Desperate - Kitty is insulin resistant

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amandalynn48

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Hi everyone,

I am new to this site but I am definitely not new to feline diabetes. My 15 year old kitty (Fat Cat - who is NOT fat and has never been fat) was diagnosed with diabetes October 5, 2011 at the vet with a blood sugar reading of 480. The vet started him on 3U BID of Humulin N and we were to return in one week for a checkup. We returned to the vet October 12 and his blood sugar was 470. The dose was upped to 5U BID for another week. We retured on October 19th for his checkup and his blood sugar was 459. Since Humulin was obviously not working well, I did some research and found out the PZI Bovine insulin was supposed to be the 'superior' insulin in resistant cats due to the amino acid similarities in bovine and cat insulin. So, I had my vet write a script for PZI Insulin (ordered from BCP Pharmeceuticals) starting at 3 U BID begininng October 21st. Spot glucose checks continued to show no improvement (three hours after his morning shot he was still around 330s), so I upped him to 5 U BID on October 28th. Three hours after his 5U shot, his blood sugar was 188. THIS NEVER HAPPEND AGAIN :( :(. October 29th three hours after 5U shot his blood sugar was 281. On October 31st three hours after his 5U shot his blood sugar was 321. Novemeber 2 three hours after his 5U shot his blood sugar was 232. November 3rd three hours after 5U shot his blood sugar was 271. I completed a blood glucose curve on Novemeber 5th (1 week after Fat Cat was started on 5U of PZI BID) and this is what I got:

9:00am (pre-shot glucose) - 386, 5U given
11:00am - 286
1:00pm - 250 (nadir)
3:00pm - 299
5:00pm - 348
9:00pm - 504 (OMG! Upped dose to 6U)
11:45pm - 368 (wanted to make sure 6U didn't cause him to crash)

11/6: 9:00am 5U given
12:00pm - 345
2:30pm - 313
8:30pm - 340

11/7: 9:00am (pre-shot glucose) - 362, 5 U given
12:00pm - 371

11/8: blood sugar three hours after 5 U dose was 340

I am a medical student doing some of my rotations away from home so my mom is in charge of Fat Cat's insulin and spot checks. She works from 1:00pm-9:00pm and that is why he gets his shot at 9am, we check it three hours later at noon, then my mom goes to work.

We had Fat Cat tested for hyperthyroidism because this is one of the insulin-resistant diseases that you can actually treat (acromegaly or cushing disease is a death sentence anyways) and he was found to be slightly HYPOthyroid! We didnt start treating his thyroid problem because I read that giving thyroid replacement can also make it more difficult to regulate diabetes and that some cats have thyroid problems that can be corrected by treating diabetes anyways.

We kept Fat Cat on 6 U of PZI BID for several weeks with still no improvement. Blood sugars three hours after morning injection we starting to climb to the high 300s. I called 1800KITTYDR (Cornell University's Feline Hotline) and spoke to a Vet about all of this since my vet clocked out on this case a long time ago. She suggested switching to Lantus (glargine) BID as she has had a lot of success with 3 units and under for all of her patients. We started Fat Cat on 2U as she directed BID starting December 2nd. On december 4th, he was 279 three hours after his morning dose of 2U. At 3:00pm this same day, he was already back up to 381!! We upped him to 3 units today December 11. His blood sugar three hours after injection was 326. His blood sugar at 2:00pm (5 hours after his 3U injection) was 385.

He is about 8.5lbs now, losing weight :(. Pees a lot, is always hungry, and very sleepy. It seems as though he responds to new insulin for two weeks and then he's resistant to it. He is on an all-wet diet, Fancy Feast Classic brand. We have dry kitten food (high protein) available all day long in case he gets hungry. It does have corn gluten in it but it's supposed to be low carb.

Does anyone have any suggestions? My poor sweet pea is continuing to lose weight and is starting to look pretty rough. I'll be home for a month this Wednesday (THANK GOD) so that I can monitor him even closer than before. I say he's 15 because we've had him for 14 years, but he was a stray kitty and we estimate that he was a year old when we got him. So he could be 18-20 for all I know!

Thank you everyone, god bless.
Amanda
 
Hi Amanda,

This sounds almost exactly my story with Gandalf in the beginning. We were up to 6U of PZI and he was getting worse not better. Then I found FDMB.

I hope none of this sounds condescending since you are a medical student and obviously understand the mechanisms behind insulin use and diabetes.

Most likely Fat Cat has been getting too much insulin all along - too much N, too much PZI, and now too much Lantus. The recommended starting dose for any insulin with cats is 1U BID.

Lantus is a very gentle insulin and works differently than N or even PZI. There is an excellent protocol used on FDMB called Tight Regulation and we have a tremendous section devoted to that method. http://felinediabetes.com/FDMB/viewforum.php?f=9

Since you will be home for while and can implement the protocol and have testing under your belt already, I recommend you head there for advice. Normally we like new members to remain on the Health section for a while before going to the Insulin Support Groups, but you sound good to go on the basics such as testing and lo-carb diet, you just need help understanding Lantus and getting on track.
 
I'm with Vickie 100%.
I think the dose has been too high from day one on each of the three insulins.
Since you have a month free, and obviously know the routine and have tried everything possible, and you obviously love Fat Cat, I think the Lantus Group will be able to step right in and help you figure him out.

Welcome to the board!
Carl
 
Please get Fat Cat tested for acromegaly and IAA. I don't think you're kitty has been dosed correctly, and Lantus or Levemir are great insulins, but if you get these two tests done, you'll know how to proceed. Some people will want you to start over; some won't. If Fat Cat comes back positive on either of those tests, treatment will be a bit different.

Acromegaly is bad, but it's not an automatic death sentence. Stereotactic radiation surgery put Boo's diabetes in remission; she died recently of chronic renal failure.

Michigan State University is the only lab in the country that tests for acromegaly, so you might as well send the blood straight there. If you send it out Monday, you should have your answer by the end of the week.

You might want to read the information here: viewtopic.php?f=12&t=375
 
Thank you everyone for taking the time to respond to my post.

If Fat Cat has been getting too much insulin since the very beginning, wouldn't he ever show some low numbers? He's always been so, so high :( Also, I wouldn't mind testing him for Acro or Cushings, but I HATED when the vet had to sedate him to draw his blood to test his thyroid. He was out of it the whole day, staggering around and even accidentally peeing on the floor. It broke my heart. I'm afraid that he is too weak now, and sedating him + taking blood will push him over the edge.

Do you recommend that I start all over with Lantus, 1 U BID? When I first started Lantus, we did 1 unit BID for 2 days with no dent in blood sugar. So I got restless and upped it to 2 units and kept him on that for 1.5 weeks, now he just started 3U today.

This is so hard - I know you all know your stuff on this website, and I have a 100% open mind to any suggestions. If I need to start over, I will.

Also, does anyone know of any good high calorie diets that I can implement to help the old guy gain back some weight?

Thanks so much!
Still hopefull,
Amanda
 
Is he bad at the vet's? I've never heard of being sedated for a blood draw. Do you have a cat vet you could try out?
 
Fat Cat is actually not bad at the Vet's office - every time that I have taken him, he's been really good. The day he was sedated for his blood draw, my mom took him. I was 5.5hours away at school :( I am going to contact a different vet once I get home on Wednesday. I really hope I can find someone who knows what they are doing and can draw a little bit of blood without sedating my poor baby, because I will not do that again.

Thank you,
Amanda
 
agree that the dosing hasn't been done very well. and yeah, i'd probably go back to 1 unit twice a day with the lantus, and read up as soon as you can on the lantus protocol. dose adjustments should be done by small amounts, not whole units at a time, anddddd, lantus needs fairly consistent shooting for several days as it "builds up" in their system and then starts working. so for instance, if you go back to 1 unit, you won't see much action for roughly the first 2-4 days in the numbers. the key is patience, waiting that 2-4 days, without jumping the gun and raising the dose. also, getting a few more numbers thru the day, or night, is more important in the beginning too. you don't have to do it 20 times a day forever but a few more tests than you've got would tell you quite a bit in the beginning. fwiw, i test Mousie only twice a day anymore because we've been doing this for 5 years now and i've got her figured out. :-) if her numbers start getting wonky on me, then i test a few more times when i can so as to find where i need to make an adjustment.

do you know about ketone testing? any diabetic should be tested regularly for these and even moreso kitties in the beginning of this journey, when we're trying to figure out the food and the dosing, etc..... so make sure you do that too :-)
 
I can see why you are frustrated! You were correct that the Hum N was not the best choice for cats anymore, many more improved options for cats these days. While using Lantus, keep in mind that it is an insulin with a storage "shed" that needs to fill so you do need to have some patience and changing doses isn't going to have immediate effects because you will need to wait for the shed to fill or drain. You can read some really good information in the sticky threads here viewforum.php?f=9

What is the dry kitten food your are feeding? There are only a few dry foods that are low enough for a diabetic: Innova Cat and Kitten, Wellness Core, and Nature's Variety Raw Instinct are all under 10% carbs and if your dry is high in carb it could be contributing to the high numbers, some kitties are very carb sensitive. You DON'T want to make food changes to lower carbs while on that kind of dose though. You can see some lists of foods with their information here http://binkyspage.tripod.com/index.html and https://docs.google.com/leaf?id=0B8Uu8g ... ist&num=50

With numbers this high, ketones might also become a factor, especially if you do restart at 1U to let the insulin clear from his system and see if the dose was started too high. You can use Ketostix that humans use and check his urine to make sure he's not running a risk of DKA. You will need to be patient if you give restarting a try, it will take a little time for the Lantus shed to empty and that extra insulin to clear the system and the body to quit dumping extra sugar into the blood stream before you see results. Having the acro and IAA tests run first might help put your mind at ease that it is the a good path to be on.

Is Fat Cat overly stressed or aggressive at the vet that they need to sedate him just to do a blood draw? Unless he is just too hard to handle, they should be able to do a simple blood draw without sedation, mine have never been sedated for blood draws and sometimes that blood draw went both ways :o

Best of luck getting Fat Cat under control. I know it is heartbreaking to watch them be sick and not have the treatment work. You are doing your best and you have found the best place to be to get help.
 
Thanks again everyone,

My dad just called and sent me a picture of Fat Cat. He looks so sick and sad. It's heartbreaking. My dad wants to put him to sleep tomorrow morning because he says that we are just torturing him at this point. This is so awful, I wish I knew what the right thing is to do. I am going to continue reading and searching for experienced vets back home. :(:(
 
My mom said that fat cat's pee has gone down quite a bit in the last couple of days - he's also starting to act more sickly (laying down more, ears are back, tail twitching, laying couched down on high stomach as opposed to his side)...could be having kidney failure? It doesn't make any sense that his pee volume is decreasing despite high blood sugar readings. I want to start all over and decrease his dose to 1U/day and cut out the milk my mom has been giving him as a treat (she didn't know any better) and see if this works, but I don't want to make him suffer if he is going through organ failure. Oh gosh, please help!
 
Hi Amanda,
There a couple things that you can do right away.
The first would be to start getting rid of the dry food, but don't cut it out immediately as you will likely see a big drop in FC's BG numbers, if he's just a normal diabetic kitty. If he's truly resistant, I doubt it will make much of a difference. Many people use timed feeders as you can space out/ration the day's food at regular intervals if nobody will be home to feed. If you start him over at 1u BID, then it's likely safe to remove the dry food right away. My Shadoe cannot eat any dry food or her numbers will jump at least 200 and that's on only a few pieces. She is an acro cat.
Petsafe 5-meal Auto Feeder

Here are the sheets for the two tests, acro and IAA:
Print these out and take them to the vet to get a quote for costs and have your vet be ready ahead to make arrangements for shipping.
IAA Test
IGF-1 (Acro) Test

Here are some notes on how people usually start out on these insulins, but I don't think you will need to do the 5-7 days to start as that's to build up the shed if using lantus/levemir
"General" Guidelines:
--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).
--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).
--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose...
--- If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

--- If an attempted reduction fails, go right back up to the last good dose.
--- Try to go from 0.25u to 0.1u before stopping insulin completely.

Random Notes...
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.
A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.
Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.

Now, if you try the start-over for a few days, please be sure you have Ketostix to test for ketones as FC is going to have much higher numbers if he is anything like my Oliver. I was told he should be started over and it was horrible, all the high 400 numbers, but it eliminated any doubt that he was getting too much insulin. I had him tested and he was positive for both acro and IAA. Today, he's doing just fine and just getting alot more insulin than regular diabetic kitties. And don't you worry about gaining back the weight; once you get him into his proper insulin dose range, you may think he is getting too fat. Oliver has doubled his weight!

If you saw my porky pussycats, you would see that acro and IAA are no death sentences.
Get a spreadhsheet set up so that you can keep track of your test results, and so others can view the numbers and help you with advice.

You are in a good place now; there are many around here who can help you.

There is absolutely NO NEED to have him put to sleep. All he needs is the right amount of insulin.
ETA I don't know any acro on PZI; most are on Levemir with some on Lantus.
 
The most immediate this to do is to get him to a Vet and see what the underlying issue is. Putting the cat to sleep would be , in my opinion, a last resort measure. But, that's me.

The other people who have given you advice so far are right on the money. You need to start over and you need to follow a blue print or regimen for kitty that will fit in to his condition, your parent's schedule, and your schedule.

I would stall Dad on the "put to sleep" issue as much as possible. Everyone needs to take a step back and take a deep breath.

Oh, and for canned food that's high in calories but low in carbs, I feed EVO 95% Chicken & Turkey. It has 0% carbs and, I don't remember the exact calorie count off the top of my head, but it is high in calories. My guy, Cini Mini, is underweight right now and that was the best food option that keeps with his FD.
 
amandalynn48 said:
My mom said that fat cat's pee has gone down quite a bit in the last couple of days - he's also starting to act more sickly (laying down more, ears are back, tail twitching, laying couched down on high stomach as opposed to his side)...could be having kidney failure? It doesn't make any sense that his pee volume is decreasing despite high blood sugar readings. I want to start all over and decrease his dose to 1U/day and cut out the milk my mom has been giving him as a treat (she didn't know any better) and see if this works, but I don't want to make him suffer if he is going through organ failure. Oh gosh, please help!
Click to expand...

Your parents should take him to an ER clinic. Those behaviors and symptoms are an indication something serious is going on and before they make a hasty decision, an ER clinic should be consulted. He could have a urinary blockage or ketones - that's not to diagnose anything, just to make you aware that this sounds serious. Those things can be treated and cats survive even DKA.
 
Ok, we are going to hold off and try starting him at 1U again. I really think he needs more than that and his sugars are going to go hay wire, but I want to do this right this time around because I have a feeling that this is going to be our last chance. How long should he be on 1U BID before I up him? I will get his blood drawn for acro and IAA if the vet can do it without having to sedate him. I am going to ask my attending physician if I can finish my week off tomorrow and head home tomorrow evening instead of having to wait til Wednesday to get home to my cat.

The vet told me all three times we went to him back when Fat Cat started Humulin in October that he had ketones - he would say, "His sugar is 470 with ketones." If he's on 1U for a couple of days and I am getting a postive ketone test, do I up the dose?
 
Before you reduce the insulin dose, please get a ketone test! Your parents can pick up ketone test strips at a pharmacy. If ketones are positive, then I would not reduce the insulin dose at this time. This is especially true since Kitty has had ketones before. If he has ketones present, then reducing the insulin dose is likely to make things worse. If ketones are more than Trace, I would call the vet tonight.

I agree with Vicky, a vet visit is in order. Pancreatitis is also very common in diabetic cats and can be very painful, but also very treatable. There are so many things it could be that a vet visit is the only way to know for sure.

The thing about Lantus is that it is a slower acting insulin. If your cat is in a crisis situation, making adjustments in his Lantus dose will not help quickly enough. At the vet's office, they can use fast acting insulin in combination with dextrose drips (if needed) to get his numbers under control. Lantus is a great insulin for daily use, but it is not a good emergency insulin.
 
Amanda,
I'm with the people telling you that Fat Cat needs to be seen really soon by a vet or the ER. If he's displaying those symptoms you mentioned, it could be very serious, but not something he needs to be PTS for. Ketones are not a good thing to see.
Bob went DKA and I came really close to losing him. The vet told me one more day might have been one day too many. He spent 3 nights in emergency care. Today, he's a diet controlled happy and healthy kitty. Please keep in close touch with Mom and Dad about how he's doing until you get home. He may need to go in before you get there.

Carl
 
Ok, So Fat Cat's blood sugar was 326 three hours after a 3U injection of Lantus, then it went to 385 five hours after the injection, and my mom just took his blood sugar (now 9 hours after injection) and its back down to 326. He wanted out, so my mom let him outside. I have an appointment at the vet for Tuesday - I will be home Monday night after my rotation. Tonight, we will go back to 1U of Lantus.

How do you guys collect your cats urine for ketone analysis? Do you use that nonabsorbent litter?

Thank you,
Amanda
 
Several tricks on catching pee.
Some people use a long handled ladle/spoon.
Some people use aquarium gravel on a one-time basis.
I've seen one where they just laid the stick in the box (of course, kitty peed on the other end!)
Some people put saran wrap in the box.

I use a blood ketone meter, so I don't have to mess with all that stuff!
Carl
 
amandalynn48 said:
...My mom said that fat cat's pee has gone down quite a bit in the last couple of days - he's also starting to act more sickly (laying down more, ears are back, tail twitching, laying couched down on high stomach as opposed to his side)...could be having kidney failure? It doesn't make any sense that his pee volume is decreasing despite high blood sugar readings. ...
Click to expand...

Decreased urination = possible obstruction = ER VET NOW
crouching in the "meatloaf" position can mean the cat is in pain
 
I'm sorry he's not feeling well. I do hope he's still eating. High numbers in themselves are not immediately troublesome but the fact that he may be in pain is of concern. If he's not eating there are some things we can suggest to tempt him such as baby food, dehydrated chicken, even deli meat.
 
He's still eating tons. He loves his Fancy Feast Classic. The only thing that concerns we as well is the extreme weight loss and sometimes wondering if he is in pain. Hopefully my vet apt on Tuesday with a new vet will shed some light.
 
He is clearly not in agony. He jumped up on my mom chair to be pet and purred away. He is doing a lot better than he was earlier - perhaps the 3U of lantus was just way too much and he was having a somogyi rebound...it's hard to tell. I need to be patient with his diabetes and not expect to see the results that I want for a long while. He's back on 1U for a couple of days and I plan to do a glucose curve on him this saturday. I just want him to stop losing weight, stop peeing all the time, and stop being so hungry. :( We are going to have his kidneys and liver checked at his vet apt on Tuesday. That's the earliest I can get home and to the vet.
 
Amanda
It is encouraging to read that he seems to be feeling a little better. The plan you have in place sounds like a good one. Find out everything you can at the vet on Tuesday, and then let us know what you find out. If you plan on a curve for next weekend, there will be plenty of people around here to help, advise, or just "be here" for you.

Carl
 
Thank you. I will definitely keep everyone posted. I really appreciate the help. My eyes are burning and my head is pounding from all the crying that I have done today- can't wait to get home! It's been so hard trying to treat him from a distance, instructing my poor parents on what to do without a whole lot of guidance from a vet. Tuesday will hopefully give us an idea of how his organs are doing and whether or not we should keep fighting the good fight.

Take care, ttys
Amanda
 
Hi, Amanda,

I can't add to the wonderful specific input you've gotten, but I thought it might encourage you to know about my Kitty's experience.

Briefly: Our original vet mis-dosed Kitty. Because he wasn't getting regulated, the vet kept raising the dose, until Kitty was getting 10 units once daily - and of course, not regulated, but rather bouncing around and nearly a goner.

We found FDMB and started over, gradually raising his dose using the protocol mentioned earlier. Even at 5 units twice daily, we weren't getting his numbers in a safe range. I got the acromegaly and IAA tests; thankfully, they were negative.

So we kept on methodically until we hit around 5.5 units, and he hit his breakthrough dose. Today, Kitty is in his 18th month of remission, after 15 months on insulin.

This is just to encourage you, and your parents, that this bad picture could still turn around. Kitty had terrible neuropathy - couldn't move a foot away from the litter box without sitting & resting - but that's better too.

You will find the best input, experience and support here. We're all pulling for you!
 
Many well wishes and prayers for your Tuesday appt. I am SO glad you found your way to the boards here when you did. I believe you will see that there is a lot of people pulling for you and here to help and there is a lot of hope in a situation where it sounds like you may have all been starting to lose hope.
 
hi amanda,

i also have a cat that has acromegaly. it is not a death sentence. insulin resistance is also not a death sentence - it is considered a "self-limiting" diagnosis, meaning that it resolves in time with the correct handling. we have experience with all of the conditions that require a high dose of insulin for a cat. none is fatal.

in your case, we don't know exactly what's going on. i would not assume insulin resistance from what you've said at all. more likely it's poor management of the dosing. we can teach you how to manage the insulin dosing accurately so that you will know exactly what's going on. lantus is predictable and understandable, but it takes a bit to learn it. many of us post every day (or often) so that others with more experience can read our spreadsheets and help us interpret and learn when to increase a dose, hold it, or decrease it.

i understand that you have an appt on tuesday, but i hope your folks will take him to the vet before then if he seems sicker. it's a good thing he's eating. when you mention that he's had ketones, that raises a red flag. the combination of high blood sugar with not eating with not enough insulin is a combination that can make the cat very sick very quickly.

not at this moment, but it's likely you will need to get rid of the dry food. some cats can't handle 2 kibbles without it making their BG increase. canned food can be safely left out overnight.

with the lantus - are you giving shots at 12 hour intervals, or did your vet give you a window of time? mine told me i had a couple of hours to shoot within, but i know now that lantus likes certain things. it likes 12 hr apart shots. it likes to settle in after a dose change is made for about 3 days. we make dosing change decisions based upon the lowest number in each 12 hour cycle (between shots), which is usually somewhere between 3 & 8 hours after a shot. we also like to see tests that are at least a couple of hours after eating anything. food causes a rise in BG as well.

as well as checking for ketones, please start adding water to his canned food to get more water in him. i add enough to make it like a runny oatmeal. uncontrolled diabetic cats are dehydrated. this is the only home remedy for ketones.

we've all given you lots of info. can you answer some of the questions and do you have more questions?
 
The hunger and weight loss will improve as his diabetes gets under control.

I would think 3 or 4 hour spot checks would suffice as opposed to full curves until numbers are flatter. Try for level numbers before bringing whole range down. This can take weeks or months rather than days but I think you'll see other improvements such as coat, eyes and attitude now that he's on insulin. And Lantus is a great choice.

I'm glad he's feeling better. Libby posted earlier - see if there's a link to when her Lucy was sick, it's very inspIring.

(Sorry if typos, can't see while screen from my phone. Oh, what area are you in? Just wondering if we have someone nearby for vet rec. Or just support. No adress, this is an open site.)
 
Hi everyone!
Thank you all SO MUCH for your information and support. Vet apt got moved to this morning at 9:00am so I just wanted to post here quickly before we leave. I am going to a vet hospital called Camboro in Edinboro, PA. I will answer all the questions that were posted and update everyone w/what the vet said later today when I get home.

I really appreciate all of you.
Amanda
 
Hey friends!

Fat Cat's vet appointment was Thursday morning with his new kitty doctor and everything went absolutely perfect. I love our new vet - he has a lot of experience with feline diabetes...what a relief! He was able to easily draw blood from Fat Cat without having to sedate him - my kitty was on his best behavior.
The doc got a complete blood count with differentials, complete metabolic panel, and did a cystocentesis for a urinary analysis. Labs showed that Fat Cat's kidneys and liver are functioning very well (liver enzymes and BUN/creatinine were in check). His cholesterol was a little elevated, which the vet said doesn't really mean anything in felines like it does humans. The only thing that altered the vet was Fat Cat's low potassium (he was 3.0mmol/L when normal is 3.5-5.8). So, Fat Cat was prescribed potassium gluconate gel BID - hypokalemia impairs insulin release and the tissues response to insulin - so hopefully this will help my poor little guy respond better to insulin, too! The urine analysis SHOWED NO KETONES!!!!!! But, his glucose was 1000mg/dL (ouch) and he was throwing out some protein, too. The vet wasn't too suprised by how much glucose was in his urine because we know he is very diabetic. Fat Cat weighed in at a mighty 8lbs 15oz. He got his blood pressure checked (which was very good) and his ears cleaned. They did a fundoscopic exam and did not find any signs of macular degeneration or retinal detachment. Most importantly, the vet suspects somogyi effect (like you all said) and wants to keep Fat Cat on 1 Unit for 2 more weeks. We are transitioning him from Fancy Feast Classic to Purina DM over the next 10 days. He also now gets CoQ10 once every morning.

I am amazed by how well my baby has been doing since the vet appointment. He's already put on a little bit of weight and he is not laying down as much anymore. His blood sugar on Friday three hours after a 1unit dose was 271 --- oh how this warms my heart!!! :) :) :) I haven't poked him since, but I plan on doing a few spot checks throughout next week to monitor him. The vet said to not worry about doing a glucose curve quite yet - he wants to give Fat Cat a little bit of time to adjust to all the changes we have made. The doctor suspects that Fat Cat will be needing an insulin increase, but he wants to see how he does with the diet change, potassium, COQ10, and 1U of glargine for 2 weeks before we do anything.

I am going to scroll back up now and repost with answers to any of your questions that I might have left out.

Thank you all for your support and guidence - what a wonderful message board to have on your side :) :) :) :)

SIncerely,
The Happy Momma of Fat Cat
 
The dry kitten food that we are using (but starting to wean him off) is purina's kitten chow.

Also, we did not test Fat Cat for IAA or Acromegaly at the vet apt because it would be unnecessary if the proper changes bring his numbers down.
 
want a chart want a char want a chart! :RAHCAT I would love to look at a spread sheet of what is going on and I think that a LOT of people would find it helpful if they are in a similar situation. It's great that you are getting a reaction with that small dose!
 
Hi friends!
How do you guys feel about Blue Wilderness High Protein Grain Free Canned Kitten food? It's supposed to only be 2% total carbs. Fat Cat hates purina DM canned and since I bought a huge case of 20 cans, I was thinking about mixing Blue Wilderness with purina DM until it's gone, then switch 100% to blue wilderness (fat cat loves the blue wilderness).
 
Hi Amanda,

Most of us use Janet and Binky's food charts to guide us on what the carb content is for a cat food. Here's the link -

http://binkyspage.tripod.com/canfood.html

If you click the link in on the page that says "New Canned Food Table', you'll see Blue Buffalo brand is at the top of the page. I don't see the exact name of the food you said you had so it may be that it's worded a little different? If it's the Chicken Kitten Entrée on the list then looks like you are good with a 2% carb food.

And as bookw0rm indicated, most vets will let you return unused cans of DM if that's where you purchased the food from.

On the "Old Canned Food" table Purina DM is listed as 7% carbs, which is not too bad, but lower carbs is better.
 
Hey everyone!
I actually called BlUe Buffalo today because some of the info on that table is outdated, and the lady said that the kitten canned cat food is actually 0.2% (not 2%) carbs for every 3oz can. All the other flavors are 0.5%- how awesome is that?!? I'm going to try to take the DM back tomorrow :)
 
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