Xuxu 2/23/13, 750 first 12 hrs on PZI

Thanks to whoever told me to start at .5 on PZI. He'd be crashing again if I'd done any more. The BCP sent us 5 ml free of 100u/ml. I was so hoping it would be 40 u/ml so I could use the other syringes. I've posted his numbers today, and on a Fat .5, he went down to 66. I didn't panic and give karo because I needed to see how low he would go. An hour later he was up to 89. It took 13 hrs and he still wasn't quite back up to 750, but I want to sleep tonight, so I went ahead and gave the 2nd shot as a regular .5 at 734.

I wish I knew how to get him to stay down in the 2-300. It just doesn't seem like he's ever going to have an average curve. At least he's happy and purring and eating now. The key seems to be not letting him stay at 750 for more than a couple of hours. He gets tested next week to see what his Eos is doing, whether it's gone back up or not.

 

I don't have an idea how that's even possible...that he could drop that far in eight hours and zoom right back again, on a dose that's hard to even see in a syringe. So I'm no help at all.

One question.... are all your numbers from an Alpha Trak meter?

Carl

 

What an unusual kitty. Did you give him .5 again last night? It doesn't have an amount on your ss. (Robin suggested the .5. She's the cautious one and it worked well for him)

We are definitely in uncharted territory. I'm with Carl. I have never seen a jump like that. The nice thing about ProZinc is that there is little concern about overlap. It sure looks like with him, at 11, it is gone. But what to do then, I don't know.

 

All the numbers are on Alpha Trak 2. He seems to be confounding everyone, specialists included. This type of curve has been typical of him on all the insulin types, (I think I've tried them all now). At least on PZI, it looks like there isn't the absorption problem he had on Lantus. Even swinging that much, he seems happy as long as he doesn't stay too high or too low for very long.

It has been assumed that his diabetes is secondary to something else, but we can't figure out what. We've ruled out everything we can think of except some type of cancer, but there is no evidence in his blood or on ultrasound. And if it was cancer, you'd think he would be declining in the last 6 months. But except for the times he's gone DKA, or hypo, he's been fine. He's always bounced back well. I guess I may have to accept that this is now his normal and stop trying to figure out why.

 

Deb

I went to the session on insulin resistance at the MidWest Vet Expo because I hoped I'd get some info or ideas specifically for Xuxu. Dr R. Lynn (one of the researchers who helped develop PZI) said Cushings is very difficult to diagnose. You mentioned previously that Xuxu was "Cushingoid". Maybe you might ask your vet what would be the risk and costs of a theraputic trial of treatment as if he had Cushings.

And I forget - was Xuxu checked for hyperthyroidism? That can alter glucose regulation, too.

The presenter was Dr Mark Peterson of the New York Animal Endocrine Clinic Might be worth a consult.

 

Wow pretty wild swinging still. Yesterday's daytime cycle looked like the insulin lasted longer.

 

yes, it did seem like the insulin lasted longer yesterday, I hoped I could get some overlap, but I let him out of the bedroom late yesterday (hid all the Iams) and he got more exercise running up and down the stairs. maybe that made the difference.

We did test for hyperthyroidism, definitely negative. I've thought about going ahead and giving him the Cushings medication. There are some side effect though. I'm going to keep him on the PZI for a couple of weeks, check to see if his EOS is still down and go from there. The reason they were saying cushingoid was because of the high EOS, so if that's down, maybe it isn't a possibility anymore.

 

Just like in humans exercise will bring down his bg's. Maybe you should get him playing with a laser pointer or mousie on a regular basis.

This has probably been asked and answered but has he been tested for Acro/IAA?

 

I haven't heard of the Acro/IAA test. If you have a link to something, I'd appreciate having it. I'll do some searching for it too.

 

He isn't really a high dose cat; his response to insulin is rapid and intense.

He's more of a hypermetabolism cat - breaks down the insulin quickly. Testing for insulin-like growth factor (found in acromegaly) still might be useful.

Deb, take a look at Acromegaly and Other High Dose Conditions: What We Know. Do any of these points seem familiar?