New Member, Dosing Issues and Shaking of Paws

Hello Everyone. I just found your forum today and what a fabulous resource!

My kitty, Bella, was diagnosed with diabetes at the beginning of August. Her glucose reading was about 368 and she had sugar in her urine. She is 10 years old and has just gained 2 lbs so she weights about 15 lbs.

She had 4 diabetic curves done trying to figure out her correct dosage. She started at 1 unit of Vetsulin and was moved up to 2 and then 3 twice a day. I have been through several foods both wet and dry and finally settled on Dr. Elsey's Clean Protein Chicken dry and Smalls wet. Both the dry and the wet are under 5 grams of carbs. I just read the food post so will work on limiting dry and moving toward more wet.

We thought she was in remission after her 3rd curve, and then again after this 4th curve last Thursday (3 days ago). Then at the end of this last curve, her final measurement at 5:30pm was 43 (from 3 units of Vetsulin given at 8am) and I was told to stay off insulin until after her glucose reading is 200 and then give 2 units. And give her food when we get home. She was back over 200 that night so I gave her the 2 units.

Vet put a freestyle libre on her (after Thursday's 4th curve) because I have been unable to do home glucose testing. Yes, I have tried to do home testing but she was squirmy and ran away to hide. Then when I needed to give insulin, I had to chase her down. She just hated to see me coming. That was not good so the vet and I decided that giving the insulin was most important and I gave up trying to get home measurements. Thus the freestyle.

So late night, I woke up at 1:30am and Bella was in my room. I scanned her (yes I am obsessed with the freestyle) and got a glucose reading of 63. And it looks like it had been lower (in the 40s) and had come back up to 63 based on the graph the freestyle creates. I immediately gave her some Temptations cat treats. I sat up for an hour with her and scanned twice until it was 88, then I went back to bed. This morning I backed off of the 2 units and gave 1.75. According to the freestyle graph, it looks like she was again below 50 this morning from about 9:30am to noon.

I am scared to give her insulin tonight because I don't want her to get hypoglycemic when I am asleep.

And both yesterday and today she is shaking her front paws like they are wet. I am worried about neuropathy. This shaking of paws just started yesterday evening so I might have a chance to reverse whatever it is. Fingers crossed.

I have decided not to give any insulin tonight and just wait it see how her glucose goes for 24 hours. It would be time for her dose right about now and yes, I am having doubts. But I have read that high is better than low and her glucose in the 40's really scares me.

That is our story so far.... I look forward to interacting with all of you on Facebook and the forum.

Jill & Bella

 

Hello! I am also new to feline diabetes and to this forum. Judging from the information you gave in your post, I think it is the safest option to withhold the insulin dose for tonight like you planned. Granted, I'm not an expert so if someone more experienced is able to offer you advice I'd listen to them first. They'll also recommend that you set up your signature and spreadsheet so that other people can better help you.

 

Tagging @JanetNJ

 

Sounds like the dose was raised too quickly, esp with the diet change. We recommend raising in 0.25-0.5 increments. Next shot time she's over 200 don't give more than 1 unit. She my need even less than that. They can be sensitive to insulin following a hypo.

 

link to the Helping Us to Help You

 

Welcome to FDMB.

Like Janet noted, it sounds like the dose of Vetsulin is too high. I would likewise suggest dropping it back to 1.0. This is our link to information on Vetsulin dosing.

Just a bit of information on Vetsulin. Vetsulin was developed for use with dogs -- it's name outside of the US in Caninsulin. Dogs have a slower metabolism than cats and as a result, Vetsulin does not have sufficient duration to keep up with a cat's metabolism. It also causes a cat's numbers to drop fast and hard, much like you've been experiencing\. For these reasons, it's not been recommended for the treatment of feline diabetes by the American Animal Hospital Assn (AAHA) since 2018. This is the link to AAHA guidelines. They recommend either Prozinc or Lantus (or the recently available generic/biosimilars for glargine).

Generally diabetic neuropathy doesn't involve a cat shaking her paws. It manifests as weakness in the back legs. At it's worst, a cat will be walking on her hocks. This is a video of a cat with neuropathy. watch

It would have been helpful if Diane provided a bit of context for the helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.

I'm tagging @Bandit's Mom in case you need help getting your spreadsheet set up.

Please let us know how we can help or if you have more questions.