Hi there,
Full disclosure: I have never treated a cat with Prozinc insulin. I am an experienced user of other insulins.
Howie got into a bag of bread last night which he has never done before.
What we know:
- Larger 6IU dose was given last night.
- Howie got into a bag of bread. Has never exhibited such behaviour before.
- Overnight Howie had diarrhoea.
- This morning Howie is extremely lethargic.
- Howie's appetite is poor this morning.
- There is no mid-cycle data for the Prozinc 6 IU dose, either on AM cycle or PM cycle.
What follows is conjecture on my part but it is based on general principles of managing a cat on insulin.
Because there are no historical data available to give an idea of the safety of the 6IU Prozinc dose all one can go on are the observed behaviours and Howie's clinical signs.
Lethargy may be observed when a cat is running high. This morning Howie's AMPS was higher than usual. Possible causes:
(a) BG still elevated after eating bread.
(b) Rebound from a low BG level overnight triggered by the body's self-protective mechanisms (bouncing).
(c) A combination of the above.
A cat may become lethargic when blood sugar is too low, or BG levels have gone through a big, steep drop. it can take time for a cat to recover from a symtomatic hypo during which time it may also exhibit lethargy.
Here's a typical description of some of the after-effects humans may feel after a hypo episode (from a human diabetics' discussion forum):
"When I bounce back after treating a hypo I feel weak, lethargic, achey and I tend to develop a thumping headache too."
The diarrhoea may have been triggered by the bread Howie ate, but there's a wee niggling in the back of my mind that loose bowels may also be a hypo symptom (though I couldn't swear to the latter in open court).
Weighing up what information there is available, I am leaning towards Howie possibly having had a significant hypo event last night. What tips the balance for me is that he tore into the bread, something he has
never done before.
If Howie were mine, I would NOT not give another 6 unit dose of insulin. I do not think it's safe.
You do have a home-run curve for the 3IU Prozinc dose so you have at least some evidence of its safety. I suggest you contact your vet today to discuss giving a 3IU dose twice a day. For safety, I also
strongly recommend that you get at least one mid-cycle test each day. If your schedule is tight then the one that most people can manage is the 'just before bed' test on the PM cycle. Even if it's only a few hours after the insulin dose was administered, it will give you
some idea of how a dose is working and throw some bit of light on whether or not the dose is safe.
This is just my interpretation of events given the information available. Other members may have a different take.
I don't know Howie's dosing history but doubling up the 3IU Prozinc dose on some cycles is not a dosing method I've observed before. How did you arrive at these doses?
I'm tagging
@Deb & Wink, a highly experienced Prozinc user, to ask her to review this thread and Howie's spreadsheet and give you some feedback next time she's online.
If you do reduce the dose
please make sure to check Howard's pee daily for ketones until the situation becomes clearer, especially if he has any history of throwing ketones or DKA episodes. I also recommend you contact your vet ASAP to let them know about this episode and to discuss Howard's current insulin requirements.
I'm glad to read you're testing today. Note that if you get a run of high numbers, or if the BG levels don't go any lower by a noteworthy degree than the BG values in the curve you ran for the 3IU dose, today's tests will throw no light at all on the potential safety of the 6IU Prozinc dose.
Mogs
.
It'll go down at some point.
