How much to reduce insulin if not eating enough?

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topcat1952

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Nelson is 20 yrs old. Has been diabetic for 4 years almost. Has some dementia and generally getting very old. Has 6 units of Caninsulin twice a day. Usually eats 50g of Royal Canin renal twice a day. Also has Lactulose now to soften his stools. 2 units am & 3 units pm.

The last 2 days he has been eating about half his food. Seems enthusiastic enough to start with but loses interest halfway though. Can be persuaded to eat a bit of plain chicken breast also though. I have to mix water in with the Royal Canin because the Lactulose takes water out if his system so need to replace it.

I have been told by our vat in the past to reduce his insulin if he hasn't eaten enough but they have never specified by how much.

Today is a Bank Holiday in the UK so only a emergency vet service with someone not familiar with his case.

Can anyone give me some advice please? Should I get some really tasty normal wet cat food working on the theory that some food is better than none? Thank you.
 
Hello, and welcome to you and to Nelson.

I'm sorry that Nelson is feeling poorly.

May I ask, do you test Nelson's blood glucose at home at all? The reason I ask is that without that info we can't know how the reduced appetite is affecting Nelson's blood glucose levels.
Neither do we know the reason for Nelson's lack of appetite. So your question is hard to answer.
Does Nelson have any history of ketones? Does his breath smell strange? (like peardrops or acetone?)
Has he had any infection recently?
And do you know how advanced his kidney disease is (am assuming kidney disease because of the renal diet)?

Yes, I definitely agree that your kitty needs to eat. That's vital. So do try to tempt him with other foods.
And ordinarily, reduced appetite (or reduced carb content of the diet) would call for a reduced insulin dose. But I'd honestly only be guessing as to how much to reduce if I were to suggest that you reduce it by half.

I think I'd suggest two things.
Firstly, I do think you need to call your emergency vet and get their advice.
Secondly, if you can find a pharmacy that is open I'd suggest that you get a tub of urine test strips (Ketostix or Ketodiastix) and test Nelson's urine for ketones. I understand that anything above a trace level is a reason for a vet visit ASAP.

I'm in the UK also and understand how everything seems to grind to a halt on Bank Holidays. :roll:

Eliz
 
Thanks for your advice. I did the keytone strips and it was fine.

I spoke to the emergency vet who suggested the 'recovery' food.

I remembered I had a tin of Hills A/D from when he had a tooth op. Offers it to him and he scoffed it!

So at least he has eaten something. Vet also said to cut insulin by half if he only eats half his usual food.

I will speak to our vet tomorrow but at least we got through today.

Many thanks.
 
Have been thinking about you and wondering how you are.
I'm so glad Nelson ate some more food. That's certainly encouraging.
I hope all goes well when you talk to your regular vet tomorrow. Please let us know how things go.

Keeping fingers and paws crossed for you!

Eliz
 
Well. Today was eventful. I think the A/D food was a bit too rich which resulted in diarrhoea all over the hall carpet. Am now mixing it with the usual Royal Canin Renal which seems to be going down well. Nelson is a lot happier and eating reasonably well so fingers crossed. He is very old and I know we won't have him much longer but he seems happy so we'll persevere for now.

Thank you for your support. Nelson is a complete ringer for your Bertie and I see you are in Cobham - we are in Woking!
 
Aha, so Nelson is another member of the The Black Cat club! cat_pet_icon

I'm SO pleased to hear that he's feeling happier. (Shame about the 'dire rear' though.... On the carpet too.... :-| )
You've done a great job in getting Nelson to 20 years of age. He is very lucky to have you as a care-giver, and I hope you still have lots of time with him.

Since you're in Woking that almost makes us neighbours!
So, if you ever want me to show you how to test Nelson's blood glucose at home just let me know... ;-)

On another tack entirely, you may (or may not) be interested in this thread from the Community forum. Just let me know if you're interested.
viewtopic.php?f=4&t=118166

Eliz
 
Hi - sorry not to get back before.

Yes, we in the Black Cat Club!

Would like to take part in the lunch meet but I work during the week unfortunately.

Nelson still with us although it's exhausting at times!

Thanks for the offer of the blood tests but we have a very accomodating vet who will fit him in instantly for a test. We did try but I think we were more stressed than he was - even the vet nurses say he doesn't give it up easily!

If I can give encouragement to anyone else who thinks a diabetes diagnosis is the end of the world I will. One thing I will say is if anyone has a cat needing hospital treatment try to get a referral to the Royal Vet College in Hatfield. They have consultant vets there who specialise in feline diabetes & without them we would have lost Nelson 2 years ago, the operating & anaethatist facilities there are obviously far superior to any local vet. Nelson then needed dental work so they referred him to the Sainsbury Beaumont Hospital in Camden who again did a wonderful job. Both venues involved very early monings & long journeys but it was worth it & once you are with the RVC you can email back to them at any time for advice. They only charge the cost of the treatment as it is a teaching hospital. They keep your own vet informed too.

Regards. Tina
 
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