Grandkitty new diabetic prozinc 2 units hypo

I’m back to help my grand kitty he is 9 years old. I found him when he was a kitten in the bushes outside my office crying as I was leaving one night. Grand kitty had normal glucose in October 2022. He had been on prednisolone for anemia low hemocrit from 2015 to 2020 and was tapered off in 2020. His hemocrit is low normal now.

In late January 2023 took him to vet he was limping and hiding. Vet ran CBC no chemistry ran urinalysis glucose 1000. He is easily startled, small noises spook him much worse now. Vet drew blood glucose 464 began prozinc 2 units based on his 13 lb weight no curve. Glucose before first dose 274 +6 hr 55 he scratched at wall gave fancy feast and honey on gums. No insulin next day waited for appointment with vet. Put libre glucose monitor on - what a wonderful way to always know his glucose! Second dose predose 335 1 unit no hypo. Third dose predose 393 gave 1 unit at +3.5 hr glucose 60 dropped to 52 gave food and honey on gums. At +8 hr glucose 70 honey didn’t improve stayed 70 for hour. Skipped next dose, everyone stressed. Fourth dose predose 393 gave 1 unit +3 hr glucose 52 for 2 hr and +7 hr 70 gave food and honey.

We welcome your thoughts and suggestions to help get grand kitty regulated and to consider what else.
Thank you
Kitty kitty mom

 

Poor kitty all those hypos, I can tag some prozinc users for you
@FrostD

@Suzanne & Darcy

@Bron and Sheba (GA)

 

Hi and welcome to the forum.
Did your kitty have a fructosamine test done to diagnose diabetes? Or just a glucose test?

It would be very helpful if you could setup the spreadsheet and enter your data onto it. We need to see as much blood glucose data as possible to help you.
And also if you could set up your signature so we can find out a bit about your kitty.
Here is the link to help us help you which has the links to the spreadsheet, signature and hypo and other useful information for new members.

2 units is too high a dose. to start off with with a newly diagnosed cat. If your kitty drops under 90 you need to reduce the dose . Don’t give the same dose again.
You need to reduce the dose of Prozinc further to 1/2 unit twice a day and see if that helps.
I would also check the blood glucose (BG) at +2 and give a good snack of low carb food. And then keep checking the a bag until he has reached nadir ( lowest point ) and started to come back up again.
What diet are you feeding him…a wet low carb diet ? Or dry food? Are you giving snacks during the cycles as well as the 2 main meals
I’m going to tag @Suzanne & Darcy and @FrostD as they are Prozinc users.

 

Can you post screenshots of the Libre data?
Do you also test BG with meter to see if the Libre is working properly? I have found the libre usually reads lower than a ear stick with a human meter. Here is graph I made last year. Livre 14 day was lower than huan meter exceto at beginning.

 

Hello and welcome! I’m sorry you are having trouble with Grand Kitty. I agree with everything that Bron said. I look forward to seeing your spreadsheet if you can get one set up. If you are having trouble, we can help you. We can get it set up very quickly. Then if you could please load some of the data into it from the Libre into it so we can see what’s happening that would be so helpful.
Kitty’s dose definitely must be reduced immediately. Feeding a good snack at +2 (two hours after shot) is important and probably more snacks in the early part of the cycle. I will check back later for replies to Bron’s questions. Right now I’m sitting in a theater waiting for a play to begin so it will be a few hours. Again, welcome!

 

Thank you for your suggestions. No a fructosamine has not been done. He was eating dry which he preferred over wet fancy feast until he began to limp and hide. He’s been eating fancy feast. He has always loved dry food and I could never get him to eat canned food. A few weeks ago he started asking (in the way that cats always do) for canned food instead. About a week after he started preferring canned food he suddenly had a limp and was hiding behind the toilet. He has never hid before but I had a cat years ago who did, so I immediately booked a vet visit because I knew something was up. There was nothing on his paw, vet only did a visual exam and said he was fine. Limp disappeared about 3 days later. Vet ran a CBC and urinalysis. Urinalysis showed glucose in urine was 1000. Vet said to take him home, might be stress hyperglycemia (his previous vet diagnosed him with this years ago too) and do some home testing.

We have an alphatrak2 tester from the vet, a reli-on tester and an accu-chek tester. For about 2-3 days he had numbers ranging from 250-400 at home. We did exactly 4 doses of insulin. First dose we were told to do 2 units. He went hypo within 6 hours. He dropped over 220 points from the start (he was 274) despite me feeding him tons of snacks and honey it took 4 hours to get him out of the red/yellow. My boyfriend is a type 1 diabetic and said that is incredibly abnormal. This is long acting insulin so the drop shouldn't have been so steep. My mother had a diabetic cat (she helped me find this website) that we took care of for 8 years and we went through her records and saw that that vet started him low (0.5) and said to always begin low with insulin dosages. I read everything here and online about insulin and we cut the dosage to 1 unit, thinking it would be safer to cut the dosage. The first dosage of 1 unit went okay. The second dose of 1 unit (so this would be our 3rd try of insulin) he went hypo despite me giving him honey and snacks. The fourth dose (the third try of 1 unit) he went hypo two times in the entire span of 12 hours. I had to syringe feed him and rub honey on his gums and it seemed to take forever to get it back in the green. We got a libre installed on him and I have been checking and comparing his before and after eating and for the past two days, without insulin, he has been in the 200 range never going above 300.

At the vet visit, I asked them to check his teeth. They said he has an infection in his gums and that they would treat it after his diabetes is stable. He has been having some issues eating, where he spits out the wet food while he is eating it. His gums are red and they said they were bleeding a bit. He may need a tooth pulled. I think this is what started this. With his reaction to the insulin and going hypo 3 times out of 4, we wanted to get a baseline of what his sugars are when he was not stressed before we give him another dose. The vet says start at 2 units and stay at 2 units even though he has gone hypo 3 times out of 4. Even the 1 unit seemed to be too much.

As far as diet, he was eating dry Purina before this began. He has been fully switched to low carb fancy feast (I went through the list on this site of low carb FF to choose from because I know he will eat the brand) and really doesn't want much else. He will eat Temptations treats but those are not good for him, so we have stuck to canned FF classic pate. I will make a second comment on here to answer questions so it's less of a wall of text, my apologies for the length!

 

I am typing out answers to the questions and working on the spreadsheet but I wanted to ask, his glucose has been ranging from 200-270 without insulin. It has not gone back above 300. My previous vet he has seen since he was a kitten said that he has "stress hyperglycemia" and noted that his sugars rise at vet visits but was not concerned about it because once he gets some time to relax his sugars go back down. We are in a new area at a new vet now and just a few months ago we have blood tests and urine tests that say he had normal glucose readings. The past few visits to the vet for him have been extremely stressful for him. Its harder for them to do blood work on him because he is anemic. The past few weeks he has just been super stressed because he has been to the vet so much and between the ear cleaning (he has an ear condition), dental exam when his gums are inflamed, blood tests when he is anemic, and the car ride I think is some of the worst of it (he hates cars) I would like input to see what could potentially be wrong. I think these sugar readings are due to stress, because he has finally had just a few days to relax and his sugar levels have been much lower. He is still quite bothered by the Libre, and has been trying to excessively groom it, but he seems to have accepted its existence (somewhat). These vet visits are bothering him so much if he sees us open the door or get dressed he gets scared and hides. He doesn't come out for at least an hour unless you coax him out. We can't touch the carrier either even if he is in another room because if he hears the door on it close he will hide (I actually haven't put the carrier away because of this).

 

I would try a dose of ¼ unit. Some cats need insulin but very little. My Wiggles needs about 0.6 units. If I give here more he goes too low. If I give less he goes high, like in the 300's

 

The smallest notch on our syringe goes to 0.5 Units. Is there a different sort of syringe that would work with Prozinc? For the past two days hes been in the 200s and the past several hours he has been around 180/190. I couldn't believe it, checked him on the Libre and 2 other meters to make sure it was reading correctly. Then we opened the front door to take the garbage out and I guess he was convinced he was going to the vet at 2am apparently because he immediately hid and his sugars went up 30 points.

 

May I ask what his HCT is now - at his last vet visit/blood draw? What is the cause of the anemia? What therapies have you tried (other than the prednisolone) to help with the anemia? Have you ever tried giving B-Complex vitamins? These can be helpful. Are able to give him pills?

EDIT: I see now that your signature says hemolytic anemia so I see the cause. Do you know how he got this? He didn’t have a Convenia (antibiotic injection by any chance?)

 

This is not good. If he jas an infection in his mouth then he should have been put on a course of Antirobe (Clindamycin) for the infection. This is the antibiotic which has the most specific action against oral bacteria. This mouth infection will just drive up his blood glucose and also may be the reason for him no longer wanting dry food (painful to chew) and may result in his not wanting to eat at all. Oral infections can also negatively affect other organs of the body (even the heart.).

 

Normal numbers for a non-diabetic cat will be approximately 50 (even a little less) to not more than around 100 or 120 (depending on if they’ve eaten and what they have eaten.). Some cats seem to run a little higher and some lower. So it sounds like your cat may need a small dose of insulin. If you can clear up the mouth infection, he may not need any at all. As to drawing a small dose like 1/4 unit, you put the plunger between the 1/2 unit markings and the “zero” mark. You kind of have to eyeball it. Some people use digital calipers to measure small doses. Since his numbers are not that high - although above normal, I would prioritize getting the oral infection under control and monitoring BG carefully as well.

 

What kind of syringes are you using? Are they U-40 syringes? I only ask because we have seen people use the wrong size syringes before, which has resulted in the incorrect dose being given.

 

His HCT was 33 so just above normal in October. We did not figure out the cause with my old vet back home. She ran some tests and determined it was hemolytic anemia so he ended up on Prednisolone for several years. Finally in 2020 he had normal levels and was able to go off of it. It is possible he had Convenia, I have heard how bad it is but back then I am not sure. The vet no longer had records that far back so she had minimal info for me other than test results. When I moved him up where we are now with this new vet she checked his usual tests and they were "low normal" so we did some B12 injections, which didn't do much. He is very used to taking pills and doesn't mind taking them. This vet was wondering if he had some kind of inflammatory bowel that could have been causing it. However the stomach issues he had cleared up entirely when I switched him to the lower carb Fancy Feast pate and off dry food entirely. He was 2 years old when he developed the anemia, it came on suddenly and he just couldn't walk by himself. On the prednisolone he was able to walk again and function normally.

 

The syringes are U40, and in the office they did a demonstration for us as well to make sure we measured right