Hi, I’m relatively new at this diabetes treatment, and I’m totally confused. When my Oreo was diagnosed a few weeks ago, the pro zinc seemed to work, but then her numbers wouldn’t come below 350. The vet tried glargine last week and the numbers stayed above 400, so Friday we put her back on prozinc. The first dose brought her down to 240 and I was really excited, thinking we were on the right track. After the first injection she dipped to 350, then right back up. Shes at 4 units now and eats glycobalance. I’m at my wits end all and any advice would be appreciated!
Hi there! Welcome. When was your kitty diagnosed? What was the fructosamine level at diagnosis? I do hope the diagnosis was made with a fruc test, but if not it would be helpful to know the BG level. Are you home testing? Are you keeping track of the blood glucose (BG). The “glycobalance” food is too high carb for a diacat, but we can work on diet. Try not to worry. I know what it’s like. We are here to help.
Oh, also I can’t really comment too much until you have some data - a spreadsheet- to help analyze the insulin given and BG recorded. I hope you have some because we definitely want to keep your baby safe.
Thank you so much for your response. She was diagnosed on may 18th—she was hospitalized for ketosis. I don’t know about the fructosamine, but I believe her glucose was above 600. I’m using the libre monitor -I will post pictures of her curves when I figure out the site requirements. Her appetite has definitely decreased in the last week or so and she has lost some weight. Unfortunately the upload file button is broken and I’m using my phone, so I’ll have to figure out how to send the curves. There’s not a lot of movement now—after dropping to 240 after the first dose of prozinc they’re staying at about 400+.
I've tried to upload pics of the curve--one seemed to go through but I can only get one to attach. This is actually after the first dip down to 240
So I went to talk to the vet about the situation (she was in surgery so little help there—told me to continue as usual). I just got home and her glucose is 111. My husband said Oreo threw and then ate a little more. I got the canned glycobalance which seems to have less carbs. What should I do about insulin tonight if her numbers remain low. Any help is truly appreciated!
I can’t make out much from that Libre data except that she’s quite high and it looks like she never dropped below 350. I can’t tell where in the cycle any of this was occurring- how many hours after insulin, that is.
I will be unavailable for about the next hour and a half. Since I do not know the answers to the questions above, I don’t know what to say except that I urge you not to give insulin if the glucose number continues low at 111. Have you read the ProZinc dosing protocols on the ProZinc forum? It lays out a lot of detail about how to use ProZinc and starting dosages, when to increase, when to reduce, when not to shoot and when to give a token dose and reduced dose, etc.
Thank you so much for your response—I read the articles and they were very informative. Oreo’s BG went under 40 last night but I got it up with some syrup—I was up all through the night testing. She’s back over 400 now. She gets dosed at 9:00 am and pm with 8 units using a u100 syringe. The vet wants me to go to 10. She has lost weight and I’m wondering if I should feed her more—I now that makes her BG go up , so I don’t know.
Please do not increase the dose. Below 40 is dangerous territory. In fact that would be an automatic reduction in dose. To not decrease would be a dangerous mistake.
Also, ProZinc is supposed to be dosed using a U-40 syringe. I noticed you mentioned a U-100 syringe. @Teetee (UK)
@Diane Tyler's Mom can you help with the instructions for getting a spreadsheet set up - the template?
As for feeding, if she has lost weight then she does need more food. The 400 is likely a bounce from the 40. The cat’s body will release stored glycogen and certain hormones that serve to raise blood sugar up - frequently very high. It can take some time to come back down. It’s also not generally a good idea to increase insulin when your cat is bouncing because the bounce will break and their BG will naturally come back down and you would then also have the increased insulin working to push the BG down further also. I am very glad that you were able to keep Oreo safe from the hypo last night.
Okay- so about the syringes. If you are actually using U-100 syringes to inject the ProZinc instead of the U-40 syringes, you should be aware of this conversion chart. I would, however, strongly urge you to use the U-40 syringes with half unit markings. It appears that 8 units in a U-100 syringe are equivalent to 3.2 units of ProZinc dosed using a U-40 syringe. I would also urge you again to reduce the dose after the 40 that you had last night on only the 3.2 (8 in the U-100) dose. I would reduce to 2 units (in a U-40 syringe), start a spreadsheet to record BG numbers and the hours that you scan the Libre and gather data about the preshot numbers, the mid-cycle numbers, etc. This will really help us to help you and Oreo. It will help you to help him, too. Don’t be put off by the look of the spreadsheet. I delayed making one for a long time because it jist looked onerous to me and complicated. I finally made one and never looked back. I could clearly see patterns and trends that I never would have noticed without it. Oh, anyway… here’s the conversion chart and explanation. http://www.felinediabetes.com/insulin-conversions.htm http://www.felinediabetes.com/insulin-conversions.htm
Please do not increase that dose! I agree, really need to see a spreadsheet, but in the meantime, to be extra safe I like the idea of reducing to 2.0 units of Prozinc and gathering data. (If using U100 syringes = draw to the 5 unit line). If you have any U40 syringes at all, please, please, make sure you don't mix them up! From what you've written this is what I see: Friday, back on Prozinc, dropped to 240 Bounced for 3 days and why her BG stayed high Broke the bounce yesterday and dropped too low again because the dose is too high. Bouncing again from going way too low (40) and now it will "seem" like the insulin isn't working again. Even if the preshot BG is high do not be tempted to increase the dose or even keep the same dose. She told you with that reading of 40 that 3.2 units of Prozinc is too much. (@Suzanne & Darcy, sorry, my phone died)
This is an excellent explanation and I agree 100 percent! Definitely decrease the dose as we have suggested. Thank you, Shelley.
Thank you, I’ll try to get a spreadsheet going—I’m not the most tech-savvy person. The dr converted the u40 to u100 units. She has her regular dose of 8 units (a little over 3 with a u40 syringe) at 9:00 am. Her BG has been over 400 all day.The vet wants her at 10 units
Thank you all so much for your help. I really don’t understand all of this to be honest. She started at .5 units in the beginning. We had a little success then nothing—numbers stay off the chart—500+. That’s how we’ve kept increasing insulin. We got for a while that we had a dip down to 350, then back up. The vet want her at 250 at least, so she recommended an increase. We were on glargine for a week and never a number below 400. Does anyone have a vet that understands this? I left her office in tears yesterday because she just tells me to increase and nothing is working.
Hang in there. This is a sprint and not a marathon. Believe it or not, vets don’t receive a lot of training in feline diabetes at vet school. If they don’t educate themselves about it, then their understanding is limited. They’re often busy and overwhelmed. Here you have a lot of people who have a good deal of experience with managing Feline Diabetes. You are giving insulin every 12 hours, correct? Today she was very high because of what is called a bounce. This is the self-protective process that I talked about above. Trust me. It is a bounce and those numbers will come back down. Do not be fooled into thinking that you should increase the insulin because of those temporary high numbers. Increasing will be even more dangerous. You have already seen that the current dose puts your cat in danger of a hypoglycemic event.
FDMB has a template to download. Here's the link: HOW TO CREATE A SPREADSHEET You'll need a google account. The link above explains it all. If you have ANY troubles please let us know. We have members we can tag that can set it up for you and just love to help.
Thank you—I will attempt this. I do have another question though—we’ve never achieved normal BG even when we started at .5 units, and we only got down to 350–was that enough of a drop to cause rebound?
Possibly, but hard to say for sure without seeing the data, the patterns and trends. Have you used the Libre right from the start?
Good, good, good!! See if you can get a spreadsheet happening and enter as much data as you can. I'd like to see a couple of weeks but with the Lantus interlude it'd be good if you could go back a little further. And notes on the spreadsheet when insulin change(s) were made will be helpful too.
@Bandit's Mom can help you get a spreadsheet set up easily. She can do it in her sleep. Did you shoot insulin tonight? I hope everything is okay. If a cat’s body is really used to being in high numbers - for example in the 500s - then dropping into the 300s could potentially cause a bounce. Any time that the BG drops either too FAST or to a level that the cat is not accustomed to, a bounce can be triggered.
I took her down to 6 units last night and 5 this morning. She’s been on a downward curve all day—she’s at 205 right now. I just hope she doesn’t keep dropping too low. I’ve also been transitioning her off the dry food to canned.
The food transition will help lower the BG, yes. I hope you can share some spreadsheet data with us soon.
