High numbers but happy kitty - Switch insulin to Lantus or Pro Zinc???

[Monica & Josie]

Hello everyone, I need some advice please on what to do right now as I am really not sure..

Josie is 13 years old, we've been doing the sugar-dance since April 2017 plus after several vomiting incidents diagnosed with chronic pancreatitis 5 weeks ago.
Started on 1 unit of Caninsulin but gradually reduced her dosage as she seemed to be responding well plus had a couple of hypos that made me very cautious.
She has occasional pancreatitis flare-ups that pushes her numbers up or down, in her most recent one she hardly ate anything for a week so had to reduce her insulin.
Lately she's not happy for us to test her at times ( but very chilled and purring at other times..?) which is quite frustrating as I can't get reliable data.. so I apologise for the lack of readings, whatever we manage to get we consider ourselves lucky as sometimes it takes several attempts and test strips with tears..

Would like to get her BG numbers down obviously as I know it's not good for her long term if staying where she is but Im not sure at this point which way to go.

Increase her Caninsulin dosage further? Although oddly today from almost red 21.3 amps she went down to blue 9.5 at +4?! It's quite a drop all of a sudden and not sure where it came from..?
We increased her dose from 0.75 to 1 unit 10 days ago but it didn't seem to make much of a difference.

Or change her insulin to a less drastic one which she might respond better to and maybe even out her numbers more as surprisingly it seem to be all over the place at the moment..

She had a couple of promising periods recently with nice consistent low ps numbers in the yellow and I actually thought we were finally getting somewhere but then the numbers started creeping up and stayed up even with the dosage increase.
Just changed her diet recently after pancreatitis diagnosis from Sheba Flakes 2.4% carbs to Ropocat/Mac's Sensitive single protein source 1% carbs so the food change shouldn't affect her readings too much..

She just had another blood test to see if her pancreatitis got any better but the results came back the same, she is still off the charts with no actual improvement..

On the other hand my DH pointed out and I have to agree that although she's been running on high numbers Josie seems very happy lately, she is eating very well, very sociable, playful, bouncy, no signs of illness and she's not drinking excessively like before. She can jump with ease these days as well. Considering I actually thought she was going to die a few weeks ago she certainly bounced back well! So her overall behaviour is contradicting her high numbers and gets me thinking if we should poke the bear with some drastic changes..?

An insulin change would be risky but might just be the right solution? I really don't know.

Any thoughts and suggestions from you supportive experienced ladies would be much appreciated!
Thank you for taking the time reading my rambling post, hope you are all having a nice day!

 

[Kris & Teasel]

You're still getting large dives from PS to nadir, typical of Caninsulin. You haven't had any greens for a very long time. You could try going to 1.25 u but it might also provoke big bounces. A switch to a depot insulin might well be helpful. There are many here who have done it successfully. I suggest that you go post on the Lantus forum saying that you're considering a switch and would like input about your current situation, risks in switching, etc. There are many very experienced people over there to help.

 

[Monica & Josie]

You're still getting large dives from PS to nadir, typical of Caninsulin. You haven't had any greens for a very long time. You could try going to 1.25 u but it might also provoke big bounces. A switch to a depot insulin might well be helpful. There are many here who have done it successfully. I suggest that you go post on the Lantus forum saying that you're considering a switch and would like input about your current situation, risks in switching, etc. There are many very experienced people over there to help.

That's a good idea, thank you Kris will post there when I get home.
Yes she had a big dive today but at the same time some days on the same dose numbers hardly go down during the day.. and that's what puzzles me..

 

[Diana&Tom]

It's certainly baffling how Josie's response to insulin varies so much, in fact it's almost impossible to work out from her spreadsheet what was a good dose and what wasn't. I just had another look and was even starting to wonder if she's a low dose kitty - 0.25u as a starting point, seemed to have a good day on that - but then no, later on she zooms up high on that dose. So a bigger dose is given but does that cause a bounce...?

The problem is that what we're not seeing in a spreadsheet is the other info that can affect BGs... if she is in some kind of pain and/or not eating, etc this can affect BG too, so a certain dose given on a day like that may have a different response to another day without those factors. There is also the possibility that Josie is sometimes producing a little bit of insulin herself, such as when her numbers go unexpectedly low. And to top it all, she is being a cat and as we know, cats do whatever they like... I'm recalling all sorts of lines from poetry and literature written by famous authors who have lived with cats and said just that!

Sigh... it really is hard to know what to do or say, and I certainly feel your frustration. An insulin change might be worth considering - see what people on the Lantus forum say, good idea of Kris's. I think I'd be tempted to give it a go now, but that's just me. But the positive thing to bear in mind is that Josie is in good form and happy in herself. It may not be good for cats long-term to live with consistently high BG but some cats just get used to their BG running higher than is ideal and don't feel many if any ill-effects on a day to day basis.

I'm not sure what else to say but hang in there - see what the Lantus peeps have to say - and don't give up! You've come such a long way in a short time, you know the basics and more, you're advising others very ably; you just have to figure out this particular complicated corner of the jigsaw. And meanwhile I think a few extra treats are in order!

 

[Monica & Josie]

It's certainly baffling how Josie's response to insulin varies so much, in fact it's almost impossible to work out from her spreadsheet what was a good dose and what wasn't. I just had another look and was even starting to wonder if she's a low dose kitty - 0.25u as a starting point, seemed to have a good day on that - but then no, later on she zooms up high on that dose. So a bigger dose is given but does that cause a bounce...?

The problem is that what we're not seeing in a spreadsheet is the other info that can affect BGs... if she is in some kind of pain and/or not eating, etc this can affect BG too, so a certain dose given on a day like that may have a different response to another day without those factors. There is also the possibility that Josie is sometimes producing a little bit of insulin herself, such as when her numbers go unexpectedly low. And to top it all, she is being a cat and as we know, cats do whatever they like... I'm recalling all sorts of lines from poetry and literature written by famous authors who have lived with cats and said just that!

Sigh... it really is hard to know what to do or say, and I certainly feel your frustration. An insulin change might be worth considering - see what people on the Lantus forum say, good idea of Kris's. I think I'd be tempted to give it a go now, but that's just me. But the positive thing to bear in mind is that Josie is in good form and happy in herself. It may not be good for cats long-term to live with consistently high BG but some cats just get used to their BG running higher than is ideal and don't feel many if any ill-effects on a day to day basis.

I'm not sure what else to say but hang in there - see what the Lantus peeps have to say - and don't give up! You've come such a long way in a short time, you know the basics and more, you're advising others very ably; you just have to figure out this particular complicated corner of the jigsaw. And meanwhile I think a few extra treats are in order!

Thank you Diana, yes very baffling indeed! I just can't see any pattern in her response on the SS that would indicate what would be the right dose as she responds differently to same dose and she also responds the same to different doses!?
Thank you for your support and brainstorming ideas!

 

[Monica & Josie]

Hello, just an update to say that I emailed the vet regarding switching insulin and she replied saying:

'I'm not convinced that changing the insulin will make a difference but if you want to give it a try we can give it a go. Pro Zinc is licensed for cats and often works well. Lantus is not licensed for cats but I have used it in the past, it can have a longer period of action but not always'

Now it's a question between Pro Zinc and Lantus... Will have to read up about the pros and cons and ask more questions..

Wonder what people think, any feedback on the subject from experience would be greatly appreciated, thank you!

 

[Diana&Tom]

Hi Monica, just replied on FB so no point saying the same thing here, which wasn't much anyway!!! Def worth trying another insulin though so wishing you good luck!

 

[Monica & Josie]

Hi Monica, just replied on FB so no point saying the same thing here, which wasn't much anyway!!! Def worth trying another insulin though so wishing you good luck!

Diana Diana it's aways really good to hear from you! Your opinion and input does help me a lot to make up my mind about things. Thank you for being there always