Insulin Resistance?

Teddie

Teddie

Member Since 2020
Hi everyone:
I posted a few months ago about my 10 year old cat Max who was first diagnosed with diabetes in November. He is now currently on Lantus - 2 units every 12 hours. Even though we have done curves and given the information to the specialist, she wanted us to use the Freestyle Libre. He had it put on, March 22. It keeps reading HI (which means higher than 499). I was also told that it reads a different fluid and that is why when I still check with the glucometer and get a reading lower than 499, that the Libre is still HI. I don't know if this is actually true or not. I emailed my specialist and Vet yesterday about this and how his numbers just aren't coming down and his quality of life is just laying around sleeping and the only time he is happy is when he is eating.
My vet told me she thinks the insulin isn't unlocking the door to his cells so the glucose can get in to make energy. I think this is called insulin resistance. I could be wrong. My vet suggested an oral glucose regulator but someone told me that they are only effective in a 1/3 of cats and that it works by forcing the pancreas to produce more insulin, which can lead to pancreas burnout and the need to go on the insulin permanently and that it can cause liver damage.
His specialist suggested we go up to 3 units every 12 hours. I've read that you aren't supposed to do that. That when raising the insulin, it's supposed to go up a 1/4. I hope to god someone on here can explain all this to me.
I feel like I'm watching my baby slowly die! So Max used to play paper ball, play with the laser pointer and feathers. He loved snuggling. Since being diagnosed he doesn't do any of that. He just sleeps, eats, drinks lots of water, uses the bathroom. When I try to get him to play, he just looks at me like he is zoned out, not seeing me or hearing me, doped up, etc.
As of this morning, we have gone up to 3 units of Lantus but it someone on here thinks we should go back down to two and slowly increase, please let me know before 6 pm today as that is when he gets his next injection.
He is on wet food only and it only has 3 % carbs. He also has irritable bowel disease and early pancreatitis (all according to the specialist). Please help!!!
 
Hi ,

It is safer to increase insulin slowly, by 1/4 units or 1/2 units. That way you can monitor the effect, before you give a dose that it is so high that can creat a hypo.

People here do not like to give ideas without actually seeing the data on your kitty, since no one wants to give bad advice. There are two methods suggested here to manage your insulin slgs and TR. detail of the methods can be found here: https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

If you would like more specific advice, folks would need to see a spread sheet with blood glucose numbers for a few days. You will also need to read up in the methods and decide which one fits your routine better.

I can say though that I have seen many cats that are resistant to insulin and need higher and higher dose, and all of a sudden once the correct dose is found, recover and start feel better. Do read up on all the "sticky notes at the top of the lantus forum and ask as many questions as you need to get your head around it. People will love to help see your kitty feel better!
 
Any chance you could populate the spreadsheet with some of the data you've seen in the last week or two? We'll be able to help you with suggestions on dose suggestions once we've seen a bit of data on your sweet Teddie. Some cats need more insulin than others, my girl got up to 8.75 units. But without data, it's not safe for us to suggest what to do next, or whether you should back down from the 3 unit dose.

Perhaps reading this post can help you know what information we like to see, including in the signature:
New? How You Can Help Us Help You!
 
I can see you spreadsheet now!
I see your nadir (the lowest value the insulin takes your kitty) is on the 100 to 200 range. That is not bad!
It is normal for preshot values to remian quite high for a while after diagnosis. Don't focus on preshot values, focus on how low a dose takes kittie's BG. You do not want to give a dose that would go too low.
With such nadir values you may want to hold the dose for a few more days, at least until there is a clearer picture of what is happening. I must say I am finding surprising that Max can go from 190 to 570 in a hour! He might be bouncing, but it is quite extreme. Perhaps when you see such strange numbers you might want to re-test and make sure the result is ok.

btw, you might find when you start testing a lot, that alphatrak glucometer gets quite expensive. I switched to a human glucometer within a few weeks of testing regularly, and most folks here use human glucometers.

Last, but not least, you may want to spy on other user's spreadsheet to get an idea of what others cats do. Look at the questions people have and what they did, to become more confident in managing Max. Feel free to look at mine. Although lately I have not been writing as many notes as I should....
 
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I am using the Alphatraks 2 and the Freestyle Libre. Alphatraks was recommended by my vet and the Libre was recommended by the Internal Specialist. It seems it really doesn't matter what device I use because he isn't responding to the insulin correctly. We were told to up his dose from 2 units to 3 units, so we did. I was home with him all day. He slept most of the day. He didn't finish his breakfast, didn't bug me for lunch and when I did a reading with both devices they said HI. I have never gotten a HI with the Alpharaks. I thought is was a messed up reading but I did it again waited 2 hours and retested, same thing, HI. I also noticed on this day when I pricked his ear he bleed like he never has before. It's as if the insulin (Lantus) made him extra tired, not hungry, thinned his blood and made his numbers go even higher. So, I did what any good mom would do, I went back down to 2 units. He just is not responding to the Lantus. I feel like something else is going on and the specialist is too busy at her practice to take the time to see it. He now has a distended belly that he never had before. I was told that his liver, kidneys, spleen and pancreas are enlarged. I am hoping the now distended belly is not from the organs getting larger. We still don't have any answers after spending almost 3 thousand dollars and it has been almost 6 months.
I cry every damn day because there is nothing I can do to help him get better or feel better. His siblings don't want to have anything to do with him anymore and that breaks my heart. Thank you to everyone for their advice but I think we might be at the end. Take care - Teddie and Maxbear
 
:bighug::bighug::bighug:

I can tell how much you care, and hang in there. As a fellow cat mom whose kitty is hard to regulate, I can relate to how you are feeling. We keep trying, and although it doesn’t seem like we are making much progress, we are, in our own way. You are not alone. Every cat is different and the path to a better place is different for all of us.

Feel free to check out Cosmo’s spreadsheet...which is...colourful. He has good days and not so good days. Our other non diabetic cat notices too. He lets Cosmo sleep through the high number days, and is so excited to play with him on better days. It took Cosmo months to feel a bit better and be more active. If he walks around the house, or wants to put on his harness and go outside, or play with a mouse, that is a good day, and we will take it!

I can’t tell from your spreadsheet whether you are testing each day and at each preshot. We also have 2 dosing methods that we use here that @Hercule's mum linked for you. This, along with testing, allows us to find the right dose for our kitties - which can change over time.

I hope you have a good night and know there are people here willing to help if you would like. :bighug:
 
We can't really help figure out the dosing unless you put the blood sugar data you are seeing in the spreadsheet. I can thing of a couple reasons you are seeing "Hi", one that the dose is too high, one that it's too low. We need the context of the data around it.

There is a condition called acromegaly, caused by a benign tumour on the pituitary glad, that causes excess growth hormone to be output. One of the possible side effects is organ growth. My girl had this condition, but didn't see much organ growth until later on. The condition can cause insulin resistance and some cats need way more than 3 units. There is a blood test for it.
 
Hi Teddie, I feel your frustration. My Minnie was diagnosed a year ago and we still don't have it under control (she is on 5u Levemir and counting) but I feel like we're on a better path now I have the support of this group here. It feels overwhelming when you start - so much to read, so much data to collect and seems to take so long to get enough info. But honestly, it is worth it. I see you put some data in the spreadsheet - I am envious of Max's blues!

We used the Freestyle Libre until January - she became allergic to the adhesive and the vets recommended I start blood testing instead. I started with the Alphatrak - I had a really tough time getting the blood samples and I liked that the Alphatrak needed the smallest sample size 0.3, but the strips were so expensive. But to begin with, there was just so much to think about that I didn't want to change meters. I went through 3 or maybe 4 containers of Alphatrak strips before I was ready to move to a human meter.

I really liked the style of those strips, so when I switched to the human meter I picked the Freestyle Lite which has strips that work the same way as the Alphatrak and also only needs 0.3microliter. Strips still not the cheapest but around half the price of the Alphatrak.

To get things started so the team here can start helping, I echo what the others say - start tracking readings on the spreadsheet - at minimum once before each shot and one other time in the cycle - but if the Libre is still working, that makes it a bit easier and you just need to type the numbers into the spreadsheet. You will need a different tab for the Alphatrak data and the Libre data - if you need help with that I think @Bandit's Mom can help.

Good luck and keep your chin up. Your Max is lucky to have you! If you get your spreadsheet populated with current data, the experts here will help you. :bighug::bighug:
 
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