Newly diagnosed diabetic cat with high units of insulin

[Julia Glus]

Hi guys!
I really need your help please. My cat is going to be 10 year old this January and he was diagnosed in April 2021 with DM. We started low and went slow with dosing of insulin (1U twice daily) but his sugar was still high and in May he ended up in hospital with DKA for 7 days and pancreatitis … Then we increased again units and again and he got into hospital again for 3 days in August. Right now he is on Lantus 7U twice daily.He is also taking Pancea tabs for digestion, Rx Purina Pro Plan EN wet food. We did blood work in October and his Fructosamine still in high range 630, it was the reason to increase insulin dose, because I noticed that his blood sugar that j measure twice daily again went to 300s. We had 4 times Freestyle Libre Sensor( 14 days) while adjusting the dose. But he is a tough guy I also did B12, Folate, pancreatic insufficiency and everything came normal within the range… Any suggestions and advice please?! What do you think about Pet Wellbeing Blood Sugar Gold drops?
Thank you so much really appreciate all advices!

 

[Wendy&Neko]

Hello and welcome. That is a rather higher dose of insulin. Most kitties need less unless they have some other secondary conditions, or are on really high carb food. My cat was one of those with secondary conditions and needed higher doses. Can you tell me why he is on the EN wet food? The regular EN wet food is listed as 17% carbs, which we consider high carb. Anything under 10% carbs is better for diabetics.

I have seen several people try the blood sugar gold, but so far no impact.

When you've got the time, some reading for you.
New? How You Can Help Us Help You!

INDEX: Health Links/FAQs

 

[Julia Glus]

Hello and welcome. That is a rather higher dose of insulin. Most kitties need less unless they have some other secondary conditions, or are on really high carb food. My cat was one of those with secondary conditions and needed higher doses. Can you tell me why he is on the EN wet food? The regular EN wet food is listed as 17% carbs, which we consider high carb. Anything under 10% carbs is better for diabetics.

I have seen several people try the blood sugar gold, but so far no impact.

When you've got the time, some reading for you.
New? How You Can Help Us Help You!

INDEX: Health Links/FAQs

Hi Wendy &Neko!
He was previous on Purina Pro Plan OM for weight management to loose weight because he was overweight (18lbs), he lost up to 14 lbs. I also tried Purina Pro Plan DM but one of the vet didn’t like it for some reasons.. Then after 2 months he started vomited on OM formulation and they switched him to EN formulation. And even now they trying to switch to Royal Canin PR but there is lots of fat…Meanwhile to prevent nausea so am giving him Zofran.
I am anxious to start PetWellbeing because my cat has history of pancreatitis, don’t want cause crisis with herbs…
I also asked them if he has IBS or IBD they didn’t confirm it yet, so far pancreatitis history.

 

[Wendy&Neko]

There is absolutely no reason for him to be on the so called "veterinary prescription" foods. Most of us feed commercially available canned food or raw.

Fat tends to be an issue for pancreatic dogs, not so much cats. Zofran or ondansetron (generic) is a great option for nausea if given the right dosage.

Has he had an ultrasound to see if he has bowel inflammation? Cats get IBD, not IBS. Novel proteins and a good probiotic like Visbiome may help if he has IBD with food allergies. By novel proteins I mean some protein he might not have had yet, like venison, lamb, duck, rabbit, port, etc. And this post will give you more info about pancreatis in cats and the tests to diagnose it. A Primer On Pancreatitis

 

[Julia Glus]

There is absolutely no reason for him to be on the so called "veterinary prescription" foods. Most of us feed commercially available canned food or raw.

Fat tends to be an issue for pancreatic dogs, not so much cats. Zofran or ondansetron (generic) is a great option for nausea if given the right dosage.

Has he had an ultrasound to see if he has bowel inflammation? Cats get IBD, not IBS. Novel proteins and a good probiotic like Visbiome may help if he has IBD with food allergies. By novel proteins I mean some protein he might not have had yet, like venison, lamb, duck, rabbit, port, etc. And this post will give you more info about pancreatis in cats and the tests to diagnose it. A Primer On Pancreatitis

Wendy&Neko,
All the time they do Utrasound of the pancreas. I even asked them if he has pancreatic cancer, they told they don’t think so… but his uncontrolled diabetes causes him inflammation of pancreas.He loves raw chicken but Vet told me that he cannot it eat anymore … I checked for amylase, lipase, and pancreas insufficiency and it was normal in October.
His Cobalamin level on11/02/21 was > 1000 Ng/L,Folate13.5mcg/L,TLI 33.7.Also, giving him LR 100 ml 2-3 time/week.Honestly, my head spinning now with all his diet changes, increase in insulin dose and high Fructosamine level.I am bouncing between two Vet, one is my family Vet and another Vet from UC Davis Teaching hospital and each one has different protocol for DM treatment.My family vet told me oh give him during the night food whenever he is hungry, I did it and his Fructosamine went to the top of the roof. While another one told me to a strict diet ( only twice a day feeding).I talked today with one guy and he told me try to check maybe he has insulin Resistance or acromegaly. Check his IGF-1 to see it.

 

[Wendy&Neko]

He loves raw chicken but Vet told me that he cannot it eat anymore

Why did the vet say he can't eat it anymore?

I checked for amylase, lipase, and pancreas insufficiency and it was normal in October

Again, good things to look at for pancreatitis in dogs. You want the Spec fPL test. Good to see his cobalamin level isn't low.

The twice a day feeding is old school, surprised it came from someone at UC Davis. Which type of insulin are you giving? Some of the old school insulins they used to recommend just twice a day feeding. Both Prozinc and Lantus are recommended in the latest (2018) AAHA Diabetes Management Guidelines for Dogs and Cats

Insulin resistance is a possibility. I would check for both acromegaly (IGF-1 test) and insulin auto antibodies (IAA) test. My Neko had both conditions. The blood draw for both conditions is send to Michigan State University.

 

[Julia Glus]

Why did the vet say he can't eat it anymore?

Again, good things to look at for pancreatitis in dogs. You want the Spec fPL test. Good to see his cobalamin level isn't low.

The twice a day feeding is old school, surprised it came from someone at UC Davis. Which type of insulin are you giving? Some of the old school insulins they used to recommend just twice a day feeding. Both Prozinc and Lantus are recommended in the latest (2018) AAHA Diabetes Management Guidelines for Dogs and Cats

Insulin resistance is a possibility. I would check for both acromegaly (IGF-1 test) and insulin auto antibodies (IAA) test. My Neko had both conditions. The blood draw for both conditions is send to Michigan State University.

I did fPL test for my cat Oliver in end of July and then in August and it came normal too. I am doing Lantus Solostar pen.Most likely, I should contact my Vet and order these two test to figure out if he is resistance and should be probably switch to sulfanylurea which I don't really won't since it will high change of hypoglycemia and renal side effects. They said that he cannot eat raw meat because it will cause him more vomiting and inflammation of pancreas.

 

[Wendy&Neko]

We don't use sulfanylurea. For insulin resistance you need to safely getting to whatever insulin dose he needs.

 

[Julia Glus]

We don't use sulfanylurea. For insulin resistance you need to safely getting to whatever insulin dose he needs.

Wendy but my Vet told me that:" We are getting closer to a point where I might consider changing his insulin type if we have to continue to increase his dose (usually around 1-1.5 U/kg is where we get concerned)", which freak me out.Because right now his weight is 15.7lb. And if she will change to ProZinc there will be less change for remission... I did some research and read the remission usually occurs with Lantus or Levemir. Can I copy paste his glucometer reading here? And my family et told me if he is insulin resistant then the next option is sulfanylurea ( but he will need to be on wet food 100%).

11/8/21
7am—> 301(7U)
6:36pm—> 344( sensor)
6:38 pm—> 262 ( glucometer)
6:45pm—>6(U)



11/9/21
5:50am—> 257 (6U) glucometer
6pm—> 6U
8:19pm—> 404 sensor
8:30 pm—> 279 glucometer( food)

11/10/21
6:30 am—> 251 (6U) glucometer
6:30 am—> 360 sensor
5:42pm—> 350 (sensor)
5:47pm—> 254(glucometer)
***ketones 0.2
6pm—> 7U



11/11/21
6:25 am—> 7U
6:30 am —> 284( right after food glucometer),
6:30 am—> 401 ( right after food with sensor)
11:30am –> 202 sensor
11:31am—>160( glucometer)
1:30 pm—> Zofran
6:09pm—>484(sensor)
6:10pm—> 350(glucometer)7U
7pm—> 369 ( glucometer)
***ketones 0.2
8:22 pm—> 281(glucometer)



11/12/21
5:21 am —> 370(sensor)
5:24 am—>217 ( glucometer)
5:37 am—> 7U
12:44pm—> 286(sensor)
12:46pm—>223( glucometer)
5:02pm—> 333(sensor)
5:03pm—> 249
5:20 pm—> 7U
6pm—> Zofran


11/13/21
5:29am—> 402 ( sensor)
5:33 am—> 267( glucometer) —> 7 U
6:10pm—> 243(sensor)
6:11pm—> 188( glucometer)7U

11/14/21
5:52 am—> 367 ( sensor)
5:53 am—> 249( glucometer) 7U
Weight:15.6 lb
5:15 pm—> 347( sensor)
5:16 pm—> 209( glucometer)
***ketones 0.1
5:30 pm—> 7U


11/15/21
5:39 am—> 194( sensor) 6U
5:42 am—> 132( glucometer)
5pm—> 7U



11/16/21
4:41 am—> 381(sensor)
4:50 am—>244(glucometer) 7U
4:14pm—>339(sensor)
4:17 pm—> 200( glucometer)
5pm—> 7U



11/17/21
5:06am—>254(sensor)7U
4:34pm—> 286(glucometer)
4:35pm—> 393(sensor)7U
8:54 pm—> Zofran

11/18/21
4:54am—>370(sensor)
4:57 am—> 268( glucometer) 7U
***Ketones 0.1
4:30 pm—> 7U


11/19/21 ( Oliver took off sensor

)
4:15am—> 251(glucometer)
4:20am—> 359(sensor)
4:20 am—> food(7U)
4:25 am Zofran
Weight: 15.6lb
12:40pm—> 263( finished his breakfast)


11/24/21

4:18am—>229(7U)
4 pm—> 275(7U)



11/25/21

4:15am—>239(7U)
12pm—>246
3:30pm—> 247(7U)



11/26/21
4am—>238(7U)
3:42pm—> 248(7U)
9:30pm—> 199


11/27/21
3:50am—> 213(7U)
3:35 pm—> 291(7U)



11/28/21
3:57am—> 212(7U)
3:53pm—>256(7U)
4:26pm—> Zofran
***ketones 0.1
9 pm—>Fluids 50-70 ml


11/29/21

***pee 3 times over the night
3:57am—>333(7U)
8:45am—>277
Fluids —>100ml(@ 9:10 am)
11:10am—>253
***ketones 0.3
3:30pm—> 264
3:40pm—> Zofran

 

[Wendy&Neko]

Diabetic cats and people are treated differently. Levemir is indeed a good option for cats on higher doses. Low carb wet or raw food is a good option regardless.

For numbers, almost all of us use spreadsheets to record our numbers, and we are used to looking at numbers that way. Instructions are in the post for new members I linked above. If you have issues doing spreadsheets, let us know, we have people who can help.

An ultrasound of the bowels (not pancreas) is one of the steps towards diagnosing IBD.

 

[Julia Glus]

Why did the vet say he can't eat it anymore?

Again, good things to look at for pancreatitis in dogs. You want the Spec fPL test. Good to see his cobalamin level isn't low.

The twice a day feeding is old school, surprised it came from someone at UC Davis. Which type of insulin are you giving? Some of the old school insulins they used to recommend just twice a day feeding. Both Prozinc and Lantus are recommended in the latest (2018) AAHA Diabetes Management Guidelines for Dogs and Cats

Insulin resistance is a possibility. I would check for both acromegaly (IGF-1 test) and insulin auto antibodies (IAA) test. My Neko had both conditions. The blood draw for both conditions is send to Michigan State University.

Diabetic cats and people are treated differently. Levemir is indeed a good option for cats on higher doses. Low carb wet or raw food is a good option regardless.

For numbers, almost all of us use spreadsheets to record our numbers, and we are used to looking at numbers that way. Instructions are in the post for new members I linked above. If you have issues doing spreadsheets, let us know, we have people who can help.

An ultrasound of the bowels (not pancreas) is one of the steps towards diagnosing IBD.

Oh guys I will definitely need help with spreadsheet because I recorded different for myself. Thank you so much for all your help Wendy, million of thanks your are giving me a hope that I can safe my little bundle of joy!

 

[Wendy&Neko]

Tagging @Bandit's Mom Bhooma can get you started on your spreadsheet.

 

[Bandit's Mom]

Hi Julia! Welcome to FDMB!
I can set up your spreadsheet and signature. Will send you a PM with the details I need. Look for it in the Inbox at the top right corner of this page.