Insulin isn’t working

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M & Maisie

M & Maisie

Member Since 2021
Hi,
My cat Maisie (who will be 11 in July) was diagnosed with diabetes 4 months ago. Unfortunately we have not been able to stabilise her blood sugars at all. I’ve just spoken to her vet who rang with the latest blood test results, her glucose levels are sky high (she didn’t give me any figures but said they’re basically the highest they can be), that was on 2 units of insulin twice a day. The vet reluctantly increased her dose again, this time to 2.5 units twice a day but she said they won’t be able to go any higher than this if this higher dose doesn’t work because it’s already a large dose for her body weight (she’s currently 4kg). She told me some cats are insulin resistant and unfortunately just don’t respond to it no matter how much they get. She’s given us 4 weeks to see if it works, if not I think I’m going to lose her! It sounded like there was nothing else they would be able to do for her.
I guess I just wanted to ask if this sounds usual? Is 5 units a lot for a cat of her weight?

Her symptoms have never went away, she’s still drinking A LOT all day, obviously peeing a lot and quite hungry most of the time. I’ve noticed her back legs are now starting to get a bit weaker and she’s falling occasionally (eg if she tries to jump in the sink for a drink, she’ll not make the jump or she’ll slip and fall).

She’s on Caninsulin.

Diet- she’s always been very fussy with food, she never liked any wet food so was on 100% dry food before diagnosis. After diagnosis the dry food is still available 24/7 to graze on but I’ve been able to get her to eat pate wet food which she has twice a day (at the times of her injections because that’s the only way I can give them).

The vets have also ruled out any kidney issues as a possible reason for the insulin not working.

I don’t check her sugars at home, I did try but she would not tolerate it at all unfortunately.
 
Might be a good idea to set up your signature, it's at the end of everyone's post in gray

Click on your name upper right hand corner , a drop down will appear , tap in signature , fill out info
  • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback. There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.
 
Here's a link to your last post: https://www.felinediabetes.com/FDMB...n-on-friday-feeling-lost.244474/#post-2759806

I'm so sorry to hear that Maisie isn't improving and still showing such high glucose levels. Caninsulin is not a great insulin for cats. The insulin that has regulated the most cats on this forum is Lantus; it is a long acting, depot insulin typically used for humans but great with kitties. Have you had a conversation with your vet about changing insulins?
 
M & Maisie said:
Hi,
My cat Maisie (who will be 11 in July) was diagnosed with diabetes 4 months ago. Unfortunately we have not been able to stabilise her blood sugars at all. I’ve just spoken to her vet who rang with the latest blood test results, her glucose levels are sky high (she didn’t give me any figures but said they’re basically the highest they can be), that was on 2 units of insulin twice a day. The vet reluctantly increased her dose again, this time to 2.5 units twice a day but she said they won’t be able to go any higher than this if this higher dose doesn’t work because it’s already a large dose for her body weight (she’s currently 4kg). She told me some cats are insulin resistant and unfortunately just don’t respond to it no matter how much they get. She’s given us 4 weeks to see if it works, if not I think I’m going to lose her! It sounded like there was nothing else they would be able to do for her.
I guess I just wanted to ask if this sounds usual? Is 5 units a lot for a cat of her weight?

Her symptoms have never went away, she’s still drinking A LOT all day, obviously peeing a lot and quite hungry most of the time. I’ve noticed her back legs are now starting to get a bit weaker and she’s falling occasionally (eg if she tries to jump in the sink for a drink, she’ll not make the jump or she’ll slip and fall).

She’s on Caninsulin.

Diet- she’s always been very fussy with food, she never liked any wet food so was on 100% dry food before diagnosis. After diagnosis the dry food is still available 24/7 to graze on but I’ve been able to get her to eat pate wet food which she has twice a day (at the times of her injections because that’s the only way I can give them).

The vets have also ruled out any kidney issues as a possible reason for the insulin not working.

I don’t check her sugars at home, I did try but she would not tolerate it at all unfortunately.
Click to expand...
Diane Tyler's Mom said:
Might be a good idea to set up your signature, it's at the end of everyone's post in gray

Click on your name upper right hand corner , a drop down will appear , tap in signature , fill out info
  • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback. There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.
Click to expand...

I’m sorry. I don’t know what some of the things you said mean, I don’t use a meter or have readings to share and I’m never told any specific results so I can’t share them either. I tried to include all of the important things I know in my post so it saved people from needing to ask me. Sorry again.
 
PerfumedCatMom said:
Here's a link to your last post: https://www.felinediabetes.com/FDMB...n-on-friday-feeling-lost.244474/#post-2759806

I'm so sorry to hear that Maisie isn't improving and still showing such high glucose levels. Caninsulin is not a great insulin for cats. The insulin that has regulated the most cats on this forum is Lantus; it is a long acting, depot insulin typically used for humans but great with kitties. Have you had a conversation with your vet about changing insulins?
Click to expand...

I asked if their was another kind we could try maybe a couple of vet visits ago, I was told that’s the only type they use. Is Lantus readily available in the UK?
Thank you
 
M & Maisie said:
I asked if their was another kind we could try maybe a couple of vet visits ago, I was told that’s the only type they use. Is Lantus readily available in the UK?
Thank you
Click to expand...
@Hercule's mum is in the UK and she uses Lantus. Perhaps she can provide you with some tips on how to get it.

Also, if your vet is not familiar with it, you can share this paper written by Roomp and Rand who developed the protocol upon which the FDMB uses for Lantus (Tight Regulation), based on a studying cats from the German diabetic cat forum:
http://www.rednacionaldeveterinaria...‏/intensive_glucose_control_glargine_cats.pdf
 
In the UK, Prozinc is also approved for cats, and is a much better option. My Neko started on Caninsulin, got to 5 units before we switched to Lantus and eventually did much better. She did have a couple secondary conditions that meant she needed more insulin. 2.5 units is not a larger dose of insulin - it it's what the cat needs. Your vet is wrong about setting a maximum dose - a cat needs however much they need. If you could start home testing, we could help you get to a better dose faster.
 
On the dose.... They need what they need. The weight of your cat isn't really a factor. 2.5 isn't a super large dose.

I strongly suggest you start testing at home... It will be the best way to find a correct dose and keep her safe. I have a video in my signature showing how I tested my cat CC at home.
 
M & Maisie said:
I’m sorry. I don’t know what some of the things you said mean, I don’t use a meter or have readings to share and I’m never told any specific results so I can’t share them either. I tried to include all of the important things I know in my post so it saved people from needing to ask me. Sorry again.
Click to expand...
Just look at mine at the end of my post about Tyler , just put down what you can
You are not home testing yet so just put not home testing

Then just put
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)

  • Diet: "LC wet" or "dry food" or "combo"
Members don't have time to go back and read posts from the beginning and will
likely ask you the same questions over again
 
M & Maisie said:
I’ve noticed her back legs are now starting to get a bit weaker and she’s falling occasionally (eg if she tries to jump in the sink for a drink, she’ll not make the jump or she’ll slip and fall).
Click to expand...

This probably is neuropathy ,getting her BG regulated will help
When she walks does it look like he's walking like a rabbit, flat footed
Does she walk short distances and then has to stop and rest.
This info below is from the UK site

OTHER GENERAL INFO

METHYL B12 FOR DIABETIC NEUROPATHY (weak back legs)
Back leg weakness is fairly common in newly diagnosed diabetics and those who remain in high blood glucose levels. This can resolve entirely! Many people have found that supplementing methyl B12 (methylcobalamin) helps speed the healing process. (Although some cats will not recover completely unless they get into a healthier blood glucose range.)

People in the US often use a methyl B12 supplement called 'Zobaline' specifically made for cats. And UK folks used to use that also, but it has now become expensive to import.
One alternative is to use 'Dr's Best fully active B12' methylcobalamin. To equal the 3mg Zobaline dose you will need two of the Dr's Best capsules. Zobaline also contains a small amount of folic acid. And if you want to copy the Zobaline formula you can add the folic acid also. One drop of 'BioCare Vitasorb Folic Acid' liquid should contain the 200 mcg necessary (but check the product details beforehand to be sure).

'Bodykind' is one place where both supplements are available:
Folic acid: https://www.bodykind.com/product/81...id-folic-acid-15ml.aspx#ctl00_cpBody_contents
Dr's Best B12: https://www.bodykind.com/product/4749-best-fully-active-b12-60-x-1500mcg-vegicaps.aspx?Referer=Froogle_Best-Fully-Active-B12-60-x-1500mcg-Vegicaps&utm_source=froogle&utm_medium=price comparison&utm_campaign=Best-Fully-Active-B12-60-x-1500mcg-Vegicaps&gclid=CjwKEAjwps2_BRC5jduHor-h8xESJADGT-Lt7IdposUdW87VD_9f6kVU9lGGBcs984M-fsFHOpJdkxoCP3Tw_wcB#ctl00_cpBody_contents

Methylcobalamin has no discernable taste, so can mix easily into a little bit of the cat's food. :cat:
 
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You can also try

https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-60-capsules-5
Alot of members use this , I use it myself you can buy it on line from Vitacost
Vitamin B-12 Methylcobalamin -- 5000 mcg - 100 Capsules
It's 14.49 but out of stock , see what I wrote at the end
Some us Zobaline , but it's expensive
This is the same thing
The only difference is the Zobaline has 200 mcgs of folic acid
So I buy the folic acid at the supermarket and crush it up and add it to the B-12
If you can't find the 200 mcg get the 400 mcg and cut it in half
The Vitacost brand is a capsule so just open it and pour the powder on the wet food
Has no taste, no need to crush it up
The Zobaline is 33.99 for 60 pills, too expensive
I saw a big improvement I'd say 3 months, could be sooner. One capsule a day.
Once you get your kitty better regulated the B-12 methyl will help


Vitamin B-12 Methylcobalamin -- 5000 mcg - 100 Capsules

I see they are out stock for the 100 capsules 14.49
Go to the drop down you will see 60 capsules for 9.44 that's still a good price even if you buy 2 bottles. Call them to see if they ship to the UK , but I think they do
https://www.vitacost.com
 
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JanetNJ said:
On the dose.... They need what they need. The weight of your cat isn't really a factor. 2.5 isn't a super large dose.

I strongly suggest you start testing at home... It will be the best way to find a correct dose and keep her safe. I have a video in my signature showing how I tested my cat CC at home.
Click to expand...

That definitely confused me when she said that, I have seen people on this group who’s cats were on higher than 5 units a day. She made it sound like if there’s no improvement in 4 weeks then I’ll have to let her go.

I really tried but she wouldn’t let me go near her, it got to the point that she was even starting to hide from me at injection times.
 
M & Maisie said:
That definitely confused me when she said that, I have seen people on this group who’s cats were on higher than 5 units a day. She made it sound like if there’s no improvement in 4 weeks then I’ll have to let her go.

I really tried but she wouldn’t let me go near her, it got to the point that she was even starting to hide from me at injection times.
Click to expand...
I'm so sorry to hear she's difficult to test. I totally understand that. I'm very fortunate that my cat that was diabetic was chill, but several of my cats are backyard finds and very skiddish and would be near impossible to test. A longer lasting insulin may be a better solution for her.
 
M & Maisie said:
That definitely confused me when she said that, I have seen people on this group who’s cats were on higher than 5 units a day. She made it sound like if there’s no improvement in 4 weeks then I’ll have to let her go.

I really tried but she wouldn’t let me go near her, it got to the point that she was even starting to hide from me at injection times.
Click to expand...
My cat had a special condition called acromegaly.... At her most she needed 12.5 units twice a day. They need what they need.
 
M & Maisie said:
Hi,
My cat Maisie (who will be 11 in July) was diagnosed with diabetes 4 months ago. Unfortunately we have not been able to stabilise her blood sugars at all. I’ve just spoken to her vet who rang with the latest blood test results, her glucose levels are sky high (she didn’t give me any figures but said they’re basically the highest they can be), that was on 2 units of insulin twice a day. The vet reluctantly increased her dose again, this time to 2.5 units twice a day but she said they won’t be able to go any higher than this if this higher dose doesn’t work because it’s already a large dose for her body weight (she’s currently 4kg). She told me some cats are insulin resistant and unfortunately just don’t respond to it no matter how much they get. She’s given us 4 weeks to see if it works, if not I think I’m going to lose her! It sounded like there was nothing else they would be able to do for her.
I guess I just wanted to ask if this sounds usual? Is 5 units a lot for a cat of her weight?

Her symptoms have never went away, she’s still drinking A LOT all day, obviously peeing a lot and quite hungry most of the time. I’ve noticed her back legs are now starting to get a bit weaker and she’s falling occasionally (eg if she tries to jump in the sink for a drink, she’ll not make the jump or she’ll slip and fall).

She’s on Caninsulin.

Diet- she’s always been very fussy with food, she never liked any wet food so was on 100% dry food before diagnosis. After diagnosis the dry food is still available 24/7 to graze on but I’ve been able to get her to eat pate wet food which she has twice a day (at the times of her injections because that’s the only way I can give them).

The vets have also ruled out any kidney issues as a possible reason for the insulin not working.

I don’t check her sugars at home, I did try but she would not tolerate it at all unfortunately.
Click to expand...

@M & Maisie
I would if i were you i would ring your vet asap and speak to them about changing over to Prozinc (prozinc designed for especially for cats. Caninsulin is designed for dogs and Lantus used for humans will only be prescribed if the other two have not worked due to the cascade system they use here in the UK.
If you don't get any joy with the insulin then change your vets as they obviously don't know enough about diabetic cats, and as for saying you can't go any higher is tosh, a cat needs what a cat needs, you will not lose her.
Have a ring around your local vets and ask if they use Prozinc and if they do then change over to them asap.
As for the back leg weakness buy some Doctor's Best fully active B12 methylcobalamin and some BioCare Vitasorb Folic Acid, both easily available online with next day delivery.

B12.jpg


folic acid_.jpg


What i do with my duke is i give him 1 capsule AM and PM with his food, i open the capsule a put in one drop of the folic acid and give him it but you can just as easy mix it in food.
You really must try the home testing because how will you know what Maisie bloods are, she could possible go into a hypo if you're not monitoring, it's amazing what a little roast chicken can do to bribe a cat. My Duke does not like being pricked but after it's done he's sat up eyes bright and waiting for his treat.
I use the Alphatrak 2 but it's expensive for the strips, some UK members use the human meter called Gluco navi.
Taken from this UK thread
https://www.felinediabetes.com/FDMB...-vit-b12-and-other-need-to-know-stuff.137376/
Take a look at @JanetNJ video on how to test, it's very informative.
How to test your cat's blood sugar
The members on here are fantastic and will do everything in their power to help you, i was helped out countless times when Duke was first diagnosed and i didn't know what to do and i still am being helped now when i have problems.
I really can't help you with dosing as i'm not experienced enough but please do the home testing because the data you produce on your spreadsheet (when you create one) will be invaluable to members on here if you need help with dosing and to help you if you need any previous information.
Here's a thread on how to create a spreadsheed (for when you're checking Maisie's bloods.) If you have any problems setting it up there are members here that will help you.
https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
Where abouts in the UK are you?
 

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M & Maisie said:
I really tried but she wouldn’t let me go near her, it got to the point that she was even starting to hide from me at injection times.
Click to expand...
My Clawdius was just diagnosed in May of this year. Between my needle phobia and him not liking his ears being handled it took us quite a while to begin home testing but we did it. I first got him some freeze dried chicken snacks which I call kitty crack because he goes crazy for them. I put them into a jar so that they make a noise when I shake them. I also put all the testing stuff into a plastic container with clips that makes a noise when I unclip it. Next I would call "needle" while unclipping the testing container and shaking the treats. I sit on the couch in the same place each time. When he comes I would praise him, pet him, handle his ears a bit then give him a treat. I did several times a day. When he started coming as soon as he heard the container unclipping I started handling his ears a bit more, rubbing and massaging them as long as he would let me then giving him a treat. We progressed to adding setting off the lancet gadget close to his ear and praising him when he didn't move, and again a treat and much praise and loving. By the time we got to the actual testing he was on my lap before I could even get the container finished opening! Take it slow and easy, at Maisie's pace. You want this to be a good experience (or at least tolerable) for her. It's really important that you stay calm and unstressed. It took us almost a month to get our first good test. Just keep working at it, you'll get there. You have found a wonderful group of caring, knowledgeable people here. They are so patient with us newbies!
 
M & Maisie said:
Is Lantus readily available in the UK?
Click to expand...
yes, it is definetely available. It is the main insulin used in humans, so you can just walk in a UK pharmacy with a vet prescription and get it.

I suspect a change in food would do wonders for Maisie. Zooplus have many different kinds of foods to try.

With all due respect, if you want to give Maisie a better chance, I think it is time for you to get a new vet...

Please feel free to Pm me if you need any more info, but you can refer your vet to the royal college of veterinarians, which reccomends lantus.
 
Hercule's mum said:
yes, it is definetely available. It is the main insulin used in humans, so you can just walk in a UK pharmacy with a vet prescription and get it.

I suspect a change in food would do wonders for Maisie. Zooplus have many different kinds of foods to try.

With all due respect, if you want to give Maisie a better chance, I think it is time for you to get a new vet...

Please feel free to Pm me if you need any more info, but you can refer your vet to the royal college of veterinarians, which reccomends lantus.
Click to expand...

Hi Karen,
I was under the impression that Lantus was only prescribed when the pet/animal insulins don't work using the cascade system.
Maisie's vet should be giving her prozinc at least as the Caninsulin clearly is not working.
 
Teetee (UK) said:
Maisie's vet should be giving her prozinc at least as the Caninsulin clearly is not working
Click to expand...
I agree, that this would be a step forward. But my understanding is that as long as you sign a form saying you take responsability for giving aprescription that is not "cat-approved" that it is at discretion of the vet, but I am no expert.

But more importantly, I was shocked at the idea that they couldn't do anything more for maisie because she received 2.5U of caninsulin. That is just not correct, hence the suggestion she should look for another vet.....
 
Hercule's mum said:
I agree, that this would be a step forward. But my understanding is that as long as you sign a form saying you take responsability for giving aprescription that is not "cat-approved" that it is at discretion of the vet, but I am no expert.
Click to expand...

Ah right i see.

Hercule's mum said:
But more importantly, I was shocked at the idea that they couldn't do anything more for maisie because she received 2.5U of caninsulin. That is just not correct, hence the suggestion she should look for another vet.....
Click to expand...

That's what got me too, i don't like to slag vets off but as you say that is just not correct.
 
This is what I was talking about, training them to come for the needle. Unclipping the needle box gets their attention. You can see that shaking the jar one way doesn't get much of a reaction but shaking it so the treats are in the lid makes the magic noise. Clawdius doesn't care if it's for insulin or a glucose test as long as he gets the treat at the end. You'll have to see what your baby reacts to. Of course since I was trying to video our routine Clawdie decided to really stretch it out. lol My other cat Jester also gets a treat when the needles are done so no one has to feel sorry that he gets pushed down to the floor. He is really distracting to Clawdius. I hope this helps a little bit.

 
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