Newly diagnosed cat gets sick on Lantus

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Puddles' Person

Member Since 2014
Hello everyone and thank you for any help you can give me. About a month ago I noticed that my eight year old cat Donut, who also has IBD, had lost a pound within a month. Her weight has always fluctuated about a pound over the course of a year, considering her flare-ups with IBD and her general activity level (her being more active and sleeping less in summer than in the long dark days of winter.) When I took her to the vet he found her sugar was 373 and her liver enzymes were elevated (ALT was 249.) He thought the two were connected. He started her on 1.5 units of Lantus and she just seemed to act like she was a balloon that someone had let the air out of. This was on her very first day on insulin and I had not yet started home testing, which I quickly began to do after reading up on feline diabetes. I called the vet the next day and he said maybe we had started her out on too much Lantus, especially given her sick liver. So he reduced it down to 1 unit once a day and she acted the same way. He then did a biopsy and found she had mild pancreatitis. She wouldn't eat so I hand fed her for several days and gave her sub-Q fluids at home. He then said try 1/2 unit once a day. Her sugar fluctuates between 232-374, not horrible but definitely not acceptable in the long run. The problem is, even with the tiniest dose of Lantus she becomes ill-acting and very lethargic. Has anyone else experienced this weird phenomenon? The vet and I are both at wits' end and he says he has never seen a case like this. Her liver and pancreas are under control and recovering well and her IBD is well-controlled on no steroids. It's just the Lantus. When it is nearly out of her system she acts great, just like her happy self. But a dose of Lantus and she's sick again. I'm desperate and would be so grateful for any advice. This is all new to me and I have a lot to learn. And boy has this last month been a roller coaster of ups and downs for me and my poor Donut. Thanks so much. I know this was a long post :sad:
 
I think that has been posted here before maybe once. It is very rare to have such an insulin reaction. The solution is to change to a different type of insulin. I would switch to ProZinc since that is a totally different kind of insulin.
Lantus, and other insulins are twice a day in cats.
You said "Her sugar fluctuates between 232-374". What were the specific BGs and when were they taken with respect to the insulin injection and eating.
What are you feeding Donut? a low-carb canned is best.
 
Larry,
Thank you so much for your reply. Upon the diabetes diagnosis a month ago I switched Donut to all canned, low carb. For the IBD, her previous vet had put her on Royal Canin Intestinal Response which I have subsequently discovered is around 33-36% carb. So I blame myself that I caused her diabetes. We recently had her tested for food allergies and found she is allergic to tuna, salmon, corn, rabbit and soy so unfortunately that rules out a lot of the low carb canned foods. I have to read the labels with a magnifying glass to look for troublesome ingredients while staying within the confines of low carb. On an average day, her fasting glucose first thing in the morning is around 275. Then she has her breakfast and insulin shot. The vet told me to test her 1 hour after shot (around 255), 2 hours after shot (around 235) and 6 hours after shot and meal (335). As I mentioned, I am new at this and thought at first that her blood sugar must be plummeting to cause her to act so limp and sleepy. But the numbers are barely budging, yet she acts awful. The vets have said that they never heard of this extreme reaction in how she feels, yet no real effect on the BG. I am looking forward to discussing the change in insulin with my vet on Monday. Both vets who have been involved have expressed some doubt as to whether she is (or will remain) a "true diabetic" because of the pancreatic and liver issues. I am so concerned, worried and feeling kind of hopeless. I really appreciate your input. Thanks so much for replying.

Molly
 
I agree with Larry, you may want to try a different insulin. Prozinc or PZI may be a better choice. If you want to try BCP PZI, your vet can order a free vial for you to try http://www.bcpvetpharm.com/products_bovine.htm

I used to have a dog with severe food allergies. I found that keeping her on a single protein diet worked best. One brand that she responded well to was Nature's Variety. On the food chart on Lisa Pierson's site http://catinfo.org/ the Instinct line seems to be low carbs.
 
Thank you so much, Lisa. I am definitely going to push for trying one of the insulins you and Larry suggested because Donut can't go on this way :sad: Also, I appreciate the tip about single protein helping and am going right now to check out the Lisa Pierson site. As you know with your dog, it is really a balancing act between the food allergies and now the diabetes. Thank you so much for your help--I need all the suggestions I can get right now!

Molly and Donut
 
hi Molly and sweet Donut ~ i didn't see whether or not Donut is allergic to chicken, but my experience was that the raw diet works the best for my FD Errol. He seems much happier on it and his numbers go even lower than with lowcarb tinned food. I have stopped the tinned food altogether as of a month ago after Friskies Pamper contributed to the death of one of my civvie kitties :cry:
It might seem like a mission to make it, but at the end of the day it is easier in the longrun because you know exactly what you're feeding.
Here are some links :
http://feline-nutrition.org/
http://www.catinfo.org/?link=makingcatfood
 
Hi Michele and Errol,
I am very interested in pursuing the raw diet that you spoke of and have been studying the links--thank you so much. Happily, Donut is not allergic to chicken and it seems to be her meat of choice. How very awful that Friskies contributed to the death of one of your beloved kitties. I am so sorry. After a terrible experience like that, it is a very strong argument in favor of making your own. As you said, at least you know what goes in it. Donut goes to the vet tomorrow but I'm definitely getting my feeding advice from FD members as his suggestion was either Purina DM dry or that awful Hills'. Can you BELIEVE it? Pure poison. I have often wondered what kind of hold Hills has over vets as they all push it and seem not to ever question the abysmal ingredients in it. If anyone knows, I would sure like to know too although that is a question for another post :-)
Hugs to Errol :-)

Molly and Donut
 
Michelangelo had adverse reactions to Lantus. He was on it for a year and a half and we just kept pushing through it. I finally switched him to Levemira couple of months ago (works similarly to Lantus). What a totally different cat I have now! I never realized how bad it was with him on the Lantus until seeing how happy and normal he's been since switching to the Levemir. Lantus has a negative pH and some kitties just don't seem to do well on it, both in attitude and with BG numbers.
 
KPassa,
Thank you so much for responding. I never heard about the negative pH but it is nice to know I'm not nuts in insisting that the effect on Donut has been awful and needing to try something else. I thought it was my imagination that Donut's personality had changed for the worse on Lantus but it sounds like maybe you had a similar experience with Michelangelo. Wow-- I couldn't believe your great spreadsheet! I really need some help on how to do that. We're in the early "shock" stage and need to learn to keep better records. Thanks so much for sharing your experience because I know Donut doesn't want to keep on feeling this awful with Lantus, especially when there are alternatives.

Molly and Donut
 
Hi Molly and extra sweet Donut!

Here's some instructions on Setting up a spreadsheet. It's one of the most valuable tools in this fight!

If you have trouble with it, let us know...we have some people who can set it up for you and then transfer it to you to keep up with.

Would you do us a favor and remove the 911 icon from your first post? We try to use that only when there's a medical emergency (like a hypoglycemic episode) so when we see it, we all kind of freak out.

What kind of hold does Hill's have over vets? There's money to be made! Vets get very little education on nutrition while they're in school, so most of their "education" comes from pet food salesmen. And of course for every bag or can sold, they make money! It's sad to think that's the only thing our vets are interested in, but unfortunately, it's true all too often.

Keep asking questions here! The people here are very generous with their time and can help get Donut feeling better!
 
Hi Chris and China,
Thank you so much for the info on the spreadsheet. I am going to download one shortly.
I am so sorry about leaving the 911 emblem on my post. I think I have removed it. :oops: I am new to this and will probably embarrass myself more in the future :?
It's just really disgusting to me that vets will keep people's pets sick by pushing garbage food. With the Internet, there's no reason vets can't educate themselves about animal nutrition--I mean everyone here has!
You are so right about the people on here being so helpful and generous with their advice. It takes time to post helpful ideas and as a newbie to this (and one who's feeling pretty overwhelmed and discouraged right now) the help I'm getting here is the only thing giving me some hope.
Thanks again, so much.

Molly and Donut
 
It's still there Molly....the 911

Go to your first post...the original one and right above the "Subject" line, you'll see a bunch of icons (None, 911, candle, rainbow, etc)

Click on 'None" and then Submit

And don't worry about it! We all had to learn how to use the message board, as well as trying to understand all the new information that people are giving us too! It's a lot of learning in a short time period!
 
Thanks so much, Chris and China. I thought I did it before--I'm so embarrassed. But I forgot to click "submit." Hope I did it right this time. If not, would you be able to let me know? Geeeesh--sorry all!

Molly
 
No worries!

I noticed it disappeared last night, so you got it done!

It's no big deal, other than like I said..we really watch for those 911's since it can mean a medical emergency, so it always makes our heart race a little faster when we see them. Also the candle and rainbow icons since we use those to indicate one of our furbabies has gone ahead to the Rainbow Bridge

How's Donut today?
 
Hi Chris and China,
I'm glad I finally figured out hot to remove the 911--next time I'll know better :?
Thank you for asking about Donut. She started acting a little lethargic yesterday and I had to coax her to eat so we were relieved to see the vet today. He ran a blood panel on her to check liver enzymes which had been very high a month ago. Her liver was back in the normal range but her white cell count was very high, indicating I guess, an infection somewhere. So she's on antibiotics. He wants to start her on Vetsulin tomorrow and I put a post on asking for thoughts from anyone with Vetsulin experience. She has been through so much this past month that I hope I don't make a mistake and make her sicker. Right now getting her on track seems like it will never happen. Thanks so much for asking. I truly appreciate all your help and so does Donut :smile:

Molly
 
If you're dead set against continuing on Lantus, there are much better choices for insulin than Vetsulin. It's very harsh, can drop them quickly and then wear off, not lasting anywhere close to 12 hours.

Levemir and ProZinc (or PZI) are the only other insulins that work well with cats. If you really want to get away from the Lantus, the ProZinc would be the way to go IMO

Also, if she's got an infection (which the bloodwork indicates), that may be what's causing her to act so lousy, as well as keeping her blood glucose numbers higher. Once the infection is cleared up, her numbers may look a lot better

Have you been giving the lantus for now? Or have you stopped giving any insulin?

No matter which insulin you end up using, the spreadsheet will still be a very valuable tool to show how well Donut is responding.

Hope she feels better soon!!
 
Hi Molly and extra sweet Donut and welcome to the message board.

Boy, you sure are getting a crash course in treating feline diabetes! :o :shock: :o

Hang in there, this sugardance does get easier and you'll be a pro in no time.

Remember to take some time out for yourself to keep you healthy and relieve the stress of dealing with this newfangled diagnosis for Donut.

Give Donut a couple of hugs from all of us here.
 
Hi Chris and China,
We will be starting Donut on PZI tomorrow. (I live out in the boonies so it has to be overnighted to me and was ordered today.) I got a copy of the book by Elizabeth Hodgkins, DVM who has Tight Protocol explanations and lots on diabetes so I am studying that. I wasn't aware whether infection drove up sugar numbers in blood but it sounds like it does. Does infection also affect ketones? She had trace and small ketones on 2 different days but since she started the antibiotics the ketones have disappeared for now, thank goodness. Wonder if there's a connection.
The vet feels and I agree that we gave Lantus an adequate try (6 weeks) with Donut getting sick with each dose and no movement in the BG numbers. He said to not give her any more about 4 days ago so she would have a slight "rest" before introducing a new insulin. Her BG runs around 300 right now, not something we want to let go on but he says not dangerous in the short term as she's not showing symptoms like drinking excessively, peeing excessively, etc. and never has. That's what has made this such a confusing case. Since I replaced her dry food with all lowcarb canned her BG numbers have dropped about 75 points so there is hope. But this has sure been a steep learning curve for me and I've gotten so much help here. Thank you so much for all your thoughts and advice!

Molly and Donut
 
Hi Deb and Wink,
Thank you so much for your kind words of encouragement--they are so appreciated. I have felt so overwhelmed since Donut's diagnosis, plus dealing with her high liver numbers, pancreatitis and chronic IBD. For a few weeks I really wondered if she was going to make it. I hope so much that the PZI will get her well-controlled and maybe that will even take the stress off her liver, pancreas and maybe even other body systems.
All of you kind folks here are so well-informed on diabetes and really take it in stride. Someday I hope to be like that ;-)
And Donut appreciates your hugs :smile: Hugs to Wink too!

Molly and Donut
 
Good to hear you're trying the PZI! I wish you only the best of luck with it and hope Donut responds better with it than with the Lantus!

YES! Infection raises the blood glucose and can also be a factor in the ketones! I'm so glad that now that she's on the AB's, that you're not seeing any more of those! If you do start to see them again, make sure to say something here!

We have members who've been able to deal with trace ketones at home with IV fluids, but anything more than "trace" really needs to be seen by a vet as soon as possible. Ketones aren't anything to play with and can be very expensive to treat (and unfortunately, not always successfully)

You're doing an awesome job advocating for Donut....hopefully the PZI will do the trick for her! There's a ProZinc/PZI forum on the message board too. I encourage you to post over there as well as read the "stickys" at the top of the page. We have developed a "protocol" for using those insulins, but it's a work in progress as much as anything I think since those insulins work so differently than Lantus or Levemir

I'm also thrilled you have a vet who was willing to consider another insulin other than the Vetsulin!
 
If I understand you correctly, you've stopped the insulin for a couple of days, until the Prozinc arrives.

Please be sure to check Donut's urine at least once a day with ketone urine test strips. A lingering infection, not enough insulin, and not eating well can lead to DKA (diabetic ketoacidosis). We don't want to see that happen.

Since Donut has been prone to ketones in the past, these ketone checks are very important for you to do and highly recommended.

Urine catching/testing tips.
 
Thanks so much, Deb and Wink. Donut's ketones disappeared after day 2 of antibiotics but I am still checking them at least once a day, and 2-3 times if I can. Unfortunately, the antibiotics seem to give her a disinterest in eating so for now I'm hand-feeding her again if she needs a little encouragement. Usually she will lick the food off my finger so I don't have to stress her. Donut started on a small dose of PZI insulin this afternoon so I will be monitoring her closely. Would you believe ketones were something I had to find out about on this board, as I was never even warned about their danger by the vet?!!! Since then, we've changed vets! Thanks for emphasizing the need for testing--maybe other newbies are as ill-informed as I was (and am) but I hope not :sad:

Molly and Donut
 
rougecheveux said:
... Donut's ketones disappeared after day 2 of antibiotics but I am still checking them at least once a day, and 2-3 times if I can. Unfortunately, the antibiotics seem to give her a disinterest in eating so for now I'm hand-feeding her again if she needs a little encouragement. ...
Click to expand...

Antibiotics kill off both bad AND good bacteria in the gut. This can be why a lack of appetite happens. Probiotics may be your friend in this case. Forti Flora is based on an animal digest so many cats find it appealing. Intelliflora may be found on Amazon. And 1-2 teaspoons a day of plain yogurt with active cultures may help in cats with no dairy sensitivities.
 
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