Newly diagnosed 17-year-old cat problems with insulin

[zoealleyne]

Hi, my name is Zoe, my cat's name is Peanut. She got diabetes from prednisolone for asthma. S(She is now in an inhaled steroid with prednisolone only as emergency med) She also has early CKD. She started treatment about 2 weeks ago. She has a libre 3. The first medication my vet tried was vetsulin. Without medication, her BG registers on the Libre3 as over 400 (at her diagnosis it was like 531 or something.) On Vetsulin, her BG plummetted to 180. She was having tremors and I took her to the vet and a blood draw showed it was really 80. So the monitor was way off. The vet had me skip a dose and then the next day try half a unit. She didnt bottom out that time but she dives quickly to a low number and then after about 3-4 hours jumps back up to 400 plus. So on Vetsulin she gets 6-8 hours tops of a normalish BG and 16 hours unregulated high, and a rapid change that causes her physical stress.

Next we are trying Glargine. This is extending the amount of time that she is below 400, but it is causing the same problem with a dramatic drop in BG. She is on a TINY dose, less than .5 of a unit, literally 2 drops. Tonight she went from >400 to 200 in less than an hour, even with me feeding her Royal Canin Kidney E (carbs are like 27%,) She reacts really badly to the falling blood sugar, tonight she was twitching but also panting and had her tongue out like she does when she goes into respiratory distress and I got scared and gave her honey (and also her asthma rescue inhalers). So now she's jumping back up, which is also hard for her.

My Vet is awesome but she is not a diabetes specialist and I don't think there is one anywhere near me.

I'm hoping someone can give me some advice on how to prevent her having such a drastic reaction, or if there is some medication that is less likely to cause this. I have not slept at all in days trying to monitor her and so I apologize that this is rambling.

 

[Bron and Sheba (GA)]

Hi and welcome to the forum.
Glargine is a really good insulin for cats. Vetsulin is not a cat insulin so I’m glad you are now not using it.
How was Peanut diagnosed? Was it with a fructosamine test or just a urine or blood test?
Did the vet say if there were any ketones in the urine at diagnosis?
Did you give her a good meal before the dose of insulin?
And did you give her the snack of the higher carb food after the drop. Maybe a normal snack before the drop might help.
Dropping from 400 to 200 is not good but it does happen. It can make cats bounce from the big drop but doesn’t usually cause the symptoms you describe.
What concerns me is her reactions to the drop…ie the twitching, panting and tongue out.
Are you still relying on the libre meter? They can be unreliable so if you could start testing with a handheld meter that would be much more reliable.
You Can get a ReliOn premier meter from Walmart very cheaply, you will also need a box of 100 test strips to go with the meter, a box of 100 lancets size 26 or 28 and some cotton balls to hold behind the ear. I will give you a link to how to home test. Sounds scary but it’s not and it is a much better way really.
HOMETESTING HINTS AND LINKS
I will ask @Bandit's Mom to help you with setting up a spreadsheet so we can see any data you may have.
Then if you could maybe do a days testing without insulin so we can see what is happening…as long as there were no ketones at diagnosis.
If there were ketones at diagnosis please tell us.
Also while you are getting a glucose meter, can you also get a bottle of ketostix from Walmart or a pharmacy to test the urine for ketones.

Thee are smaller doses of insulin than 0.5 units which you could try but first I think we need to establish how she was diagnosed and what the BGs are without insulin for a day.
Can you post a photo of the syringe you are using please with the dose of the insulin drawn up so we can check it please? To post it you will need to copy and paste the photo into this page.
Could you also post a photo of the markings on the syringe please?thank you.
I am going to ask @Wendy&Neko and @Sienne and Gabby (GA) for their input.

 

[Sienne and Gabby (GA)]

Please make sure you are using the correct syringes. I hope your vet told you that Vetsulin and glargine require different syringes. You need a U40 insulin syringe for Vetsulin and a U100 syringe for glargine. We don't recommend using the insulin pens to dispense insulin since you can't calibrate the dose to anything that isn't a full unit.