Cannot get blood sugar down

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Robiond19

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Hi, This is my first post.
My cat Peepers has been diagnosed with diabetes. After two months of twice daily injections with Humilin N her blood sugar has risen.
It started at 350 and started to go down the first few weeks but yesterday it was at 650! I have read much of the information on this site but now I am overwhelmed.
My vet wants to do keep her for a day and do a monitoring to get a curve. Money is going to be an issue here as testing can get very expensive.
Is it possible that the insulin has gone bad? Any ideas or insight will help.

Thanks for your help

Rob
 
Robiond19 said:
Hi, This is my first post.
My cat Peepers has been diagnosed with diabetes. After two months of twice daily injections with Humilin N her blood sugar has risen.
It started at 350 and started to go down the first few weeks but yesterday it was at 650! I have read much of the information on this site but now I am overwhelmed.
My vet wants to do keep her for a day and do a monitoring to get a curve. Money is going to be an issue here as testing can get very expensive.
Is it possible that the insulin has gone bad? Any ideas or insight will help.

Thanks for your help

Rob
Click to expand...

Hi Rob,
First welcome to the site and sorry to hear things are starting out rough for you two, but let's see if we can help you out with some advice and direction.

To me, the insulin you are using is not very good at all and I would suggest you switch to a much better insulin like Lantus or Levemir. You will definitely see an improvement. What dose of N are you currently giving Peeper? Your current insulin may be cheaper, but as you can see, it's doing much good for your girl!
Here's some info on your current insulin:
Humulin Primer Info

Now, to comment on the expense of having a curve done at the vet..... you can do the very same thing at home and get BETTER results! The numbers your vet gets at the vet office from Peepers are very likely skewed because of her stress at being in the office in the first place.... how many animals are happy to be at the vet? I bet almost none. One of my cats tests higher at the vet, and another tests lower. When we get home, their numbers return to normal within 20 min.
The best thing you can do is to pick up an ordinary BG meter, test strips and lancets at the pharmacy, if you are in the US, you can get the Relion as their strips are the most inexpensive. There are other good meters like Bayer, OneTouch, Accu-Chek. Also pick up a container of KETOSTIX as Peeper has pretty high numbers so you want to test her urine at home for ketones.
When you get home, there are any number of people here who can help you out with home testing, and you can get some real numbers when you do your own curve on Peeper in her home environment. Once you are testing, you may find out that you are giving her too much insulin and that's part of the reason for her higher numbers. Testing needs to be done before each shot so that you know it's safe to give the shot.

Finally, food. This part of the equation is VERY important. There are so many cats who are DIET CONTROLLED and do not need insulin, so it's important to be feeding Peeper only wet, low carb foods. No dry food OR treats. There are many healthy treats aside from those store bought hard crunchy things.
Here's some food links for you. Look up some foods on Binky's list and be sure Peeper is eating only wet foods that are under 10%, OK?

Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition

Now, before you go changing the food, it's advisable that you are testing first because once you change the food, you are going to see a dramatic change in Peepers numbers, for the better! It could be dangerous if you are not decreasing her insulin to go along with any food change.

Very quickly, you will find that your subject is incorrect.
You say 'Cannot get blood sugar down', but we say 'Yes you can!'

Pats for Peeper and be sure to ask all the questions you like; someone will be able to help you here.
 
I agree that hometesting is the best place to start. If money is an issue, you can get a free test kit from us (see the picture link at the top of this page) or go to Walmart and buy their ReliOn meter and strips. You'll also need some 25-27 gauge lancets. We have taught hundreds of people how to test over the Internet.

Humulin may not be the easiest insulin to regulate with, but it is possible for some cats, so if money is an issue, I would stay with it until you can test at home and really see how it is working. Cats tend to be stressed at the vet, so your numbers there are not likely to be as accurate at your home tests.

The diet change is also a huge piece. As soon as you get testing down, you can change food. (when we switched from dry to wet, our Oliver went down 100 points overnight. If we hadn't tested, we would have overdosed him on insulin with our usual dose)

Let us know how we can help.
 
Gayle Shadoe & Oliver said:
No dry food OR treats. There are many healthy treats aside from those store bought hard crunchy things.
Click to expand...

There are store bought treats that are good for diabetics :smile: Here's a list: http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=9172 Most can be found at the chain pet store (Petco, etc) and specialty pet boutiques, some at Wal Mart.


Gayle Shadoe & Oliver said:
The best thing you can do is to pick up an ordinary BG meter, test strips and lancets at the pharmacy, if you are in the US, you can get the Relion as their strips are the most inexpensive. There are other good meters like Bayer, OneTouch, Accu-Chek.
Click to expand...


BG meter = blood glucose meter, the thing a Human diabetic uses to test his or her own blood glucose level.

It works just as well for cats. Here is info on how to test your cat's blood glucose levels at home: http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=287

I agree that learning to test your cat's blood glucose levels at home will save you $$$ and be much more accurate.

Here are tips on how to save money on diabetic costs: http://binkyspage.tripod.com/frugal.html

Humulin N isn't the greatest insulin to use for cats. It tends to last a few hours at most.Sure it's cheap but it's not worth using if it's not working for your cat, IMO.

Lantus, Levemir, and ProZinc are better insulin choices to use. Talk to your vet about these. Lantus and Levemir are Human insulins that you buy at the Human pharmacy with a prescription. ProZinc is a pet insulin so your vet may sell this to you or give you a prescription to buy at an online pet pharmacy like DrsFosterandSmith.com or 1800PetMeds.com.
 
There are store bought treats that are good for diabetics Here's a list: viewtopic.php?f=14&t=9172 Most can be found at the chain pet store (Petco, etc) and specialty pet boutiques, some at Wal Mart.
Click to expand...

I agree that there are some store bought treats that are suitable, but there are only 2 on the list above that could be found by me: the Freeze Dried Chicken - PureBites at a few places, and a couple Petsmart shops had the Halo liv-a-little treats.
There was one treat that was excellent, flat moist treats called My Mighty Lion in 4 flavors that had no sweeteners, but I think they are just available in Canada. When I was in Toronto, I got them all the time.

I also would feed chunks of raw chicken to a couple of my cats as treats, just before or after their shots.
 
If you need to stick with the Humulin N due to cost, note that it lasts only 6-8 hours in the cat.

This translates into doing 1 or both of the following:
- Dosing every 8 hours to get better coverage through the day. This is tough on most folks schedules and uses more syringes and glucose testing strips (please don't give insulin unless you test - if the cat is low already, extra insulin can kill)
- Picking up the food after the cat has eaten so there is no nibbling after the insulin has worn off. If you've got an insulin dose that is too high (which you won't know without testing), not having food down risks a hypoglycemic event which could kill the cat.

Some additional ways to monitor your cat include:
- water consumption - measure how much is put down, subtract how much is left at the next fill, and divide by the number of hours to get hourly consumption. If you put out fresh water every 24 hours, you can go with a daily value for water consumption. It should go down as the diabetes is controlled.
- appetitite - if the cat is voracious and always hungry, the diabetes probably isn't controlled. Without enough insulin, the body cannot use the food which is digested and is literally starving.
- urine output - if there are lakes of wet litter and the cat does not have other problems which can cause this (renal disease, hyperthyroidism, etc), the diabetes is probably not controlled.
- urine test strips - both glucose and ketones may be measured this way with products like Ketodiastix. If there is glucose in the urine, the diabetes is not controlled. If there are high levels of ketones in the urine, it is a medical emergency.
- behavior - is the cat lethargic? active? vocalizing more than usual? Playing, purring, grooming? These are all clues as to how the cat is doing.
 
I've been able to find the beefeater freeze dried treats regularly at our local Petsmart. My guys love 'em!
Carl
 
carlinsc said:
I've been able to find the beefeater freeze dried treats regularly at our local Petsmart. My guys love 'em!
Carl
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I also get the Beefeaters at PetSmart--they're very reasonably priced! When you take into account how much you're getting, they're about the same price as the regular cat treats.

If you're in Canada, I recall that Canadian Walmarts now have a diabetic safe treat, they're called pure snacks: http://puresnackstreat.com/

Rob, as others have mentioned, Humulin N is not a very good insulin for cats. I've attached an article about Lantus (glargine) for you to print out and bring to your vet. Some vets are a little behind in their treatment recommendations and need to be updated. Lantus is a slow acting insulin that lasts a full 24 hrs in cats when shot twice a day. Levemir (detemir) is not mentioned in the article but it works the same way. I would try to get a prescription for one of those two insulins and then head back here for advice. They have an excellent remission rate (84%) in cats when used in combination with a low carb, canned diet, and regulation via home testing. However, there's a window--the longer you wait to start treatment the less likely remission is, so it's important to get going right away.
 

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Hi Rob
My cat was on a Humulin N variant and he is in remission now but it was because I changed him to all wet food, 6 feeds a day. As others have said, however, you wouldnt want to make that change until you are home testing as Akbah's insulin needs dropped through the floor straight away. I needed to do a looot of testing in that first week. Check out Akbah's spreadsheet between 19-22January.

Akbah was on two shots a day, started at 3U (which was too high) and I reduced it from there.

Home testing can be confronting but that is the only way you can work out how your cat is reacting to insulin throughout the day, and help your cat get back into some steady BL levels. Its really really really worth doing.

I wasn't happy with Humulin for Akbah, but instead of changing insulin, I home tested and was lucky enough that akbah could get off the juice with diet alone.
 
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