Question regarding why my cat keeps going hypo on any dose

Status
Not open for further replies.
Dana Marin

Dana Marin

Member Since 2024
Hi all, I am new to the forum but I've browsed it already quite a lot. There is a lot of great info here.
My main question is: does anyone have any idea why a cat would go hypo on any amount of insulin?

And here is the story.
I have a male cat, Eric, 9 yo, who was diagnosed with diabetes in December. Since then we've had a bumpy ride, with various insulin amounts tried, and breaks in between because of the holidays, or waiting for test results etc. We started with Caninsulin, 3 units twice a day, and he went hypo. We then changed the vet. The new one did blood tests (fructozamine was 600) and a glucose curve at the clinic, which showed that his glucose was dropping drastically on this insulin, so we switched to Prozinc. Started 1 unit twice a day, he went hypo again the second day. We started 0.25 units twice a day, and after 2 days he became lethargic, not really eating. At this point we went to the hospital and did an ultrasound to check for other issues and blood tests again. Nothing showed up except a potassium deficiency which we decided to treat with supplements. But the weird thing is that this time the fructosamine was not elevated (I don/t know the exact numbers, that's what they told me). This was one month after the first test. They told me this result is probably because his glucose was constantly fluctuating during the past month.
My vet discussed with a specialist and they reached the conclusion that probably the cat is still producing insulin, randomly, hence the hypo episodes. They advised 0.25 units Prozinc once a day and wait until the new medication for diabetic cats comes to the Netherlands (it's about Bexacat). The thing is... I gave him this low dose for a few days and every day he becomes slow and sleepy in the first 6-7 hours after the shot. I tested yesterday and it showed he was hypo :( I gave him food and he became more energetic later. The potassium supplements seem to be working as he is feeling stronger, although not completely back to his old self.

So now I am completely lost and puzzled and I can't understand what is going on with my cat. Could it be a connection between the potassium deficiency and the hypo episodes? Why is he reacting to insulin like he doesn't have diabetes? Anyone else encountered this? Thank you!
 
Hi Dana, welcome to the group. That sounds scary!

from what I have read, Bexacat cannot be given to a cat that is already on insulin.

Can you please find out the exact results of the 2nd Fructosomine test and post them here for the experts to review? Those results are really really important.

Regarding the dosing and possible hypos, what I would do is start tracking the BG numbers in a spreadsheet, test a lot, figure out what's going on. If you're not testing before you shoot, you have no idea if it is safe to give insulin or not. Highly highly recommend you start testing at home before each shot, and at least once or twice after the shot as well if you can manage it (no idea of your schedule, work, home, etc)

there has been the occasional cat here at the FDMB that was extra sensitive to insulin, this can sometimes happen after a hypo event. That could be what is going on. But the key to unraveling this mystery is data -- need to build some data in a spreadsheet so we can see what is going on in that little feline body.

This sticky post here has instructions on how to setup a tracking spreadsheet as well as other things to get you started here at the FDMB.

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
 
Last edited:
Thanks for the reply! I will work on getting a copy of all the tests results. Also will have a look at the spreadsheet. The problem with measuring often is that it's very difficult to do, as my cat is not cooperating, especially now after all the stress of vet visits he had. And pre-shot is ultra difficult as he is hungry and not interested in anything else. I live alone and have to do this alone... I will try though and see if I manage.

As for the Bexacat, I've read the same, but the vet says it will be perfect for him, as they suspect he's still producing some insulin... I don't know. I feel very lost and wonder why my cat had to be so special and if there is a real chance to treat him :((
 
You really need to be home testing. You can use any human glucose meter for testing. There are pet meters available but they can be expensive to use. If you are in the US, Walmart's Relion brand meters are very good and inexpensive to use. You will need to test before every dose and several times between to determine how low Eric's levels are dropping.

What are you feeding him? With him being so sensitive to even a small dose, there may be a possibility that his glucose levels can be controlled with a diet change and no insulin may be needed.
 
I have a veterinary use meter, GPet Plus. I live in the Netherlands.
He is eating mainly canned food (grain free as much as possible. He's not eating a lot of the special diabetic food so I had to try whatever he wanted) and a bit of dried Hills prescription for diabetic cats.
 
he needs to be on a canned/wet food diet that is low-carb. No dry food at all would be best. The Hills is actually around 20% calories from carbs and that is too high for a diabetic cat. Still baffles me to this day that they sell that as a good dietary option for diabetic cats! Food should be under 10% carbs and many of us feed around 5%. As Lisa mentions, if given the proper low-carb diet Eric may not need any insulin at all, and be diet-controlled.

Don't trust "grain-free" labels. That does not mean it is good for a diabetic feline. I am trying to think of another member who lives in your area who could possibly suggest certain stores or brands.
 
There a discussion on Bexacat here: https://www.felinediabetes.com/FDMB...oral-feline-diabetes-treatment-option.272071/

Dana Marin said:
The problem with measuring often is that it's very difficult to do, as my cat is not cooperating, especially now after all the stress of vet visits he had. And pre-shot is ultra difficult as he is hungry and not interested in anything else. I live alone and have to do this alone... I will try though and see if I manage.
Click to expand...

:bighug::bighug:
There are people here who live alone and manage to test and give insulin on their own, myself included. There is a bit of a learning curve as you figure out what works for you and the cat but you soon get into a routine. My current diabetic had a few days where he'd run off to hide as soon as he thought I was going to mess with him. Now I can just pick up him, kneel on the floor with him tucked between my knees, and test. I then feed him and while he's eating, I inject. With my previous diabetic, I was able to test and give insulin while he was busy stuffing his face with food. The whole process takes less than a minute.


Hendrick Cuddleclaw said:
I am trying to think of another member who lives in your area who could possibly suggest certain stores or brands.
Click to expand...

Steve and Jock, I think. Are they still around FDMB? Or @Ekzakte
 
Hendrick Cuddleclaw said:
he needs to be on a canned/wet food diet that is low-carb. No dry food at all would be best. The Hills is actually around 20% calories from carbs and that is too high for a diabetic cat. Still baffles me to this day that they sell that as a good dietary option for diabetic cats! Food should be under 10% carbs and many of us feed around 5%. As Lisa mentions, if given the proper low-carb diet Eric may not need any insulin at all, and be diet-controlled.

Don't trust "grain-free" labels. That does not mean it is good for a diabetic feline. I am trying to think of another member who lives in your area who could possibly suggest certain stores or brands.
Click to expand...

Thanks. Some recommendations would be great.
 
We have a metric ton of tips and tricks to help you and your cat get into a routine with testing. TREATS ARE KEY. When I first started trying to test at home I thought "well, this is impossible."

but with the help of people here, I ended up a pro. One of the first things that helped was establishing a spot for the testing. Always use the same location. Take Eric there, plop him down and rub his ears for several minutes until the ears are nice and warm, then give a freeze dried zero carb treat like Whole Life "Just One" chicken or turkey. Do this several times a day without even doing a BG test. Cats are creatures of habit and routine and most will pick up on a new routine quickly. Especially if it involves a yummy treat!

And when you do test, give a treat even if you fail. Use a tiny dab of petroleum jelly at the poke spot so the blood forms a nice droplet. Aim for the very edge of the ear, lancet at 45 degree angle, sharp part pointed downward.

Sing a song. Make it a happy time that the cat looks forward to. Eventually, most of us got to the point where our sugar cats would go to the testing spot on their own. Hendrick still does this today, hopeful for some treats -- that is his focus not the quick little sharp stab. And he's been in remission for 1.5 years, we only test once a month, if that.
 
Hendrick Cuddleclaw said:
We have a metric ton of tips and tricks to help you and your cat get into a routine with testing. TREATS ARE KEY. When I first started trying to test at home I thought "well, this is impossible."

but with the help of people here, I ended up a pro. One of the first things that helped was establishing a spot for the testing. Always use the same location. Take Eric there, plop him down and rub his ears for several minutes until the ears are nice and warm, then give a freeze dried zero carb treat like Whole Life "Just One" chicken or turkey. Do this several times a day without even doing a BG test. Cats are creatures of habit and routine and most will pick up on a new routine quickly. Especially if it involves a yummy treat!

And when you do test, give a treat even if you fail. Use a tiny dab of petroleum jelly at the poke spot so the blood forms a nice droplet. Aim for the very edge of the ear, lancet at 45 degree angle, sharp part pointed downward.

Sing a song. Make it a happy time that the cat looks forward to. Eventually, most of us got to the point where our sugar cats would go to the testing spot on their own. Hendrick still does this today, hopeful for some treats -- that is his focus not the quick little sharp stab. And he's been in remission for 1.5 years, we only test once a month, if that.
Click to expand...


I'll do my best to do this a habit. I know everyone here tests a lot, but since I found it very traumatic for myself in the beginning (fear of needles, improper training from the first vet etc), it took a while to get used to it at least a bit. Now I have to teach Eric as well. The vet discouraged me from measuring at home often, because she thought it's a big stress on the cat.
 
Dana Marin said:
The vet discouraged me from measuring at home often, because she thought it's a big stress on the cat.
Click to expand...

I'm sure it can be, but it can also be something the cat actually looks forward to. It's all about conditioning.

For the vast majority of cats, going to the vet is a WAY bigger stress. So in that regard, home testing can reduce kitty's stress levels.
 
Dana Marin said:
Hi all, I am new to the forum but I've browsed it already quite a lot. There is a lot of great info here.
My main question is: does anyone have any idea why a cat would go hypo on any amount of insulin?

And here is the story.
I have a male cat, Eric, 9 yo, who was diagnosed with diabetes in December. Since then we've had a bumpy ride, with various insulin amounts tried, and breaks in between because of the holidays, or waiting for test results etc. We started with Caninsulin, 3 units twice a day, and he went hypo. We then changed the vet. The new one did blood tests (fructozamine was 600) and a glucose curve at the clinic, which showed that his glucose was dropping drastically on this insulin, so we switched to Prozinc. Started 1 unit twice a day, he went hypo again the second day. We started 0.25 units twice a day, and after 2 days he became lethargic, not really eating. At this point we went to the hospital and did an ultrasound to check for other issues and blood tests again. Nothing showed up except a potassium deficiency which we decided to treat with supplements. But the weird thing is that this time the fructosamine was not elevated (I don/t know the exact numbers, that's what they told me). This was one month after the first test. They told me this result is probably because his glucose was constantly fluctuating during the past month.
My vet discussed with a specialist and they reached the conclusion that probably the cat is still producing insulin, randomly, hence the hypo episodes. They advised 0.25 units Prozinc once a day and wait until the new medication for diabetic cats comes to the Netherlands (it's about Bexacat). The thing is... I gave him this low dose for a few days and every day he becomes slow and sleepy in the first 6-7 hours after the shot. I tested yesterday and it showed he was hypo :( I gave him food and he became more energetic later. The potassium supplements seem to be working as he is feeling stronger, although not completely back to his old self.

So now I am completely lost and puzzled and I can't understand what is going on with my cat. Could it be a connection between the potassium deficiency and the hypo episodes? Why is he reacting to insulin like he doesn't have diabetes? Anyone else encountered this? Thank you!
Click to expand...
Tagging @Suzanne & Darcy as she is familiar with both insulins
 
Here is a UK Cat Food List A lot of the foods on that list are also available in Europe. Look for something that is 10% or less carbs.

When you say your kitty went hypo, was that by symptoms or a number on the meter? If a number, how low was he going on 0.25 units of Prozinc? Side note, 3 units of Caninsulin was way too high to start. Glad you changed vets.

We have seen people need to give really small doses of insulin, like 0.1 units.

 
Status
Not open for further replies.
Back
Top