2/2/2020 Tiggo's treatment and second thoughts

[Sarah97]

some of you might remember me and my sugarcat tiggo. He's two and was diagnosed two weeks ago with high BG and high ketones. He was hospitalized for a week and got out yesterday. The vet said i should give him Mixtard 30 , SID 2 units. The shot should be given at 8 am and he should be fed at 8:30. Today i tried to test him before his shot but no blood came out from his ears. He's still being fed RC sensible dry food because the RC diabetic dry food is out of stock atm and needs a week to arrive.
He told me that he needs to eat at 8:30 after his insulin shot and at later on at 5-6. I should divide the recommended kibble intake according to the bag which mean 25g in the morning and 25g at night.
He's waking me up because of his hunger and he keeps begging for food so i give boiled chicken breast shreds in between meals.
According to the curves the vet did; his BG drops between 12-2 pm which is the time i am not home. I work 8:30-6pm MON-SAT.
I'm extremely scared of giving him the insulin shot and my anxiety skyrockets, i start to shake. What should i do? his vet is extremely expensive i paid 1000$ for one week. which is much more than what i earn in a month.
my life is unstable right now and i dont want to him to suffer with me. I'm having second thoughts about returning him to his foster house. He's only been with me for 3 weeks and i didn't know he's diabetic when i got him. My previous cat died in october and im still not over it, i dont want to lose another pet.
please tell me what should i do..

 

[Larry and Kitties]

Can you provide the curves done at the vet?
Mixtard (30% regular (R) insulin and 70% N/NPH (isophane insulin) insulin). R insulin is very fast action and n?NP{H is a little slower but only last about 8 hours. Thus, SID (once per day dosing of Mixtard 30) essentially leaves that cat with no insulin for 18 hours.
Just N/NPH (isophane insulin) insulin) dosed twice daily would be better but but better yest would be to dose three times daily especially with history of ketones.
Is Lantus or Levemir available where you are since one of those would be best.

 

[Sienne and Gabby (GA)]

Please talk to your vet. I recently had a conversation with a vet and did some quick research on Mixtard. The vet I spoke with did not think that Mixtard is good for use at home. In fact, she thought it was risky. It is fine in a veterinary hospital where your cat is being monitored 24/7. We do not even begin to suggest a fast acting insulin like R unless you have someone experienced with it's. use to mentor you. I could find no research relevant to the use of Mixtard in cats -- and I have access to a medical/veterinary library system. Mixtard isn't typically used in the US -- so I'm assuming you're outside of the US. It's similar to Lispro which is available here and most of the vet's apprehension was based on the use of Lispro.

The current recommendations for insulin by the American Animal Hospital Association are either Lantus or Prozinc. (Levemir is very similar in its action to Lantus.) It's likely that Prozinc may be a better choice for an immediately post-DKA kitty since it takes about a week for Lantus to build up in your cat's system. Vetsulin/Caninsulin would be a better choice than Humulin N/Novolin given that the latter has a faster action which could be challenging for your schedule. Neither Vetsulin/Caninsulin or either of the "N" insulins are ideal for cats.

I would also feed your cat! Chances are that your kitty's blood glucose levels are high from the dry food. The RC is over 35% (approx) carbohydrate. It's also what is likely keeping your kitty safe from dropping into low numbers from the Mixtard. I echo your concern about the insulin your vet prescribed. When a cat's numbers are high, they are always hungry. With managing ketones, food/calories are essential. It's also important that your cat is eating at shot time.