Just started my cat on insulin - need advice

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Heli911

Member Since 2012
Hello, new member here. My cat Simon was diagnosed with diabetes a few weeks ago. Simon is a male american shorthair "alley cat" I adopted when he was a kitten. No fancy breed here, just your typical cat. He is 11 years old. Simon is a big cat. Bigger, taller, and just a large cat. He might have a touch of maine coone in his DNA. In his prime he weighed 22 lbs. He was bit overweight, however he is a larger cat as a whole. I put him on a diet using science diet r/d and he lost 2 lbs a year the last 2 years, so 4 lbs lost. He is now 18lbs. He looks about right, proportion wise, and the vet is happy. A few weeks ago i noticed he was drinking out of the toilet every 20-30 minutes and was flooding the litter box. I'm a nurse, so I knew something was up. I tested his BGL and it was 340. I made an appointment with my vet and we started him on science diet md food.

So 4 days on the new diet his BGLs ran a little lower. His range was 165-280. I was hopeful, however his BGL's started to increase and the next few days they remained greater than 300. I was making no progress. My vet suggested that I start Simon on lantus insulin. I obtained some lantus insulin and started Simon on 1 unit daily for a trial period.

*disclaimer* - I use lantus insulin everyday on my patients at work. I'm very familiar with how it works and dosing it accordingly. If Simon was a human I would have his BGL's controlled in a matter of 3 days. However, Simon, my be my most stubborn patient EVER.

The Vet and I established a strict diet protocol with the science diet md and I have been following that well, and Simon seems to be tolerating it fine with no finicky attitude. I feed him twice daily, he eats it, it's gone until his evening meal.

So I started Simon on 1 unit daily, and this is what my BGL's averaged fasting, pre-shot.

Day 1: 9pm, 367 - 1 unit given
Day 2: 3pm 314 (mid day check), 9pm 297 1 unit given
Day 3. 9pm 287 1 unit given.

I was making no headway on his sugars. So I got on the internet and found this forum and also found the Tilley study. I read the tilley study and it made more sense me as a medical professional in relation to his sugars. I tried to contact my vet for a discussion of this study. However he was out of town for a week at a conference. So I self enrolled Simon in this study. Worse case scenario I would bottom out his sugars and I would have to resuscitate my cat. At that point I was willing to risk it.

So I dose him with 0.25 units per kg of ideal body weight. So Simons starting dose was 2 units lantus twice daily per the Tilley study.

Day 4: 9am 384 - 2 units given, 3pm check 317, 9pm 308 - 2 units given
Day 5: 9am 280 - 2 units given, 9pm "Hi" - 2 units given. (Wife on her own for the first time stressed poor Simon out trying to get a sample)
Day 6: 9am 397 - 2 units given, 9pm 460 - 2 units given
Day 7: 9am 417 - 2 units given, 9pm 404 - 2 units given

Tilley study recommends to increase by 0.5 units since BGL's >300

Day 8 (today): 9am 414 - 2.5 units given, 4pm check 391

So Simons sugars just keep going up. I don't know why. He tolerates testing well. He is all purrs and affectionate. He doesn't appear to be stressed out over getting his ear poked. He looks more vibrant, happy, and his thirst has gone down and he is no longer excessively urinating. He looks overall better than he did a week ago.

I'm completely stumped here. Has anybody seen this happen?
 
It could very likely be his diet. Our Oliver was on Science Diet light (30% carbs) and the day we changed, his glucose levels went down 100 points. Dry food - especially the high carb varieties - is like feeding donuts while giving insulin to a human diabetic. A vet has excellent information on the value of wet, low carb and the danger of dry catfood here: www.catinfo.org

We feed wet low carb - under 8% carbs. Check out this food chart: Janet and Binky’s chart
 
I'm feeding him the science diet md low carb cat food for diabetic cats. He gets 1/2 cup day total of the dry and 2 large spoonfuls of the wet cat food. Is there something better?
 
*disclaimer* - I use lantus insulin everyday on my patients at work. I'm very familiar with how it works and dosing it accordingly. If Simon was a human I would have his BGL's controlled in a matter of 3 days. However, Simon, my be my most stubborn patient EVER.

The Vet and I established a strict diet protocol with the science diet md and I have been following that well, and Simon seems to be tolerating it fine with no finicky attitude. I feed him twice daily, he eats it, it's gone until his evening meal.
Click to expand...

Awesome, then you understand "diabetes". Having Simon's BGs under control in 3 days? Not going to happen, at least I've never seen it happen here.
Diet is your major obstacle right now. Unfortunately, your vet has "bought into" the Hill's sales pitch. You know from dealing with human patients that a low carb diet is key to controlling diabetes, right? And I'm assuming you would also tell human patients that eating multiple small meals each day, to spread the "boost" from eating more evenly over the course of the insulin's cycle is a great idea?
No different with a cat. Except a cat metabolizes Lantus twice as fast as a human, so two shots a day are needed. But feeding 4 or more times a day will help Simon out. And feeding quality low-carb canned food, rather than that Hill's MD "carbage" will drop his numbers without the need for higher and higher doses of Lantus will. Not only is Hills MD high in carbs. It's also pretty crappy quality as far as ingredients go. Friskees pate flavors, or Fancy Feast Classis flavors are much lower-carb. And they contain as least as high quality ingredients. And they cost a heck of a lot less, without a "prescription". If you want higher quality, there are dozens of choices found here:
http://www.catinfo.org/docs/Food Chart Public 9-22-12.pdf
That chart was put together by a vet who is an authority on feline nutrition. Her website will also tell you all about "Hills" prescription food, and how good it isn't for Simon.
I think you should change the diet first before upping the dose again. You might discover that less insulin is actually needed once you remove the carbs in the Hills food.
Carl

P.S. - just saw your latest response. YES! There's lots of better choices. And never, never, ever, ever feed dry food to your kitty (especially to your diabetic kitty!).
Dry food is the worst possible thing you could feed a cat:
http://www.catinfo.org
 
Ok, that makes sense. I'm probably going to have to stick to twice a day feedings. We work 12 hour shifts. If I put a whole can of food out, he will eat the whole thing at once. I'll check out the recommended food and find my cats nutritional needs and go from there. Thanks!
 
I didn't have to resort to this when Bob was on insulin, because I work close to home so I could drop by and feed mid-cycle, but a lot of people here use timed feeders to space out the meals. It's an option you might find useful.

Carl
 
MD is about 14% carbs, too high for a diabetic. We advise staying under 10%, even under 7% if possible. 3-5% is what most kitties here do the best on. The food chart that Carl linked is great but the food I feed my cats, Petsmart's Grreat Choice (previously Sophistacat), is not on that one (the pate varieties without gravy are all low carb and cheap though) ;-)

As far as feeding during the day goes, you can do the auto feeder, or you can try freezing some canned food in ice cube trays and popping a few cubes in the bowl before you leave. They thaw out over a few hours and can be snacked on when they warm up :)
 
Timed feeders or freezing food in ice food trays- or BOTH. That way the food stays fresher, longer.

I did this with Sneakers- she gets 3 small meals and, since it rotates around and closes the last 'bowl' I can see how much she ate.

In either case, I would monitor closely on the nights you are home- getting in those mid-cycle numbers are crucial. Dose is supposed to be based on the mid-cycle numbers rather than the pre-shot numbers.

***ETA
It is wonderful that you are being so proactive about this!
 
They days I have off I've been getting mid cycle numbers. However everything has been high. Tonight I switched him over to friskies classic pate. Which he loves. He hasn't had it in years. Honestly when my cat was slightly overweight, he was more active, happier, and generally healthier. But I was feeding him strictly canned cat food then. The vet told me it would rot his teeth out and he needed to be on dry cat food. So then I switched over to science diet dry, got some weight off, and now my cat is diabetic. I can't help but think I did this to him.

I'll have to look into the self feeder option. Now i get to try to train my neighbor how to check BGL's and give insulin when we are out of town.
 
I forgot to add that I actually have 2 cats. So with the self feeder option, how do you keep the cats from eating each others food? I have to play referee between the two at meal times. And I have a chocolate lab, aka "lola the garbage disposal". They all get along surprisingly. They are my animal children.
 
So i switched from science diet to friskies pate. Last night my blood sugar was 384. I gave 2.5 units lantus and fed him the pate. This morning my cat actually woke me up for the first time in a month to let me know he was hungry. He seemed very normal. I checked his blood sugar and it was 140! WOW, did that drop fast. So now i'm a little worried. I gave him 1 unit and will be checking him throughout the day. This is the first time in a month that his BGL was less than 200. I think it was definitely the diet change. He may require the 2.5 units of lantus and the new diet change, or the diet change alone along with a much lower dose of lantus. We'll see throughout the day how he tolerates everything. I will be watching him closely. Thanks for everybody's help.
 
Great news! The diet change can certainly be a big one. Good thing Mamabean has a good grip on what to do! Do be careful so he doesn't' get too low nailbite_smile The frozen food trick is a great way to make sure he has a treat mid-cycle which can be very important as the numbers drop. Good job!
 
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