New With Question - about 2nd Cat Bret

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Nancy_Sierra & crew

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Hi,
Bret is a 12 year old boy who was born in my upstairs bathroom. He was diagnosed diabetic about six weeks ago, and has gone from being a normal energetic "brat cat" to a quiet boy who curls up in the pathways, and now has difficulty with his hind quarters. His original diagnosis level was around 420 according to the vet, so he was put on 1 unit of Lantus/day, which I split into 1/2 unit 2x/day. He is not easy to get blood samples from, but I was able to get a mid dose reading of around 180 with help. Still the "output" was rather voluminous so after getting the OK from the vet we upped the dosage to 1 unit 2x/day. He's been on that now for about a month, and I've only gotten two subsequent readings, one of 288 right before a dosage, and one of 401 after skipping a dose when I started noticing some unusual behavior.

I decided to take Bret off his insulin this morning and called the Vet at lunch time. He is having weakness in his hind quarters, and laying around, and not acting himself at all. This all started when I began giving him the insulin and has been gradually getting worse. I am afraid that it is a reaction to the insulin which is why I stopped giving it to him. My vet wasn't available, but will be in first thing tomorrow and will call then. Right now Bret is curled up over on the sofa instead of the carpet near me. He is having difficulty getting into the box, and his feet don't always work the way he wants them to, including going up and down the steps. His back end is smaller than usual, and he is also not being his normal bratty self. Before the insulin, the only way you could tell he was diabetic was the increased thirst and increased box usage.

I should also mention that I've been trying to change the foods for all of the cats, to more canned food, and less dry. Bret is one who likes dry, and I've gone to a different lower carb dry mixed with the original, and in very limited quantities.... maybe a cup a day for the whole group (five). I'm very worried and have no idea if I'm doing the right thing, but right now, I feel the Insulin may be more of a problem than high sugar for him ... and I'm not necessarily thinking straight either.... which is why I didn't think about this sooner.

This is my second current diabetic cat, the first is Sierra, who is also on Lantus at 3.5 units 2x/day and seems to be fairly well controlled. I'll post more about her at a later date.

Thanks for any guidance,
Nancy
 
Hi Nancy,
At first read, it sounds like Bret is suffering from diabetic neuropathy in hind hind legs. The only way that this will resolve is to get his blood sugar regulated. Lantus is a nice gentle insulin, and 1 unit twice a day is not too high a dose. You mentioned some odd behaviour - were you able to test his blood glucose at that time? I hope that you ar able to speak with your vet. Unles there is something else going on with Bret, I would encourage you to be as regular as possible with home testing - b4 each shot and one or two in between when you can. It is important to test around the 6 hour mark to see just how low the insulin is taking Bret. The other thing to work on is transition to all wet, lo carb canned food. Dry food will keep his bg high.

Methyl B12 will also help with the neuropathy. It is usually available in a natural food store or the vitamin section of the larger chain pharmacies.
 
Meant to add - the other thing that I'd worry about, esp with a bg that high and now you have toppd insulin, is ketones. Are you testing? This can be very serious. I really hope that you hav had a chance to talk to your vet.
 
Hi,

Thanks for responding. I was able to get his blood sugar this morning after a day without insulin it is 336. I've taken the day off today to keep an eye on him, and to take him to the vet, if I can get an appointment. This morning he did seem a little better. I am only stopping the insulin until I talk with the vet to rule out a bad reaction since this problem began shortly after I started the insulin. Working toward wet food is also on the agenda for all of the kitties, but I do want to keep some dry on hand (and plan to go grain free) as a treat. It is also for those times when leaving canned food out is impractical (i.e. eaten by visiting dog).

As for testing, I can only do mid-dose testing three days a week and if I can get him to cooperate. Having Fluffy Sierra on Lantus for about 3 years now, we've gotten things pretty regular on the timing and have a routine, that he's fallen into pretty well. In fact all of the cats have come to enjoy morning combing time. Weekdays, insulin is given around 5am, and usually around 5pm (depending on when I get home from work). Weekends, its closer to 6 am and pm. I try not to migrate more than an hour either side of that schedule, so that they are never more than 13 hours or less than 11 hours apart. Sierra should also have a curve done here at home since her food is also changing.

I did some reading on the diabetic neuropathy, and it does accurately describe his symptoms. My fear is that it is a reaction to the insulin, rather than diabetic neuropathy since the onset was gradual within a few weeks of the start of insulin. I don't know for sure how long he was diabetic prior to my getting confirmation.

Nancy
 
Nancy,

I hope you reconsider your decision to stop insulin. I wonder if you are thinking of your can in the pre-diabetic days and comparing behavior to now, when high numbers and diabetic neuropathy are present. I don't think this is uncommon since we often miss the day-to-day changes.

I hope you see your vet today and things are better for you and your kitty.

Best,
Pam & Layla
 
Pam & Layla

The insulin has restarted, but at a lower dosage. I spoke with my vet and have an appointment with her tomorrow. While I saw an adverse reaction, she suspects low blood sugar, and that his dose was too high. I know that it is difficult to see day to day changes, but he went from being able to bound up and down the steps and use his box without difficulty to having to stop in the middle of is trips up and down the steps and having difficulty getting in and out of the box in less than six weeks. (I have high sided boxes - about 10" high - when Vincent covers he "flings for distance.")

Nancy, Sierra, Bret & the crew
 
Nancy - that sounds like a great plan. I hope Bret responds well to the lower dose and improves quickly.

Good luck!
Pam and Layla
 
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