Please Help, BG 450+

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cats_toy

Member Since 2012
Hello Everyone,

Please let me begin by saying I am very familiar with feline diabetes. Our “Chick” was diagnosed with diabetes when she was 6, she passed away from an unrelated illness at 18.

When Clyde was diagnosed with diabetes in June 2012 at the age of 10 we did not question our ability to care for him. Using the Walgreens TrueResult, his BG was monitored daily. Numbers were encouraging as they reached no higher than 235. Clyde is by nature a very large cat, weighing over 22lbs. When he contracted diabetes however, his weight dropped to 12.4 lbs. The vet assured us it would take time for him to regain his weight so we continued to test and wait.

It was a few weeks ago I learned from this website the Walgreens TrueResult was inaccurate. We wasted no time purchasing the WalMart Reli On Ultima. We were devastated to see his BG readings were so high the meter was incapable of registering the numbers. I picked up some Purina DM from the vet and Novolin N from WalMart. We were instructed by our vet to give him 1 unit of insulin every 12 hours and a 50/50 mix of Purina DM and existing food.

Days passed with no change in his BG, he has lost control of his back legs and bladder. The insulin was increased to 1 ½ units every 12 hours but again there was no change. After increasing to 2 units and still no results our vet wanted the insulin increased to 4 units every 12 hours. I suggested we switch to Lantus or ProZinc but she is against this idea stating we need to wait to see if the Novolin would work.

My level of confidence with this vet has become very strained. She never questioned the glucose meter we were using even when she found he had lost more weight. Results from bloodwork weren’t learned until a week later. And now she is against us trying different insulin.

I could really use some advice before it’s to late.
 
Where are you located? (city/state) Maybe we have a member nearby who knows a FD friendly vet.

You are correct. N is not a popular insulin here. We feel it hits hard and fast in most cats, doesn't last very long and then the cat is high at next shot time. We prefer milder, longer lasting insulin like Lantus, Levemir or ProZinc. If you think your vet can be persuaded, we have studies that you could show him. It is hard to challenge your vet, but you are your cat's best advocate; you are the one that cares the most about him. You are the customer. And you can insist that another insulin be tried.

Is the Purina DM wet or dry? Purina Dry is 13% carbs and the ingredients are not as good as commercial cat food, which is more cheaper. The Purina Wet is 8% which is better, but you can find lower carb foods that are also cheaper and have better ingredients. What is the other food you are feeding? We try to feed under 8-10%. You can read more about food here: www.catinfo.org
 
Hi, and welcome to FDMB,

Gosh, it sounds like you're having a really tough time... (((Hugs))).... But don't give up hope. You'll get a lot of support here.

Can you give some examples of your cat's typical BG numbers? For example, what are his numbers prior to receiving insulin? And then do you also have some mid-cycle numbers?

When you say that your cat has lost control of his back legs, do you mean that he is sort of walking on his hocks? (Diabetic neuropathy?) If so, then methyl B12 can really help with that (you can buy it online as 'Zobaline').

As to the bladder problem, do you just mean that he is peeing really frequently? And maybe not making it to the litter box? (That's not uncommon in cats with high numbers). Or is there a different problem?

I don't know Novolin insulin so can't advise on that. But I do know that Lantus and Prozinc are good insulins for cats. And it may be that you do need to switch. It would be great to have more info though about what's going on with your cats BGs on a day to day basis.
 
TELL your vet you want another insulin, N just doesn't do it for 99% of cats. Also, food needs to be given a 1/2 hr. before shooting N because it is fast acting and short duration. Increasing the N dose WILL NOT give longer duration but it will cause you to run a risk of hypo in Clyde. If you opt for Lantus or Levemir please go to those forums and read up on them. They are treated differently than ProZinc which is a PZI. Also, Fancy Feast and Friskies are used by many on this board......not many use any vet foods, even canned ones.
 
It sounds like you're going through a tough time. You've come to the right place, the people here have a wealth of information on all things FD related, I am sure you will find a huge amount of advice and support here.

I have a few questions for you:

Between diagnosis in June, and when you went back to the vet recently after discovering the BG meter readings were incorrect, did your vet not prescribe any insulin at all?

You state your kitty was diagnosed in June - was a blood glucose reading taken by the vet at that point? Were other bloodwork tests taken? What were the results of that?

Did your vet advise you to wait, and not start up on insulin? Was any reasoning given for this decision?

What were the results from the bloodwork taken when you revisited the vet recently? Have you or the vet tested for the presence of ketones? If so, what were the results? If you don't already, could you test for ketones yourself now, by using ketodiastix, which are urine test strips?

How long has it been since your vet started your cat on the Novolin?

And finally, is the Purina food dry or wet? If dry, this is not suitable for diabetics, or any cats for that matter. It is too high in carbs. What food were you feeding your cat before diagnosis is June? And did you change this between June and when your vet recommended a switch to Purina? A lot of great info has been given above about the correct foods, this will help a huge amount in bringing down a cat's blood glucose.

If the vet will not agree to a change to an insulin such as lantus, I think you should change vets. Immediately. Long periods at such high levels can result in diabete ketoacidosis, when fat starts to be broken down and used for energy, which can eventually cause your cat to starve to death. Demand a new insulin; if the vet still refuses, go to a new vet.

Good luck.

H
 
I am so sorry to hear of your saga of the meter of ill-repute. I, too, purchased a True meter and it never read true at all. I guess we can safely say that the True meters are still not to be used for cats.

BUT! Congratulations on getting a good meter and for testing regularly. We track the levels on a spreadsheet. Here is the link to set up:
http://felinediabetes.com/FDMB/viewtopi ... =6&t=18207

The food question everyone is asking is a biggie and can help lower the BG levels.

We have several lists that can help you choose the best food-
https://docs.google.com/spreadsheet/ccc ... hYXc#gid=0 (called Hobo's List)
http://binkyspage.tripod.com/canfood.html (called binky's list)
http://www.catinfo.org/docs/Food%20Char ... -22-12.pdf (new list from CatInfo.org)


I would insist on another insulin- you pay the vet not the other way around. Levemir, Lantus, and ProZinc are the better insulins. The two L's are long lasting insulin and have a better remission rate than ProZinc. They do cost more- for the L's insist on getting the pens not the vials- but the return is much worth it.

Ketones- are VERY important. If Clyde has been high for months- much like many cats are before they get diagnosed, he could be in danger of ketones. The best insurance is a bottle of keto-sticks from a pharmacy. Walmart sells them 50/$7 or so. This is a $4000-5000 illness to treat and unless you happen to have that much in spare change lying around it is not something you want to get a foothold. Big issues for ketones- not enough insulin (novilin isn't the best, harsh and leaves early- so you have this going on), not enough food (if Clyde doesn't eat- get the sticks out immediately and stack out the LB's in the house), and infection (tooth, pancreatitis, UTI- they all can cause it).

Leg problems- others have already addressed them- and once Clyde starts getting the proper insulin should regain mobility. Maybe not all of it but enough that he doesn't stagger along.

Heather
 
Hi,

Thank you all so much for coming to Clyde's rescue! I would have replied much sooner but I didn't receive notifications anyone had responded to my post. I now see I should have checked "Notify me when a reply is posted."

Okay, now to answer your questions. :-D

*hmjohnston; it has indeed been a very upsetting ordeal. Our past experiences with feline diabetes was a walk in the park compared to this but we are determined to do ALL we can to help our Big Boy! :smile: Thank you for the links, creating spreadsheet levels and food. We have a HUGE problem with Clyde getting him to accept can/wet food. We tried Lisa Pierson's steps for transitioning all our cats to wet food but months went by without success.

*Helene & Cleo; A month went by, we knew Clyde wasn't doing well and our vet at the time of diagnosing him with diabetes wasn't helping so we took him to another vet on 7/26/12. All his records were given to new vet including blood glucose readings. A ketone test was also performed, the test was negative. This first visit with the new vet was more of a consult and to affirm Clyde did in fact have feline diabetes. At the time she did not prescribe insulin because I had ProZinc. I contacted the vet by phone on numerous occasions after his initial visit because Clyde wasn't improving, little did we know the reason he wasn't improving is due to the faulty glucose meter. On 10/25/12 he was taken back to the vet for more blood work to rule out other illnesses. It took an entire week before we learned the blood work numbers were very high due to the lack of insulin.
He's been on Novolin for 13 days. As for food; Iams Multi Cat. We tried CORE but he wouldn't touch it. Also tried EVO he ate it for a while but soon stopped. Now its 25% Purina DM (Dry) 75% Iams. The vet did not recommend the Purina I requested this food because I heard positive reviews from others. Please keep in mind this mess all stems from a faulty meter as of two weeks ago we are working to get Clyde on a healthy path.

*Hope + (((Baby))) Thanks for your advice.

*Elizabeth and Bertie; Thanks for the (((Hugs))) they are graciously accepted. :smile: Clyde's BG numbers are running 404, 409, 439, 493, 425, 451. Some are so high they don't register on meter. The numbers you see are examples of what is recorded just before insulin is given. Sorry but I don't have mid-cycle numbers because of my work schedule.
Not Diabetic neuropathy yet but I fear he will succumb to that if we don't get his diabetes under control. My guess for his lack of back leg control stems from 1) To high BG and 2) He has lost most if not all muscle.
The frequent peeing outside litter box I believe is his inability to walk. He attempts to use the litter by stepping just inside the box. By him not entering the litter box completely he ends up peeing on the floor. (Thank goodness for potty pads.) :-D The bloodwork tests ran on 10/25/12 did not indicate other illnesses.

*Sue and Oliver; I live in Jensen Beach, Florida. The Purina DM is dry. 25% DM/75% Iams Multi Cat. I couldn't agree with you more about me knowing my cat much better than a vet. I will most likely be requesting ProZinc or I will find another vet.

UPDATED info from vet 11/13/12; She wants me to increase the insulin to 6 units twice a day for six days. If after six days the 12 units a day isn't helping I am to bring him in for a BG test between shot times which are 6:30a and 7:30p
 
It's hard to go against your vet, but I think the advice is dangerous. We have very few cats who need 6 units and it is usually due to an underlying disease. The Purina dry is part of the issue as it is 13% carbs (we try to feed under 8) I would keep working on switching to wet. But you do need another insulin.

I put out some feelers for FL members who might help with a new vet. (you are sort of close to Palm Beach?) But you can also make some calls to vets. Just a quick few questions for the front desk will give an idea - what insulin do you regularly prescribe? What diet do you suggest? Do your patients hometest? If you don't get the answers you need, go to the next vet.
 
IMHO, your vet is trying her hardest to hypo your kitty. Upping to 6 units in any insulin is a large dose and with N you really run the risk of a hypo and you will not get any longer duration. Also, bringing kitty in so the vet can do a bg check is ridiculous because of vet stress. Please, don't increase that N insulin......go to another vet. Please also do not shoot that dose and go to work. Try and get some early spot checks in on a Sat. or Sun. when you are home. He's in the higher numbers because the N is wearing out early and he shoots back up OR he is going too low and right now food is saving him or his liver is.
 
I can tell you right now, the N will not work. Doogle was up to 5 units twice a day with no change. I told my vet about lantus and everything I had learned and he said ok to changing. Get rid of the dry food. If he wont eat the wet food at first, sprinkle some parmesan cheese on it. Most here use Fancy feast pates (classics) or Friskies pates. Cats LOVE the cheese! Or you could try getting some Fortiflora for Cats. Its like crack for kitties..........LOL. But I agree with the others, find a new vet. There is no reason not to change. Tell the vet about this website. Show him spreadsheets of others that use different insulins. Insist you want a new insulin. My vet had never used Lantus before so I was kinda a test subject. Now if he gets a diabetic kitty, he gives them Lantus.

Good Luck!
 
Hello Again,

Once again I would like to extend a heartfelt Thanks to all of you for taking the time to respond to my situation. :-D

*About Changing Vets; The sad truth is I've lived in my current location going on 19 yrs and unfortunately, for one reason or another I have changed vets so many times that finding a trustworthy vet is very, very difficult.

*I agree with all of you the insulin must be changed! I have no idea why this vet has an aversion to changing insulin's but I promise you this I WILL find out. I do have a standing prescription with previous vet for ProZinc, if forced I will purchase the insulin from them.

*Changing his food while trying to get him stable is a asking for more trouble wouldn't you agree? Though I understand the importance of getting him off the dry stuff working on to many issues at one time I feel could do more harm than good.
 
Changing food to all canned would definitely lower his numbers but on that dose of N you would have to monitor constantly. How about going back to that vet that gave you the script for ProZinc and asking them for Lantus or Levemir? Ask your current vet if she even reads vet journals that promote Lantus and hometesting and canned only.
 
Hope + (((Baby)))

Asking previous vet for a script for Lantus or Levemir is a doable, however, I priced Lantus (Pens and Vials) at Walmart; the cost of Lantus is well above my financial means. ProZinc at this time is more affordable.
 
Then I would get the Prozinc , stop the N, change to all canned food, and start over at 1 unit and test, especially test before feeding and shooting.
 
oh my gosh. I'm in Stuart, you are right next door to me.
Here's the number for my new vet.
Dr. White. Port Salerno Animal Hospital
772-286-3833
Sorry if we're not supposed to do this.
They prescribe usually prescribe lantus, but will work with you, they like home testing. they want to see your spreadsheet, they advise low carb wet food for our diabetic cat.
Hope this helps you.
xoxo
mary and oliver
 
Hello Mary & (((Hugs))) to Oliver Twist :lol:

I did respond to your PM but I'm not sure it went through. Thank you for the vet recommendation. I was able to get my previous vet to prescribe Lantus. YEAH!!! I will keep this vets information for future reference, you never know when it may come in handy! :-D

Have a Great Day!
 
Prozinc is perfectly fine. Honestly, the studies concerning remission with glargine were flawed anyway in that they were only studying acutely diabetic cats. You can probably do just as well with prozinc. N wouldn't be my choice.

I definitely hear ya on the trueresult. I owned one of those, but quickly threw it in the garbage when I started getting repeated errors with it. Did a web search concerning monitors with good reviews and came up with the onetouch ultramini. Though the test strips are expensive, it is considered to have very good measurement accuracy and repeatability, automatically runs each sample twice for verification, and gives an answer in 5 seconds. Been quite happy with it and haven't had any inexplicable repeated errors as with the trueresult. For cheaper ultramini strips try Hocks.com.

http://www.consumersearch.com/blood-glu ... -ultramini

What you are feeding the kitty is the more important issue here. And though zealotry is in vogue in favor of moist canned foods, you can do as well with certain dry ones. However, you absolutely need to know the % of calories from carbs in the food you're giving. Less carbs and more protein is better. Cats have no biological need for carbs at all, and their livers can produce all the sugar they need from protein. So if you can afford a zero carb food that is the best. Trust me on this; with a zero carb food, the blood glucose curves will be much, much smoother, and you won't find yourself with a 450+ blood glucose which turns to a 45 blood glucose after treatment. Ideally, you should combine the switch to low carb/zero carb food with a sliding scale and very frequent (4X per day ideally) blood glucose measurement with dosing at those times based on the results. Aim for tight control with BG < 150 for as many hours as possible during the day. Wellness Core (11% of calories from carbs) is the only dry food I would even consider using that's available at a say petsmart. Young Again sells some dry cat foods coming in at 5% carbs and zero carbs that are excellent choices, but you need to order directly from them. Many canned moist foods are acceptable as well. Many of the "fancy feast classic" moist foods come in at the 5% range which is acceptable, if your cat will eat them. But at 4 cans/day, you're talking $75/month in cat food, and a zero carb dry food like that from young again, will be cheaper and quite possibly better as well. Of course, your kitty needs to actually eat the food!! Need to shoot for <10% of calories from carbs and high protein.

Finally, it's important to know there isn't something else going on with the cat (infection, etc). I hope your vet is smart enough to be able to exclude that, but based on what I've heard, I'm not so sure. That your cat has lost bladder control and has a hind leg neuropathy I would consider an emergency, in that you may well be considering euthanasia on that basis. And that is what kills many cats when their owners get frustrated or sick of the urine smell. That your vet is dithering around with NPH insulin and hasn't done something about your cat's diet (which should have been done long before going on huge insulin doses) is a pretty big indictment of his/her skill. JMHO.
 
*Sandman Thanks for your reply. Right now we are giving Lantus a try. Hopefully, it will work out for our "Big Boy". :-D
Finding out that the TrueResult meter is faulty was infuriating. So much time was wasted on inaccurate readings. The only thing we can do is put the past where it belongs and move forward and hope we aren't to late.
The food situation I will admit is not ideal for a diabetic, (Iams Multi Cat), we tried CORE but he would not touch it. Evo is great however, as a multi cat household the rest of the cats started putting on too much weight and unfortunately wasn't helping Clyde ("Big Boy"). I will be talking with my vet on Monday for her thoughts about food changes. Its possible we will go back to Evo because of the high protein, this will require us to resort back to feeding schedules. I will also be discussing tests recently performed by a previous vet with current vet, including the continuing loss of his hind legs. Euthanasia is considered only if he is suffering.
 
Thanks for your reply. Right now we are giving Lantus a try. Hopefully, it will work out for our "Big Boy
Click to expand...

Lantus (aka glargine) is just fine, but it requires a bit more patience being even a longer duration insulin than the prozinc I use. Whereas I was testing every 6 hours and dosing at those times with PZI, you may want to test & dose at an even longer timeframe with the lantus. The idea is to test at the nadir & then redose per whatever you get on the glucometer. I would never, ever just blindly dose without checking. If your baby goes into remission suddenly you may get a very nasty surprise! Just be aware, dealing with the sugar spikes from a high carb food is impossible with protamine zinc and even more impossible with lantus, which is why I say you really need to get the carbs out of the food. And that should be first and foremost. Zero carb is best. Low carb less so. Certainly doesn't make sense to test with glargine more than every 12 hours, and from the looks of this paper, perhaps every 16, it's so long to peak effect. I prefer PZI, but lantus is infinitely better than NPH, which is totally inappropriate.

http://www.ncbi.nlm.nih.gov/pubmed/18471141

My sluggo remains carb addicted, I think. He's been in remission a week now on the zero carb food, but sometimes comes & cries like he wants his old eukanuba. I redirect him to his bowl of zero carb food & sometimes he nibbles on it, sometimes not. I have broken down a few times & given him a few of his old "cat treats" which from the label, sure look to be carb packed with all sorts of things totally inappropriate for a kitty. I do extra glucometer checks a few hours after though & he doesn't spike from it. Nice & sedate 50-85 glucometer readings off insulin. I guess his pancreas is really back on the job with the few remaining beta cells awakened from their slumber...
 
It's good that you were able to get him on Lantus and I have a feeling you'll start seeing better results than when you were on the N stuff. :mrgreen: Since you're now using Lantus, I wanted to provide you with a couple of links for how it works. First, Lantus is long-acting and uses something called a "depot." You might also want to check out the Tight Regulation Protocol for Lantus. I also suggest that you create a spreadsheet for tracking Clyde's numbers to help with dose increases/decreases. It's recommended that while on Lantus, you always test at minimum once before each shot and at least once around nadir (anywhere from +5 to +7 hours after their shot) at least once each 24-hour period (it's preferable if you can test at both nadirs, but most of us have day jobs ;-) ). Here's a rough schedule of how Lantus works over a 12-hour period:

Insulin has a timeline, and typically what you will see with Lantus is a curve that looks something like this:
Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
Click to expand...

And don't forget to let us know how it goes! Check out the Lantus board for some examples of daily posts that allow us to see how everyone is doing and to ask and answer questions as they come up.
 
Hello KPassa,

Thanks so much for your reply! :smile: Unfortunately, after 8 days on Lantus there was no change with Clyde's BG numbers.They remain in the high 400's and in some cases his BG was so high the meter wasn't able to register the numbers. His dosage has been increased from 2 units twice daily to 3 units twice daily. We are keeping our fingers crossed we will begin to see his numbers decline.
I really appreciate the rough schedule of how Lantus works. Being new to Lantus this information is very helpful.
When time permits I would like to create a spreadsheet not only for myself but for others to track Clyde's progress. :-D
 
That's disappointing to hear he's still running high numbers even on the Lantus. Were you able to successfully transition him to low carb, wet food only? High carb food (generally anything over 10% carbs) can spike BG levels over 100 points or more so getting him on low carb food is a HIGH priority for regulation. This does require closer monitoring during the move, but it's worth it for your kitty's health. :smile:

Were you also able to get some nadir (+5 to +7) readings for him? He might be "bouncing" from lower numbers that you're not seeing.
 
cats_toy said:
Hello KPassa,

Thanks so much for your reply! :smile: Unfortunately, after 8 days on Lantus there was no change with Clyde's BG numbers.They remain in the high 400's and in some cases his BG was so high the meter wasn't able to register the numbers. His dosage has been increased from 2 units twice daily to 3 units twice daily. We are keeping our fingers crossed we will begin to see his numbers decline.
I really appreciate the rough schedule of how Lantus works. Being new to Lantus this information is very helpful.
When time permits I would like to create a spreadsheet not only for myself but for others to track Clyde's progress. :-D
Click to expand...

Until you get your spreadsheet up and running, would you be able to post some numbers here and it may help others in giving you some suggestions.
I am glad that you are home testing because the numbers will let you know if you are getting some reaction or not.

The usual guidelines followed and that have worked extremely well on FDMB in the Lantus and Levemir forums are below...

"General" Guidelines:
--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).
--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).
--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose...
--- If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

--- If an attempted reduction fails, go right back up to the last good dose.
--- Try to go from 0.25u to 0.1u before stopping insulin completely.

Random Notes...
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.


I mention the above because the dose increase you posted .... 2u up to 3u may be too much.... maybe not but possibly.

The logic behind a slower increase in doses, plus a holding of each new dose is so that you give the cat a chance to 'recognize' the new dose and react in the way of better numbers.

By jumping up in dose so much .... from 2u to 3u is quite a high percentage increase, and there's a possibility that you may pass over your cat's good dose..... what if the ideal dose for your cat is 2.5u? By jumping right up to 3u, you will have bypassed it.

Just something to think about when adjusting doses.

I would like to mention that some cats can be VERY SENSITIVE to dry food. One of my cats could get BG in the 400s just from stealing a small mouthful of a few pieces of dry food.
If you are feeding wet and dry, I would suggest to remove all the dry and see if the 2u dose gives you better numbers on a strictly wet diet. My girl was a carb addict and it reflected in her numbers, even when it came to wet food, so if you are feeding an all wet diet now, be sure to keep the carbs as low as you can because it makes quite a difference for some cats.
 
Hello Blue,

Thanks so much for reply.

I am HAPPY to report I have created Clyde's SS (see signature link). Changing his dosage in 1/2 increments isn't an option. I am using the pen which doesn't allow 1/2 increments at least not that I can figure out. :-D As for food, both our vets do not want us changing his dry food at this time. We do hope that is something to consider in the near future.
 
cats_toy said:
Hello Blue,

Thanks so much for reply.

I am HAPPY to report I have created Clyde's SS (see signature link). Changing his dosage in 1/2 increments isn't an option. I am using the pen which doesn't allow 1/2 increments at least not that I can figure out. :-D As for food, both our vets do not want us changing his dry food at this time. We do hope that is something to consider in the near future.
Click to expand...

You're not supposed to use the pen needles that come with the pens for cats. Not only do they not allow for finer dosing (Lantus and Levemir require that dose adjustments are made in .25u-.5u increments), but they also allow for dose variation. Humans are taking much larger doses, so a .1u-.25u variation caused by the pen needles isn't a concern for them, but for a cat that's a significant change in dose. What you need to do is run out and get a box of .3cc, 30-31g syringes with 5/16" needles and half unit markings. You don't need a script for these in most states, and they're only about 11 bucks at walmart for a box of 100. You draw the insulin out of the pen like a vial. See this thread for pictures and handling advice: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151

Your vets are making money selling you the prescription food, so of course they don't want you to change it. However, all the current feline diabetes guidelines (including the American Animal Hospital Association Guidelines recommend a low carb, canned diet. You will have great difficulty getting his Blood Glucose under control until you change the diet. Just make sure you're testing and lowering the dose when you change--switching to low carb canned can drop BG 100-300 points immediately and drastically reduce insulin need, and in about 25% of cases it causes spontaneous remission.

To print and give to your vet: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151
 
Hi Julia & Bandit,

Oh My! I had no idea the needles you buy for the Lantus pen wasn't recommended. On the up side I do have the exact needles you suggested. I will begin using those tonight. :-D
 
After reading this thread I have one thing to add. My kitty was reading in th high 400's, after removing the dry food completely his numbers dropped by 100 points overnight. I know your kitty doesnt like the canned but honestly I'd use the Parmasean cheese to see if your kitty will eat the canned. Sorry if you've already tried this but I felt I had to relate our story.
Good luck and God bless,
jeanne
 
Great job on creating and sharing Clyde's spreadsheet! :thumbup I highly recommend getting more nadir readings (+5 to +7) because another problem might be he's on too high a dose so he's dropping too low and bouncing back up. You won't be able to see that happening unless you get more nadir data.

I also agree with everyone else (and wholeheartedly disagree with your vets) that it's imperative that you get him on low carb, wet food ASAP as that will significantly drop his numbers.
 
*KPassa - With only two days off a month it is extremely difficult for me to do nadir testing. I did however devote one of my two days to full curve on 12/2/12. It wasn't pretty!

*jeanne - Thank you for your reply! :-D Adding Parmesan cheese is certainly a clever little trick I will consider!
 
I sprinkle crushed up freeze dried treats to our kitties wet food when they won't eat it. They really love the PureSnacks they come in Liver, duck, chicken, whitefish and shrimp. Our guys don't get the fish or shrimpmuch because they only come in the small cat treat size bags and it is much cheaper to by the dog treats which are identical only larger and cheaper :lol:
 
cats_toy said:
*KPassa - With only two days off a month it is extremely difficult for me to do nadir testing. I did however devote one of my two days to full curve on 12/2/12. It wasn't pretty!
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I'm not sure what your schedule is, but in my case, his +5 occurs right around bedtime. So, if all the testing I've done for the day has only be pre-shot numbers, I'll always grab at least that nighttime +5. Sometimes I stay up later and grab a +6, but as long as the +5 isn't showing he's going too low (aka hypo), then it's usually okay for me to go to bed. ECID (Every Cat is Different), but getting frequent nadir readings is highly important because there's no way to tell otherwise whether or not your cat is getting too much or too little insulin, especially since a cat's pancreas can heal and start producing more insulin on its own. You don't want a hypo!

If it's easier for you, you also can do a curve across several days, like grabbing a +2 one morning and a +4 another night and so on till you have a good 12-hour span. If you notice my cat's spreadsheet, he can change from day-to-day, so grabbing a curve test that spans across several days can be just as helpful.

Have you had him tested for Acro/IAA? I don't know much about it, but considering how high his numbers are, this might be something you want to look into. You might want to check out and/or try posting on the Acro/IAA/Cushings board to see if anyone there can give you some more information.
 
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