Difficulty getting regulated after diagnosis

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emm

Member Since 2022
Suits (10yo neutered, not overweight 12lb DSH tuxedo) was diagnosed diabetic around Labor Day after fooling more than one round of labs trying to figure out his muscle loss, water intake, crazy appetite, and poor coat condition. A keen ER vet finally did a spot test instead of ordering a panel, and starting 1U Lantus every 12hr made a massive improvement in his demeanor and overall condition.

2 months after initial diagnosis, we are still struggling to get him regulated. He’s been on solely wet food for years and switched to a 50-50 mix of Weruva Paw Lickin Chicken and Chicken Frick a Zee starting the first week of October. He’s been allowed 15oz a day (3oz more than Weruva suggests for his size), remains ravenous, and we confirmed today he is just maintaining his weight.

The vet just bumped him up to 4.5U of Lantus twice daily. His water intake is massively improved since hitting 3-4U, but after a week at 4U the vet just clocked his glucose at something like 380 an hour before his evening dose. It was over 400 after a week at 3U, and a bit under 400 the test before that at 2U (which wasn’t timed as closely to his evening dose due to scheduling issues).

Today, I’m addition to the half-unit increase in dose from 4 to 4.5U, the vet wants to try switching him from the Weruva mix I have him on (>55% protein, <3% carbs) to canned Purina DM. She sent me home with some donated cans for free. Suits went straight for the spoonful I trialed beside his Weruva this evening, so it seems he’s game to try it. I’m a bit skeptical, though.

Has anyone had any experience to suggest the DM could actually make a difference for better or worse? Anything we should be asking or checking for since he appears to be so insulin resistant? I do want to learn to test at home but haven’t sorted that out yet. I’m concerned his levels could be artificially elevated at the vet, but his clinical signs don’t suggest he’s well regulated, either.
 
Hi and welcome to the forum!
Sorry I have no idea when labour day is because I don’t live on the US. Can you tell me the date he was diagnosed please.
Are you saying the vet bumped him up from 1 unit to 4 units in 1 unit increments? How long did he stay on each amount of insulin? How was he tested to decide on an increase?
We recommend increasing in 1/4 unit increments only.
If he is just being tested every so often at the vet, it is very possible he is dropping lower at other times and then bouncing up afterwards …this in common. If you only catch the bounces, you will only see high numbers, and doing increases if that is happening can be very risky as you don’t know how low the dose is taking your kitty…..does that make sense? .
BOUNCING information from The Basics
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

Unregulated diabetic cats will be very hungry because they can’t absorb all the nutrients in the food without the correct amount of insulin. That will improve when the BG numbers are in more normal range. Are you giving 2 good meals a day and the at least 2 or 3 snacks each cycle?

the vet wants to try switching him from the Weruva mix I have him on (>55% protein, <3% carbs) to canned Purina DM. She sent me home with some donated cans for free.
There is nothing wrong with the Weruva cat food. And it is cheaper than the prescription food. There is nothing special about prescription cat food at all. Except the price! I would not swap myself. Vets get their nutritional training from the big food companies that promote their own prescription foods so they all tend to promote the use of prescription foods. We don’t recommend the use of them. Normal cat food that is 10% or lower in carbs is perfectly ok for diabetic cats.

What I would suggest you do is start hometesting the blood glucose tests so you can see what the insulin is doing each cycle. And I would use a human monitor to test the blood glucose not a pet meter which is much more expensive to run. A ReliOn meter from Walmart is very reasonably priced. Some vets are not on board with caregivers hometesting but please don’t let that put you off. It is one of the most important things you can do to get your kitty regulated and happy again.
We not only need to see what the BG is before the shots but we need to see it about 4 to 6 hours after the dose to see how low it takes the cat. Lantus is a good insulin for cats.
HELP US HELP YOU has good information for new members. If you could set up your spreadsheets and signature for us that would help a lot.

HOMETESTING HINKS AND LINKS can help you get set up to hometest the blood glucose which we recommend you do.

I hope this has been of some help. Please keep asking questions. We are very happy to help. This is a wonderful community and our aim is to help all diabetic kitties.
Bron



 
@Bron and Sheba (GA) labor day 2022 was the 5th of September

Hi and welcome to the group to you and Suits. Bron is super smart and knowledgeable and gave you great advice. The Purina DM is a higher carb-content food at around 10% calories from carbs, it is not likely Suit will have better numbers on a diet higher in carbs. Many people here shoot for under 5% calories from carbs and that is what you have been feeding.

as far as possible insulin resistance, it is hard to say without more BG test data. Doing hometesting is super important and will help you get a handle on what is going on with Suits, and allow for the experts here like Bron to offer some guidance on dosing if you set up a spreadsheet.
 
I agree with what everyone has already said about the food. I wouldn’t switch. Prescription food is higher in carbs and although every vet out there seems to recommend it, it’s not ideal for diabetic kitties.

I would also suggest you feed him as much as he wants right now since he’s unregulated and will need more food to keep or gain weight. A good rule of thumb for daily calorie intake is 20 x ideal weight. If he’s ideal weight is 15 pounds that would be 300 calories a day. More while you’re trying to get him to gain weigh back. Also keep in mind diabetic cats can’t process the nutrients in food well and lose calories just by peeing since there’s sugar in their urine. Most of us give 2 large meals at shot times and then smaller meals throughout the day. It’s easier on cats, who are typically grazers, and on their pancreas too!
 
Welcome!!

You've already got some great advice, I just want to add that you are going to need to be very very very patient a little bit over two months may seem a lot of time for the cat to get regulated but is really not that much it can take months many months and a lot of information (that is why home testing is so important) to really get there so take a big breath and relax you will get there eventually and he will start regaining weight once he's regulated, for know I would suggest that you allow him to eat as much as he wants and as long as he doesn't lose more weight do not worry too much about it for now.

Testing at the vet usually raises their blood glucose numbers because of stress, Babu could get a blood glucose result of over 200 more at the vet that what he had tested at home just before going to the vet so home testing is way more accurate and there's the issue that if he's getting high numbers at the vet you may be giving too much insulin which could cause you to have the same sympthoms as giving to little
 
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