Can someone please take a look at his SS; I know there's not much data there yet, only started the testing yesterday, have done a number of blood tests today, and he's on 5 units caninsulin b.i.d., his PMPS was in the black range!!! A few weeks ago vet put him on 6 units a day, but when I saw his water consumption instantly increase to A LITER A DAY (!!!) I put him back on 5x2, that was two days after the vet said 6x2. So he's been on 5x2 since; water is down to about 400 ml a day but only for the past two days. Chuffed about that, but black range?!?!?! I did ask vet for Prozinc, he says he'll try to get it but there's no guarantee in the UK that it will always be available, e.g. from one month to the next and we don't want him having to switch between insulin types etc. Did I do the right thing by giving him 5.5 at the same time as feeding? Not a complete 12 hour cycle (about 10 hours since morning shot). Any ideas? edit: I've been looking at other cats' SSs and am concerned that my vet doesn't know what he's doing? ECID ok but others do not give this much, 1.7, 2 units; am I killing Puss? edit2: I realise I haven't done my homework. Just found the sticky on caninsulin. more reading is necessary. but in the meantime, I have a feeling I should actually DECREASE the insulin I give Puss.
Hi, Can you tell us what dose of insulin Galaxy started on, and over what time period the dose was increased? And do you happen to know what his blood glucose levels were like initially at diagnosis? It 'may' be that the dose is too high. We certainly see cats here on doses that are way too high. There are 'some' cats who do need a high dose, but most don't. Have you changed the diet since Galaxy was diagnosed and put on insulin? Or was he already on a low carb diet? Um.... There are lots of cats on Prozinc in the UK. And I've not heard of any problems with availability.... The RVC actually recommend Prozinc for all new cases of feline diabetes. And this is the European guidelines also (to recommend longer lasting insulins for feline diabetes.). Is your cat otherwise healthy? Any ketones at diagnosis? (Just wondering about reducing dose and working up again from low dose....) Eliz
Hello, thank you for your response. His initial diag was No 2018 with 16.8, we started him on tablets!!! that didn't do anything OC; then there was a change of vets at the practice, started Puss on 1 unit, then that crept up to 4 after this last curve I copied in here: 1st Of April 2019 Insulin Curve 8: INSULIN 3iu BID 8:45 29.1 10:45 22.5 12:45 18.1 14:45 20.2 16:45 29.2 18:45 31.9 This was when he put him up to 4 units BID. Polydipsic and -uric AF, called vet, he recommended I increase dose to 5 units BID. No mention of bouncing or anything, back then I hadn't found the forum yet so didn't even know what to ask etc... Diet: November onward we've been feeding him the diabetic dry food vets sell from their surgeries. Never before had Puss been fed dry food for very good and well known reasons, I was also surprised that he should be put on dry but took the advice as God's word, coming from the vet. I found the forum and since then (few weeks back) the dry food is only his reward for bloodtests etc, a few pieces until I buy something more suitable. Before the dry food, he had always been on raw but mostly shop-bought canned wet. Which must be the culprit. Ketones: NEGATIVE. did two urine tests, both neg. I managed to go home in my lunch break, did a test at +9, as can be seen on SS; I decided, as an experiment, to give him 1.5 and see what it does in the next 3 hours. It looks like within the nine hours he bounced back to almost exactly where he was. All this is telling me that we want the prozinc, ASAP!!! Otherwise he is healthy, apart from neuropathy. Healthy weight that's stable. Also demeanour and generally he's OK.
There's a few things in the mix there, so it's a bit of a complicated picture... Initally eating raw and canned food. Diagnosed diabetic with BG of 16.8 back in Nov (?) ..(which actually wasn't too bad...) Switch to diabetic dry food in Nov. (High carb, so almost certainly increased blood glucose) Put onto Glipizide? Or similar? Then since no success with that started on 1 unit Caninsulin; and increased to 4, and (looking at the SS) up to 5.5 on one occasion? Numbers increasing? Few weeks ago removed dry food other than using as rewards for tests, etc. (Removing dry food will almost certainly have reduced blood glucose.) Ketones negative. Okey dokey... Just a few thoughts... If the numbers increase as the dose is increased this is very often due to too much insulin. And sometimes, seeing high numbers, the vet prescribes even more insulin (with too little data to support that dose increase), pushing the numbers up further.... There are certainly cats who 'do' need high doses of insulin. But vets prescribing too much insulin is something we see quite a bit of here. And when the numbers go up as the dose goes up this always rings alarm bells. The dry food will have raised the blood glucose. So it's not surprising there wasn't much progress initially because the vet had suggested you give your cat one thing to drop the blood glucose, and another to raise it... And so the insulin dose starts to get increased to try to get a result... It is actually very common to raise the dose too quickly (and with insufficient data to support the increase) and go straight past the most effective dose. Then, a few weeks ago, you removed the dry food, which would most likely have reduced the blood glucose and the insulin requirement, meaning that if the dose was too high before the removal of dry food, that will be even more the case now. If the dose is too high a cat is at huge risk of hypoglycemia. Given that your cat is otherwise healthy, and ketone tests have been negative, would you consider reducing the dose significantly and seeing if that helps the numbers...? It may not do. But at least you'd know... And now that your cat is back on a low carb wet diet (?) a low dose may well be sufficient. If a low dose isn't sufficient, then you'd be able to raise the dose again safely, based on your own blood glucose data. Eliz
Hi Eliz, thank you for the response. Yes it was glipizide, the tablet we were given. I have updated the SS. I gave him an experimental 1.5 unit at 14:25 as it was the exact same as AMPS at 05:20 am. That's practically where we started within 9 hours. Came home from work, 17:25 PMPS=36.6, so within the three hours, the 1.5 unit didn't budge it. gave him 4 units then with dinner. Having read others' posts and looking at various SSs, I also think that he's bouncing because of too much insulin. However, these lower doses (back on 4 now, 1.5 earlier today) don't seem to do enough. Obviously I haven't got much data but I think we've messed around with caninsulin long enough PLUS everyone knows and advises that Prozinc is the right thing for cats... I am almost certain that Prozinc would sort him, I'm just waiting for the vet to get back to me at last. if he has to stay on caninsulin, for whatever reason, I would love to do what you do, the sliding scale, cos it makes more sense? But I have a 9-5 job so can't ATM. Edith
