controlled diabetic with reduced appetite

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pups

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I have a 15 year old cat who has been medicated for nearly two years. He currently gets 3.5U with his morning meal and 3U with his evening (insulin glargine). He's happily eaten MD dry food since his diagnosis. I've given numerous curves at home, many in the first half year as we had a tough time determining his dose. We had a great vet who helped us through it.

Over the last three days my cat has had a reduced appetite. This guy is always ready to eat his measly 1/4 cup food, meowing from wake-up until feed time. But these last few meals he hasn't once asked for food verbally. He comes when he hears his food, but seems content to eat half - even if I coax him with pets. I tried wet food, which has never once gone uneaten, and he smelt it, had a bite or two, and then left it.

Besides that he seems perfectly normal. Things look good in the litter box. I took his glucose levels a half hour after dinner (he got his 3U before I noticed his unfinished food so I was a little scared). It was a little high (7.5). His last curve ran from 2.2 to 8.7.

Any advice? Other symptoms I should be looking for? I know I shouldn't give him his full dose if he doesn't eat his food ... should I give him 1/2 the dose if he eats 1/2 the food? I'd like to do a curve tomorrow, but how can I use those numbers if his eating and dose aren't normal?
 
2.2 is bordering on too low.. Almost hypo territory and merits a dose decrease. He may be going even lower at night .. Cats do that. My Tiggy stopped eating when he started dropping too low. Anyway a few questions....

1. Did u change food recently?
2. Does his breath smell of acetone ? Can u check for ketones?
3. Can u do a curve today (every 2-3 hours is fine) and post here
4. Do u have syrup and /or high carb gravy food in the house?

Lantus works best on consistent dosing, at the least I would do 3 units twice a day, not different doses am and pm .. But I would like to see today's curve. And that recent one too.
Thanks
Wendy
 
Things change. Reduced appetite may come from a number of conditions, including these common co-ocurring conditions: pancreatitis, inflammatory bowel disease, bladder infection/stones, and hepatic lipidosis.

Whenever you see a sudden change in behavior, the first stop is the vet's office. The more data you can provide the vet, the better.
- Blood glucose tests
- eating - amount?
- drinking - amount?
- peeing - amount and frequency?
- pooping - volume and frequency?
- vomiting?
 
Thanks for the replies Wendy and BJM,
We also thought 2.2 was low as well. During that curve he was at 3.5U morning and night, after that we bumped his night dosage down to 3U.

To answer Wendy's questions:
1. No changes in food
2. No distinct smell from his breath
3. Doing a curve today, I'll post the results - however, as I mentioned in my post, he is only eating 1/2 his usual amount. I made a decision to not give him insulin today, but proceed with the curve to monitor his sugar every couple hours. I'm also giving him a chance to finish his food every couple hours.
4. Yes, I keep corn syrup on hand for emergencies

To answer BJM's questions:
No changes in drinking, peeing or pooping. No vomiting.

Previous curve:
3.3 08:09:00 AM
feed 1/4 cup MD dry 08:10:00 AM
2.2 08:39:00 AM
3.2 11:33:00 AM
8.7 02:40:00 PM
6.3 05:40:00 PM
4.6 08:21:00 PM
feed 1/4 cup MD dry 8:30:00 PM
 
Are you using a human glucometer or a pet-specific glucometer?

With a human glucometer, if you go below 50 mg/dL (2.7-2.8), you are set up for a hypo, especially if it is less than 5 to 7 hours after the shot. With a new diabetic of less than 1 year, the 2.2 would earn a dose reduction of 0.25 units. With a pet-specifi meter, going below 80 (4.4) is the reference number.

Some animals, if they go much lower than normal, will actually have an increase in glucose due to triggering couter-regulatory hormones which release any stored glucose.
 
Yah this a Bayer human glucose meter, indeed the 2.2 was quite low. We reduced his evening dose by 0.5U as a result.
As I mentioned I did a glucose curve on him yesterday but gave him no insulin. I should be able to post those results tomorrow, but I can tell you all the readings were between 3.5 and 9.0. Is it possible he's gone into remission? Could something else be causing his glucose levels to be normal even though he had no insulin that day and ate 1/2 his usual amount?
 
pups said:
...all the readings were between 3.5 and 9.0.
Is it possible he's gone into remission? Could something else be causing his glucose levels to be normal even though he had no insulin that day and ate 1/2 his usual amount?
Click to expand...

Readings of 3.5 (63) to 9 (162) are pretty good, although we'd like them to be under 7.2 (130 mg/dL). So it is getting closer to possible remission.

Eating less food = less glucose = less for insulin to manage. Note that cats may make carbohydrates by re-arranging either protein or fat molecules.
 
As BJM said those readings are pretty good.

If you are still giving three units, you will slowly need to earn dose reductions until you get down to 0.1U of insulin and are seeing those great numbers. A cat that needs any insulin can not be considered in remission, regulated perhaps but not in remission. We'd love to help get you to that remission stage.

One way to do that, would be to feed a lower carb food than the Hill's M/d dry which is around 16% carbs, the canned is 14% carbs. Will your cat eat canned food? Would you be willing to try to transition him from a dry to a wet food?
 
Those numbers are good.. I am looking forward to seeing the curve you did without the insulin!

It sounds like he is bordering on remission, you just might want to tweak his food to help him more since dry is higher in carbs and carbs spike the blood sugar... Losing the dry and going to a low carb wet canned will help and may be the tipping point... Ie fancy feast classic Pâtés, friskies pâtés, wellness grain free etc.
 
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