Stumpy's carer
Member Since 2025
My name is Kay and I am a new member seeking advice regarding my cat Stumpy who was diagnosed as diabetic 6 months ago, and we have been unable to get his blood glucose levels stabilised. The (rather long) process we have gone through is described below. FYI we are in New Zealand.
Stumpy is a neutured black and white male (domestic short haired, photo attached), he has a short tail, hence his name. He weighs about 5.9kg. He was diagnosed (by blood glucose and fructosamine levels) after we observed he was drinking a lot of water, and eating a lot, but losing weight. Stumpy is fed ad lib, and he grazes both day and night.
The vet put him on Lantus (Glargine) at a dose of 1 U, twice daily. At this point we introduce Royal Canin Diabetic biscuits rather than any other dry food and continued feeding wet foods including lots of fancy feast pate. After a few days he went hypoglycaemic, so we stopped the insulin injections. The vet did a fasted glucose curve (but he didn't eat while he was at the vet), and dose was changed to 0.5U BID. The next day a Freestyle Libre was fitted at the vet, it only functioned for about 5 days and during this time there were a lot of error messages before it shut itself off. While it was functioning, Stumpy's blood glucose readings varied from a low of 12.9mM to being off scale at 27.8mM. The vet adjusted his dose up in 0.5U increments during this time to 2U BID, and then to 2.5U BID after the Libre unit failed. We were instructed to monitor his urine using urine dipsticks. We did this for 2 weeks during which time all the urine samples were glucose positive at level 4. Another Freestyle libre was then fitted, however, it failed to work right from the start. Vet increased his dose again to 3U BID, and he was on this for another 2 weeks during which time, his urine glucose was monitored (all glucose positive level 4), and his body weight was stable.
Stumpy's dose was increased (on vet advice) again to 3.5U BID, and after about 10 days we got a normal urine glucose, followed by 2 more samples at level 3 on the same day. Over the next few days all his urine samples were glucose normal. I was concerned he may go hypo so booked him in for a glucose curve asap. Vet did another fasted glucose curve (again he barely ate, his glucose curve is attached, Stumpy wasn't given insulin and he didn't eat much until afternoon). Based on the glucose curve I was told he was in remission and to stop the insulin injections all together and to continue to monitor his urine glucose levels and to get another fructosamine in one month. I had read that it was not standard practice to totally withdraw insulin, but rather to slowly reduce the dose, and so when Stumpy's urine was glucose positive at level 4 the following evening, and he was showing physical signs (his eyes go really bulgy and dilated), I restarted insulin at 2.5U BID rather than the 3.5U he had been on. The vet was informed, and I was given a message from the vet that I shouldn't give him any insulin and he should have another glucose curve done. At this point I requested to change vet, but had to wait a couple of weeks for an appointment. During this time we monitored Stumpy's urine glucose levels, and continued to slowly lower his dose to 1.5U BID as his urine was consistently glucose normal.
At the visit with the new vet, Stumpy's blood glucose was 16.1mM (he hadn't had insulin). The vet said he may be in remission, taught me how to do an earprick so I could do blood glucose readings, and said to not give him insulin for a couple of days and to do some blood glucose measures and let him know the results. That evening Stumpy's urine was glucose positive again at level 4. The blood glucose reading the next morning was 18.6mM (no insulin). Information was sent to the vet, but we received no advice on what to do. We gave Stumpy 1U of insulin that evening, and again the following morning. During the day his urine was glucose normal and his evening blood glucose was 6.7mM so we did not give insulin that evening or the following morning. His urine was glucose positive at 1pm that afternoon, so we gave him 0.5U insulin in the evening. Sent the information to the vet but again received no advice.
At this point I must say that I am not very good at getting the ear prick blood samples. Stumpy doesn't like it, and won't hold his head still (he jerks it around), and it was traumatizing for us all, hence the very intermittent blood glucose readings. It is definitely a 2 person job. I am however, pretty good at collecting urine samples and generally get at least one a day and sometimes 3 samples per day.
Over the next week or so we tried to find a dose that would keep Stumpy's urine glucose normal and continued to get blood samples when we could. It seemed that 0.5U BID wasn't enough, and 1U BID was too much. We tried 0.75U BID but that didn't seem to hold him either. By this point it was the end of September and his urine samples were all positive at +4 level, and have been ever since. Over the past 3 months we have slowly increased his dose by 0.5U (or o.25U) at a time, and this was done after he had been on each dose around 2 weeks, or a slightly shorter time if his eyes were very dilated. He is now on a dose of 5U BID, and we have a couple of recent blood glucose levels of 20.2 and 22.4mM which were 1.5h and 1h respectively to being given insulin.
We are at a loss of what else to do, and whether what we have been doing is the best for Stumpy. I know it would be good to have more blood glucose values and glucose curves but at the moment I'm just not good enough to do that, and I don't think his glucose curves at the vet are that that realistic as he has been fasted and he doesn't eat, and gets very stressed. The new vet did say he didn't have to be fasted though, so that was something. Stumpy does seem better in himself these days on the higher dose, but do we keep increasing the insulin dose? do we go back to the vet? Any advice would be gratefully received. Thank you in advance.
Stumpy is a neutured black and white male (domestic short haired, photo attached), he has a short tail, hence his name. He weighs about 5.9kg. He was diagnosed (by blood glucose and fructosamine levels) after we observed he was drinking a lot of water, and eating a lot, but losing weight. Stumpy is fed ad lib, and he grazes both day and night.
The vet put him on Lantus (Glargine) at a dose of 1 U, twice daily. At this point we introduce Royal Canin Diabetic biscuits rather than any other dry food and continued feeding wet foods including lots of fancy feast pate. After a few days he went hypoglycaemic, so we stopped the insulin injections. The vet did a fasted glucose curve (but he didn't eat while he was at the vet), and dose was changed to 0.5U BID. The next day a Freestyle Libre was fitted at the vet, it only functioned for about 5 days and during this time there were a lot of error messages before it shut itself off. While it was functioning, Stumpy's blood glucose readings varied from a low of 12.9mM to being off scale at 27.8mM. The vet adjusted his dose up in 0.5U increments during this time to 2U BID, and then to 2.5U BID after the Libre unit failed. We were instructed to monitor his urine using urine dipsticks. We did this for 2 weeks during which time all the urine samples were glucose positive at level 4. Another Freestyle libre was then fitted, however, it failed to work right from the start. Vet increased his dose again to 3U BID, and he was on this for another 2 weeks during which time, his urine glucose was monitored (all glucose positive level 4), and his body weight was stable.
Stumpy's dose was increased (on vet advice) again to 3.5U BID, and after about 10 days we got a normal urine glucose, followed by 2 more samples at level 3 on the same day. Over the next few days all his urine samples were glucose normal. I was concerned he may go hypo so booked him in for a glucose curve asap. Vet did another fasted glucose curve (again he barely ate, his glucose curve is attached, Stumpy wasn't given insulin and he didn't eat much until afternoon). Based on the glucose curve I was told he was in remission and to stop the insulin injections all together and to continue to monitor his urine glucose levels and to get another fructosamine in one month. I had read that it was not standard practice to totally withdraw insulin, but rather to slowly reduce the dose, and so when Stumpy's urine was glucose positive at level 4 the following evening, and he was showing physical signs (his eyes go really bulgy and dilated), I restarted insulin at 2.5U BID rather than the 3.5U he had been on. The vet was informed, and I was given a message from the vet that I shouldn't give him any insulin and he should have another glucose curve done. At this point I requested to change vet, but had to wait a couple of weeks for an appointment. During this time we monitored Stumpy's urine glucose levels, and continued to slowly lower his dose to 1.5U BID as his urine was consistently glucose normal.
At the visit with the new vet, Stumpy's blood glucose was 16.1mM (he hadn't had insulin). The vet said he may be in remission, taught me how to do an earprick so I could do blood glucose readings, and said to not give him insulin for a couple of days and to do some blood glucose measures and let him know the results. That evening Stumpy's urine was glucose positive again at level 4. The blood glucose reading the next morning was 18.6mM (no insulin). Information was sent to the vet, but we received no advice on what to do. We gave Stumpy 1U of insulin that evening, and again the following morning. During the day his urine was glucose normal and his evening blood glucose was 6.7mM so we did not give insulin that evening or the following morning. His urine was glucose positive at 1pm that afternoon, so we gave him 0.5U insulin in the evening. Sent the information to the vet but again received no advice.
At this point I must say that I am not very good at getting the ear prick blood samples. Stumpy doesn't like it, and won't hold his head still (he jerks it around), and it was traumatizing for us all, hence the very intermittent blood glucose readings. It is definitely a 2 person job. I am however, pretty good at collecting urine samples and generally get at least one a day and sometimes 3 samples per day.
Over the next week or so we tried to find a dose that would keep Stumpy's urine glucose normal and continued to get blood samples when we could. It seemed that 0.5U BID wasn't enough, and 1U BID was too much. We tried 0.75U BID but that didn't seem to hold him either. By this point it was the end of September and his urine samples were all positive at +4 level, and have been ever since. Over the past 3 months we have slowly increased his dose by 0.5U (or o.25U) at a time, and this was done after he had been on each dose around 2 weeks, or a slightly shorter time if his eyes were very dilated. He is now on a dose of 5U BID, and we have a couple of recent blood glucose levels of 20.2 and 22.4mM which were 1.5h and 1h respectively to being given insulin.
We are at a loss of what else to do, and whether what we have been doing is the best for Stumpy. I know it would be good to have more blood glucose values and glucose curves but at the moment I'm just not good enough to do that, and I don't think his glucose curves at the vet are that that realistic as he has been fasted and he doesn't eat, and gets very stressed. The new vet did say he didn't have to be fasted though, so that was something. Stumpy does seem better in himself these days on the higher dose, but do we keep increasing the insulin dose? do we go back to the vet? Any advice would be gratefully received. Thank you in advance.
