Cannot Regulate/Urination Issues

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MarLee

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I have a 9 year old male cat (in a house of 4 cats). In December it became apparent that he lost weight. It had not occurred to me yet that he was drinking a lot of water. The vet appointment showed he was diabetic. My vet had me start with Novolin. After several increases, my Luke was still high, water consumption became crazed, i.e., getting into toilets, licking the bathtub. Having never had a readable glucose read, the vet kept him for the day and the sugar was driven down with the fast acting insulin. My vet had me switch to Lantus. After a short bit, his glucose level was readable. STill high (240) but at least registered. I thought we were on the road to recovering. He then had a UTI which became apparent when very smelly urine was throughout the house. That was controlled with antibiotic. Luke was starting to really look better. I took him Friday for weigh in and glucose check and even though he is getting 6 units twice a day of Lantus, he was back in the HI range - not measurable on the meter. He had gained a pound (after having lost 6). I was stunned that the sugar was high. Within a day of that appointment, Luke is now miscellaneously urinating around the house. He also wants to be spoiled with water which of course I am happy to do - any way he wants for now. My vet has never experienced a cat that would not regulate. I do not have limitless funds. The work up and resulting visits have added up to well over $1000. I am increasing the Lantus to 7 and seeing if there is any change at all. Today my vet had a phone consult with me and I know that he is also upset but he is questioning whether euthansia might be coming into the picture. I am having a terrible time with that concept with a cat that "looks" well. Any advice or thoughts would be appreciated. I am very sad and am afraid that maybe I am making my Luke suffer.
 
Welcome Marlee and Luke!

It sounds like you have had a difficult time of this sugar dance. I hope we can help.

What are you feeding Luke? We advocate wet lo carb food. This FD vet explains why: www.catinfo.org. It may make a huge difference in bg levels.

7 units is a lot of insulin. Is that dose twice a day? Some cats do have conditions that require that much insulin, but the majority are regulated on much less.

Are you testing at home? That can really help you see how the insulin is actually working and can make dose changes much easier.

Have you seen our Lantus support group? The stickies on that page have great information of how Lantus works, dosing etc.: viewforum.php?f=9

Read and ask questions. We would love to help you help your Luke.
 
A couple questions here .... what are you feeding? are you home testing?

Diabetic cats can greatly improve by feeding low carb wet food.

Home testing will cut way down on your vet bills; I never take mine to the vet unless it's time for annual checkups or if there is something wrong. Diabetes is controllable, so I don't consider it a sickness really, more like a condition.

There is absolutely no reason to be considering PTS for your cat! It could be that Luke could have an insulin resistance issue/condition.

you can track Luke's BG numbers in a spreadsheet like many others on this site, testing regularly with a normal BG meter for humans like Relion can be picked up at the pharmacy.

you can also adjust Luke's food and may see a big improvement. If you are feeding dry food and switch to wet, it needs to be done with caution as you may need to give him alot less insulin.


First things first though. Testing Luke yourself at home, recording the numbers, and then adjusting his diet. From there, you need to take care of any health issues, like UTI or dental, and then you will see how Luke is doing.

Switching to Lantus was a great change. There are stickys in the Lantus group that you should read which tell you how that insulin works.
Tight Regulation Protocol
Lantus & Levemir – Insulin Depot –AKA- Storage Shed
Lantus & Levemir – Data Ready to Shoot Low Numbers

There are some links to info on low BG numbers as well you should read:
List of Hypo symptoms
How to treat HYPOS-They can kill! Print this out!
Jojo’s HYPO TOOLKIT


There are plenty of people here who will help you get Luke feeling better soon.
 
Marley & Luke-
I have been where you are at with urination issues- increased water drinking possible infection (which will cause higher bg levels)- I do not want to ask the same questions- but I have a shop cat (in my shop and I am only available to him 7-5 mon thru fri although i go in sat & sun to give him a shot). I changed his food right away from dry with wet to entirely low carb wet and his inappropriate peeing and pooping ceased within two days- He is on lantus and has adjusted really well to it. his pu and pd and improved 100%. I test him regularly and have noticed that if he runs higher numbers increasing his insulin does not help. This is where testing his bgs does come into play- the only way I have learned to know my cat has been to test him. Please do not let your vet tell you you need the "vet alpha trak" for animals only- I use the truetrak from cvs which costs about
10.00 and test trips about 24.00 for 50. Much cheaper than taking cat in for testing. This can be done very easily by you. I test my "shop" cat while he is eating a tbs of food. If you need help with how to do this please ask. There is no reason to feel you have to pts because this is a very treatable disease and everyone here will help you. One last thought..look at the whole cat not just he has diabetes..is he happy, purring, playful,he loves you for trying to help him..
 
On 7U Lantus BID

*Bump*

Hopefully some more eyes will see this and OP will return with further questions. Good stuff has been covered so far, although I'd like to add that you must lower the insulin dose before you begin a diet change, if Luke is currently eating only dry food. The high carb in most dry food is keeping his blood glucose from going dangerously low on that high of dose. Changing to low carb wet food could be dangerous for a cat on that much insulin.
 
Cannot Regulate/Urination Issues/Luke

Traditionally Luke was a "I want my chow and my water." That was it. He did not care for anything else. When the diabetes kicked in, he started eating wet food, treats and even begging for people food. And of course the water consumption went haywire. Since being on insulin, he has gone back to chow but does eat wet also and is still consuming a huge amount of water. The dry food is Purina One Pro and the wet food is either Friskies or Fancy Feast or sometimes Whiskas pouches. I did buy a bag of Wellness Core at the advice of one of the vets and none of my cats wanted any part of that. I did read the whole article today about the foods. I would be willing to transition my cats to wet food only but would need some time to learn how to test Luke. I have not done any home testing. Is there somewhere on this site or a site that I can be referred to as to how to learn to do it. I have seen the vets office do the quick test on him twice. I do work full time however so I would not be a +++ caretaker Mom but I am willing to try the home testing and perhaps the change in diet. Also, no one feels that there is a preference in what tester is bought? And I need the tester, lancelets and strips? Any help would be appreciated. Thank you.

I am hoping that I am not the first person to feel extremely overwhelmed by this website. Some of the things that I am reading are going right over my head.
 
You are absolutely NOT the first person to be completely overwhelmed. We all felt the same way. But this is a great support group and we want to help!

So glad you are willing to consider a diet change and testing! We will help all we can. Lots of members work full time and can help you with scheduling.

Here is a good beginning test site: Newbie hometesting site and a video: Video for hometesting

Here's a shopping list:


A human glucometer. Any one that sips and takes a tiny sample is fine. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 25-26 gauge is good. Any brand will work.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats

It looks easy on the video. Sometimes it is that easy. We spent an entire weekend poking poor Oliver before getting a drop of blood. What really helped us was warming the ear. We all have tips that helped us the first time. If you have trouble, just come on and ask. We will bombard you with things that helped us.
 
Hi Marley,

Purina One is about 35% carbs, and a diabetic cat needs food that is 10% carbs or lower. While many wet foods fall in this range, I don't know of a dry food that does. All those carbs will raise his BG levels. I don't think you'll be able to regulate Luke until you get him on a low carb wet diet.

However, 7 units is also an extremely high dose of insulin. You need to reduce his insulin and hometest before you switch his diet. Most cats only need 1or 2 units of Lantus.

You can use any glucose meter that a person would use, but it's easier if you get one that uses a small sample of blood. I started out with a Relion Micro (Walmart) and it worked very well. You will need to buy the strips that go along with it, and some Lancets (I've found that 26-28 gauge work best). Some people like to use the lancet device (like me), and some like to poke with the lancet freehand. It will all depend on what works best for you.

You'll find that the cost of managing Luke's diabetes will go way down once you start hometesting, because you won't be paying for as many tests at the vet. And you can work testing around your schedule...I work 70 hours a week and go to grad school and was able to manage it, it just takes some routines and scheduling.
 
Because of the high dose he is on, also pick up some ketone urine test strips so you can monitor him for ketones. Ketones occur when the body breaks down fat for energy because it doesn't have any glucose to use.

Also, if he has acromegaly or insulin antibodies, those result in a much higher need for insulin and dropping back down to 1 unit to start over could result in ketoacidosis. You won't know until you are home-testing and can see how low his glucose goes between shots. If it turns out he does require high doses like this, there are some tests to determine what is going on.

One step at a time! Learn to do the hometesting first.

Its a process, not an event!

You may find it helpful to read other's posts in the various forums to see what they go through with their cats. All of us, I think, have had something go 'bump' at least once!
 
Re: Cannot Regulate/Urination Issues/Testing

I bought the Relion testing materials and Luke was very good the first attempt for me to get blood but it was 1 tiny droplet that soon disappeared. The attempts after that to get anything were unsuccessful. It took all my courage to do those pokes with the lancet.

What are the tricks to get the blood? Also, do certain testers require less blood?
 
If you got a drop of blood you are more than half way there - even if not enough for a test. A couple of hints:
1. For every time you try to test (successful or not), give Luke a treat. Freeze dried chicken from PEtSmart or other lo-carb treat.
2. Warming the ear helps with some ears - a thin sock filled with rice and warmed in the microwave or a face cloth in hot water and then a plastic bag are 2 things that peole used.
3. If you see a little drop of blood, sometimes you can coax a little more out by milking the ear gently. And always run the test strip along the hair, not against.
Be sure to hold a little pressure on the ear so that it won't bruise - a few seconds is all it takes.

If these don't help, ask again. all of us have our fav techniques.
 
Cannot Regulate/Urination Issues/Good Result

Today unexpectedly Luke had a good reading of 135 at the 9 hour point (I was taking another cat to the vet so brought Luke too). We were all shocked as this has been going on since January with no readable BG's. The vet wants me to take home readings this weekend. He said would be easier to use the syringe as opposed to the Lancet. However, I was just looking and it seems to me that the Lancet is actually bigger than the needle. Both times they attempted at the vets, they got a good amount of blood right away - something I was unable to do. I am wondering if they are using an even larger needle there. My syringes are 31 and my lancets are 30 gauge. I will be reducing the Lantus by 1 unit tonight and check the readings on the weekend. Suggestions on the gauge - should I get different lancets? I can't see that the 31 gauge syringe is going to be better? Maybe my vet was confused as to what size syringe I was using. He is also treating Luke for a UTI with a different antibiotic in the hopes that the inappropriate urination will stop.
 
I would get a bigger gauge lancet. 25-26 gauge makes a nice sized hole at first. 30-31 may be too tiny. I would think using a syringe would be awkward and overkill. The lancet and lancet device make the process pretty easy.

Glad you will be testing. 135 at +9 is a low number for the vet. Be sure to test before every shot to make sure you don't need to lower the dose.
 
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