How much insulin is too much?

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stuartm

Member Since 2013
My name is Stuart and my cat's name is Sidney. He is male and 9 years old. He weighs around 10 pounds, and we live in Red Deer, Alberta, Canada.

He was diagnosed in August of this year (2013) and I started him on Lantus, 1 unit twice a day. I stopped the dry food and have him on canned only, and regularly give him raw fish, prawns, shrimp, chicken or turkey that I cook for him with no spices or seasonings, instead of any canned food.
He goes up and down like a yo-yo. Yesterday at noon he was 20.9 (around 15 to 17 is his normal) and today at noon he was at 1.8
I upped him to 5 units last night from 4 units twice a day for the last month. I know I just upped him last night, but last week several times he was around the 1.9 - 2.1 mark with the 4 units. I don't get why he goes so high and low when I keep everything very consistent.

My question is: Does 5 units seem like a lot, or is 4 to 5 units twice a day fairly normal?

Thanks!
 

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Welcome. Without more BG number we really can't tell what is happening. However, you may be giving too much insulin and the body is responds by first going too low and the as a defence, the body secrets glycogen which raised the BG very high. This is called rebound or sometime bounce.
What is needed is a BG before you give a shot and then at various times between shots. Since y did not supply any preshot (PS) BGs, we do not know what is happening.

The amount of insulin a cat needs depends upon the cat. My Patch get abut 2 units Lantus twice daily. My Thunder 1 unit Lantus twice daily. However, my MurrFee get 11 units Levemir (similar to Lantus) twice daily.
 
Welcome to FDMB.

First, let me give you the following reference table:

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]
 
stuartm said:
...He was diagnosed in August of this year (2013) and I started him on Lantus, 1 unit twice a day. I stopped the dry food and have him on canned only, and regularly give him raw fish, prawns, shrimp, chicken or turkey that I cook for him with no spices or seasonings, instead of any canned food....
Click to expand...

This is not a complete diet nutritionally. That can cause a lot of health problems for a cat, including kill him. Please go to Cat Info and see the section on Making Cat Food for reference.
 
4-5 units of Lantus insulin is more than most of our kitties require.

You have been increasing in whole unit increments, which is too much too fast.

In fact, that 1-9-2.1 mmoL (34-38 mg d/L) you were getting earns your cat an automatic REDUCTION in dose, not an increase.

Please, please, please, drop the dose back down ASAP.

Those low numbers are hypoglycemic territory and tell us the current dose is too much.
 
Thanks everyone for your input. After reading lots more stuff yesterday after my post, I reduced him back to 4 units/shot.

I think some of the wild ups and downs may be my fault, I am giving him too much food - I break down too easily when he is pitifully whining for more. I thought that by giving him the raw fish and other no carb stuff, that I wasn't doing him any harm.

I will be adamant today that he gets 1 5.5 oz can of Friskees Mariner's catch spread out over 4 feedings, and absolutely nothing else. No matter how much squawking he does. ( Around 4 in the morning he will actually start nipping on my toes or leg to make me get up and feed him)

His readings yesterday (Dec 22) were:
(His readings the previous 4 days had all been from 17 - 21, that is why I felt I had to increase him to 5 units twice a day.)

7:45 AM just before before eating - 6.6 (fed cooked turkey and 5 units)
12:50 PM before eating again - 1.8 (fed canned and added 1/4 teaspoon syrup)
3:15 PM - before eating 4.8 (fed him raw fish)
8 PM before feeding - 22.0 (fed him raw fish and gave him 4 units.)

The numbers jump around like this no matter what dosage I have been giving him. I have been upping it by 1 unit twice a day around once a month. The 5 units have only been done the 3 times, but as mentioned I have immediately dropped it back to 4 for now.

I will do a curve on him tomorrow and post the results.

How do I check his ketones? I have a 2 cat litterbox.
I bought Bayer Ketostix and it says "for in vitro testing only" What does that mean?
I catch him "spraying" occasionally - is this the same thing as "peeing"? Can I test that?
He doesn't do that very often, he knows I really don't like him doing that at all, and chastise him if I catch him doing it. He was "fixed" at around 8 weeks of birth, so I don't know why he sprays at all.

Again, thanks everyone for your input, I very much appreciate it.

I am very concerned about my "little guy", he means the world to me, and I want him around for a long time.

Cheers!
 
If he is not regulated, he may well need more than 1 can, even 5.5 oz, and mariners catch is fish, so its likely less calories per oz. than other foods
 
A single 5.5 ounce can isn't enough food.
He'll need roughly 1.5 ounces per pound, divided into 2 or more feedings.
As he gets controlled, that may reduce to about 1 ounce per pound divided into 2 or more feedings.

10 lbs * 1.5 = 15 oz, divided into 4 meals of 3 3/4 oz per meal.
 
Hello and welcome to the board from another Canadian!

It looks to me like his dose is way too high and he is bouncing (explained below). The trick is to find the correct dose for him, as I suspect his insulin needs dropped when you switched to wet.

I think we need to start again. I would drop him to 1 or 1.5 units and work slowly back up by 1/4 unit every few days. Heres a protocol to read that many of us have success with : http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

The key things to note are

1. If he drops below 2.2, then reduce the dose by 1/4 unit immediately
2. if your pre shot test is under 11.1, don't shoot for now. You don't have enough data yet to shoot that low but will need to learn to over time
3. Hold every dose for 3-5 days unless he drops under 2.2 - This is because Lantus is a depot insulin which means it needs a few days for any dose to build up in the cats system. You don't see the true impact of a dose change for a few days and you need to let any new dose settle.


Wendy

Bounces - what are they and is my cat doing them?
When a cat isnt regulated, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.
The insulin depot - what it is and why it effects your cat’s BG numbers.
 
7:45 AM just before before eating - 6.6 (fed cooked turkey and 5 units)
12:50 PM before eating again - 1.8 (fed canned and added 1/4 teaspoon syrup)
3:15 PM - before eating 4.8 (fed him raw fish)
8 PM before feeding - 22.0 (fed him raw fish and gave him 4 units.)
Click to expand...
In our language, this would be
AMPS 6.6 (118.8) 5U
+5 1.8 (32.4)
+7.5 4.8 (86.4)
PMPS 22 (396) 4U

That drop to 1.8 mmoL (32.4 mg/dL) is low enough for an immediate dose reduction.

Lantus dose changes are not based on the pre-shot test numbers. Lantus dose changes are based on the nadir or lowest point in the cycle. Looks to me like you have had a lot of lows where we would have recommended a reduction in dose.

I think the 4U is even too much insulin for your cat. Wendy gave you a good explanation of bouncing, and boy, is your kitty bouncing all over the place. It's no wonder the numbers are all over the place! Too much insulin can cause high BG numbers and that looks to me like what is happening here. :dizcat

"Better too high for a day, than too low for a moment" is one of our mottos. Your kitty has been way too low many times. We want to keep him safe.

I like Wendy's suggest to cut the dose back down low, to 1 or 1.5U. We can always work the dose back up if needed.
 
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