optimisim of 81 goes to dispair of 368

last night at midnight - about 5 hours past his 8units of humilin (7:15ish), 6 hours after dinner (5:30ish) and about 3 hours (9ish, maybe 9:30) after a small snack of wet food Robbie's first home BG test came up at 81 - he had been sleepy since his shot according to my husband (I was at work) and seemed a bit spaced out to me- I gave him a small handful of the diabetic dry mixture we are working on (has some nutro max hairball and some Wellness adult in it too) - he perked up after a bit and was cleaning himself and seemed to feel frisky almost. This morning at 7am before any food or any insulin he registered a whopping 368. We administered the 8 units of humilin and now have given him his breakfast of wet beef EVO mixed with wet Royal Canin Diabetes cat food. He is currently lapping up water (something he has started to do less of but not stopped) and has finished eating. I have to be out of here in 30 minutes (taking the car in for repairs) so I can't wait a reasonable time to test him again. Very frustrating. Is this kind of up and down what we are fighting? Normal? Really bad? I am talking to my vet today but would love input from all of you here who have already been more helpful than I can say.

 

Looking at your previous posts, I see that you are feeding dry food, and working on transitioning to wet. The dry food contributes to the big swings in BG. When you get him on only low carb wet food, it will help.

If you can get him switched to a long acting insulin, like Lantus, Levemir, PZI or ProZinc, that will help also.

One more suggestion, get some high carb wet food in the house to give him when his BG is low. Dry food takes too long to digest to help in a hypo situation. Take a look at Janet & Binky's food list and pick something that has 18 or higher for carbs, and get a couple of cans for your hypo tool kit. Usually any of the wet food that has "with gravy" is high carb, and you can just give a little gravy for low BG. Just make sure you mark the cans so you don't give it to him by accident as regular food! The idea is to bring his numbers up a little, then get out of the system quickly. The dry food acts too slowly and gives you a big, longer lasting spike later.

 

The high number later is a bounce from the low number earlier, their body releases hormones to try to avert a too low number, that will pass and he will come down again.

 

couldn't stand not knowing how he was doing so I went back after dropping my car off and told work I'd be really late- so at 7:03 before food or insulin he was 368 at 9am after both a wet food only - low carb/high protein meal and his 8 units of insulin he was 267 - on his way down perhaps?
I have to try and get the timing of shots and food better - it's been hard with my husband and my work schedule in the summer - it's our busy time of year. GOing to focus on that some too.
Thanks again.

 

Unfortunately these big swings are typical of Humulin N because it doesn't last a full 12 hours in most cats.

Have you considered switching to a longer duration insulin like Lantus, Levemir or PZI?

Food does also play into it, but you are giving a very high dose ---- the food may be protecting your kitty from HYPO on that dose.

 

I agree with Phoebe.

8u is a whopping dose twice a day.
Can you get a +3 and 4? +5 the Humuin has usually peaked so he was more than likely lower than 81.
Deb is right too, when kitty drops really low, the cats body kicks in a life saving response and releases glucagon into the blood stream to bring up bg's. Also the dry food (also been said) will raise bg's but it takes too long to work when faced with a hypo situation. High carb wet food will start working withinminutes, dry can take an hour or more.

Like everyone else, I would urge you to speak to your vet about swapping to a onger lasting insulin. Humulin N really is considred an outdated insulin these days with much better ones available (Lantus, Levemir, Proxinc/PZI)

Humulin N 'peters'out around +10 anotherreason why your preshot bg seems high.
You often have a tradeoff with these insulins of higher preshots and nadir (lowest bg number in the cycle)to try and achieve a shalow curve. Can be much harder to achieve than with the longer acting insulins.
Using food really helps, it is possible but more work (Have a look at the suggested feeding cycle in the caninsulin isg post by Sweetgrass)

Although I'm really keen for you to reconsider your dose, you need to be testing for keytones (dip stick in their pee).

Good luck and please keep asking questions, we're all here to help and support each other. :mrgreen:

 

OK LONG talk with Vet who swears we are on ProZinc... I have to look at the bottle again - I didn't know the names of these insulins before so where did I get Humalin if it wasn't off the bottle? Going to be the first thing I do when I get home - if he is on ProZinc that is better but still a high dose right?

How on earth do you guys check the pee? If I get near him when he is peeing he stops, or tries to and gets all nutsy - they both do. I can't imagine getting a pee test from him.
.......hubby just called from home - checked bottle of insulin - he is on ProZinc. I have to admit I've been very very busy and stressed out at work - so I guess I'm losing it - this diabetes diagnosis was kind of a real smack in the head -

Vet is happy with the numbers - told me to remember (which I had blocked) that he was at 726 the last time he got the fructosimine (sp?) test about 9 days ago. So that IS a big difference even at 300+. Poor kitty - all this and a mother who's losing her mind...

Going to stick on current dose, diet and all. Continue cutting back on dry food, home testing 2/3 times a day for the next 11 days (suggests doing the mid point test six hours after morning dose), chart water intake - and take DEEP breaths. Vet is thrilled I found this site and horrified I thought he'd put Robbie on Humalin...
thank you all - more input whenever you can please.

 

Well, that is good news. I still don't understand the high dose. I believe you started at 3 units, instead of the standard one unit.

If you are going to stay at the high dose (8 Units 2 X daily, right?) and change to wet lo carb, you will have to be very diligent about hometesting. Remember that an all wet lo carb diet can mean a sudden dip of 100 points or more, or can mean a gradual dip. Both will require your being on top of the numbers and ready to adjust the dose downward as needed. Plan NEVER to give a shot without checking the bg levels, just in case he has moved down since his last shot. Vet is right; the usual nadir with ProZinc is around +6. It will be good to start getting the nadir number also.

Time to start a spreadsheet so you have a clear picture of what is happening:
http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=16

 

yes i am very perplexed at the dose myself. can we get a spread sheet going...and some more eyes on this...does'nt feel right to me.

 

Prozinc is a different kettle of fish, but like the others, still concerned about the dose.

If you are going to continue dosing at 8u you need more than 2-3 tests a day.

I haven't used Prozinc (need to have a look at PZI isg and ask for some eyes) but unless you have a high dose kitty (not very common) 8u is way over what we usually see as an on-going dose.

If you can, have an empty litter tray (but very clean) and as soon as he's finished his pee, test it.
Another one is to put cling film over the tray to fool him and same again, test as soon as possible after.

The transition from wet/dry to wet can have significant impact on bg numbers and thus dose required.
Lucky was 454 on dry.Went home and a week later on just wet food (no insulin in this week) she was 257-heck of a difference.

Post your numbers when you get them.

 

Prozinc is better than Humulin N for duration.

When you get a chance (weekend?), it would be good to do a curve on your kitty (testing blood sugar every two hours) to see how long the insulin lasts because ECID - every cat is different.

The fructosamine numbers do not line up exactly with the instant readings that you get off your meter -- so a 700 Fructosamine might be very similar to a 400 instant test -- "diabetes not controlled" A fructosamine is essentially an average glucose over a period of 2-3 weeks. If/when you start testing every day, you won't need to get any more fructosamine tests done.

 

Wow, that's a very high dose of ProZinc. I urge you to drop that dose down immediately. DO NOT stop feeding dry food, you will almost certainly end up in a hypo situation! The dry food is all that is protecting him right now.

The 368 is NOT a high BG number. Mr Tinkles was over 600 when I started testing him, and we started out on ProZinc, 2 units twice a day. Eight units is a crazy high dose! There is another member here who was in the same situation as you, 8 units twice a day, dry food, and when she changed the diet to lower carb wet food, her cat had a hypo event the next day. If she had not been home testing, I hate to think what would have happened to her cat. Please, for your cat's safety, drop that dose down. If you don't want to go all the way down to 1 unit, please lower it to at least 2 units.

 

now if only I'd read some of these posts earlier -
you have all been right on target with what will had has happened. I dropped the dry food after reading here how it helped - didn't advise the vet and also have been moving him over to Royal Canin diabetic formula (which vet knew about) - to be clear I had the numbers all wrong - his BG at the vets was always about 386 and as high as 400+ his fructosimine was 849 never lower than low 800's - he's had 3 of those tests. From talking to other diabetic cat owners around here Fructosimine is the gold standard and I know the similar tests they do on humans is the one my MD is really more interested in - gives and average of what my numbers have been around for a 2 week period - this is basically what the fructosimine is - I wouldn't NOT get that test at least 2x per year if not once a quarter - seems imprudent to suggest it's not needed at all . Ive had stripes go bad, false readings, didn't realize there was a bit of something on my finger when I did the blood - alcohol wipe didn't dry completely - all showing very wrong readings with my one touch ultra on a daily basis -simply because of this I wouldn't give up onthe Fructosimine tests. However, I cannot say you are all very much ON the money with this and here I sit exhausted and grateful for your input and support.
going to bed where robbie is happily snoring away.

 

Ok. My cat was on ProZinc after trying the Glipizide tablets when she was first diagnosed on March 13th, and then she went to Vetsulin, which was recalled due to the zinc in it not working right. Then, she was given ProZinc. Now, she's on Lantus, as of July 25th. This is how she got there:

Blackie was put on the Hill's Prescription W/D dry formula per the vet when she was first diagnosed with diabetes. The vet checked her BG's each week, and each week increased her insulin by a unit. We were told to NOT hometest her as they wanted to do it themselves. At the time of the last vet check, she was at 8u BID AND on high carb dry food. NOT a good mix. At the time, I suggested that I wanted to put her on Fancy Feast wet food. Vet was fine with the wet food, but not with the brand of food. She wanted us to give Blackie the Hill's Prescription W/D wet instead, and STILL keep her on 8u BID of ProZinc. I told vet that we'll try that for a week, and see, and after that I want Blackie to start eating Fancy Feast. That Saturday, Blackie was fine. Sunday, Blackie was fine, but I started doing some research and found this message board. Someone on here contacted me offboard, and offered up a hometesting kit. She came to visit Monday and showed me how to hometest. Blackie was fine Monday. Blackie was fine Tuesday morning. Still eating the same food. Tuesday afternoon, her #'s went dangerously low (down to 21, she was having a hypoglycemic episode) which resulted in eating high carb food and having a high dose of ProZinc. I was on the phone with my friend immediately, and together we got her back up to more manageable #'s. That very same night, I immediately dropped Blackie's insulin to 1u BID, AND switched her food to Fancy Feast. Called the vet up Wednesday morning, and told her what had happened. Vet said that she would've dropped the insulin down 1/2 (making it 4u BID), and I said that I dropped it down to 1, and am starting over (Start Low, Go Slow is this board's motto, and they're right). I started a spreadsheet, and started hometesting Blackie each day and every day. She gets 2 1/2 to 3 cans of Fancy Feast each day (I'm monitoring her weight), and some boiled chicken as treats.

She arrived at Lantus after over a month of trying to regulate her on ProZinc, and after countless suggestions from the board members, and my friend. I'm glad that I listened because she's now getting lower #'s, and I'm still working on getting her regulated.

I HIGHLY recommend getting your cat off that high carb food, and getting him/her to eat something very low in carbs (ie. 3.9% Turkey & Giblets by Fancy Feast is a good one, or others on here can suggest something, plus you can got to Binky's page, too... Just make sure it's very low wet carb food, whatever it is), before he goes into a hypoglycemic episode. DO keep that high carb food around (preferably canned with the gravy, and perhaps some kibble so that you can give 1 or 2 kibbles to help bring up his #'s should they go low), keep some honey around, too. In case you need to hand syringe feed him, the honey will help. Just a very small amount on the gums or tongue can help bring up the #'s.

High amount of ProZinc BID with the high carb food is a very dangerous mix. I know. I've been there, and I'm sure that others have, too. Good luck.

 

Interesting Angela - thank you I will run that all past my Vet. He is thrilled I'm home testing and wants Robbie on Royal Canin Diabetic wet and if I insist he also have dry (he loves the crunchies) they have a dry too - so we are working towards low carb/high protein diet - and my vet would very much like to lower dose and after last nights episode I'm sure will - if not I will - but until Tuesday his numbers were still in the high 300 range on each test. At the vets - and he has very little obvious vet stress- he sits on my lap in the car and curls up on the table at the vets - I know cats are good at hiding stuff but I can honestly say - since this all began and we've been to the vet 2 times a day sometimes a couple times a week - he's gotten very sanguine about it.

 

300's are not very high. nope, 450-500 that's high. 300's depending on where in the cycle he is ...in the middle, empty tummy first thing am...? see, if it's in the mid of a cycle, 6 hours after dose...concern. if' it's am or pm pre shot, that's not high. it's not great but it's not 8 units. how long has robbie been on insulin?

 

Hang in there! Your doing a great job!! I'm thinking of you and your cat! Khan -my cat and I are doing our best too..working at it and relying on this webpage to direct me. I'll be watching how great your cat gets regulated.. I KNOW it can and will happen!

 

Robbie has been on insulin for 6 weeks approx.

 

Robbie looks a lot like my Khan! I'm told MANY orange cats are diabetic.. seems to be seen more in orange cats. Khan has long hair as well but has lost so much weight he does not look heathy like your Robbie. I have high hopes Khan will start to become regulated and then be on the road to gaining weight.