Long-term diabetic on high dose seeking general and specific advice | Feline Diabetes Management Board

Long-term diabetic on high dose seeking general and specific advice

Hannah and Phoebe

Hannah and Phoebe

Member
Previous Thread (My first post on FDMB)

Hello all! My name is Hannah and my cat's name is Phoebe (aka Beans). I've filled in her full info on my profile, but here is a summary.
Phoebe has been diabetic for 5 years. Her dosage has steadily increased from 2u-6u over the years (She is now on 5.0u). She was previously on Vetsulin, but has been on ProZince since May 2024 (links to historical data are available in the header of her SS). We are currently weaning her off of the maximum dosage of predisolone, which was prescribed for IBD (which was diagnosed through bouts of abdominal pain and pooping outside the litterbox). I work full-time (9-5) at a job that is sometimes fully at a desk, and sometimes sequestered in a cleanroom all day.

I've just completed a close reading of ProZinc Dosing Methods and am hoping to get some feedback on Phoebe's data, as well as pose some questions to the group. My questions are below, prefaced by some caveats/statements of strategies suggested by this forum that I haven't implemented yet, but intend to. Thank you for taking the time to read my post. And please let me know if I can clarify anything about Phoebe's profile or data.

Would like to implement in the near future:
  • Switch to LC wet food (after pred weaning is complete)
  • Testing for ketones
  • Feeding small meals throughout the day
  • Higher precision dosing (currently using U-40 Vetrijec Medium Dose)
  • Try to identify food spikes in her Libre data
Questions:
  1. When would you suggest beginning the switch to an LC wet food? After pred weaning is complete? If so, how long after?
    • Suggestions for LC wet foods that may soothe GI issues are also very welcome
  2. Regarding grazing throughout the day, I have two other cats and they (and Phoebe) usually scarf down everything I put down immediately. Do folks typically use a timed autofeeder in this situation? Is there a way to ensure that one of them is not eating all the food while the other two don't get any?
  3. Does the "do not feed within a 2-hour window of PS" rule apply to small amounts of LC treats (e.g. freeze-dried salmon)? (Like the amount I'd give her after a blood test)
  4. Based on Phoebe's data, would you say that Phoebe would be considered a "diver", a "bouncer", or neither/both?
  5. Based on her high dose, and looking at previous data, I suspect glucose toxicity in Phoebe. Would you agree?
  6. I have read some info online, and seen data on this forum, that show that the Libre readings can differ significantly from other human meters, especially at the low and high ends. Given that, are the numbers given in the ProZinc Dosing Methods guidance document still valid for the Libre?
  7. Would you say that Phoebe is in a "high dose" condition as described in the "Reducing the dose" section?
  8. Lastly, I welcome any general advice or guidance on Phoebe's care!
 
Last edited:
Hannah and Phoebe said:
Previous Thread (My first post on FDMB)

Hello all! My name is Hannah and my cat's name is Phoebe (aka Beans). I've filled in her full info on my profile, but here is a summary.
Phoebe has been diabetic for 5 years. Her dosage has steadily increased from 2u-6u over the years (She is now on 5.0u). She was previously on Vetsulin, but has been on ProZince since May 2024 (links to historical data are available in the header of her SS). We are currently weaning her off of the maximum dosage of predisolone, which was prescribed for IBD (which was diagnosed through bouts of abdominal pain and pooping outside the litterbox). I work full-time (9-5) at a job that is sometimes fully at a desk, and sometimes sequestered in a cleanroom all day.

I've just completed a close reading of ProZinc Dosing Methods and am hoping to get some feedback on Phoebe's data, as well as pose some questions to the group. My questions are below, prefaced by some caveats/statements of strategies suggested by this forum that I haven't implemented yet, but intend to. Thank you for taking the time to read my post. And please let me know if I can clarify anything about Phoebe's profile or data.

Would like to implement in the near future:
  • Switch to LC wet food (after pred weaning is complete)
  • Testing for ketones
  • Feeding small meals throughout the day
  • Higher precision dosing (currently using U-40 Vetrijec Medium Dose)
  • Try to identify food spikes in her Libre data
Questions:
  1. When would you suggest beginning the switch to an LC wet food? After pred weaning is complete? If so, how long after?
    • Suggestions for LC wet foods that may soothe GI issues are also very welcome
  2. Regarding grazing throughout the day, I have two other cats and they (and Phoebe) usually scarf down everything I put down immediately. Do folks typically use a timed autofeeder in this situation? Is there a way to ensure that one of them is not eating all the food while the other two don't get any?
  3. Does the "do not feed within a 2-hour window of PS" rule apply to small amounts of LC treats (e.g. freeze-dried salmon)? (Like the amount I'd give her after a blood test)
  4. Based on Phoebe's data, would you say that Phoebe would be considered a "diver", a "bouncer", or neither/both?
  5. Based on her high dose, and looking at previous data, I suspect glucose toxicity in Phoebe. Would you agree?
  6. I have read some info online, and seen data on this forum, that show that the Libre readings can differ significantly from other human meters, especially at the low and high ends. Given that, are the numbers given in the ProZinc Dosing Methods guidance document still valid for the Libre?
  7. Would you say that Phoebe is in a "high dose" condition as described in the "Reducing the dose" section?
  8. Lastly, I welcome any general advice or guidance on Phoebe's care!
Click to expand...
Hi again. Did you get any answers to these questions?
 
Novel protein foods typically are best for IBD cats. Many of these are low carb. Try Rawz, Koha, ZiwiPeak, among others. Rabbit is popular with many IBD cats but there are other novel proteins: vension, lamb, duck if your cat isn't sensitive to poultry (many IBD cats are), bison, etc. Are you familiar with these two web sites? IBDKitties – Helping Save Lives…One Paw at a Time and Feline IBD - Healing can happen!

A programmable timed feeder works for many people. Some people use a microchip feeder so only one cat who wears the microchip collar tag can access the feeder. Many people feed their other cats the same food as the diabetic because it's just easier to not buy multiple different foods and there's no worry about the diabetic eating something that's a no-no.

A meal 2 hours before insulin time is a no-no. A piece of freeze dried treat is fine. Or reward with catnip or something that isn't food.
 
Hannah and Phoebe said:
Feeding small meals throughout the day
Click to expand...
I recommend for ProZinc users to feed a small meal of a tablespoon or so at +2, +4 and possibly +6 if it’s not after the nadir. Feeding much food after nadir can make the numbers rise more quickly. It’s still okay to give low carb treats with each BG test.

No food for two hours prior to the AMPS and PMPS tests — at least in the beginning until we learn how carb sensitive kitty is with the food she’s eating. How is her weight? Does she need to gain weight or is she at a good weight right now? She has IBD so we may have to make allowances for her eating if she needs it at different times.

What is your work schedule like? I believe you said you are gone during the weekdays. Will anyone be at home with Phoebe during the day at all … or just on weekends? Will anyone be home for at least two hours after her shot time?
 
Hannah and Phoebe said:
Would you say that Phoebe is in a "high dose" condition as described in the "Reducing the dose" section?
Click to expand...
When referring to high dose conditions we are referring to conditions like Acromegaly or Insulin Autoimmune Antibodies (IAA). My cat had Acromegaly which creates extreme insulin resistance— his dose was over 40 units at one time and he also received supplemental short acting insulin at times to help keep his BG under control.
 
Hannah and Phoebe said:
Based on her high dose, and looking at previous data, I suspect glucose toxicity in Phoebe. Would you agree?
Click to expand...
Not really. I believe the higher dose is due to the Prednisolone. You are already seeing lower numbers and she’s showing herself to be very responsive to the insulin. However, stopping the Prednisolone could also be a double edged sword because if she starts having a lot of inflammation then it’s possible that her numbers could creep up again.

Nice cycle today so far, by the way. Good thing you made the mistake with the calipers. Can you test and compare any of these greens with the ReliOn?
 
Suzanne and Darcy said:
I recommend for ProZinc users to feed a small meal of a tablespoon or so at +2, +4 and possibly +6 if it’s not after the nadir. Feeding much food after nadir can make the numbers rise more quickly. It’s still okay to give low carb treats with each BG test.

No food for two hours prior to the AMPS and PMPS tests — at least in the beginning until we learn how carb sensitive kitty is with the food she’s eating. How is her weight? Does she need to gain weight or is she at a good weight right now? She has IBD so we may have to make allowances for her eating if she needs it at different times.

What is your work schedule like? I believe you said you are gone during the weekdays. Will anyone be at home with Phoebe during the day at all … or just on weekends? Will anyone be home for at least two hours after her shot time?
Click to expand...
Thank you! With regards to feeding it sounds like a timed microchip feeder would be good for us. We both work full time 9-5, but are able to work from home relatively often. But there are definitely days (usually 2-3 days per week) when we are both gone from ~8:30am to ~5:30pm (my partner can usually leave later though, more like 11). Occasionally we are away in the evening, but we are homebodies so not often. And we are typically home on weekends.

Phoebe's weight is good. The groomer last week actually said she feels like a very good weight for a diabetic kitty (it's a cats-only groomer who has had a diabetic cat before, and grooms many elderly cats). She has some muscle wasting along her spine and hindquarters though.
 
Suzanne and Darcy said:
When referring to high dose conditions we are referring to conditions like Acromegaly or Insulin Autoimmune Antibodies (IAA). My cat had Acromegaly which creates extreme insulin resistance— his dose was over 40 units at one time and he also received supplemental short acting insulin at times to help keep his BG under control.
Click to expand...
Wow! Thank you for the clarification!
 
Suzanne and Darcy said:
Not really. I believe the higher dose is due to the Prednisolone. You are already seeing lower numbers and she’s showing herself to be very responsive to the insulin. However, stopping the Prednisolone could also be a double edged sword because if she starts having a lot of inflammation then it’s possible that her numbers could creep up again.

Nice cycle today so far, by the way. Good thing you made the mistake with the calipers. Can you test and compare any of these greens with the ReliOn?
Click to expand...
I wasn't able to do ReliOn crosschecks this morning unfortunately. I will get one at +6 for sure.
 
Suzanne and Darcy said:
She gets groomed?
Click to expand...
Yes, we have a cats-only mobile groomer in town who come every 6 months or so. Phoebe is long-haired and has never been a consistent self-groomer. She gets brushed daily, but is still prone to developing mats under her arms and on her belly. She gets a belly trim and a "sani" (butt and tail trim) to help with clean-up after diarrhea bouts. The groomer also comes to help me shave her Libre spots, until I'm more comfortable with the clippers on her sensitive skin.
 
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