Not responding to insulin help

[STARGAZE]

Hello everyone, I'm new here and in a bit of an emergency and haven't had time to read all posting guidelines so I do aplogize if I break a rule or forget certain information.

Long story short, my cat is not responding as well to insulin as of the last few days and her I'm not able to get her blood sugar under 250. She has stage 4 kidney disease so this is somewhat of an emergency as it's been 2 or 3 days now of 300+.

My cats name is Girl and she is almost 18 years old, she has stage 4 kidney disease, heart disease, and diabetes. She was diagnosed with diabetes back in 2019 and has been on vetsulin the entire time. She has always been very sensitive to insulin and typically had a dose around 1/4 unit give or take but I have increased it to half unit and now I'm at a full unit as of tonight and is still seeming to have minimal effect. Pre meal her blood sugar is 330ish and nadir is around 250 if I'm lucky. I'm at a loss of what to do, should I just keep increasing? She has never needed a full unit before so something is definitely gone horribly wrong. She has stage 4 kidney disease and is also borderline anemic?. I did change the timing of her diet, which was 4 meals a day: breakfast, snack 4 hours later dinner and another snack 4 hours later again, insulin shot every 12 hours/twice a day. All I did was stop giving her the snack after 2.5 hours instead of 4 hours to try and get food in her before nadir. So I didn't change the amount of calories, just the timing but over the last 24 hours I've skipped her snacks to try and get her blood sugar down but it hasn't worked. I'm really worried that continous high blood glucose is going to do a lot of damage to her kidneys and push her over the edge. Should I keep increasing the insulin amount? Try a new insulin type? Take her to the vet? Please help

Also she has been mildly constipated for the last 4 or 5 days, could that be it?

 

[Bron and Sheba (GA)]

I’ve read your post as will get back to you asap

 

[Bron and Sheba (GA)]

Hi and welcome to the forum to you and Girl.
Can you give us a bit of information please.
What type of glucose meter are you using?
What is the food you are feeding her?
Do you give her subQ fluids at home?
Do you have a spreadsheet with her BG data on it?

but over the last 24 hours I've skipped her snacks to try and get her blood sugar down but it hasn't worked. I'm

I would not reduce the amount of food you are giving her. It is important she eat and eats well. I would continue the 2 main meals and the 2 snacks.

Should I keep increasing the insulin amount? Try a new insulin type? Take her to the vet? Please help

How old is the insulin? Could it be out of date or need replacing?
Now that you have increased the dose to 1 unit, you need to give it several days before increasing the dose again.
Without seeing some BG data it is hard to help you.
If you could setup a spreadsheet and add some of your data, that would make it much easier to help you.
HELP US HELP YOU has the link to how to set up the spreadsheet
Vetsulin is not really a good insulin for cats. You would be much better seeing if you could swap to another insulin such as lantus or a biosimilar insulin. Lantus is a longer lasting and more gentle insulin and is recommended for cats by the American animal hospital accociation
Association
Keep asking questions. We are happy to help you in any way
Bron

 

[Diane Tyler's Mom GA]

If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
I see Bron has given you the Help us Help You link, that's the information we need about Girl for your signature

 

[Sienne and Gabby (GA)]

I would suggest a vet appointment. There could easily be an infection or inflammation that's causing her numbers to be elevated. Dental issues like gingivitis are notorious for raising blood glucose levels. Given your cat's age and medical issues the vet may not want to do a dental procedure but if it's a dental issue, an antibiotic may help to drop numbers back to a better range.

 

[STARGAZE]

Hey guys I'm extremely busy right now and have very little free time to read all of the guides and how to's but I will get around to it soon.

A few more details: I'm using a reli0n prime classic meter as well as a pet control HQ meter(which is my main one) she eats fancy feast and I syringe her a prescription kidney food for extra calories.

As far as the spreadsheet the only issue I'm facing js that my testing times are not consistently at 1 hour or 2 hour intervals with how busy I am i just can't be here to test at the exact right moment each time. So alot of my curves will have unusual gaps in between. How should I go about creating a spreadsheet with those type of numbers?

A little update, I gave her 1.25 this morning and it worked well, her lowest reading was 126! I thought i was onto something but then her blood sugar quickly shot up to 300+ again. I'm very worried about her high numbers cause they've been elevated for so long and the vet offered me no help and was reluctant to give me a new insulin and said we should wait. So i decided to give her another smaller dose (.5 unit) once her numbers went up past 200 which was 6ish hours after the previous dose. Basicslly I was intending to give her insulin 3 to 4 times a day. Only this time the insulin did nothing. I panicked and 5 hours later when her sugar was up to 350 I decided to give her another 1.25 units, which is what worked the last few days, but now 5 hours later again and it's had no effect and her blood sugar is at 420 right now. I'm sorry this is not in spreadsheet format but I am very stressed and I'm a complete mess with very little time. Once you guys tell me how to do a spreadsheet with random intervals I'll get that set up. What do I do? 420 is so high and has to be causing damage to her kidneys. I'm freaking out. She is constipated right now and isn't sleeping, could that be it? I'm thinking about going back to the old insulin bottle and giving her another 1.25 units but I'm scared to just keep pumping more into her. Please help

 

[Chrispooky12]

Hey guys I'm extremely busy right now and have very little free time to read all of the guides and how to's but I will get around to it soon.

A few more details: I'm using a reli0n prime classic meter as well as a pet control HQ meter(which is my main one) she eats fancy feast and I syringe her a prescription kidney food for extra calories.

As far as the spreadsheet the only issue I'm facing js that my testing times are not consistently at 1 hour or 2 hour intervals with how busy I am i just can't be here to test at the exact right moment each time. So alot of my curves will have unusual gaps in between. How should I go about creating a spreadsheet with those type of numbers?

A little update, I gave her 1.25 this morning and it worked well, her lowest reading was 126! I thought i was onto something but then her blood sugar quickly shot up to 300+ again. I'm very worried about her high numbers cause they've been elevated for so long and the vet offered me no help and was reluctant to give me a new insulin and said we should wait. So i decided to give her another smaller dose (.5 unit) once her numbers went up past 200 which was 6ish hours after the previous dose. Basicslly I was intending to give her insulin 3 to 4 times a day. Only this time the insulin did nothing. I panicked and 5 hours later when her sugar was up to 350 I decided to give her another 1.25 units, which is what worked the last few days, but now 5 hours later again and it's had no effect and her blood sugar is at 420 right now. I'm sorry this is not in spreadsheet format but I am very stressed and I'm a complete mess with very little time. Once you guys tell me how to do a spreadsheet with random intervals I'll get that set up. What do I do? 420 is so high and has to be causing damage to her kidneys. I'm freaking out. She is constipated right now and isn't sleeping, could that be it? I'm thinking about going back to the old insulin bottle and giving her another 1.25 units but I'm scared to just keep pumping more into her. Please help

Please do not give anymore insulin. You only give insulin 2xs a day. You give it in the am after you test to see if her numbers are safe to give insulin & then you give again 12hrs later in the pm after testing to make sure it's safe. You also need to be consistent with the dose you are giving unless she drops under 90 during the 12hr cycle. If that happens you reduce the dose by .25 units. We increase & decrease in .25 units only. I'm tagging a few people whom have been helping you @Sienne and Gabby (GA) @Bron and Sheba (GA) please help

 

[Sienne and Gabby (GA)]

I hate to say this again but please get your cat in to see your vet. There is something going on and typically infection or inflammation will cause numbers to be elevated. They will be unlikely to return to a better range until the underlying cause is addressed.

The kidney food you're giving your cat is likely to be very high in carbs. That's not helping. Try feeding your kitty the Fancy Feast only for a couple of days to see if removing what is likely to be a high carbohydrate food helps.

Like Christina noted, please do not give extra Vetsulin. It is a harsh, fast acting insulin. It could easily drop your cat's numbers dangerously low and make it a necessity to get your cat to an emergency vet.