Switching from vetsulin to prozinc: Part 3

http://www.felinediabetes.com/FDMB/...etsulin-to-prozinc.168561/page-2#post-1837693

On to part three

 

How are his ears and tolerance for poking holding up?

 

so far so good, but I test him with paw pads instead. Its time to check his BG again. BRB

 

I've never tried Teasel's paw pads. He's really good with the ear pokes and my technique is vastly improved compared to to the beginning

 

Smoky was at 95 for +8. I gave him a purely FF real piece of salmon treat for being such a trooper.

 

I have to remember to post on part 3 instead of part 2.

 

I'm thinking about giving him either 2.25 or 2.5 depending on what his PMPS is later

 

I'd try that. Can you do one test before bed tonight?

 

Yep I can do that, don't have to work tomorrow.

 

Smokys PMPS was 228 but I noticed he is breathing very hard. I can see his nostrils flaring and his sides go in. It is very noticeable since he is still underweight, about 8.7 lbs last time I checked him. I am worried about his breathing as I've never seem him do that before today. I check him for ketones every Monday and he has been negative for weeks now.

 

I don't know what to say about this, Lisa. He has allergies. Have you ever sensed there might be asthma involved? Does he seem to be in distress? How was he earlier today? Was this sudden in onset? Does your current vet have after hours at her clinic so you could call for advice?

 

I didn't think about him having asthma. He has had bad reactions to meds before but is only taking Denamarin for his liver and cerenia as needed for nausea.

 

There is only one vet in this area that is open and it is an emergency pet hospital.
I didn't notice him breathing hard earlier in the day, started about 6 hours after his am shot. His appetite is down a little, has eaten about 10 oz today compared to the 17 or 18 oz he has eaten daily in the last few days. I'm not sure about giving him his pm shot, feel I shld give him a much lower dose

 

I wonder if it's a sensitivity reaction to something in the ProZinc. I read somewhere that it can cause a reaction in cats who are sensitive to fish or maybe it was salmon in particular. I've just been looking for that info but can't find it. The other thing that can be associated with rapid breathing is ketosis. Would you be able to grab a ketone test this evening just in case? His BGs have been good but you never know.

Your SS shows a 2.5 u dose for this evening. Have you given it yet?

Another thing you might want to try is posting on the main health forum with a question mark asking for info about onset of rapid breathing. If you feel it's urgent you could put a 911 on it.

 

I gave him 2.5 u minus one big drop.

 

I've just read in a few places that low BG can make them breath more rapidly and Smoky's was not hypo but much lower than he's had. Around 6 hours after the AM dose was when he nosedived.

 

I cld put him in bedroom with me and test him. I have beads I got from the vet which makes it easy to test urine sample

 

Should be OK. If I was looking for the simplest explanation I'd say the very low BGs today might be behind it. He's been on ProZinc for almost a month so any sensitivity reaction would likely have shown up.

 

Smokys breathing seems to have slowed a little bit but still too fast for my comfort. I think I will put him in my bedroom with me tonight with his water dish and litter box. I can keep a better eye on him that way.

 

I'd do that just to rule it out. Keep an eye on him to see if it subsides, stays the same or gets worse. You might want to do a BG at +2 and +3 or +4 to see what's going on.

 

I did post on the main health forum asking about his fast and hard breathing.

 

No panicking allowed. He'll probably be OK, especially if it seems to be slowing and you can keep an eye on him overnight.

 

How's he doing?

 

+ 3 was 162. He was hungry so ate a 3 oz can of food. No ketones but he is still breathing a little fast.

 

I saw the AMPS of 264 on your SS, Lisa. Probably a tad higher because you lowered his dose last night. I suggest you stick with 2.5 u today after his dive yesterday. I know you're doing a curve today and will probably use the AT meter, right? I'm familiar with how those read so I'll keep an eye on your data.

How's his breathing this AM? You mentioned that he was wobbly yesterday when his BG was low. I wonder if he's extra sensitive to a drop like that and the rapid breathing is part of what he displays. More observations to keep track of for future reference.

 

Update on Smoky: His fast breathing has slowed down quite a bit. He is still breathing a little fast and feels quite warm compared to the other two cats.
I will call the vet back when she opens this morning. I took his AMPS using my relion and AT2 meter using the same drop of blood just to have some data for vet.
Relion: 264
AT2: 385

I have to do his am shoot soon so trying to decide what dose to give since he is a little higher for am.

 

His vet will holler at me for sure since I lowered the dose down from the 3.25u she had put him on two weeks ago. Not to mention the fact that she may not pay any attention to his BG numbers over that time frame since I used relion meter.
I think I still need to take him to the vet though and shld I still do a curve today?

 

I suggested 2.5 u in my post above given his low BGs yesterday. What do you think?

I completely understand the dread you feel at having to face your bossy vet. Just keep telling yourself that Smoky's welfare comes first. The focus while you're there has to be on his breathing, not what meter you're using. If you can steel yourself for that and let her attitude roll off your back you'll be fine. BTW - the difference in meter readings is larger when the number is higher (264 v2 385) rather than lower like yesterday's 56 around nadir.

As for a curve - you could do a partial one depending on what time you're back from the vet.

Any luck finding out about other vets in your area who would be more collaborative than dictatorial? You'd be much less stressed about his care if you had a vet to lean on instead of dreading.

 

I did talk to one vet clinic near me already. They looked over smokys records except for those from cat clinic. I still have to get a copy of those records, they only ever give me a receipt for the bills.
I know they will give me a hard time about it but I paid for those services and I want his records

 

Sometimes we have to be a bit "assertive". Hard to do but necessary.

 

I am at the vet now waiting for Smoky to be seen.

 

They said they could squeeze him in today at 9:30 but still waiting. I did call on short notice though.

 

Worth waiting ... does he get really stressed at the vet's?

 

He just hides in his carrier so he is not too bad usually. The vet said he might be a little anemic based on his results from his last bloodwork.

 

They just took him back for chest X-ray's

 

Good. I'm sorry that your finances are taking another hit though.

 

I posted an update on my other thread.
It's not sounding good right now.

 

Smoky was 243 at +3 on AT2 meter.

 

Good response to the dose. I'm glad you're going ahead with the routine of doing the curve. Standard advice but useful: try to find as many mindless tasks as you can to tackle today to keep your mind from running away with you.

How's Smoky feeling right now?

 

He ate some lunch and is sleeping in his cat bed by the baseboard heater. He is still having trouble with his breathing. I guess the spot on his lung cld be causing that.
The vet said to try to restrict his movements as much as possible. He is sleeping a lot so that's easy to do.
I'm surprised they didn't try to give him oxygen

 

I actually have some errands to run in between curve times.

 

It's odd that this was sudden in onset.

 

Good distraction.

 

The vet and I both thought it was strange that it came on so suddenly. I hate to see him feeling so lousy.

 

It's the worst thing seeing a kitty feeling unwell. I hope you get results ASAP.

 

Me too. I'm just doing a mini curve today.
Smoky is so lethargic he didn't even make a fuss or try to get up when I tested him at +3. I'll check him at +6, +9, and then PMPS. I'm trying to keep his stress levels at a minimum.

 

Poor kitty. Did this downturn in energy, etc. coincide with the onset of breathing difficulty yesterday or was he under the weather before that?

 

He has been feeling sick since his diabetes was diagnosed. It's hard to tell between that and his allergies. He has been feeling worse since yesterday afternoon.

 

The near hypo could certainly make him feel unwell, lethargic, weak, etc. The breathing issue is odd.

 

I agree about the breathing problem since it seems to have come on so suddenly.
I just updated his SS, 130 for +7.5 didn't get back in time for a +6.
Isn't 385 down to 130 in 7.5 hours a pretty steep drop?

 

It's not turning out to be a good day to get in a decent curve. I'm beginning to wonder if the 2.5 is even too much for him right now.

 

Yes, it is a steep drop. That can be a sign of too high a dose. Maybe try a 2.25 or even a 2 u dose tonight?

 

Maybe not a good curve day but it's data with the AT meter.

 

So he jumped from 130 at 7.5 to 267 at +10. I'll have to wait until PMPS to determine dose for tonight. I think it's possible that his breathing problems are affecting his BG's right now. The vet assumed I've been giving him three units for the past two weeks. I really didn't feel like correcting her since she has not changed his dose in a month now.

 

I'm really much more concerned about his breathing difficulties and what the bloodwork and X-ray consult from radiologist results might mean for him.

 

You didn't need to get into that with her today. You have enough on your mind. Yes, if the breathing is stressing him it could raise BG. Is it better, worse or about the same?

 

It is better than yesterday afternoon but same tonight as today. I just updated his SS if you want to take a peak at it. I'm giving him his shot in about 15 minutes.

 

I say hang on to the improvement in his breathing today as a positive thing. Had a look at your SS. Are you thinking the same dose as this AM?

 

I would rather give him either 2.25 tonight while I can watch him. Either that or give him 2 u tonight and tomorrow am.
He did drop pretty low on the 2.5 dose earlier.

 

Good call. Either dose would be safe. Can you get one more test this evening?

 

I gave him the 2.25 u tonight. I'll try and get in a before bed test tonight.

 

OK so now that the curve is done shld I use relion or AT2 for before bed test? I'm thinking pet meter since I used one all day.

 

How is he this morning, Lisa?

 

He is about the same, doesn't seem to be in any distress though. He was running in circles when I took out his canned food for his breakfast.

 

Nice!

 

He was breathing hard for a little bit after running around. The vet said he probably would not survive surgery or radiation treatments if it is cancer. First of all, I would not put him thru that. I have to wait and see what the results are at this point.

 

Yes, that's all you can do, Lisa. One day at a time. Fingers crossed ...

 

Smoky was back in the pinks tonight. I don't know if the 2.25u is enough. Maybe give him 2.5u again? Also, it could be the breathing difficulties are causing his BG's to go up again.

 

You could give 2.5 u and get a before bed test.

 

Yep I can do that, would have to be a +2 though. I have to go to bed early as I hardly slept at all last night.

 

Get some rest! You have to take care of yourself too.

 

Thanks Rachel,
You're right, I need to be rested up so I can take good care of my boy.

 

I'm a little confused this morning with Smokys BG numbers
Tues AMPS: 296, gave 2.25u
PMPS: 315, gave 2.5u
+2 was 297
Wed AMPS: 393

Smokys BG's seemed to have shot up this morning, was last nights dose too high or not enough. I don't want to give him too much since he dropped so low on Sunday.

 

It's possible that he dropped lower after his 297 last night and has given you a bounce number this AM. Not to worry. You can try dropping back to 2.25 u to see if he lowers a bit from the bounce or you can give 2.5 u because of today's AM pink. Can you test him at lunch time?

 

Not today, Christmas luncheon for employees

 

I think I will go with your idea of giving 2.25 just to keep him safe. The breathing issues could be raising it temporarily, I think

 

Enjoy!

 

That works. Are you keeping a log of how he's breathing? Might be worthwhile, maybe even use a bit of a rating scale, say 0 to 3 with 0 being no problem and 3 being a struggle. I've done that in the past for kitty issues and it helped me see progress better if recovery was slow-ish. I couldn't just rely on my memory.

 

Yep, the vet said to count his breaths for 10 seconds and multiply by 6. The normal range is 28-32 breaths per minute. Smoky is at 36 right now.

 

That's above normal but not extreme. If this air in lungs issue slowly developed after the fall (and that's a decent theory for now) it'll probably take some time to resolve. No need to worry about the needle procedure right now. I know how easy it is to get into a frightened muddle when your mind jumps ahead.

 

I posted an update for Smoky on my other thread on Health forum.

 

Smoky at 250 for am
Safe to give 2.25? thought maybe 2u wld be safer. I'm not sure if I can check him at lunchtime today or not.

 

Hi Lisa,

You gave him 2.25 u on a 206 on 12/15 AM so he should be OK with 2.25 u today. But - if you feel better giving 2 u so you don't worry if you can't check him, go with that. We have to consider our feelings about doses too.

 

I gave him a fat 2u, about halfway between 2 and 2.25.

 

Peace of mind.

 

Smoky: PMPS was 212, think I will give him 2.25u tonight. I feel better in the evening changing doses as I can watch him.

 

Good plan, Lisa.

 

His respiration rate has gone down a little more: 32 to 30 so almost normal

 

Great news!

 

Smoky was 212 for PMPS last night and dropped to 146 for am. Wow! I guess that's not too big a drop though. I don't want to give him 2.25u with a 146 though.

 

No, not at 146 for sure. You shot 2 u on a 137 on 12/11. You could try that. Here's where having the SS data is so very useful.

 

Thanks, I gave him 1.75 units for am

 

Breathing room! Any time off around Christmas?

 

I saw the date you were referencing, I don't have any mid day tests on that date to see how low he went. I thought it wld be safer to stick with the 2.75u dose.
I have to work on Christmas day so have off Monday and Thursday of the week following the holiday.

 

Safe is always best.

 

Hi Lisa,
I just saw that blue. He's certainly making progress and you're doing great with deciding on doses.

 

I'm thinking about giving him same dose as yesterday am, a little over 2 u, maybe 2.25 a little too high? Your thoughts on that?

 

Roommate said he was nauseous this morning so going to give a 1/4 tab of cerenia. When is the best time to give that to him? On an empty stomach or how long after a meal? Smoky tends to get sick when given pills on a completely empty tummy.

 

You gave 2.25 u last night on a 212 and he was low this AM. PMPS tonight is high enough to try 2.25 u again. Can you so a test before bed? When you start seeing action like this dosing is a bit of trial and (hopefully not too big) error.