Insulin resistant cat?

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cathayes

Member Since 2014
Hello,

I am new to this forum and pretty new to the world of feline diabetes. My 12 year old cat, Delilah, was diagnosed with diabetes at the end of June 2014 with a BG of 550. She was put on Vetsulin twice a day. We started at 1 unit twice a day and increased it weekly until she maxed out at 10 units twice a day. The lowest we were able to get her blood glucose was 305. During this time (July), she had a test for pancreatitis and fructosamine levels. She had a slight case of pancreatitis and her fructosamine levels were fine. She also had a glucose curve done and her BG never dropped below 300. Mid-September, the insulin was changed to ProZinc, 2 units twice a day. We saw her behavior change immediately and assumed this insulin change was all that was needed. Her BG a week later had gone up slightly from 380 to 397 and the following week, after switching her dose to 4 units twice a day, it was up to 405. A week later, it is up to 500. The vet says our next option is an ultrasound. Any ideas about what could be causing all of this? Currently, I do not do any home testing but I will be starting this week.
 
Numbers at the vet may be elevated 100 to 180 mg/dL.
What are you feeding? If it is prescription food, it may still bee too high carb. However, don't change the food until you are home testing.

There are a few medical conditions which require very high doses on insulin : acromegaly, insulin autoantibodies, and Cushings are 3 of them. With these, it is best to use a depot insulin such as Levemir or Lantus. Here is more info on them.

See my signature link Glucometr Notes for some info on home blood glucose testing.

See my signature link Secondary Monitoring Tools for urine testing tips and pick up some KetoStix or KetoDiaStix asap to monitor for ketones. These form as a by-product of fat breakdown for calories. Too many may indicate diabetic ketoacidosis, a potentially fatal, expensive to treat, complication of diabetes.
 
Hello and welcome to you and sweet Delilah. It's great that you are planning to start home testing. That is a key tool to help you figure out what is going on. Without home testing, it's hard to know for sure whether the blood sugar is high because the dose is too high or whether Delilah has a high dose condition. My Neko also started on Caninsulin/Vetsulin, but she only got to 5 units before switching to Lantus. Levemir is probably a better choice for a high dose cat, although some high dose cats do fine on Lantus too. My Neko has two high dose conditions, acromegaly and IAA/insulin auto antibodies (think of it like an allergy to the injected insulin).

You said that Delilah's fructosamine levels came back fine - do you know what the number was? Testing at the vet can greatly elevate the numbers. My non diabetic cat has tested 150 points higher at the vet than at home.

There are several things that can contribute to insulin resistance in cats. This paper describes some of them. If the cat is eating low carb wet food, has no infections present (such as needing a dental), and has had their insulin dose safely raised but is still at a high dose of insulin, then we look to get kitties tested for the high dose conditions acromegaly and IAA. An ultrasound will not reveal either of these conditions - they need to have blood samples sent to Michigan State University for testing.

Step one - start home testing. That will help us determine whether the dose is too high or not enough.
 
A couple people have linked to the insulin resistant conditions in cats that you can read about.

What I wanted to say is I think it is GREAT that you are starting to home test to find out what is going on with your kitty. One of the things that stood out to me is that while Delilah was still not coming below 300s and a on a large dose of 10U b.i.d. of Vetsulin you say her fructosamine test was fine. The fructosamine test measures what would have been an average of BG over the previous approx. 3 weeks. Usually it isn't useful after a cat starts insulin because they can be 500 to 50 over and over again and show the same number as just sitting between those two numbers constantly. Both very different places in regulation for the cat. Its very possible if you were only testing Delilah once in a while at the vet, that she was bouncing around between high and low numbers and not really just staying around the numbers you were finding at those tests. All those high numbers could be bounces off of low numbers if her dose is too high and she is getting low to too much insulin. Home testing will help you figure out what she's been doing and finding the appropriate dose for her or find out that she is a high dose kitty and still better be able to determine the right dose.
 
Thank you all for the additional information. I have already researched acromegaly and Cushing's. I'm not sure if she has many of the Cushing's symptoms but testing might be worth it just to rule it out. I have switched her over to a mostly canned food diet (which she is thrilled about!!) twice a day but I've only been using the food I normally would have fed her anyway. She didn't used to get it every day. I am going to switch to a lower carb canned food. She had a dental in August and had two teeth removed so should be no infections there. I'm wondering if the pancreatitis has worsened. If she had an ultrasound, what would it show other than a possible growth that would be contributing to the insulin resistance? It's so expensive that I really don't want to get it unless it's a last resort. Should I have another urine test to rule out infection? I will try to begin testing tomorrow night and will hopefully have some numbers to begin with. Just have to figure out what to get and where to buy!
 
When you have a choice about a test, ask yourself if it will change what you do. If the answer is yes, then you may want to do it. If the answer is no, then you may wish not to pursue additional testing.
 
I think you are feeding your cat food that has too many carbs. Even low carb sometimes isn't low enough. Low carb did not work for me. No carb did. I feed Wysong Epigen which has zero carbs.
 
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