Hi - My cat was diagnosed with Diabetes over 3 months ago. $1500 and 3 months later we are still at square one. We have tried 4 types of insulin (ProZinc, Vetsulin, Novolin N and Lantus). Each starting with a small dose and increasing slowly. Some Insulin brands we stopped after 2-3 weeks, as her numbers remained above 600 despite increasing from 2 to 3 to 4 units. She is 8 lbs. The vet called today and said they don't have any more options for her, as she seems to be Insulin Resistant. Her glucose levels have remained above 400 despite the different doses and kinds of insulin? The vet also moved her to a prescription W/D food (mostly canned and about 1/2 a cup of W/D dry food each day). She is confined to the basement :sad: as she is having 3-10 accidents a day (occasionally uses the litter box, but usually goes right next to it on the flooor). Not sure what to do now. Frustrated! Stressed! Disappointed and sad! Any ideas?
Insulin Resistant Cat
- Thread starter Pearl12
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BJM
Member Since 2010
1) home testing - vet stress raises glucose from 100 -180 mg/dL
2) food - Rx diets are often too high carb. See http://www.catInfo.org for more info.
Low carb canned foods such as Friskies Turkey and Giblet pate or Fancy Feast classic pates work just fine.
3) there are high dose conditions; you continue with dose increases, even up to 30 units or so a day for those if you have to. There are special tests to diagnose these.
2) food - Rx diets are often too high carb. See http://www.catInfo.org for more info.
Low carb canned foods such as Friskies Turkey and Giblet pate or Fancy Feast classic pates work just fine.
3) there are high dose conditions; you continue with dose increases, even up to 30 units or so a day for those if you have to. There are special tests to diagnose these.
Larry and Kitties
Member Since 2009
How high of a dose did yo reach and for how long?
What does a curve show? A curve is BG taken every two hours after shot in addition to BG before shot.
See the following since it may be the reason and there are tests for it ;
viewtopic.php?f=12&t=375
Acromegaly and Other High Dose Conditions: What We Know
My Murfee is on 18 units of Levemir twice daily. When he was on 6 he was about 500 before shot and went to Hi (above 600) mid between shots and down to about 500 before next shot.
What does a curve show? A curve is BG taken every two hours after shot in addition to BG before shot.
See the following since it may be the reason and there are tests for it ;
viewtopic.php?f=12&t=375
Acromegaly and Other High Dose Conditions: What We Know
My Murfee is on 18 units of Levemir twice daily. When he was on 6 he was about 500 before shot and went to Hi (above 600) mid between shots and down to about 500 before next shot.
MommaOfMuse
Member Since 2010
Well BJM beat me to most of mine. 
So I will just second a couple of them. Home testing is your best tool to fight this disease as well as giving you a much better picture of what the insulin is or isn't doing for her.
Second stop all dry and as BJM suggested switch her over to a good affordable pate style commercial canned diet (I have two in remission and one trying hard to follow) all eat the same diet as the rest of my cats which is just good old fashioned Friskies pate. My most recent to go into remission was up to 11u twice a day when I adopted him and was eating the very same thing your girl is now and being shot based solely on vet curves. I got him home started testing him and he was falling like a stone, switched his diet over to what my furry family ate and his dose kept going down steadily until this September 8th when I gave him his last insulin shot and he has remained in double digits ever since.
Also you aren't out of insulin choices just yet there is one other and my personal favorite for cats (because mine have done fantastic on it) LEVEMIR many cats that don't do well on other insulins do fantastic on it. Cassanova also went through Prozinc and Lantus before being switched to Levemir and finally that is what he went into remission on.
Mel and The Fur Gang
So I will just second a couple of them. Home testing is your best tool to fight this disease as well as giving you a much better picture of what the insulin is or isn't doing for her. Second stop all dry and as BJM suggested switch her over to a good affordable pate style commercial canned diet (I have two in remission and one trying hard to follow) all eat the same diet as the rest of my cats which is just good old fashioned Friskies pate. My most recent to go into remission was up to 11u twice a day when I adopted him and was eating the very same thing your girl is now and being shot based solely on vet curves. I got him home started testing him and he was falling like a stone, switched his diet over to what my furry family ate and his dose kept going down steadily until this September 8th when I gave him his last insulin shot and he has remained in double digits ever since.
Also you aren't out of insulin choices just yet there is one other and my personal favorite for cats (because mine have done fantastic on it) LEVEMIR many cats that don't do well on other insulins do fantastic on it. Cassanova also went through Prozinc and Lantus before being switched to Levemir and finally that is what he went into remission on.
Mel and The Fur Gang
Thanks to both of you for your suggestions. I will try Fancy Feast or Friskies for food. Should I completely move off the dry food?
As far as the dosage, the max we have gone up to is 6. For each insulin, we have started at two units for 1 week and then I have taken her in after a week for a BG curve. It starts in the high 600's and then has reached as low as the high 400's after 5-6 hours. Vet has increased the dose then to 3 units and we have the same results. Then bumped up to four units and similar results. By the time we've reached 5-6 units, the numbers have actually been worse (BG levels still in the 600s). Since she seemed to plateau at that point, the vet has moved her to a new insulin, starting over at the 2 units. Is it normal for the BG to increase with a higher dose of insulin? Did we give up on that insulin too soon? Vet told me 6 units was really the max she felt comfortable going up to for an 8 lb. cat. Thanks again so much for your suggestions and help!!!
As far as the dosage, the max we have gone up to is 6. For each insulin, we have started at two units for 1 week and then I have taken her in after a week for a BG curve. It starts in the high 600's and then has reached as low as the high 400's after 5-6 hours. Vet has increased the dose then to 3 units and we have the same results. Then bumped up to four units and similar results. By the time we've reached 5-6 units, the numbers have actually been worse (BG levels still in the 600s). Since she seemed to plateau at that point, the vet has moved her to a new insulin, starting over at the 2 units. Is it normal for the BG to increase with a higher dose of insulin? Did we give up on that insulin too soon? Vet told me 6 units was really the max she felt comfortable going up to for an 8 lb. cat. Thanks again so much for your suggestions and help!!!
BJM
Member Since 2010
When you increase the insulin and start getting worse numbers, chances are possible you've gone too high on the insulin. This happens often if you increase by full units, and some times when you increase by 0.5 units each time. Also, Lantus needs you to stick sith a dose 3 to 5 days for it to stabilizen ProZinc likes about 36 hours to get somewhat settled.
Before you change the food, you need to be home testing OR, drop the insulin to 0.25 units per kiligram of lean weight. Food change can drop the glucose 100 mg/dL and as much as 2 units of insulin.
Current weight:
Ideal weight:
Take the lowest of these.
Convert to Kg = pounds / 2.2
Multiply by 0.25
Round down to nearest quarter unit (we eyeball 0.25 and 0.75 increments)
Before you change the food, you need to be home testing OR, drop the insulin to 0.25 units per kiligram of lean weight. Food change can drop the glucose 100 mg/dL and as much as 2 units of insulin.
Current weight:
Ideal weight:
Take the lowest of these.
Convert to Kg = pounds / 2.2
Multiply by 0.25
Round down to nearest quarter unit (we eyeball 0.25 and 0.75 increments)
MommaOfMuse
Member Since 2010
My favorite meter (got a bunch) is Walmart's Relion Micro it is about $16 for the meter and strips to fit it run about $35/100 strips. I like it because it takes very little blood and is nice and small as I have little hands.
Friskies Pate and Fancy Feast classics are most definitely available at Walmart unless you're in Hastings NE on Friday evenings and I've beaten you there :lol: I go through 120 cans a week but then again I'm feeding 16 (giggle)
Walmart has the 5.5 oz cans for 46cents and 13 oz for $1 And yep ditch the dry but only AFTER you have a meter to test at home. Just removing dry from the diet can drop them as much as 100 points.
Also at least with the Lantus your starting dose could have been way to high. Normally we like to see a starting dose at .5 to 1u twice a day. Too much and not enough can often look exactly alike.
Mel and The Fur Gang
Friskies Pate and Fancy Feast classics are most definitely available at Walmart unless you're in Hastings NE on Friday evenings and I've beaten you there :lol: I go through 120 cans a week but then again I'm feeding 16 (giggle)
Walmart has the 5.5 oz cans for 46cents and 13 oz for $1 And yep ditch the dry but only AFTER you have a meter to test at home. Just removing dry from the diet can drop them as much as 100 points.
Also at least with the Lantus your starting dose could have been way to high. Normally we like to see a starting dose at .5 to 1u twice a day. Too much and not enough can often look exactly alike.
Mel and The Fur Gang
Shelly & Jersey (GA)
Member Since 2014
Welcome to FDMB, although I'm sorry you had to find this site. My name is Shelly, and my cat's name is Jersey. We are one of the many success stories of FDMB. Jersey was on insulin for just a few months and then went into remission. She is now diet-controlled.
You've been getting some great advice, so I'll just add in my personal experiences in case it helps. Jersey was diagnosed in November and the vet recommended Hill's w/d dry food first. He said that some cats can go into remission from diet change alone. In January of this year, her numbers still hadn't come down, so he prescribed Humulin. That's when I found this site. I learned that the w/d was high in carbs - it was just as bad, in fact, as the Meow Mix I had been feeding her. I learned that diabetic cats really do best on a low-carb diet (less than 10% carbs). I also learned that Humulin is not the best insulin for cats because it brings the numbers down quickly and then wears off just as fast. Lantus, Levemir, & Prozinc are the best insulins for cats. I also learned that home testing is a crucial key in getting diabetes regulated.
We made a food switch to low-carb food and went to a different vet for a Lantus prescription. We also started home testing. It took a while (about 6 weeks) on the Lantus before we started to see Jersey's numbers come down, and it wasn't long after that before she went into complete remission. Some cats become regulated very quickly; some cats take a bit longer. And some cats - like Jersey - go into remission.
On the food - I agree with what others have said. It's really important to make sure you're testing before you make the food switch since the insulin dose may need to be lowered when you do that.
On the home testing - Most people here use the ReliOn brand meters from Wal-Mart because they are a lot cheaper. (Some vets recommend pet-specific meters, but the test strips can run about $1 each, so that gets expensive quickly.) We used the ReliOn micro meter. You'll need to get the meter, the matching test strips, and the lancets. We also recommend Neosporin ointment with pain relief. The ointment can be used prior to poking to help the blood bead up and after poking to help the site heal. I know home testing sounds scary/awful, but it really isn't as bad as it sounds. And people have tons of tips to help you learn how to test successfully.
On the insulin - Which insulin are you currently using - Lantus? We base the dose on how low the insulin takes the kitty - that's what we call the "nadir." For Lantus, most cats usually reach nadir around 5 to 7 hours after the shot. Getting in some tests around that time can be really helpful in figuring out how well the dose is working. I know the vet has run some curves, but kitties often are stressed out at the vet's office, which naturally raises their glucose levels. Testing at home, without all of that vet stress, can give you a better idea of what's really happening with your kitty's numbers.
My cat urinated outside of the litter box, too, so I know how frustrating that can be. The good news is that once the numbers come down, the accidents will stop.
Hang in there - you're in a great place to get help. If you'll stick with us, I really believe we'll be able to help you and your kitty. (What are your names, by the way? I hate just calling you "you and kitty." :lol
Shelly
You've been getting some great advice, so I'll just add in my personal experiences in case it helps. Jersey was diagnosed in November and the vet recommended Hill's w/d dry food first. He said that some cats can go into remission from diet change alone. In January of this year, her numbers still hadn't come down, so he prescribed Humulin. That's when I found this site. I learned that the w/d was high in carbs - it was just as bad, in fact, as the Meow Mix I had been feeding her. I learned that diabetic cats really do best on a low-carb diet (less than 10% carbs). I also learned that Humulin is not the best insulin for cats because it brings the numbers down quickly and then wears off just as fast. Lantus, Levemir, & Prozinc are the best insulins for cats. I also learned that home testing is a crucial key in getting diabetes regulated.
We made a food switch to low-carb food and went to a different vet for a Lantus prescription. We also started home testing. It took a while (about 6 weeks) on the Lantus before we started to see Jersey's numbers come down, and it wasn't long after that before she went into complete remission. Some cats become regulated very quickly; some cats take a bit longer. And some cats - like Jersey - go into remission.
On the food - I agree with what others have said. It's really important to make sure you're testing before you make the food switch since the insulin dose may need to be lowered when you do that.
On the home testing - Most people here use the ReliOn brand meters from Wal-Mart because they are a lot cheaper. (Some vets recommend pet-specific meters, but the test strips can run about $1 each, so that gets expensive quickly.) We used the ReliOn micro meter. You'll need to get the meter, the matching test strips, and the lancets. We also recommend Neosporin ointment with pain relief. The ointment can be used prior to poking to help the blood bead up and after poking to help the site heal. I know home testing sounds scary/awful, but it really isn't as bad as it sounds. And people have tons of tips to help you learn how to test successfully.
On the insulin - Which insulin are you currently using - Lantus? We base the dose on how low the insulin takes the kitty - that's what we call the "nadir." For Lantus, most cats usually reach nadir around 5 to 7 hours after the shot. Getting in some tests around that time can be really helpful in figuring out how well the dose is working. I know the vet has run some curves, but kitties often are stressed out at the vet's office, which naturally raises their glucose levels. Testing at home, without all of that vet stress, can give you a better idea of what's really happening with your kitty's numbers.
My cat urinated outside of the litter box, too, so I know how frustrating that can be. The good news is that once the numbers come down, the accidents will stop.
Hang in there - you're in a great place to get help. If you'll stick with us, I really believe we'll be able to help you and your kitty. (What are your names, by the way? I hate just calling you "you and kitty." :lol
Shelly
Thanks everyone for all your very helpful advise. I did pick up Friskies Pate tonight and will try to make it to Walmart tomorrow to pick up the Relion Micro tester and strips.
Shelly, my cat's name is Pearl and she's 12 years old (hence my uncreative Username). My name is Jill.
She has been on Lantus for the last 3 weeks. We started out on 2 units and then moved up to 3 and now she's at 4 units. She had another BG curve done today and her numbers actually got worse at 5-6 hours after her morning shot (all in the 600's). When she started on the previous insulin, Novolin N, at 2 units for a week, her BG numbers were off the chart and she could hardly walk on her very weak back legs. Her walking improved as we increased the dose, but not the BG numbers. Pearl's vet suggested I go back to the ProZinc that we originally started with, as at least we were able to get her in the 400's on that before she plateaued. The vet suggested I start back on 5 units, but as another post had suggested it might be best to start much lower. If I'm doing the math right, since she is an 8 lb cat, I would need to start with 0.5 units, I think. Not sure if that's wise to switch back to the ProZinc or maybe give the Lantus a little more time. All the accidents are certainly getting frustrating and cleaning them up is adding stress to our family's already busy morning and nightly routine. But mostly, I just feel bad for poor Pearl, as she loves being around all of us and I don't like to have to keep her confined in the basement, especially when she's not feeling good. But having the carpet and rest of the house destroyed isn't an option either. Just hoping we can get her regulated, so she can come up and join the rest of the family again soon! Thanks again for all the helpful advise!
Jill
Shelly, my cat's name is Pearl and she's 12 years old (hence my uncreative Username). My name is Jill.
She has been on Lantus for the last 3 weeks. We started out on 2 units and then moved up to 3 and now she's at 4 units. She had another BG curve done today and her numbers actually got worse at 5-6 hours after her morning shot (all in the 600's). When she started on the previous insulin, Novolin N, at 2 units for a week, her BG numbers were off the chart and she could hardly walk on her very weak back legs. Her walking improved as we increased the dose, but not the BG numbers. Pearl's vet suggested I go back to the ProZinc that we originally started with, as at least we were able to get her in the 400's on that before she plateaued. The vet suggested I start back on 5 units, but as another post had suggested it might be best to start much lower. If I'm doing the math right, since she is an 8 lb cat, I would need to start with 0.5 units, I think. Not sure if that's wise to switch back to the ProZinc or maybe give the Lantus a little more time. All the accidents are certainly getting frustrating and cleaning them up is adding stress to our family's already busy morning and nightly routine. But mostly, I just feel bad for poor Pearl, as she loves being around all of us and I don't like to have to keep her confined in the basement, especially when she's not feeling good. But having the carpet and rest of the house destroyed isn't an option either. Just hoping we can get her regulated, so she can come up and join the rest of the family again soon! Thanks again for all the helpful advise!
Jill
Critter Mom
Member Since 2014
Hi Jill,
You've come to a very good place to get help for Pearl. There are many highly knowledgeable people here.
Here's a handy forum link with information and links to tutorials for home testing:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=287
It will help if you can do some home tests before you transition to the low carbohydrate food so that you know a bit more about how Pearl is responding to her current insulin. When you start the transition, you'll need to monitor Pearl more closely. As the above posters have already said, the w/d prescription diet is very high in carbohydrates so the change to low carb could dramatically lower Pearl's insulin requirements very quickly.
That' may be a symptom of diabetic neuropathy. If you haven't done so already, I'd recommend asking your vet to test Pearl's B12 and folate levels. If she is deficient in B12 and gets a course of B12 supplementation it could help to strengthen her legs.
You've come to a very good place to get help for Pearl. There are many highly knowledgeable people here.
Here's a handy forum link with information and links to tutorials for home testing:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=287
It will help if you can do some home tests before you transition to the low carbohydrate food so that you know a bit more about how Pearl is responding to her current insulin. When you start the transition, you'll need to monitor Pearl more closely. As the above posters have already said, the w/d prescription diet is very high in carbohydrates so the change to low carb could dramatically lower Pearl's insulin requirements very quickly.
That' may be a symptom of diabetic neuropathy. If you haven't done so already, I'd recommend asking your vet to test Pearl's B12 and folate levels. If she is deficient in B12 and gets a course of B12 supplementation it could help to strengthen her legs.
Nancy and Scotty
Member Since 2014
Everyone here has given you great ideas on what to do but the main thing is do not give up, my cat was diagnosed the first week in January and his blood sugar has just started coming down, in June we were up to 15 units of ProZinc twice a day and toward the end of June switched to Levemir, we went up to 6.5 units of Levemir twice a day but just in the past couple weeks I have had to reduce his insulin 3 times, he had neuropathy so bad that he would cry for me to carry him around the house and when his blood sugar was the highest he had diarrhea all the time, once we started on the Levemir both these problems started clearing up and now he does not want me to carry him, if you are patient and let these great people help you the insulin resistance will finally break, just don't give up.
HI Everyone,
Thought I'd give an update on Pearl. Thanks to everyone for your suggestions! I picked up a BG monitor, Friskies Pate and stopped giving her the W/D prescription food (both canned and dry). I started her back up on the ProZinc at a dose of 1.5 and have been slowly increasing by .5 every 48-72 hours. Over the weekend, I got a BG reading of 176 on 4.0 Prozinc and Friskies Pate Turkey and Giblets. That is the lowest her BG has been in over 3 months! It has spiked up into the high 400s several times since then, but I've been experimenting with other flavors of Friskies Pate and the Mixed grill must be higher in Carbs as that seems to make the BG spike higher. So no more mixed grill. We might just have to stick to the Turkey and Giblets. :smile: She has only had 2 accidents in the last 4-5 days! She seems so hungry though. I've been giving her one can of Friskies Pate in the morning and one at night. Does that seem like an adequate amount for an 8 lb. cat? I have another question too around the BG curve. I know it is supposed to be around 100 when the insulin is peaking (about 5-6 hours after injection). What is the "normal" high though right before she receives insulin (in other words 12 hours after her last insulin injection)? That's when I see her BG spiking into the 400s. Not sure if that's normal, or if that just means I should continue to increase the dose or perhaps look at another insulin. Thanks again for your help!
Thought I'd give an update on Pearl. Thanks to everyone for your suggestions! I picked up a BG monitor, Friskies Pate and stopped giving her the W/D prescription food (both canned and dry). I started her back up on the ProZinc at a dose of 1.5 and have been slowly increasing by .5 every 48-72 hours. Over the weekend, I got a BG reading of 176 on 4.0 Prozinc and Friskies Pate Turkey and Giblets. That is the lowest her BG has been in over 3 months! It has spiked up into the high 400s several times since then, but I've been experimenting with other flavors of Friskies Pate and the Mixed grill must be higher in Carbs as that seems to make the BG spike higher. So no more mixed grill. We might just have to stick to the Turkey and Giblets. :smile: She has only had 2 accidents in the last 4-5 days! She seems so hungry though. I've been giving her one can of Friskies Pate in the morning and one at night. Does that seem like an adequate amount for an 8 lb. cat? I have another question too around the BG curve. I know it is supposed to be around 100 when the insulin is peaking (about 5-6 hours after injection). What is the "normal" high though right before she receives insulin (in other words 12 hours after her last insulin injection)? That's when I see her BG spiking into the 400s. Not sure if that's normal, or if that just means I should continue to increase the dose or perhaps look at another insulin. Thanks again for your help!
Sue and Oliver (GA)
Member Since 2009
I'm glad Pearl is doing better. Amazing what low carb food can do.
It is hard to tell what is going on without a spreadsheet. We have a wonderful color coded that can be shared with us and your vet. Here are the instructions:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
It's a little tricky. If you need help, just ask.
It does sound like Pearl could be bouncing into the higher ranges. If their body preceives a higher blood glucose level than she has seen in a while ( like the 176), it panics and releases extra glucose, which causes a bounce into higher numbers. Once she gets used to the lower ranges, that should subside.
Just for reference: generally we considered a cat regulated if they are in the lower to mid 200s at preshot and double digits at nadir (but not below 40 which is approaching hypo territory). So that is your first goal!
It is hard to tell what is going on without a spreadsheet. We have a wonderful color coded that can be shared with us and your vet. Here are the instructions:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
It's a little tricky. If you need help, just ask.
It does sound like Pearl could be bouncing into the higher ranges. If their body preceives a higher blood glucose level than she has seen in a while ( like the 176), it panics and releases extra glucose, which causes a bounce into higher numbers. Once she gets used to the lower ranges, that should subside.
Just for reference: generally we considered a cat regulated if they are in the lower to mid 200s at preshot and double digits at nadir (but not below 40 which is approaching hypo territory). So that is your first goal!
Larry and Kitties
Member Since 2009
Todays' curve looks pretty good. I would not say Pearl is insulin resistant. If you keep getting similar BGs then I would increase to 5 units.
I agree, in that the insulin does appear to be working! Pearl's vet stated she was insulin resistant, but the big key was getting her off the W/D prescription dry food. Numbers started dropping right away after that. While she was on the dry food, the lowest we could get her BG to was in the high 400s (went through 4 different types of insulin). Wish I had known it was the dry food causing the problem. It would have saved hundreds of $ and lots of stress! :smile:
Critter Mom
Member Since 2014
I got the same line when Saoirse was on w/d as well. She has been in the normal range for a non-diabetic kitty for the last 4 weeks and her Lantus dose over that period has gone down from 0.25 IU to 0.1 IU on days when she started to drift upwards a little.Pearl12 said:
:razz: to the FD specialist who assessed her curves when she was on 3 IU Caninsulin BID and w/d Dry.
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