11/10 Fluffy - All high and constipated | Feline Diabetes Message Board - FDMB

11/10 Fluffy - All high and constipated

K

Kayleegoose

Member since 2025
My boy Fluffy was diagnosed about a month ago. Also had pancreatitis but we believe it’s cleared. Immediately switched to fancy feast pate. Added the chart in my info. Want to note that where it says “HI” it could really be in the high 300s. I’m using the Libre so I don’t get detailed numbers looking back. Doesn’t spend much time above 400 usually. The vet is saying to go to 9 units twice a day. I have been slowly increasing by half units instead of basically doubling it because I was nervous about that and it seems like it just gets higher. I know I’m not holding long enough at the increased dose. I think I’m panicking trying to increase to bring down the glucose.

Second part is since his diagnosis, he’s had constipation problems. We’ve gone in for 3 enemas. I have tried a supplement with psyllium husk, I’m adding two giant scoops of pumpkin to his food, Miralax 1/4 tsp twice a day, the vet added Cisapride 5mg twice a day, and he’s still getting backed up. The vet wants me to do the Royal canin gastro fiber response food which I’m going to do because at this point we’re dealing with megacolon. Trying lactulose starting today, too. He was completely regular before his diagnosis. Is there any chance it could be the insulin?

I took him in again today because he’s barely pooped and the vet agreed to bring the insulin back down for a bit. Starting over at 2 I think.

I just want to know if anyone has experience with either of these situations and how they handled it. I think 9 units twice a day is a lot based on what I’ve read, but if it’s a lot then why isn’t his glucose dropping? I feel like it can’t be the effect that some people talk about where it gets too low and the body reacts to raise the glucose in defense because it basically hasn’t dropped. I feel like the diabetes is causing the dehydration and then the constipation and the stress of the constipation on his body raises the glucose so I’m just in a vicious cycle.
 
Hello and welcome. I've moved your post to Feline Health as it's more likely to get attention here than the busy Lantus forum if you don't have a spreadsheet set up yet where people can see it.

I have a few questions. But first, could you move all the data in your info to your signature? Information on what we like to see in the signature is in this post: New? How You Can Help Us Help You! If information in in your signature, we can see it immediately as part of your post.
Kayleegoose said:
Is there any chance it could be the insulin?
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Not likely. I have a possible theory. When cats get up to 6 units of insulin, we suggest that they get their kitty tested for a couple of secondary endocrine conditions, which can cause the need for higher doses of insulin. The first condition is called acromegaly, and is caused by a benign tumour of the pituitary which sends out excess growth hormone which causes the diabetes. One in four diabetic cats has this condition, some need higher doses of insulin. One of the common symptoms is megacolon. There are treatments for this condition. The second condition is called insulin auto antibodies (IAA) and it sort of like an allergic reaction to injected insulin. My girl had both conditions. There are blood tests for these condition, the blood is sent to Michigan State University for testing. Maybe suggest to the vet that you would like those tests done?

Good luck with the lactulose, I've seen some kitties respond favourably to it. Is Fluffy getting lots of liquids? Diabetes can be dehydrating as they pee so much and that can cause some constipation. Extra water added to their food or any other ways to get them to drink more can help. Lowering his dose may make dehydration worse as he pees more.
 
How fast did your vet raise his dose? To go up to 9 units after just a month of lantus makes me wonder if a good dose was missed. How much does he weigh and how much have you increased each time? What was his starting dose? How often were the increases?
 
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tiffmaxee said:
How fast did your vet raise his dose? To go up to 9 units after just a month of lantus makes me wonder if a good dose was missed. How much does he weigh and how much have you increased each time? What was his starting dose? How often were the increases?
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Sorry, I had the spreadsheet in the wrong spot. It’s in my signature now with most of this info. He was around 14 lbs after losing quite a few pounds when diagnosed. Back up to 15 today. Dosage and increases are in the spreadsheet. Have a feeling there were too many jumps..brought him back down to 2 tonight to try to start again
 
Wendy&Neko said:
Hello and welcome. I've moved your post to Feline Health as it's more likely to get attention here than the busy Lantus forum if you don't have a spreadsheet set up yet where people can see it.

I have a few questions. But first, could you move all the data in your info to your signature? Information on what we like to see in the signature is in this post: New? How You Can Help Us Help You! If information in in your signature, we can see it immediately as part of your post.

Not likely. I have a possible theory. When cats get up to 6 units of insulin, we suggest that they get their kitty tested for a couple of secondary endocrine conditions, which can cause the need for higher doses of insulin. The first condition is called acromegaly, and is caused by a benign tumour of the pituitary which sends out excess growth hormone which causes the diabetes. One in four diabetic cats has this condition, some need higher doses of insulin. One of the common symptoms is megacolon. There are treatments for this condition. The second condition is called insulin auto antibodies (IAA) and it sort of like an allergic reaction to injected insulin. My girl had both conditions. There are blood tests for these condition, the blood is sent to Michigan State University for testing. Maybe suggest to the vet that you would like those tests done?

Good luck with the lactulose, I've seen some kitties respond favourably to it. Is Fluffy getting lots of liquids? Diabetes can be dehydrating as they pee so much and that can cause some constipation. Extra water added to their food or any other ways to get them to drink more can help. Lowering his dose may make dehydration worse as he pees more.
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Thank you for your response. I have moved the details to my signature including the link to the spreadsheet I made. I will ask about testing for those tomorrow. Others have suggested the insulin was raised too high too fast, and I was reading that if they aren’t able to regulate after a few months then these conditions are considered. Did you know this early that your cat had these or did it take more time trying to regulate?
 
I would not go all the way back to 2 units. He was on that dose long enough to show it wasn’t enough. Looking at his spreadsheet maybe go back to 6 units after You want to his each dose at least 3 days (6 cycles ) when the bg is not budging much. See what Wendy thinks. @Wendy&Neko
 
tiffmaxee said:
I would not go all the way back to 2 units. He was on that dose long enough to show it wasn’t enough. Looking at his spreadsheet maybe go back to 6 units after You want to his each dose at least 3 days (6 cycles ) when the bg is not budging much. See what Wendy thinks. @Wendy&Neko
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That makes sense. I think I’m getting so much conflicting advice that my head is spinning. I made a post on Reddit and the person who suggested this forum said I should go all the way down to .25 a day. I’m really not sure what on earth to do or how to know what to do Here’s the post
 
Absolutely do not go back to .25 or even 2 units. When I was thinking he was increased too quickly I had not seen your spreadsheet. Have a look at our dosing methods. Since you are feeding all wet food I would follow TR. I’ll give you the link.
 
tiffmaxee said:
Here’s the link to our dosing methods. Since you are feeding all wet follow look at TR.

Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
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Ok, so I should go back to 5, keep for 3 days and adjust based on that? They prescribed the Royal canin gastro fiber response. I ordered the cans but they won’t be here for a couple days. They only had dry in stock. I’m really desperate to have him not get constipated again so gave him some of the dry food today. Does that change anything?
 
If you are going to feed dry food you will not follow TR. However, with bg so high you still might need to fast track him. Let’s get some more input on what to do from Wendy. And a few others. I believe the dry gastro is high carb.
 
Kayleegoose said:
I will ask about testing for those tomorrow. Others have suggested the insulin was raised too high too fast, and I was reading that if they aren’t able to regulate after a few months then these conditions are considered. Did you know this early that your cat had these or did it take more time trying to regulate?
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One thing to consider if that blood is drawn for the acromegaly test (called IGF-1) too early (before 73 days on insulin), there is a 1/3 chance of getting a false negative. We have seen that here in a cat, who was tested later and tested positive after the initial negative test. Today is only day 37 on insulin for Fluffy. You could do tests now, but there is a risk you might have to retest again later. Get a quote from the vet and that might help your decision. It's also just a good idea to have the vet think about the possibility and have that conversation. It took me a long time to get the vet to do the tests after I asked. As an aside, gaining weight in spite of not being near regulated is also a symptom.

My cat was started on Caninsulin, not a good insulin for cats. Unfortunately I reset back to 1 unit when I started Lantus, per the vet. It took a while before her dose got high enough to consider testing. She also didn't have many symptoms, just her incredible appetite (think growing teenage boys when their growth hormones are in play) and eventually her dose. The complicating factor was her IAA. She saw some number under 100 on about 3.5 units, which meant I held doses longer, but then the good numbers went away. That is an IAA characteristic.

I read that Reddit post, please ignore the comment to post on the FDSG FB group. They don't give very good suggestions. Are you home testing Fluffy for ketones? You should be, especially when you reduce the dose that much. There is a risk of DKA if there are ketones and you reduce the dose too much. I've seen that as a consequence of the FDSG group folk suggestions.

There is no reason to go back to 2 units, he wasn't doing well on it, and you were on it for 12 days - too long. Also long enough to know it was too low a dose. If a cat is on too high a dose, at some point you will see his numbers dive. I haven't seen that on 5 units, therefore it was also too low a dose. You could try the 6 units that Elise (@tiffmaxee ) suggested. Although we usually suggest holding doses for 3 days/6 cycles unless you see numbers under 200, in some case we can increase a little faster, but only if following the TR protocol for dosing. The dosing method that would be best to follow is Tight Regulation (TR), but it requires and all wet food or raw low carb diet. The other dosing method SLGS (start low go slow) does increases after a week and allows higher carb food. The gastro food is a complication, but I can understand how you need to get the megacolon under control.

After today, I think you'll be OK posting on the Lantus forum.
 
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