Cat not responding to insulin (Norway)

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Marianne Thorsrud

Marianne Thorsrud

Member Since 2016
Hello. I'm a newbie in this forum and also a newbie on the subject of feline diabetes, and I'm hoping you can help me. My 7 year old cat, Pelle was diagnosed with diabetes about two months ago. We were very in doubt about what to do. We have a 2-year old and a baby due in May, we lead a busy life, and we like to travel. But we love Pelle and didn't want to give him up. So we decided to start him up on insulin. He was hospitalized, they quicky got his levels stable, and we were able to bring him home the next day. We started up with one unit Caninsulin morning and evening and have since then been increasing with about one unit per day every two weeks. We just started giving him 3 units morning and evening, but he is not responding very much to the insulin. We have been measuring his blood sugar with home testing. I don't know if you are using the same measuring system as in Norway, but the last time I measured (when he was receiving 2,5 units morning and evening), we measured 29,7 mmol/L before insulin and 22,7 after 5 and a half hours. He weighs about 5 kilos. The vet sais he is now receiving a high dose and should have responded better, she suspects that he might have cushings or acromegaly and sais that it's okay if we want to let him go. I'm so unsure of what to do, I cry every day because I think it's so frustrating. I can't bear the thought of putting him to sleep, but I don't want him to suffer either. We don't have very much money and Pelle does not have insurance. Any advice for me? Pelle is eating Hills m/d dry food, he hardly touches canned food.

Best Regards,
Marianne
 
Dear Marianne
First, welcome to this forum and second, please don't despair! Very many people have the same issues as you and very many find a way to manage their beloved kitties' diabetes and give them a long and happy life. Feline diabetes is very treatable with the right attitude and information - you will find those things here, as well as as much moral support as you could possibly need.

If you're saying that Pelle's blood sugar levels were stabilised at the vet, it should be possible to do this at home too. I will wait to see what the more experienced people say in reply to you, but it is possible that the amount of insulin has been increased too quickly. There are other variables that could be contributing to Pelle's high numbers - dry food, foe example, is too high in carbs for most diabetics. Most of our kitties like dry food but if you can wean them off it and on to a good quality wet food with greater moisture content, this may very well help with the BGs.

If you can, read as much information on this site as possible and you will start to feel better informed and more optimistic. Others will be along soon to offer more specific advice but for now, try to be positive. There is absolutely no need to give up on your dear Pelle.

Rooting for you!

Diana in the UK
 
Thank you, Diana, for your optimistic response! I also found it strange that we can't manage to stabilize him when they managed to get his numbers down at the hospital. I asked the vet about it, and she said that in the hospital he received the fluids intravenously and that this is very different from giving insulin at home.

Marianne
 
Hmmm, I'm not sure what you mean by Pelle receiving fluids (insulin?) intravenously, Marianne, but again, other more experienced members should be able to comment on this.

There are various reasons why Pelle is not responding better to the dose you are giving at present. The dose may be too high or too low (some cats are 'big gulpers' and need higher doses than average). It may also be that a different insulin would suit Pelle better - insulins work in different ways; some work quickly and are 'used up' quickly; others work more gradually and may last longer. These things are trial and error. The additional conditions that the vet mentioned are always possibilities, but until tests are done (which I don't think you need to consider until further down the line), those things are by no means certain.

Do keep checking here for more responses, and read as much as you can about the process of trying to regulate Pelle. This is one of those situations where there may be no quick fix, but if you can make progress the results are soooo worth it!

Diana
 
Marianne

Welcome to the forum and sorry to hear that you are having to deal with diabetes.

Caninsulin ( also called Vetsulin in other parts of the world) can be a good insulin for some kitties, but not all. It is a faster acting, harsher insulin that acts fairly quickly and can bring glucose numbers down quite a bit early after the shot. In some kitties it does not last the whole 12 hours between shots. Sometimes if the numbers drop quickly in the early part of the cycle (the time between shots) it can cause "bouncing" which is where the kitty's body releases counter-regulatory "sugar" (glucogen) to bring the numbers back up which can show as higher glucose and may appear as if the insulin is not working. Bounces can sometimes last a few days and if tests where done at that time then the numbers would appear high and it might look like the insulin is not working. Diabetes is a complex disease and it is not as easy as just giving a shot and having the glucose numbers get back to normal.

If you are not already testing, home testing with a glucose meter is the best way to see how the insulin is working with your kitty. It really is not as difficult as it sounds and there is lots of information and help available on this site to teach you about how to home test. By doing a number of tests during each day you can see how the insulin is working and how low it brings the numbers. With this information it is much easier to see if the dose is correct or whether your kitty responds well to Caninsulin.

Some people who have not had good results with Caninsulin have found that some of the longer acting insulins such as Prozinc, Labtus or Levemir will last longer and give nicer results. However until you know how your kitty is responding to Caninsulin, which is best done by doing consistent home testing to gather data, you don't know whether switching to another insulin is the best approach.

Also dry food is very high in carbs even the prescription dry foods. High carbs are never good for any kitty , but especially bad for diabetic kitties. If at all possible if you could convince your kitty to start eating a low carb wet food, you may see a big difference. There have been quite a few people here who have been able to actually get their kitty off insulin just with changing from dry food to all low carb wet food. Proper diet can make a huge difference. Plus you can buy regular foods that are low carb and not have to spend the extra money on prescription food.

Don't give up. With diet changes and good monitoring of the glucose levels you will find what works for your kitty. :)
 
Hi, Marianne, and welcome to FDMB! Please don't let Pelle's diabetes overwhelm you, it is a very treatable disease. There are lots of reasons why his BG could still be high, it will just take a little while to figure out which one(s) are at play here.

Hill's m/d dry food is very high in carbs and, in spite of what the manufacturer's want you to believe, not good for diabetic cats. The best food for a diabetic kitty is canned/wet food with carbs under 10% (not certain of the exact numbers, but I believe the Hill's m/d is somewhere around 35% carbs). Pelle would definitely benefit from a diet change, you would be amazed how much BG can drop when kitty is eating a low carb, wet food diet! I don't know what foods you have available to you in Norway but I believe you can order from here:

http://www.bozita.com/

and here:

www.zooplus.com

This may also provide you with some useful information:

http://www.felinediabetes.com/FDMB/...for-europeans-and-international-buyers.64843/

There is one very serious caveat to changing from dry food to wet food: You absolutely MUST be home testing and able to closely monitor your kitty. The change should be made gradually over several days, and you must be alert for a serious drop in BG that could cause a hypoglycemic episode. I don't mean to scare you, I just want to make sure you are aware of the potential for a hypo. If you monitor your kitty closely you should be able to avoid any serious issues, and he may very well require a dose reduction as a result. Here are links to some very helpful information regarding switching foods, and dealing with hypos:

www.catinfo.org

http://www.felinediabetes.com/FDMB/threads/transitioning-your-cat-from-dry-to-wet-food.956/

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

I am also giving you a link to a post with a good description of what a "bounce" is, and how to handle it:

http://www.felinediabetes.com/FDMB/threads/what-is-a-bounce.108796/

My cat started on Vetsulin/Caninsulin when he was first diagnosed. It took a few months to find the right dose and get his BG under control. Because Caninsulin is a short-acting insulin it may be more difficult to get/keep Pelle's BG lowered to an acceptable level, but it can be done; I know, because I've been there. Once we got him stabilized on it, my cat was almost the poster-child for Vetsulin, lol, he did very well on it for almost a year. We have recently changed to Lantus, which is working very well for us.

I know it seems like a lot of reading, but I hope some of this will help you. And remember, you are not dealing with this alone, now; any time you have questions just reach out and the great folks her will be more than happy to help you! :):):)

Lucy
 
Thank you so much for all your help and support! I really want to switch diet to canned food and I've read the article you linked to. But the problem is, if I only present a bowl of canned food to my cat (even if I have mixed some dry food into it), he hardly eats anything. He doesn't have much of an appetite these days. And if he doesn't eat, I can't give him the insulin, in case of hypoglycemia. How do I know that he has eaten enough to receive the insulin?
 
Marianne Thorsrud said:
Thank you so much for all your help and support! I really want to switch diet to canned food and I've read the article you linked to. But the problem is, if I only present a bowl of canned food to my cat (even if I have mixed some dry food into it), he hardly eats anything. He doesn't have much of an appetite these days. And if he doesn't eat, I can't give him the insulin, in case of hypoglycemia. How do I know that he has eaten enough to receive the insulin?
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One of my kitties (non-diabetic) was a dry food addict. It took me a long time to get her on wet food. You can start with a bit of wet food...the smellier the better...and crumble a bit of the usual dry food on top. Also you can put a bit of tuna or salmon juice on the wet food. Cats are motivated by smell and putting something with an attractive smell (for a cat) can help convince them to eat the food. Some people on here have put a bit of Parmesan cheese on the food and found that it worked. If you are able to get your kitty to eat wet food it could show much better results with the insulin.
 
This is good advice about feeding, Marianne, give it a go. Pelle's BGs would almost certainly be lower on a diet of wet food (but with a change in diet, make sure you test before giving insulin to make sure levels haven't dropped substantially, which can sometimes happen).
Is Pelle's health otherwise good, by the way? You mention a poor appetite which is unusual in an unregulated diabetic - often they are ravenous. Have you had Pelle's teeth checked for possible problems which may be preventing eating? Or are there other reasons for a poor appetite? Infections can cause BGs to rise as well so you have to take into account the whole picture.
Good luck and keep posting...

Diana
 
Sometimes feeding smaller, more frequent meals helps. My cats all love the freeze-dried chicken or turkey treats, sometimes I will crumble them over food if appetites are waning. I have recently switched cat foods and apparently none of my fur babies like it, so I have been putting Young Again Zero Carb (which it isn't, really!) dry food in my little food chopper and making a dust to sprinkle over their food; it helps a little.
 
Sorry for the late response! I had the vet change to Lantus so we have been trying that for two weeks now, starting with 2 units 2 times a day and then increasing to 3 units 2 times a day. We have been measuring today, but the numbers are still way too high, showing only red numbers in the spreadsheet. I have not been putting much effort to force the canned food on him. He eats a bit of the Hills m/d canned food, along with the Hills m/d dry food, but doesn't want anything else. The vet has told me that I have to give him the food he wants to eat, she doesn't have much faith in a change of diet and keeps telling me that Hills m/d dry food is good food and that there is nothing wrong with it. I'm not very pleased with my vet, she is both very expensive and I feel like I'm doing her job, constantly having to come up with suggestions on what could be causing the high numbers. So I'm going to try another vet again and bring Pelle in for a check to find out whether he is suffering from any infections. If the answer is negative, I guess there's not much we can do except continuing to increase the dosage and try other types of canned food. Of course, if he needs a very high dosage to keep his numbers down, this will be very expensive for us :(
 
Hi Marianne,

I empathize completely with how frustrating it is to be doing a vet's job for them. :bighug:

For general information, the best way to adjust Lantus doses is in small increments - typically 0.25 IU - in order to avoid skipping over an 'ideal' dose.

Hills m/d has too many carbs.


Mogs
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Marianne Thorsrud said:
Sorry for the late response! I had the vet change to Lantus so we have been trying that for two weeks now, starting with 2 units 2 times a day and then increasing to 3 units 2 times a day. We have been measuring today, but the numbers are still way too high, showing only red numbers in the spreadsheet. I have not been putting much effort to force the canned food on him. He eats a bit of the Hills m/d canned food, along with the Hills m/d dry food, but doesn't want anything else. The vet has told me that I have to give him the food he wants to eat, she doesn't have much faith in a change of diet and keeps telling me that Hills m/d dry food is good food and that there is nothing wrong with it. I'm not very pleased with my vet, she is both very expensive and I feel like I'm doing her job, constantly having to come up with suggestions on what could be causing the high numbers. So I'm going to try another vet again and bring Pelle in for a check to find out whether he is suffering from any infections. If the answer is negative, I guess there's not much we can do except continuing to increase the dosage and try other types of canned food. Of course, if he needs a very high dosage to keep his numbers down, this will be very expensive for us :(
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Hi!!
I am very happy to hear you are trying a different vet-
Hills dry is high in carb and not a good food choice for a diabetic cat-
I do not give dosing advice but raising the dose by a whole unit at a time is a big jump..... you could easily miss the "right" dose. We increase by .25 as a general guideline ....
This will bump up for the experts to weigh in..
your doing a great job with good instincts!!:bighug:
 
Yes, different vets can have quite different attitudes so ring round and have a chat with one or two and see what they say. Many of us have done just that.
Good luck!
Diana
 
Thank you guys! Unfortunately, the Lantus pen that was prescribed to me only has whole units, so it's not possible to increase by .25 units
 
Marianne Thorsrud said:
Thank you guys! Unfortunately, the Lantus pen that was prescribed to me only has whole units, so it's not possible to increase by .25 units
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You can draw up insulin from the pen cartridge using a conventional insulin syringe; in effect, using it as a 'mini vial'. This allows for finer dose adjustments. The best syringes for fine dosing Lantus are U100 0.3ml insulin syringes with half unit markings.


Mogs
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But we have been measuring his BGs for every dosage, and he has never been below the red values. Wouldn't a too high dosage cause hypoglycemia? I don't quite understand this.
 
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