Diabetes and CRF

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kajal.setpal

Member Since 2014
My 16 year old cat boo was diagnosed with diabetes recently. She also was diagnosed with chronic renal failure few months ago. She been on royal canin diabetic dry kibbles since but she does not like it one bit. She had reduced to skin and bones. I switched her back on royal canin renal failure food, which she likes. She drinks tons of water throughout the day. Her readings have been going up to 550-600 every 6 hours after insulin. She is currently on humulin 30/70 every 6 hours, but I think she needs to be on a more long lasting insulin (may be lantus). Any one got any suggestions please. I have started her off with 2 units undiluted insulin today, her BG goes down till the first 2- 2.5 hours and starts rising up again, by the 5th-6th hour it is back to what we started with. I am very worried and confused i don't know what to do. These are her readings:

04:21am 588 (0.14 ml of insulin, diluted to 1ml. final doze given was 0.1ml)
07:13am 355
10:10am 571 (0.14 ml of insulin, diluted to 1ml. final doze given was 0.1ml)
12:32pm 339
16:17pm 419 (0.14 ml of insulin, diluted to 1ml. final doze given was 0.1ml)
18:31pm 242
22:27pm 538 (0.14 ml of insulin, diluted to 1ml. final doze given was 0.1ml)
00:14am 343
 
Good morning and welcome to FDMB.

A longer acting insulin will help. Lantus, Levemir, ProZinc and PZI are good choices. The first two can be purchased through your pharmacy, the last two your vet can order for you. All work very well.

One option for food is the canned Friskies Special Diet food. It will help with both the diabetes and CRF.
 
First, you should use insulin syringes to measure insulin in units.

Second, what is the reason you are diluting? Doing that on the fly every time may result in varying doses. If its a problem seeing the dose, there are all kinds of magnifiers out there that can be used.

Third, at least make a switch to plain Humulin as you don't need the rapid part of it to drop the cat quickly - straight Humulin N will do that quite well on its own and lasts 6 to 8 hours in the cat.

Fourth, recommeded longer acting insulins include ProZinc, PZI, Lantus, and Levemir.
Comparing cost on a per unit basis actually has Lantus be less expensive per unit. We suggest purchasing Lantus as a pen of insulin and using regular syringes to draw it out, not the pen tips.

Fifth, print the AAHA guidelines out, read them, and share them with your vet who is out of date.
 
Hi to sweet princess Boo and her mommabean or daddybean and welcome to the message board. Would your introduce your momma/papa to us? Perhaps sharing their first name with us?

Where do you live? US, Canada, somewhere international?

We want to give you the best suggestions for food and testing supplies, and that is dependent on where you live.

You already have some great suggestions from folks here.

Welcome, and let us know how else we may help you.

ETA: You mentioned maybe trying Lantus. Here is a document by DCIN on how to get Lantus insulin less expensively.
 
30/70 Humulin insulin 30% R (Regular) insulin and 70% N (NPH) insulin. The short duration is what is expect with that insulin and that is shy is is not really suitable for cats.
Also yo say you are giving 0.14 ml of insulin, diluted to 1ml. final dsze given was 0.1ml. That equates to 1.4 units of insulin. You can do a good job of estimating that without diluting by using insulin syringes that have 1/2 unit markings.
However, as others have said, 30/70 Humulin is not suitable for a cat and a longer lasting insulin is recommended. Even straight N (NPH) would be better.
 
Hi guys thanks a lot for all the replies. My name is Kajal, I live in Dubai, UAE. I am so grateful for this forum, I seriously don't know what i would have done without your help and support.I have just purchased lantus pens, will take it to the vet to see how much i need to administer. Is there a particular reason as to why you draw from the pens into the syringe? Cant we use the pen needle directly? Secondly, since lantus is a long lasting insulin and not fast acting, what should i do if i need an immediate drop in BG.
Can someone tell me what exactly does 30/70 mean in Humulin? The reason I've been diluting the insulin is because the final measure of pure insulin I'm expected to give boo is 0.01. This is what we had started her off with when she was diagnosed. We have gradually been increasing her dose since 0.01 doesn't really do much for her.
Hopefully with the change in insulin and her food, we will see much better results.
 
Welcome, I'm really new on here but my vet told me my diabetic kitty needed to have canned food only. I haven't started her yet on insulin, we go Friday for a vet visit but Baby was up over 560 both visits so far. The first week I didn't follow the canned food diet right, Then I found this forum and have so many great responses and learned so many things. I know the CRF that your kitty has also complicates her health. I have a cat newly diagnosed with CRF. Yes, one of each. There is a chart showing the canned foods that are low in carbs for the diabetes, and low in phosphorus for the CRF. Somebody mentioned the Friskies Special Diets and they are low for both issues with your kitty. My Baby lost a lot of weight and I need to get some weight back on here.

Here is a link to the page with the canned food that has most of the info you need and the group of canned foods that are good for your kitty if you have these foods available, http://www.catinfo.org/?link=origin Then you can read the article and the link to the food chart is on the right as commercial cat food link. That takes you to another page with Commercial Canned foods or you can go right to the link which comes up as a pdf or other options. That has a list of foods you can read more about the canned food or skip and go right to the food list.

I can see a difference in my cat with eating just canned food. She is calmer, not breathing as deeply and seems more content.

Hope this helps some with her diet.
 
My previous reply said what 30/70 Humulin insulin is. For more info see:
http://www.rxlist.com/humulin-70-30-drug.htm

I would start with 1 unit Lantus every 12 hours. We typically use syringes to draw the Lantus out of the pen since the pens only dose in 1 unit increments. Usually you end up with non-integer (e.g 1 1/2 unit) dosing.

kajal.setpal said:
Hi guys thanks a lot for all the replies. My name is Kajal, I live in Dubai, UAE. I am so grateful for this forum, I seriously don't know what i would have done without your help and support.I have just purchased lantus pens, will take it to the vet to see how much i need to administer. Is there a particular reason as to why you draw from the pens into the syringe? Cant we use the pen needle directly? Secondly, since lantus is a long lasting insulin and not fast acting, what should i do if i need an immediate drop in BG.
Can someone tell me what exactly does 30/70 mean in Humulin? The reason I've been diluting the insulin is because the final measure of pure insulin I'm expected to give boo is 0.01. This is what we had started her off with when she was diagnosed. We have gradually been increasing her dose since 0.01 doesn't really do much for her.
Hopefully with the change in insulin and her food, we will see much better results.
Click to expand...
 
Because of how Lantus works, it is likely that you won't see a drastic drop much of the time, unless you get to the point of shooting low to stay low in the Tight Regulation forum. Then, you may want to check at +2 hours after the shot to see if there is a lot of drop quickly.

For now, always test before shooting and if the glucose is < 200, wait 30 minutes without food and retest. If still not over 200, check with us about shooting.
 
boo's BG levels are 550, should i still give her 1unit i.e. 0.1ml of lantus insulin? She has currently been taking 0.02ml of humulin 30/70 every 5-6 hours.
 
1 unit of lantus is 0.01 ml (Lantus is a U100 insulin and that means 100 units per ml)
Yes, I would start with 1 unit insulin

kajal.setpal said:
boo's BG levels are 550, should i still give her 1unit i.e. 0.1ml of lantus insulin? She has currently been taking 0.02ml of humulin 30/70 every 5-6 hours.
Click to expand...
 
The food choices are very different in Dubai I'm sure. The food list you were given, from catinfo.org, has mostly foods to be found in the USA and Canada.

This post, from the Feline Health forum, Canned cat food for EUROPEANS and INTERNATIONAL buyershas some possible food suggestions for international members. You might want to see if any of these foods would be available in Dubai.

We had one other FDMB member in Dubai. She was feeding her cat Friskies pate style foods.

You have the added complication of finding a food that will also be helpful for the CRF. I don't believe the Friskies Special Diet foods are available in the U.A.E.

Would you please go into your user control panel, Profile tab, Edit Profile and add your location of Dubai, U.A.E.? Since you are in a very different part of the world, having this information readily available to us will get you better suggestions on food and meters and other help. Sure would appreciate it if you would do that to help us help you better.
 
what is the best way to switch from Humulin 30/70 to lantus? What should the appropriate time gap be between the 2 shots?
 
the problem with that is boo has been taking the humulin shot every 6 hours, so if i give her a gap of 12 hours her sugar with spike up too high. her sugar anyways reaches mid 400 to early 500 within 6 hours.
 
I am unable to switch boo to to a low carb wet food diet because of her CRF, should i still start her off with 0.1 unit of lantus every 12 hours? how long should i monitor this before i can increase or decrease her dose. I know her BG levels are very erratic because of her die at but I'm helpless. I don't know what to do.
 
You previously said "1unit i.e. 0.1ml of lantus insulin?" I then replied that 1 unit of lantus is 0.01 ml of insulin.
Yes I would give 1 unit of Lantus twice daily.
Just what are you feeding?
 
She is on Royal canin Renal special diet.

Larry and Kitties said:
You previously said "1unit i.e. 0.1ml of lantus insulin?" I then replied that 1 unit of lantus is 0.01 ml of insulin.
Yes I would give 1 unit of Lantus twice daily.
Just what are you feeding?
Click to expand...
 
Hi my 16 year old diabetic also has CRF. It would be best to feed a low carb low phosphorus food instead of the renal diet. I'm on my phone will write later. Sandy
 
I'm not sure about the foods that you have available but you are better off trying to find a low carb low phosphorus canned food. Many of the kidney diets are too high in carbs for a diabetic cat. Weruva has some foods that are low in carbs and phos and they have a great website with nutritional info. I think someone posted a link to dr lisa pierson's food chart. Many cats can go into remission on a low carb diet. I don't know what Boo's bloodwork showed as far as kidney numbers. Many kidney cats also have a high phos. Hopefully he is in early stage CRF. Uncontrolled diabetes can have adverse effects on the kidneys. Hopefully you will have better luck with lantus. There are many here who are very good with lantus dosing. I myself have never felt comfortable giving doing advise. Yahoo also has a few groups for feline CKD if you need help with that.
Sandy
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Im gonna try and upload boo's blood work here... once i figure it out. For now, i gave boo her first lantus shot today. started her with 1 unit at 8:30am. Her BG was 580. I checked her in 2 hours and the BG had spiked to "HI" on the machine. I am going to check her in another hour to see if it has come down a bit. I understand she is on a high carb diet and that may have caused her sugar to go up more. Im still trying to find a food solution that is good for her diabetes and CRF. There aren't a lot of options available here for her condition. There is nothing available from all the different food lists i have seen.

My point is, how long should i wait till i start panicking and rush her to the vet. Boo is not showing any signs of hyperglycemic shock yet.

I just checked boo again, reading still says "HI"

Basically 4 hours after her shot and her reading still says "HI"

p.s. I think the machine cannot read beyond 600
 
That is correct. Most meter indicate HI when over 600. If yo do not get below 500 all day I would up the dose to 1 1/2 in the PM. Normally one waits a couple of days to increase dose but in your case I would increase.
 
It would be nice you you started a spreadsheet with your dose and time of shots and insulin needed,. See:
viewtopic.php?f=6&t=50130
Knowing that I would be tempted to give 1 or 1/12 Lantus together with maybe 1/4 unit of the 30/70. That way you keep the BG lowers while you get to the right dose of Lantus.
I myself have give Lantus with R insulin and with N insulin.
 
Per Cat Info, you can add about 20-25% plain meat or poultry (cooked) to canned food. This will lower the carb percentage a bit.

Have you considered making your own? There's a recipe @ Cat Info, too.
 
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