Looking for Advice on Insulin and Cat Health

[Melanie and Buddy]

Hello,

It will be 2 years in June that my boy Buddy was diagnosed with diabetes.

It took awhile for his glucose to start coming down. I had to do glucose curve every 2 weeks. His doctor would advise me on his insulin dosage. He uses Lantus.

It came to a point where he remained at normal levels and doctor said she feels he is going into remission. I was told to reduce his insulin again, and do another curve in 2 weeks. Unfortunately his levels went back up.

It has been a year since then, and every time he gets to a point where his curve is better he spikes back up again. Currently he is on 7 units of Lantus twice a day every 12 hours. I have to do another curve in a few days. I for sure do spot checks with his glucose in between the curves to check. It is crazy! With spot checks he will be at 12.5 mmol which is better, then another time at 25 mmol.

Buddy has not been acting any different. I work from home so I am with him all the time. I see pretty much everything he does. I know that drinking alot more water than usual and peeing alot more than usual are not good signs. But he has not at all been doing that. His behavious is no different. He plays, has fun, same sweet boy as always.

His vet wants to do a bunch of tests. She feels that maybe there is an underlying cause. But I also know that vets can sometimes try and do tests for the money. Not saying I think that is what she is doing..... but I have been researching and heard of Somogyi effect.

Does anyone have more info on personal experience with Somogyi effect? I am wondering if I should try redusing his dosage from 7 units to 6.5 to see if it makes a difference.

Any advice is appreciated!

 

[Mary & Jude]

Hi Melanie! Welcome to the forum! Don't be surprised if your post is moved to the main forum. The moderators on the board like for folks to post there first so that newcomer's posts don't get overlooked, and so that we can help you get your signature and spreadsheet set up before coming over to the Lantus forum

Here is some good information about Somogyi effect. Bottom line, it is a disproven theory. In this link, Marje discusses how the concept of Symogyi differs from bouncing, which you will see us talking about on the forum. Info - Chronic Somogyi Rebound: Myths and Facts

Before anyone offers advice about Buddy, they are going to want to see what his blood glucose numbers look like. Here is a link that discusses setting up a spreadsheet, in which you will track Buddy's test results, as well as a signature, which helps folks here to see at a glance some basics about Buddy. Sticky - New? How You Can Help Us Help You!

It is common that a cat's blood glucose can be influenced by underlying conditions. What sort of tests is the doctor suggesting? Has the doctor examined Buddy's teeth--diabetic cats are prone to dental issues, which can drive up their blood glucose.

 

[Melanie and Buddy]

Hi Melanie! Welcome to the forum! Don't be surprised if your post is moved to the main forum. The moderators on the board like for folks to post there first so that newcomer's posts don't get overlooked, and so that we can help you get your signature and spreadsheet set up before coming over to the Lantus forum

Here is some good information about Somogyi effect. Bottom line, it is a disproven theory. In this link, Marje discusses how the concept of Symogyi differs from bouncing, which you will see us talking about on the forum. Info - Chronic Somogyi Rebound: Myths and Facts

Before anyone offers advice about Buddy, they are going to want to see what his blood glucose numbers look like. Here is a link that discusses setting up a spreadsheet, in which you will track Buddy's test results, as well as a signature, which helps folks here to see at a glance some basics about Buddy. Sticky - New? How You Can Help Us Help You!

It is common that a cat's blood glucose can be influenced by underlying conditions. What sort of tests is the doctor suggesting? Has the doctor examined Buddy's teeth--diabetic cats are prone to dental issues, which can drive up their blood glucose.

Thank you for the information, much appreciated!
When you mentioned my post could be moved to the main forum, I actually tried to post there, but it was not working. I am not sure how to move my post on my own.
As for your question about Buddy's glucose and saying "they' will want his numbers, I assume you meant when my post gets moved.

Buddy's monitor measure in mmol. I have the Alpha Track 3. My issue is that once he gets stable he suddenly shoots up again. I know from his doctor that for him as long as he is between 8-10 mmol he is good. Buddy is also a big boy because of his breed. And yes he does need to lose a bit of weight. He is 22 pounds. I rescued him from an abusive home 6 years ago. He was at that time 18 lbs. When I do his blood curve, I do the ear prick every 2 hours and email his doctor the results. As instructed I do 5 tests every 2 hours. The first one has to be before he has his food in the morning. Do the test, then feed him, the give him his shot of Lantus.

With his last curve the results were as follows
8am 19.5
10am 17.4
12pm 11.8
2pm 10.8
4pm 10.1

But then there are the spot checks...this is where it kind of goes odd.

April 6 at 6:45pm 23.3
April 10 at 7:00 pm 12.9
April 20 at 11:00am 19.3
May 4 at 11:00am 22.4

And yesterday and today he is where it is better
Tuesday May 5 at 7:30pm it was 10.6
Wed May 6 at 4:30pm it was 12.9

I am not understanding why he suddenly shoots up, but You did mention dental.
Fact is when he was first diagnosed he had another doctor. That doctor never mentioned to me that I need to look out for his teeth. She wound up leaving his vet clinic, and another doctor was assigned to him.

His new doctor has not actually examined his teeth yet. But with the fact that I email her his blood curves, and my concerns, she did mention the dental. Dental is an issue because it is very expensive if he needs to have something done there. She did say that infections can cause interference with the insulin. I have looked at Buddy's teeth (NOT EASY TO DO, LOL) and his front row on top.... the tiny ones have black on them. It really would be nearly impossible to brush his teeth. Buddy is strong and will fight that, causing me to get a really bad bite. But I am willing to try. What would you suggest for toothpaste and toothbrush? (keep in mind I am in Canada) Also if he has a gum infection, if his doctor prescribed and antibiotic would that work?

 

[Tim & Pookey]

I moved the post for you, no worries.

That link Mary sent titled “New Here…” is a good one because it walks you through setting stuff up for folks to be able to better see Buddy’s numbers and offer advice. For example, a lot of people are used to the mg/dL number instead of the mmoL, and the spreadsheet in that link will do the conversion for you.

Good idea to have the vet to look at his teeth at some point if they haven’t been checked in a while.

Has the vet given you a target weight for him?

7 units is a decent size dose. Once you have some BG data in the spreadsheet format I think folks might have some other ideas for you. You might want to speak with @Wendy&Neko. She’s in Canada too and has experience with the higher dose conditions.

 

[Melanie and Buddy]

I moved the post for you, no worries.

That link Mary sent titled “New Here…” is a good one because it walks you through setting stuff up for folks to be able to better see Buddy’s numbers and offer advice. For example, a lot of people are used to the mg/dL number instead of the mmoL, and the spreadsheet in that link will do the conversion for you.

Good idea to have the vet to look at his teeth at some point if they haven’t been checked in a while.

Has the vet given you a target weight for him?

7 units is a decent size dose. Once you have some BG data in the spreadsheet format I think folks might have some other ideas for you. You might want to speak with @Wendy&Neko. She’s in Canada too and has experience with the higher dose conditions.

 

[Melanie and Buddy]

Yes, for his weight vet wants him to go down at least 3lbs.

One thing that I did notice when it comes to preparing the insulin shot is that the sysringe is already pulled back a little bit. I checked Google the info I got said that you have to push that air back into the vial...as in put the needle into the vial of insulin and push in the air from the syringe. Honestly I did this the last couple of days and his reading went down. When he was diagnosed, the vet technician told me to push that air out of the syringe before I put in into the vial of insulin...
Yes, you should push that air back into the vial. Injecting air equal to your dose into the vial helps prevent a vacuum, making it easier to draw the correct amount of insulin. If you have large air bubbles, push the insulin and air back into the bottle, then draw it up again slowly. [1, 2, 3]
Key Tips for Handling Air in Syringes:

• Remove Bubbles: Before taking the needle out, turn the bottle upside down and push the air bubbles out of the syringe.
• Correct Dose: Ensure you have the exact, correct number of units in the syringe without air gaps.
• Small Bubbles: Tiny, tiny bubbles are generally fine, but it is best to remove them to ensure a full dose.
• Order of Operations: You must first fill the syringe with the same amount of air as your dose before inserting it into the vial to equalize the pressure. [1, 2, 3, 4, 5, 6]

 

[Tim & Pookey]

For vials, yep. Not sure that would make a difference in his numbers though. Unless it’s more or less insulin than you were giving before.

 

[Mary & Jude]

Melanie, Are you testing Buddy before you give him his insulin shots to ensure he is not too low to receive insulin? Or are you just doing the curves? Diabetic cats need, at a minimum, to have their blood glucose checked prior to receiving their insulin shot. This check allows you to see if his blood glucose is not too low to receive insulin, which can prevent a hypoglycemic episode. Additionally, it is equally important to test your kitty at strategic points in the 12-hour cycle to ensure Buddy is handling the insulin well. That test data is what we track on the spreadsheet, and it is data that, overtime, can give you (and anyone guiding you) a good picture of what is happening with Buddy in terms of his insulin processing. Most everyone on this forum also follows a specific dosing method (called tightly regulated or start low go slow) which guides the increases and decreases in insulin--the post below has a link to these methods.

If I'm understanding you correctly, you are concerned about the spikes you are seeing when you've done a curve on Buddy. In a given cycle, cats can and do experience spikes in their bg for a variety of reasons. What you want to see is a daily reading of his blood glucose, as I said earlier, tested at least twice at day, prior to the insulin shot, and then tested periodically through a cycle. (Take a look at Jude's spreadsheet, which is posted at the bottom of my signature.) This offers a better picture of what is happening with his insulin processing than an occasional curve.

Are there any other tests the doctor recommended? A visual examination of his teeth should be performed by the vet, and there should be no extra cost for that exam outside of a regular vet visit. If he has problems with his teeth, the vet can let you know the extent of the issue, and then you can plan what is necessary for Buddy.

This sticky has a lot of helpful information: Sticky - The Basics: New to the Group? Start here!

 

[Wendy&Neko]

Hello and welcome from the west coast. What food is Buddy eating?

About half way through this post Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing there is a video showing you the steps for withdrawing insulin from either a vial or a pen or cartridge. I used cartridges and the first vial.