Wide Variation of Blood Glucose Numbers

Hi, My name is Richard and my cat's name is Ziggy. He has been treated for diabetes for about two years now and I do BG testing on him at home. Ziggy's Vet prescribed 2 units of Prozinc BID to be given after his AM and PM feeding. My concerns are that he has such a wide spread of BG numbers that I'm not sure the Prozinc is effectively handling his diabetes. His numbers for his last BG curve are shown below:

8:30am - 508
8:45am - Food & insulin
10:30am - 432
12:30pm - 81
2:30pm - 45 Gave some food after reading
3:30pm - 99
4:30pm - 256
6:30pm - 454

I'm concerned that his preshot is way too high and it appears that the insulin does not last long enough for the full 12 hour cycle. After he gets his insulin within 3-4 hours his BG drops like a stone and his nadir is is too low to be in the "safe Zone". We use a Walmart Relion meter. We feed him Fancy Feast Classic and Purina DM Savory Select and try to keep his dry food to an absolute minimum. Ziggy also likes to be a grazer so it is difficult to know that he is eating enough food all of the time. Does anyone in the group have any suggestions that I might try to get his Preshot numbers down and mediate his insulin so that it is at a more gradual BG Curve?

Thanks.
Richard and Ziggy (Zigmeister)

 

When you get test numbers below 50 mg/dL, the dose is likely too high. It can be difficult to eyeball, but for that level of pre-shot, I would lower the dose 0.25 units.

An advantage to ProZinc is that you can work out a sliding scale, rather than giving a static dose all the time. As you collect test data, look for pre-shot ranges and how the insulin dose worked at that range by 5 hours later.

And welcome to FDMB.

 

Hello and welcome to the board!

I agree with BJ - that dose is probably too high since its bringing him under 50. And anything under 50 can trigger a "bounce" where his liver will panic and cause his blood sugar to then stay high for a few days as a result.

What do you mean" try to keep his dry food to an absolute minimum"? Dry food, even a little, can spike cats blood sugar for over 24 hours. If you eliminate that you may find you can wean him off insulin entirely. My Baileys numbers jump by up to 200 with only 5 pieces of kibble.

Whats his weight? we can work out how much food he needs based on that.
Wendy

 

Thank you BJM! I'll try your suggestion. Do you think that if the dose is lowered that Ziggy's preshot will be lowered also? Could it be the Somogyi affect that is occurring?

Thanks,
Richard & Ziggy

 

You may, as you get test data to show it is safe, lower your pre-shot limit to around 150 mg/dL when using ProZinc. As you learn how your cat respond, it may be possible to shoot tiny doses lower, but please only do that if you are home to monitor for safety.

This issue has been discussed a lot. Clinical research and our experiences here do not support the Somogyi phenomena of sustained elevated glucose due to excessive insulin. It is more likely transient bouncing - a compensatory response by the body to release stored glycogen, which is converted into glucose. This happens when either the glucose level drops very quickly OR when the glucose drops to an unacustomed level for the diabetic.
As an example, in working with Dusty, an initial 2 week visit tested him at 31! If Somogyi existed, he should have been pumping out glycogen like there was no tomorrow...and he didn't. He just stayed low and ate like a madman, according to Jo. (She couldn't home test due to poor hands from arthritis.)

 

Thank you for your input on this! Ziggy is 11.2 pounds and I think he has lost some weight as I remember him to have been about 13 pounds a year ago. Is this weight loss because his diabetes is not controlled? We have withheld dry cat food for Ziggy lately and plan to only give him canned food. We have reduced his Prozinc by .25 units and will see how he responds to the lower dose. My Vet does not seem to have any explanation for Ziggy's high preshot numbers. If we could manage his food intake that would definitely help his condition.

Thanks,
Richard & Ziggy

 

How much do you feed him daily? What is his ideal weight?

 

That steep drop then rise back up may calm down or not; it depends on the cat.

 

In answer to the amount of food we give Ziggy -- about 3/4 - 1 can of Fancy Feast Classic in the morning and evening. I don't know what Ziggy's ideal weight would be but he was about 13 pounds a year or so ago. We will be doing another BG Curve on him this Wednesday and will let you know the results.

Thanks,
Richard & Ziggy