New Member Post - Snowball

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jwbsings Snowball

jwbsings Snowball

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Hi,
I'm Janet and my cat, Snowball was recently diagnosed with diabetes on November 18th this. He is receiving ProZinc, 2 units twice a day. Yesterday was the second time his glucose dived into dangerous territory. I measured twice, because the meter read 50 and then 11 (it is calibrated for pets). I gave him dextrose right away and he ate a full can of his low protein Vet Concept. His glucose rose to 136 a couple of hours later. I decided not to shoot insulin. This morning, his glucose was 106 before his feeding, after not having had insulin since the previous morning. I fed him and now his glucose reading is 298. I'm not sure whether to shoot insulin or reduce the insulin if I do give him his morning shot, or if I should monitor his glucose and give him his evening shot. (I am in Germany) My vet is closed for the holidays. Any advice would be greatly appreciated, as I am very new to this entire process. Thank you for your help!
 
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Hi Janet and Snowball and welcome to the forum. @jwbsings Snowball
You will definitely need to reduce the dose of Prozinc. Having the blood glucose level drop to 50 and then 11 on a pet meter is dangerously low.
Any drop below 68 on a pet meter needs a dose reduction immediately.. And depending on what dosing method you are following the dose at which you reduce may be 90.
It sounds like you are hometesting the blood glucose which most likely saved his life. So well done.
Did Snowball have any hypo symptoms when he dropped so low?
I would make sure you have some higher carb foods and some honey in the house in case it happens again.

Did the vet mention that Snowball had any ketones at diagnosis?
If he did we don’t really like to skip doses of insulin but if he didn’t it won’t hurt to skip at times.
If he did not have any ketones at diagnosis I would be inclined to skip this dose as his blood glucose (BG) was only 106 preshot and has only gone up after food.
Monitor this cycle and see how the BG goes this cycle and that will give us an idea of what is happening.
Are you testing before every dose to see that it is safe to give the insulin? And are you testing during the cycles to see how low the dose is taking Snowball?
We also recommend giving a good meal before every dose and then give 2 or 3 snacks of low carb foods during the cycles. A snack is a teaspoon or 2 of low carb foods.
is Snowball eating well?

Do you think you could set up our spreadsheet and add a couple of weeks data to it so we can see what has been happening. We are very data driven here and rely on the spreadsheet to help us decide on dosing.
Also if you could set up your signature which will tell us all about Snowball and this will appear at the bottom of all your posts.
Here is a link to the spreadsheet, signature and our hypo box.
HELP US HELP YOU
If you think you will have trouble setting up the spreadsheet I can ask @Bandit's Mom to help you.
I am also going to tag @Suzanne & Darcy about the dose moving forward as she is a Prozinc user and I am not.
It will be a few hours until she is online though.
 
Thanks so much Bron and Sheba! I'm not sure about ketones at diagnosis. I just checked Snowball's glucose again and it is now 309. Should I give him a lower dose of insulin after he eats? Btw, he's eating well and didn't show any symptoms of hypo. I just happened to see it when I tested him before giving him his insulin last night. He's on a CKD diet (Royal Canin Renal wet food as well as the dry food for snacks.)
I will set up the spreadsheet tonight. I'm looking for his blood test results that indicated diabetes and will enter all that information.
I have honey and dextrose in the house. I gave him dextrose last night and then fed him. He ate well.
I hadn't been testing before every dose, just once every few days - per my vet's recommendation. Now I will test before every dose and in between as well.
Once again, thanks so much for your help!!! I was feeling helpless and now less so!

Bron and Sheba (GA) said:
Hi Janet and Snowball and welcome to the forum. @jwbsings Snowball
You will definitely need to reduce the dose of Prozinc. Having the blood glucose level drop to 50 and then 11 on a pet meter is dangerously low.
Any drop below 68 on a pet meter needs a dose reduction immediately.. And depending on what dosing method you are following the dose at which you reduce may be 90.
It sounds like you are hometesting the blood glucose which most likely saved his life. So well done.
Did Snowball have any hypo symptoms when he dropped so low?
I would make sure you have some higher carb foods and some honey in the house in case it happens again.

Did the vet mention that Snowball had any ketones at diagnosis?
If he did we don’t really like to skip doses of insulin but if he didn’t it won’t hurt to skip at times.
If he did not have any ketones at diagnosis I would be inclined to skip this dose as his blood glucose (BG) was only 106 preshot and has only gone up after food.
Monitor this cycle and see how the BG goes this cycle and that will give us an idea of what is happening.
Are you testing before every dose to see that it is safe to give the insulin? And are you testing during the cycles to see how low the dose is taking Snowball?
We also recommend giving a good meal before every dose and then give 2 or 3 snacks of low carb foods during the cycles. A snack is a teaspoon or 2 of low carb foods.
is Snowball eating well?

Do you think you could set up our spreadsheet and add a couple of weeks data to it so we can see what has been happening. We are very data driven here and rely on the spreadsheet to help us decide on dosing.
Also if you could set up your signature which will tell us all about Snowball and this will appear at the bottom of all your posts.
Here is a link to the spreadsheet, signature and our hypo box.
HELP US HELP YOU
If you think you will have trouble setting up the spreadsheet I can ask @Bandit's Mom to help you.
I am also going to tag @Suzanne & Darcy about the dose moving forward as she is a Prozinc user and I am not.
It will be a few hours until she is online though.
Click to expand...
 
When is the next dose due?
What stage CKD is he?
The food you are feeding is not low carb.
Do you have his kidney values from the vet as well? If so could you also post there also please?. To post documents you will need to copy and paste them into this page.
I live in Australia and will be heading to sleep in an hour so hopefully you will answer before then.
 
Hi Bron and Sheba,
His next dose is due tonight at 8 PM.
The food I am feeding him is for his kidney disease. I've finally gotten that under control by adding SUC homeopathic treatments (Solidago, Ubichinon and Coenzyme 10) three times a week. His vet doesn't want to weaken his kidneys anymore as he is in Stage 4 renal disease. Snowball is only 9 years old and has been through so much. But he's such a sweetie and doesn't complain at all. When I took him to the vet for the last blood test, I thought his kidneys were the issue: drinking lots and lots of water, urinating constantly and losing weight although he was eating regularly. We could feel his spine and hip bones he was so thin. Now since the insulin shots, he's picked up more muscle mass and was doing so much better until the 1st dip in his glucose a couple of weeks ago. We got that under control and then there was the huge dip yesterday.
I tried uploading his kidney values from December 2023 (in the USA), March 2024, May 2024 and November 2024 (in Germany), but for some reason it isn't allowing me to do so.
 
Snowball Blood Test Results Dec. 2023.jpg
Snowball Blood Test Results p. 2 Nov. 16, 2024.jpg
Snowball Blood Test Results p. 1 Nov. 16, 2024.jpg
 

Attachments

Just figured out how to attach the files. Here are blood test results from Dec. 2023, March 2024, May 2024 and November 2024.
Thanks for taking a look at this for me!
 
jwbsings Snowball said:
I tried uploading his kidney values from December 2023 (in the USA), March 2024, May 2024 and November 2024 (in Germany), but for some reason it isn't allowing me to do so.
Click to expand...
The upload file does not work. You will need to copy and paste it.
Do you give him sub Q fluids?
I would wait until tonight to give the next dose of insulin. If you wanted to change the time to an earlier time schedule such as 6:6 you could do that or you could leave it as it is.
Hopefully Suzanne will have popped in by then with a suggestion as to the dose. But if she doesn’t I would try 1 unit Prozinc as long as the Preshot is over 220 on the pet meter. And try and get a couple of tests in during the cycle please.
And make sure he is eating lots please.
Ah.. I see you have posted lab results.
 
I’m going to ask @Marje and Gracie to have a look at your lab results for you.
It’s really late here so I’m going to have to head to bed.
I’ll look in again tomorrow my time.
I’m going to ask @Bandit's Mom to look in in case you have any more questions before the others come along.:)
 
I’m here and will look over this whole thread and respond. It would be so helpful if you could set up a spreadsheet with the test information. Or provide as much information as you can on numbers.
 
The Royal Canin renal foods are between 16 and 23 percent carbs (depending upon which flavor.). The dry version would be even higher in carbs. Having said that, if you must feed him that food and he likes it, we can adjust his insulin accordingly. I was in a position at one point where I had to feed these foods to my diabetic cat also. Which flavor do you give him?
 
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Suzanne & Darcy said:
The Royal Canin renal foods are between 16 and 23 percent carbs (depending upon which flavor.). The dry version would be even higher in carbs. Having said that, if you must feed him that food and he likes it, we can adjust his insulin accordingly. I was in a position at one point where I had to feed these foods to my diabetic cat also. Which flavor do you give him?
Click to expand...
Hi Suzanne & Darcy, thanks for posting! Snowball likes the Royal Canin Fish flavor in the wet food, and the Special and the Select flavors. Does your cat also have CKD? It's a delicate balance when they have different dietary needs for different conditions.
 
Bron and Sheba (GA) said:
The upload file does not work. You will need to copy and paste it.
Do you give him sub Q fluids?
I would wait until tonight to give the next dose of insulin. If you wanted to change the time to an earlier time schedule such as 6:6 you could do that or you could leave it as it is.
Hopefully Suzanne will have popped in by then with a suggestion as to the dose. But if she doesn’t I would try 1 unit Prozinc as long as the Preshot is over 220 on the pet meter. And try and get a couple of tests in during the cycle please.
And make sure he is eating lots please.
Ah.. I see you have posted lab results.
Click to expand...
I decided to wait to give him his next dose. I'm glad you agree. I'll check his Preshot number and go from there. He's eating a lot, thank God!
 
jwbsings Snowball said:
Hi Suzanne & Darcy,
I just got back home and saw your messages. Thank you for responding! I usually give Snowball his insulin after his 8 AM and 8 PM feeding.
Click to expand...
I don’t know when your 8 a.m. and 8 p.m. is relative to me. When I look at my World Clock, see that right now it’s 6:32 p.m. Where I am now it’s 12:32 p.m. so you are six hours ahead of me. I’m on U.S. Eastern time.
 
I would cut his dose back to probably 1unit since the 2 unit dose has driven him down to a dangerously low BG. Then I would test and gather data to see how it goes. I would hold that dose for 7 days even if it looks like his numbers are too high. I would not be surprised if his numbers are high right now as a result of the hypoglycemic numbers yesterday. It would be a bounce and the higher numbers could last for up to three days after the low BG.

What numbers have you collected today? I can try to pop back around in an hour and a half to check on the PMPS number. That would be 2 p.m. my time.
 
jwbsings Snowball said:
Hi Suzanne & Darcy, thanks for posting! Snowball likes the Royal Canin Fish flavor in the wet food, and the Special and the Select flavors. Does your cat also have CKD? It's a delicate balance when they have different dietary needs for different conditions.
Click to expand...
I’m not familiar with those RC renal diets. Are they really renal foods? The ones we have here have letters of the alphabet associated with them— T for Tempting, E for Enticing, etc.
 
Suzanne & Darcy said:
I’m not familiar with those RC renal diets. Are they really renal foods? The ones we have here have letters of the alphabet associated with them— T for Tempting, E for Enticing, etc.
Click to expand...
Yes, that's how they classify them in the USA. When I was there with Snowball, he liked the T and the E flavors. Here in Germany, they're labeled "fish" or "Chicken" or "Beef" for the wet food and either Select or Special for the dry.
On another note, I just published Snowball's spreadsheet and I'm in the process of trying to fill in the values. Not sure what I'm doing or what some of the abbreviations are for. Is there a page that explains all of the details and where I can find that information from my records?
 
With regard to the spreadsheet, AMPS means a.m. preshot number- so that’s the BG test you will take before shooting insulin at 8.a.m.
PMPS is the p.m. preshot test you would record before the 8 p.m. shot.

U stands for units and that is where you record the number of units of insulin given.
 
The +1, +2 hours at the top indicates how many hours after the shot is given the BG test was taken. For example, +2 means two hours after the shot was given (in your case that would be 10 a.m. and p.m. +4 would be four hours after the shot was given, etc.

We need to use the +hours on the spreadsheet since we are all on different time zones.
 
Hi Janet
Mean time
Can you set up your signature and add from Germany
Your signature should be in gray letters, do you see mine at the end of my post
This is where you can set up what we call your signature, it's at the end of everyone's post in gray letters. Just tap on your name up top then tap on signature and add this information. You will link it to your spreadsheet

  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Can you set up our spreadsheet where we track our cats BG numbers
This Link will also explain how to use it , it's very easy
https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/



Maybe this will make it easier to understand how to enter numbers on the spreadsheet
About the spreadsheet to make it easier for you to understand
AMPS - means AM Pre Shot the first test you take in the AM that number goes there ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave


+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers



You can look at any members spreadsheet to see what it looks like, it's at the end of everyone's signature just tap on it

On the spreadsheet where you put the dates, you just put the dates
Like
11-12 next line under that
11-13 then
11-14 and so on


Take a look at Tim and Pookey's spreadsheet just to see what it looks like

https://felinediabetes.com/FDMB/threads/11-27-pookey-amps-273-8-233.296048/#post-3223639

Tap on where it says Pookey's spreadsheet
 
Suzanne & Darcy said:
Isn’t it shot time now?
Click to expand...
Snowball needed a lot of coaxing to eat. I think I gave him too many snacks today or just too close to his insulin time. In any case, his BS preshot was 265 (down from 309 earlier). I gave him just 1 unit of insulin at 8:45. I'll test his BS again in an hour or two - is that right?
 
Suzanne & Darcy said:
The +1, +2 hours at the top indicates how many hours after the shot is given the BG test was taken. For example, +2 means two hours after the shot was given (in your case that would be 10 a.m. and p.m. +4 would be four hours after the shot was given, etc.

We need to use the +hours on the spreadsheet since we are all on different time zones.
Click to expand...
Thanks so much for your help explaining the abbreviations and the set up of the spreadsheet! I'm in the process of filling that in with the information I have. I didn't regularly measure his BS before shots (which I now do), nor did I measure in between the shots. I was doing a BS test twice a week - once before the morning and once before the evening shots. I realize that this is not sufficient and will test him regularly from now on.
 
jwbsings Snowball said:
Snowball needed a lot of coaxing to eat. I think I gave him too many snacks today or just too close to his insulin time. In any case, his BS preshot was 265 (down from 309 earlier). I gave him just 1 unit of insulin at 8:45. I'll test his BS again in an hour or two - is that right?
Click to expand...
Yes. Test in two hours after the shot — and put the number in the +2 cell
 
Anyway, it’s all good. You saved him from a hypo and we can move forward from here. Just link the spreadsheet into your signature when you get finished. Also, don’t forget to set the permissions on the spreadsheet to — anyone with the link can view spreadsheet. Then we will be able to view it. Thanks!
 
Suzanne & Darcy said:
Anyway, it’s all good. You saved him from a hypo and we can move forward from here. Just link the spreadsheet into your signature when you get finished. Also, don’t forget to set the permissions on the spreadsheet to — anyone with the link can view spreadsheet. Then we will be able to view it. Thanks!
Click to expand...
I just published the spreadsheet and changed my signature, saved it as you said. Hope it works!
 
It worked. I can see it. Well done! Oh, where it says current insulin on the spreadsheet (upper left corner) you would write ProZinc. Don’t write the dose as that can change all the time.
 
I see the +4 thank you. It is a nice gentle drop. I feel comfortable with that.
You can tell me about SUC THERAPY tomorrow perhaps.
Are you sure he is Stage 4 CKD? Maybe it was just the translation from German to English or maybe I was looking at the wrong dates, but his Creatinine and BUN didn’t look that bad to me…. Yes elevated but not horribly. Perhaps I was looking at the wrong dates. It was a little blurry as well.
Snowball is very beautiful, by the way. I was just showing his photo to my daughter.
 
Suzanne & Darcy said:
Tell me about this SUC therapy.
Click to expand...
A friend told me about it, as it helped her cat with kidney disease. It's a homeopathic combination of Solidago compositum ad us. vet., Ubichinon compositum and Coenzyme compositum. It helped my Snowball tremendously. He had been treated for kidney insufficiency since 2017, but last year things got worse.He was all but given an immediate death sentence over a year ago when in the USA. He'd lost a lot of weight even though he ate full meals, and he was drinking a lot of water. I took him to the vet who did a blood panel and the diagnosis came back Stage 4 Renal Disease. When I got back to Germany, my friend told me how SUC therapy had saved her cat's life. I spoke with my vet and got the okay to try it and Snowball made a complete turnaround. In fact, when he began to show the same symptoms again, I was afraid the SUC had stopped working, but the blood test results showed that his kidneys weren't the cause - they were not worse than before, in fact, the values had improved. Instead, it was the diabetes - which brings me here! Snowball continues to take SUC by mouth two to three times a week. Here's more info about a study done in 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7384345/
https://www.google.com/search?q=Hee...d=0CCMQ9_gLahcKEwjI--WW0MuKAxUAAAAAHQAAAAAQEw
 
jwbsings Snowball said:
Got it in. It was 219
Click to expand...
Suzanne & Darcy said:
I see the +4 thank you. It is a nice gentle drop. I feel comfortable with that.
You can tell me about SUC THERAPY tomorrow perhaps.
Are you sure he is Stage 4 CKD? Maybe it was just the translation from German to English or maybe I was looking at the wrong dates, but his Creatinine and BUN didn’t look that bad to me…. Yes elevated but not horribly. Perhaps I was looking at the wrong dates. It was a little blurry as well.
Snowball is very beautiful, by the way. I was just showing his photo to my daughter.
Click to expand...
That's exactly what my German vet said. I am American, so I understood exactly what the doctor was telling me in the States. He even wrote it as a diagnosis. I was scared to death.
How often should I test Snowball's BS???
Yes, Snowball is a beauty and is a sweetheart as well. He loves people and music. I'm a voice teacher and he greets everyone at the door when they arrive and hangs out listening to all the opera singers coming through my studio all day! He seems to love the big voices best!
 
jwbsings Snowball said:
That's exactly what my German vet said. I am American, so I understood exactly what the doctor was telling me in the States. He even wrote it as a diagnosis. I was scared to death.
How often should I test Snowball's BS???
Yes, Snowball is a beauty and is a sweetheart as well. He loves people and music. I'm a voice teacher and he greets everyone at the door when they arrive and hangs out listening to all the opera singers coming through my studio all day! He seems to love the big voices best!
Click to expand...
@Suzanne & Darcy
 
jwbsings Snowball said:
That's exactly what my German vet said. I am American, so I understood exactly what the doctor was telling me in the States. He even wrote it as a diagnosis. I was scared to death.
How often should I test Snowball's BS???
Yes, Snowball is a beauty and is a sweetheart as well. He loves people and music. I'm a voice teacher and he greets everyone at the door when they arrive and hangs out listening to all the opera singers coming through my studio all day! He seems to love the big voices best!
Click to expand...
That is so wonderful that you teach classical operatic singing! I love that! How long have you lived in Germany? It sounds like you’re very busy. I sing in a choir and we don’t sing opera arias or anything (unfortunately!) We do sing some Handel’s Messiah - well we do a mean Hallelujah Chorus anyway. I think we are going to be adding more to our repertoire. We do sing quite a bit in Latin, which I don’t mind because I used to teach Latin and it’s ecclesiastical pronunciation which I am used to. Do you train opera singers? I love opera because my father used to take me to the Washington Opera at the Kennedy Center for many years (many moons ago… back in the Plácido Domingo era when he was director of the opera there.) We got to hear a lot of great talent.

Your Snowball really does sound like a remarkable cat. I bet everyone loves him.
 
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jwbsings Snowball said:
A friend told me about it, as it helped her cat with kidney disease. It's a homeopathic combination of Solidago compositum ad us. vet., Ubichinon compositum and Coenzyme compositum. It helped my Snowball tremendously. He had been treated for kidney insufficiency since 2017, but last year things got worse.He was all but given an immediate death sentence over a year ago when in the USA. He'd lost a lot of weight even though he ate full meals, and he was drinking a lot of water. I took him to the vet who did a blood panel and the diagnosis came back Stage 4 Renal Disease. When I got back to Germany, my friend told me how SUC therapy had saved her cat's life. I spoke with my vet and got the okay to try it and Snowball made a complete turnaround. In fact, when he began to show the same symptoms again, I was afraid the SUC had stopped working, but the blood test results showed that his kidneys weren't the cause - they were not worse than before, in fact, the values had improved. Instead, it was the diabetes - which brings me here! Snowball continues to take SUC by mouth two to three times a week. Here's more info about a study done in 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7384345/
https://www.google.com/search?q=Heel Vet SUC Bundle 3 Pck&kgmid=/g/11vytv4wqc&hl=de&gl=US&ved=0CCMQ9_gLahcKEwjI--WW0MuKAxUAAAAAHQAAAAAQEw
Click to expand...

Thank you. This is extremely valuable information. I will investigate it more. I had found a study, it may be the same as the one you have linked.
 
I hope you went to sleep and rest without worrying about dear Snowball. ProZinc usually kicks in (what we call onset) at around +2. So if you get a +2 it can be a good indicator of how the cycle is going to go. If the +2 is a lot lower than the preshot BG number, then you should be alert to check again in an hour or two (depending upon how low we are talking about.
This is why +2 is a good time to give a small low carb wet food snack (1 teaspoon or 2.) On a regular day, you can just get one or two mid-cycle tests. You can vary the times that you test so we can get an idea of when he nadirs. Many cats will nadir at +6, but not all. Some will hit their lowest point earlier, especially when they are new to insulin. Gradually you can build up data for us to interpret. We will be looking for patterns.
 
Don’t forget to put how much you shot this morning (hopefully 1 unit) in the units column of the spreadsheet. Not a bad start to the day at all.
 
Suzanne & Darcy said:
Don’t forget to put how much you shot this morning (hopefully 1 unit) in the units column of the spreadsheet. Not a bad start to the day at all.
Click to expand...
@Suzanne & Darcy
I'm really getting frustrated. I shot 1.5 this morning instead of the 1.0 I shot last night. Snowball was at 193. At +4 he was at 99 and I gave him a snack. Now at +6 his BS reads 45 at the 3rd attempt. The first two readings just said "Lo". I re-calibrated the meter this morning because I opened a new pack of test strips. Now I'm not sure if the meter is giving a false reading or if his BS is really that low. I gave him some Dextrose and a snack, just to be on the safe side. But honestly, I'm worried I'm doing something wrong.
 
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