cat not responding to insulin

fatcat

Member
Hi, I am pretty frustrated and at my wits end and worried about my cat. He is 10, was diagnosed June 20, started on Prozinc at 1 unit, and has been steadily going up because his BG is still too high. I was told to up it to 4 units on Thursday after I phoned in the results of a blood glucose cure I did on Wednesday. I found a link in one of the threads to Catinfo.org and read about food. The vet told me to put him on Hills Prescription Diet m/d, and was giving him one can of wet a day and one feeding of dry. After looking at the food composition table that Dr. Pierson posted on her catinfo.org, I switched to another food with lower carbs, lower fat and higher protein, but it's not a vet food. But my cat seems hungrier, even though I upped it. He is bugging me for food two hours before he's supposed to get fed and get his insulin. My vet is not helpful, the only communications I have is with the techs. They tell me not to switch food and that I should do another BG curve in a week. Should I go back to the Hills m/d and up it to 4, or stay on the new food and leave the insulin at 3.5? I am considering switching to a new vet.f
 
Start with this, vet food is a scam. The carbs are the key.
Although it might look like a BigMac that's left out in the sun too long many of us feed Fancy Feast and not because it's cheap. You're vet is running a business, not a charity and they make a whack of money selling $3 a can food. And just like any business he should be providing better service instead of having his techs talk to you. I'm too tired to comment on the rest.
 
Hi and welcome! Although I'm sorry for the circumstances that have lead you to join here.

I'll start with the easier one: the best food for a diabetic cat is low carb wet food. It absolutely does not need to be a vet food. Most of us feed fancy feast classics or friskies pate. There is a sortable food list in my signature (the same one from Dr. Pierson). Any food that is below 10% carbs is fine. It's okay to feed your kitty several small meals throughout the day, or even to just leave wet food out and let him eat when he wants. The only time you don;t want him to have food is the two hours right before each shot. So if he's hungry two hours before, try giving him a snack three hours before (if your schedule allows).

As far as dosing, we need to see the numbers you're getting to be able to help with that part. Can you put whatever data you've collected in this spreadsheet and then we can take a look and help you figure out what to do next.

Changing the food makes a huge difference for most cats, so I definitely wouldn't increase the dose until you get rid of the dry food and the prescription food and get him on something low carb enough to be healthy.

Please keep asking as many questions as you have. We're happy to help! Oh, and you probably don't need to change vets. There are very few vets that really know a lot about feline diabetes. We can help fill in the gaps there.
 
Hi all, I just did the spreadsheet. I only have the data I collected. I will ask the vet for the BG curves they did. I just did my first one this week. I changed his food to Fancy Feast Medleys Shredded white meat chicken fare after that. He loves the food, but I am not sure if I am giving him enough. My vet says he should have 250 cal per day, the FF can says 84 cals per can, but it also says give 1 can per 3 pounds of cat. My big guy weighs 15.7 pounds, so that would be 5 or nearly six a day! I tried to get a blood sample this morning before I fed and shot him, but I couldn't do it by myself, he was too squirmy and fighting. Any tips on how to get the sample without having another person to hold him?
 
Hi and welcome! Although I'm sorry for the circumstances that have lead you to join here.

I'll start with the easier one: the best food for a diabetic cat is low carb wet food. It absolutely does not need to be a vet food. Most of us feed fancy feast classics or friskies pate. There is a sortable food list in my signature (the same one from Dr. Pierson). Any food that is below 10% carbs is fine. It's okay to feed your kitty several small meals throughout the day, or even to just leave wet food out and let him eat when he wants. The only time you don;t want him to have food is the two hours right before each shot. So if he's hungry two hours before, try giving him a snack three hours before (if your schedule allows).

As far as dosing, we need to see the numbers you're getting to be able to help with that part. Can you put whatever data you've collected in this spreadsheet and then we can take a look and help you figure out what to do next.

Changing the food makes a huge difference for most cats, so I definitely wouldn't increase the dose until you get rid of the dry food and the prescription food and get him on something low carb enough to be healthy.

Please keep asking as many questions as you have. We're happy to help! Oh, and you probably don't need to change vets. There are very few vets that really know a lot about feline diabetes. We can help fill in the gaps there.

Thanks Djamila, so I was giving him one feeding of dry Hills d/m and one feeding of wet, and now I changed him to Fancy Feast for both feedings. I should mention my cat was diagnosed as diabetic a few years ago, and after a month, he went into remission. I don't remember what insulin he was on, but I can find out. I don't think it was ProZinc. Also, when he was diagnosed a few years ago, the way we found out is because he couldn't stand on his back legs. We thought he had something wrong with his legs. That went away. The way I found out he was diabetic this time was because he was peeing alot and was ravenous all the time. No problems with his legs this time. We had him on wet food exclusively, but our vet said our cat was showing signs of fatty liver disease and that our wet food didn't have the nutritional requirements for that, so we put him back on dry food she suggested. I feel so stupid for believing her.
 
Hurray for getting your spreadsheet set up! I see you have values entered on the "world" sheet. Are you in Canada? The SS should auto convert to the US units on that sheet when they're entered on the world sheet. There seems to be a glitch with your first entry for Aug 22 AM though. It's showing lime a lime green 24 on the US sheet but a red 24.6 on the world sheet. That translates to 443 in US units (multiply the world units by 18 to get US units). Your vet curve data will tell us more but the curve you've posted shows that the 3 u dose was safe that day.

There are good tips here for testing: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
 
Hurray for getting your spreadsheet set up! I see you have values entered on the "world" sheet. Are you in Canada? The SS should auto convert to the US units on that sheet when they're entered on the world sheet. There seems to be a glitch with your first entry for Aug 22 AM though. It's showing lime a lime green 24 on the US sheet but a red 24.6 on the world sheet. That translates to 443 in US units (multiply the world units by 18 to get US units). Your vet curve data will tell us more but the curve you've posted shows that the 3 u dose was safe that day.

There are good tips here for testing: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Yes, I am in Canada. I will try to change it. The first test, taken at 7 a.m. before he was fed and shot, was 24.6 mmol/L. That converts to around 435 mg/dl. I was told to up his insulin to 4 units. I've changed his food to
Fancy Feast but am unsure if I am giving him enough and I'm afraid to give him the 4, so I've been giving him 3.5. Do you think that's OK? Also, I tried to get a blood sample this morning before I fed and dosed him, but he is so hungry I couldn't hold him and get the sample. Any suggestions how to do this without having someone else there to hold him? I also did a furshot this am, any tips on how to not do this? I feel like such a failure as a cat owner, I can't seem to do anything right. :(
 
Here is a video that shows someone testing their cat:


Of course, this kitty is much more cooperative than my kitty. So here are a few things to try if you have a wiggly one:

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like or being made to stay in one place, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm.
A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well.
When you're first starting, it's also important to use a lower gauge lancet, like 25-28 gauge. Most of the "lancet devices" come with 33 gauge lancets and they are just too tiny to start with. The bigger lancets (that are lower numbers) make a bigger "hole". As you poke more and more, the ears will grow new capillaries and will be easier and easier to get blood from...we call it "learning to bleed"

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat!

Finally, patience and practice. The more you do it, and the more consistently, the easier it becomes. When you're first starting, there will be failed attempts. It's okay. Try three times, then take a break. Walk away. Breathe. Then try again. And remember that kitty gets a treat if there is a poke, even if it doesn't result in a test. It's important to keep up that postiive association.

A few other tricks: some folks find it easier to wrap their cat in a towel or blanket like a kitty burrito. If your cat isn't food motivated, try brushing or head/chin scratches -- whatever makes him purr and happy and want to stick around. A folded towel gently around their neck like a neck brace -- I emphasize gently here! -- can help hold them still during testing.

Make sure the test strip is inserted part way into the meter while you warm the ear. Then when you're ready to poke, first push the strip all the way in, then poke and "milk" the spot to get the blood to come out, then you can just grab the meter and suck up the blood.

If you're not getting enough blood, soemtimes a double poke in the same spot helps.

Hope something in here helps. There is a learning curve on this. It will get easier, I promise. I can literally do it without fully waking up now, and my cat was semi-feral when we started this! Where there's a will there's a way!
 
Yes, I am in Canada. I will try to change it. The first test, taken at 7 a.m. before he was fed and shot, was 24.6 mmol/L. That converts to around 435 mg/dl. I was told to up his insulin to 4 units. I've changed his food to
Fancy Feast but am unsure if I am giving him enough and I'm afraid to give him the 4, so I've been giving him 3.5. Do you think that's OK? Also, I tried to get a blood sample this morning before I fed and dosed him, but he is so hungry I couldn't hold him and get the sample. Any suggestions how to do this without having someone else there to hold him? I also did a furshot this am, any tips on how to not do this? I feel like such a failure as a cat owner, I can't seem to do anything right. :(


Oh please don't feel like a failure!!! This is a lot to learn all at once. It's going to take some time, and you're doing great!

If your cat is super hungry, go ahead and give him some food first. Just enough that he can finish it in a few minutes to take the edge off his hunger, and then do the test. Their BG takes about 15 minutest o start to respond to food, so you have a little window to get the test in where it will in effect be the same as if you did it before he ate.
 
Also, I tried to get a blood sample this morning before I fed and dosed him, but he is so hungry I couldn't hold him and get the sample.
If hunger is making it more difficult you can give him a teaspoon or two of his Fancy Feast to take the edge off and then test within a 15 -20 minute window. It takes about that long for food to begin entering his bloodstream so your test should be "non food influenced" and he might be less frantic.
 
As for the fur shots, we all have slightly different techniques, so it's a matter of figuring out what works for you and your cat. Sam (my cat) doesn't have much extra skin, so I've never been able to tent his skin very well. I usually grab a little clump of fur and pull up. It makes that gap between his skin and muscle that we need, and also reveals a little line of skin so I know I'm injecting into him and not just into his fur. It doesn't seem to bother him at all to have me pulling up on his fur like that. I used to be the queen of fur shots since I kept trying and trying to make the tent thing and Sam is super wiggly, so he doesn't have much patience for me messing with him for long!
 
By the way, great job on your curve! It's hard to test that much in a single day, so gold star for you all!

I just want to confirm that you're using a human meter, and not a pet meter? Most of us use human meters, but usually vets that push prescription food also push for you to buy their meter, so I just want to confirm that.

Don't worry about trying another test for a few hours, but if you could grab one somewhere between +4 and +6 today, that would be really helpful information to have on the 3.5u dose.
 
Oh please don't feel like a failure!!! This is a lot to learn all at once. It's going to take some time, and you're doing great!

If your cat is super hungry, go ahead and give him some food first. Just enough that he can finish it in a few minutes to take the edge off his hunger, and then do the test. Their BG takes about 15 minutest o start to respond to food, so you have a little window to get the test in where it will in effect be the same as if you did it before he ate.

OK that's good to know. He is such a good boy, he just is super hungry in the morning. I don't have any trouble getting blood from him, he's a good bleeder. It's just the morning and night feedings that he won't sit still. During the day, he is so easy.
As for the fur shots, we all have slightly different techniques, so it's a matter of figuring out what works for you and your cat. Sam (my cat) doesn't have much extra skin, so I've never been able to tent his skin very well. I usually grab a little clump of fur and pull up. It makes that gap between his skin and muscle that we need, and also reveals a little line of skin so I know I'm injecting into him and not just into his fur. It doesn't seem to bother him at all to have me pulling up on his fur like that. I used to be the queen of fur shots since I kept trying and trying to make the tent thing and Sam is super wiggly, so he doesn't have much patience for me messing with him for long!
As for the fur shots, we all have slightly different techniques, so it's a matter of figuring out what works for you and your cat. Sam (my cat) doesn't have much extra skin, so I've never been able to tent his skin very well. I usually grab a little clump of fur and pull up. It makes that gap between his skin and muscle that we need, and also reveals a little line of skin so I know I'm injecting into him and not just into his fur. It doesn't seem to bother him at all to have me pulling up on his fur like that. I used to be the queen of fur shots since I kept trying and trying to make the tent thing and Sam is super wiggly, so he doesn't have much patience for me messing with him for long!

Thanks so much, these tips really help!
 
By the way, great job on your curve! It's hard to test that much in a single day, so gold star for you all!

I just want to confirm that you're using a human meter, and not a pet meter? Most of us use human meters, but usually vets that push prescription food also push for you to buy their meter, so I just want to confirm that.

Don't worry about trying another test for a few hours, but if you could grab one somewhere between +4 and +6 today, that would be really helpful information to have on the 3.5u dose.

Yes, I am using One Touch Verio Flex. I did a fur shot this morning, so he didn't get any insulin. I will test again in a few hours and update everyone. Thanks again, this forum is saving my sanity!
 
Oh shoot! I forgot he didn't get any insulin. Don't worry about getting a test then. The only time we test without insulin on board is when there is a problem or they're close to remission. You both get the day off today and can pick up again with the evening shot. :)
 
S
Oh shoot! I forgot he didn't get any insulin. Don't worry about getting a test then. The only time we test without insulin on board is when there is a problem or they're close to remission. You both get the day off today and can pick up again with the evening shot. :)

Should I be testing him every morning and night before his shot?
 
That pictures is great! That's what I was trying to describe, but as they say, a picture is worth a thousand words!

What’s weird though is I don’t know how I ever found it! I could swear it was a sticky at the top of the Lantus forum, but now I don’t see it?? (Not ruling out having lost my mind ...) I found it now by using a keyword search.
 
S


Should I be testing him every morning and night before his shot?

Yes. Definitely before each shot (PreShot = PS on the spreadsheet) and ideally also mid-cycle (around +6) so that you can see how low kitty goes. For the evening cycle, lots of us shift that mid-cycle up a couple of hours to “before bed” (so, maybe around +4), which is usually enough to give an idea of how low the cycle may be going and, therefore, if you should stay up a little later. I confess to sometimes being a tiny bit happy to see a higher number than is optimal for her at Before Bed because it’s more optimal for a very tired me! ;)
 
Here's the basic testing routine we recommend:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
 
Ok thanks. And it's ok to give him a bit of food to settle him down before the am and pm test? He is always so hungry!
 
Hi there. You can always trust Djamila's and Kris & Teasel's advice, and I for one love it when they cross-post giving the same advice -- talk about instilling confidence! If either of them said okay to give a bit of settling food, I'd trust it; since both of them said it, that's litany and verse! :D
 
Hi there. You can always trust Djamila's and Kris & Teasel's advice, and I for one love it when they cross-post giving the same advice -- talk about instilling confidence! If either of them said okay to give a bit of settling food, I'd trust it; since both of them said it, that's litany and verse! :D

OK, great! Thanks everyone, you are all so kind and helpful. :)
 
Hi there. You can always trust Djamila's and Kris & Teasel's advice, and I for one love it when they cross-post giving the same advice -- talk about instilling confidence! If either of them said okay to give a bit of settling food, I'd trust it; since both of them said it, that's litany and verse! :D
Thanks for the vote of confidence! :)
 
So need some advice...I tested my cat's blood glucose at 6 p.m. tonite, it was 400. I gave him his food and 4 units of prozinc. I just tested now, 4 hours and 45 minutes later, and his BG is 122. That's good, right? I plan to test him in the morning before I give him insulin.
 
Hi. Just to be clear, I am not competent to advise (I’m too new), but you’re probably at +5 now and nadir is usually around +6, so Cat (is that his name?) is probably just fine and may surf nicely into the pretty dark greens before starting to come back up after the insulin peak. tahats what I would think even though you haven’t had the opportunity to get a lot of data yet. If it were me, and if I weren’t too tired, I’d be curious to stay up and grab the +6, mostly for data’s sake.

400 to probably 100 (a guess for +6?) does seem like a pretty big drop, though, so I would be sure to get the thoughts from the much more experienced people about what to look for tomorrow.
 
That seems like a huge drop... I was going to go to bed, but I'm afraid he may go lower and hypo. :(

I really don’t think he will because he’s so close to what is probably his nadir. He’s still got a long way to go before the “take action” number of 50 (human meter) and not all that much time to do it in, so time is on his side!
 
Hi. Just to be clear, I am not competent to advise (I’m too new), but you’re probably at +5 now and nadir is usually around +6, so Cat (is that his name?) is probably just fine and may surf nicely into the pretty dark greens before starting to come back up after the insulin peak. tahats what I would think even though you haven’t had the opportunity to get a lot of data yet. If it were me, and if I weren’t too tired, I’d be curious to stay up and grab the +6, mostly for data’s sake.

400 to probably 100 (a guess for +6?) does seem like a pretty big drop, though, so I would be sure to get the thoughts from the much more experienced people about what to look for tomorrow.
Sorry, the spreadsheet always wants mg/dl. He was 6.9 and when I gave him his insulin about five hours ago, he was at 22.7. His name is Tige (tee zhee).
 
So what numbers are the danger zone? Below 100?

Assuming a human meter, “take action” is 50. I believe it’s 68 on a pet meter (alpha track, I think, is what that meter is called?). But either number is still pretty far away from 122 at +5.

Edit: it looks likes “take action” for the mg/dl SS is 2.7 ... a long way from 6.9! [edit again: that should be mmol /L]
 
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Assuming a human meter, “take action” is 50. I believe it’s 68 on a pet meter (alpha track, I think, is what that meter is called?). But either number is still pretty far away from 122 at +5.

Edit: it looks likes “take action” for the mg/dl SS is 2.7 ... a long way from 6.9!

The units are confusing me. My human meter tests in mmol/L. He dropped to 6.9 mmol/L, or between 120 and 126 mg/dl, from 22.7, or between 400 and 414. I changed his food, that may have accounted for the bigger drop. I will be doing another blood test in about 20 minutes and I hope it is heading back up. But what do I do tomorrow morning? What number do I NOT give insulin?
 
It’s almost certainly the food. That has a major impact on BG,just like on human diabetics. When did you change him over to the lower carb wet food? Just recently, I think?

Regarding tomorrow’s dose, that’s where we’re going to need to get some more experienced eyes! :) My kitty’s highest dose was 2units, so I really have no sense of 4u like Tige has been getting. (The “No Shoot” number, before you have more data, is 200, but I don’t know about shooting 4u again ....)

My rec for that would be to start a new thread in this forum. Use the little drop down to put the Question Mark icon on it, and call it something like, “Need dosing advice after big drop (400 to [whatever the number ends up being])”.

Let me know what the +6 is! I’m here with you! :)
 
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Yay! Good job, Tige, and good job you, too. I know how scarey it is the first time seeing those numbers that are actually great numbers ... once we get used to them. :D

I would put up the new post about dose for tomorrow and then get some rest. :)

Good night!
 
I changed him tonight to Fancy Feast classic pate Chicken -- with 3 % carbs, from FF medleys chicken fare, with 11 per cent carbs. Before that he was on Hills prescription diet m/d, which is 13 per cent carbs. I will take your advice and do a new thread. Thanks so much for being here for me!
 
I changed him tonight to Fancy Feast classic pate Chicken -- with 3 % carbs, from FF medleys chicken fare, with 11 per cent carbs. Before that he was on Hills prescription diet m/d, which is 13 per cent carbs. I will take your advice and do a new thread. Thanks so much for being here for me!
Good night and thanks again!
 
No worries! I’m glad I was here.

P.s. be sure to put in the bit about the carb change from 11% to 3% coincided with this cycle’s big drop.
 
We are doing a BCG today and his AMPS was 8.3 (or 149), and went down to 2.7 (49) at +2 and stayed at 2.7 (49) at +3. No hypo symptoms. I gave him some food at both times, and put some corn syrup on his food the second time, and at +4 he's at 6.8. (122) Did I do the right thing? I go afraid and that's why I gave him the food and corn syrup. I will test again at +6.
 
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Hi. Yes, it’s very scary when you first see a lime! Actually, it’s kind of scary every time. :nailbiting:

You did a great job steering him up, and I do think that intervening with a lime +3 (even if it’s just barely lime) is important. After all, +3 is pretty much the onset of the insulin, and it’s a long way to nadir at that point, and I know from experience that three hours feels like for.ev.er.

It’s really hard to know what to do, esp the first time (or two or three!) before you trust yourself to be able to pull him up and know his reactions. I want to break out the honey right away and give a bottleful!

I’m slowly becoming more comfortable with steering the numbers up. From my understanding (and hopefully someone will correct me if I’m wrong!) this means a little normal LC food — we use a quarter of a 3 oz can — and then test after 20 mins to see what effect that is having, if any. *If it’s helping, then wait an hour and retest to see if kitty is holding his own. If staying about the same, then small feeding again, retest in 20, etc. If dropping, then I think it depends on where you are in the cycle. A couple of weeks ago, Josie was still dropping at +4, and so with two hours to go til nadir, we popped the top of a gravy food, put the lid back down, and squeezed out about a teaspoon of just the gravy to help her come back up. This has two benefits: it keeps them from shooting sky high, which can mess them up for the next cycles, and it also gives them the carbs without filling them up in case you have to keep feeding as the cycle goes on.

I read on the main forum recently that a *very* experienced member (Marje) likes to reserve honey for a symptomatic hypo, and though I don’t know if I could be that brave, it does make sense when I’m not in the moment. Honey spikes them right away but doesn’t last long, so it’s good if you use it to mix it with food, as you did.

But I’m kind of a hypocrite! The first time Josie “limed,” I think we gave her a full can of gravy food AND temptations treats (essentially kitty sugar cookies) AND we “iced” the treats with honey! We’re lucky she didn’t spontaneously morph into a big bag of sugar on the spot! ... esp since, I’ll admit it, I think she was at +5.5 or even +6 at the time and so was almost certainly about to come up all on her own as she hit her nadir. :oops:

*Edit: IIRC, there’s another 20 minute wait without feeding/re-test right here. Once you get a couple of numbers in the “Good Greens,” then wait the hour to retest to see if kitty is holding his own.
 
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