Newly diagnosed and struggling with hypo

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membeth

membeth

Member Since 2017
I adopted Pants almost a decade ago and I'm pretty sure she doesn't know she's a cat. She didn't get the memo on being aloof or graceful -- she's the friendliest, most outgoing, most affectionate, doofiest kitty I've ever met.

She was diagnosed with diabetes two weeks ago after unexplained weight loss (~20% of her weight) and we've been really struggling with figuring this out. I got her switched to a low-carb canned food immediately and started on Lantus a few days later, and it's been a total mess. She's been very cooperative for the injections and the home testing, but her body seemingly overreacts to insulin.

She's currently hospitalized for hypoglycemia for the second time in a week. After the first incident, the emergency vet dropped her dose from 2 units every 12 hours to 1/2 a unit every 12 hours, and that's still too much. This second time around the emergency vet tried 1/2 unit every 24 hours, and that dropped her from ~300 to ~30 at +3 hours.

I am super stressed and exhausted and don't know where to go from here. She's likely coming home tomorrow on no insulin to see what diet alone does, but based on her prior numbers, I think she's going to be too high.
 
Diet changes can change the BG numbers quiet dramatically especially if coming from a dry food diet. I can't advise on a dose, but I think it is worth a discussion with your ER vet/vet and determine if a insulin free trial on the new food is working and she can be diet controlled for now. IMHO I would continue testing morning and night during that time and see how she is doing. If her numbers seem to creep back up...then you can have another discussion with your vet on a small starting dose.
 
You may want to also post on the lantus forum and see if anyone may have had a similar experience. It could also be that the starting dose was too high for your cat, and even with the reduced amount, since Lantus is a depo long term insulin, she still reacting to the previous higher dose. There are more experience folks on the Lantus forum who can explain how this better than I.
 
membeth said:
Thanks. I don't think I know enough about the dosing/timing at the emergency vet to know if the problem is they're not waiting for the too-high dose of Lantus to clear her system. When she went from 2 --> 1/2, I don't know how long they waited to start her back on 1/2 after the hypo and she was there for two full days.
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I wonder if that is something they can provide you with tomorrow when she gets home (time of shot, and how much), from what I've heard it can take 3 days (6 cycles) for it to clear. I would copy the information you put in this post and create the same post on the Lantus forum. It is also a busier forum so you will probably get alot of responses.
 
Tracey&Jones said:
Diet changes can change the BG numbers quiet dramatically especially if coming from a dry food diet. I can't advise on a dose, but I think it is worth a discussion with your ER vet/vet and determine if a insulin free trial on the new food is working and she can be diet controlled for now. IMHO I would continue testing morning and night during that time and see how she is doing. If her numbers seem to creep back up...then you can have another discussion with your vet on a small starting dose.
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Thanks. I think I will have to wait a few days to even assess what her numbers at home really are without the insulin -- she seems to have had a stress-induced spike after the emergency vet last time. They got readings between 400 - 500, which is way above her baseline two weeks ago and way above anything I saw at home on the same dose of insulin. I don't have a baseline for her without insulin on low carb wet food -- the regular vet had me start insulin without home testing, so I only have her numbers on dry food before the switch and on wet food after dropping to 1/2 unit of insulin. Her BG at the vet two weeks ago while still on dry food was 300.
 
the one thing you could do just in case is to use the spread sheet we use here and fill in the numbers you do have. It is good that you are home testing, and if she does need to go back on insulin, there are good guidelines here, which will allow you to learn her patterns and what to do when her numbers get too low to avoid Hypo... it really depends on when and how often you test.

Heres a link to the spread sheet, fill it out and add to your profile signature, you will need to setup a google docs account to be able to share it. http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/

Hope all goes well tomorrow, alot of people here can help :bighug:
 
You're right about stress induced anything. The numbers you get at the vet and what you get at home will never be the same. We went through the same thing with our first sugar cat. It's an extremely short term fix but better too high than too low. Remember you can do curves as often as Pants ears will tolerate it, there's no minimum time required between curves. Like everyone says, you'll get more info in the Lantus forum. Ask someone there what "Bouncing" is.
 
Welcome, and what a welcome to feline diabetes you've had! Fantastic that you are home testing.

Along with getting a spreadsheet ready to go, I'd suggest compiling as much information as you have and posting in the Lantus section of the forum, just to give folks there a head's up about what's happening. You will get a lot more eyes on the situation there.
 
Pants is home and off insulin completely for now. The vet who diagnosed her never got a baseline BG after the switch from dry to canned and that was a major mistake. That vet just said to start the insulin once Pants accepted the new food and told me not to do home testing, so I hadn't started until after the first hypo episode. We've got a new primary care vet now and she wants a complete do over. We're going to wait a few days until all the insulin is definitely out of Pants's system and the stress of the emergency vet has worn off and do an insulin-free curve at home.

Her BG at the old vet on dry food before the diet change/insulin was 300, so it's possible diet alone will be enough. If not, the new vet says the emergency vet messed up the change to .5 every 24 hours instead of every 12 by giving the .5 too soon after the last dose, so that may actually work. If that really is too much when done correctly, maybe microdosing. And if she continues overreacting to insulin even when we do the start correctly, she will probably get more testing to make sure the diabetes isn't secondary to another medical condition.

Pants seems totally fine. After carefully patrolling my apartment and inspecting her toys, she's back to her usual self and is snoring away in a patch of sun in her favorite spot on top of my bookshelf. I, on the other hand, am still a nervous wreck.
 
Glad to hear Pants is home. Would be wonderful if she's a diet controlled diabetic. Feel free to make a post to update us on Main Health :)
 
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