Is Big Head Insulin Resistant?

[BigHeadTodd]

I am hoping to reach out and get a better understanding as to why Big's numbers are only increasing with the amount of insulin 5.0u of Lantus and 1.0u of Humulin R...

Could it have anything to do with his heart Medications?! Diltiazem, Hydrochlorothiazide, Enalapril, Lasix. I am getting him tested for resistance but until then was hoping that there is someone else out there with a furry friend that has heart disease and hi numbers... Bigs will no longer eat can food... not chicken... only kibble... I have tried everything and bought the highest protein "raw" freeze dried coated kibble out there that I was able to find INSTINCT chicken.

Any suggestions

 

[BJM]

How much does he weigh and what is his ideal weight?

Are you letting him nibble, using a pet feeder, or feeding in small meals? The latter 2 methods may help level the numbers a smidge.

If he'll only eat dry, Wellness Core and Evo Cat and Kitten were 2 that were close to 10% calories from carbs.

A little light reading for you:
Here is the prior version (9th ed) of the Merck Veterinary Manual on the pancreas and specifically on diabetes mellitus

From the Merck Veterinary Manual the various drugs you mentioned don't seem to affect the glucose:
Diltiazem is a calium channel blocker.

Diltiazem is indicated for the treatment of atrial fibrillation, supraventricular tachycardias, hypertrophic cardiomyopathy, and hypertension. The dosage for dogs is 0.5–1.5 mg/kg, PO, tid, and for cats 0.5–2.5 mg/kg, PO, tid, with middle range to high-end dosages for hypertrophic cardiomyopathy. Alternatively, sustained-release formulations of diltiazem are available for administration to cats. The benefits of diltiazem for hypertrophic cardiomyopathy include decreased heart rate, edema formation, and possibly ventricular wall thickness, and improved diastolic relaxation and ventricular compliance. To slow the ventricular response to supraventricular tachyarrhythmias, generally a lower dosage is initially administered and increased in 2–3 days as needed to achieve the desired ventricular rate. Diltiazem is well tolerated by dogs and cats. Noncardiovascular adverse effects might include GI or CNS disturbances and increases in liver enzymes. Diltiazem increases the bioavailability of propranolol; concurrent therapy with β-blockers increases the propensity for cardiovascular side effects.

Enalapril is an Angiotensin-converting Enzyme (ACE) Inhibitor.

In the pathogenesis of CHF, the proteolytic enzyme renin is released by the kidneys and acts on angiotensinogen, which is produced by the liver and distributed in the blood, to produce angiotensin I. The formation of angiotensin II from angiotensin I occurs through the action of ACE. Angiotensin II causes retention of Na+ and water, in part through stimulation of the synthesis and release of aldosterone by the adrenal cortex. Angiotensin II also causes vasoconstriction, thus increasing vascular resistance. By inhibiting the formation of angiotensin II, ACE inhibitors prevent vasoconstriction and reduce the retention of Na+ and water in animals with CHF. ACE inhibitors are balanced vasodilators, reducing both preload and afterload. The effects during CHF include decreased vascular resistance and cardiac filling pressures and increased cardiac output and exercise tolerance.

Hydrochlorothiazide is a thiazide diuretic.

Thiazide Diuretics

The thiazide diuretics, hydrochlorothiazide and chlorothiazide, are not as potent as furosemide and thus are infrequently used in veterinary medicine. The thiazides act on the proximal portion of the distal convoluted tubule to inhibit sodium resorption and promote potassium excretion. They may be administered to animals that cannot tolerate a potent loop diuretic such as furosemide. They should not be administered to azotemic animals, as they decrease renal blood flow. Because the thiazides act on a different site of the renal tubule than other diuretics, they may be combined with a loop diuretic or potassium-sparing diuretic for treatment of refractory fluid retention. Adverse effects are electrolyte and fluid balance disturbances, similar to furosemide.

furosemide (Lasix) is a loop diuretic.

Furosemide therapy is associated with a number of adverse effects. By nature of its mechanism of action, it causes dehydration, volume depletion, hypokalemia, and hyponatremia, which may be excessive and detrimental. The high degree of protein binding can lead to interactions with other highly protein-bound drugs, and any condition that alters albumin concentrations affects the concentration of free drug available for diuretic action. Furosemide's most important drug interaction is with the digitalis glycosides digoxin and digitoxin. The hypokalemia induced by furosemide diuresis potentiates digitalis toxicity. As long as animals continue to eat, hypokalemia does not usually develop. Hypokalemia also predisposes animals to hyponatremia by enhancing antidiuretic hormone secretion and the exchange of sodium ions for lost intracellular potassium ions. Concurrent administration of NSAID may interfere with prostanglandin-controlled renal vasodilation. Furosemide-induced dehydration of airway secretions may exacerbate respiratory disease.

 

[BJM]

You might find these helpful:

Transitioning Dry Food Addicts to Canned Food

Food Composition Chart

 

[BigHeadTodd]

THANK YOU!!! Will review all the great info you sent to us

Bigs and Jenny

 

[Wendy&Tiggy(GA)]

Welcome back Big Head! We were wondering how you were doing.

Is that Instinct the grain free chicken flavour?

 

[Blue]

Jenny,
It's really hard to tell if Bigs is insulin resistant because of the dry food. If he's really carb sensitive like my Shadoe was, it could explain the high numbers and dose.

If he is eating dry food, then you'll just have to give more insulin to balance out the food, but if you switch him to wet food, you may need to bring the dose down again.

 

[SusanandOwen]

I am pretty much a newbie here but my cat is not a fan of canned food either. I have been adding some Young Again ZERO CARB dry food to the canned stuff and it has been a spectacular success. My guy is eating stuff he wouldn't touch before (and I think I tried every canned low carb food on the market...) I put about a teaspoon or so of the dry in with the canned stuff and he scarfs it up like crazy. Several people on this BB suggested it to me and have cats that have gone into remission on this food, so I thought it was worth a try. Just another option to consider.

http://www.youngagainpetfood.com/10brow ... egory=cats (Note they have other versions which are NOT zero carb as well, so you have to choose the right one.)

It is expensive but I find that I use so little per meal that it's not a big deal at all. Certainly more cost effective than going through can after can of low carb wet food trying to find one he would eat!