New Member with questions on High Dose Insulin, BG Curve, Food

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LJoyT

LJoyT

Member Since 2020
Hi All, I have been reading and learning so much - getting slightly overwhelmed so thought I would just ask my questions directly. Our cat, Sherwood, a loveable large 20 lb orange tabby, was diagnosed with diabetes in October. He presented with having a sudden weight gain (not loss), excessive drinking and peeing. Not sure how excessive his drinking and peeing is as one of our other cats, Sylvia, has chronic kidney disease so she is drinking and peeing a lot too (we give her subcutaneous fluids). His blood glucose was extremely high (don't know the number) and he was started on 2 units of Lantus twice a day. Since then we have brought him back to the vet every week to two weeks and he is now on 9 units of Lantus twice a day.

I decided to do a blood glucose curve on him at home - how much harder could this be than subcutanous hydration? I am in the process of doing that today - I am using the AlphaTrak2 monitor as per the recommendation of my vet (I know I will probably switch due to the cost at some point).

This is what I have so far:

02/21/2020 404 (AMPS), 9Units, 560 @+2 , 494 @+4, 480 @+5, 361 @+6, 434 @+7

In looking at what other cats seem to have on this site, Sherwood's numbers are very high and he is on such a high dose of insulin (9 units of Lantus twice a day). Every time we have brought him in, the numbers have been at least this high as well but were told that there was a possibility of stress playing in to it. Currently, he is purring through the non-events, so don't think stress an issue.

So my first question: Is this something others have come across and have been able to get under control?

My next question is regarding diet. Is there a food that all three of my cats can eat? Sherwood has diabetes, Sylvia had chronic kidney disease, and Whiskers develops crystals (and she has possibly had a blood clot). I am guessing the answer is no, but, well, fingers crossed.

Thank you for this wonderful site and any help would be much appreciated.
 
Based on the dose and the BD curve, Sherwood may have acromegaly. See the following for a information regarding this high-dose condition. My MurrFee had acromegaly and was on 50 units a combination of Levemir and N twice daily. Levemir is not suposed to sting at high dose like Lantus does. N was added since it is a lot less expensive than Levemir or Lantus. Some caretakers have used R in addition to a long lasting insulin like Lantus/Levemir.
http://www.felinediabetes.com/FDMB/...ns-on-high-dose-insulin-bg-curve-food.226000/
The following forum also has addition about acromegaly.
http://www.felinediabetes.com/FDMB/forums/acromegaly-iaa-cushings-cats.12/
 
Thank you so much for your reply. I will take a look at that forum and about acromegaly. I assume N and R are alternate insulins - what are the full names? The first link you provided is just back to this thread, was there another place you were suggesting I look?
 
When kitties get to 6 units total dose, we suggest they get tested for some secondary endocrine conditions, which can cause the need for higher doses of insulin. Two of the more common conditions are acromegaly which is a benign tumour of the pituitary that sends out excess grown hormone, and IAA or insulin auto antibodies (think allergic reaction to injected insulin). My girl had both these conditions, but only got up to 8.75 units. At one point she was down to 0.25 units and fairly well regulated. We have cats with these conditions on all ranges of doses, some even higher than Larry's Murrfee.

My first suggestion would be to talk to your vet and get the tests done for those two conditions. They are blood tests, both go to Michigan State University. That is the only place in North America that does the tests. One in four diabetic cats has acromegaly, so it's the mostly likely condition Sherwood may have. The excess growth hormone can also explain weight gain.

I am glad to hear that you are starting to blood test. If you are willing to continue doing that, and can start using the spreadsheet that we commonly use here, we can help you with dosing and getting to a better dose faster. Instructions on the spreadsheet and other things are in the How You Can Help us Help You note. Click on the blue, it's a link. We have a number of reasonably regulated higher dose cats here.

Diet is an excellent question. My girl also later got CKD and I had another cat with crystals, so I had to do the same search for a food both could eat. The ideal food is something that is low carb, and low phosphorus. I ended up serving a raw diet, one without ground bones as that added phosphorus. There are premixes out there such as EZComplete on the FoodFurLife website that make it very easy to make your own. Plus I had some commercially available raw products that worked for me. But there are also low carb low phosphorus canned foods. What are you feeding now?

At some point, you may decide to switch to Levemir, as Lantus can sting at higher doses. I would not bother looking for N or R just yet. You need to do enough home testing to know how Sherwood is doing on the Lantus (or Levemir if you switch), before adding R safely to the mix. Humulin or Novolin R are the names, or Regular insulin. And not all high dose cats need it.
 
Thank you for responding. I will definitely talk to my vet about these conditions - been looking at websites on feline acromegaly and now I keep looking at older pictures of Sherwood with how he looks now to see if his jaw or anything looks bigger...

I just assumed the 50 units of Levemir was a different scale of dosing from Lantus!! Wow that is high!!

I added my results to the spreadsheet and put it in my signature line - hopefully I did it correctly.

As for diet, It is phosphorous not protein that needs to be low for Sylvia (CKD)? I currently have Sherwood on a combo of a couple of different Weruva and Tiki Cat cans plus the Vet recommended Purina DM dry (and now I am reading in this forum how I should not be feeding him that); and Sylvia and Whiskers on the same Weruva and Tiki Cat cans (mostly because they insist - and because I wanted them to eat a wet food but was not sure which to get given that the wet prescription ones make Sylvia throw up) plus the Vet recommended Royal Canin Renal Support dry.

Thanks again!
 
I would stick with the Weruva and Tiki Cat, and ditch the dry. Dry isn’t good for diabetes or kidneys. Sylvia has good taste in foods. :p

Kitties who switch from Lantus to Levemir have similar doses.

Only around 35% of acromegalic cats have obvious symptoms on diagnosis. My girl had a higher dose, insane appetite and one tears eye which was from soft tissue growth in her tear duct, but I didn’t know that at the time.
 
For Neko, the teary eye showed up about six months before her diabetes diagnosis, vet thought it was nothing. I found it got a better when Neko’s numbers were improved.
 
Sherwood's showed up right around diagnosis - Vet said she isn't worried about it. It has been getting worse as has his breathing but he has had chronic sinusitus for years (I never put him on steroids for fear he would become diabetic - ha!). Hopefully his numbers will get better and he will feel a little better.

Sherwood is hungry all of the time which is why I like having the dry. I guess we will both have to adjust.
 
Many of us use automated feeders, such as the Petsafe 5, to provide wet wood around the clock, but at timed intervals. There is a spot under the feeder ring where you can put a gel pack to keep it cool.
 
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