Is this vet diagnosis of insulin amount experience typical?

[Richard Zenk]

About three weeks, Baxter 16 yo DSH brown tabby currently 12 lbs (14 lbs pre-diabetes) was diagnosed with diabetes with blood sugar over 500. After three days in the hospital he was released and his blood sugar was 200-300 which was told was normal. Told me to give him 1 mark of insulin on a 3/10 BD syringe with 31 units.

I was asked to bring him back in two weeks which I did and the vet found the readings were high (didn't tell me what they were) and increased it to 2 units. Three days I noticed 2-3 clumps of large deposits of urine like prior diabetes diagnosis and him drinking water several times a day.

I called the vet yesterday and was concerned about the urine clumps and his drinking. She said it took a while for the 2 units to take effect and suggested I bring him in about a week. She had previously told me that taking blood sugar samples myself was not necessary and would hurt my relationship with Baxter. When first diagnosed she told me that monitoring exact blood sugar levels were as important for cats as they were for humans, since cats don't live long enough to have organ and other damage from diabetes.

I know many of you will feel strongly about home blood sugar monitoring.

My biggest concern is the damage to Baxter's health with this gradual increase in dosage and the harm caused by the 2 weeks when the unit was 1 and then increased to 2. His eating and pooping are normal as is his energy which is better than pre-diagnosis. Though he spends more time siting in between walking. Yesterday I noticed he spent more time awake in the afternoon which I saw pre-diagnosis. I feed him yesterday when I saw him awake around me then. I feed him more this morning and he is now sleeping in the afternoon.

He is eating about 6 ounces of wet food daily. I feed him BFF and other high protein low carb canned food only. There aren't other cats who have diabetes.

In a week if his sugar is still high, she may increase it. I know too much insulin is harmful but wonder if this gradual (1 unit - conservative for a vet to prescribe) then gradual increase is normal/typical.

 

[BJM]

What insulin? ProZinc, BCP PZI, Lantus, and Levemir are the recommended cat insulins. Others typically do not last 12 hours(-ish) per shot Lantus and Levemir are depot insulins which have overlapping effects, so you need 5-7 days on the initial dose before evaluating them. Starting at 1 unit is a safe dose. Increasing too fast, especially with a depot insulin, may set you up for hypoglycemia, which can be fatal, quickly.

See my signature link Secondary Monitoring Tools for additional assessments which you may wish to make.

 

[Richard Zenk]

Lantus Solostar

 

[BJM]

Then starting with 1 unit is OK. We typically make increases 0.25 -0.5 units at a time, here, so we don't by-pass an optimal dose.
Home glucose testing may show numbers 100-180 mg/dL lower than at the vet. An inexpensive human glucometer, such as the WalMart ReliOn Confirm, works fine with feline reference numbers, which are in my signature link Glucometer Notes.

 

[Richard Zenk]

Thanks, what is the normal/expected blood sugar ranges?

 

[BJM]

With a human glucometer:
- off insulin about 40-120 mg/dL on a human glucometer
- on insulin about 50-130 mg/dL on a human glucometer
More details in the signature link Glucometer Notes.

 

[Larry and Kitties]

Typically BGs taken at the vet are artificially elevated due to stress. The elevation can be up tp 100 points (USA) or sometimes greater. That is why it is best to do BG testing at home.

 

[Critter Mom]

[The vet] ]had previously told me that taking blood sugar samples myself was not necessary and would hurt my relationship with Baxter.

1. As other members here have probably already told you, home BG testing is invaluable in helping keep Baxter safe on insulin.

2. I haven't seen any figures here, but I suspect that a straw poll of members here would probably show that home testing more often than not can significantly strengthen the bond of love and trust between cat and caregiver - with the proviso that Every Cat Is Different, of course!

 

[Elizabeth and Bertie]

2. I haven't seen any figures here, but I suspect that a straw poll of members here would probably show that home testing more often than not can significantly strengthen the bond of love and trust between cat and caregiver - with the proviso that Every Cat Is Different, of course!

Hi,

I absolutely agree with Aine. The test process can certainly strengthen the bond between cat and caregiver.
Your vet seems to be assuming that the test process will be unpleasant, but in fact it can be quite the contrary. Testing should not hurt the cat at all. And many cats look forward to being tested because they are rewarded with a treat or a cuddle. My cat comes running when I rattle the test strip vial. And I've clocked up over 17,000 tests on him and he still loves me!
There have, very occasionally, been folks here whose cats were not keen on being tested, but these have been very much in the minority, I promise you.

It is, of course, entirely your choice as to whether you hometest or not. But you could always just try testing your kitty and see how you get along with it. There's nothing to lose: If he hates being tested then at least you'll know you did try. But if he doesn't hate it you will have a fantastic tool to help you manage his diabetes....

Good luck!

Eliz

 

[Deb & Wink]

Home testing allowed me to see for myself what Wink's BG levels were in a low stress environment. The testing was tricky at first, especially since that blood drop disappears in Wink's black fur. Being able to monitor the BG levels, switching him from high carb dry food to low carb wet food and adjusting his insulin needs based on the nadirs (lows) helped me to get him OTJ (off-the-juice, insulin being the juice). He has remained OTJ for 22 months now.

Yes, your vet is pretty typical in the advice you are getting. Perhaps if you share the AAHA Diabetes Management Guidelines for Dogs and Cats, vet journal published in 2010, with your vet, she will see that home testing is highly recommended.