GA New Member 5th Jan 2021- Difficulties stabilising 4 months in

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Kirsty86

Member Since 2021
Hi Everyone,

My 13 year old cat, Rufus, was diagnosed with feline diabetes in September 2020 following dramatic weight loss, ravenous appetite and excessive urination.
He started on 1 units of Caninsulin twice a day and after a month showed little signs of improvement therefore his dose was increased to 1.5 units twice daily. However, this put his blood glucose level dangerously low (BM 1.2) and his dose was immediately reduced back to 1 unit twice daily whilst a glucose curve was carried out.
I was able to carry out his glucose curve at home, BM as follows:
7am (pre food and insulin)- 17.8
7.30 (after insulin and food)- 27.5
This was repeatedly hourly until 1.30pm to identify nadir, which was 16.1.

Having reviewed the results the vet did not feel able to increase his dose again after but also shared her confusion with me regarding the trend of his blood glucose levels and his body’s response to the insulin. She gave me the option to increase by 0.25 of a unit (which is extremely difficult to get accurate even with 0.5 syringes!) or to switch to a long acting insulin which is 4x the cost of his current treatment along with branded syringes, prescription food, regular check ups... etc. We have spent about £1000 in the last 4 months getting to this point.

Just wondering if anyone had any similar experiences, insights or advice as 4 months on and we’re no further forward. His quality of life is poor and he is so food focussed and hungry constantly it’s so distressing. We have been giving him lots of extra food (wet and a little diabetic dry cat food) as he continues to lost weight (he has now lost over half his body weight). He cries constantly, drains the water bowl about 3 times a day along with drinking from the sink/puddles etc and litter tray is totally soaked in a matter of 2 days.
I’d be so grateful of any advice as I’m not sure how much longer he can go on like this, he’s fading away before our eyes.

Thank you so much xxx
 
Hello and welcome. My girl started out with Caninsulin - though she got up to 5 units. It didn't do much for her, wore off well before the next shot and she was spending quite a bit of time in higher numbers. I'd strongly recommend one of the longer lasting insulins like Prozinc, Lantus, or Levemir. They are much gentler insulins and much better for cats. By the way, you don't need prescription food. There are lots of low cost commercially available low carb foods. This post might also help you with sourcing other supplies too:
Good for you for doing some home testing. As for the blood sugar numbers you are seeing, it looks like you might not have chosen the best cycle to test. If cats see a lower number than they are used to, they do what we call bouncing:
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

If you test during a bounce, you'll get numbers that go higher during the curve, rather that numbers that curve down during a regular cycle.
 
Kirsty86 said:
She gave me the option to increase by 0.25 of a unit (which is extremely difficult to get accurate even with 0.5 syringes!)
Click to expand...
We usually recommend 0.25 dose increase here as well. You will have an easier time if you switch to 3/10 cc syringes with half unit markings rather than 0.5 syringes.

Are you testing the bg at home? If so it would really help us to help you to see the readings. This is a link to a template for the spreadsheet you see in our signatures.
https://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
Hi Kirsty. Welcome to yourself and Rufus.

The big drop in BG when you increased the insulin dose might potentially be influenced by Rufus being underweight. It might be worth discussing with your vets feeding Rufus something closer to the 10% carb mark - possibly higher - for the time being in order to support adequate dosing of insulin to help him regain weight.

Kirsty86 said:
or to switch to a long acting insulin which is 4x the cost of his current treatment along with branded syringes, prescription food, regular check ups... etc. We have spent about £1000 in the last 4 months getting to this point.
Click to expand...
Your vet's recommendation to switch to a more cat-suited insulin is a good one (e.g. Prozinc, Lantus, Levemir). These insulins tend to be gentler in effect and longer-acting than Caninsulin in cats. Chances of remission are greater when using these insulins.

On cost of insulin, one option is to look online for better prices and get the vet to give you a written prescription. You can also get cheaper syringes than the branded Caninsulin ones. Here's a helpful thread about where to source all manner of relevant supplies in the UK:

https://www.felinediabetes.com/FDMB...-vit-b12-and-other-need-to-know-stuff.137376/

For Prozinc you'd need to buy from a pharmacy that supplies veterinary medicines (see link above). If your vet were to prescribe Lantus then they might be able to offer you 3ml pen cartridges (bit like a mini vial, doses are drawn up with a syringe). You can get 10ml vials from human pharmacies. Assuming Rufus would only need a small dose, with proper handling and refrigeration the vial would last you 6 months. It's a while since I bought any, but to give you some bit of a guide a 10ml Lantus vial was about £50 in 2016 from my local chemist.

There's also a link to a list of UK low carb commercial foods on the above thread (cheaper than the prescription diets). If you did want to stick with prescription foods, they're typically a good bit cheaper online than when purchased from a vet.

It's great that you're home testing. With a view to getting a better understanding of Rufus' response to his insulin treatment, it would be great if you could set up one of our shareable spreadsheets. It would give you a better picture of what's going on and also enable us to make more helpful suggestions on how to improve Rufus' regulation. Here's the info you need to get going:

FDMB spreadsheet instructions

Understanding the spreadsheet grid

If you'd like assistance with the above, just give a shout and we'll find someone to help. There's also useful information at the following link:

How you can help us to help you


Mogs
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Hi Everyone,

Firstly thank you so much for your responses and wealth of information that you have shared with my- My only wish I that I could have found this forum some 4 months ago.

Unfortunately, Rufus became seriously unwell during the night (his BM was 19 so not exceptionally low or high for him) however, he started vomiting profusely and collapsed- he could not eat or drink and was incontinent. He was rushed to the emergency vets and unfortunately there was no further treatment that could be offered other than more investigations which I did not feel was in his best interests given how diminished his quality of life has become over recent weeks. He had lost further weight and only weighed 1.9 kgs this morning... sadly, we felt it in his best interests to have him out to sleep.
I’m obviously devastated and feel this could have been such a different outcome.
Thank you for your help and I wish all of you and your gorgeous kitties the best xxx
 
Thank you so much... really appreciate your kind words and help. I just can’t understand how quickly he deteriorated and wondered if I could have done more. I only took him to the vets yesterday afternoon as felt something wasn’t quite right but they told me he seemed ok and just to continue on. Just can’t get my head around it.

Thank you for your kind words xxx
 
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