? 11/12 Hampton, Lantus, 80s

StephL

StephL

Member Since 2020
Hello,
We are new here, Hampton was diagnosed in August as diabetic. He started on a pill to manage his diabetes to start off while we moved states, he did ok on this, some improvement in his health but he then got very sick from the stress of the move/improper diabetes control. Once we arrived he was switched to Lantus in September, he was doing really well but our human glucometer malfunctioned and was reporting much lower numbers than he really was so we stopped his insulin for 2 days which resulted in BG of 470 (uneducated humans :( ....) He went into Ketoacidosis and recovered from that with SubQ fluids, insulin therapy and appetite stimulant around 6 days he was doing much better. After this episode he was receiving Lantus - 1u at night and 1u in morning but this was bringing him very low (30s) so the vet suggested going to 1u in mornings only. At this point I started to read these forums. Since then we have been slowly reducing his insulin and he is now at .25u in mornings but has not received any insulin in two days due to his BG being from 60-80 in the mornings (night time he is sitting 70-90). We are not always home to monitor for hypoglycemia and it scares us for him to drop too low. Hampton the last 2 weeks has been more active, playful, happy, purry, snuggly and just plain joyful than we have seen him in MONTHS! he also eats like a horse now and barely drinks (Which the vet said is good beacuse he is getting most fluids from his wet food and it means his diabetes is in check)
We now use VetMate Glucometer because the human one betrayed us. The VetMate read 40 points lower than the Alphatrac that the vet has. (Which was similar to how our human meter was reading too) So with that being said, we tend to assume he is actually higher than what his glucometer reads. Without an exact science we assume if he reads 60 he really is more like 100.
My questions....
We are terrified for him to go DKA again... are we doing the wrong thing by not giving him his .25 in mornings when he is reading 60-80? If so at what BG numbers do we not administer Lantus? He's acting like he feels so great but we dont want to mess it up.
Is it possible for a cat who has always been slender to go into remission?
Our vet thinks he will never go into remission because he went DKA... Why might she think that?
By Fluctuating insulin doses from .25 to .50 to .25 to none, does that do more harm than good since its not consistency or is it better to tailor shots every morning to BG levels? (we were doing this when his numbers were getting super low but again we just want to know what's best)
Thanks for the help!
Sorry if my lingo isn't right, we are new to this!
Steph
 
Hi and welcome Hampton and Steph to FDMB. we are very glad you have found us.

Are you testing for ketones in the urine?
After DKA it is really important that you test for ketones every day in the urine as that is the way you will be able to tell if you have the food/ insulin balance right and are keeping the ketones at bay. If you haven’t been doing it, please go out today and buy a bottle of Ketostix from Walmart or a pharmacy, collect a urine sample from Hampton and dip the test strip into the urine. Compare the result of the strip against the colours on the side of the bottle exactly 15 seconds later...please let us know the result.

Also if you could set up a spreadsheet and enter all the data from the last few weeks, that would help us determine how things are going and if you need to continue with insulin or maybe reduce the dose. Here is the link to the SS. If you have any trouble setting it up, @Bandit's Mom will help you.
https://www.felinediabetes.com/FDMB/forums/spreadsheets-tech-support-testing-area.6/

Lantus is a twice a day insulin not a once a day insulin. Cats have a faster metabolism than humans.
So if only giving it once a day you are leaving him with no insulin for the other 12 hours.

Your vet is not correct saying that DKA kitties can’t go into remission......they can just like any other diabetic cat....
But you need to be very careful not to stop the insulin too soon or you may put them back into DKA. We can help you with that.

I don’t know the vetmate meter you mention or how the BG numbers compare to the human or the alphatrak meter.
Would you be willing to get a human ReliOn meter from Walmart? They are very cheap and reliable and it would be far safer to be using a meter that we know and would take the guessing out of it all when it is really important we can trust the BG numbers.

How is his appetite?. After DKA which is caused by not enough insulin, not enough food and an infection or inflammation in the body..........food and insulin are really important. He needs to be eating up to 1 and 1/2 times as much food as normal. And we need to keep the insulin going if possible especially if there are any ketones present.
We need to find a dose that you can safely give twice a day.

Here is another link for you
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Can you tell us when he had the DKA and how long since he came out of hospital, thanks?

Bron
 
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Hi Bron,
Thanks for the response and the "welcome to the group". I will get that spread sheet with data on it for sure!
We are able to pick up the meter from Walmart and can get Ketone test strips. We have not done this, although he has been in the clear from the vet from ketones almost 4 weeks ago 10/19. Although I see from the sticky posts you should test for Ketones often? how often should we test?
Well he was on twice a day but we were up with him doing curves and at night when he wasnt eating his BG was staying low (50-60).
His appetite is great, he is eating 3oz can for breakfast, 1oz pouch for snack, 3oz can for lunch, 1oz pouch for snack and 3oz can for dinner.
I will update with a spreadsheet by tomorrow.
Thank you!
 
What a gorgeous boy Hampton is!
When a cat is post DKA it is recommended you test for ketones every day in the beginning, sometimes twice a day, depending if there are any ketones present. Then the tests can be every second day for a while as long as no ketones present then gradually reducing the time as things improve.
Some cats are more prone to ketones than others. Now that Hampton has had ketones you will need to be aware and if he seems unwell, not eating or his BG is high, always test the urine for ketones as if caught early they can be managed.
Once everything has settled down and we know there are no ketones and haven’t been for while you could go to twice then once a week testing of the urine. It is a very quick test but so important and can save lives and your bank account!!
Cats post DKA can have a negative ketone test then a positive test if the insulin isn’t enough or the cat isn’t eating enough food.
Food is like a medicine for cats with ketones and post DKA.

It sounds as if he is eating well which is a very good sign.
I’ll look forward to seeing the SS tomorrow:)

keep asking lots of questions, we are very happy to help and this is a very supportive community.
Bron
 
I don’t know the vetmate glucometer either but I’d bet my life savings it doesn’t read consistently 40 points lower than the vet’s meter. Some people here use an alphatrack meter while most use a human one. The alphatrack reads consistently higher but the difference in the readings is much greater in higher numbers than it is in lower numbers. I have a suspicion that your human meter might have been fine with the problem being your vet was treating the human numbers as if they were readings from their meter and hence thinking young Hampton’s BG was significantly lower than it was. I say this because when Vyktor was first diagnosed the vet didn’t want to treat him at all because he didn’t think the numbers were too high - I think also because he thought Vyktor would be too difficult to treat, he always hated vets and let them know. I wasn’t satisfied with that and started home testing with a human meter and reporting his BG numbers. The vet continued to say they weren’t high enough to treat. Vyktor ended up in spending several days teetering between life and death with DKA - at a different vet! I blamed the meter for a long time but looking back I’m not sure it wasn’t just because the vet didn’t understand how to interpret the human BG readings. Fortunately we found this board and by following TR with the support of the people here and ignoring the vet’s diabetes advice, four months later Vyktor was in remission. There is certainly hope for Hampton :cat:
 
Hello,
Sorry for the radio silence! I have joined a Facebook Group and was receiving info on there as well because its easier for me to communicate through the app. My Brother has a career in the medical industry and we have been doing some research on our own for Hampton too. He has been hovering in the 60-80 BG range for about 11 days with no insulin at all. His personality is the best it has been in over a year, he is eating like normal and then some, he purrs, he cuddles, he plays hard 2 times a day consistently, the positives are endless! We are for sure crossing our fingers still because we really dont know what could be going on. But going back to my brothers research, he has found some vet journals on certain steroids causing diabetes in cats. Hampton received two steroid shots, one about 2 years ago and another around May 2020, exactly at this time he started drinking like crazy and peeing all the time. I should say that he began looking sick shortly after his first shot, but nothing too alarming. After the 2nd shot he really took a turn. The vet said his urination was caused by the steroid and should wear off, however it never did. He was then Diagnosed with Diabetes a few months later in August 2020 when he was very very sick. These articles about steroids in relation to diabetes state that remission in common when put on Insulin Therapy. Hampton was put on Insulin Therapy during his DKA and 6 days after his numbers began dropping from 470BG and he just kept dropping and dropping until giving him his shots was causing Hypo.
Now here we are, day 11 of of consistent 60-80BG numbers morning, mid-day and night with a very lively cat...
Opinions are welcome.... Anyone else heard of this happening??
We are going to keep doing what we are doing with him and testing multiple times a day to catch him if he spikes at all but fingers crossed we just keep moving how we are moving.
 
Fanatastic news :joyful: we consider a cat to be in remission after 14 days of no insulin and normal numbers so Hampton is almost there and unlikely not to make it at this point. Yes this does happen and I’m really happy that it’s happened for Hampton. Of course you will have to think carefully before letting a vet give him steroids again and only if it’s absolutely essential, also make sure any new vets know his history. :joyful::D:joyful::D:joyful:
 
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