My 12 year old male cat is currently on Vetsulin 1 1/2 units 2x a day. His numbers usually run mid 400s to low to mid 500s. His 6 hour level sometimes drops 100 points but that is very rare. Sometimes it goes up. I would like to switch to ProZinc but my vet claims it’s the same as Vetsulin. Waiting on a call back from the vet now. Do you think ProZinc will help regulate these high numbers? Prior the Vet suggested taking him to an internal specialist. Prior to insulin his numbers were high 300s to low 400s. He started out on 1/2 unit and has been as high as 2 units. Do you think a switch to ProZinc first and if no improvement than a specialist? He’s on Purina dm wet only. Stopped Purina dm dry about a week ago
Hello! Yes, Prozinc is MUCH better in cats. Vetsulin is only good for dogs, cats do not get the same duration in it due to their high metabolism. You can refer your vet to the 2018 AAHA Diabetes Management Guidelines for Dogs and Cats. It clearly states that Prozinc and Lantus are the only recommended insulins for cats.
You said you were up to 2 units. Why was the dose reduced? Did he go too low? Many cats so better on ProZinc because it tends to last longer. My cat was on vetsulin and did well on it and went into remission after 4 months. She stayed in remission for a year before coming out. The second time around we started on vetsulin but switched to ProZinc because the vetsulin stung at high doses.
Wriggley started out at a half a unit. His numbers didn’t drop. Worked up to two units. He numbers seemed to go up slightly as the doses increased. Vet dropped him back down to one and a half. Vet thought maybe he had Somogyi effect. Didn’t really matter what his dose was numbers pretty much stayed 400-500 range. He dropped occasionally into the mid 200 range a couple times at plus 6 reading but back up at evening reading. One time he dropped to 120s at plus 5 and all the way down to 87 at plus 7. Thought he was gonna go hypo but he was 200 at plus 9. He didn’t get a shot that night and was back over 500 next morning. This has been going on for over a month. Just seems like this is not working
This sounds like a bounce, it's a common phenomenon where the BG drops too low, too fast, or lower than it's used to and the body tries to protect itself but dumping excess glucose into the bloodstream. Then you get those sky-high numbers the next day. Somogyi effect has been disproven in cats. Diabetes is like a moving target; a dose today may not be the same dose that he needs a week from now. We have a spreadsheet we use to keep track of BG numbers and track the data to help members adjust the dose as-needed. Below are the instructions to create one OR if you like I can ping a mod to set one up for you. We could take a look and help you and Wriggley out, if you'd like. Spreadsheet Instructions
I’ll give a try at the spreadsheet If I have any problems I will seek your help. That bounce was a one time thing. In re-reading my post it looks like it happens all the time when actually I meant his numbers are high all the time.
Sounds good! It's entirely possible Wriggley is bouncing a lot and you just don't "catch" it when it happens. If Wriggley drops low a couple hours after injection but you don't test until later that day, it will just look like he's high all the time. One bounce can also cause high numbers for up to three days ... then if they drop again it starts the cycle over. Just a general example, there are others. Vetsulin is notorious for causing perpetual bounces so hopefully you can get him feeling better by switching over to Prozinc or Lantus. Keep us updated!
Here’s his spreadsheet https://docs.google.com/spreadsheets/d/1g49B9XUQ96GXFK9QiGxph7pr2qgj2EbEbwqxrQASeQA/edit
Hi, my cat was on Caninsulin for 4 months. After her insuline shot she wen't down very quickly (7 mmol in 2 hours) and was completely up again after 4 hours! So the insuline was completely gone after 4hours. Then, I started to give insuline 3 times a day: every 8 hours. This was better, but it was no solution for the long term off course. Now I work at home, but normally I am not at home during the day. I switched to Prozinc now for one month. (earlier was not possible because there was a problem to get it in Europe for some months). And what a difference! her BG stays "low" all day long. I am following the SLGS and I see her improving every day. If your vet does not want to prescribe Prozinc, you better try another one.
Great job setting up the spreadsheet (sorry I don't know your name)! So I'm seeing a lot of reds (400+) and blacks (500+). Those numbers, especially blacks, are usually indicative of bouncing. Here is a more in-depth summary of bouncing so you can understand what it is. Bouncing is a phenomenon that occurs when the body experiences (or at least thinks it does) hypoglycemia. Luckily the body uses bouncing as a defense mechanism against this where it attempts to compensate the low blood sugar by dumping excess glucose provided by the liver in an attempt to raise blood sugar back to “normal” numbers. Unfortunately, “normal” is a relative term according to the body. For a diabetic whose body has been untreated for so long that it considered very high numbers to be the new normal, lower numbers can often make the body overreact in attempt to save itself, even if it’s not in danger. A cat who has been suffering from diabetes for some time may at the point of diagnosis have a new “normal” of 400. When insulin is introduced and brings it down, even to 200 (still diabetic levels), the body thinks it is in danger, dumps excess glucose, and thus the blood sugar skyrockets up to the 400-600s. After enough time has passed, the body will eventually realize that 200 isn’t such a bad number, and bouncing will happen less often. Note some cats are extremely bounce-prone and a switch to Lantus/Levemir is needed. There are three main causes of bouncing: when blood sugar drops too low (hypoglycemia), drops lower than the body is used too, or by dropping too much too quickly. Typically if a cat drops more than 50% of their blood sugar a bounce is likely to happen, or if they drop 100 points within an hour. While bouncing can be considered as a safety net in the instances of hypoglycemia, it can look very confusing on paper. Wriggley's numbers are more than likely from bouncing and/or Vetsulin not last long enough to last the full 12 hours, making his BG high by pre-shot test. It's a little too soon to tell what Wriggley's ideal dose is right now - would you be willing to get in some early tests for us to look at? Vetsulin usually only lasts 3-5 hours before burning out ... however I see he had an 87 last month 7 hours into the cycle, so he may have slightly longer duration than most cats. This depends on your schedule of course, but it would be helpful if you got some tests in at +1, +3, +5, and +7 for a couple cycles. That way we can see how the insulin fully affects him. Right now we only have a couple tests to go by which is only part of the full picture. We may see that Wriggley dips hard and fast 1-3 hours in and by +5 when you usually get his test, he's on his way up again. That behavior would be normal for Vetsulin if it did. If the numbers stay high for a few days it might indicate needing more insulin. If the numbers are high for a couple days and then go down again, that would indicate he was bouncing and was "clearing the bounce". Some housekeeping tips, ignore if you already know all this but one can never assume: Test BG, feed, wait 20-30 minutes, then give insulin. Food must be on-board before shooting because of how fast Vetsulin hits the system. Give a small snack of his regular food about an hour after giving insulin. This will help slow the drop of BG so it doesn't drop so fast. Feed small meals throughout the day, not just at shot-time. Big meals twice a day are very hard on the pancreas, cats are naturally grazers. Leave food out at night - cats drop lower then. You can do this by using an autofeeder and/or freezing chunks of food to leave out. Now this is a cost issue with the food and testing meter you're using. Purina DM wet is low in carbs but it is mostly liver; most cats will tire of it quickly. Either way, most of us feed commercial low-carb food such as Fancy Feast Classics or Friskies Pate, however ANYTHING that is below 10% carbs and wet is suitable. Even Special Kitty or 9 Lives wet, which are considerably cheaper. We have a chart here where you can see all the wet food carbs, calories, etc. at once. Again, DM wet is fine, but if you need something more affordable, there's plenty of higher quality, cheaper options out there. The Alphatrak is a good meter, however as I'm sure you're aware, the test strips are very expensive. About $1 each. When you test even the bare minimum with pre-shots, that's $2 a day. Above I asked if you could get an additional 4 tests in if possible - that's an extra $4 though! Yikes! Vets like to use Alphatraks because they are designed for pets, however human meters have been used in cats and other animals for several decades now, long before the Alphatrak came onto the market, and they work just fine. The human meters run a little lower than pet meters, but we compensate it by just knowing what the acceptable BG range for felines is as read on a human meter (50-120). Again, nothing wrong with using the Alphatrak, but most of us just can't justify the cost so we go with human meters. You are in the US, so if you want to consider a human meter, I'd recommend the ReliOn Prime from Walmart. The meter is $9, strips are $18 for 100. Versus I think the Alphatrak is around $45 with strips $50 for 50. I hope that's helpful! I do definitely recommend switching either to Prozinc or Lantus. Lantus is a depot insulin that works a bit differently than in-and-out insulins such as Vetsulin and Prozinc but there is an incredible rate of success in cats on Lantus. Lantus is very expensive in the US; about $400 a bottle, however most of us buy from Marks' Marine Pharmacy out of Canada at a third of the price. We also buy them in 5-pen packs, I think with overnight shipping and everything it runs about $200 altogether, but the pack will last you 1-2 years. That makes it cheaper than both Prozinc OR Vetsulin.
My vet finally agreed to ProZinc. Placed an order with Chewie. Should be here this week. Fingers crossed. Vetsulin isn’t working!
. I would like to test more but lately I’m having a hard time. I use a lancing device and for some reason I’ve been having to poke him several times before getting blood. I don’t know if I’m not going deep enough or what. Wriggley handles it like a champ though. No problems from him but his ears are starting to take a beating. I’ve tried just using a lancet but no success I’m afraid to hurt him. He’s an orange tabby and I can clearly see the vein running the whole edge of his ears. Should be a simple poke. I will look into the ReliOn. Much cheaper! I have a Contour Next human meter. Do you know if they work?
Most lancing devices have different settings to poke further down - you usually aren't going to need to go higher than the low setting, but that's an option if needed. I never went higher than that. What size lancets are you using? If you're using the Alphatrak lancing device I think those come with size 28 G lancets ... 26 is better, the needle is bigger. You can buy ReliOn brand lancets ($1-2) from Walmart too - you can also pick up their lancing device (about $5) if you want. I never liked free-hand poking, I snagged my girl's ear once on it and decided to stick with the lancing device. Here is a picture of where you want to aim for. The "sweet spot" is the easiest spot to use, but you can poke anywhere along the edge of the ear. Don't poke the vein, you'll make it bruise. I would just poke riiiight next to the edge. You'll probably find that one ear bleeds easier than the other too. Another thing (if you aren't already) is warm up the ear first. Heat up a rice sock, fill a pill bottle with warm water, rub his ear between your fingers, anything to get the blood flowing. Afterwards put just a little dab of Neosporin Ointment + Pain Relief (NOT the cream) where you poked, that will help the ears to heal and feel better. Contour Next works just fine too! Pretty sure I've seen it around. Most go with ReliOn just because the strips are the cheapest available, but any human meter is good.
I definitely notice his left ear bleeds much better but his left ear is the one taking a beating. I will try warming it up first. I got away from the alphatrax lancets. They were $16 for a hundred. Got a generic brand $6 for 300 but I went with the 28 gage. I’ll order some 26’s. I figured the higher gauge would be less painful but sometimes I get blood but it’s such a small drop it doesn’t register and I get the dreaded error 3 code and have to toss the strip. Do you use vasa
I meant do you use Vaseline to help form a blood drop. I usually just put a cotton ball under to ear and poke
$16 for 100? Insanity!! When I first started, yes I'd use a little bit of Vaseline. After a while I found I didn't need it anymore. Warming the ear will make things 100x easier! I liked using the rice sock because after I warmed the ear I could then use it under her ear to keep from poking myself. Some people like cotton balls, others prefer cotton pads so they could hold the ear with it to stop the bleeding/prevent bruising. I just used my fingers though. Lots of ways to do the same thing!
