Posting for new member, Elizabeth B. Advice needed.

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Elizabeth and Bertie

Member Since 2010
(@Elizabeth B is having some technical issues with posting, so I'm posting on her behalf):
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Our little prince, Hamilton (12lb Maine Coon), was diagnosed with diabetes about six weeks ago. We immediately switched him to Purina DM (dry, changing to wet) and started him on Lantus.

Well, we got up to 5 units of Lantus twice a day before his glucose even began to budge.

We are now at 8 units (only for three days now) and I am concerned about his clinical signs. He is drinking excessively and has hind end weakness, which leads me to think he's getting too much and rebounding.

However, his curves are regularly between 100-250 (using alphatrak) and he has never had a nadir below 100. His glucose readings are telling me one thing, but his little body is telling me something else.

We do not use ketostix as he had no ketones present at diagnosis. (Though, I've always thought we should be checking.)

His glucose has not been over 300 since increasing his units to 7. I am headed to the vet on Thursday to run a panel to check kidney and potassium deficiency. (Though, these values were normal 6 weeks ago.)

My vet is great, but not that experienced with diabetes. Thus, I would like to hear from some experienced pet parents about what I'd like to do moving forward.


1. Eliminate all dry food and switch him to canned food. I have chosen Wellness - Chicken an Blue Wilderness Chicken for their carb content...let's hope he'll eat them.

2. Adjust his Lantus in concert with the diet change to avoid hypo. Thoughts on starting doses?

3. Understand realistic expectations for symptoms...should the excessive drinking stop the moment he's controlled, does it take a while? What about hind end weakness? Shouldn't it improve because he is controlled?

4. Supplement according to lab results (diabetic neuropathy vs kidney vs potassium deficiency).


Thank you for any help and suggestions!
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At the start, they were increased at 1 unit until 5 units, then 0.5 units every six cycles. His glucose response was a steady decrease with each increase and his nadirs were never low. (I check 3-5 times per day and curve him.)
 
Welcome. When you are able please post the labs. Sounds like he has CKD? Even just creatinine, bun, potassium and urinalysis results especially USG. If you haven't already start a spreadsheet. There are directions in this on line and if you can fill in as much as possible since duagnosrc that will help a lot. Dry food is not good for cats with kidney disease or diabetes. DM is too high in carbs. If you are dealing with kidney disease depending on the test results you might need lower phosphorus foods. Wellness is lower than many. Look at the food list to see Blue.
 
Great testing. Were you getting a night test before bed and sometimes between +5-7 as many cats drop at night? If not he could be bouncing from missed lows. If you gave been testing he may be a high dose cat but I think there's a good chance he was increased by too high a dose which can look like more insulin is needed but not. We really need to see those numbers to try to figure it out.
 
Yes. I actually stay up with him until midnight or 1 am to make sure he doesn't drop. The lowest I've seen is 103 and that was just last night.

7/29
630 am 202
600 pm 227
700 pm 176
800 pm 167
900 pm 140
1000 pm 130
1100 pm 115
1200 am 116


7/30
630 am 235
1030 am 211
1200 pm 205
600 pm 194
800 pm 161
1000 pm 152
1100 pm 103
midnight 108

This morning, was 292, but he was pretty angry about being pulled out from under the dining room table for his reading. I read him again at 9:30am and he was back down to 214.
 
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Good. What was the amps? It's just been six weeks on insulin so I wonder if you have a bouncy cat that moved up the scale too quickly or a high dose one.
 
Hello and welcome. Any chance you could post the blood test data you have done so far in a spreadsheet. We all use a common format, with the instruction here. We are rather stat driven and find it's a great tool for figuring what is to do about the dose. It also contains a tab for lab results which is useful for tracking trends.

It is possible that Hamilton has a high dose condition, one in four diabetic cats do. Though not all get to what we consider high doses, ie. over 6 units. Your data might help us distinguish between overdosing due to too large increases, or a high dose condition. His nadirs look not bad for ar ending on the AT.
 
I have downloaded the spreadsheet and will work on it. I haven't closely tracked my midday readings, but can easily update the AMPS and PMPS along with the times I did document the additional reads. I moved the vet appointment to tomorrow in case it is his kidneys, I'd like to adjust sooner than later. I'll put the labwork in, also.

For now, I have to jump back into work so I can log enough hours to pay for all these strips and 16 units of lantus per day!!!
 
UPDATE: We had our visit yesterday since I was not comfortable with the symptoms I was seeing and we were able to piece together the mystery.

His symptoms coincided with a change to a new vial of Lantus. We believe his lantus pen had been compromised (which is a tough when it's right off the bat before you have numbers that make sense) and the same dose with the new vial was getting him way too much insulin. We immediately reduced him to 4 units and his symptoms were gone within 12 hours. His amps was 190 this am, with a nadir of 145. THANK GOODNESS!

Thank you all so much for the information and tools. I am still using the spreadsheet provided just in case I need some help moving forward! I am so grateful to this community. I've learned so much just reading the sticky notes and general info.
 
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