Need some thoughts on my Max kitty

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Jmsimpson9

Member Since 2021
Hello all.

I have been a long time reader but this is my first post. Had a diabetic cat about 8 years ago, she was kinda tubby, older and badly allergic to fleas. Vet gave her an allergy shot and she went diabetic for about 6 months, found this site and its wealth of information, put her on insulin and we got her turned around and in permanent remission till her passing.

Fast forward to now, beginning of July saw our Max cat was walking across the floor on his hocks. (neuropathy). Grabbed my test meter and yep his blood sugars too high.

Immediately took him off all canned food over 8% carbs. He’s now on Fancy Feast naturals no grain with an occasional FF classic Pate. We don’t feed fish. He doesn’t eat dry.

Went to the vet who did blood work and urine test. Yep diabetic. He put him on Humulin N. Vet wanted to keep him a week. Said no. Wanted me to start him at 2 units. I started him at 1 to see how he did. (He did throw some low numbers)

Second trip to vet and another urine test. Vet says still spilling sugar into his urine. Increase dose to 2 units (which I didn’t do) Asked about a Lantus blend and he stated “that doesn’t work”. Ok time for a second opinion.....

I have concerns about giving a higher dose as if you look at his attached chart, he just occasionally throws low numbers. No rhyme or reason that I can figure out, it just happens.Same as when he throws high numbers there’s no reason for it. It just happens.

So off to a second vet at a large hospital near us. This vet says keep him on Humilin N. Did a fustosomine test, result of 401. This vet says even though his blood numbers go high then go low, his condition is great so keep him on 1 1/2 units. His neuropathy has corrected.

Ok. I need your thoughts. Would the 70/30 Humulin N /Lantus be better for him? Or stay with the Humulin? (Walmart has the 70/30 for $25 vs the $167 for the Humulin). Whichever is better we will use. Are Max’s blood numbers ok or is the high to low numbers too far apart? Is it worth trying to reduce the pre shot numbers?

I do give a small Treat of pate midway through his cycle. For a while there I watched whether or not it affected his numbers. And it’s surprising but it really didn’t much. His morning numbers actually went down when he gets something to eat 4-5 hours after his shot.

I appreciate any thoughts on his numbers and some guidance. Thanks from both of us!
 
Hi and welcome to the forum.
I can’t see the spreadsheet ….did you press the share button?
I’ll post more but wanted to tell you about the SS.
 
You obviously know a bit about FD. Well done with the testing the BGs and changing to a low carb diet.
I would definitely change the insulin to Lantus.
The Humulin N or Humulin insulin are not a suitable insulin for cats. I find it hard to believe that 2 vets told you to stay using it. I’m glad you didn’t take their advice and give the 2 units to start.
I would be looking for a vet who will prescribe Lantus.

In regards to feeding Maxwell…..are you testing, then feeding then waiting 60 minutes before giving the insulin? It is a fast acting insulin and you need food aboard before giving the shot.
HERE is a link to using Humulin N insulin..please read carefully

As well as feeding the main meals I would give at least 2 snacks every cycle, during the cycle. The first one at +2 and then one around +4 or 5.

I can’t comment on the dose until I can see the spreadsheet.
I’ll ask @Bandit's Mom to have a look at your SS incase you can’t fix it so we can see it.
 
At this point, the American Animal Hospital Assn's guidelines recommend either Lantus (or one of the biosimilars/generics -- Basaglar or Semglee) or Prozinc for the treatment of feline diabetes. Humulin N and Vetsulin do not have the kind of duration that's needed given a cat's fast metabolism. (Either Humulin N or Vetsulin are better for dogs.) I would push your vet to prescribe one of those types of insulin. I attached the guidelines if you need to bring them to the vet to point out that your instincts are better than his!

I can't open your spreadsheet either. It needs to be shared with anyone with the link.
 
Ok somehow google sheets was the one that was changed. (I swear I had that not restricted)..

Yes that two vets said Humulin N. The first vet was very snarky about it as well. Second vet was very focused on selling me “their” food. I pretty much felt pushed out the door after I told her I wouldn’t feed it as I considered it junk food.

After reading over the AAHA recommendations I will make a new appointment with the hospital (will try a different vet there). Will bring a hard copy as well.
 
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I would not increase the dose of the insulin. That dose is bringing the BG down quite well.
But I think if you changed to an insulin like Lantus or Prozinc, you would get a longer duration…that is, instead of the BG coming back up in the 300s at the end of all the cycles, the BG will start to stay lower as the longer lasting insulins like Lantus and Prozinc last 12 hours or sometimes longer.
The insulin you are using at the moment is bringing Maxwell down but he is back up high again towards the end of the cycle. So he is still spending more of his day in higher numbers than lower numbers, which is not what you want.

Jmsimpson9 said:
Is it worth trying to reduce the pre shot numbers?
Click to expand...
You can’t do that with an insulin like the one you are using because it has a short duration.
The way to bring down the preshot BGs is to start using a longer acting insulin like Lantus or Prozinc
.
 
Ok, what dose do you think I should start out using with the Lantus? I will keep vet shopping until I get a vet that will prescribe it.
 
Great choice!
Normally with changing over to a different insulin, we suggest using the same dose as you have been using or slightly less. When you get the Lantus insulin, post and ask for dose guidance. Change the subject line to …changing to Lantus, need dose advice. You will need to do the change over at a time when you can monitor Maxwell closely as some cats respond more quickly than others.
As Lantus is a depot insulin, it can take up to 10 cycles initially for the dose to show its full effect.
It’s a very good insulin for cats. To do the swap over you just give the Humulin N dose in say the morning and then Lantus the next dose in the evening.
If you go to the top of the Lantus page you will see yellow stickies. Lots of information there about Lantus. I’ll post the link.
https://felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/
 
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Bron and Sheba (GA) said:
Great choice!
Normally with changing over to a different insulin, we suggest using the same dose as you have been using or slightly less. When you get the Lantus insulin, post and ask for dose guidance. Change the subject line to …changing to Lantus, need dose advice. You will need to do the change over at a time when you can monitor Maxwell closely as some cats respond more quickly than others.
As Lantus is a depot insulin, it can take up to 10 cycles initially for the dose to show its full effect.
It’s a very good insulin for cats. To do the swap over you just give the Humulin N dose and then Lantus the next dose.
If you go to the top of the Lantus page you will see yellow stickies. Lots of information there about Lantus. I’ll post the link.
https://felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/
Click to expand...
Thank you! I have been doing some research and I am sure this is where I am going with him. However, I have a vacation in a few weeks and Max will be going with. I think it’s best I wait till we are back and all is back to routine before I start making changes with him. He’s a many generation feral, he doesn’t like changes and some days he’s just plain weird lol. (I think he only likes me because I have thumbs and can open cans )
 
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