12/8/2020 - New Member - Maxie Moo Moo’s Story

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MaxieMooMoo’sMom

Member Since 2020
Hello, I’m Max’s mom!

Max is a 12 year old, 20 pound, white, male, domestic shorthair cat that I got when he was a few days old. His litter was picked up from a feral colony and I was asked to care for them. He attached himself to me at a very early age and I could not adopt him out!

Max has had diabetes for 5 years. He is on 10 units of Lantus twice a day. Has never been well regulated, and the vets have never been proactive in helping, only raising the insulin dose.

He had pancreatitis twice and they changed his food to Hills Gastrointestinal moderate calorie.

In October he had his annual then back in for a glucose curve. The new doctor said his curve was all over the place, thought he is “insulin resistant” and sent us to an internist. The internist noticed that his calcium was high in the blood work, tested his ionized calcium 1.43. Because of that they tested for acromegaly and lymphoma, they were both negative. Went back to my vet to do X-rays for masses. They could not see his spleen and think there is a mass covering it. There was also something between his lungs. He is going back in on December 10 for an ultrasound to determine what those masses are.

Meanwhile I asked the doctor about changing his food to a “diabetic” food, they agreed and gave me the prescriptions. He is on Hills M/D dry and Purina DM wet half and half right now. Trying to get him to go all wet then I will start adding the fancy feast classics as suggested by this group.

Started home testing yesterday and am surprised at how low his numbers were. Testing again today with a smaller dose of insulin since he got so low yesterday. It seems he is not insulin resistant.

Want to say a big thank you to Chris and Julianne for making me feel welcomed already!
 
Lantus is a depot insulin, that means it takes a few days for a dose change to be fully seen.
What was the dose before 12/7/2020 since your spreadsheet only starts with 12/7 for 2020. Also, the convention here is to had dates/dat at the end of the spreadsheet while yo seem to at them to the top.
After you get more BGs today then I could give a suggestion on what dose to use next.
 
Hello and welcome!

I'll let those with more experience with high-dose conditions get into the details, but just to clarify, when you had him tested for acro and lymphoma, did they do an IAA (checking for insulin antibodies) test as well? That's another high-dose condition; my understanding is that one of the things that can happen is very sudden changes in insulin needs, so that might go along with what you're seeing. I find it hard to imagine that a cat could be on 10U of Lantus for five years without having some kind of high-dose condition (but again, there are others here who have a lot more knowlege about these things).

Congrats on getting started with the testing! I'm sure that you'll find it much easier to manage the diabetes end of things-- no more guessing about what the dose is doing to him.

Always very scary when they see things like masses. Crossing fingers and paws that they turn out to be minor/benign... things of some kind (who cares what at that point).

Maxie Moo Moo is adorable, with his tennis ball! Glad you found us here, welcome again!
 
Lantus is a depot insulin, that means it takes a few days for a dose change to be fully seen.
What was the dose before 12/7/2020 since your spreadsheet only starts with 12/7 for 2020. Also, the convention here is to had dates/dat at the end of the spreadsheet while yo seem to at them to the top.
After you get more BGs today then I could give a suggestion on what dose to use next.

Hello, thank you for your response!

No problem, I will make the change to the chronological order.

Yes, he was on the 10 units of Lantus twice a day until yesterday. I lowered to 9 yesterday because I have been exclusively feeding him the "diabetic" cat foods for about a week. He was on the Hills Gastrointestinal before. It is much higher in carbs and lower in protein so my thought was that the lower carb diet may be making the insulin more effective and I was starting the testing so I would go ahead and lower a little and see. When I got the low readings in the 80's yesterday afternoon it scared me. This morning he was at 190 before eating and I delayed giving him insulin until his blood sugar was above 200.

I'll make those changes to the spreadsheet as soon as I can. It's nap time for my little girl!
 
First of all, hello and welcome to you and sweet Maxie Moo Moo. Way to go on starting home testing. :)

My girl had two secondary conditions that caused her to need higher doses. (acromegaly and IAA or insulin auto antibodies). Note, not all cats with these conditions need higher doses, but most cats with higher doses have either these conditions or Cushings, or they are on very high carb food. We did have one member who adopted a kitty on 13 units of Levemir (similar action to Lantus), that was keeping himself alive by gorging on high carb vet dry food. Once the dry food was removed and a low carb wet food introduced, kitty ended up on less than 2 units of insulin. Of course, don't change the diet until you are very comfortable with home testing. You don't need "vet" food at all to treat a diabetic, most of us use commercially available low carb wet or raw food. Or make our own.

With a cat on 10 units of Lantus, that means the depot is also 10 units. It can take 4-6 cycles, or even longer for higher doses, for the depot to deplete. The depot is going to be heavily influencing the numbers you see until the depot depletes.

Because of that they tested for acromegaly and lymphoma, they were both negative.
There is no blood test for lymphoma. How did they test for it?
 
Hello and welcome!

I'll let those with more experience with high-dose conditions get into the details, but just to clarify, when you had him tested for acro and lymphoma, did they do an IAA (checking for insulin antibodies) test as well? That's another high-dose condition; my understanding is that one of the things that can happen is very sudden changes in insulin needs, so that might go along with what you're seeing. I find it hard to imagine that a cat could be on 10U of Lantus for five years without having some kind of high-dose condition (but again, there are others here who have a lot more knowlege about these things).

Congrats on getting started with the testing! I'm sure that you'll find it much easier to manage the diabetes end of things-- no more guessing about what the dose is doing to him.

Always very scary when they see things like masses. Crossing fingers and paws that they turn out to be minor/benign... things of some kind (who cares what at that point).

Maxie Moo Moo is adorable, with his tennis ball! Glad you found us here, welcome again!
Hi Nan & Amber,

Thank you!

They did not mention anything about the antibodies. I will go ahead and give them a call tomorrow and ask.

I’m not even sure that he has an insulin resistance considering the numbers yesterday. He was definitely responding to the insulin and was under control all day. Also, if you look at his history, all of the curves he had done at the vet offices were all over the place.

Love your calico! Max’s mother was a calico!
 
First of all, hello and welcome to you and sweet Maxie Moo Moo. Way to go on starting home testing. :)

My girl had two secondary conditions that caused her to need higher doses. (acromegaly and IAA or insulin auto antibodies). Note, not all cats with these conditions need higher doses, but most cats with higher doses have either these conditions or Cushings, or they are on very high carb food. We did have one member who adopted a kitty on 13 units of Levemir (similar action to Lantus), that was keeping himself alive by gorging on high carb vet dry food. Once the dry food was removed and a low carb wet food introduced, kitty ended up on less than 2 units of insulin. Of course, don't change the diet until you are very comfortable with home testing. You don't need "vet" food at all to treat a diabetic, most of us use commercially available low carb wet or raw food. Or make our own.

With a cat on 10 units of Lantus, that means the depot is also 10 units. It can take 4-6 cycles, or even longer for higher doses, for the depot to deplete. The depot is going to be heavily influencing the numbers you see until the depot depletes.


There is no blood test for lymphoma. How did they test for it?


Hi Wendy & Neko,

Not sure how they tested for the lymphoma. Had to wait in the car for the entire visit since they are not allowing humans into their office right now. I have a few questions for them so I'll add it to the list for tomorrow.

He was changed from the Hills Gastro to the M/D hard & DM soft foods so that is why I am starting to test. The vet kind of blew it off (wanting to change him to a diabetic food) but knew he would need monitoring because of that change.

Honestly don't know anything about the depot and have a lot to learn. Last night at feeding time he was in the 80's so I did not give him insulin. I just started testing yesterday so not sure how many times he has been given insulin in that range. It's scary.

Is 4-6 cycles about 2-3 days? 2 cycles per day if giving insulin twice?

Thank you for all your help!
 
DM is dietetic management, not diabetic management. M/D is not food for diabetics either.

Yes, a cycle starts from the time of the shot, to the next one. So most times two times a day. The fact that you skipped the shot last night will help drain the depot some more, so it was a good thing in more than one way. But you could still see some impact for the next day or so.
 
DM is dietetic management, not diabetic management. M/D is not food for diabetics either.

Yes, a cycle starts from the time of the shot, to the next one. So most times two times a day. The fact that you skipped the shot last night will help drain the depot some more, so it was a good thing in more than one way. But you could still see some impact for the next day or so.

Yes, definitely know about the food situation since joining the group and my plan is once he goes to all wet then I will start adding the fancy feast classics as suggested by this group.

Thank you!
 
Welcome Max's Mom.

I will let Wendy answer all your high dose possibilities. Ollie was high dose with other issues. I do check in daily, don't always post. I'm nosey and want to see what all my FD family is up to or should I say down to????????
 
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