My cat resisting the Insulin

Status
Not open for further replies.
rawia

rawia

Member Since 2017
Hi

please give me few moments from your time helping me in my situation.

I am new here and hope to find some help and motivation to push me up through this. my 12 lb ( around 4.8 kg) little girl diagnosed with diabetes a month ago, the vet told me that her BG is little above 400 and suggested to start insulin treatment, she put her on LANTUS (1 unit) once a day as a starting to see how her body reacting to the insulin, a week after i took her for check up and they kept her for monitoring and the BG still the same, she decided to raise the dose up to (2 Unit) once a day, and a week later the same problem. so she decided to make the dose twice a day, ( 2 unit in the morning and 1 unit )after 12 hours, today i decided to check her BG my self as i read that cats get stressed at the clinic and the BG can go up higher, i tested her BG 5 hours after her morning shot and it was 412 ( i want to cry when i saw the number), later i tested her BG 5 hours after the second shot and it is 287. what is going wrong :(

i will share with you my cat food diet, maybe there is something wrong in her diet.

after her diagnosed i stoped feeding her dry food, but she loves dry food. the vet recommended Royal Canin M/d wet and dry food and my kitty does not like the wet so i purchased the dry food but i only feeding that to her from time to time or as treat or sometimes a few pieces with her wet food to encourage her eating the wet.

for the wet food i used to feed her an Italian brand which i found in our stores and it looks very good to me and low in carbs-high in protein as it is most real meat. I emailed the company in order to know the as-fed value and they old me that the ingredients listed is guaranteed and the crab only in the rice which is not more than 1%.



Lifecat-70g-CHICKEN-FILLETS-copia-2.png


the listed ingredients as below:

CHICKEN 75%
RICE 1%

PROTEIN 17%
CRUDE FIBER 0.1%
FAT 0.5%
ASH 0.8%

their web site is
http://www.lifepetcare.it/en/



does this sounds good for my cat or should i switch to fancy feast, i could not find this brand anywhere in diabetic nutrition list, but it contain real meat and that is obvious when i open the can. i will be appreciated help me evaluating this food.

my cat eats little amount every 3 or 4 hours, i found it difficult to feed her just twice a day. she had some raw chicken from time to time also.


am i feeding her wrong or what, i start this optimistic as my vet told me that her diabetes is mild and many cats go for remission and i should not give up. but three weeks nothing getting better even after the shot the BG still high and i am scared and worried.


one more question, is it normal for a ca with ideal weight to get diabetic??




Thank you and sorry for writing too much
 
Welcome! We can help you to help your kitty. :)

The normal starting dose for Lantus is 1 unit twice a day. Cats metabolize insulin quickly so once a day doesn't work well for them. It's best to give the same dose AM and PM 12 hours apart. It takes time to get a cat responding properly to insulin, sometimes quite a long time, so you're still very early in her treatment. We recommend testing as follows to figure out a good dose:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your SS, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
The best diet is low carb canned food. There's rice in the food you showed above but it might or might not raise the carb level. Almost all dry food is too high in carbs so it's best to try hard to switch your kitty.

Not all diabetic cats are overweight. Mine isn't. There are many reasons why they might develop diabetes - genetics, inflammatory disease, etc.

I suggest you go to the Lantus forum and read some of the information on the yellow "stickies" to learn more. Take it in small amounts because there's a lot to learn. Ask a lot of questions on that forum. We're here to help.
 
You are off to a good start. Like Kris said, twice a day is better with most insulins. The insulin gets used up at the 12 hour mark, and you are reintroducing another dose for their body to use. Also agree with Kris on reading up on the stickies.

I don't know about the food you are using, but it does look pretty decent.. Dr Lisa Pierson has a good food chart that shows a breakdown of foods. You want one with low carbs and high protein.
http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Please read up and be prepared for a hypo. Also we recommend home testing . It is the only way to be sure you are not dosing your cat...when they don't need the dose.

Kudos to you for taking care of your kitteh.
 
Thank you all for your help

Just have concerns , Meme now is on lantus 1 unit twice a day, i did the ferst test right before her morning injection , her BG was 375 and i tested agian aevery two hours , the lowest number was on 10 am 125, and then start to raise , last test is 4 pm and the number is 415

Why this is happinng, why it is raise up only after 5 hourse instead of going down. Should i increase the dose??
 
rawia said:
Thank you all for your help

Just have concerns , Meme now is on lantus 1 unit twice a day, i did the ferst test right before her morning injection , her BG was 375 and i tested agian aevery two hours , the lowest number was on 10 am 125, and then start to raise , last test is 4 pm and the number is 415

Why this is happinng, why it is raise up only after 5 hourse instead of going down. Should i increase the dose??
Click to expand...
That BG of 125 is a lot lower than the first BG of 375. That big drop, even though 125 is not too low, is enough to cause her body to overreact and send the BG very high before the cycle is over. Lantus doses are assessed according to how low they can drop the BG and 125 is a very good number. You don't make dose decisions from the high number, only the low numbers. Stay at 1 unit twice a day for now. It takes time for a cat to start responding well to insulin and one month since diagnosis is a short time.

It would help us to help you if you set up the spreadsheet we use here. All members can see it and it's the first thing we look at before giving advice.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
There are people here to help you set it up if needed.

I gave you the basic testing routine we recommend in my post #2 above.

I suggest you go to the Lantus forum to read about the two sets of dosing guidelines that we use, TR and SLGS:
http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/
You can decide which method would work better for you. :)
 
125 was mistake reading :arghh:, it was 251 and i read it wrong while i was busy calm my cat.

Any way just came from vet and he recommend to put her on 2 unit. He did a quick urine test and find little infection, he said that might be a reason why her body resist insulin, he put her on antibiotic for 5 days. Should i go for two unit or stay on one and see after she finished her antibiotics course??
 
It will really help us to help you if you'll start using our spreadsheet program that Kris linked above. We really depend on it to see the "patterns" we look for when making dosing decisions.

That being said, we never go up in whole unit increments. Insulin is a very powerful hormone and as little as .25 unit can make a big difference. Without seeing more numbers, I really can't advise you if you need to go up to 1.25 or stay at the current 1U, but I definitely wouldn't go up from 1 to 2

If there is an infection, getting that under control will probably help lower her blood glucose levels too. Infection/inflammation can cause higher glucose numbers.
 
Hi

I changed MeMe food to fancy feast, it was all about diet,
Her second shot was on 6:00pm and her BG now is 94 . This is the first time i see number below 300.

What should i do, for morning shot at 6:00 should i see a number above 200 to shot or what. Is 94 too low , should i worry about hypo!!
 
Time is different in my country it has been 5 hours from her noon shot and BG 94
 
rawia said:
Time is different in my country it has been 5 hours from her noon shot and BG 94
Click to expand...

That's a good number, but I would watch carefully as you don't want to go too much lower at +5 are you using a pet meter or human meter?
 
I am using pet meter ( alpha track) i am new to this and i did not know that i can use humen meter. Think will change to humen meter after i finish the strips, but for now i am using pet meter

I will test again after 1 hour again, i mean before her next shoot if the number still in 100-200 should i shoot!!
 
rawia said:
Her second shot was on 6:00pm and her BG now is 94 .
Click to expand...
rawia said:
Time is different in my country it has been 5 hours from her noon shot and BG 94
Click to expand...
Just want to confirm you are giving shots twice daily 12 hours apart. Is that correct? I ask because you mentioned second shot at 6:00pm and then you mentioned a shot at Noon which suggest shots might have been given 6 hours apart.

We don't go by clock times here but rather just by how long after the shot a reading occurred because of all the different time zones we all live in.

Normally we don't recommend giving insulin with any reading under 200 on a human meter. Since you are using a pet meter I would suggest no shot for any reading 250 or less. That said, skipping the shot might not be the best thing if your cat has a history of ketones or DKA.

We are more than happy to help you out but it is difficult to make suggestions without being able to see some data of how your cat has been doing up till now. We have a spreadsheet available to track the readings you take and I encourage you to set one up so you can get the most out of the support available here. The instruction for setting up the spreadsheet are HERE and THIS will explain how to use it. If you have any problems, just holler and we'll help you get it going.
 
She just diagnosed a month ago and her BG never go brlow 300 till today when i changed her food completly to FF

She recieved insulin twice day 12 hours apart, 2 unit in the morning and 1 unit after 12 hours.

She has no history of ketones or DKA.

Yes you told me before about the spread sheet and i was trying to go trough some of member spread sheet to see how it works and how they do it. I will start doing my own soon and share it with you.


Thank you
 
Let us know if you need help with the spreadsheet.

Lantus usually works better if you give the same dose consistently twice a day. And now that you have switched over to low carb food, that may lower your cat's need for insulin. I'm guessing you are now about 6 hours post shot. Lantus can cause lowest BG to occur up to 7 or possibly even 8 hours past the shot so I would retest now just to make sure she is not still dropping or dropping too much. Any reading 68 or below is too low and you will need to give your kitty a bit of food and continue to test every 20 minutes or so until her numbers are holding without extra food. Have you seen the document about
Dealing with Low Numbers?

Please let us know how your kitty is doing now and if you need any assistance.:)
 
Yes i read a lot about hypo, hope not reach that but i am ready.

Just test now, the number is 110
 
Ok you are in good shape. Now without seeing any data it's difficult to suggest what you should do dose wise. Seems your kitty has had a good cycle today but they often go lower at night. Since you are only giving one unit at night, I'm thinking best to stick with that for now. Not to sound like a broken record, but without any data to look at it's hard to say what to do tomorrow as the BG may start coming down more from the lower carb food. If you cannot monitor during the day tomorrow, a slightly lower dose would be advisable since it sounds like this is the first time you've had a double digit reading.
 
Yes this is the first time, he BG was always 300 and above and the highest was 480 , she was on antibiotic for a week because the vet saw minor infection in her urine test and he said it might be the infection that cause this very high BG and never goes down. Today i gave her the last pill so it might be because of this or the low carb diet. I will keep and eye on her and re test every hour until her shoot.
 
An infection can definitely raise BG as can the higher carb food so having the infection clear and the lower carb diet introduced, I would be very cautious about the insulin dose you are giving right now. Keep an eye on her (she is a beauty!) and you'll be fine. If you need any help or just support if you get any more low readings, just holler and we'll do what we can to help you out. :D
 
What is wrong now , i keep testing her after morning shoot (2 unit) and BG still in 300 and above even after 5 hours.

Is it the dose??

Her second shoot is (1 unit) and after that i saw the low numbers. Thought this morning will be lower as the dose is higher


Any advice
 
rawia said:
What is wrong now , i keep testing her after morning shoot (2 unit) and BG still in 300 and above even after 5 hours.

Is it the dose??

Her second shoot is (1 unit) and after that i saw the low numbers. Thought this morning will be lower as the dose is higher


Any advice
Click to expand...

Honestly I don't know as you don't have a SS or any information for me to work with? Can you set one up and fill in all the data you Have, also helpful to add info to your signature like insulin used, food fed etc :)
 
As Tempest's Mom mentioned it's hard to say without data but my best guess is that your cat is now bouncing from the lower numbers yesterday. This is a normal process caused because a diabetic gets used to being in higher BG ranges and when they reach lower BG levels, the body panics and different hormones are released to raise BG which it wrongly presumes is a problem. This does NOT mean your cat needs more insulin and giving more will just set off more bouncing and could be dangerous. Those higher numbers could last for a few cycles.

I'd still reduce the daytime dose slightly if you are unable to monitor just to be on the safe side and to avoid setting off more bouncing.
 
Hi

I did my homeworke and but all the information on the SS.

i have a nice reading today at Mid cycle after her morning shoot ( 145). i was so happy to see this number after high BG's yesterday.

may be it was Bouncing as you told me, hope the BG will hold and regulated, please take a look at My SS and tell me what do you think.

i was doing the curve yesterday to email it to the clinic as the vet requested after 7 days of new dose but after i saw the numbers yesterday so high and today down i decided to wait and do the curve tomorrow, is it OK??
 
Yes, that blue is a nice number. Is there a reason why you gave only 1.0 unit in the PM after the blue? You seem to be able to test frequently when necessary so I strongly recommend that you get a pre shot test before every injection AM and PM.

I suggest you do a curve after she has received the same dose both AM and PM for a couple of days. When you change the dose it affects the insulin depot and can make the BG numbers more erratic.
 
@Kris & Teasel Vet had them doing 2u on day cycles and 1u at night and without data to look at I recommended sticking with 1u last night because of the blue reached during the day. I agree it would be much better to do the same dose consistently but wanted to see data before suggesting anything different. :).
 
I know that i should give same units but that is what my vet told me and he asked me not to adjust the dose by myself so i am waiting for his openion after the next curve.
 
I will do the curve tomorrow if her numbers today is good and will contact with my vet to ask him adjusting the dose.
 
MrWorfMen's Mom said:
@Kris & Teasel Vet had them doing 2u on day cycles and 1u at night and without data to look at I recommended sticking with 1u last night because of the blue reached during the day. I agree it would be much better to do the same dose consistently but wanted to see data before suggesting anything different. :).
Click to expand...
OK. I missed that. Thanks, Linda. :)
 
First of all, I'd strongly suggest you get a pre-shot test before every shot. This is critical to kitty's safety as it tells you if it's safe to give insulin and gives you a baseline to see how well a dose is working in combination with the lowest reading in the cycle.

Lantus works best with consistent dosing so my suggestion would be to try 1.5u units twice daily and monitor mid-cycle to see how low that dose is taking Rawia. I understand you wanting to follow your vet's advice but it appears he is not very familiar with Lantus as he is applying dosing as if you were using a different insulin. Vet is probably more familiar with some faster acting insulins and Lantus does not work the same way. Lantus has a depot (like a little gas tank) that builds up over a few days and the idea is to keep it consistent throughout the day to keep BG under control. Giving different doses day and night means the depot is altering continually making it difficult if not impossible to determine best dose.
 
Hi again,

Sorry for bothering with my questions but from your experience how long does it take to regulate the glucose level?? Could it be months?? Is that normal for BG to go up and down like that. You told me that it is too early because my cat just diagnosed a month ago but i am worry and afraid that my cat is one of those who is hard to regulate. I was happy that she diagnosed early and hope that she reached remission early but now i am afraid because till now it is just going up and down .

I started my curve today and hopped to see some low numbers like yesterday but no . It gors up and down but not lower than 260-300
 
Hi,
Let's take a deep breath and calm down a bit. Your kitty was just diagnosed a month ago so you need to give him and yourself a bit more time to understand how he's responding to the insulin. There are many kind people here who will help you to get your kitty regulated. You can't rush through this. Take it slow and let your kitty set his own pace. You will definitely see the numbers being less erratic with time as you get closer to the right dose for your kitty. And every cat is different so there's no fixed time towards being regulated or in remission.
 
Regulation does take time. As has been previously mentioned getting preshots tests every time is a must....first to make sure the glucose levels are safe to shoot and as a baseline for where the glucose levels are before insulin each time. The other important piece of data is mid cycle readings. A kitty can start off high, drop into much lower numbers and end up high again at the next preshot. Also a large drop or drop into lower than "usual" numbers for your kitty can cause a bounce into higher numbers which can last a day or several days. Insulin is a hormone and does not have a linear pattern from day to day so tracking the preshots and nadirs (lowest numbers) can help in determining how well the insulin and dose is working. Sort of like adding more pieces to a puzzle in order to see what the picture is. :bighug::bighug:

ETA Also if you are still using the Royal Canin M/D or is that supposed to be Hill's M/D ?? dry food that will make it harder to regulate your kitty since it is too high in carbs for a diabetic kitty.
 
Last edited:
good day again,

thank you all for your help.

will this week the vet rise up the dose into 2 Unit twice a day. it seems work r too high.

yesterday the PSPM was 193 ( alpha track)and i was afraid to shoot, and it rise up again to 400 this morning so i gave her 2 u, but her BG continue drooping down and now is the time for her second shoot ad BG 129.

i do not what to do, i was thinking to give her 1 U instead of 2 but i did not. is it suppose to rise up again after 12 hours??

i do not want to skip the shoot and have very high number tomorrow and i can not measure half units because am shooting directly from the pen as my vet told me.

what i think that i have to wait a few hours until it rise and then shoot or you do not recommend that.
 
Ok so maybe I missed the bit where you said why you moved from 1U of insulin to 2?

The reason I'm wondering is because kitty was such a short time on 1U and then seems to leap up to 2u without gradually increasing it? It's very bad to increase by full units as kitty will bounce (her bg levels will be higher than they actually are) also if you have removed the dry food kitty will have lower bgs but this also needs to be done very slowly so that kitty doesn't hypo and end up very sick or (dead).

Looking at your numbers it looks like kitty is bouncing from a massive 2 unit dose in the mornings so is then too low to shoot again in the evenings. Personally speaking I'd be sticking with 1U for th next several days so that kitty can recover from all that bouncing.

Please remember that insulin is a hormone and NOT a medicine that you just give and it makes everything better. It needs to be used consistently and carefully.
 
I know that but the vet asked me to prepare a curve every week and based on the last curve ( the BG was going up and down on high level) that is why he increased the dose.

To be honest i was going to reduce it back to 1 U myself but i thought that the vet knows better.


I am afraid that if she reached 400 again 1 U will be low and not bring her down.


Last week i used to give her 2 unit morning and 1 unit evening as vet said and it did not work.

And as i read not to hold a dose more than 7 days if BG highers than 300?

Is it right?
 
rawia said:
I know that but the vet asked me to prepare a curve every week and based on the last curve ( the BG was going up and down on high level) that is why he increased the dose.

To be honest i was going to reduce it back to 1 U myself but i thought that the vet knows better.


I am afraid that if she reached 400 again 1 U will be low and not bring her down.


Last week i used to give her 2 unit morning and 1 unit evening as vet said and it did not work.

And as i read not to hold a dose more than 7 days if BG highers than 300?

Is it right?
Click to expand...
Vets rarely are good at dosing. Your better off with the experience you'll find here. Read the protocol for tight regulation and slow regulation and decide which you are more comfortable with.
 
rawia said:
I know that but the vet asked me to prepare a curve every week and based on the last curve ( the BG was going up and down on high level) that is why he increased the dose.

To be honest i was going to reduce it back to 1 U myself but i thought that the vet knows better.


I am afraid that if she reached 400 again 1 U will be low and not bring her down.


Last week i used to give her 2 unit morning and 1 unit evening as vet said and it did not work.

And as i read not to hold a dose more than 7 days if BG highers than 300?

Is it right?
Click to expand...


I think you need insulin specific people as lantus is a depot insulin so kitty holds the insulin in her system longer so when you shoot there is an overlap. My advice is to go to the lantus forums and read the stickies there that explain how it works and what a normal curve looks like as it differs from in and out insulins. :) You shoud post there with your questions.
 
Yes but i am shooting from lantus pen and i ca not increase or decrease by half unit or less.

And for lantus pen i read that i need U-100 3/10cc with half marking which is hard to find in my country and many US sites need prescription for that.

Does ADW site ask for prescreption or call you for vet information??

I do have US box and can order it if they wont call or ask for vet info in US?
 
rawia said:
Yes but i am shooting from lantus pen and i ca not increase or decrease by half unit or less.

And for lantus pen i read that i need U-100 3/10cc with half marking which is hard to find in my country and many US sites need prescription for that.

Does ADW site ask for prescreption or call you for vet information??

I do have US box and can order it if they wont call or ask for vet info in US?
Click to expand...

Please go to the forums list and ask on the lantus forums, there are a lot of experienced people there that use lantus every day, they can answer those questions better. :)
 
We have many European members that get their syringes at their local pharmacy/chemist or you can get them from European on line sites. It's likely the BD Microfine II syringe. You want the syringes that are designed for small children, they have the half unit markings.
Tagging some people from Europe @Gill & George , @Diana&Tom
 
Hi there,

I'm in Spain, I got my syringes at my pharmacy, the pharmacist didn't have any, but I took the info of the syringes I needed and she was able to get them for me.

Some of our other European members who had difficulty getting them or if they were very expensive in their country used this UK site to order the syringes, they deliver in Europe and don't require a prescription.

http://www.vetuk.co.uk/insulin-syri...-0-3ml-u100-insulin-syringes-box-of-100-p-296

Search for bd micro fine+ demi u100 insulin syringes, they are also available through Amazon and there are other sites too, but make sure it's the same ones as in the link above, you want those 1/2u markings, sometimes the descriptions are not very clear.

Looks like stopping the dry food made quite a difference, when exactly did you make the change? Do you think you could make a note on the remarks in the SS, this is important info, and will influence advice you might get.

I see you are feeding Fancy Feast, there are also other options available to you in Europe (always good to have some other choices as we all know cats can be fussy), here's a link to a UK food list, a lot of the foods listed are available throughout Europe, I have difficulty sourcing them at local pet stores here in southern Spain, so I order on line, I use zooplus, delivery is free and service has always been good. Here's a link to their. Italian site http://www.zooplus.it

I use granata pet symphonie, Terra faelis, thrive complete and Feringa duo.


If there is anything else you are having difficulty with don't hesitate to ask.
 
My kitty is a good example of why not to increase by more then .25 units lol. When we first switched to lantus a little over a month ago, the first increase I did was supposed to be to 2.25 units (starting dose 2 units, because we were changing from another insulin), but I had a huge brain fart for a couple days and though I swore I was doing 2.25, i was actually doing 2.50 units. We just stuck with the mistake and eventually made it up to 2.75 and then started earning reductions and now here we sit on the dose that we missed, 2.25. Zeke is finally about done with all his bouncing and we are starting to see some great numbers on this dose. What we experienced with Zeke was anytime he hit a low number, especially between 50 - 100, he would immediately bounce and we wouldn't see good numbers for a few days. This is normal for kitties. Some kitties go through this longer then others. We started this sugar dance in April, it takes time. Just because your kitty isn't getting regulated quickly doesn't mean he is insulin resistant. Another thing to remember, and this will probably be the hardest part for you, vets really aren't very good at all when it comes to dosing our babies. Let those here with much more experience (and yes they have more experience then the vet surprisingly) help you with your dosing. Please listen to those here on the board and read all the information on the Lantus/Levemir forum and do your posting there. Whole unit increases is a huge jump in insulin for these little guys. Get with your pharmacist and get some syringes with the half units marked so you can start doing the smaller doses. Your kitty will thank you for it. When you post, if you are in urgent need of advice, put a subtext of 911 for your subject on your thread. If you just have a question, put the ? for it. Many of the members here who are good at advice and helping, watch for the 911 and ? on threads and will be right there helping you as quickly as they can.
 
Status
Not open for further replies.
Back
Top