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Emu85

Emu85

New Member
Greetings!

I have a 16 year old female spayed Devon rex called Evie.

Having trouble with possible insulin resistance...

BID = TWICE daily
SID = ONCE daily

TLDR of it is diagnosed with steroid induced DM about 1.5 months ago. She has had freestyle Libres every 14 days since then. I didn't make a spreadsheet as all the data is in the reports which I can upload if helpful? Has tried Lantus 1iu BID a few weeks no reliable response ended up on 2.5iu SID (she's super small so not safe to do bid), recently switched over to Toujeo 2.0iu BID with little to no response. Lowest she's been in the 2 months was 8.0 on the once daily lantus but nadired late in the day and wasn't for long.

Hx of IBD/Bladder stones has been on Royal Canin Hypo HP/Urinary SO dry long term because when off this develops stones faster and vomits. Open to trying another diet but live in Canada can't order internationally. Evie will not eat wet food. Hunger strikes rather than trying it.

Other Rxs: Budesonide 1mg SID, Solensia monthly, B12 monthly, Ketamine injections weekly (severe spondylosis/arthritis).

I'm working with an Internal Med Specialist but wanted some advice/opinions as it's sad to think about resistance...thanks!
 
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Hello and welcome. Waving at your from BC. Evie has such a cute little face. :)

To start, just giving an insulin less than a month to work is not a long enough time. We have a lot more experience here with Lantus that we do with Toujeo. By the way, size of cat can dictate starting dose size, but has nothing to do with the size of dose they eventually need. We've seen large cats on tiny doses that work and tiny cats on larger doses. SID dosing doesn't work with Lantus or Toujeo. BID is best.

With the Lantus, did you use the pens or syringes to give the dose?

We'd love to see data in a spreadsheet - maybe the last couple weeks of Lantus and the current data in Toujeo? Most important would be preshot data (test before you shoot insulin) and a couple points in between, most important how low she went after that shot. The reports are not very helpful - too much info. Other information that can go in your signature is listed in this post:
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We've got a number of kitties here with IBD. Eating high carb dry food can definitely make a huge difference in the amount of insulin needed. Have you ever tried air dried or freeze dried raw food? It has some crunch, you can get a lot of different proteins and it's low carb. In BC, I can even get elk and water buffalo along with some more common proteins. Feeding tip - don't start with the most expensive protein first as that's the one they'll love the most.:p Some more tips here from a vet specializing in feline nutrition:
I had a cat with two types on insulin resistance, acromegaly and insulin auto antibodies. With a cat that never had less than 3 units, I wouldn't even think about insulin resistance yet. Go for the easy wins, fix the food first. I've seen a cat on 13 units of Levemir and high carb dry food got down to 1.5 units on wet food, another from 5.5 units to off of insulin once switched from dry to wet.
 
The budesonide will likely keep your cat's bgs somewhat high and insulin may always be needed. My cat has IBD as well (and other issues) and he's currently on 1 mg of budesonide as well. His bgs are always high after getting budesonide but by the next insulin cycle, bgs are lower.

A better diet would help both the diabetes and IBD. I personally feed my cat a commercial freeze dried raw diet in rabbit. Canned food in a novel protein is good as well. I'm not sure what brands are available in Canada. I think Chewy ships to Canada now? Dry food is horrible for a cat's health so keep trying to get your cat to eat canned. Some cats are stubborn.
 
The budesonide may or may not impact blood sugar numbers. Neko was on budesonide and it made no difference to her blood sugars. Each cat is different (ECID).

Is there any way you can get your kitty to drink more water? Water fountain, having meat broth (no salt) available. Water helps flush out crystals.
 
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