New to board - Yankee is our sweet boy

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Lcrawford

Member Since 2012
So glad to find this board and community! Yankee is 12 and was just diagnosed Oct 15th. He is an important member of our family and we are determined but are still trying to sort everything out. There is a lot of info out there and much of it seems contradictory. It's all a little overwhelming.

The vet started him on 3 units twice a day of Humulin N. Then went to 5, then to 7, then to 9 last weekend when he tested 560 at the vet. This seemed like so much to us after reading a few Internet articles, and we ended up backing down to 8 and we started to home test today.

The vet said to continue giving the Humulin N a chance for another month but we really wonder if this is not the right insulin for him since the vet keeps saying we just aren't high enough, although he also says this is a really high dose for a cat.

For our first day of testing Yankee tested at 360 @ 6:10 this morning, then 73 two hours later then 102 three hours later. We are waiting to test again before his evening meal. He is not enjoying being forced to hold still while we fumble with the rice sock and lancet pen, but he hates to go to the vet or in the car at all really so hopefully as we improve our technique he will not mind the home testing so much.

When we first started w/ the three units in Oct he immediately began to behave more like himself, so we were quite hopeful, but the neuropathy in his back paws/legs which had just begun, seemed to worsen as each day went by and he was always at the water bowl and continued losing weight. Each time we returned to the vet, they advised us to increase the units (about every two weeks) Last week when we returned from the vet after a fasting testing of 560, his front paws/legs were affected as well and he was really struggling to get anywhere. We haven't seen the front be a problem for him since then but he continues to walk as if wearing clown shoes. He prefers to stay upstairs which is carpeted because getting around on hardwood is difficult. We were told that the neuropathy would get better when we were at the right dose.

He is drinking less water and urinating more normally and has gained a pound back of the 2 1/2 he lost so he's now 11 lbs. We feed him at 6:15 am and 6:15 pm and give him his shots 30 minutes after feeding begins. We used to feed him Purina indoor cat dry food, but since his diagnosis we give him fancy feast classic wet which we remove when he stops eating and leave about 1/8 cup hills science diet m/d dry out all day because he doesn't eat all of the wet and no one will be home for 11 hours. We worry that his sugar will drop too low and no one would be home to help him. He does always eat the dry by the time we return.

We appreciate any input or advice!

~L
 
If it is neuropathy, it will get better as his numbers improve. Did your vet mention Methyl B-12 or zobaline? That can help with neuropathy.

OK, the insulin your vet gave you, Humulin, is not a really good or appropriate insulin for cats. Works better on dogs. That, I think, is one problem. It just doesn't have the duration needed for cats, who metabolize insulin twice as fast as doges (or humans). Lantus, Levemir, and Prozinc are all much better for treating felines.

The other thing is the dose. That is a HUGE dose for a cat unless they have one of the "high dose" conditions which at this point your vet should have asked if you wanted tested. My cat, Bob, was up to 4u at one time, and that's much higher than many cats ever need.

The numbers you saw this morning are surprising to me actually. For him to have gotten 8 units and only dropped from 360 to 73.... I would have assumed he'd go down further. I am very happy you started home testing too.

What I think is encouraging is that he's drinking/peeing less, and has gained back some weight.

But that insulin, especially at those doses, concerns the heck out of me. Is there another vet you can go to for a 2nd opinion?

Carl
 
While N is not really good for most cats, it works for a few. My Tonis was one of the exception. I could keep his BG below about 150 with 8 units Levemir and 5 units N twice daily.
Depending upon the results of more measurements yo may want to reduce the dose for the next shot.
 
Thanks for the replying.
I found a site that recommended B-12 on Friday and called the vet. He said come on by for a shot. But the site I read said give mixed with food every other day so I didn't go by to pick up the shot and decided to search more on this. Would a shot help as much as orally do you think?

The vet said he'd only seen a few cases of neuropathy but seems certain that is Yanks problem. He said he doesn't believe there are any underlying problems although he hasn't tested for any. He said could be the cat is forming antibodies that fight the insulin and maybe we should change to PZI but give the Humulin another month. A month seems so long to me when we are talking about our boy not being well.

Now I'm thinking we should try the lantus. Since we don't need a prescription for that, can't I just switch that on my own, or will this upset my vet? Since I'm testing at home now, we should be able to see exactly what's going on, although with our schedules during the week being what they are, maybe wait until the weekend when we can monitor him if we change insulins. The fact that they have recommended we jump up 2 units each time concerns me also given everything I've read now about increasing slowly. If I reduce the humulin based on bg measurements how do I know how much I should give? Are there charts out there with appropriate dose for each reading?


Our current vet did a surgery on our dog for kidney stones a few years ago and was so informative each step of the way we were impressed and we've stayed with him even though he's now a 40 minute drive from our home. Perhaps he's better with dogs or just less familiar with feline diabetes. I need to ask around to see if anyone can recommend another vet for a second opinion.
 
Usually the B12 shots are the cyanocobalamin type of B12. For neuropathy you want the methylcobolamin type which is generally oral.
 
Where do you live? Asking because you said you don't need a 'scrip for Lantus...

Yes, it might tick off your vet, but he works for you, not the other way around ;-)
It could very well be that he's great with dogs, not so much with diabetic cats. It's gotta be impossible for a vet to keep up with a million things, and each one probably doesn't see very many animals with diabetes. Based on the insulin choice and the "up by 2u" adjustments, it sounds like he might see more diabetic dogs than cats.

From what I have read here (I never had to use it), the Methyl B-12 is usually given in pill form. You can get it at a pharmacy I think (off the shelf), and then you break it into "cat-sized" doses.

I don't know of a chart that tells you what to dose based on your numbers with Humulin. My instincts are just screaming "less". But if you are able to change insulin, that would be my suggestion.

Carl
 
I guess it's clear my vet will be learning from this as I do. I only said I read b-12 would help and what did he think, he said come by for a shot. It seems he didn't even know what B-12 I was referring to. Must not be common knowledge even for a vet?

Just tested Yankee before dinner and bg was 426. We intended to test him today every hour but he was not thrilled at all so we decided to go for every 2-3 hours then after our third test he hid out under the bed and we thought we'd give him a break until dinner. Should have tested every hour so we would know at each point what was occurring. Now it's been like 6 hours so who knows what time it climbed high, it's a learning process for sure. Wish he didn't have to suffer while we figure it out poor guy. We need to get better at this quickly. He actually trembled while I held him this time, seems like we are traumatizing him however soothing we are trying to be.
 
We live in Overland Park, Ks. The vet said we didn't need a script for the insulin, only for the syringes and sent us off with a script for the syringes. At the pharmacy they said they had to call the vet cause they didn't know what kind to give us and also told us that we didn't need a script for the syringes. Then they called the vet and the vet said Humulin which turned out was what they had sent us home with around 12 units of when we left the vets office in case we didn't get the insulin for a couple of days.

So we will likely need a script for the lantus then? I'll call the pharmacy and check tomorrow.
 
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