Look for some help (insight)

Hello All,

My cat Penny has been diabetic for about 1.5 years. I have been unable to get her regulated in the last 3 months. She use to do great on 1 unit (Lantus) but 3 months ago her numbers started to climb. Currently she is on 3.5 units and numbers are still high. Her vet had me do a 3 day curve and it was basically straight showing that the insulin is having little to no effect. Tonight before feeding she had one of the highest readings I've seen on her 457. Her water consumption is much higher than normal (has been for a few weeks).

All the testing came back clean. No UTI, The Fructosamine Level Test showed exactly the same as my curves, elevated and showing little to no effect from the injections, in most cases it actually increased after injections because it corresponded with feeding. Both myself and the vet are hesitant to go higher than 3.5 units at this point.
Levels since this started mostly mid 200 to high 300's
Levels before on 1 unit 120 -220 ish.

Yes I'm injecting different locations, tried a different bottle of insulin (still Lantus), Changed to twice daily feeding (mixed diet of different wet foods RC glycobalance, DM, FF, Merrick, Weruva) NO DRY.

Any thoughts or suggestions would be appreciated, Thanks

 

Hi, welcome

It would help if you posted at least some of the test results you have last month maybe, there's a spreasheet we use it's easier for everyone to understand this is the link with the instructions http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Insulin needs do change over time, and there are people giving more than 3.5 units so you could actually give her more insulin if it gets to that but before doing it, it would help to know if there some other health issue, did the vet did some blood work other than the fructosamine? an ultrasound ? How old is you cat? it would also help if you posted those results also

Her increased water consumption is probably because of her high blood glucose numbers

 

Thanks for the reply. I'll have to work on the spreadsheet. I keep all my test results in a notebook so I'll start transferring so I can share.
Penny is a little over 15 yo
The vet did not share the exact results of the test listed below only said everything looked ok and there was no uti.

• Superchem/cbc/t4/u-a
• Fecal
• Fructosamine
• Cystocentesis

as far as health issues she has a mild heart murmur and she had a massive insulin overdose at the vet this past December (1/2ml instead of 1/2unit) and spent 6 days recovering in the vet icu. She had 2 seizures the month following the od but as far as I know has not had any since early February.

 

Ask if they can give you a copy of the superchem/cbc/t4, once you can show us your test results post them in here so that we can take a look at them

 

Just completed the Spreadsheet and linked it. I'll call the Vet in the AM and see if I can get the test results.

 

I hope one of the experts takes a look at your spreadsheet soon, @Wendy&Neko, @Chris & China, @Bobbie And Bubba, @Kris & Teasel could you please take a look at her results and help us here what do you think?

 

OMG that is quite a mix up...... what a fighter!
I am no expert but FWIW my boy has crazy swings still at 3 years being diabetic. Good thoughts to you

 

You're not testing enough for us to really give you much in the way of helpful advice.

Lantus dosing is based on how LOW it takes them, not the pre-shot numbers so it's important to get some mid-cycle tests in during the daytime and at least a "before bed" test every night.

You should test before every shot....you never know when their pancreas can kick in and start working and you wouldn't want to give insulin if they're not high enough!

If it's not possible to get mid-cycle tests during the day due to work, it's even more important to get them on the PM cycle and then on days off, do a curve (test every 2 hours for 12 hours or every 3 hours for 18 hours)

Could you do us a favor and add some information to your signature? (Where your spreadsheet link is)

We like to have information like:

Your name/Cat's name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health issues/medications? and maybe a general location.

By having this in your signature, we don't have to keep asking the same questions over and over.

 

First the food, not sure why you are feeding the RC glycobalance. According to the food chart, it's 14% carbs and we generally like to feed under 10% as our low carb. Second, it's fine to feed multiple small meals. In fact, it's easier on a recovering pancreas.

As for dosing, I agree with Chris. There isn't enough data in there for us to say. Your vet also had you increase in larger amounts than we do. We will typically change the dose by 0.25 units at once. Yes you have to eyeball that. It's possible you've gone past a good dose.

Has the vet checked her teeth? Dental or other sources of inflammation or infection can play havoc with the blood sugars.

 

Good advice from Chris and Wendy.

 

Thanks everyone for taking a look

Mike you probably have a lot of questions now keep asking we will try to help you dealing with diabetes requires a lot of patience

 

Thanks for reading and the input. I've updated my signature and attached the Lab Report from the July 20th visit.

 

Yes the vet did check her teeth and said there was no sign of infection. Thanks for the info

 

I'm going to take her to the vet in the AM.
I just got PMPS 467, +3 600, +4 540

Question? how many ounces of wet food is the norm (per sitting / daily)

 

Her labs look pretty ok to me actually, I think her kidney values look just fine actually

I think you should consider what Wendy mentioned that it is possible that you passed the good dose, too much insulin can look like too little, so maybe you could consider going back to the dose where you were seeing some nice numbers, the blue ones (1 or 1.25u for example) for a few days and start raising her dose in small increments this time (0.25 units is recommended) or wait a few more days while you collect more information

I suggest you take a look at the protocols we use so that you can choose which one suits you best although for tight regulation you need to feed low carb only

http://www.felinediabetes.com/FDMB/threads/start-low-go-slow-method-slgs.129446/
http://www.felinediabetes.com/FDMB/threads/tight-regulation-protocol-tr.1581/

 

Thanks Veronica,

I'm hoping to get Penny to the Vet in the AM. I just did +5 test and it was 468. So something has got to change obviously.

• PMPS 467
• +3 600
• +4 540
• +5 468

 

Lantus is a long acting insulin usually the nadir (lowest number) is around +6 +7 it will vary from one cat to another,and I'm guessing you gave him food after his shoot which could explain the raise you saw you would need a few more days of collecting information maybe do a complete curve during the weekend to get some insight