? Need Dosing Advice -recovering from pancreatitis

Discussion in 'Prozinc / PZI' started by JessiLee, May 17, 2021.

  1. JessiLee

    JessiLee New Member

    Joined:
    Jun 11, 2020
    Hello,

    Sorry in advance for the long post!

    Beau was diagnosed with pancreatitis (again) and dka (first time) on 5/5. He was hospitalized for several days while they flushed out the ketones and monitored his blood sugar. Ever since, I've been having trouble getting a "nice" looking curve.

    Prior to being hospitalized, he was on 2u regularly which was doing well for him. His preshot number was slowly coming down and his nadir was sitting just under 100 most days.

    When the vet tried to switch him back to prozinc from the constant drip, they were having difficulty getting any response from the dosage and increased from 2u to 3u to 4u each shot. The day he came home he had received 4u. That seemed to work well to bring him down from the 600+ the vet said he was at AMPS to around 200 at +6. However, I was afraid to give him 4u at home when his preshot number was much lower than the 600 they saw at the vet. So I started him back on his 2u, but received literally no response (see spreadsheet). I've been increasing his dosage steadily ever since, but am a little afraid as this is a higher dosage than he has ever needed before -even when his PS numbers were higher.

    My question is if this could be a result of his pancreatitis and if I'm doing the right thing increasing his dosage or if I should try and keep him at a steady value for a little while. I'm nervous about repeating his DKA diagnosis so I think I may be responding a little more aggressively than normal. An additional wrench in any plans is that I will be away for a week starting 5/24 and he'll be at a friend's house. I worry that if the dosage is unusually high because of his pancreatitis recovery, there may be a hypo situation in his future.

    Thank you all in advance. This forum has been very informative as I navigate the joys ( :rolleyes: ) of feline diabetes.
     
  2. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    It does appear he needs a higher dose. We typically recommend holding a dose for a week, but given the high numbers and DKA I'd maybe hold 3 days.

    Are you testing ketones at home? I'd recommend testing daily with a recent DKA and high numbers.

    I'd stick with 3.2 again tomorrow. If you don't see anything in the blues, I'd go up to 3.5 on Wednesday.

    Edit: is he eating ok? On any medications? It's entirely possible the pancreatitis inflammation raised BGs and you have to break through before coming back down. When you're away, will the person be home testing?
     
  3. JessiLee

    JessiLee New Member

    Joined:
    Jun 11, 2020
    The ketone test strips I had have expired. I just ordered more and will begin testing his urine asap. That's definitely a good call.

    He has been eating great since he came home. Back to his hungry self. He is on gabapentin for another day or so and finished his last cerenia pill this morning.

    The person will unfortunately not be home testing. I was lucky I could find someone that agreed to giving him the insulin shot. I thought about boarding him but that just makes his number so much worse from stress.
     
  4. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    Hmm that's a tough call. I'd try to increase every 3 days (6 cycles) and hope he gets a little lower by the time you leave. You can always leave sliding scale instructions, such as if "above this number, give this amount" "between these two numbers give a half dose" "below this number no shot"

    But keep in mind any reduced or skipped shots are very risky with a recent DKA...it's balancing potential hypo without home testing or another potential DKA.
     
  5. JessiLee

    JessiLee New Member

    Joined:
    Jun 11, 2020
    Thanks for the advice. He was lower than normal for his AMPS today, but I waited it out and gave him the full dosage. I'll do a curve today and see how he cares. I'm hoping his numbers settle down in the next week.

    Not that there's ever a "good time" to get sick, but this was decidedly a bad one..
     

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