On and Off Diabetes

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Jherndon

Member Since 2015
Our 17 year old orange tabby mix Lucy developed diabetes after a week long stay at the vet for a kidney infection. She was on antibiotics via intravenous feed for the week. She came home and started exhibiting diabetes symptoms (increased urine volume & water consumption) shortly thereafter. That was well over 3 years ago. She has been on Lantus brand glargine insulin.

Since then it has been difficult to get to a consistent dose She has gone up and down and then off at least five times. She eats the same high protein wet food diet (specific varieties of Fancy Feast). Her weight is stable. I settled into routine weekly testing at least three hours after eating to track her status either on or off insulin. I add a test if her appetite gets stronger and she want more frequent feedings and she gets daily tests when we are changing or reestablishing dose or when she first goes "off the juice"(OTJ as they like to call it here).

She goes OTJ for between several months and a few weeks, then boom, her glucose is in the upper 100s to lower 200s range. The reintroduction of insulin is a challenge. Her body "resists" the insulin initially, requiring split shots totaling 4-5 units, then usually within a week or so, she drops down to 2-3 units total. She goes back to weekly monitoring and is stable for sometimes several months, then we find we again have to taper till eventually she is back OTJ. Her normal glucose using a Bayer glucose tester is 80-130.

The thing we would like to understand is what drives her body the on and off the need for insulin? We are good about her diet and general care. Is there something else that can be driving the on and off conditions?
 
There are things like infection and pancreatitis that can cause a cat's BGs to rise. When her numbers go back up do they check for infection?

When you say "split shot" what do you mean? Lantus is a 2 shot per day insulin in cats. Shots should be equal in dose and 12 hours apart. When you taper her down how low do you go before you take her off? On the Lantus board here we tend to lower the dose from one to .5 to .25 to 0.1 before taking a cat off of Lantus. This sometimes finds that cat needs a tiny dose of insulin forever, but will also assist that freshly healed pancreas for longer and can sometimes help that OTJ stick longer if you take them off that way.

Good luck on figuring out what is going on with Lucy. Hopefully you can make OTJ stick one of these times.
 
Thanks for the quick response. The split shots mean they are 12 hours apart. The lowest amount we can reasonably get to is 0.5 units on one shot. Our syringes are not graduated in a way that allows us to get to below that level insulin amount with any accuracy. When we get her to 1.0 units a day using two shots that is where we stop the insulin and start testing her glucose daily 3 hr after her last meal. If the glucose level stays in the 70-140 range for three days we call it good and put her back to a one a week glucose test and watch her urine volume for an increase.
 
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