Can a cat be insulin resistant?

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TammieCA

TammieCA

Member Since 2011
Hi everyone.

Please bear with me for a few minutes as I try to articulate my thoughts, confusion and concern. I'm so worried about my boy, Caspian, and I am really at a loss at what to do for him.

Caspian was dx at the very end of May. He was immediately started on Pro-Zinc. He was on the Pro Zinc until mid October because we weren't seeing any real results. His BG continued to be high. He was on 2 units of Prozinc 2x a day. Also during this time, he lost a significant amount of weight and was down to 15.5 pounds. Caspian used to be a very healthy, very muscular and tall 22 pound Savannah cat. Savannah's are somewhat known to be bigger cats. At no point did we ever think Caspian was overweight, nor did our vet who owns Savannah cats herself. His weight was never an issue. So, to see this beautiful boy go from pure muscle, to nothing really...has been heartbreaking in itself.

During the visit where we noticed the weight loss, it was decided to switch his insulin to Lantus. I've heard good stuff about Lantus and was very hopeful this might be the one to help our boy. He's been on it for just over a month now and it currently on 3 units in the morning and 2 units at night. His numbers are STILL high. He just got the three unit increase 10 days ago after he had his last curve done at the vet. The only good thing that came out of that appointment was that he gained weight and was up to 17 pounds. Small victory.

I tested him this AM before his shot at he was at 378. I practically cry every single time I see his numbers. Just once I would like to see something below 300. I cannot test Caspian every day. He absolutely won't allow it. I test him when I can and do the best that I can. Sometimes, he can be really good for me but I'm just flat unable to get a decent drop of blood. After three tries, I give him kisses and let him go.

He's had these high numbers since diagnosis and all I can think about is what's going on internally. I know he has bad days. Yesterday, I could tell he just didn't feel well. Nothing like the symptoms of DKA, but just not right. He's still eating, drinking, not lethargic, likes attention, etc. His back legs have really taken a toll from his loss of muscle and he walks a little wobbly now. He doesn't walk on the bottom of his back legs. He just moves slower and, again, I can tell he just doesn't feel good. During all of the urine samples at the vet, he's never had ketones in his urine.

Probably the hardest thing with Caspian is that he is a very picky eater. He won't eat wet food and I fear that might be a huge problem. The only thing he will eat is EVO dry. He gets baby food as a supplement, which he likes, but most recently has even been turning his nose up at that. He used to like Fussie Cat now and again, but now he doesn't want that either. Obviously, my boy has to eat. I've tried practically every wet food from the pet store and beyond and he absolutely WILL NOT touch it. He will not eat raw, either. I'm not kidding when I say I really think I've tried everything.

He's just not getting better. And it's killing me. I lost a cat to diabetes almost six years ago and Caspian's diagnosis has been extremely difficult for me to handle. I feel like the worst mom in the world right now because all I want to do is help him and nothing that I do is working.

I'm posting here because I'm out of ideas and I honestly don't know what to do. I don't have a spreadsheet and I'm unable to home test all of the time like so many of you do. Please, please don't judge me for that. I am doing the best I can and I am trying so hard. I cry myself to sleep because I feel like I'm failing my boy. I can't lose him and he so needs to get better or at least show some improvement. Could it really be the dry food that's not causing his numbers to go down? Is it possible he may just not be accepting the insulin? My vet is even a bit curious after his last curve, saying (obviously) she wishes his numbers would have been lower. I think he only got down to 209 the day of the curve. So, yes, something isn't working. I just don't know what it is.....

Any advice or ideas? Any secret wet food a totally anti-wet food cat might like that I haven't tried? And, just to note, I also tried Young Again but he wouldn't touch that either.

I'm watching him now at the water bowl. My heart is breaking.

Thanks in advance for reading this. I really, really appreciate your time.

Tammie and Caspian
 
Do you have any BG numbers to share with us?

Most of us here test or cats blood glucose at home using a human meter. We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

Here is a link to home testing blood sugarshttp://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

There is one condition, acromegaly that requires a high insulin does. There is a blood test that tends to indicate that condition. There is also a blood test that test for insulin resistance. There are discussed here:
http://www.felinediabetes.com/FDMB/...-other-high-dose-conditions-what-we-know.375/

My MurrFee has acromegaly and is on 24 units Levemir and 20 units N twice daily
 
Hi Tammie. Please stop beating yourself up over this. You are anything but a bad Mom. You are a great Mom doing everything you can and working on getting Caspian to better numbers. I know how difficult all this is because I have a kibble addicted girl who refuses to acknowledge that anything that does not crunch is food. I have tried EVERYTHING and save for a few tiny licked pieces of a peanut butter sandwich one day, she is proving to be one tough nut to crack. I can no longer get the EVO dry here and I'm not sure I can get the Young Again across the border or if she will eat it if I can, so right now my girl is on a pretty high carb kibble (20% is the lowest I've found that she will eat). I have concluded that this is just something some of us have to contend with in our efforts to regulate our cats. I feel your pain but as we both know, our cats have to eat so all you can do is keep offering soft food when Caspian is hungry and hope one day he will decide it's worth a try!

Acromegaly usually isn't considered until a cat requires higher doses of insulin than you are giving right now. My girl is up to 9.5u of Levemir and her numbers still aren't budging much. I had tests done once she got over 6u twice daily and she came back positive for insulin autoantibodies. She also has some dental issues which we are going to deal with and I am hoping that will improve her numbers. Have you had Caspian's teeth checked lately as that can have an effect on their numbers?

Caspian is a big cat and may need a little higher doses of insulin than a domestic. I'm curious as to why the dose at night is lower than the dose in the morning? Lantus is usually given at the same dose every 12 hours. Was there a reason for lowering the night dose?
 
Hi Tammie. You are doing everything you can so please do not feel bad about it. I had a couple dry food addicts in my group of cats. It took several months to convert the last of them, but what worked for me was to start adding a tiny bit of either the gravy or food from the can to the dry food. Gradually I would increase it over several weeks to where I could add a tablespoon of food mixed with the dry. As they began to eat that, then again slowly I would increase the canned and reduced the dry. Finally, I was able to give them all canned food with a few pieces of dry on top. Evo is a good food, but it still can cause higher BG readings. But Caspian does have to eat. Is he the only cat? If not, are all of them eating the same food or could he be sneaking food from the other cats?

Since he is a bigger cat and also on dry, you may want to try increasing the evening dose by 1/4 unit. Keep it at that dose for at least a week before increasing again. If another one is needed, then only go up by another 1/4 unit. The goal is to find the optimal dose. The reason you wait at least a week before dose changes is to give his body time to adjust to it. Lantus is an insulin that you want to use a consistent dose. You said he has only been on it a month. What was his starting dose? It may be that he also started too high and you missed the optimal dose. That also can cause higher readings.

Caspian is a beautiful cat. I love that picture of him.
 
Hi Tammie,
I'm pretty new at this myself, so I won't give you any advice health-wise, but I just wanted to chime in with some support and e-hugs. You wouldn't be here posting if you were a bad cat mom, so please just try and resist those negative feelings. You're already doing plenty more than most, and I'm sure your boy knows how much you love him and are trying to help. You'll find excellent advice here, so just keep posting and reading, and I'm sure that before long you'll find a way to bring Caspian's numbers down. What WorfMen's Mom said seems to make a lot of sense - he's a big cat, so may need a higher dose. It sounds like you have a supportive vet , which is important. What kind of meter and lancets are you using? I can say that I sometimes try to switch to using the shallower depth on the lancing device for Jones, because it seems gentler, but after several cycles of having to poke him more than once to get enough blood, I go back to the deeper, and honestly he doesn't notice a difference. So if you're using more than a 26-28 gauge lancet and trying not to poke him too deep to make the process easier on him, you may be better off being more aggressive so you can get it quickly the first time.
I really hope you find some tools to help you here, and send you and Caspian good wishes.
 
Thank you so much for your kind words. Let me attempt to answer some questions as best as I can.

I think I'm really starting to worry about these high numbers because it's been going on for so long. It's almost been six months and we've yet to reach a point where I feel he's well regulated. He continues to have all of the symptoms (except being excessively hungry, we actually had to put him on an appetite stimulant for his weight loss.) I also think I'm feeling the frustration over the feeding issue. If I could just find something else that he likes to eat! I've tried mixing wet and dry. He just turns up his nose and refuses. I do have other cats and they are all on the EVO. We DO free feed and, again, that's because of Caspian's weight loss so we don't want him to be without food. It's very hard because I want to do this right, but he's just very challenging.

I'm new to Lantus and I've read a lot over on that message board as well. We started on Lantus on 10/13/15. We started at one unit 2x a day. After a week, we increased it to 2 units 2x a day. His last curve was done on the 10th and that's when our vet said to go up to 3 units in the morning and 2 units at night. I asked her about this and she said she doesn't want to increase the insulin dosage too fast. She's been very great with our boy and super supportive. We usually talk every Saturday about how he's doing. I have a feeling she's going to tell us to go up at night, too. In my heart, I do feel like he needs a higher dose of insulin, but I also know it's not a process to rush. I really am hoping to find that optimal dose soon.

For home testing, which I'm still learning, we use the ReliOn confirm with the 30 gauge needles. I'm slowly getting better at getting blood. In fact, he's been REALLY good for me today and I've been able to check him three times so far and got results each try! That's a pretty big deal for us. :-)

He gets his insulin at 9AM/9PM. So far today, this is where he was:

9:00 AM (pre-shot): 387
1:00 PM- 330
5:00 PM- 271

This is the first time I've been able to get three readings in one day. I'm going to try again before his shot at 9:00 as well.

He seems to be feeling a bit better today. He actually played a little. I engage him with his favorite toy, although not too much because he is weak in his legs now. But he was having fun and it was really cute to see.

I will read more about the spreadsheet and trying to learn more of the terminology, etc. Right now, I just don't have a lot of numbers to share. I'm working on that though.

Thanks for reading and thanks for the well wishes. Lisa, thank you for your kind words about my boy. He's such a beautiful cat. And, like everyone else here, it just hurts so bad to see them sick.

Sending love and good health to all.
 
TammieCA said:
In fact, he's been REALLY good for me today and I've been able to check him three times so far and got results each try! That's a pretty big deal for us
Click to expand...
I'm so proud of you and your handsome Caspian.
smiley-dance013.gif
You have no idea how big a deal that is. If you can get Caspian to continue to co-operate for testing, then you will be able to run curves at home and get a better feel for how Caspian is doing which not only will save you money but also makes sure you are getting accurate readings because trips to the vet usually cause our kitties to have an elevated glucose readings. That can present a problem because a vet might suggest too high a dose based on elevated numbers and that can either cause a cat to go too low or cause them to bounce and get even higher numbers. Your vet sounds very sensible and is working with you and that is a blessing. Caspian is a lucky kitty to have you and your vet!

So glad to hear Caspian is playing a little and maybe feeling a little better. You mentioned you are using 30 gauge lancets. You might find it easier to test if you get some lancets that are 26-28 gauge as most people find they work better with our cats at least until their ears learn to bleed better. With more testing, they grow more capillaries and it becomes easier to get a sample. Also try to make sure Caspian ear is warm. You can use a sock with some rice warmed in a microwave or a pill bottle with some hot water in it and hold that on his ear for a moment to warm it before testing if he will let you. If not maybe just some cuddly ear rubs before poking.

While treating our cats isn't exactly rocket science, it does involve some finesse and knowing our own cats. Once you have more readings you will start to see some patterns emerging. Lantus is usually dosed based on the lowest reading of the 12 hour cycles while taking into consideration the pre-shot numbers. Since Caspian is currently on a kibble diet, you will be using the Start Low, Go Slow method (referred to here as SLGS) and we generally hold doses for 7 days unless the cat starts getting lower numbers in which case obviously a dose change might be needed. And when we do increases, we increase by .25 or at most 0.5u to ensure that we don't go past the optimal dose. Until you can transition Caspian to a canned food diet (notice how positive I am that you will eventually get him to co-operate ;)), Tight Regulation (known here as TR) is not an option. It sounds like your vet is being conservative which is much the same as our SLGS method.

On the food front, if you read my signature, you will see that I have been trying to transition my girl to canned food since she joined our family 5 years ago. Little did I know then, how frustrated I was going to be when the vet told me she had diabetes. I have even managed to get a 17 yr. old kibble addict to switch to a canned diet but my wonderful sugar kid is being as pig headed :rolleyes: :banghead: as they get, so I really understand your frustration!:bighug:

If you have any problems setting up the spreadsheet, just holler. Someone here can set it up for you and then give you ownership if need be.
 
Thank you for this, Linda. Still working hard on this. Just downloaded the spreadsheet and am going to try and figure all of that out. I really, really appreciate your reply and encouragement.

And, of course, that day when I was able to test him three times...I wasn't able to get him again. :-/ I'm going to take your advice and get some new lancets to see if that helps.

Will be in touch soon. <3
 
Hi Tammie, and welcome to you and sweet Caspian. Awesome news on the blood glucose tests today! :woot::woot: I did a lot of crying the first couple of weeks as I attempted and failed those readings. It really does get easier. :bighug:

As others have said, Caspian is not at what we consider a high dose yet. My Neko has two high dose conditions, acromegaly and IAA (insulina auto antibodies), although the IAA has broken now. She's up to 7 units twice a day. Recent research has shown that one in four diabetic cats has acromegaly but I wouldn't worry about that yet for Capsian.

There are other things that cause a need for more insulin. Higher carb food like dry food is one. Will he eat plain boiled chicken breast or other meats? Needing a dental can be a huge factor in blood sugar control. As can other underlying conditions like hyperthyroidism or pancreatitis. I presume you vet has checked into all those.

First thing I'd do is do the same dose evening and night. Lantus is a depot insulin and likes consistency. Dosing differently day and night is what is done with the older in and out insulins like Vetsulin/Caninsulin. You can get some wonky numbers with inconsistent Lantus dosing. Lantus is a good insulin, but it does take time. One month is still early days but you will get there and find the dose that Caspian needs. Here is the information on Start Low Go Slow Method that @MrWorfMen's Mom mentioned above.
 
Hi Wendy,

Thank you so much for your reply. Caspian is now on three units x2 daily.

When he was first diagnosed, we had an ultrasound done of his abdomen because I insisted on checking his pancreas for any visible tumors, etc. That came back negative. All of his other blood work is within normal range. My vet has checked his teeth and, while he has some tartar build up, she doesn't see anything concerning as far as his mouth goes. I think I'm just frustrated and sad because my boy just doesn't feel well and he seems to just be deteriorating before my eyes. I was so used to this big, solid, muscular boy.

I'm going to start working on my spreadsheet and continue testing as much as I can. I really appreciate your advice.

Thanks so much,
Tammie
 
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