Discussion in 'Prozinc / PZI' started by LUT605, Sep 11, 2020.
Are you taking advice of the previous thread and changing his dose back to a safe 0.5 units? This "insulin shock" that your vet mentioned is hypoglycemia - it occurs when you the blood sugar drops too low and can be fatal. This is why we highly suggest testing before EVERY shot ... you will have no way of knowing what his current BG levels are if you are not testing, and you can very easily overdose your cat this way. Starting your cat on 2 units is a good way to send him into hypoglycemia - so if you haven't yet, PLEASE go down to 0.5 units. The last thing you want to do is give too much and send him into a seizure. I don't say that to scare you, because it's very rarely seen here on the forum - but that's because everyone here tests to prevent that from happening, and that's the danger you put him in by not reducing the dose back down to a safe appropriate starting dose and testing before shot-time.
This is the 2018 AAHA Diabetes Management Guidelines for Dogs and Cats. Despite what your vet has done by starting him on 2 units, this national guideline says to start at 0.5 units, NOT 2. For your cat's safety please reduce to a more appropriate dose.
I would still like to see those lab results please. There is a lot at play right now with your cat, with the URI and dental problems. You need to address them before adding a high starting dose to the mix.
I also recommend getting ketostix - they are urine ketone strips, easily found at Walmart or any pharmacy. A lethargic diabetic cat is a concern, mainly for ketones. But your cat is having other issues so it's hard to pinpoint what's going on.
I also would like to know what kind of food he is eating. Diabetics need a low-carb, wet food. Fancy Feast Classics, Friskies Pate, are common ones but anything under 10% is acceptable. If he is not already on an acceptable carb-level food, I would recommend dropping the food immediately and dropping the dose to 0.5 units. He's early in the diagnosis and people who have already started have a much harder time reversing the bad food / high dose so you are in a good place to correct this.
As for injections - your cat should not feel anything when you inject. Are you giving insulin while he is distracted with a meal? Do that. You want to slide the needle in parallel with the spine with just a slight angle to it, facing his head. We're not trying to hit muscle, just dip right under the skin.
You are welcome! Yes that is DEFINITELY safe now that you switched him so suddenly. A cat on insulin switched to a low-carb diet will need less insulin, so maintaining the dose is dangerous. Thank you for reducing.
Okay. So, you DO need to tackle that dental. Lots of things increase insulin needs. We had a kitty here recently whose owner thought he was knocked out of remission because his BG was going up - turns out he had some bad teeth, and she's getting it corrected. We want to eliminate all things that cause BG to be high - stress, high-carb food, bad teeth, infection/illness. Added to that, diabetics NEED to eat. If his teeth hurt too much to eat you're going to have issues giving him shots.
Wellness Core I believe is suitable for diabetics. Canidae is a little on the high side, minus the Under The Sun variations. Not sure about Meow Mix. Here is a chart we use for picking out food - it's extensive, but just look at the carb amounts. Anything under 10% (ideally under 5%) is good for diabetics. There are cheap options if price is an issue.
Are you in the US? If so go to Walmart and purchase a ReliOn Prime, it is the cheapest meter + strips available. $9 for the meter, $18 for 100 strips. Here is a link to learning how to test for when you're ready! It's got a learning curve in the beginning but don't worry, everyone here can do them in their sleep now, it becomes second nature. I recommend getting your kitty (what's his name?) some treats to get him used to testing. Baked chicken or PureBites treats are popular. I think they sell PureBites at Petsmart too.
Here's a shopping list for testing, to make it easier on you:
ReliOn Prime meter - $9
ReliOn Prime testing strips - $18 for 100
ReliOn Lancets 26 Gauge - $1-2 for 100
ReliOn Lancing Device - $5 (optional, some people prefer to poke freehand)
Travel-sized Vaseline - $1
Neosporin Ointment + Pain Relief (NOT the cream) - $5
Cotton Pads - $2 (optional - you can use a homemade rice sock instead)
Ketostix - $7
I also would like to see you prepare a "Hypo Kit". This is to prepare you in the event that your cat experiences low numbers. You can keep him safe if you are well-stocked!
Karo Syrup - $3
A few single cans of Fancy Feast Grilled OR Sliced OR Marinated in Gravy - $.60 each (these are your medium-carb cans)
A few single cans of Fancy Feast Medleys Tuscany OR Medleys in Gravy or Broth OR Gravy Lovers Gourmet Beef Feast in Gravy - $.60 each (these are your high-carb cans)
Did either of the vets mention why he may be not feeling well? Diabetic cats are usually up and about and crying for food. When did it start for him not having energy? Normally a lethargic diabetic needs to go to the ER. Is he acting lethargic or just not interested in doing much? How long has he been doing this? I wonder if he's just feeling bad from the respiratory infection.
Just a whim, but did his eating improve after he started on Clavamox? I know it's used for dental problems as well as respiratory so I wonder if maybe it was helping two things at the time.
The fact that there was sugar in his urine does indicate diabetes, but you'll find that cats are not all in the same "range" of diabetes, so to speak. Some cats only need a diet change, and don't need insulin. Some need to overcome illnesses that teeter them close to the edge of diabetes. Others have been affected by steroids and after removing said steroids and insulin therapy can go back to just being diet-controlled. Others have a lot of damage to the pancreas and need a LOT of help getting better. We don't know which one your kitty is, but if he's not showing many symptoms (if any) I'd be really curious to see what an at-home test says.
Good luck with the doxycycline, I've got a vet visit scheduled for my kitten and am going to request that as well. She's had a URI since I adopted her in June. They can be hard to kick. :/
Just a heads up about doxycycline ... be sure to either put it in a treat or pill pocket or coat it with a lubricating substance AND chase it with at least 3-5 ml of water to ensure it passes to the stomach.
Doxy can be caustic and cause esophagitis and esophageal strictures, so it’s very, very important not to “dry pill” it. It’s a great drug, just please be aware.
Note that “chasing” with water or tuna juice or food is a good practice for any pill/tablet, but especially imperative for doxycycline. Dr. Lisa (Pierson) addresses it on her website: https://catinfo.org/pilling-cats-an...natives-transdermal-medications-pill-pockets/