New to home glucose testing...

[Jack the Grey]

well here goes Jack's full health introduction....

Jack, my neutered indoor only 8 year old DSH, who weighs about 16 lbs was diagnosed 12/2015 when his blood work showed a glucose of 446 and vet immediately prescribed 4 units of Vetsulin 2x per day. His symptoms were mainly just not being himself, not grooming and lethargic. Jack was never a fat cat, just a long and lean larger male cat. His only med. history (vet visits) prior to diabetes diagnosis, was due to his peeing out of the litter box that started the year before for which we did blood work and urinanalysis, which resulted in no medical findings at that time. One other vet visit was after a week of sneezing and eating less for which he was put on antibiotics.
In Jan. 2016 2, a glucose curve was attempted at vet, but unfortunately not fully successful. The conclusion was that glucose was still in 500, so vet increased vetsulin dose to 6 units and recommended in home glucose testing. At that time we concluded that Jack's eyesight has become poor and he slowly started to walk on his hocks due to neuropathy.
Since then, Vetsulin has been given regularly with 1/4 cup Fromm dry food in the morning and 1/2 can of Spots Pate in evening. He improved, started a little grooming, but throughout theses months still seems starving at the sound/sight of food and definitely has continued increased thirst and urination. He is completely walking on his hocks now, so I have started giving him methycobalamin supplement.
I recently started using the AlphaTrack glucometer to try to understand his glucose curves to see how to better manage his diabetes. So far I only see that his morning fasting glucose is in the hundreds and then it seems to climb in evening to 400 even with evening dose of vetsulin. At this point taking him to vet is too stressful and will only spike his sugar, but I can't help wondering is there anything else I should test for? Is this the right insulin for him? Should anything else be tried? Should food be changed? Should I get another vet's opinion on diabetes management?

 

[scoobydoox]

Hi, you came to the right place to get your kitty back on track! My first suggestion is to see if you can find a vet that has a fair amount of knowledge about feline diabetes or see if your current vet is willing to start learning and working with you and take the information you will learn here to your vet. My cat was diagnosed on Mar 9 and given vetinsulin 2 units twice a day first week then three units twice a day second week. The entire time while on that he was not himself. Once I started home testing I realized his blood glucose numbers were high most of the time and only low for about 4 hours a day. Vetinsulin its hard and fast. Lantus insulin is easier on a cat and also linked to remissions. I would see if you can switch insulin. Diet also is recommened to be wet food and not what the vet trys to sell. Fancy Feast classics,9lives patetes and some others are popular on this forum. Also the alpha track meter is going to be expensive to test a lot with. Human meters and supplies are very popular and a lot cheaper here. you will want to setup your spreadsheet as well. There is a lot to cover but I dont want to overwhelm you so I will stop here.

 

[Critter Mom]

Hi there,

I am wondering whether Jack's Vetsulin dose might be too high. Too much insulin can look like too little in that BG levels may be high in both cases. In addition to the pre-injection tests you need to get tests mid-cycle to see how low/high the dose is taking Jack's numbers. Ideally it would be great if you could get a test at about +3-4 hours after each injection is given because that's when the main fraction of Vetsulin should have kicked in. Here's a link to instructions on how to set up an FDMB spreadsheet to record Jack's BG test results:

FDMB Spreadsheet Instructions

If you need help getting the spreadsheet going, just holler. It would be a help if you could include all of the BG data you've already got in the spreadsheet. Having better visibility of Jack's BG data will enable us to give you better suggestions on how to help improve his regulation.


Mogs
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[Mogmom and Goofus]

Another insulin you could try is ProZinc, it's made for cats. It's a little more pricey but also a little more flexible, in its dosing.

I'd get away from feeding the dry to your sugar baby, and stick to canned only. There are a couple of dry low carb but but jeez are they expensive!

Also, several of us use Freestyle LITE strips in our AT2 meters, they cost half what the AT strips cost. Not as inexpensive as using a human meter and strips, but still much cheaper. The FSL strips are made by the same company that makes the AT meter and those of us that use them believe that they're the same strip as the numbers run very close.

 

[Lisa and Witn (GA)]

BCP PZI is another insulin you can try that works well in cats. Your vet can order the first vial for free for you from BCP. http://www.bcpvetpharm.com/pdf/sample.pdf

 

[Julia & Bandit (GA)]

Unfortunately, Vetsulin (lente) is not a good insulin for cats. Cats have metabolisms that are twice as fast as dogs, so insulins that work well for dogs are not the same as those that work for cats. Vetsulin does not have a long enough duration of action in cats to last the full 12 hour cycle, so you have a full 4 hours from each cycle where the insulin is not working to lower blood glucose. Lantus (glargine) and Levemir (detemir) have the highest remission rates, and last a full 12 hours in cats. They are also safer, and have far fewer instances of dangerous hypoglycemic incidents than Vetsulin. Prozinc and PZI are ok insulins for cats (better than Vetsulin or Novolin, which aren't recommended at all), but not quite as successful in cats as Lantus or Levemir.

Lantus and Levemir are pricy in the US, but you can order from an online Canadian pharmacy at a third the cost with a script from your vet. The most economical way to order Lantus is to get a 5 pack of pens ($170 after shipping), and that will last you a year or more, so you're spending $14 or less a month on insulin.

As others mentioned, dry food is not good for diabetic cats and will keep blood glucose levels consistently high. A low carb, canned diet will help a great deal in getting your cat's diabetes under control. However, do not remove the dry food until you're home testing and lowering the insulin dose. Removing the dry food can reduce blood sugar levels dramatically and drastically reduce the need for insulin, turning a formerly safe dose into a dangerously high dose.

This is a great website that explains the basics of feline nutrition: http://catinfo.org. The website also has a chart with many commerical cat foods broken down by protein, fat, and carb content. You can pick any food your cat likes that is less than 10% carbs (but preferably below 8%). You're also going to want to look into a supplement for his neuropathy--Methylcobalamin B12--it works wonders with neuropathy. You can either get the human supplement and mix it with food (recommended dose for cats is 3000-5000 mcg per day), or the supplment made specifically for cats called Zobaline.

It sounds that your vet may be a bit outdated in terms of his/her feline diabetes knowledge. Most people here usually end up having to educate their vets in current treatment recommendations. Here's a link to the American Animal Hospital Association treatment recommendations, which discusses the correct diet (low carb, canned), and insulins. I've also attached an article below that discusses the remission rates and treatment guidelines for the recommended insulins for cats, Lantus, Levemir, and Prozinc. I would print both out and bring them to your vet to discuss.

 

[Julia & Bandit (GA)]

I also want to add that it's never too late to start on the right treatment path! The sooner you make changes, the better results you'll see. I had a friend who stuck to her vet's recommendation of the wrong insulin (Novolin, similar in action to Vetsulin), the wrong diet (high carb dry food), and wasn't home testing. Her cat gradually got worse and worse for 8 months on the Novolin (which her vet had her up to 6u twice a day), until her cat's neuropathy was so bad he couldn't even go to the litter box (he peed on a puppy pad in her kitchen). She came to me for advice when she hit her breaking point and didn't understand why Sidney's diabetes was getting so bad and why Bandit was doing so well. I convinced her to switch to Lantus and she got rid of the dry food and fed Friskies pates, and with the right dosing via home testing Sidney was in remission in 6 months. He did great on the Methyl B12 and was running around and climbing within several months of starting treatment with Lantus. And he never needed more than 2.25 units the whole time he was on Lantus with his new diet--and that was just at the beginning while we were getting him regulated. Most of the time on insulin he needed 1u or less.