Ever heard of insulin stop working?

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HyperJMA

HyperJMA

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Hey Everyone,
I went to do a glucose test and it just appears that the insulin has stopped working?
A few weeks ago they increased his dose from 2 to 3 units twice a day, and then his BG started going haywire. We made the decision to lower it to 2/2 for a week and then do a glucose curve, with the intention of possibly increasing it using the protocol, by either .25 or .5 units....
But today was just weird! As was yesterday!
I can't make any sense of this information.

Also ---- for food, we are giving him 1/4 of his daily calories in dry kibble in the morning before his AM shot and 1/4 of his calories in dry kibble at his PM shot. We are having a difficult time getting him to eat any wet food, so we are trying to ensure he is getting a minimum amount of gaurenteed calories. We know it isn't optimum for a diabetic cat, so we have some wet food samples being sent to us.

Any insight?
Jess
 
I don't think the insulin has stopped working. His numbers are all definitely over the place. He has gotten some pretty good numbers - 200s at preshot and some blues. I think 2 units could be too much. Sometimes when the levels are higher midcycle than they are at preshot, it can be indicative of too much insulin. The other variable is the dry food. When he gets more of that on a given cycle, he may have higher levels.

What kind of dry are you feeding? There are lower carb dry varieties that you can try while you are working to transition to wet. I assume you have seen this vet's ideas for transitioning: www.catinfo.org. @Carol & Murphy has a difficult kitty as far as food goes, and she may be able to help.

What would you think about lowering the dose to 1.5 for a few cycles and see if the numbers are better? And continue with the transition to dry - it can make all the difference.
 
I agree with Sue. I think lowering the dose for a bit could help. It may be that your dose is too high and if you lower it, you'll see some nicer numbers!
 
Hi Everyone!
Thanks for the input! I think I will talk to the hubby about lowering the dose, but it just sounds so counterintuitive since he's in the 400's. Can you provide any links explaining why this would happen? I think having those would help with explaining it to the hubby.
Also, he is on a special k/d kidney diet. His kidneys are so bad that the vet (and us also) feel that treating the kidneys is more important than the glucose.... We are trying to find additonal low phosphate, low carbs, but medium protein diets. We have a few on order from Cats In the Kitchen and Weruva. So, since he only consistently eats the dry food, we can't switch it to lower carbs since that is the food we believe are helping the kidneys.
 
Have you seen this site for kidney kitties? She has great info on it, including diet ideas.

http://www.felinecrf.org/index.htm
I don't have any documentation for the inverse curves, but it is not a normal pattern to be higher midcycle than at preshot. It suggests the insulin is not working correctly. ProZinc usually gives you a smile shaped curve with the lowest point in the middle (5-7 hours after the shot). When your highest numbers are midcycle, and when the insulin is wearing off (12 hours after the previous shot) the levels are lower, it may be that his body reacts better to less insulin rather than more.

It is sometimes worth it to just test the theory. So, reduce for three cycles, testing at preshots and nadir (lowest point) to see if the numbers are lower and the curve more smile shaped. If it doesn't improve the numbers, you can go right back up. If you do decide to try it, get some ketone strips and test for ketones.
 
Sue and Oliver (GA) said:
Have you seen this site for kidney kitties? She has great info on it, including diet ideas.

http://www.felinecrf.org/index.htm
I don't have any documentation for the inverse curves, but it is not a normal pattern to be higher midcycle than at preshot. It suggests the insulin is not working correctly. ProZinc usually gives you a smile shaped curve with the lowest point in the middle (5-7 hours after the shot). When your highest numbers are midcycle, and when the insulin is wearing off (12 hours after the previous shot) the levels are lower, it may be that his body reacts better to less insulin rather than more.

It is sometimes worth it to just test the theory. So, reduce for three cycles, testing at preshots and nadir (lowest point) to see if the numbers are lower and the curve more smile shaped. If it doesn't improve the numbers, you can go right back up. If you do decide to try it, get some ketone strips and test for ketones.
Click to expand...
Yeah, I've been on that site alot. I think I've read almost everything! Haha
I will ask hubby about giving the lower dose a chance. But I was just wondering... do you think insulin goes bad? I know it says on the bottle that if you shake it too hard it might make the insulin unusable?
 
Sharon14 said:
Have you seen this food
https://www.chewy.com/hi-tor-veterinary-select-neo-diet/dp/36200
It is 9% carbs
Also here is a list of low carb, low Phos foods
https://docs.google.com/spreadsheets/d/1E_HZnTcJdsr20Gpivo2ID1KQ9wlZAe1Xy3LDTDVRofU/htmlview?pli=1
Click to expand...

Yeah, we've tried that food. He didn't go for it. We are considering putting fortiflora on it to try to tempt him.

And thanks for the reference. I've seen it many times and we are ordering lots of food samples from that list to try. Right now he is into Fowl Ball...
 
Insulin can go bad. You usually see floaties in it. But you got a blue preshot on 6/28. If it wasn't working, you'd only see high numbers, consistently.
 
Looking at your spreadsheet, it looks like 2.5 is a good dose for the higher preshots and 2 did well on the lower ones. I think you'll be seeing better numbers once you get rid of the kibble - good job working so diligently on that!
 
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