Diabetes and Hyperthyroidism

[Jackie55 & Bootsie]

Bootsie was recently diagnose as being hyperthyroid. She started on methimazole 5 mg per day and will have her level checked again this week. My question is about her blood sugars. They are all over the place which is sort of her but they are definitely trending lower. I adjust her insulin on a sliding scale based on her previous history and her blood sugar levels. I know many of you say her insulin needs to be consistent but “I know my cat!” , so please do not judge how I manage her. I just wondered if anyone else has had this experience with hyperthyroid disease and diabetes

 

[Wendy&Neko]

We have had quite a few people on FDMB with cats that have hyperthyroidism as well as diabetes. Hyperthyroidism can cause a form of insulin resistance, so controlling the hyperT can help lower the amount of insulin needed. I remember one member whose cat went into remission, but came out a remission a couple of times when the methimazole dose needed to be adjusted.

I also cannot stop saying something about insulin dosing. My comment is not about being consistent with dosing - some people use different dosing methods than we use here. You might want to take the phrase "TR" off the spreadsheet and signature and put "custom dosing". The one thing I will say is that Bootsie needs less insulin now, and you shouldn't be giving her doses based on preshots. Especially not 25 and 26 units again. Maybe not in the 20's units at all. You can't shoot down high numbers with a one time higher dose of insulin when using glargine. Your current dosing method is causing her to go dangerously low, as evidence by the 30's you are seeing.

 

[Jackie55 & Bootsie]

We have had quite a few people on FDMB with cats that have hyperthyroidism as well as diabetes. Hyperthyroidism can cause a form of insulin resistance, so controlling the hyperT can help lower the amount of insulin needed. I remember one member whose cat went into remission, but came out a remission a couple of times when the methimazole dose needed to be adjusted.

I also cannot stop saying something about insulin dosing. My comment is not about being consistent with dosing - some people use different dosing methods than we use here. You might want to take the phrase "TR" off the spreadsheet and signature and put "custom dosing". The one thing I will say is that Bootsie needs less insulin now, and you shouldn't be giving her doses based on preshots. Especially not 25 and 26 units again. Maybe not in the 20's units at all. You can't shoot down high numbers with a one time higher dose of insulin when using glargine. Your current dosing method is causing her to go dangerously low, as evidence by the 30's you are seeing.

Wendy, thank you and I understand what you are saying regarding her dosing. I will change her sheet to reflect custom dosing. When she has lower BS I have tried to either give 2/3 or 1/2 dose depending on where she is. That being said she is challenging me. However even when she is in the 30’s, she is never symptomatic. Never is she lethargic, unstable, or clumsy, she just does not want to eat but I give her the honey and 1 Tbsp dry food for diabetic cats (which she will always eat) and she will usually balance out.
Thanks again for the advice.

 

[Suzanne & Darcy]

Hi Jackie. I haven’t talked to you in a while, and I have been thinking about you lately. I think the suggestion is that you should actually cut Bootsie’s dose by quite a bit. If you lower her dose, which really would be beneficial now that she is on methimazole and will be less resistant to the insulin, I think she would do better. She is on a cycle of dropping too low and then bouncing. I can see that in her spreadsheet. I am not “judging!” Judging is such a condemning word that is not appropriate in this situation. Please don’t be angry with me. I know how you work very hard at caring for Bootsie! @Wendy&Neko what did you have in mind for a lower dose to try for Bootsie.

 

[Wendy&Neko]

what did you have in mind for a lower dose to try for Bootsie

I didn't have a single dose in mind. Jackie is not following any dosing method I know, but does seem to be dosing based on preshot values, which is not what I am familiar with. I just see that she needs less insulin and shouldn't be shooting those higher doses.

 

[Suzanne & Darcy]

I didn't have a single dose in mind. Jackie is not following any dosing method I know, but does seem to be dosing based on preshot values, which is not what I am familiar with. I just see that she needs less insulin and shouldn't be shooting those higher doses.

Thank you.