Advice on dosage

[beckyandwinston]

We've been diabetic for about 10 weeks now and finally seem to be getting more settled. My boy has gradually risen to 5 units of caninsulin twice a day as he is a big boy, although he did lose alot of weight to begin with but is gradually putting it back on now which is good. We went to the vets again this morning for a weekly check as he only went up to 5u last Friday as on 4u his glucose was at 8 after 5 hours but he was still peeing and drinking alot and hadn't put on any weight, so we went up to 5u. So today after 5 1/2 hours his glucose was 2.8. The vet didn't seem phased by it and said to keep him on 5u but am worried that that is a really low result and should decrease his insulin a bit or is the 2.8 about right as his levels should start to rise now? I obviously don't want him going too low now. Was worried he was too high and now that he's too low. Any advise would be great. confused_cat

 

[Sue and Oliver (GA)]

I'd suggest you do a lot of reading on this site to help you figure out this disease. There is a wealth of information here. It is the best step in learning how to help your cat.

First job, test at home. Cats are stressed at the vet with all the strange noises, smells and animals. Stress raises blood glucose levels so numbers there can be much higher than those at home. Doses based on those numbers can cause low numbers once the cat gets home and relaxes. We can teach you how to test over the internet; we have taught hundreds of people.

Second, diet. This website by a vet explains why wet low carb food is best: www.catinfo.org But DON'T change over until you are testing. Our Oliver went down 100 points overnight when we switched from dry to wet. If we hadn't been testing, we would have overdosed him. Very few cats here need 5 units of insulin. It is possible that a combination of dry food and rebound is causing his high and low numbers: http://petdiabetes.wikia.com/wiki/Somogyi_rebound

Once you get a number at home, then you can decide how much insulin he needs for that number.

Are you in Europe? If not, you have the opportunity to change to a different insulin that is milder and lasts longer. Canninsulin is fine for dogs but cats metabolize insulin differently. In cats, Canninsulin tends to hit faster and harder early in the cycle and not last as long. We prefer Lantus, Levemir or Prozinc.

Start reading and asking questions. We would love to help you help your cat.

 

[Julia & Bandit (GA)]

There are three very important steps to getting your cat regulated (and hopefully off insulin).

1. Switch to a low carb, canned diet. Do not feed any dry food at all, because dry foods are all too high in carbohydrates for diabetics. You need to feed something canned under 10% carbs. Here's a link to the non-US food charts: http://binkyspage.tripod.com/nonusfd.html. If you can't find anything suitable on that chart, post your general location and some members will be able to provide you with more food suggestions in your area. However, do not change the diet without drastically reducing the dose of insulin (down to 1u). Many cats see a huge drop in blood glucose levels once the diet is changed, and if you give the same amount of insulin it can cause a deadly hypoglycemic incident. Most cats on a low carb, canned diet do not need much more than 1u of insulin.

2. Switch to a better insulin. Caninsulin (porcine zinc) is not recommended for use with cats because it does not last long enough to be effective. This makes the insulin very dangerous for cats, because vets will overdose it to compensate for poor duration of action, as you're seeing with your vet. Here is some literature for you to print out and give to your vet, so that he/she will write you a script for a better insulin. See p. 218 (4) of the AAHA diabetes guidelines that discusses what types of insulin should or should not be used in cats: http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf. Also, here are two studies--the first compares the efficacy of Caninsulin to Lantus and PZI, and the second discusses the safety and effectiveness of Lantus (Levemir works the same as Lantus), and provides a safe dosing protocol for those insulins.





3. Home test with a human glucometer. You can get one at any drug store. It is the only safe and effective way to administer insulin to cats, and it's very easy to do once you learn how. Without home testing, you're just guessing at how much insulin your cat should get, because testing done at the vet is inaccurate because stress raises cats blood glucose levels, as well as too infrequent to adequately determine how a dose is working.