New Member - Meli - Neuropathy & Switching Insulin

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Ami & Meli

Ami & Meli

Member Since 2021
Hi, my name is Ami my cat is Meli and we're in need of some advice. Meli is having a hard time walking today, her back legs are very weak.

Three days ago we switched insulin brands. Meli was on Vetsulin since February 2021 and we were up to 6 units and still getting BG readings of 400+ so we switched to Lantus. Here are her readings from her first few days on Lantus:

Tues (5/4) - 1 Unit of Lantus 2x per day
501 @ 6am (before insulin)
493 @ 8am
533 @ 10am
557 @ noon
527 @ 2pm
462 @4pm
484 @ 6pm (before insulin)

Wed (5/5) - 2 Units of Lantus 2x per day
506 @ 6am (before insulin)
488 @ 8am
467 @ 10 am
493 @ noon
463 @ 2pm
453 @ 4pm
477 @ 6pm (before insulin)

Thurs (5/6) - 2 Units of Lantus 2x per day
504 @ 6am (before insulin)
422 @ noon

Meli now has a decreased appetite, is lethargic, is peeing outside of her litter box and is having a hard time walking. We just called the vet and they said they can give us pain meds to help her back legs and a B12 injection.

Any suggestions? Should we increase the dosage of Lantus?
 
Were you doing any testing when you were on Vetsulin? What food is Meli eating now and was he eating anything different on Vetsulin?

I think what's going on is your vet dropping your dose back too much. If Meli was eating a low carb food and getting 6U of Vetsulin, we would have taken that into consideration when suggesting a starting dose of Lantus. Dropping all the way back to 1U was a mistake on your vet's part.

Also, Lantus takes 5-7 days to build up inside the body before you're going to see the true effect of the starting dose....but I still think your vet gave you horrible advice to drop that far back.

I'll tag somebody who has a lot of experience with high dose cats and get some extra information for you. @Wendy&Neko
 
Thanks for your reply, Chris.

Yes, we were testing while on Vetsulin and all readings since mid-April were above 400.

She's eating a combination of Tiki Cat wet food and Fancy Feast classic pate. Both are high protein low carb. Her diet did not change during the insulin switch.

I am concerned about not giving her enough insulin and giving her too much and I have no idea what to do. Any help would be so very much appreciated!

Also, an UPDATE: My mom went to the vet and they gave us a B12 Complex injectable that we just gave her and they said we'll do this once a week for 6 weeks. I also ordered Zobaline online in case this doesn't work.
 
Ami Meli said:
they gave us a B12 Complex injectable that we just gave her and they said we'll do this once a week for 6 weeks.
Click to expand...

That won't help the neuropathy but it may help give her a boost....some extra energy and improved appetite.

We have a spreadsheet we all use to record our cat's BG numbers that we really depend on. Here are the instructions on getting the FDMB spreadsheet but if you need help, feel free to ask. You can send me a private message on Facebook or here if you need some help getting it set up.
Once it's set up, you put the link into your signature so we can see it any time you need some advice.

If you could enter the last 2 weeks or so, it would be helpful.
 
Good job! Can we get you to put a line between when you were using Vetsulin and when you started Lantus?

Something like the line between 4/19 and 4/20 on this spreadsheet only put in L A N T U S instead.

It will also be important in the future to get at least a "before bed" test on the PM cycle. Most cats go lower at night so it really is important to make sure she's not dropping too fast or too low while you're snoozing.

I would immediately go up to at least 4U (although Wendy may suggest you go back up to 5 or 6) I'd defer to her since she has more experience with high dose cats.

If you do end up on 6U of Lantus and are still getting lousy numbers, it's going to be time to consider having her tested for acromegaly and IAA. Your vet will need to pull blood and have it sent to MSU (they're the only place that does the testing).
 
Chris & China (GA) said:
Good job! Can we get you to put a line between when you were using Vetsulin and when you started Lantus?

Something like the line between 4/19 and 4/20 on this spreadsheet only put in L A N T U S instead.

It will also be important in the future to get at least a "before bed" test on the PM cycle. Most cats go lower at night so it really is important to make sure she's not dropping too fast or too low while you're snoozing.

I would immediately go up to at least 4U (although Wendy may suggest you go back up to 5 or 6) I'd defer to her since she has more experience with high dose cats.

If you do end up on 6U of Lantus and are still getting lousy numbers, it's going to be time to consider having her tested for acromegaly and IAA. Your vet will need to pull blood and have it sent to MSU (they're the only place that does the testing).
Click to expand...

Yes, just updated the spreadsheet.

Thank you so much, her next dose is in 30 min and we will increase to 4 units. I really really appreciate your help.
 
Wendy&Neko said:
I would go up to 5 units right away and immediately start testing daily for urinary ketones. I am really worried about the drop back in dose, combined with lethargy, and decreased appetite. This post has more detail: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters

Any change you can get a night time test in before you go to bed? Many cats go lower at night.
Click to expand...

Yes, we can test tonight.
I gave her 4 units this evening (didn't see your reply in time) and will go up to 5 units for the morning dose.
Will also look into testing for ketones.
Thank you, Wendy.
 
Ami Meli said:
Will also look into testing for ketones.
Click to expand...

Here are some Urine Testing Tips that may be helpful. You can get urine ketone test strips at any pharmacy that carries human diabetic supplies.

You can get these at WalMart for $6.64/50

There are also blood ketone meters but you usually have to order them from someplace. The strips are more than glucose strips and take a larger sample too but they're also a lot more accurate since ketones show up in the blood before they show up in the urine. The Novo Max and the Keto-Mojo are the ones I see the most here. (should be available on Amazon)

I'm glad Wendy got the tag. I was thinking 5U too but since I don't have the experience with high dose cats that Wendy does, I like to get her input. Thanks @Wendy&Neko!
 
Chris & China (GA) said:
Here are some Urine Testing Tips that may be helpful. You can get urine ketone test strips at any pharmacy that carries human diabetic supplies.

You can get these at WalMart for $6.64/50

There are also blood ketone meters but you usually have to order them from someplace. The strips are more than glucose strips and take a larger sample too but they're also a lot more accurate since ketones show up in the blood before they show up in the urine. The Novo Max and the Keto-Mojo are the ones I see the most here. (should be available on Amazon)

I'm glad Wendy got the tag. I was thinking 5U too but since I don't have the experience with high dose cats that Wendy does, I like to get her input. Thanks @Wendy&Neko!
Click to expand...

Great! Thank you, I'll go to Walmart tomorrow and look for this.

Thank you so much Chris and Wendy. I appreciate your support. Meli's behavior is a little better tonight than it was in the afternoon. She asked for her dinner and ate some food with her PM shot and has been walking around more, although her legs are still wobbly. But she did jump up on a bench and a table.
 
AMPS reading was 559 :(
However, her behavior is better today and her appetite has increased a little. Gave 5 units of Lantus this morning.
 
After cats get an increase, they will sometimes do something we call "new dose wonkiness". It happens in the first few cycles after an increase. We don't know exactly why, but it could be due to the depot rebuilding. The good news is that it's short lived.

Great news that her behaviour and appetite are better. :)
 
You might want to call Walmart before you go since they don’t always have everything in stock these days. Is she on any type of anti nausea meds? Sometimes it helps with the not eating.

I can speak more about the neuropathy since Minnie went through it before her diabetes was regulated. Hers got prey severe with not being able to jump and take more than 2-3 steps before having to stop. I had pee pads all over because she couldn’t go in and out of the litter box either. The b12 methyl is what will help, the Zobaline and there’s a more affordable version from vitacost I believe. The catch is that is only really going to start working once the diabetes is under control. It works direct in the spinal fluid to regenerate the nerves. The good news is that Minnie recovered quickly in about 3 months and is now 99% back to normal with just a bit of a residual arthritis on her front legs. She can jump and run and going in and out of the litter box like nothing ever happened. Hang in there because there’s a light at the end of tunnel :cat:
 
I’m just chiming in here to say hi - I am pretty new and in a similar situation with a higher dose kitty still unregulated, hints of neuropathy from day to day and administering methyl B12 (the info above was very helpful for me too), and we will be switching to Levemir soon.

This is a great group and very helpful for me already - they’ve even put up with my tech challenges and anxiety attacks!
 
UPDATE: BG readings over the past 24 hours have all been above 500. However, she is walking much better now. The B12 shot seems to have worked. Meli's behavior is still better than it was a couple of days ago and she's eating a little but not a lot. Worried about these high readings, and hoping that since this is day 5 on Lantus that we will start seeing some results.
 
It takes several days of the sane dose to build the Lantus depot so you can see what the dose can do. Did you give insulin last night and this morning? The spreadsheet entries are empty.
 
Wendy&Neko said:
It takes several days of the sane dose to build the Lantus depot so you can see what the dose can do. Did you give insulin last night and this morning? The spreadsheet entries are empty.
Click to expand...

Yes, gave her 5 units last night and this morning, forgot to put that on the chart! Her latest BG reading is 506.
Should we increase the next dose?
 
No, you need to hold this dose at least six cycles. It's time for patience as the depot builds.
 
We decrease the Lantus dose based on how low it takes the cat. We have a couple of dosing methods, and depending on which one you want to follow, you reduce if they go below 90, or below 50.
 
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