Advice on our cat's glucose levels

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syntax53

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Hello,

Read a lot of information on here over the past few days. Our cat (Zoe) was diagnosed with diabetes a few months ago when we noticed her going to the box an awful lot. At the time the doctor said her glucose levels were over 400. She prescribed ProZinc to us and after a glucose curve done at the doctors office, had us giving her 2 units of U40 ProZinc twice a day. Nearing the end of the bottle a couple months later we came to the hard decision of wondering if we can support Zoe financially as we were looking at $800+ a year in insulin and needle costs alone. That was when we heard from a friend that you could get insulin from Wal-Mart for $25 (ProZinc is $150 a bottle).

So we called our vet and the vet confirmed that we could switch but that we would have to do testing all over again to figure out how she would react to the new insulin. The vet told us to give her one unit of the Humulin N (U-100) twice a day. After reading a ton of information on here and here I decided just to buy our own meter since on this insulin I would feel safer doing regular checks ourselves as the Humulin N insulin is so much stronger than the PZI.

Now a little side note before I get into our testing results. I also read here under section "Q3.9. How long does a bottle of insulin last?" that insulin bottles start to lose their effectiveness between 30 days and 8 weeks. It doesn't say exactly for the PZI, but our bottle of PZI was over 3 months old (400 unit bottle and giving here 4 units per day = 100 days, and there was very very little left in the bottle.) So with that said, I'm not sure if what we had been giving her the past few days or weeks was as effective as it should have been? Anyone have any experience with that? Should we be more concerened about that with the Humulin N?

So anyway, onward with our results. We bought the Reli-On Ultima from Wal-Mart as I had read a couple posters on here said they had success with that one and it was pretty accurate.

The last shot we gave Zoe was @ 7AM Thursday December 8th.

We tested her at 8pm that night and she was only at 109! So right off that bat we were glad we bought a tester as I know that faq says not to give insulin when they are under 200. We wanted to test her again the next morning but as we were still learning how to get the blood out we weren't successful in the short time we have to get ready in the morning (we also have a 14-month old child). So we didn't give her a shot. That night we tested her again and @ 7:30pm she was only 169. So obviously no shot again. The next day was the weekend so we started monitoring her every couple hours and here are our results:

  • 12/08 @ 8:00pm - 109
    ------------------------
  • 12/09 @ 7:30pm - 169
    ------------------------
  • 12/10 @ 9:30am - 220
  • 12/10 @ 9:45am - Zoe ate 1/4 low carb friskies canned food (fish)
  • 12/10 @ 11:45am - 179
  • 12/10 @ 2:00pm - noticed Zoe eating some of her Purina DM dry food
  • 12/10 @ 2:30pm - 108
  • 12/10 @ 8:00pm - 193
    -------------------------
  • 12/11 @ 9:00am - 270
  • 12/11 @ 1:00pm - 188
  • 12/11 @ 7:15pm - 296
  • 12/11 @ 7:15pm - Zoe ate 1/4 of low carb friskis canned food (fish)
  • 12/11 @ 9:45pm - 255
    -------------------------
  • 12/12 @ 8:00am - 230

So to us it seems like she is fine by just being on a low-carb diet as she hasn't had any insulin in over 3 days now. I'd be afraid to give her any insulin when she consistently dips below 200 and she doesn't seem to go over 300 (yet, although very close once). So I called the vet today and ask the vets opinion and the clerk at the desk said that our meter could be inaccurate and we should bring her on to get tested with their machine and to go over our results. To me that speaks of, "we don't want to give you our opinion unless you pay us for it." It'd be $80 for the visit and I know stress ups the glucose levels so I'm not sure how accurate a visit there would be either. So I ask the experience folks here for their opinion? I almost want to stop the insulin and then just test her randomly every couple days and she where she is.

Thanks for reading.

-Matt
 
Hi Matt,

You've certainly done your research. The Humulin is a harsher insulin so I would also have concerns with giving that based on your numbers. But your numbers are heading back up and they are considered diabetic numbers.

I see the note about the Purina DM dry. If you really want to see if she can lower her numbers without insulin you should remove the dry immediately. Canned only, not the gravy kind but classic Fancy Feast pate varieties, Friskies pate or the higher end brands like Wellness, Merrick, or Evo.

I wouldn't wait too long, try the dry food removal immediately and check those numbers. If they start to come down below 200 pretty fast, keep going and wait and see if they dip below 150. But I wouldn't wait long, not even a week or so, just a few days. Getting her into healthier numbers with insulin will give you the best chance of getting her into remission if she's going to go in remission. Many cats can go into remission on diet change alone, but some need a bit of insulin to help.

Whether your ProZinc was good to the last drop, there's no way to know because you weren't hometesting. Many vets don't have clients do this, but now that you know how to you will be able to take care of Zoe much better.

Again, I would not wait too long without giving her insulin if she continues to go up, unregulated diabetes can be dangerous and she won't be getting the proper nutrition she needs. She would be literally starving to death in addition to organ damage from higher blood sugar.

I know cost is a concern, but many of buy insulin cheaper through other avenues than the vet. Local pharmacy for one, I have a discount card for family there, some can use AAA for discounts. I have recently started buying my insulin from Canada. I purchased Lantus that way. Lantus is a very good insulin and one I would suggest you look into rather than the Humulin. While it costs more initially, it is gentler than the Humulin and it would give you a great shot at remission, Humulin won't offer that because it metabolizes too quickly. Cat's metabolize insulin much faster than humans. My own boy zipped through his Humulin, it wore off by about 4 hours and with shots just twice a day he felt bad much of the day and nothing was able to heal during that time.

I'm not a vet, this is just my own personal experience.
 
Another note on Humulin N - it lasts about 6-8 hours in the cat, leaving 4-6 hours without insulin, unless you are giving it every 8 hours. and giving it more frequently ups your costs.

While the sticker shock on Lantus and ProZinc seems high, do some math to figure out approximately how many doses are being purchased and what the daily cost may be.

Lantus 3 mL pen - 300 units of insulin in the pen, @ 2 units, twice a day, 75 days of doses in that pen, so divide the pen cost by 75 to get the cost per day. Many cats use less than 1 unit, which would make it 150 days of doses.

ProZinc 10 mL vial - 400 units of insulin in the vial, @ 2 units, twice a day, 100 days of doses in that pen, so divide the vial cost by 100 to get the cost per day. At 1 unit twice a day, 200 days of doses.

Also factor in the convenience of dosing only twice a day, vs Humulin N which may require 3 times a day in order to have good control over the blood glucose. And factor in the cost of not regulating the glucose ... the cat could become very ill requiring costly hospitalization (or euthanasia because of cost) or could die.
 
What I'm confused about though is why is Zoe consistently dropping her own levels by significant amounts without giving her insulin? Is she on her way to remission?

We took her dry food away earlier today and will see how she does on canned food only. When we tested her tonight she was 280 so we gave her her first shot in 4 days of 1 unit of the Humulin.
 
Hi there, welcome to FDMB! I haven't been here very long myself, but I believe if your cat's numbers are dropping after feeding (and you haven't given any insulin) then kitty's pancreas is putting out some insulin. It is possible that a change in diet will be all she needs, you should know within a few days. Have you checked her BG after you gave the Humulin tonight?
 
We didn't get a chance to test her last night as it was already 9:00 at night and my wife goes to bed early. We tested her this morning though. I fed her half a can at 6:30am, she ate maybe half of that, and then we tested her at 7am and she was only @ 179. We'll check her again tonight.
 
The diet change might be all you need. If you give Humulin N again, maybe just give 1/2 unit instead of a full 1 unit. From my experience with it, the numbers can drop sometimes faster than you expect and we don't want her to get too low. Just in case, do you know about hypoglycemia, did your vet mention it?

Here's a link explaining it and how to handle: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=1122

If you don't give insulin and after a few days the numbers go low, let's say into the 50s, don't worry, but if she gets insulin the same day her numbers get low then you'd want to be concerned.

I'm not trying to scare you, so please don't worry, just be prepared because you have a kitty with nice numbers already so it's good to be prepared.
 
Yes we know all about hypoglycemia, that's why I bought the tester as I wanted to be safe. Is there any documentation about how much the level should drop based on how many units are given? I know there are so many factors involved such as diet, weight, type of insulin and just the cat itself, but I was curious if there was any general guideline.

The FAQ said if the cat is below 200 then don't give a shot. I came across this page last night where it mentions that we should be aiming to be around 100-180 and anything above that the cat will start to show signs of being diabetic. At the same time though it says 300 is the maximum safe value for cats and further more it says, "Cats are quite resilient to high blood glucose compared to dogs, and some cats lead reasonably normal lives at levels between 200 and 350 all day long. Neuropathy and other long-term effects can still build up over time, though."

With Zoe's numbers being as low as 108 and as high as 296 and fluctuating everywhere in between without any insulin, we're finding it hard to get her on any sort of schedule. Hopefully with the new diet it will level out. Fingers crossed.
 
I don't think anyone can tell you what your kitty is going to do with insulin. Getting the meter was the best thing you could do, not only to avoid hypos but to collect data and see how her body handles insulin. The humulin is not widely used, but we do have a document written by a well respected member who used it for years with her kitty. http://felinediabetes.com/FDMB/viewtopic.php?f=19&t=303

Ignore the L and U insulins mentioned, those were both Humulin insulins that I believe were discontinued a while back, I remember hearing about them in 2006, but they weren't available. These days when we talk about L insulins we mean Lantus or Levemir which are both wonderful for kitties and if you need to give insulin in the future I'd ask you to read about that.

But for now, with the Humulin I probably would not shoot under 200. Unlike the two L insulins I mentioned, the Humulin does not need consistency or a build up in the system. You are correct, you want to keep your kitty in lower numbers per the FAQ above 100 your cat will start showing some signs, but watch the numbers today and tomorrow, with the dry gone she may do some nice things.
 
Here is our progress. As I mentioned earlier, back on the 12th @ 9pm Zoe was at 280 and we had given her 1 unit of the Humulin N. That was her first shot in almost 5 days. Since then here are our readings:

12/13 @ 7:00am - 172
12/13 @ 7:00pm - 159
12/14 @ 8:30am - 149
12/14 @ 7:45pm - 148

... So she definitely seems to be regulated without any insulin strictly on the canned food. We give her friskies pate style and she only likes the fish kind it seems. Only problem is she has lived her whole life having food out all the time so she only eats a little at a time. So while we put half a can out, she'll only eat a small portion of it and then it dries up a couple hours later and she prancing around meowing for food.
 
bookw0rm said:
Try putting out smaller portions more often (or adding water so it doesn't dry out so fast).
Click to expand...


I agree, add water, it keeps it softer longer.

Glad to see things are going well. My own dry food addict started out eating just fish flavors, we mixed some chicken canned with his fish and slowly he started to eat chicken by itself and beef, but he did always prefer the fish.
 
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