Rafiki needs help with insulin

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Delia Valenti

Delia Valenti

Member Since 2021
Hi everyone. Thank you for taking the time to read this and offer any sort of brainstorming ideas.
Rafiki my beloved kitty cat is 11 years old and she say long hair mix. He was diagnosed back in October weighing in at 15 pounds. Now he is only 9. And I’m very worries. He eats fine. All DM wet can food- 1.5 cans a day.
His number started in the 800s our vet put us on 2 units of Lantus every 12 hours. He only went down to 700s and sat there but seemed Glycemic and had glassy eyes so our vet put us down to one unit in the morning and 1.5 in the evening. 4 months later no progress. He still drinks on limited amounts of water - And urinates incredible amounts.
So I brought him to a new vet on Thursday that suggested we try another form of insulin. They did Peozink and Lantus together. 9 units which seems very high to me. They then would not give him back to me because his numbers were too high-
Today (Tuesday) I finally found them and have him back- but no progress. He’s still in 600s and now on both insulins. I feel in my gut this is wrong and want to get some diabetic advice. Should I stop and the start again with only Prozink and test him my self. I use the alpha tracker. thank you
 
Hi Delia

Your post is in the wrong place, that's why you're not getting any response.
@Wendy&Neko can you help move it?

@Bandit's Mom :nailbiting:

You definitely do not want to use two different insulins at a time!
Stick to Lantus. It's depot, prozinc is not.
I'm really worried about what your vet is doing. Where are you from?
 
Oh no. Maybe I can repost and delete this one. Where should I post this?? Thank you for your help!

exactly my thoughts. I live in Wilmington NC
 
Delia Valenti said:
Oh no. Maybe I can repost and delete this one. Where should I post this?? Thank you for your help!

exactly my thoughts. I live in Wilmington NC
Click to expand...
In Feline Health and Main Forum.
Is Wilmington in the US?:oops:
Just copy this post over in the right forum. :bighug:
 
Hi everyone. Thank you for taking the time to read this and offer any sort of brainstorming ideas.
Rafiki my beloved kitty cat is 11 years old and he is a long hair mix. He was diagnosed with diabetes back in October weighing in at 15 pounds. Now he is only 9. And I’m very worried. He eats fine. All DM wet can food- 1.5 cans a day.
His number started in the 800s our vet put us on 2 units of Lantus every 12 hours. He only went down to 700s and sat there but seemed Glycemic and had glassy eyes so our vet put us down to one unit in the morning and 1.5 in the evening. 4 months later no progress. He still drinks on limited amounts of water - And urinates incredible amounts.
So I brought him to a new vet on Thursday that suggested we try another form of insulin. They did Peozink and Lantus together. 9 units which seems very high to me. They then would not give him back to me because his numbers were too high-
Today (Tuesday) I finally got them to give him back- but no progress. He’s still in 600s and now on both insulins. I feel in my gut this is wrong and want to get some diabetic advice. Should I stop and the start again with only Prozink or Lantus and test him my self. I use the alpha tracker?
many tips are appreciated!! thank you
 
Hi and welcome, my goodness, you sure do have a story, and am I ever glad you found us.

First-thank goodness he is home with you.
Second-if I were you, I would NEVER go back to the second vet. Ever. I have been here for almost 4 years, and thought I have seen it all, but the combo of Prozinc and Lantus at the same time is a first for me. I can't see why anyone would want to do that. And, what is even worse is seeing that they are suggesting you go from 2u of Lantus twice a day to 9u of Prozinc/Lantus (I assume that's twice a day, but feel free to clarify). Are you supposed to be giving both insulins at the same time? The other concern is that the Prozinc is a U40 insulin and the Lantus is U100 so you need different insulin syringes. Did the vet mention that? Regardless, that is a huge jump, from 2u to 9u.

It sounds like you are prepared to test at home, which is excellent, you will be in a much better position when you can start to get an idea of how the insulin is working. Here is a really good info post for new members.

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

In general, I think without seeing any data, I will suggest you go back to 2u of Lantus twice a day and test each preshot first, and try and get some tests in during each cycle now that you can test at home. Once you start to see what the numbers look like, we can help you with increasing the dose, perhaps a bit more on a fast track, depending on the numbers. We dose based on how low the dose is taking the kitty, which is why getting some mid cycle tests is important, since we need to see if he is staying high and flat, or if there is some movement mid cycle.

The weight loss is not good, I presume 15 lbs is a good weight for him? He is likely not getting enough calories, especially when kitties are so unregulated like Rafiki, you actually want to feed more food, because their bodies can't metabolize food properly without enough insulin, and you end up having excess sugars in the system. And, as with what you see with weight loss, if he doesn't get enough food, his body goes into the fat stores, then the muscles, not good. 1.5 cans of DM probably isn't enough food at the moment.

The Alphatrak pet meter is fine, most of us prefer using a human meter, since we have dosing methods on this forum that we follow which were developed with human meter ranges in mind. Test strips are cheaper too ;)

Please post any questions you have, there are a lot of people here who can offer suggestions, and we can help. I don't want to overwhelm you, so I'll let you process, perhaps I can share some more info with you after that.
 
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Della --

I've been here longer than Christie, almost 12 years. While two different insulins can be used in combination, I've never seen two longer acting (i.e., basal) insulins like Lantus and Prozinc used that way. Typically, if you need to get an immediate "boost", a short acting (i.e., bolus) insulin is used -- an insulin like Humulin R.

Christie's suggestion to go to a lower dose may make sense. However, I would strongly encourage you to test frequently and to get urine ketone test strips (Ketostix). Given how high your cat's blood glucose (BG) has been, ketones are a risk. The rationale for dropping the dose is that if a large dose of insulin drops numbers low, your kitty's liver and pancreas may release a stored form or glucose along with counterregulatory hormones which at to spike the BG numbers back up. Depending on when you're testing, if you miss the lows, all you may see are high numbers. In addition, it can take 3 days for the high numbers to clear. We refer to this phenomenon as a "bounce."

There are a couple of things that come to mind if you see consistently high numbers. I'd suggest finding an internal medicine vet. I don't think you're getting the benefit of good veterinary advice. You can always ask here if there's anyone in your area who can offer a recommendation for a vet. (I'd open another thread with the city and state in the subject line and note you're looking for a vet.) Your kitty may have a high dose condition. If that's the case, you'll need a vet to get a blood sample to sent out to Michigan State's veterinary lab to run tests. @Wendy&Neko can give you information about this process.
 
Thanks, Sienne, I thought I saw the dose had been 2u until Thursday, when the second vet wanted the increase to 9u, which is what made me think going to 2u made sense.
 
I'm one of those around here who has used two insulins together, Levemir and R (regular) insulin. We've had a couple people use Levemir and N insulin. Sienne has been around longer than me, but I agree with that no one has used both Prozinc and Lantus. I would use one or the other, and just increase the dose as needed.

It's great you are thinking of home testing, that's what the majority of people do here. With that data, and following our dosing methods, you'll soon enough be able to make changes in doses on your own. Or with our help. Here are some tips on home testing: Hometesting Links and Tips and you definitely do not need to use the Alphatrak. The test strips are very expensive compared to those in human meters. Our dosing methods were designed with human meters in mind, as that's all people used to use.

Without a bit of testing data, it's hard for me to say if you need to think about testing for secondary conditions yet that can cause a cat to need higher doses of insulin.
 
Hi everyone. Thank you so much for your help and responses. Rafiki and I super appreciate it. I have been giving him the 2 units on Lantus as advised. The first day we started was the 4/1 his numbers were 641 and about an hour after the Lantus it was 481 but since that number he has only been in the high 600s again. He is still eating and seems to prefer the fancy feast over the DM wet food. But this morning he seemed not himself. He is still urinating incredible amounts and drinking a lot.
should I up the insulin amount? Also Should I buy the key stone test that was mentioned earlier? How does that work.
Thank you everyone.
 
Also how many pricks should I be giving him to test glucose a day ?? I’m still so bad at it :( (luckily by husband is a lot better but I hate waiting on him)
 
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