New Meowmber 6Sept Fenster and Kamo

[Fenster]

Hello!

I am Jenny and the menace with diabetes is Kamo. I stumbled across this forum while googling insulin resistance in cats and have been spending hours reading through the posts! You are all very connected and I love that.

Here's Kamo's Stats:
He just turned 13, weighs around 5kg (as of last vet visit) and is neutered. I will post a picture later only because I don't want anyone to get distracted of how handsome he is and try to set him up with one of their single female cats (hahaha). He is a rescue that claimed me immediately - I suspect he's got some maine coon in his genetics and/or some ragdoll but I don't know. He's just my hairbag. He was found with his tail stuck under a rock at a very small age - I would guess maybe 5 or 6 weeks old? He has had me wrapped around his paw since. Now I call him my SugarCookie.

He was diagnosed in March 2025 after about a month of being obviously symptomatic. I had noticed weird behaviour in the months leading up but sadly it only made sense after diagnosis (peeing so much but it not smelling like cat pee, drinking a ton, sleeping all the time) but I never suspected diabetes. His diagnosis story is that I was away for a couple of months and had a really good catdaddy friend taking care of him. He had stepped on Kamo (dude gets underfoot a lot) and my friend thought he had maybe hurt his paw or caused some sort of leg injury. Turned out that he had plantigrade stance. I picked him up Sunday night and then Monday morning I took him to the vet and was actually relieved when he was diagnosed as diabetes (blood test, urine test) and not anything more sinister (last cat passed due to saddle clot).

Treatment history: The first vet I had had not been exposed to diabetes much and gave unfortunate advice which had some negative outcomes with initial treatment (not bashing, just stating fact for history). Starting insulin was Lantus U100 0.5U twice a day. Then after a few glucose curves it went up to 1.0U twice a day. I thought it was too quick of a jump but I'm not the expert and she was not open for discussion but really - we just have to trust our doctors! We had many really bad hypoglycemic crashes, almost every other day, in the first few months and then in early July after being essentially uncontrolled for 4 months and after a night that I thought i was going to lose him, I ended up with a different vet who has more experience and has been a godsend (same clinic). Working with her has been amazing and we have been trying to navigate treatment together since. Initially he was on twice daily Lantus 1U. This was causing wicked peaks and valleys... >20mmol/L to 2.5 in a matter of a couple hours instead of the slow steady release that it is supposed to do. The lows were lasting hours. Not so bad to correct during the day but at 2am you have no one to call. Many tears were shed and kilos of food were consumed (for both of us haha). We pulled back to 0.5U twice per day and he was still getting bad fluctuations but the bad lows were not as frequent, but still happening. And then some days it was like he never got any insulin at all because his numbers didn't move. I spoke to my current vet about "chasing the lows" and she was stumped. She consulted an internal med vet (through the analyzers they use) and it was suggested to try Toujeo. I am interested in connecting with other toujeo users but I can't find anyone that has been using it. I did find this post though: ? re Toujeo, insulin pens, Libre. I have a CGM on him pretty regularly so I can monitor him all day long (whether he likes it or not). He started with 1U once per day, the curve flattened out beautifully but still running 18mmol/L-ish going high over night. We started 1U x2 per day about a week ago with less times over range but essentially the same results, although we did have a significant low day but then it went back up. So, his glucose has been extremely inconsistent, despite all the variables being as controlled as I possibly can.

Dose: Toujeo 1U x2 per day, always at 0700 and 1900, sites shaved and rotated every dose, he takes it like a champ too, no fights, using a universal needle (can't seem to find, neither can my human pharmacy, toujeo specific needles and the pens did not come with any...vet and I both thought that strange).
Food: Purina vet diabetes dry food, free-grazing, occasional friskies wet food just because he's such a good boy (vet oks this at injection only - he's a bit underweight for his size), Toujeo is not food dependent but he's become used to the 0700/1900 feeding times from the Lantus so we just go with it
Bathroom habits: "normal" - his pee clumps are way smaller than they used to be but he's quite proud of his contributions to the air quality of the household
Behaviour: he is way more back to normal the last few weeks vs earlier in the year - his zoomies finally returned and his stance is back to normal, a bit of right back leg weakness at times but I am considering the VitB supplementation, I'm not sure he "needs" more needles at this time, he's spicy as usual, cuddly, comes to bed etc etc. The days after he has the lows he is very sleepy and only leaves bed to eat and empty...but then the next day he's back to his normal
Monitoring: wears a LibreFreestyle2 (highly recommend) and occasional earpoke spot checks using AlphaTrak3, it's pretty darned close to the sensor data except when he's really low then it's out by a bit (2-3mmol/L) but at least it's out on the good side (higher than the sensor reads). I am aware of the 15 minute-ish delay between sensor (it will usually match 15mins later!) and ear poke values and the variance between interstitial and blood readings and take those into account (I'm a lab tech so I'm nerdy like that)
Exercise: as much as a 13 year old diabetic senior allows and only on his terms, he does go outside during the day for a few hours to defend his territory but this is normal activity for him, he usually sleeps on the deck for hours in the sun now (he's an old man after all!)
Vet: she has been AMAZING to work with and has not seen this type of non-compliance in a cat. She commends me on my diligence with him so I think I'm doing it right! We are in constant contact and trying to figure things out together. I wish she could be everyones diabetes vet!

He seems otherwise health and happy. I would love to connect with other people who have been using the toujeo and/or have and similar experiences with the uncontrolled glucose with good clinical signs. Sorry for the long story, I finally feel like I have found my people and it all came gushing out.

Thanks for reading...I hope you didn't fall asleep. Now back to the readings of all the forums!
Love to All,
Jenny and Kamo

 

[Tim & Pookey]

Welcome Jenny and Kamo. Bumping you to the top of the board. There’s so much information here, keep reading! That’s one thing that drew me in when we started, and how this group is focused on educating as opposed to telling.

 

[Wendy&Neko]

Hi Jenny and welcome to you a super sweet Kamo. Here's a post we recommend new people read: New? How You Can Help Us Help You! In there is a list of information it's good to put in your signature, so that we keep asking the same questions of you, over and over. We also love to see some of his blood sugar test values in a spreadsheet. That provides a lot of good information to us when we try to help you.

There aren't a lot of Toujeo users here, though I have seen a few. There are no U-300 syringes (anywhere) so people have to use the pen needles created for Toujeo. You might want to get the pharmacist to order them in. When you say "universal needles", what are you referring to? Brand, etc. The downside to using pen needles is that you can only change doses by 1 unit at a time, and it's common for us to use smaller increases/decreases. A quote from toujeo.com, though it doesn't say why. I suspect the lack of U-300 syringes may be why.

Do NOT use a syringe to remove Toujeo from your pen.

Food: Purina vet diabetes dry food, free-grazing, occasional friskies wet food just because he's such a good boy (vet oks this at injection only - he's a bit underweight for his size),

Any reason you aren't switching to an all wet food diet? I don't understand the vet's comment on feeding wet only at injection time. The so called "prescription" Purina diabetes dry food is not suitable for a diabetic cat. You'll note is is called dietetic management, not diabetic management. The carb content of the dry food is 33% and we recommend feeding 10% and under to a diabetic cat. We encourage feeding an all wet food or raw diet here, all the time. Cats need the extra moisture. Another website you might want to check out is catinfo.org a website written by a vet specializing in feline nutrition. I suspect the "uncontrolled glucose" is due to the DM dry food.

I did have a diabetic cat with uncontrolled glucose (Neko), but she had a couple secondary endocrine conditions (acromegaly and insulin auto antibodies) which made her much more difficult to regulate. I did eventually, after treating the acromegaly and time and plenty of patience!

 

[Sienne and Gabby (GA)]

Welcome to FDMB!

Just out of curiosity, how high of a dose of Lantus were you giving Kamo? The only difference between Lantus and Toujeo is the concentration. Toujeo is 3 times as concentrated as Lantus. As Wendy noted, we have not had many people using Toujeo whereas we have LOTS of Lantus users.

I also agree with Wendy that it's likely that the culprit is the dry food. The Purina diabetic food, actually most of the diabetic dry foods are surprisingly high is carbohydrates. In fact, if you look at the label closely, it is now called "dietetic" not diabetic. This is due to the pet food manufacturers having lost a class action lawsuit and are now prohibited from referring to the food as specific to a condition. There is nothing in the food that is prescription-worthy or specific to managing diabetes. In fact, the ingredients are not wonderful You have lots of better choices. The feline nutrition website that Wendy linked is great. You will notice, though, that the vet who authored the website recommends a canned food diet for all cats. This is due to cats having a limited thirst drive. In the wild, they get fluids largely from eating live prey. In the home setting, a canned or raw food diet is the next best alternative.

It's also not necessary to feed your cat only twice a day. It sounds like he grazes. Most of the members here will feed their cats in a few installments over the cycle. This has the advantage of keeping the numbers more level over the earlier part of the cycle when the insulin is most active.