone from 1U to 1.5U and now maybe 1.75 U.
Choice is yours. You hold the insulin syringe. You know your cat better than we do or will ever know him. You are there to observe him. You know what your work/life responsibilities are and know when you will be home to monitor Tigger.

"Know thy cat." ECID. Every Cat is Different. Every Caregiver is Different. Every Cycle is Different.

 

Those "pink" BG ranges are not low. Yellow BG ranges are not low. Blues and dark greens are what you want to see more often. Numbers in the dark greens are lowish. Numbers in the bright green colors are too low and need to be brought up quickly. With food from your hypo kit.

 

The insulin I was using before was fine..Jazz Man is on it. I'll go back to that vial. If I do tonights shoot at 1.5u and check every couple hours..if he is STILL high like around the +6 could I give him .25 then? UGH!! Oh heck with it...he is sooooo high I'm gonna do 1.75u tonight. Yes I got a hypo kit..always.

 

He's got a long way to go..I think to go too low.

 

NO. Please never do that extra dose of insulin in the same dosing cycle. Then the doses will overlap and make it impossible to understand what is going on. Not for a suspected fur shot either. You can never tell how much insulin actually got into your cat.
Once the insulin is inside your cat, you can't take it back out.

"Better too high for a day, than too low for a moment."

It's what I would have chosen for my cat.

He surely does.

Try to hold this higher 1.75U dose for 3 cycles. Unless Tiger has other ideas and drops <90 mg/dL. Doubt he is anywhere near doing that.

 

Ya I didn't think you could do a small dose. Just wanted to double check..been awhile since I had to start with a newbie sugar baby. Yeah definitely 1.75.

 

How is he acting?

I too vote for switching to a new bottle of insulin to remove that variable from the equation. I’ve had bottles of Prozinc lose their efficacy and feel like I was shooting water; other vials were good to the last drop. It’s an easy change to make. I’m glad you’ll be testing and ready with your hypo toolkit given that, if the insulin was bad, your prior BG tests aren’t particularly “telling” and it’s as if you’re actually starting out at a higher dose.

As has been mentioned, that’s not necesssrioy true. Clavamox is frequently used for UTIs and has an amoxicillin component, but I’m not sure amoxi alone is the first choice of most vets. A sterile sample of urine drawn by cystocentesis (needle directly to the bladder) followed by a culture/sensitivity is the only way to know for sure. Antibiotics can skew the results, however, so you’d need to wait at least a week after stopping antibiotics to get a sample. Just something to keep in mind.

 

I'm very familiar with Uti's. He doesn't act like he has one..even before the diabetes. Amoxi usually does the trick. Clavamox is too strong..I usually only want that one if a cat had a cat fight wound or if I had one lol. I'm going to try to get a pee sample and take it into my Vet..she's fine with that. We've never had to do the needle in the bladder with any of my prior UTI kids, urine sample is all that was needed. Tiger is a high stress cat when driving. He cries, meows and then pants..he definitely doesn't need that right now.

 

Bet he would test extremely high at the vet.

Is he calmer at home when you test him?

 

Yes he would..his ears even turn red. Oh he is very calm with me.

 

SS updated(I think lol)
PMPS was HI, upped his dose to 1.75u-Prozinc
All Hi except for 1 reading..3AM(CST) +3 540
Basically we are starting over..since the consensus is that the insulin was bad for 2 shoots

 

Is Gerbers Baby Food ok for him? He loves it!!! The flavors with gravy.
I looked and did a search through some of the forums couldn't find much talk about it.

 

The little "meat-only" jars are fine. China's favorite was ham. You don't want any of the "meals"...just the kind that only contain meat

 

Cool Cool!! Right now he is liking the Turkey. I bought like a bunch of the meat only jars.

 

Gerber meat only baby foods are a good food for when a cat won't eat.
Not nutritionally complete, but ok temporarily.
Gets expensive to feed all the time.

 

YIPPEEE +5 463

 

I'll take a number over the meter giving that "HI" greeting anytime! Hopefully this is the first of many lower numbers.

 

+7 460...

 

Ugh...not +4, but +5..I entered it in correctly on the ss..messed up here

 

Tiger is now up to 3u..Updated his SS
AMPS=Noon..PMPS=Midnight

 

Hi Jacque, I simply wanted to make you aware of this.

All the "Sticky" or pinned posts in the Prozinc forum have been updated and there are a couple of new ones.

Highly recommend that everyone using Prozinc or helping those using Prozinc read them thoroughly.

I'll be doing that myself. Been expecting this for some time. Came about a week before I thought it would.
Thanks Marje, and Robert, and especially Djamila for the Modified Prozinc Method. You folks are FANTASTIC!

 

Are the updates good or bad?

 

Someone take a look see at Tiger's ss. Do you think he has been rebounding in the HI and black numbers?

 

Good ones of course.

That's more than rebound.
1. Tiger was never diabetic in the first place. (You self diagnosed him.)
2. Old insulin bottle is not good.
3. You have to keep increasing the dose until you get past the insulin resistance/glucose toxicity.
4. Getting into high carb contraband food somehow.
5. Barely a response from any dose of insulin.
6. Prozinc may not be the right insulin for Tiger.

I sure hope you are ketone testing daily.

What does Jazz Mans SS look like?

 

I tossed the one insulin that expires next month. I used it for a 3 or 4 cycles. His ketones are fine. He is eating good, pee has no funky odor.
Jazz Man's regulated the low 300s, if I increase his dose he dives. I did a 12hr check a few days ago, he is right as rain acting normal..so I don't think this bottle is bad too.

 

Used to dealing with Prozinc kitties that are not simply "regulated" in the low 300's. But with people trying to get their cats under renal threshold and better.

Yes, a cat will dive at mid-cycle. But you want to see those lower yellows and then the blues and greens on the SS.
The pre-shot tests are the last ones to come down on Prozinc.

Dives how low? to under 50?

 

Here is a definition of regulated. What is Regulation?

What is Regulation?
There are different definitions of regulation. As hometesting becomes more common, we've been getting a better understanding of what cats and their humans might be capable of. Janet & Fitzgerald propose the following "regulation continuum":

• Not treated - blood glucose typically above 300 mg/dl (16.7 mmol/L), poor clinical signs
• Treated, but not regulated - often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs
• Regulated - generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia
• Well regulated - generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia
• Tightly regulated - generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin
• Normalized - 60-120 (3.3-6.7) except perhaps directly after meals -- usually not receiving insulin

There may also be an extra category of "mostly above 300 (16.7) but with good clinical signs" which occurs with some cats who are getting insulin. We don't know why it happens, but such a cat probably should not be considered to be regulated. On the other end of the spectrum, it is possible for a cat who is not getting insulin to have blood glucose as low as 40 mg/dl (2.2 mmol/L) on a glucometer calibrated for humans. If you have a non-diabetic cat, try testing her with the same meter to get a safe comparison figure.

We would consider Jazz Man treated but not regulated.

 

yep..had to use Karo on him once and thats why I haven't altered the 2u

 

Ok I agree and yes I did check one of my other non diabetic kids..meter is ok.

 

He is now getting 4u's. Should I stick with that for 3 or 6 cycles? Or do you think I should lower the dose to 3u's and do a 6 cycle?

 

Starting to think that he has been diabetic for quite some time..just wasn't showing any signs until around the 8th of this month. Pancreas is likely shot and maybe even his kidneys. Doc said he is drinking too much water to do an accurate blood test for the kidneys. She said for me to save the $300.

 

Maybe I should switch him to Vetsulin. I'm used to working with that. Jazz Man was on it for several yrs before I switched to Prozinc.

 

Jacque, the choice of how to treat your cats for the feline diabetes is always yours. Always.

But if all the members here never changed the dose because of 1 low number incident, then they never would have achieved regulation for their cats or diet controlled remission, or be adjusting the dose for their cats.

Look at a few of the people posting over on the Lantus forum. toomanycats for example.
2/25 Buzzy AMPS 161 = 1u
Look at Diane Engoron and her cat Wenchie, posting here in the Main health forum.
Help Needed - not 911 - Wenchie

Look at Patty & Teal's SS working towards lower numbers.
Look at Juls and Billy's SS went OTJ about a month ago. 1/31/2020
Look at Hailey & Oscar's SS went OTJ this week. 2/22/2020
Look at Breanna H's SS for Tigger. She's pretty new at this and a member of our facebook group.
Look at HelloKrystie SS for Sirius. Down to using drop dosing. Also a facebook group member.

 

Look in the supply closet. There may be someone that has Lantus for sale for a low cost.
There are less expensive ways to get insulin, by ordering Prozinc from Chewy for example. But you need a prescription from your vet.
There are less expensive ways to order lantus insulin from Canada. But there too you need a vet prescription first.

 

Right now I'm more concerned for Tiger. Jazz Man is good to go. Ever since I switched to Prozinc he hardly hock walks now. Lantus makes me nervous. I talked with Chris about it yesterday.

 

I just took a look see at the other members ss's. None of the ones I looked at had HI HI HI like Tiger's, I would need to find someone who has the insane numbers that Tiger has.

 

Jacque, my point was that people change the dose for their cats all the time. By doing so, they get their cats regulated and even in to lower healing numbers.

You want someone that is getting insane high numbers? Do you read and write French? You'd have to be approved to join the group, but there is a French language facebook group. Know a couple of cats over there getting insanely high numbers, and 1 that just got released from the vet hospital after a DKA episode.

There is M-Kuqi. He's in Italy, using Vetsulin (aka Caninsulin). HI readings like Tiger. Not sure how much good it would do you to look at that SS but here it is. Kuqi's SS. His owner basically does no testing at night.

You shouldn't be afraid of Lantus. That is the most used insulin on the message board and has more experienced people to guide you.

Personally, I think Prozinc is a very good option for cats. Better than Vetsulin, with it's short duration. IMHO.

 

Look at the newly revised Sticky in the Prozinc ISG.
This one, with the dosing protocols.
Sticky PROZINC DOSING METHODS

 

"If nadirs are more than 200, increase the dose by 0.5u. Dose increases should be made every 3-6 cycles and should continue to increase until nadir numbers begin to come down". Tiger's lowest nadirs was on the 23rd. I did what the sticky said..to increase it by .50. Haven't had a reading below "HI" since. What should I do now??? Stay at 4u's or what? Hold for 6 cycles instead of 4?

 

Just checked ketones negative

 

I'd hold at 4U for now. Re-evaluate after 3 cycles at this dose. You may need to hold the 4U dose for the full 6 cycles, but I don't think so.
You skipped from 3.5 to 4 after only 2 cycles.

On the other hand, those high HI readings are concerning. How aggressive do you want to be with the dosing? Syringe is in your hands.

I'm still not convinced that Tiger is diabetic. His body may be kicking in to protect itself against too much insulin. Hard to tell.

You've been giving him amoxicillin on your own initiative. Liquid amoxicillin contains sugar. Are you still giving him the amoxicillin?

You need to talk to your vet about Tiger and what you are doing.

ECID Every Cat is Different. Even in the same household. Even getting the same insulin, the same food, the same attention and care.

We would consider Jazz Man treated but not regulated.

 

I need to redo my signature. No he isn't on Amoxi anymore, he was taking it in powder form for the 10 days. Doc said if he had one that should clear it up. Stay with the 4u for now then? Not lower it..just in case he had an infection and He is like you said "kickin in" Doc said most cats that have an infection their bg doesn't shoot through the roof like his but kept him on the amoxi for the 10 days

 

The powdered amoxicillin contains sucrose. It gets reconstituted to a liquid, pink color is from the red dye and then given orally.

https://www.drugs.com/pro/amoxicillin-suspension.html

 

Yes, think the 4U dose for now. He may need more or less. Have to wait and see what the BG numbers do.

 

I already know what they'll do..HI..I'm getting ready to do a check right now..

 

Hi +8, also did a temp..102..his whole life he has ran on the warm side.

 

He has all the signs of diabetes except for increased hunger " Signs of diabetes in cats other than increased drinking and urination include increased appetite, weight loss, an abnormal hair coat, or hind limb weakness" https://metro-vet.com/why-is-my-cat-so-thirsty/

 

Low potassium (hypokalemia) can also be the cause of hind limb weakness, lack of appetite and the poor quality coat. CKD is the most common cause of low potassium.

You did say your vet thought Tigers' kidneys were "shot".
Decreased hunger is a common symptom of chronic kidney disease, especially in the later stages of CKD. Symptoms of increased water intake, increased peeing, weight loss, decreased appetite all occur with late stage CKD.

Hyperthyroidism can also include increased drinking, increased appetite, weight loss, abnormal hair coat.

 

How is his breath? Not cat food smell, but ammonia smell like urine?

Can he lift his head up ok?

 

yes thats what she said too...can't check his kidneys he drinks too much water...as you know they drink more because they pee more..as far as increased appetite thats hard to say..he's never been a big eater..she said his age likely kidney's aren't working as well as they should, which I kinda figured that..I have several cats with ckd..just love to syringe feed NOT, 2 with chronic crystals, several with the "cat cold" yes I got a bunch of sick kids. I think I added my experience on my profile page on this site. Gonna try to get him in thurs or friday

 

breath smells normal thats why thinking not his kidneys...i mentioned earlier that I have several with it and yes he lifts his head fine..

 

hope it's not his thyroid because with current meds for that it can take up to a year to work..a friend of mine lost he cat to it before the meds had a chance to work

 

no vomiting either

 

I'm hoping he has diabetes and none of the other diseases..diabetes isn't a death sentence

 

How does drinking too much water effect a blood test? For a cat's kidney's to be "shot", BUN, creatinine, and phosphorus levels would need to be high. SDMA would also be high. These are all blood tests. If your cat is drinking so much water that it's having an effect on blood tests, there are other problems going on. Humans can die from water intoxication.

 

Keeping all paws crossed here too that you find out what is going on with Tiger.

Hope you can find a good dose of Prozinc for Tiger and bring those HI's down a lot more.

 

She said won't be accurate

 

If it is his kidneys disease or failure there isn't a cure and you can barely manage it..I know have several with it. Good days and bad days...all of them vomit or have diarrhea that is my experience with that nasty disease. Failure and they die quickly. He would have been gone by now..failure takes about a week. He doesn't have other signs of having kidney problems.

 

Molly 16yr old girl just passed away 2mos ago from kidney failure. Had to assist her, the signs are very fresh in my mind unfortunately.

 

The severity of kidney disease depends on what stage it is. If it's early in the process, your cat can be asymptomatic. One of my cats was in Stage 2, with a change in diet and calcitriol, his kidney values are now and have been completely normal for 2 years. If you don't treat the problem it will get worse. It's entirely up to you what you do.

 

Hi Jacque,

Would you please start a new thread and link this older one at the top?
This one is getting long and the moderators like threads to be under 50 posts when possible.

Thanks very much.

 

Appt tomorrow at 2:45