12/4 Boo Kitty AMPS: 410; +4:589

Adam Roberts

Adam Roberts

Member Since 2020
Hi folks, I know it's been a few weeks since I posted about Boo Kitty. Wanted to ask advice in light of BGC completed yesterday 12/3, and today's exceptional lethargy and low appetite.

Yesterday's curve results were a bit worse than last time, 11/19. He's normally got a ravenous appetite. Today has been the total opposite; eaten all his food but not begging. What worries me is that he's been sleeping all day and just feels so skinny (I can feel his ribs) despite a big belly. Overall, his weight hasn't fluctuated more than +/- 2 pounds since this all began in early October.

I just got this response from his vet (internal med specialist). Any thoughts? He's been on 4U for almost a month now; should we be trying to up his insulin further rather than switching to this other one?

Vet: "Good Afternoon- looking at the results you sent me it is bothersome that his BG is still so high. As mentioned the other day, we could try changing his insulin to a more potent longer acting insulin called detrimir/levemir and or we may want to consider looking into growth hormone excess as a cause for insulin resistance. This involves submitted a blood test for insulin like growth factor. Just let us know. Also if he is not feeling well, he may need to be seen through ER"

Previous thread: https://www.felinediabetes.com/FDMB/threads/11-23-boo-kitty-amps-452-vomiting.239020/
 
Forgot to mention -- while he's never been KDA, out of caution I'm going to try and test him to (hopefully) rule that out. Other than lethargy, he doesn't seem to have any of the other symptoms. Going to pick up these Ketostix now.
 
Here is the link to your last post here, for continuity: https://felinediabetes.com/FDMB/threads/11-23-boo-kitty-amps-452-vomiting.239020/

We wouldn't hold a dose for 4 weeks with those sorts of numbers, at most a week of following SLGS. I think you are more than due for an increase to 4.25 units. And good plan to get those ketostix. You should be testing daily if in high numbers. Not eating and lethargy are not good signs, so making sure he's not ketonic is absolutely the right thing to do.

By the way, I really like your vet. :) Many people find that Levemir does give a bit better duration, hence flatter numbers in cats. Most vets aren't familiar with it at all, so kudos to him/her on suggesting it. The suggestion to test for acromegaly (the IGF-1 or insulin growth factor test) is also something more knowledgeable vets are starting to do for hard to regulate cats. One in four diabetic cats has this condition., which is caused by a benign pituitary tumour that sends out excess growth hormone. My Neko was one of them. At the same time, we usually get people to test for IAA (insulin auto antibodies). It's another endocrine condition that causes insulin resistance (my girl had that too :(). The blood for the test goes the same place as the IGF-1 and is a low cost add on.

The one thing I don't like about your vet is the suggestion for DM dry food. It's way too high in carbs for a diabetic. A low carb wet or raw food diet is much better and would reduce his insulin needs. You are also fine to do multiple small meals per day, preferably all in the first half of the cycle before nadir. I found that helped curb the appetite.

Speaking of which, those high numbers might be causing him some discomfort. I'd really like to see you try to get a test in the PM before bed each and every night. Many/most cats go lower at night, and those lows are what tell us where to go with the dose. It looks like he's bouncing regularly, but we haven't seen the lows so don't know why.
 
The one thing I don't like about your vet is the suggestion for DM dry food. It's way too high in carbs for a diabetic. A low carb wet or raw food diet is much better and would reduce his insulin needs. You are also fine to do multiple small meals per day, preferably all in the first half of the cycle before nadir. I found that helped curb the appetite.
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Same! I was really surprised by this. I saw it had almost 20% carbs and stopped it after noticing his BG went even higher for the ~3 days I used it. We are back to more frequent small meals and I think we are hitting a stride on that front.

We hit a 287 AMPS this morning, 12/5, so I'm hoping we stay headed that direction!
 
It would have been so good to get a test last night before you went to bed to see if that 287 is on the way up from something lower. Did you get a PMPS or shoot last night? The spreadsheet is empty for last night.
 
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