New to this forum need some advise please

Hello
My cat Nemo was diagnosed about 3 weeks ago , he was put on 3 cc of insulin 2x a day . I would go get his BG checked 1x a week by the vet and he stayed in the 350-400 range so last week they increased the insulin to 4cc 2x a day and he's still in the low to mid 300 . So my question is how long does it take to lower his BG . I check it myself also . I feed him Wilderness High Protein and Fancy Feast classic . He seems to always be hungry and still is not gaining his weight back that he has lost since he got sick .am I expecting too much too soon ? Any advice would be appreciated
Thanks
Alex and Nemo

Welcome Alex and Nemo!

First question on everybody's minds will be what kind of insulin are you using?

Secondly, I think you mean 3u, not 3ccs (which would be a heck of a lot of insulin; 3mls). ;-) That's actually a fairly high dose to start on. What were the vet's reasons? Are there any other issues with Nemo?

Is the Wilderness High protein dry or wet food? I've not heard of it before but maybe someone else has. The Fancy Feast classics are a good choice.

Last question, I promise. :lol: How often are you checking Nemo's BGs?

Ups sorry ...lol yes its 3 u and now 4 . His BG was 440 the first time he was checked and He was on 3u for 2 weeks and his BG didn't go down so last week she increased it to 4u . He has no other health issues and the insulin is called Pro Zinc . I only feed him can food . And I check his BG 2x a day
thanks

How much does Nemo weigh? Has Nemo had a curve done at the vet's office or is he just getting a single test at a weekly office visit?

It looks like you're testing at home twice a day if I read that right. Are you just getting the two tests right before giving insulin, or are you getting any tests in-between shots?

He's 10.5 pounds now , he was only getting a once a week BG check at the vet . I usually check right before he gets his insulin 2x a day

There's a great food chart at Cat Info here. Most common US/Canadian brands of canned food are on this list. Is the Wilderness High Protein by Blue Buffalo? That's the only one I see with a similar name.

The dose adjustment for most insulins depends on the nadir, the lowest point between shots. For Lantus, that is somewhere from +5 to +7 hours after the shot. For ProZinc, it is between +5 to +6 hours after the shot.

Pre-shot tests before giving the shot establish that it is safe to shoot; we suggest new users not shoot below 200 mg/dL on a human glucometer. This number is gradually lowered to 150 mg/dL on a human glucometer.as data are gathered to show it is save.

We suggest using an inexpensive human glucometer with pet-specific reference numbers. One many of us use is the WallMart Relion Confirm, or Confirm Micro, which is also sold at American Diabetes Wholesale as as the Arkray USA Glucocard 01 or 01 Mini (same manufacturer - Arkray USA). It uses a tiny blood droplet and the cost is significantly lower for test strips (like $0.36 each).

Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]

Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)

Welcome to the FDMB Alex and extra sweet Nemo!!

It sounds like you're having the same issues a lot of our new members have when they come here...they've listened to their vet and their vet is out of touch with the latest treatments for diabetes. Luckily, you're only concern right now is Nemo still being high....too many come here when their cat is having a hypoglycemic crisis. 4 units is a huge dose unless Nemo has been diagnosed with a high dose condition, and it doesn't seem like that's true at this point.

First, you will need to get more testing in. At the very least, you need to ALWAYS test before shooting, and then during the AM cycle, at least 1 test somewhere between +5 and +7 (5 to 7 hours after the morning shot) and then a "before bed" test on the PM cycle. The more tests you can get in, the sooner you'll learn how Nemo reacts to each dose.

We need to see how LOW the dose is taking Nemo (the lowest point is called the nadir). I'm not as familiar with Pro Zinc, although I do know it's one of the 3 insulins that does work well in cats, but I think I'd suggest you go back to maybe 1 unit every 12 hours and get as many tests as you can in so we can see how low he's going. That big of a dose MAY be taking Nemo into hypo numbers, and then Nemo is "bouncing". We only do increases in .25 unit increments, never whole units, so it looks like your vet has gone too high, too fast (something we see a lot of here unfortunately).

Bouncing happens when the blood glucose goes too low (or lower than the body has become accustomed to) and the liver freaks out and releases hormones and sugars to bring it back up fast. When our kitties were "in the wild", this was a survival mechanism for them. It's totally possible that although his pre-shot numbers are in the 300's, his mid-cycle numbers are much lower, his liver is kicking in bringing him back up fast, and then you're seeing another high pre-shot number.

We have a great spreadsheet program to help keep track of Nemo's numbers too. Here's How to get a spreadsheet so you can get one started. Pretty much everyone here has their cats spreadsheet link in their signature so others can look to see how the cat is doing and help with advice on increasing or decreasing.

Keep asking questions! There are lots of us here managing our kitties diabetes at home and doing a great job, and we can help teach you how to too! Not only will you save money by not having to pay for vet tests, but you'll do a much better job of caring for Nemo both safely and effectively!

4u is a pretty high dose of ProZinc to have gotten to as rapidly as you have. Have you given your evening shot yet? If yes, how long ago?

Thanks for all the input , I tested him last night before his shot and he was at 380 .
Just tested him five minutes ago which is 8 hrs after his morning shot and he's at 272 that's the lowest he's been .
I am really new to all this and still trying to figure this all out , u guys are a lot of help .And as a lot of people I did listen to my vet , I mean who else to know better right ? ....come to find out you GUYS know better.
I will start a chart and record his levels and add it as my signature...again TY TY TY for all ur input
Alex

For ProZinc, the lowest glucose level between shots is often somewhere between +5 to +6 hours after the shot. He may have goon lower than what you tested at +8.

I wasn't sure when i needed to test again so tomorrow I will start anew and hopefully find out his lowest . So the best time is +5 correct ?

The nadir can vary some from time to time, so any time in the +5 to +6 hours after the shot is fine.

Thank you

Chris you mentioned that I should lower his insulin by .25 do I do that ea dose until i get down to one or how do I go about lowering his insulin and how often do I check his BG .Sorry for all the questions just wanna make sure my little dude is gonna be ok .

Any time he tests below 50 mg/dL, it is an automatic dose reduction of 0.25 units. If and as the pancrease heals, you may find yourself dropping enough that you fade right into being off insulin.

I am sorry I don't know what u mean by 50mg/dl

The glucometer reading.

In the US, meters read in mg/dL.
Elsewhere, they may read in mmol/L
And if you have a pet specific meter, it reads a bit higher than a human meter.

Page up a few posts to the glucose reference ranges. Those are a guide to what the numbers mean. All 3 types of reading are given.

Ok, looks like you've given 3.75u tonight. I'm assuming you are using u40 syringes and eyeballed that dose?

Can you be up for a while tonight to get some tests in? That will give us a much better idea what the dose is doing.

Hi Alex & sugardude Nemo and welcome to the message board.

The Blue Buffalo Wilderness Grain free High Protein food has potato in it. That is a source of carbohydrates that our diabetic kitties can do without. You might want to try a food trial, taking that food out of the rotation and using just the Fancy Feast classic pate foods for now. You may find that Nemo's BG (blood glucose) levels drop without those carbs in the Wilderness High Protein food.

am I expecting too much too soon ?

Click to expand...

Regulating a diabetic cat is a process. It took time for Nemo to become diabetic, it will take time to get the BG levels regulated and hopefully back to normal. "This is a marathon, not a sprint."

Patience is key in helping your Nemo to get better. I can lend you a pair of patience pants if that will help you.
I didn't know your favorite color, so hopefully you will find a color you like from this selection. ;-)

Hey again Alex and sugardude Nemo!!

Since you already shot tonight, please try to get some tests in tonight too. If possible, a +2 or +3 and maybe a later one if you can swing it.

As I said earlier, 4 units in 3 weeks is a HUGE amount when you're only 3 weeks into treatment. If I were you,(especially if you're going to cut out the Blue Buffalo food) I'd go back to 1 unit, test as often as you can, and only increase .25 units at a time. That way you can really see how he's reacting, both to insulin and food.

There are much more experienced eyes than mine using Pro Zinc, and I'm sure they'd tell you the same thing about how fast your vet has increased Nemo's dose. It's just not safe, and may even make it harder to get him controlled.

Hope you're able to get more tests in over tonight's PM cycle.

Eddie and I are ProZinc users as well, and I'm in agreement with Chris' advice.

If at all possible, try to get a couple tests in tonight. Post here, and we'll help you interpret what you're seeing. :smile: In the AM, I would definitely suggesting lowering to 1u and let's see what Nemo's numbers look like with more mid-cycle testing. You can always go back up in dose fairly quickly if warranted, but it's a lot harder to work backwards from a dose that's too high. You also run the risk of a hypo which can be deadly, if the BG is dropping too low in the middle of the cycle.

I am the permanent foster mommy of a feral cat with FIV for the last three years. I reached out to a cat rescue organization in my area back then since this poor kitty had a fractured front leg. The rescue group had a vet neuter him, and vaccinate him. The fracture eventually fused together. When this black feral returned to my home one week after the TNR process (Trap-Neuter-Release) - he has never left. My husband & I fell in love with this pathetic survivor, and with love, good food, & shelter, he came back to health and we named him "KEITH RICHARDS". It took over a year, but this "feral" is now my lap cat, with caution, however.

Even though the rescue group legally owns him, I am his caregiver, and KEITH lives in our heated garage, forever, I hope. My two purebreds live indoors, and have to be separated from Keith, and his FIV virus, which is contagious through blood.

To the point here, Keith was losing weight (four lbs.) the last six months and hair loss. Yesterday's weight was 7.95 lbs. down from 12.13 lbs. one year ago! I attributed much of that to FIV, and his years as a feral outdoors (we do not have an age for him!) Yesterday, 2/21/14, he wasn't eating or drinking his water excessively as usual. He also vomited twice and when I wiped it up with a white paper towel, I noticed blood in the vomit. I panicked, and phoned the rescue group who secured a vet appt. for Keith. I always pay for Keith's vet appointments as a "charitable" contribution, however, I receive the rescue groups 50% discount. Otherwise, we could not afford it. The vet's office is wonderful, and family owned. They not only treat feral cats and strays, they offer adoptions, and free service to "comfort dogs". Keith was hospitalized overnight and had a battery of tests and an abdominal X-Ray.

Keith was diagnosed with diabetes and pancreatitis as a secondary infection. He was given SQ fluids, buprenorphine injection, and 2 units of insulin. Doctor said initially his glucose level was over 600 - which would be diabetic coma for humans. Today, (Saturday 2/21/14), his glucose was in the 400's. We brought Keith home this morning, with pain syringes, and my Wal-Mart purchased Novolin insulin and syringes. Instructions at this early time for me is 2 units in AM, and 1 unit PM. Besides the diabetes shock, I was also shown the abdominal X-Rays where the doctor pointed out the three buckshot bullets that were lodged in Keith's hind leg and lower abdomen. Obviously, Keith was shot at when he was out in the wild, and because the buckshot bullets are encased in scar tissue - it does not appear to be a medical problem. I was appalled at all this and felt even more empathy for this cat.

Keith Richards will go back to the vet hospital Monday morning for a glucose curve over two days. The vet told me to keep Keith's diet the same for now - Fancy Feast Classic, with dry kibbles. I am committed to the insulin injections but am overwhelmed considering Keith's domestic situation is far from normal!

I will be able to give you more medical info on Keith's diabetes after his testing next Monday & Tuesday. I will definitely need your professional advice! Thank you very much, Kathy

Kathy, please go ahead and start a new post with your information. It's fine for you to just copy/paste your info from here, but it's important that you start a separate post so we don't accidentally give the wrong person the wrong information.

Just real quickly though, the dry food is too high in carbs for our diabetic kitties, and this includes the expensive "prescription" diets. The Fancy Feast classics are fine since they're less than 10% carbs. Here's a Food Chart that includes pretty much any food you can buy and the percentage of carbs (Column C). Again, it's important that you feed foods that are less than 10% carbs.

Novolin is NOT a good insulin for cats. The only 3 insulins that work well are Lantus, Levemir and ProZinc. Lantus and Levemir are human insulins so are available at any pharmacy. ProZinc is only available through a veterinarian. Novolin is too harsh, can drop their blood glucose too low too quickly and wear off too fast too. It sounds like you are going to need to talk to the rescue as well as either getting your vet to do a little research on the latest treatments for diabetes in cats or you find another vet so you can get a prescription for a better insulin. If your current vet is willing, here's the Roomp/Rand Tight Regulation Protocol which uses Lantus insulin. (Works for Levemir too)

It's very important that you learn how to home test. You wouldn't give a child insulin without knowing if it was safe first, and it's the same with our furkids.

Please go ahead and start your own thread and we'll all do our best to help you. There's a lot to learn, and we understand it can be overwhelming at first, but the people here are very experienced in treating diabetes at home, both safely and effectively.

God Bless you for caring for a FIV+ kitty too!!

Thanks for all the awesome advise , I really appreciate it . I no will longer feed him wilderness , FF only .I just checked his BG and he's down to 300 that's +3 PMPS
I am not sure how fast i can lower his insulin , is it safe to go from 3.75 to 1 ?
, I'm going to try and get one more reading tonight , that is if i can wake up :lol:
again thanks everyone

amke1970 said:

Thanks for all the awesome advise , I really appreciate it . I no will longer feed him wilderness , FF only .I just checked his BG and he's down to 300 that's +3 PMPS
I am not sure how fast i can lower his insulin , is it safe to go from 3.75 to 1 ?
, I'm going to try and get one more reading tonight , that is if i can wake up :lol:
again thanks everyone

Click to expand...

Thanks for posting the +3. The more info we have on how Nemo responds to the insulin throughout his cycle, the better you can gauge his insulin needs. If you can, do try to get another reading or two tonight yet. Does Nemo have a history of ketones? If you are going to a lower carb food, that can also reduce Nemo's insulin needs.

Yes, it's always safe to go DOWN in dose. It's the UP you need to be careful with

Remember, if you get a Pre-shot test under 200 (for now), Stall, don't feed, and post for help. Make sure the subject line says something like "stalling, need advice please" so people scanning the board can easily see you need help.

Good luck and don't worry..eventually you'll be "sleep poking" with the rest of us :lol:

It can be safe to drop back to 1 unit if you monitor for ketones in the urine. Ketones are a by-product of fat breakdown for energy. Too many may indicate diabetic ketoacidosis (DKA), a potentially fatal complication of diabetes.

See my signature link Secondary Monitoring Tools for tips on urine testing, plus other assessments you may wish to make in evaluating his health.

+8 PMPs was 196 , going back to bed ....lol

amke1970 said:

+8 PMPs was 196 , going back to bed ....lol

Click to expand...

Thank you for getting the +8. It's hard to tell whether Nemo's still going down at +8, or if he went quite a bit lower sometime between +5-+7 and is on his way back up. Either way, it appears he probably had a pretty steep drop between +3 and where he's at now.

Are you planning on trying to go with 1u to see what Nemo's numbers are really doing throughout his cycle? If so, can you get several tests throughout the day today?

I am going to be out for the day , so its hard to get so many reading and he's not liking me very much anymore after all the poking yesterday ...lol. His BG was super high this morning AMPS 471 . Giving him 3.50 today and giving him a break from poking . Thursday is my day off and i will start him on 1u and that way I can monitor throughout the day ....thanks
Happy Sunday everyone .

That high AMPS may be because he went fairly low last night and "bounced." If at all possible, please get mid-cycle (between +5 and +7) readings on Nemo if you're going to wait till Thursday to reduce.

Did your vet warn you of the risk of hypo?

Please read, study, memorize, and print out this document: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887

If you continue to post Nemo's numbers here, we can help keep an eye on him.

Alex, it's fine for you to go ahead and drop back to 1 unit at any time. Since you've been giving 3 and 4 units for several weeks, going down to 1 unit shouldn't cause any problems.

Our concern is that 4 units (or even 3.75) is already too much and may be causing Nemo to go too low and then his liver kicks in, releasing hormones and sugars to bring him back up quickly (Bouncing).

If you're unable to do a lot of testing, it's safer for Nemo for you to give him less insulin and then slowly work up to higher doses, .25 unit at a time.

I understand Nemo may be giving you a little catitude when it comes to testing? We can help with that too! Most of our cats just don't like having their ears fooled with. It's not really the poking that most of them react to since there are very few nerve endings in their ears...it's that you're touching their ears at all!! It might help to desensitize him to having you fooling with his ears.

Decide on where you want your "testing spot" to be, and as many times a day as possible, take him there, give his ears a quick rub and then give him a yummy low carb treat. Lots of us use freeze dried chicken, boiled chicken or lunch meat (no salt or sugar) as our testing treats. Here's a list of Low Carb treats you can try too. Soon Nemo will associate that special spot with the yummy treats, and won't pay any attention to what you're doing with his ears. Believe it or not, with a little time (and the all important yummy treat) most of our kitties will actually remind US it's time to test!

If you're not already doing it, warm up his ear before poking. A small sock with a tablespoon of rice or oatmeal and microwaved for about 15-20 seconds will help warm the ear and get the blood flowing. Another idea is to use a pill bottle or film canister with warm water inside. Just remember to test on your wrist like you would a baby bottle to make sure it's not too hot.

Here are some more Ear Testing Tips to try too.

Hang in there. We're here to help you any way we can so both you and Nemo will be successful in learning this new sugardance!

thanks for the great tips , i made it back in time to check him at +5.5 and he was at 276 . So as u guys recommended his next dose I'm dropping to 1 u . And checking him again @ PMPS 3+ . The trick with the heating of the ear and treat worked out great . And as far as my vet telling me about hypo , all she told me was that if his BG get to about 40 that I should rub some karo syrup across his gums .
You guys are amazing , wouldnt know what to do without ya

I gave him 1u this morning and @ PMPS +6.5 IS 356 . so do I increase his insulin tonight ? If so by how much only .25 correct ?
Didn't expect his BG to be so high .

Hi Alex!

I know it's scary seeing those high numbers, but stick with it for one more cycle at least and let's see how he does with the PM cycle tonight.

There isn't an "official" protocol for Pro Zinc, but from dealing with so many cats using it, there's one that's been developed here. Protocol for ProZinc/Pzi

You might also want to move over to the ProZinc/Pzi Forum now where you'll get the most experienced eyes to help advise you.

Each day you start a new post (we call them condo's) with the date, cats name and AMPS number in the Subject Line. In the body of the post, you put the link to your prior post (so people can quickly go back and see what you were told before) and then the WCR (Whole Cat Report)...How they're feeling, Is their appetite good? Are the 5 "P's" in place? (purring, playing, preening, peeing, pooping?) You put anything you think might help people learn to know your cat better, as well as any questions you might have that day.

I'm sure you'll get plenty of help there, and it'll be from members with lots of experience with Pro Zinc.

Of course you're free to continue posting here in Health, but usually once you get your spreadsheet started and the basics down, you would want to move to the Insulin Support Groups for the kind of insulin you're using.

Good luck with whatever you do, and I'll check in on you now and then!

Thanks for everything I just posted on the Pro Zinc forum .

AMPS +8 354

Not sure why his BG been staying in the 300's since yesterday , He get's 2 units 2x a day and had been doing well and now I'm not sure what to do , any advise would be appreciate it confused_cat

Can you try and get some mid cycle night spot tests in case he goes low then? Many cats do, and I see that's the one time you got blues before.

However I suspect he just isn't at the right dose yet. I would give it a day or so then ask the question on dose increase in the pzi forum. It's often a case of slowly working up the dose ladder till you find one that works. But don't stick too long on a dose if it isn't.

Wendy