Maddox - Need help regulating

[Bumblebee]

Hi! I just did the libre with my vet for my cat Maddox from 12/20/24-1/3/25. He's 11 years old and on 4 units Lantus insulin 2x a day at 10am/10pm.

He was recently diagnosed with stomatitis as well. He eats Weruva BFF chicken/turkey & chicken & lamb. As well as Friskies turkey pate and 9 lives turkey pate. Every other day he gets Royal Canin glycobalance wet food (just 1 can in place of the others)

His Libre data is back and most days he just stayed at 350 + or above. My vet is suggesting that I'm maybe not giving insulin correctly and that's why he's staying at 400. She suggested for me to come in to learn from a vet tech (I did a year ago for my other cat Miki) to relearn properly giving insulin and only feed him 2x a day.

When I asked if this is the ONLY reason that could be keeping his BG high, she said yes. So I would appreciate any advice or help. Is this really the only reason he'd be staying high? Or could it be his gingivitis/stomatitis? Or something else?

I check every time that it's not wet, I smell the fur for insulin too. And I spread the fur before I inject to watch the needle go into the skin and not do a fur shot. Could I be not going deep enough despite that? I really want to help get him regulated so he can get his dental cleaning/extractions if needed.

My sheet is below (I have 2 diabetic cats - Use the 2025 Maddox tab for Maddox. As well as the Libre Maddox tab for all of his libre data for 2 weeks)
https://docs.google.com/spreadsheet...zzHSaamAoX4c/edit?gid=676473182#gid=676473182

Thank you so much. Any guidance is appreciated.

 

[CORKY]

Hi! I just did the libre with my vet for my cat Maddox from 12/20/24-1/3/25. He's 11 years old and on 4 units Lantus insulin 2x a day at 10am/10pm.

He was recently diagnosed with stomatitis as well. He eats Weruva BFF chicken/turkey & chicken & lamb. As well as Friskies turkey pate and 9 lives turkey pate. Every other day he gets Royal Canin glycobalance wet food.

His Libre data is back and most days he just stayed at 350 + or above. My vet is suggesting that I'm maybe not giving insulin correctly and that's why he's staying at 400. She suggested for me to come in to learn from a vet tech (I did a year ago for my other cat Miki) to relearn properly giving insulin and only feed him 2x a day.

When I asked if this is the ONLY reason that could be keeping his BG high, she said yes. So I would appreciate any advice or help. Is this really the only reason he'd be staying high? Or could it be his gingivitis/stomatitis? Or something else?

I check every time that it's not wet, I smell the fur for insulin too. And I spread the fur before I inject to watch the needle go into the skin and not do a fur shot. Could I be not going deep enough despite that? I really want to help get him regulated so he can get his dental cleaning/extractions if needed.

My sheet is below (I have 2 diabetic cats - Use the 2025 Maddox tab for Maddox. As well as the Libre Maddox tab for all of his libre data for 2 weeks)
https://docs.google.com/spreadsheet...zzHSaamAoX4c/edit?gid=676473182#gid=676473182

Thank you so much. Any guidance is appreciated.

I will tag a couple of member very knowledgeable in Lantus and dosing, don't worry we are here for you and welcome to FDF
@Suzanne & Darcy
@Sienne and Gabby (GA)
@Bron and Sheba (GA)

 

[Bron and Sheba (GA)]

Hi and welcome to the forum.
Thanks for setting up the SS and the signature. It makes it much easier to help you.
Looking at the 2025 SS I can see that the 4 units of Lantus is getting Maddox down int the blue range which is progress.
Can you get at least one test on every pm cycle as well as the am cycle? If we can see how low the dose is taking Maddox each cycle that will help us be able to help you.
Lantus dosing is based on how low the dose takes the cat not the preshot BG.
Is there a particular reason you are feeding the RC glycobalance,? As far as I know it is about 14% carbs which is too high to be feeding on a regular basis. I would stick to lower carb food.
I am sure you are most probably giving the insulin properly as I can see it is working a lot of the time and cats do have cycles where the BGs just don’t move much. An insulin injection does not need to go deeply. It is a subcutaneous injection so just a bit below the skin. If you have treated 2 diabetic cats I am sure you know what you are doing.

And please do feed Maddox more than twice a day. Just feeding twice a day is old thinking that goes with old insulins.

When I asked if this is the ONLY reason that could be keeping his BG high, she said yes. So I would appreciate any advice or help. Is this really the only reason he'd be staying high? Or could it be his gingivitis/stomatitis? Or something else?

/
This is not correct.
There are many reasons why a cat’s BG is not responding to the insulin, or not appearing to respond. It will be doing some good, even if you can’t see it reflected in the BG numbers. Insulin is needed for other things apart from reducing the BGs.
The main reason is because you have not reached the best dose yet. Every cat is different. Some cats only need less than 1 unit and other cats need more than 6 units and some need a lot more than that. How is the vet increasing the dose?
Other concurrent health issues can certainly affect the BG. For example cats with a UTI or pancreatitis can have raised BGs and certainly a cat with teeth issues will be impacted.
If Maddox has stomatitis that will be impacting his BG and he will be needing more insulin at the moment. What is the vet doing about the stomatitis?

 

[Bumblebee]

Hi and welcome to the forum.
Thanks for setting up the SS and the signature. It makes it much easier to help you.
Looking at the 2025 SS I can see that the 4 units of Lantus is getting Maddox down int the blue range which is progress.
Can you get at least one test on every pm cycle as well as the am cycle? If we can see how low the dose is taking Maddox each cycle that will help us be able to help you.
Lantus dosing is based on how low the dose takes the cat not the preshot BG.
Is there a particular reason you are feeding the RC glycobalance,? As far as I know it is about 14% carbs which is too high to be feeding on a regular basis. I would stick to lower carb food.
I am sure you are most probably giving the insulin properly as I can see it is working a lot of the time and cats do have cycles where the BGs just don’t move much. An insulin injection does not need to go deeply. It is a subcutaneous injection so just a bit below the skin. If you have treated 2 diabetic cats I am sure you know what you are doing.

And please do feed Maddox more than twice a day. Just feeding twice a day is old thinking that goes with old insulins.

/
This is not correct.
There are many reasons why a cat’s BG is not responding to the insulin, or not appearing to respond. It will be doing some good, even if you can’t see it reflected in the BG numbers. Insulin is needed for other things apart from reducing the BGs.
The main reason is because you have not reached the best dose yet. Every cat is different. Some cats only need less than 1 unit and other cats need more than 6 units and some need a lot more than that. How is the vet increasing the dose?
Other concurrent health issues can certainly affect the BG. For example cats with a UTI or pancreatitis can have raised BGs and certainly a cat with teeth issues will be impacted.
If Maddox has stomatitis that will be impacting his BG and he will be needing more insulin at the moment. What is the vet doing about the stomatitis?

Thank you so much for your response. Re: the stomatitis/gingivitis - my prior vet was too nervous to do a teeth cleaning/extraction with Maddox being high risk (11 yrs old/ diabetic/ little chubs at 20lbs) and said with his blood sugar being so unregulated he couldn't risk anesthesia. So this is the new vet and she wanted to see if we could get him regulated while he had the libre on before we considered anesthesia for the cleaning. He also has a mass in his mouth which is how we found the stomatitis, I noticed it and had it biopsied. He's on gabapentin for pain relief now and a controlled calorie diet to get to a healthier weight.

For the PM readings, does the tab titled with the Libre data help at all if I filter to his 180 and below numbers? He had around 2 days that he dropped as low as 65 based on filtering to those. But aside from those 2-3 good days filtered, he was near 350-400 for close to 11 of the 14 days that the libre tracked. Let me know if the libre data is annoying/hard to filter through and I can try to figure out how to make it more formatted like the spreadsheet. I think that data is still valuable because it tracked all hours of the 14 days so recently that maybe it can help figure out dosing.

Also thank you for the note about the royal canin! I was just feeding it because it's what they originally recommended and both my cats seem to love it. But it's SO expensive so it's helpful to know it's 14% carbs and I might cut that one out all together.

 

[Bron and Sheba (GA)]

A few questions …
What was the result of the biopsy of the mass in Maddox’s mouth?

I’m a bit confused about the spreadsheets.
When I first looked at the SS with the libre BGs I am sure saw red colour with BGs in the 400s …now they are green with BG much lower. Was that somehow changed or am I imagining things?
I’m going to ask @Bandit's Mom if she can make that SS more user friendly.

And when I looked at another SS marked Maddox 2024 it had data from 5/3/24. I thought Maddox was diagnosed on 4/12/24.
And then there is the SS marked Maddox 2025.

Can you mark clearly at the top of each SS which SS belongs to each cat please.

For the PM readings, does the tab titled with the Libre data help at all if I filter to his 180 and below numbers?

I don’t actually know what you mean by this. What does filtering mean in this contest. It is not a term we use here as far as I know.

It is unlikely you will get a cat regulated in a couple of weeks. Do you think your current vet knows much about feline diabetes?.
A lot of cats here have an aesthetic for teeth issues when they are unregulated. It might be an idea to get a vet who specialises in dental work to have a look.

 

[CORKY]

The Libre has its little pros but many cons, the sensor tends to stop working before the 14 days, it falls off or the cat removes it, if glue is used, they will get a big irritation in their skin, they are not accurate, if any BG is over 365 the monitor will just read HI, and if is 100 or less it will always read up to 15-20+ points less, when Corky left the hospital after 8 days he left with the libre, I had no idea what to do or how, I place the low alarm on 90 and I cannot tell you the months of sleepless nights, when the alarm would go off at 50 and less, the sensors only lasted 4-6-8 days, The Company has the sensors guaranteed, so you should never throw away the box of the new replacement, you can call customer service (back of the box) but you cannot tell them is for your cat or they will not replace it, not until I got the ReliOn Premier human monitor and strips, (Corky had the last sensor still working, each sensor would cost me $78.00), while he still had the sensor, I learned how to test with the monitor, lancet and his ear with the instruction I found here, to my surprise the difference in BG number where outrageous, after that sensor finished , I started to have peace of mind and sleep, but most important accurate reading!