One year no progress!

Status
Not open for further replies.
L

Lawcarol

New Member
Hello all.. My cat flop was diagnosed with diabetes about a year ago... After we took him to the vet because he was peeing outside of this box. We started with one vet and humalin and now we are with another vet and lantus. We are home testing and his levels continue to range from 360 to 550... It was just 520 tonight! He is also still peeing outside of the box!! I'm so frustrated with all of it! He is 12 yrs old and overweight... And diabetic. I feel so bad for him as I'm sure he doesn't feel good but it's also so frustrating for us... I scoop 5 times a day, we are going through 20 lbs of liter every 4 days we r using hills food we have the insulin, needles, testing equipment etc. I have been doing my best to be patient but every time we talk to the vet they increase the insulin by 1/2 unit. They think he is on 7 units twice a day... But I am giving him 10 units twice a day.. Because I am tired of waiting for it to go down and even that isn't working.

Wow that was quite a rant I am so sorry but I need help! I love flop but it is wearing on me and I'm not sure show much longer I can keep this up!

Any advice? Can anyone suggest anything that might help?
 
I wish I had advice but, unfortunately all I bring to the table is encouragement. My 10 yr old Tabby was Dx 1 month ago (started at 1U PZI BID & is now up to 5U BID). I can relate to your frustration. Seems like no matter what we do (diet, etc) we can't get those levels down! He goes to the water bowl and guzzles the water and I just cry!

What I can say is that Flop is lucky to have you :) sticking this out for as long as you have is taxing. Please keep posting updates.
**HUGS**
 
Lawcarol said:
Hello all.. My cat flop was diagnosed with diabetes about a year ago... After we took him to the vet because he was peeing outside of this box. We started with one vet and humalin and now we are with another vet and lantus. We are home testing and his levels continue to range from 360 to 550... It was just 520 tonight!
Click to expand...

Welcome :smile: Sorry to hear that you are having a hard time regulating your diabetic cat. You'll get lots of help from this board :smile:


They think he is on 7 units twice a day... But I am giving him 10 units twice a day.. Because I am tired of waiting for it to go down and even that isn't working.
Click to expand...

10 units BID of Lantus??? :shock: That's a HUGE dose :o Very few cats need that much insulin and those that do have another condition like Acromegaly or Cushings. Has your cat ever been tested for these conditons?

Lantus is a good insulin to use. There are a few things to know about using it. You can read the stickies at the top of the Lantus board: http://felinediabetes.com/FDMB/viewforum.php?f=9

Are you using the 10 ml Lantus bottle or the 3 ml SoloStar pen? How long has it been in use? Pooped out Lantus won't work well and thus blood glucose levels go up and you would need to give more insulin.

How long ago did your cat start using Lantus? How often were dose increases done and what were the based on?

we r using hills food
Click to expand...

Well, that might be part of the problem right here. What Hills food is it? Prescription? Dry or canned? Hills foods are really high in carbs which results in blood glucose levels being too high. The prescription food (dry or canned) isn't needed at all. The ingredients are junk quality and a waste of money to buy.

The right diet is important for your diabetic cat, just like it is for Human diabetics. For cats, a low carb canned food (or raw) diet is best. Vets push the perscription junk because they don't know very much about proper nutrition and some may even get compensation from for selling the food.

Don't change your cat's diet just yet, though. Doing so and still giving the 10 units of insulin is recipie for disaster (serious or even fatal hypoglycemia). Read up on cat nutrition at http:www.catinfo.org first. You'll most likely need to drop that insulin dose way down to 1 unit BID or so and then do the diet change. More experienced Lantus users can help you with that.

To find low carb canned foods use Binky's charts, there is also the Pet Food Nutritional Values list, Dr. Lynne's Wet Food list, and the list of low carb gluten free Fancy Feast

On Binky's charts, stick with foods that have a number 10 or less in the carbs colum. On the Pet Food Nutritional Values Chart, look at the %kcal from carbs column and choose foods that have a number 10 or less.

Popular brands of low carb canned foods are Fancy Feast, Wellness, Merrick, Nature's Variety Instinct, Special Kitty, Friskies. Feed your cat whatever brand of food he like to eats and you can afford.
 
Oh yeah I know that is a ton of insulin... But it's still not decreasing his levels... At least not for more than a few hours... Would those other conditions also show a high blood sugar?
 
Hills Science Diet m/d (wet) really adversely affected my cat. I would advise getting on something else ASAP, even if it's Purina DM wet.
 
It would really help others to help you anf Flop if you could set up a ss for him, here is the link to the instructions http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=50130

I also wanted to clarify when you are testing are you just taking PS tests or also testing at nadir and doing regular curves?
- Just saw your next post so clearly you are doing some checks throughout the cycle.

The other conditions squeem mentions would not mean that Flop doesn't have diabetes and the high BG is caused by something else but they do mean that very high levels of insulin can be required.

There has been discussion recently about using lantus with fat cats too. I can't remember all the scientific jargon off the top of my head but there is a theory that because of the way lantus operates large fat cells may interfere with its action. You may want to consider a change to levemir which is absorbed differently.

You could make the change at the same time as a change in diet to LC canned food starting again at a much lower dose. The best place to get advice about that is on the lantus tight regulation forum. Levemir users post there too and there are some very experienced people there everyday pretty much around the clock. Also some of the kitties there have the other conditions that squeem mentioned and so people can give you advice about that too.

ETA: the M/D wet is still higher in carbs than the cheaper supermarket LC options and many cats go off it very quickly.
 
He is on hills DM... Carbs are 18%... I will be changing this as soon as possible ... Ugh I get so frustrated when someone tells me something that my vet should have... Thank you all... I will get a LC food...any other thoughts and advice is welcomed ... I'm still hoping for something to work
 
What was Flop started on as a beginning dose with Lantus? Sometimes more insulin can be like throwing gasoline on a bonfire, while it is a hard concept to get you head around sometimes less is more. If the cat is being overdosed with insulin their bodies will respond by dumping stored sugars to protect itself. That is a huge amount of Lantus unless there is something else going on that is causing insulin resistance. Most cats on Lantus need no more that 1u twice a day.

Mel, Maxwell, Musette & The Fur Gang
 
Lawcarol, if anyone can help you the wonderful people on these boards can.

I have learned so much from them, and they have boosted my spirits when I've needed it, too!

My Pumbaa hasn't been on insulin for a full week yet, so I have no advice for you, other than "you've come to the right place"! :)
 
hi - i'm sure we can help you, but it's often like untangling spaghetti to figure out what's going on. so be patient and we'll give you a hand. usually people answer here pretty quickly, so check back often.

lantus is a depot-type of insulin, meaning that it builds up in the body and releases over time. you can't use it to knock down numbers, it just doesn't work that way. did you only give him one dose of the 10units, or more than that? you need to monitor him for the hours after you gave that shot - i'd test every hour and if it looks like he's going down too far or too quickly, either post on here or get him to the vet. if you went from 7u to 10 units, you increased his dose by nearly 50%. that's a lot.

if you can do the spreadsheet that serryn gave you, that is the best possible way for us to see clearly what's going on.

there are things that can cause unremitting high numbers - it's possible you've got a high dose condition. there are 3 - acromegaly, insulin antibody antigens (iaa), and cushings. there are also other things that are not high dose conditions that can make it hard to get a cat regulated - too many carbs, infections including dental inflammation, steroids use (any asthma?).

cushings is characterized by fragile skin that tears easily - they are usually females.

the characteristics of acromegaly include a need for more insulin than average, the cats are often male (but i know of 3 females), some signs that they may or may not have include large overall, extra large feet, tongue, forehead pushed forward (more vertical from eyes up than before), an enlarged muzzle, spreading upper teeth, mega-colon, stridor (sound of rattling when breathing from excess tissue), and punkin's voice changed. he was diagnosed with acro last june 1st.

iaa is when the body builds up antibodies against insulin. so as the dose goes up, the numbers might go down a little and then they go up even farther. more insulin and higher numbers.

we have cats on here with both acro and iaa. those are more common than cushings, although we've had cushings cats here.

the tests for those 2 are relatively easy - a blood sample sent to Michigan State University can diagnose them. here's some basic info on all of the conditions and the tests. http://www.felinediabetes.com/FDMB/viewtopic.php?f=12&t=375 if you're in the US, the cost of fed-ex for the blood sample is $85.

I had punkin treated for acromegaly at Colorado State University last September.

it's too early to comment on whether or not he's getting an appropriate dose without more information.

our general process is to have the cat go on an all-canned food, all low-carb diet and increase insulin doses by small increments - i am NOT saying you should make any sudden changes right now. without knowing more it's hard to know if Flop's insulin increases were done in a way that says he really needs that much insulin. he might. if he's eating dry food, has an infection, is getting steroids, etc., and his doses were raised by too big of increments or too quickly, he could be overdosed. no way to know without having more data.

are you able to get the ss up and some info on it, as best as you can provide it?
 
Lawcarol said:
He is on hills DM... Carbs are 18%... I will be changing this as soon as possible ... Ugh I get so frustrated when someone tells me something that my vet should have... Thank you all... I will get a LC food...any other thoughts and advice is welcomed ... I'm still hoping for something to work
Click to expand...

If you make a quick switch to a low-carb canned diet, you will need to reduce the dose at the same time. The 18% carbs are boosting his BG. No matter what kind of numbers you are seeing now, they will drop with LC food, and most likely overnight. Definitely get advice on the Lantus forum before changing diet!

Carl
 
btw, i was just rereading your comment about your vet - one of the things we've realized here is that vets have to know a lot about different animals and different conditions, and feline diabetes is usually good for a short part of one class during vet school. then each insulin works differently, and it's just a lot to learn.

fortunately, you've found this site, where we do feline diabetes 24/7/365 and we use different insulins, and try to keep up on the latest info.

if your vet is good otherwise, you might want to just give them a pass on the diabetes. it's pretty typical for vets to now know the finer points of insulin management in cats. they are tough to regulate.
 
To echo what Julie said about vets. I thought my vet was amazing. She saved my cat's life on day one with this diabetes thing. But she wasn't really up on "dosing protocols". She didn't subscribe to the "go slow" aspect of increasing or decreasing. She had me upping Bob's dose 1u a week, and the smallest increment she dealt with was .5 at a time. I learned the "start low, go slow" rules here. That also saved my cat's life.

Some vets know a little, some seem to know not much at all, some vets know a whole heck of a lot, about feline diabetes.

They have to know a little bit about a million different things, and not just dealing with cats. Yes, you would expect your vet to "know" this stuff. But, they just can't know it all. My vet has seen about 100 cases of diabetes in her 30 years of practice. "We" see that many new diabetic cats appear here in 6 months or less. None of us know it all either, and none of us are vets. But collectively, you won't find a better resource for feline diabetes anywhere else.

Carl
 
Hello All: When Flop was first diagnosed he was going to a general vet. That is when we had him on humalin - starting with 1 dose - then slowing increasing up to 6 units in the morning and 6 units in the evening. I wasn't checking his levels at home then - but I was taking him in for regular curve tests - none of which showed progress. Then we started taking him to the Cat Practice - a vet that specialized in only cats. They are expensive, but at that point we didn't care we just wanted some substantial help.

You make a good point about the dose and it may be too high - ironically the vet has us giving him 7 units in the mornign and 7 units in the evening. We did start on 1 unit and have increased by .5 units slowly over time. on 7 units - 14 total for the day his levels haven't dropped below 450... weird huh?
 
Lawcarol: Doing the spreadsheet would be such a help to people here to help you with your sugarkitty.

From posts I've read, I'm watching for signs that Pumbaa would do better on an insulin other than Lantus as some respond better to Levemir.

I'm not the expert here...too new at this myself. But I just wanted you to know you aren't alone once you join these boards and pose questions and post data. :)
 
Lawcarol said:
Hello all.. My cat flop was diagnosed with diabetes about a year ago... After we took him to the vet because he was peeing outside of this box. We started with one vet and humalin and now we are with another vet and lantus. We are home testing and his levels continue to range from 360 to 550... It was just 520 tonight! He is also still peeing outside of the box!! I'm so frustrated with all of it! He is 12 yrs old and overweight... And diabetic. I feel so bad for him as I'm sure he doesn't feel good but it's also so frustrating for us... I scoop 5 times a day, we are going through 20 lbs of liter every 4 days we r using hills food we have the insulin, needles, testing equipment etc. I have been doing my best to be patient but every time we talk to the vet they increase the insulin by 1/2 unit. They think he is on 7 units twice a day... But I am giving him 10 units twice a day.. Because I am tired of waiting for it to go down and even that isn't working.

Wow that was quite a rant I am so sorry but I need help! I love flop but it is wearing on me and I'm not sure show much longer I can keep this up!

Any advice? Can anyone suggest anything that might help?
Click to expand...

Before anything, you need to start up home testing. Don't be changing to a lower carb wet food yet until you see what kind of numbers he gets at home where he is comfortable. Testing at the vet office usually results in a skewed curve due to stress. Both of my cats test 'off' when at the vet... one higher, and the other actually has lower numbers at the vet office. You need to see what kind of numbers you have, then you can lower the dose as needed when you switch to the low carb wet food.
Testing on cat’s ear

some food links for you:

Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition

Most people set up a google spreadsheet in which they record their test results, then others here can look at the sheet with all the numbers and help you along with decisions on dosing, etc. It's really helpful to see all the numbers and to recognize the patterns.
Create your Spreadsheet

Once you are testing and see his true numbers, you can safely make the food changes. Many cats are DIET CONTROLLED; once they are switched onto low carb wet food, their doses drop and some don't need any insulin at all.
At that point, if the dose and BG numbers are still high, despite the food change, you can tell your vet you want the tests done for insulin resistance. The tests cost $49 and $15, plus the cost of the blood draw and shipping vie FEDEX... it's alot cheaper to have the tests done as soon as you see the food change has not helped.

IAA Test
IGF-1 (Acro) Test

The cushings testing is best left till later, if needed, as the tests are not always 100% reliable.

As for the insulin, Levemir has been found to be the better insulin for cats with acromegaly. Human diabetics have stated that there is a sting from high dose shots of Lantus, but not with Levemir. Should his dose remain high, you may want to consider switching to Lev.

When it comes to protocols, the two protocols followed here are fine for diabetic cats but cats with acromegaly are not diabetics, so it has been found that more aggressive an approached to keep the resistance in line, but first things first for your Flop.
set up a spreadsheet
start home testing and recording the numbers
switch foods carefully and lowering dose as needed to keep him safe
test for acro and IAA if the above still has not brought down his dose substantially.
 
Status
Not open for further replies.
Back
Top