Advice and help

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Hi Brian,

There seem to be several possibilities here, including rebound and a high dose cat and the problems with Vetsulin. As mentioned, hometesting will give you some answers. Here is a website with good beginning info: http://www.sugarcats.net/sites/harry/bgtest.htm and a video that shows you how we test on their ears: http://www.youtube.com/watch?v=_zE12-4fVn8 We consider ear testing very effective. I don't think you have said how much your vet started him on and how fast it was increased. It could be that he is on too much insulin but we can't know without home tests.

You can buy any meter -sometimes they are free. It is the strips that are expensive, although after the initial expense, you can get them for half price on ebay. Lots of people here use the ReliOn from Walmart since it is inexpensive and so are the strips.

Keep asking questions. We will try our best to help.
 
He suggested that I start out with NPH, which he did for 3 weeks, going all the way up to 20 units and my cats numbers still hovered around 300-400. The vet said he didn't like being at those high of numbers, so he waited a week and started on Vetsulin. He informed me about the drug being taken off the market, but said he could still get some because my cat was considered hard to regulate. So for the past 9 days the cat is on Vetsulin. The vet did 2 units a day increases and his numbers would end up falling to the low 300's, but would shoot right back up to around 700 by the next day.
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I agree with the others -- the dose was raised much too fast and much too high. Based on this short track record and harsh insulins, I don't see any real basis to expect that this cat has acromegaly or is insulin antibody resistant. I base this on experience with my adopted Cole, who is a triple winner with diabetes, acro and IAA. I also have a 'normal' diabetic, Danny. I didn't hear you say anything about the vet saying that your cat has the physical hallmarks of an acro cat, and you did say that your cat has lost a lot of weight. I'm assuming that the bloodwork didn't show anything else like thyroid issues.

I see that you have learned how to hometest the BG - congrats. That's really a key step. It is essential to moving forward. One thing I want to point out is that hypo (low blood sugar) can damage or kill your cat very quickly. Hyperglycemia is also very dangerous since it can lead to ketones, but you have more time and you can use tools to test the BG and to test for ketones.

Therefore, if this was was my cat, I would:

1) immediately drop the dose to 1u and start over. This would be coupled with BG testing before every shot and several checks during the night (since I work.)

2) I would also be absolutely vigilant about testing the cat's urine for ketones, using ketostix. On second thought, forget the ketostix. For a new diabetic cat, I personally would buy a second glucometer that also tests for ketones. I would test the cat for ketones at least twice a day during the criticial initial period where I would be trying to find the ballpark insulin dose. Yes, the strips are more expensive but I would be using a regular meter for the routine BG testing. (I like the excellent but cheap Walmart Relion Micro.)

3) get the cat onto a longer acting insulin like lantus or levemir

4) post my test results here at least daily and keep asking for advice.

5) get the cat off dry food if at all possible, and onto low carb wet -- but only once the insulin dose has been significantly lowered and regular BG testing is in place. The high carb dry food may be the only thing saving the cat now from deadly hypo.

Comments on this advice, anyone?

laur
PS - I love tiger kitties! I have several myself. :cool:
 
Just wanted to note that even if a cat has acromegaly, it does not necessarily mean that the cat will be a high dose cat. Some acro cats are well regulated on low doses. Their needs can vary over time, too. My own IAA+ acrocat Cole is currently regulated better than ever on 1.25u of Levemir.

I think that regardless of whether a cat has acro, IAA, has some other condition that requires steroids, etc.... one still has to initially work up to the ballpark dose by a thoughtful, methodical process during which the BG data is tracked and carefully analyzed (we can help with that!), and ketone testing is regularly done.

best wishes,
laur
 
Laur,
I won't comment on the dosing, I know nothing about Vetsulin.

The only comment I do have is to add ProZinc as another option for insulin. It is another excellent choice. :mrgreen:
 
Based on what everyone has said, I would love to go with Lemevir, but at this time, financially, I am stuck with the vetsulin. It could be 4-6 weeks before I am able to switch. As for the ketone stix, I am really unsure how to go about getting the urine. I have 4 cats and they all share 3 boxes. Yes, I could probably separate the 1 in another room, but how to get the sample out of the litter box and wouldn't the little contaminate the sample?
 
Brian,

If you can separate the cat in its own room with a cat box, that would be great. If you can't get a fresh liquid sample (this was always hard for me, especially with Danny), you can test your litter to determine if testing a pee clump gives accurate results. Basically take some litter, put a bit of water in it, then dip the stix in it. If the color doesn't change, then it's ok. You can then stick the ketostix in the fresh pee clump (dampen with water as needed) to test it.

Giving the cat wet food with extra water mixed in (or offering the cat some tuna water, or chicken broth) will ensure your cat is well hydrated and peeing frequently.

laur
 
Oh, I should also add that cats are likely creatures of habit ... my 3 are VERY predictable as to where they do what.
My civvie Booboo will urinate at the back right corner, the clump is the size of a plum.
My Shadoe likes the middle of that same LB and her clumps are the size of a flattened large orange.
My Oliver deposits a lake at the front of either LB; I could float a toy sailboat in his deposits!

They never change; always the same spots and amounts, so I know whose is whose.

Stalking works. Even if just to slink close to see when he's going in which LB then after he comes out, look to see what he has done and where.

The ketostix can be purchased at the pharmacy, and just lay one on the urine if you can't catch him.

Good luck on the dose decrease tonite.
 
Brian and Tiger said:
Could use opinions on the above topic please.
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Hi Brian;

If Tiger were MY kitty I would do the following - just as fast as I could move:

1) get a human glucometer and start home testing - immediately - at the MINIMUM test pre-shot and nadir.
2) get a bottle of ketostix and test at least DAILY for ketones
3) lower the insulin dose to 1 unit BID to start, (with Lantus insulin as my insulin of choice).
4) Change Tiger to all low carb canned foods - immediately. Fancy Feast 'classic' flavors, Friskies 'pate' style, etc.
5) post his BGL readings daily on the Lantus sub-forum for dosing advice.

Your kitty is on very high dose of a harsh, fast acting insulin right now and it is not helping him at all.
It is past time to try something different, and hopefully, to see better results in short order.

~M
 
@ Mary --- please read PAGE 2 of the topic.

Brian is home testing and feeding low carb canned food. He has also started over at 1u BID.

Laur is sending Brian a Levemir pen and some Fortiflora to help with the diet change (soft stools)
 
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