Insuline resisence

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Niutek

Member Since 2018
(Additionally, today I did a quality-test for my glucometer with the included control solution. The test was within the correct range, so my glucometer should be working fine.)[/QUOTE]
 
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I went from 3 units of Lantus to 5 units and the BG still does not go down!
Todays readings were:
10 am: 411
12pm: 411
2 pm: 401
4 Pm 373
It is way too high.
Because Niutek had ketons in his urine 2 weeks ago- i added fast acti g insulin at meal times ( Humalog 2 units 2x daily)
It all does not result in getting the BS below 300..
Would anybody have an advice for me.im fighting for his life.
I made a humungous mistake by using human glucometer Care Touch for over a year!!!! It turned out to show readings 80-120 lower..example it showed 280 wile in reality on Alpha Track it would be 380-400!!!!im devastated because it was my fault not to know the difference-and have him on such high BG for so long..
Is it too late??
How can i lower the BG now.i saw 3 veta- none of them gives me needed help. They send me to ER or suggest euthamasia - but i was able to get rid of ketons at home.if i only knew how to get the BG down. Not sure if i can give more insuline in such short period.
He was diagnosed with pancretitas 9 months ago. The test is 40-75 % acurate.
He eats on his own( row lamb meat + fancy feast cans( no dry food) ,has big apetite , drinks, but has low energy lewel.
Please help
I do not want to loose him...
 
I went from 3 units of Lantus to 5 units and the BG still does not go down!
Todays readings were:
10 am: 411
12pm: 411
2 pm: 401
4 Pm 373
It is way too high.
Because Niutek had ketons in his urine 2 weeks ago- i added fast acti g insulin at meal times ( Humalog 2 units 2x daily)
It all does not result in getting the BS below 300..
Would anybody have an advice for me.im fighting for his life.
I made a humungous mistake by using human glucometer Care Touch for over a year!!!! It turned out to show readings 80-120 lower..example it showed 280 wile in reality on Alpha Track it would be 380-400!!!!im devastated because it was my fault not to know the difference-and have him on such high BG for so long..
Is it too late??
How can i lower the BG now.i saw 3 veta- none of them gives me needed help. They send me to ER or suggest euthamasia - but i was able to get rid of ketons at home.if i only knew how to get the BG down. Not sure if i can give more insuline in such short period.
He was diagnosed with pancretitas 9 months ago. The test is 40-75 % acurate.
He eats on his own( row lamb meat + fancy feast cans( no dry food) ,has big apetite , drinks, but has low energy lewel.
Please help
I do not want to loose him...
 
Hi Anna and Niutek and welcome to the forum.

I am sorry Niutek has not been well. We will try and help you all we can
First of all using a human meter is absolutely fine. Human meters do run lower than the Alphatrak but that doesn't mean they are not good. Most of us here use a human meter and our dosing methods are based on human meter numbers. But if you feel more comfortable using the Alphatrak that is fine too.

I think one of the first things you could do, so that we can help you is set up a spreadsheet and enter the last months BG numbers and insulin doses and anything else you think is relevant in the remarks column. I am going to tag @Chris & China (GA) to help you with the SS.
Here is the link to the SS. Chris will be in contact with you.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Are you testing for ketones each day? It is really important to test for them daily following them appearing in the urine/blood to ensure they don't come back as they can progress to DKA quickly. You need a bottle of Ketostix which you can get from Walmart or a pharmacy.. collect a urine sample from Niutek and dip a test strip in. Read it against the colours on the side of the bottle exactly 15 seconds later. Anything above a trace needs vet attention.

It is also really important that Niutek is getting enough food. He needs more than he would normally eat to help prevent ketones reappearing. Food acts like a medicine with ketones. Feed before the insulin dose and during the cycles as much as he will eat. I'm glad his appetite is good.

Did he have an infection or inflammation at the time of the ketones appearing? And was this treated. It is very important also to have that treated.

Also getting enough insulin is also important in preventing ketones reappearing. Getting your SS up and running with the data will help us help you.
With the Lantus insulin, did you go straight from 3 to 5 units? We would not recommend you do that. It is better to go up slowly in 1/4 unit increments. If ketones are present we sometimes increase more quickly and in a larger increment but not from 3 to 5 units.

Who suggested giving the Humalog insulin as well. Was that the vet?
While we do sometimes give a fast acting insulin with Lantus to bring down the numbers in special cases, we start of with a very low dose and under the supervision of a very experienced person who understands the actions of both the insulins being given at the same time/during the same cycle . The person who I know who knows a lot about this is away for a week but I will tag @Wendy&Neko
@Sienne and Gabby (GA) to see if they can help.

Keep asking lots of questions, we want to help all we can with your beautiful Niutek.

Here is a link which may be helpful
http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
 
Once you get a spreadsheet set up with some data in it, we will be able to help you with dosing. Bron has asked some very good questions which will help us help you and your kitty.

When did the ketones appear in relation to the Lantus dose? Were you on 3 or 5 units then?
 
I was giving 3 units when ketons appeared.
Im not testing for ketons at home( i do not know how).. Niutek stopped eating and i took him to vet- he checked ketons. They went from 1+ to 3+then down to 2 and about 9 days later they were no loner present.i was giving iv fluids at home - and then i started adding Humulin at the feding timea.
first 1 unit then 2 and 2,5.
He started to eat - and it is eating a lot.maybe too much. He wants to eat every 2-3 hrs..
Im not sure is I should leave the food at night or when i go to work..
i do leave it- as i know that he will be looking for it..
I do belive that giving fast acting insuline has helped with getting rid of ketons-I can not afford taking Niutek to ER.( again): he was in hospital 1,5 ago to treat ketoacidosis- and i read in the report that they were treating him with fast acting insuline.
Of course im monitoring it- and i keet detailed.
SS.
Today he received 2x 5’ of Lantus
And 3x 2,5’ of Humulin fast acting insulin.i have it feom a diabetic friend as no vet will prescribe it.
Even with that plenty of insuline - i can hardly lover the BG below 400..
I increased lantus from 3 to 5 within 10 days..
Was it too fast? Am i giving too much of insulin?
Vet is not cooperating with me- she said get him to the hospital or euthanize him!!
But why to euthanize a kitty that eats and walks- goes outside shortwile..
It is unreasonable - i do not trust vets anymore..
 
These are my ss from22.30.19
 

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Oh God and st. Francis..
I did not even know what spread sheet was!!!!!
I thought they were my notes in form of a chart!!!!oh may!
I have a lot to learn here...
 
I agree with you. You do not need to euthanise Niutek. Diabetes and ketones is very treatable. At this point you do not need to go back to the vet. We can help you.

The first thing you need to do is get your Spreadsheet up and running and put some data in it so we can see what has been happening with the insulins and the numbers.
I posted the link to the SS in post 2 of this thread. If you can’t do it yourself I will tag @Chris & China (GA) for you to help you. Once you have the numbers in the SS Wendy will be able to help you. Until
you do this we can’t help with the insulin.

To test for ketones, which is very important you do this every day, you need to buy a bottle of Ketostix from a pharmacy. I do not know which country you live in but most pharmacies should have Ketostix. Then you need to collect a urine specimen from Niutek and dip a test strip into the urine and check it against the colours on the side of the bottle. Anything above a trace is of concern and needs vet attention.
 
It’s a lot to learn in the beginning, but it will get easier. :bighug:

If you look at people’s signatures here, you will see examples of our spreadsheets.

This document has a description of how to test for ketones at home. Click on the blue link.

And yes, you were increasing too fast and by too large an increase. At the size of dose your kitty is on, we increase by 0.5 units at a time, so as to not pass a good dose. I would stay at his current dose, and keep checking his numbers so we can see how he is doing on it. Try to get some tests in the middle between shots as well. That’s when Lantus takes them lowest,
 
Thank You dear All for helping.
Im Polish- but i live in Illinois.
I will set the SS.thank You for the link.
Here is photo of humulin fast acting insuline.
Another question: can row lamb meat increase glucose levels?
His readings are better after fancy feast than row meat... really strange.
 

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I will need my work apple computer to set the SS .i will do it tomorrow.( at work)
I hope that this is not too complicated.
 
Anna -

Do you know why your vet suggested this type of insulin? From what I can sort out from the photo, Humalog/Lispro is a rapid acting insulin. This is not the kind of insulin that is recommended for cats. A cat's metabolism is too fast to benefit from this kind of insulin to manage diabetes. The two types of insulin that are recommended by the American Animal Hospital Assn for the treatment of feline diabetes are either Prozinc or Lantus.

A fast acting insulin like you're using can cause numbers to drop very fast. You MUST be testing in order to insure that your kitty is safe.

It is likely not the raw lamb that raised BG numbers. Many cats will respond to any change in diet with a rise in number. It's more a matter of change in diet than the specific food that's the issue. Also, raw meat is fine as a treat. If you want to feed your cat a raw diet, you need to make sure that it's a nutritionally complete. There are supplements that need to be added to a raw diet in order to keep your cat healthy.
 
Yes,
But Lantus stopped working..
I was not able to go below 370
Even when i went from 3 units twicedaily to 5 units.
I cannot let another ketoacidosis to take over him..
What else can I do since vet gave up on us..????
 
Anna, we want to help you.

Do you think you could collect a urine sample from Niutek to test for ketones?
One of the most important things to do, if Niutek has had ketones before, is to test the urine to see if he has any at the moment. That way you will know how he is going. At the moment you have no idea if he has any ketones or not. If you test for them, you can monitor the situation.

What you need to do is go out to Walmart or a pharmacy and buy a bottle of Ketostix. They are not expensive. Then collect a urine specimen from Niutek. You can do this by putting a small container or a large spoon under him when he goes to the litter box. If he won’t let you do this, try crumpling up plastic and put it in the litter box. When you have the urine sample, dip the test strip into the urine and then take it out and put it against the colours on the side of the Ketostix bottle. Read the result exactly 15 seconds later. You will be able to see if any ketones are present.
 
Here are some more Urine Testing Tips Anna.

There have been several of us discussing where to go with Niutek's treatment. Would you be open to trying something different?

Since you said there was ketone development at 3U of Lantus, can we see how he'd do on just 5U of Lantus given every 12 hours? (No Humalog for a few days at least)

Gather some data by testing before every shot and a few times in between shots for at least 3 days and let us see what that does?
 
I will try everything to save him..
That's great. Start with testing his ketones, at least daily for now. If we could get some data on the spreadsheet showing what 5 units of Lantus is doing, we can help you with dosing. Some cats need more than 5 units, but I don't want to suggest an increase until we can see enough evidence that 5 units of Lantus is too low instead of too high.
 
Another question: can row lamb meat increase glucose levels?
His readings are better after fancy feast than row meat... really strange.
What is "row lamb meat"? If just plain meet it should not affect BG much different than Fancy Feast.
With regards to insulin, some caretakers have used R insulin in addition to a slow acting insulin like Lantus. N i slower than Humalog and yo can purchase it at pharmacies like Walmart without a prescription. Because you are seeing little decrease in BG during a curve Niutek may be a high dose cat and may even have acromegaly. See:
http://www.felinediabetes.com/FDMB/...-other-high-dose-conditions-what-we-know.375/
My MurrFee had acromegally and was on 50 units of insulin twice a day. He used a combination of N and Levemir.
 
Dear all
Thank you for all these sugestions!
I did not give him any Humalog insuline today..
Just 2x 4 units of Lantus.
I did check BG only in the morning : it was 361.
For full day readings i have to wait till the weekend.
I will buy Ketostix. Hopefully i can “catch” some - it may be difficult- but Im willing to try.
You guys are just fantastic giving me all the advise and support!
Thank you thank you.
So should i give 5 units now?
Today i have 2x4 ..
I also gave him Gabopantin- i never know if he is in pain or not. He was diagnosed with pancretitas..
I guess he was feeling better- as he went outside for 10 min..
 
If you cannot get a test mid day, get one before bed. Testing a couple hours after the night time shot will give you an idea if he's doing down. A "before bed" test is a good one.

How is it coming on that spreadsheet? Without being able to see the data in it, we cannot comment on what to do with the dose next.
 
Anna, this is the post you started, and where you should be commenting. We do one post per cat. This one is for Niutek.
 
Ok.
Thank you!
I work very weird hrs. 1 to 9-10 pm
Give morning dose at 10 am as im not home before 10 pm
So it is not possible for me to do 6 hrs after the shot- as i would be either at work or asleep..
Im still working on my spreadsheet.
Thank You for everything!
 
If you could test at midnight or a little later, it'll still tell us if he's going down at night. Then get those middle of the cycle tests, 6 hours or so after shot, during the days you have off.
 
What level are the ketones? Are you testing his urine? There should be a level on the stick.

Is he eating well? Drinking lots?

How is the spreadsheet coming? Can't really help on dose without that.
 
Ketons shows as traces- so im back on giving fluids.i started to use keton strips for urine.
He eats- less than normal- but eats.
I did not finish the spread sheet-im so bad with typing and charts other than handwritten.
Did not test bg today- had to leave to work earlier.
Yesterday before the insulin shot at the meal time it was 365..
After food it usually goes way higher..
 
Anna, that’s great you are using the Ketostix to test the urine for ketones.

Food is really important when there are ketones so try and get Niutek to eat more if you can.

Can you upload the spreadsheet so we can see what you have put in the spreadsheet so far please Anna? Especially the BG readings of the last few days.

The BG will usually go up after eating but if you can test a bit later in the cycle around +5 we can see if the BG is coming down at all.
 
Thank You!
I will do full bg curve on Saturday.
Did not measure today..
Yesterday only once
 
Anna it is really important to test the BG before EVERY dose of insulin to check it is safe to give it. Also it is important to check the BG during the cycles to see how low the BG is going. If you only check once or even twice a day you don’t know if the insulin is working unless you can see how low the insulin is taking the BG. Does that make sense?
 
I will do full testing on saturday and sunday.
It is not possible for me to do it during week days..
Im not home since 12.30 pm and 10 pm.
I give insulin at 10am and 10 pm
 
Anna -

Do you know why your vet suggested this type of insulin? From what I can sort out from the photo, Humalog/Lispro is a rapid acting insulin. This is not the kind of insulin that is recommended for cats. A cat's metabolism is too fast to benefit from this kind of insulin to manage diabetes. The two types of insulin that are recommended by the American Animal Hospital Assn for the treatment of feline diabetes are either Prozinc or Lantus.

A fast acting insulin like you're using can cause numbers to drop very fast. You MUST be testing in order to insure that your kitty is safe.
.


It is no vet who has prescribed that Humalog insulin. She is using it unprescribed on her own and get it unprescribed from a human diabetic aquaintence, a very dangerous practice IMHO.
 
My vet does not know about my experiment with Humalog...he suggested taking him to hispital when his ketons were 3+Or ...euthanize...
I do not have thousands for hospital.
I had him in hospital 1,5 y ago and they treated him with fast acting insuline. This is why i used it for 10 days - to lower his BG to get rid of ketons.
Per vet im giving 2x 4,5 Lantus
I stopped giving humalog a week ago when he had no ketons.
Today’s curve after giving 4,5 of Lantus at 10 am scarry:
10 am:362 ( 1 3 oz can eaten)
1 pm :384 ( 1/4 can ewten)
2 pm : 468 (!!!!). No food eaten
4 pm: 390 ( no food eaten)

this is really bad..
Im helpless.
The secind vet told me to give him 2x 6 units..
I did not started doing it as only ar Christmas time he was on 3 units 2x daily..
 
Did you get any tests in last night? Looks like he might have gone lower last night and is now bouncing. That just means it wasn't a very good cycle to do the curve. Without that spreadsheet, I still can't tell what you should do with the dose.
 
No he was never tested for Cushing's Syndromand for Acromegaly.
He had PLI test for pancretitas and it came out positive.
His liver number on last ( 12.26..19) blood test came high too.: AST(SGPT) 158 ( normal is 10-100)
And ALT ( SGPT) 226 ( normal 10-100)
Cholesterol 235
Triglyceride 398
 
One of these links says:

This leaves the two treatments that are actually used on a regular
basis, and a promising new treatment.
Because this condition is rare, there's been little experience treating
it with lispro insulin (Humalog). That experience is promising; it
appears that the structural change in lispro may inhibit the antibody
binding. If this is borne out by further experience, lispro will be the
treatment of choice for extreme insulin resistance.”
 
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