Newly diagnosed cat not responding to insulin

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Wanda

Member Since 2020
Hi everybody
So glad to have found this place! My 13 year old, 17 lbs cat Pretty was diagnosed with diabetes about three weeks ago. I had noticed that she was drinking water in excess and peeing all the time so I took her to the vet. They diagnosed her with a UTI and diabetes. She had several tests including the Fructosamine which at 535 confirmed a diabetes diagnosis. Her glucose level was at the time 462. All her labs came out normal, except the ones affected by the UTI. No ketones. Two days after the visit she came down with a nasty cold and eye infection. Back to the vet to treat that and to discuss the treatment options for the Diabetes. They prescribed antibiotics for the UTI, upper respiratory infection and Vetsulin at 5 units twice a day. They told me it was not necessary at that point to check her blood glucose every day which I thought was really weird but to come back after a week to do a glucose curve. Due to the cold and antibiotics, Pretty stopped eating almost entirely so I postpone her insulin treatment to give her a chance to recover. I also bought the Relion Premiere glucometer. When she was recovered from the cold and UTI we gave her first insulin shot, 5U with a fasting blood glucose of 358. I checked the glucose again five hours later and the Relion showed it had plummeted to 60 which we thought was too sudden. Checked her glucose later that evening and for the next few days it was between 120- 200 so for a few days no insulin. The cat seemed completely recovered, happy, no more excessive drinking water or peeing. Before the diabetes diagnosis she was on Fancy Feast with around half a cup of dry Iams Weight control. After the diagnosis I eliminate the dry food and she only eats the FF now. Because she needs to lose weight we were advised to feed her 200 calories a day. So she was doing really good for a few days and then the glucose started going up again to the high 200's and mid 300's. In the meantime I have been reading everything I can about diabetic cats and this particular insulin she was prescribed and everything suggested that five units twice a day was way too much. I could see the effect only one shot did for about five days. So when her glucose started rising I called my vet and we agreed on 2Units twice a day. I also got at her suggestion the Alpha Track2 glucometer so we started the new insulin regimen on November 1 And this is when my whole ordeal started! Ever since we started with the 2U every 12 hours her glucose levels have been slowly but steadily increasing above the 500's which I find totally weird. We are pretty sure we are injecting correctly and we are being totally consistent with her diet and time of the shots. Yesterday I decided to do a glucose curve and I was totally in disbelief about how high her numbers were. She started really high at fasting glucose of 651 at 6:00AM, fed her and gave her insulin at 6:20AM then checked glucose every two hours and got these readings: 552/534/418 (the lowest reading after six hours) 528 (at 2:30 PM, after this reading I fed her lunch) then two hours later I checked again and my Alpha Track 2 read "HI" which is not a good thing. It means the glucose was over 750 and couldn't be recorded. After this I panicked because it has been 8 days today and her glucose keeps going up. I gave her two units at 5PM. Couldn't get more blood samples for the evening (poor baby was traumatized. This morning her fasting glucose was at 477, lower than yesterday but still high. Gave her 2 units of insulin after breakfast and checked her glucose at five hours and it had gone up to 559. I see the vet this coming Wednesday but I am at a loss here. Seems she was doing better without insulin. Could it be she really needs the five units twice a day? The only time we gave her that dose her levels were so stable for days. On a side note, except for yesterday when her readings got really hi in the afternoon, she has been really happy, normal, playful, eating normally, she is even jumping back on our bed, something she has stop doing for a while. So sorry for the long post but I feel so lost. Any ideas of what could be going on? Appreciate all you guys do!
 
Hello and welcome!

Vetsulin at 5 units twice a day. They told me it was not necessary at that point to check her blood glucose every day which I thought was really weird but to come back after a week to do a glucose curve. Due to the cold and antibiotics, Pretty stopped eating almost entirely so I postpone her insulin treatment to give her a chance to recover. I also bought the Relion Premiere glucometer. When she was recovered from the cold and UTI we gave her first insulin shot, 5U with a fasting blood glucose of 358. I checked the glucose again five hours later and the Relion showed it had plummeted to 60 which we thought was too sudden.

Whew! So glad you trusted your instincts and decided to test!

It's hard to interpret what might be going on currently. The 1U may not be enough insulin, or it may actually still be too much-- it's hard to say from just a few BG numbers in isolation. I get the sense that you have a fair amount of data accumulated, even beyond what you describe in your post. Is there any way you could collect it all into one of our spreadsheets? It's much easier for us to look at the numbers that way, so then we might be able to help more.

FDMB SPREADSHEET INSTRUCTIONS

And, welcome to the site!
 
OK first 5 units UNLESS your Pretty has KEYONES in her history is a MASSIVE amount of insulin in such a small body. smh
I'm am glad you had the presence of mind to stop shooting that much insulin While its not unheard of for veteran insulin receiver it IS for a newly DX'd cat. OFTEN too much insulin results in high numbers. BTW BLESS you for taking the bull by the horns and getting testing under your belt WELL DONE!
I see Nan has already linked you to our spread sheet system. THANK YOU NAN! Wanda this is your BEST tool for managing Pretty's health! PLEASE download that and enter all your numbers.

This link will take you to a page, that will get you more acquainted, with how things work around here Please pay particular attention to the section about Profiles and Signatures this WILL BE YOUR third best tool in management:
New? How You Can Help Us Help You!

You HAVE landed in a SAFE place for you and Pretty. We all look forward to getting to know you both

WELCOME TO OUR FAMILY:bighug:
This is the best site on this planet, to learn everything you need to know, about feline diabetes and BEYOND!
jeanne
 
To start off a cat on 5 units is way too much too fast. They should start at 1 unit and go up slowly from there. Can you tell us what insulin she’s on?
Thank you so much for your response! Thank God and you guys for this group. I too thought 5 units was way too much too soon. I asked why such a high dose and the vet said it was based on the cat's weight and my Pretty Girl is 17 pounds of love and fur! The insulin prescribed was Vetsulin so I went to their website and they suggest to start with one unit or two the most. When the first vet that saw her not only prescribed the 5 units but told me I should just give her two shots a day and that I didn't need to worry about measuring her glucose "because she was definitely diabetic" I thought it was outrageous. If I had followed her advise and had given her a second shot on the day her glucose went down to 60 after her morning shot, I could have killed my sweet girl! I am now seeing another vet on the same practice and she and I agreed that 5 units was too much so to start the 2units twice a day for a week which I did. I am checking in with her this Wednesday and I will email her the glucose curve I did.
 
I never used an AlphaTrak but a few of things stick out.

1. Are you using the correct code on the meter? It should be the same as on the bottle of strips.

2. Did you take a test using the control solution for the meter to make sure it is calibrated correctly?

3. It is impossible to compare the Relion (human) and AlphaTrak (pet) meters. Believe me, so many people have tried. They are calibrated differently. But I would be interested in seeing what the numbers look like using the Relion.
 
Hello and welcome!



Whew! So glad you trusted your instincts and decided to test!

It's hard to interpret what might be going on currently. The 1U may not be enough insulin, or it may actually still be too much-- it's hard to say from just a few BG numbers in isolation. I get the sense that you have a fair amount of data accumulated, even beyond what you describe in your post. Is there any way you could collect it all into one of our spreadsheets? It's much easier for us to look at the numbers that way, so then we might be able to help more.

FDMB SPREADSHEET INSTRUCTIONS

And, welcome to the site!
Thank you so much for the warm welcome! I feel so much better already having people who are familiar with this. I have been a cat lover all my life and it is the first time I have a diabetic fur baby so this is so new and complicated! You are right about me having so much date. I have been keeping a journal, then I downloaded an app and keep recording everything in there. I saw the spreadsheet you mention but it is a bit confusing. It will take me a while to post all the data I have in there but I will figure it out and will do. Thank you so much again!
 
OK first 5 units UNLESS your Pretty has KEYONES in her history is a MASSIVE amount of insulin in such a small body. smh
I'm am glad you had the presence of mind to stop shooting that much insulin While its not unheard of for veteran insulin receiver it IS for a newly DX'd cat. OFTEN too much insulin results in high numbers. BTW BLESS you for taking the bull by the horns and getting testing under your belt WELL DONE!
I see Nan has already linked you to our spread sheet system. THANK YOU NAN! Wanda this is your BEST tool for managing Pretty's health! PLEASE download that and enter all your numbers.

This link will take you to a page, that will get you more acquainted, with how things work around here Please pay particular attention to the section about Profiles and Signatures this WILL BE YOUR third best tool in management:
New? How You Can Help Us Help You!

You HAVE landed in a SAFE place for you and Pretty. We all look forward to getting to know you both

WELCOME TO OUR FAMILY:bighug:
This is the best site on this planet, to learn everything you need to know, about feline diabetes and BEYOND!
jeanne
Thank you so much for your kind words and the warm welcome!. I thought so too, that 5 units is way TOO much! She has no ketones and aside the thirst and excessive peeing she was not having any other symptoms like excessive hunger or weight loss etc. My brother had a diabetic cat and he helped me tremendously at the beginning. He got me the Relion on and taught me how to use it. Then I purchased the Alpha track 2 and starting doing a lot of research on my own. He also suggested this site as you guys helped him a lot with his diabetic cats years ago. I have downloaded the spreadsheet and it is going to take me a while to fill it out but I will do it and send it. I am so happy to be here, yay!!
 
Thank you so much for your kind words and the warm welcome!. I thought so too, that 5 units is way TOO much! She has no ketones and aside the thirst and excessive peeing she was not having any other symptoms like excessive hunger or weight loss etc. My brother had a diabetic cat and he helped me tremendously at the beginning. He got me the Relion on and taught me how to use it. Then I purchased the Alpha track 2 and starting doing a lot of research on my own. He also suggested this site as you guys helped him a lot with his diabetic cats years ago. I have downloaded the spreadsheet and it is going to take me a while to fill it out but I will do it and send it. I am so happy to be here, yay!!
:bighug:
 
I never used an AlphaTrak but a few of things stick out.

1. Are you using the correct code on the meter? It should be the same as on the bottle of strips.

2. Did you take a test using the control solution for the meter to make sure it is calibrated correctly?

3. It is impossible to compare the Relion (human) and AlphaTrak (pet) meters. Believe me, so many people have tried. They are calibrated differently. But I would be interested in seeing what the numbers look like using the Relion.
Before I even opened the Alpha Track 2 box I watched several videos on how to use it so I was not as intimidated as I thought I would be. I checked for the code, I have done several tests using the control solution and it is calibrated correctly. I did a couple comparisons with the same drop of blood on the Relion and the Alpha Track and there is no way to compare. Sometimes there is a difference of 145 points, other times they are 50 points apart so I put away my Relion and only use the Alpha track.
 
I asked why such a high dose and the vet said it was based on the cat's weight and my Pretty Girl is 17 pounds of love and fur!

Dosing by weight is more of a canine diabetes thing. Most vets see more diabetic dogs than cats in their practice...

If you've switched vets, might be a good time to ask about switching insulins too, if the new vet is willing. Vetsulin is OK, but not great, for cats. Better insulins are Lantus and Prozinc. They can be more expensive, but we can sometimes help you save some money there, esp. for Lantus.
 
You see in my screen name that (GA)? Take a moment and look up and down the thread page. See all those (GA)'s? It not there because we are all from Georgia. It means "Gone Ahead" Our babies have passed away yet here we are day in and day out helping just like we got help. ;):bighug::)
Awwww, I was wondering if you all were from Georgia LOL! Now I know it means your babies crossed the Rainbow Bridge, sorry for your loss. I have had many fur babies there already. Thank you for continuing to help those like me who are just getting started on this journey of helping our diabetic loves :)
 
Dosing by weight is more of a canine diabetes thing. Most vets see more diabetic dogs than cats in their practice...

If you've switched vets, might be a good time to ask about switching insulins too, if the new vet is willing. Vetsulin is OK, but not great, for cats. Better insulins are Lantus and Prozinc. They can be more expensive, but we can sometimes help you save some money there, esp. for Lantus.
What I have read about Lantus or long lasting insulins kind of worries me a little and its because it's more likely that they have might have an hypoglycemic episode. But honestly, I am open to any option that might work well. It has been only a week on Vetsulin so I want to see what the vet tells me on Wednesday. In the meantime I am just worried and frightened at those high numbers I am getting. Even though she seems happy and normal.
 
Hi Wanda,

Thank goodness you started home testing. A 5IU BID starting dose for Vetsulin is crazy high. FYI, the manufacturers give the maximum starting dose as 2IU BID. Here are their current guidelines:

upload_2020-11-8_18-42-38.png


When you say that Pretty is clear of ketones are you referring to the test done by the vets? If yes, then that result is now well out of date. For info, ketones can build up within hours so while kitties are running in high numbers it's a standard safety precaution to test daily for ketones. You can do this with either urine test strips or a blood beta ketone meter. The latter works the same way as a glucometer. Strips are pricey but the BBK meters do offer the advantage of being able to test on demand and ketones are detectable in blood sooner than in urine. Some helpful resources:

Ketones, DKA, Ketone Meters

Tips for Collecting Urine Samples

Also the following should help you get your head round the spreadsheet:

Understanding the Spreadsheet Grid

Have both the UTI and URI definitely cleared up now?


Mogs
.
 

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What I have read about Lantus or long lasting insulins kind of worries me a little and its because it's more likely that they have might have an hypoglycemic episode. But honestly, I am open to any option that might work well. It has been only a week on Vetsulin so I want to see what the vet tells me on Wednesday. In the meantime I am just worried and frightened at those high numbers I am getting. Even though she seems happy and normal.
Actually it’s much safer for cats. Vetsulin is also called caninsulin because it was made for canines and cats have a much faster metabolism. So Vetsulin hits fast and then wears off so the cat is not covered for the entire 24 hours. You could get a much bigger bg drop because it’s such a harsh insulin. With Vetsulin you have to make sure the cat has food onboard at least 30 minutes before the shot because of how fast it hits. The great thing for me about Lantus is that it takes about 2 hours before it starts working so I have that time to play with if Minnie is being finicky about eating. You’re also less likely to have a big crash and a hypo incident on a gentler insulin like Lantus or prozync
 
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Hi Wanda,

Thank goodness you started home testing. A 5IU BID starting dose for Vetsulin is crazy high. FYI, the manufacturers give the maximum starting dose as 2IU BID. Here are their current guidelines:

View attachment 57913

When you say that Pretty is clear of ketones are you referring to the test done by the vets? If yes, then that result is now well out of date. For info, ketones can build up within hours so while kitties are running in high numbers it's a standard safety precaution to test daily for ketones. You can do this with either urine test strips or a blood beta ketone meter. The latter works the same way as a glucometer. Strips are pricey but the BBK meters do offer the advantage of being able to test on demand and ketones are detectable in blood sooner than in urine. Some helpful resources:

Ketones, DKA, Ketone Meters

Tips for Collecting Urine Samples

Also the following should help you get your head round the spreadsheet:

Understanding the Spreadsheet Grid

Have both the UTI and URI definitely cleared up now?


Mogs
.
Thanks for all that great information. The Vet's test ruled out ketones but I bought the urine strips and test every day sometimes twice a day and so far negative for ketones. Yes, she recovered completely from the UTI and the URI and the eye infection. My poor baby girl has been through a lot and she has never been sick before. She has been on two units of Vetsulin twice a day for a week now. But her numbers are so erratic and have been going up to the point that her lowest reading of the day is still too high. I will read the Spreadsheet instructions and will post the numbers as soon as I am done. Thank you:)
 
Actually it’s much safer for cats. Vetsulin is also called caninsulin because it was made for canines and cats have a much faster metabolism. So Vetsulin hits fast and then wears off so the cat is not covered for the entire 24 hours. You could get a much bigger bg drop because it’s such a harsh insulin. With Vetsulin you have to make sure the cat has food onboard at least 30 minutes before the shot. The great thing for my about Lantus is that it takes about 2 hours before it starts working so I have that time to play with if Minnie is being finicky about eating. You’re also less likely to have a big crash and a hypo incident on a gentler insulin like Lantus or prozync
Good to know this!! Like I said, I am open to anything that can help my Pretty girl be stable. Thank you so much for that information!
 
I just want to add 2 things. If you’re okay with the AT, great. The test strips are more expensive and when you’re testing a lot you go through 100 fast. I don’t think your vet should determine what meter you use. It’s your cat, your money, your choice. Again, if you’re okay with it great, but if not I’d go with whichever you’re comfortable with. The vet should be able to interpret the numbers from either meter. Most of us here use the ReliOn. Always good to have a backup meter regardless.

I have a feeling you may see better numbers on another insulin. Not all cats do well on vetsulin and she may be one of the ones who doesn’t. A vet that prescribed Vetsulin with a weight based starting dose is more used to treating dogs so keep that in mind.
 
You have been thru a lot! I feel for you. I know every cat is different. I just went thru some of the same decisions/learning curves that you are going thru. "Oliver's SS" in my signature lists things I've had to learn the hard way: that low carb wet food helps, that AlphTrak2 is a great but expensive meter, that ReliOn does the job just as well for a lot less money, that Vetsulin didn't help my cat much because it doesn't last long enough, that my cat got sick because he was spending too much time in the bad numbers, that some vets are better than others at treating diabetic cats, that the folks in this forum are life-savers. I like to learn from other people's spreadsheets so I offer mine just in case you might like to see a snapshot of my cat's journey.
 
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You have been thru a lot! I feel for you. I know every cat is different. I just went thru some of the same decisions/learning curves that you are going thru. "Oliver's SS" in my signature lists things I've had to learn the hard way: that low carb wet food helps, that AlphTrak2 is a great but expensive meter, that ReliOn does the job just as well for a lot less money, that Vetsulin didn't help my cat much because it doesn't last long enough, that my cat got sick because he was spending too much time in the bad numbers, that some vets are better than others at treating diabetic cats, that the folks in this forum are life-savers. I like to learn from other people's spreadsheets so I offer mine just in case you might like to see a snapshot of my cat's journey.
THANKS FOR SHARING CC! ;):bighug::cool:
 
Hi to all of you beautiful fur parents! It has been a while since I last posted. My computer suddenly crashed but finally got a brand new one so I am back. I want to thank you all for all the support, the great advise and for taking the time to reach out. Well it has been a few weeks and finally I think my Pretty girl is starting to regulate. After several curves I did at home and sent to the vet with different dosages, she seems to be doing really well on 2.25 units twice a day. On that dose she has the most stable numbers at the moment. Her glucose fluctuates between the low 200 sometimes even a bit below the 200 and high 200 or low 300s with a nadir of 75-80. She is still on Vetsulin and if she continues to do as well as she has done the past couple of weeks i might keep her on it. All her symptoms are gone, no more frantic hunger or excessive water drinking. She seems really happy, active, alert and as loving as always. She is such a great girl and I think it's so cute that she KNOWS her routine, twice a day before her meals she would jump at the table where I check her glucose, she then runs to have her meal and them comes back to the table for her shot. I have another cat, Bella, a beautiful black baby, very sweet but very feisty. If she had diabetes and I had to prick her ears she would be the one drawing blood out of me! But Pretty is so gentle and sweet, she has accepted all this so well so that makes me feel better. I want to thank you all once more for all the help, it really made a difference!
 
I want to share the numbers, I am trying to understand how to download the spreadsheet but I have VERY poor eyesight and double vision so it's a bit of a challenge. I downloaded an app that Vetsulin has available and it has been so useful. I will try to transfer that info to the spreadsheet as soon as I can figure it out.:)
 
I want to share the numbers, I am trying to understand how to download the spreadsheet but I have VERY poor eyesight and double vision so it's a bit of a challenge. I downloaded an app that Vetsulin has available and it has been so useful. I will try to transfer that info to the spreadsheet as soon as I can figure it out.:)
I can get you help for that! All you have to do is answer a couple of questions hold on...
@Bandit's Mom would you be so kind to PM Wanda? She needs help with her spreadsheet
THANK YOU in advance.
jeanne
 
Well, It is my second attempt at downloading the spreadsheet and I see it is there but when I click on it, all I see is the original template and I can't write anything on it.
 
Hey guys, I will have to log in later today. When I spend too much time in the computer my double vision kicks in and gives me horrible vertigo which I have now. I will try to figure out what I did wrong with the SpreadSheet later today. Thanks once more for being there for me, you are all so helpful and kind and I truly appreciate that. Will log in back later :)
 
Well, It is my second attempt at downloading the spreadsheet and I see it is there but when I click on it, all I see is the original template and I can't write anything on it.

Hi Wanda, I see a spreadsheet linked to your signature. Have you been able to set one up? I can help you with setting up a spreadsheet if you're having difficulties with setting it up.
 
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