Low blood sugar readings-holding insulin-not sure if right

Hello,
My cat Boo is an outside cat-diagnosed with diabetes in May (glucose 500s)and on full feed dry cat food. On Prozinc 5.5u for approximately a month until 8/16 when went to the vet and his blood sugar was 62. Boo gained another almost a pound and is weighing 16.3 lbs. Vet decreased his insulin to 5 units. I have started trying to check his blood sugars before each insulin injection beginning 8/18. Using a Reli-on Micro glucometer.
8/18-830am-blood sugar 229-5 units Prozinc given
8/18-800pm-blood sugar 98-5 units Prozinc given
8/19-730am-blood sugar 202-5 units Prozinc given--did throw up this am
8/19-730pm-blood sugar 83-5 units Prozinc given
8/20-745am-blood sugar 44 then recheck 84 in opposite ear-5units Prozinc given
8/20-730pm-blood sugar 68-no insulin
8/21-730am-blood sugar 61 then recheck 81-no insulin--1/2 can fancy feast classic
8/21-730pm-blood sugar 72-no insulin-1/2-3/4 can fancy feast classic

Not sure if I am doing the right thing with his blood sugar in this range. Will contact the vet 8/22 for further recommendations but thought I might get some information tonight. Thanks in advance for any recommendations. Alena

 

Re: Low blood sugar readings-holding insulin-not sure if rig

I'm not familiar with ProZinc other than to know dosages are based on Pre-shot numbers much more than Lantus or Levemir are, and since you're new to home testing I'm not going to suggest any dose changes, but I do notice you had said you were free feeding dry...but then you posted that you had fed the Fancy Feast classics the last few meals

Switching from high carb dry (and there are only a couple that aren't high carb) to low carb wet can drastically lower numbers. I have to wonder if that's part of the reason

Are you still feeding the dry? Or are you switching over to the low carb wet food?

Hopefully one of the members who is more familiar with ProZinc will be able to chime in soon, but at that low a number, I don't think I'd feel comfortable giving any insulin either

 

Re: Low blood sugar readings-holding insulin-not sure if rig

Wow, 5u of insulin is a pretty hefty dose!

I would not give any insulin on a number under 100, period.
The best thing to do at this point, when you eventually do have to give a shot, is to get a test "in the middle" someplace. The low point of the cycle (nadir) is just as important with Prozinc as the preshot tests are. In order to know if a dose is too high, low, or just right, you have to know how low it goes during the cycle. If you can test in the +5 to +7 hours after the shot, you should be able to "catch" the low number. If so, make sure and let us and your vet know what you see.

Most likely, the dry food is keeping Boo's numbers elevated. Have you read about low-carb canned food being the best choice for diabetic cats? Dry food, in general, is very high in carbs, which elevates BG levels. With a dose that high, you should be aware that if you were to try to switch to low-carb food, the dose will need to be lowered, probably significantly. If you choose to do that, make sure to discuss it with your vet before you do anything diet-wise.

 

Re: Low blood sugar readings-holding insulin-not sure if rig

There is still free feed dry cat food available for the cat. I would like to get to no insulin if possible and canned cat food but I do know it will take some time. I fed the FF cat food because it did not seem like he was eating the dry food at his insulin injection and I wanted to make sure he got some food in since the glucose levels seems low. May not be the right thing to do, I do not know and I am fairly new to this whole thing.
alena

 

Re: Low blood sugar readings-holding insulin-not sure if rig

Nice catch Chris! I missed the reference to FF classics lately as the food of choice.

OK, that helps to explain the lower numbers.

Boo hasn't had insulin for two days. And he's been eating FF classics. Keep feeding the FF classics. Boo might not need insulin. I would suggest not even thinking about giving him any insulin unless and until you see numbers over 200. And even then, a much lower dose than 5u. Definitely detail to the vet tomorrow the numbers you have seen the past two days, and that he's been eating FF low-carb food. That will hopefully cause the vet to reevaluate the dosage of insulin, should Boo need any.

 

Re: Low blood sugar readings-holding insulin-not sure if rig

Thank you Bob and Chris for the information.
I will inform the vet what the sugar readings are pre injection and that trying to get to a low carb food even though the dry food is still available. Hopefully he will have some recommendations. I will keep posting what my findings are for the forum's information and recommendations. Just new enough to be dangerous and don't want to do any harm to Boo.

Boo has gained from 9.7lbs at diagnosis to 16.3 lbs and the vet did mention twice about changing his food to a special food like WD because of his weight gain. Has gained approximately 1 lb in each of the last two months when at the vets. Originally at one time before his diagnosis his weight was18 lbs. Not sure if the weight gain is due to the lower blood sugars or just the diabetes?
Will probably not be able to get a test at 6 hours until this weekend as I work during the day but will try to do so this weekend. Have never done a glucose curve, should this be done??? :?:

 

Re: Low blood sugar readings-holding insulin-not sure if rig

W/D is too high in carbs too...if you can transition Boo to ONLY the low carb wet foods, he MAY not need insulin at all!!

There's an excellent list by Dr. Lisa Pierson, DVM. that lists the carb percentages for pretty much any wet food available. You don't have to spend a fortune either! The Friskies and Special Kitty (Pate versions) are available at WalMart and are good choices

One of the first things we suggest is changing over to wet foods that are less than 10% carbs. Unlike most humans, sometimes just this diet change can get our kitties off insulin completely. (and although they're still considered diabetic, they're "diet-controlled")

Column "C" on the chart below shows the percentage of carbs

Dr. Lisa Pierson's food chart

As for the curve, there's no such thing as TOO much data, so the more numbers you can get, the more informed you'll be about how Boo reacts to insulin and food changes. It also helps us help advise you

 

Re: Low blood sugar readings-holding insulin-not sure if rig

You may find this helpful:

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on

insulin, this can be safe.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and

ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.

 

Re: Low blood sugar readings-holding insulin-not sure if rig

Although your vet may want you to feed the Hill's W/D to help control Boo's weight, it's not a good choice for a diabetic cat. A better suggestion to help with Boo's weight, would be to feed less food. Portion control.

My diet controlled diabetic foster cat Wink was on the Hill's W/D dry (37% carbs) at the advice of the shelter vet and 2 other consulting vets. His BG's were in the 300-400 range. When I brought him home, he was gradually switched to low carb canned food (Fancy Feast classic pate, Friskies pate) and quickly went into remission and no longer needs insulin. He has been a diet controlled diabetic for 5 months now.

Please, I think you can help Boo better by feeding him the Fancy Feast classic pate canned food. Since Boo is not currently getting insulin, you could gradually, over a week or so, try feeding less and less dry food and giving him more of the canned food.

Does he like the canned food ok?

 

Re: Low blood sugar readings-holding insulin-not sure if rig

YOu might want to set up a spreadsheet to track Boos results - it will help with dosing too and help the guys here advise - heres how : http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Also there is a board dedicated to PZI insulin which you might want to check out: http://www.felinediabetes.com/FDMB/viewforum.php?f=24