High urine glucose

[Wendy&Tiggy(GA)]

Hello, my 6 year old cat was diagnosed with diabetes 2 weeks ago. He started off for 1 week at 2IU every 12 hours and the vet had me use urine glucotests in his litter tray to measure his urine glucose levels. They measured the highest on the chart >33mol/L consistently. So the vet moved him up to 3IU every 12 hours.

Its been a second week now and his urine glucose levels still haven't changed. I bought a glucometer and his blood glucose ranges from 10.7mmol/l at the insulin peak to 13.7mmol/l just before his next dose. The vet seems happy with these numbers but i wonder why after 2 weeks of insulin we have seen no change in urine glucose? Shouldn't it have dropped a bit? I even went out and bought keto -diastix today and they registered the urine glucose at over 100mmol/L! I worry its damaging his organs.

Would appreciate any insight here.. I am still trying to learn about this illness and I am not sure I understand whats going on..
thanks!!!!

 

[Jen & Squeak]

Hi there and welcome!

I am so glad that you are testing blood glucose levels at home now, let me say that first.

Urine glucose levels do not really correspond with blood glucose levels...the kidneys filter glucose from the blood and dump it into the urine which then sits in the bladder in between urinations. So if the cat is over renal threshold, you'll see urine glucose. If the cat spends a lot of time under renal threshold, then you'd start to see urine glucose levels going down.

Honestly, I'd trust your blood glucose meter and not worry about testing urine except for ketones.

Now, could you tell us more about yourselves, like what insulin you are using, what food you are feeding, etc?

Jen

 

[Carl & Polly & Bob (GA)]

Hi,
Trying to wrap my head around those numbers and doing the "american" conversion in my head. BG is ranging from roughly 190-250 in US numbers, which are not terrible.
I know that the "blood" number would be up to the minute, but I think the urine number would be lagging behind (takes glucose longer to work it's way to the urine), but I am not sure how long that time period is.

I've never tested for glucose in urine, but I am going to see if I can locate someone who has so they can help out here.


Carl

 

[Carl & Polly & Bob (GA)]

Thanks Jen!

Carl

 

[Wendy&Tiggy(GA)]

hi! Tiggy was eating 1/2 can of Wellness core and 1/2 cup Hills TD dry a day (for his teeth - recommended by our prior vet - i tell you I am pretty angry about this - if the dry food caused the diabetes!!!) , until we found out two weeks ago he was diabetic and we cut out the dry entirely. We tried him with Purina MD canned but he wouldn't eat it so we put him back on 1 can Wellness core and 1/2 can fancy feast (pate versions) a day. He is on Lantus/Glargine insulin 3IU every twelve hours.

Since we started the insulin we have seen a decline in peeing and drinking and he is more like his old self. He has lost 2lbs (he was 17lbs and is now 15lb but he is a big long cat) so the vet wants to ensure he doesn't lose any more - he was never fat or obese. He has neuropathy weakness in his back legs - a little shaky and stumbles sometimes. The weight loss and the neuropathy was what triggered us to realize there was an issue in the first place.

I want to do whatever we can to trigger a remission if its even possible and am trying to do lots of research on it- so any advice would be very welcome!!

 

[Jen & Squeak]

Yes, TD likely pushed my Squeak into diabetes as well. And the worst part is, TD does nothing to help with their teeth!

3units twice a day is a fairly hefty dose of lantus especially when combined with a reduction in dietary carbs. I am very very glad that you are hometesting so that you can catch if his numbers really start to go down. Please note that remission is a possibility but lets first aim to understand the disease and how Tiggy responds to insulin and the food changes

There is an insulin support group specifically for lantus. I'd suggest lurking over there and reading their 'stickies' on how lantus works but please do continue to post your questions and updates here while you learn your way around. One thing with lantus is to look at the nadir or low point when basing dose, not just how high he is at shot time. Also note that while you are beginning, I wouldn't shoot full dose if he's less than 200, and don't be afraid to reduce dose or hold off on it.

Jen

 

[Julia & Bandit (GA)]

I sympathize with the TD problem! My old vet (one of the creators of Hills Science Diet) put Bandit on W/D for weight loss. I am sure this food caused his diabetes. Of course, neither me or my vet knew how bad this food was. I remember at the time thinking how wonderful it was that I had such an expert in nutrition helping me with Bandit's weight loss. Ugh, if I only had known!!!

3u is a large dose of Lantus for a newly diagnosed cat on a low carb diet. Most cats on a low carb canned diet do not need much more than 1u of insulin. When are you blood testing? Are you able to test before each shot, and then get a mid-cycle test (about 6 hours after one of the shots) in? The mid-cycle test tells you if the dose is too high. Many cats on too high a dose will maintain high blood sugar because they'll drop very low mid-cycle, and than rebound real high a few hours later a response and stay there for a while (up to 72 hours). So you have chronic hypoglycemic incidents and not know it if you don't get that daily mid-cycle test along with the preshots. Plus, dosing for Lantus is based off of this number as well. Definitely read the stickies in the Lantus forum as Jen suggested, especially the one about Tight Regulation Protocol so that you have an idea how to dose Lantus correctly and safely.