My kitty doesn't seem to be responding to insulin... help!

[Pazzo]

First off, my name is Debbie, my cat's name is Pazzo. I had noticed towards the end of May that my cat had lost weight. I took her into the vet & she was diagnosed with diabetes. Her blood sugar was something like 550. My vet put her on Vetsulin. We started out with 1 unit twice a day. I took her back every two weeks after that & her blood sugar barely came down, so each time the vet had me increase by one unit. So we tested every two weeks & kept moving up every two weeks by one unit, until she got 5 units twice a day. The vet switched her to Lantus on August 11th. I finally got tired of terrifying my cat by taking her to the vet, which I know was driving up her blood sugar & bought a Relion Prime. Pazzo had a couple appointments after that where I brought in my Relion & we compared the glucose meter readings. The vet's meter seemed to run about 60 higher than mine. But the vet said to just continue to use my meter at home & do spot checks & glucose curves, when I could & let her know by text what the readings were. I did the glucose curve, she was on 4 units of Lantus & the numbers were taken every two hours after her injection. The numbers looked like this: 327, 343 294 346. Her spot checks the week before on 4 units, which were usually 6 to 8 hours after she had the injection looked like 296,315,285,277, 307,315. The vet wanted me to increase to 5 units, so I did & her numbers are pretty much the same, if not a little higher to when she was on 4 units, except she seemed to be drinking & peeing more. I've read here on your forum that the increase should only be done 1/4th unit increments, not whole units, so I wonder if I've blown past a good dose for her. Also, probably around the same time she switched to Lantus, I removed all dry food & have only been feeding her Fancy Feast Classic Pate. I did notice more of a drop in her blood sugar from that. I feel like such a bad mom... I want & need to be completely focused on her, but have been so stressed out, I can hardly function . The company I have worked for, for the past 17 years was sold & I'm not sure I'm going to have a job & in the mean time, I'm having to learn new software & how to do things "their way" & put up mean people. I have tried to scour the forum but couldn't find out what to do if you think you've blown past a good unit number for your kitty. I mean, do you start over with one unit & move up by 1/4 unit at a time? Or do you just back down one unit at a time? How long does it take to see what the true glucose numbers for the unit increase (or decrease) are? The needles the vet prescribed for the Lantus don't even have 1/2 units marked, so I might be able to guess a 1/2 unit, but not a 1/4th. I'm not sure if I should have, but I backed her down to 4 units twice a day. The vet thinks Pazzo might have a pituitary tumor, since she's not responding well to the insulin... but I'm not sold on that idea yet. Please help me help my kitty... thank you for reading & thank you in advance. Debbie & Pazzo

 

[Chris & China (GA)]

Welcome to the FDMB! This is the best place you never wanted to be if you have a sugarcat!

The answer to most of your questions lies in home testing. I think dropping back to 4U for now was probably a good decision, but the only way we'll know for sure is to start gathering data.

First we need you to get your Signature set up and then start our spreadsheet. Here are some links that will walk you through creating the signature, adding profile information (in which you can tell us more about yourself and Pazzo, if you wish), and then setting up the spreadsheet we use here. The spreadsheet is for recording the insulin dose and testing data you will be getting and is very helpful to you and other members to see how the insulin is working.

• Editing your Signature, Profile, and Preferences

• FDMB Spreadsheet Instructions
• Understanding the Spreadsheet/Grid

If you need help with the spreadsheet set up, please let us know. There are members who can assist or set it up for you.

If you live in the US, you can get insulin syringes from Walmart that have half unit marks (no matter what they might tell you) Depending on what state you're in, you may need a script for syringes but most states don't. These are the syringes you'd want to get...the 3/10ml, 31 gauge insulin syringes. (They are $12.58 for a box of 100)


For now, start testing before every shot (the AMPS and PMPS tests) and then try to get tests sprinkled around at different points in the cycle so we can start seeing what's really going on.

If Pazzo happens to drop below 50 (on a human meter), you'd definitely reduce the dose.

Yes, it's possible your cat may have a tumor....but it's also possible that he's been getting too much insulin with doses raised by too much, too quickly. We'll know that in a few days with enough testing!

If we end up seeing that he needs more than 6U twice a day (and he's being tested regularly and eating a low carb canned or raw diet), then we'll suggest getting him tested for acromegaly and IAA. The only place that does these blood tests is MSU but you can have the blood drawn by your regular vet and sent off. But let's cross that bridge when we get to it. Some cats just need more insulin than others too!

Keep asking questions and reading. There are sticky's at the top of the Lantus Forum that have a lot more information.

 

[AmandaE]

Hi Debbie,

Welcome to the FDMB, I’m so sorry you’re having a hard time with Pazzo, the important thing is that you’re working hard to get him healthy which is much more than some other people do Its totally encouraging to hear that your vet supports home testing! Awesome! additionally youre already switched to wet food... double awesome!

There are a few things around the site here that should help you out. First of all, there is actually a whole forum dedicated to Lantus, Basaglar, and Levemir users which you can find HERE. Within that forum there are some posts marked as stickies which will help you understand Lantus better and give you some idea of what you need in order to use it effectively. For advice from now on I would recommend posting within this forum from now on because the members with the most Lantus experience are usually hanging around there Its kind of intimidating there at first but hang in there, everyone is super awesome and will help out if they can

I switched from Vetsulin to Lantus as well. I like Lantus more because it is a longer acting insulin and a little less aggressive. Typically when someone switches from Vetsulin to Lantus we take into account the most recent dose that they were on on their previous insulin. Unfortunately I don’t really have any idea how to provide guidance on that front, @Chris & China (GA) has quite a bit of experience so Its a positive that she agrees with your move to go with 4u . There are a few main differences In How we dose with Lantus as compared to Vetsulin as well. First of all Lantus is a u100 insulin not U40 like Vetsulin so please make sure that your new syringes are u100! Second is that for Lantus we change dose based on nadir (the lowest point that an insulin dose takes kitty). Third is that Lantus is a depot style insulin, that basically means it could take a few days for the dose to build up in Pazzo, meaning you may not see the true effects of it until a few days in, patience is key

I can confirm that we only change dosage amounts with Lantus by 0.25u at a time. When you change dose with Lantus typically depends on which dosing method you follow on the site ( if you choose to follow one from the site) for Lantus there are two options. Start Low Go Slow (SLGS) and Tight Regulation (TR). You can read about them HERE. If you decide to follow one of these two methods it will be more straight forward for members to provide guidance and or feedback on Passos comings and goings. I second Chris' recommendation to set up a signature and a spreadsheet it will help members understand Pazzos history, and give you a visual for spotting trends in Pazzos reactions to Lantus. If you choose to follow a dosing method from this site please add it to your signature

It seems like you're really going through a 'when it rains it pours' situation in your life right now. That sucks! at the very least we can help support you in the Feline Diabetes department! Hopefully the rest will fall into place as well

Please don't be hard on yourself about taking care of Pazzo, so many cats diagnosed with Diabetes have owners who cant even be bothered to try treating it, you are amazing for taking it on, and you're doing great already by a) home testing b) switching to wet food and c) actively searching for the best methods for treatment, Pazzo is lucky to have you.

Like Chris said, ask as many questions as you like, soon you will be amazed with how much you know. Looking forward to seeing Pazzo's progress