Insulin advice for Stubbie (Mick Jagger): challenging (BJM?)

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Steph

Steph

Member Since 2013
I've shared that a new male cat came to me in SoCal Saturday from Chicago area.

Stubbie (Mick) is barely eight pounds--his very wide whiskers suggest his former body was much bigger. He is skin, fur and bones.

He eats voraciously and his waste output is notable. Drinks more than normal, but not incessantly. Is on Friskies page, with "sprinkles" of EVO cat/kitten protein dry food (per advice here re dry food.) He eats almost two cans of Friskies a day.

His original numbers in Illinois were in the 400s, then 300s. I've only tested four times because he runs away from this, but I do have amazing help from KayPassa on this board.
(She was here last night and will return.)

He was started in Novolin, and with DCIN's advice, was switched to Lantus several weeks ago (?). He gets 3 iu a.m. and p.m. A reading last night before injection was 339 with this dose.

Please, can you help me with:

dosing this
how to put weight on him

I intend to do bloodwork next week re any other issues.

Thanks so much from us.
 

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Re: Insulin advice for Stubbie (Mick Jagger): challenging (B

He will be voracious until he is more regulated.

To help with weight gain, in addition to monitoring and adjusting the insulin, consider the low carb kitten foods (support growth and development) as they often include extra fat, which has over twice the calories per gram (8.5) of protein (3.5). Also check some of the foods on the Cat Info food list which are low carb and higher fat (ex Wellness Turkey and Giblets).

Spacing food out across the day will help him eat more food without doing a scarf 'n' barf. If he grazes, that's great, otherwise spread the food thinly across a wide plate and divide meals into 2-3 per shot period, ex feed at shot time, +2, and +4.

Something to check with the fecal output - sometimes the pancreas has other impairment, such as not enough digestive enzymes put out. This is called exocrine pancreatic insufficiency, or EPI. If the feces are pale, smooshy piles, this may be worth discussing with the vet..

If food changes were done recently, a probiotic may be helpful such as Forti Flora. As a plus, many cats like it and it may aid digestion.
 
Re: Insulin advice for Stubbie (Mick Jagger): challenging (B

1) Feces look generally well formed; today were smaller and a bit looser. They smell bad, but he was wormed. He had a tape worm. (Had.) I am told.
2) Yes, on the food: feeding Friskies, and bought EVO cat/kitten high protein dry and WYSONG super-high protein on the way (dry). Dry is only for interest, small amount--I understand.

My fear (!) is that he won't regulate. He should be showing some signs after almost a week, yes? The testing thing is trying to become "a thing," which is bad. He doesn't like it, and is "touchy" all over. Maybe because is so thin. This is a "hard case."

2) (separate issue) I was late with his 8 a.m. shot---noon. Just forgot with duties for 3 other kitties, work and a new one on this schedule. I gave him 2 IU instead of 3 IU "thinking" that would make it easier/safer to do the 3 IU tonight around 10 p.m. I am punting here. Correct to do this?

Thank you.
 
Re: Insulin advice for Stubbie (Mick Jagger): challenging (B

1) Removal of tapeworms should help a lot! He won't be feeding an army, just himself. This may alter his glucose levels and insulin requirements.

2) Fancy Feast Kitten Turkey and Giblets canned has a bit higher calorie count if it'll fit in the budget.So do most canned Wellness.

3) if canned food isn't interesting him enough, there are numerous tricks you may try - a sprinkle of grated Parmesan cheese, warming the food, FortiFlora in it -are just a few.

4) use positive reinforcement when testing - low carb treats if he likes them, brushing, play, anything that will reward him.

5) logically, that might make sense, 1/3 later shot, 1/3 lower dose. The concern is the amount of overlap in the shots - 4 hours. You might be prudent to lower the next shot too, or skip it and get back on schedule in the morning.
 
Re: Insulin advice for Stubbie (Mick Jagger): challenging (B

Understood.

NO wonder this board exists. Trying to do this with a vet is, uh, impossible.

Thank you, BJM!

Steph
 
Re: Insulin advice for Stubbie (Mick Jagger): challenging (B

Its a process, not an event, to be sure!

We call it a sugar dance - part of it is learning the steps so you don't stumble :smile:

And remember - he didn't become diabetic in a day; he won't get contolled in a day. We'd much rather a cat were high for a day, than low for a moment, because the latter kills quickly. The former may test your patience (and Deb will break out some "patience pants" for you.)
 
Re: Insulin advice for Stubbie (Mick Jagger): challenging (B

Ok Steph, patience pants coming up.

I didn't know your favorite color, so here is a 'one color fits all' pair. ;-)

My fear (!) is that he won't regulate. He should be showing some signs after almost a week, yes?
Click to expand...
I think a week is too soon to show signs of regulation. You need to give it more time, IMHO.
 

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Re: Insulin advice for Stubbie (Mick Jagger): challenging (B

Deb's got you covered on the Patience Pants and I'll be bringing you some fortiflora packets tonight. ;-) Also, if you haven't seen this yet, here's what we'll be working on with getting him more comfortable with testing.

How is he liking the freeze-dried treats?
 
Re: Insulin advice for Stubbie (Mick Jagger): challenging (B

And speaking of testing ...

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

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
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