Dunkin's losing muscle mass

[Dunkin in Hawaii]

Aloha all,
Hope I can find some answers here. My boy Dunkin is 15, diagnosed a year ago. Has been on lantus, which has been tweaked from a starting dose of 1 unit, to 2 units, then back down to 1.5 (while initial glucose curves were being done). In the last 2 months a new vet bumped it up to 2 units gain since is fructosamine results were 450. Seems that ever since then, hes been gradually losing muscle mass , more noticeably in his shoulders and hips. I have him on the lantus solostar pen at 2 units twice a day. Eating fancy feast classic, one can before each shot. He also has zero carb Young Again kibble that he can free feed on.

At his latest vet visit on friday, his BG was 250, and that was after not giving him his morning insulin shot...so it was 18 hours since his last shot. His fructosamine was 368. Ketones 2+ in his urine. (all of the previous fructosamine results were in the high 400's)

His appetite is normal, water consumption just a tad more than normal. Demeanor and activity level normal.

My concern is that he is wasting away by losing muscle tone and mass. =(.

Any ideas..? anyone? Too much insulin? Too little?

Sending much aloha from Hawaii =)

 

[BJM]

Welcome to FDMB.
The presence of ketones suggests he may not have the optimal dose of Lantus yet. As a result, he can't use all the calories from the food he is eating and is breaking down fat and muscle.
I'd feed him about 50% more food, plus test at home and follow the Tight Regulation protocol for Lantus to get his numbers into better ranges. You'd need to test his blood before each shot, as well as getting a test in the +5 to +7 hours post-shot at least once a week if not more often.

 

[Brashworks]

Thanks for posting this question. I'd be interested to know how the above works for Dunkin. Genghis was Dx in the summer and initially she gained a pound quickly (she was underweight and has the same muscle tone and mass problem, mostly in her hip area). I can't feel as much of her spine as I used to but she has stalled in her weight gain for the last 2 months. Her BG numbers with a dose of 0.1 unit are typically under 130 for the last few weeks, so she is pretty well regulated and she is probably eating twice as much as Dunkin (handsome fellow, by the way!). Given those differences (dose, BG regulation, and calorie intake), I imagine the only commonality is their advancing age.

Also, not to naysay your vet, but maybe get some advice from the folks in the Lantus/Levemir section of the website and research the sticky notes there. As I understand it, full unit dose increases aren't typical - usually it's recommended to go up by .25 unit as sometimes too much insulin can "look" like too little and you can shoot past the optimal dose (pardon the pun). Genghis is currently on 0.10 unit - I can tell you from personal experience that .25, which is mere drops of Lantus, can make a huge difference in some cats.

Best of luck and welcome!