insulin not working after 3 years

[robert & spade]

my cat spade has been on lantus for 3 years......was always controlled...............now his blood sugar is very high i can t get it down. he has been on a dietary control food food 3 years nothing has changed except his blood is very high even after increasing his insulin. i even bought a new meter,thinking the test was wrong..... he was at the vet 2 weeks ago... they have no idea. other than, he may not except the insulin any more. DOES ANY ONE HAVE ANY IDEAS WHAT I CAN DO TO HELP MY BUDDY...

 

[Ronnie & Luna]

Re: insulin not working after 3 years

hi there,

looks like you posted here twice,,,here is the link to your previous post from
April 17

In the meantime, have a look at the information stickies here in Lantus Land (with the starred icons)
We do follow a modified version of the Tilly Protocol that has worked for many kitties coming thru Lantus Land, however, we are a data driven forum, and having a spreadsheet with your test numbers would really help others see what is happening with your kitty's insulin needs.
How To Create a Spreadsheet

Sienne & Gabby had posted some questions for you in your last thread, it would be helpful to know more about your kitty. If you can, let us know ok?

To convert your numbers to the system we use here, multiply by 18.

It would be helpful to have more information. When you were increasing Spade's insulin, how were you increasing the dose -- in what kind of increment and how often? Giving a large dose of Lantus will probably not work to lower blood glucose levels. Lantus is what's called a "basal" insulin. You need a base dose that allows for a steady level. If you were giving a large dose with the hope of lowering glucose levels, you are attempting to use Lantus as a "bolus" insulin. The pharmacology of Lantus is such that it doesn't work that way. You need to methodically work the dose up.

While your vet may have given Spade an antibiotic shot, were any other tests or problems ruled out. Does Spade need to have a dental procedure done? (When was the last time he had his teeth cleaned?) Was a complete blood panel run? Is there any possibility that Spade is hyperthyroid?

One of the question I have have is what diet is Spade on? Canned wet food (brand)? Raw food diet? Or dry food?

Hope to see you posting again, please let us know how we can help.

 

[Blue]

Re: insulin not working after 3 years

Hi Robert,
Welcome to the site!

Ronnie's given you some great info, so I will just add my thoughts.

First, you mentioned you are in Canada - where are you located? Ronnie and I are both in Toronto, but there are many other members in Canada who can help you with info about local matters.

The numbers you are giving I understand, but the others in US here don't track by the same ones. Long ago, I made myself a conversion sheet to save myself time... Home testing is important to know how the insulin is working and if you need to raise the dose, drop the dose, or stay put.
BG Conversion Calculator

Ronnie gave you the link to get a spreadsheet set up, so you can track Spade's numbers and the others here can help you understand what Spade's body is doing with the insulin.
Testing is done before every shot, and it's good to get a test just before you go to bed, as many cats go lower overnite.
One thing about testing done at the vet, it's not accurate, meaning that the stress on the cat is likely to result in much higher or even much lower numbers than when tested at home.
I have two cats and one always tests higher at the vet, but the other tests lower. Once we get back home, I can test them again after 30min of relaxing at home and their numbers are very different.
As Ronnie mentioned, the numbers from testing between the shots are going to tell you very important info, especially for the insulin you are using which bases dosing on nadir or the lowest number in the 12 hrs between Spade's shots.
I am glad you have a meter and can do some home testing; when you are able, it would be helpful if you can do a curve at home and post the numbers you get. Below will be helpful for you and ask all the questions you may have - someone will be able to give you answers and assistance:
How to do a Curve
Example of a typical curve:
+0 - PreShot number.
+1 – Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 – Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
it's important to be able to know what kind of numbers that Spade is getting, so if you tested at shot time, then at every 2 or 3 hours until the next shot time, you will see what is happening.
Insulin needs change over time for cats. You may find that Spade needs more now, or you may find that you are giving him too much, but it all depends on seeing what's going on in those 12 hrs between the shots.
Let's say that you test today, and every 2 hrs, and the numbers you get are all in the high teens.... it could be that Spade needs more insulin.
Now, what about if the numbers you get show that somewhere in the middle, maybe 4 or 5 hrs after the shot, you see a very low number like below 5.0, you could be looking at giving Spade less insulin!
But, you just don't know unless you do a few tests in the middle.
Don't worry; there are tons of people around here who can help you and I bet there is not a single question or problem you could have that has not been asked or experienced by someone else here.

Food is very important for the diabetic, and you will have best results from feeding only wet foods that are low carb. There are many cats diet controlled and not needing insulin or needing much less insulin than you are giving.
Some food links for you - check Binky's list and see if you can feed some of the foods that show as being less than 10% carbs.

Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition

One important note: if you are going to switch foods to a lower carb, you will need to make the change carefully as insulin needs have dropped drastically for some cats. Some cats have gone right off insulin eventually.

Moving to health now - you mentioned going to the vet with Spade - if any tests were done and any bloodwork taken and urine checked, do you have copies of the results? If not, you can ask your vet for copies so that you can see for yourself how Spade was doing. You mentioned a shot that your vet gave to Spade - can you ask the name of that shot?
The vet may have ruled out infections, but what about dental? Just one bad tooth or a general bad condition could make a huge difference in insulin needs. Have you noticed any odd things when Spade is eating? Even if you have not, I can say that having the teeth checked would be a good idea. I had a dental done on my cat and her insulin needs dropped from 14u BID down to 2.75u BID, just after a cleaning and one tooth extraction.

So, finally, here are some links to the Lantus info and the protocol that many follow on this site.

Tight Regulation Protocol
Lantus & Levemir – Insulin Depot –AKA- Storage Shed
Lantus & Levemir – Data Ready to Shoot Low Numbers
Lantus & Levemir: Info, Proper Handling & Storage has picture of syringe and insulin pens.

I know it's alot, but knowledge is power.
Pats for Spade.

 

[Jill & Alex (GA)]

hello robert! welcome to the FDMB and the group!
i tried to combine your threads, but managed to goof it up. sorry about that! i see ronnie/luna linked the thread in her post.
you've already been given quite a bit of information and questions have been asked. hope to hear from you soon!

ps - we do ask all new members to start out on the general Health forum to introduce themselves and their cat to the board. please take the time to go over there where you'll receive a warm welcome from our members. the Tech forum has instructions for setting up a spreadsheet. while spreadsheets are not an absolute requirement, you'll notice the insulin support groups are driven by numbers... cold, hard data. since we're not vets, all we can do is offer suggestions based on data. spreadsheets make this so much easier!