Side Effects of Insulin?

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Viggo's Mom

Viggo's Mom

Member Since 2016
My cat has been on ProZinc since Saturday, so for 5 days, and we will visit the vet on friday for a check-up. He has been really out of it, sleeping a lot, and stumbling around, a zombie look in his eyes too. Is this a side effect of being on insulin? He wasn't like this last week. I have checked his BG with a home monitor since he was diagnosed these last few days and it's hovering around 270. Thanks.
 
Have you checked his BG when he has "a zombie look in his eyes" or is stumbling or just random checks at other times? Both those symptoms could be signs of his BG.is too low and that can be very dangerous and even fatal if not dealt with quickly. :nailbiting:

The stumbling could also be from some weakness in his legs which could be diabetic neuropathy. Neuropathy usually clears up once the cat's BG is brought under control and there is a supplement called Zobaline that you can give to help as well. You might also want to have your cat's potassium levels checked as that too can cause weakness.

All cats react differently to insulin. It's not unusual for them to be a little out of it and sleeping a lot especially in the early days as their body adjusts to the ups and downs the insulin causes. They become so use to the high BG that lower numbers become somewhat foreign to them and they have to "relearn" what normal feels like.

It would be helpful to know how much insulin you are giving and whether or not you are taking readings pre-shot and mid-cycle. It's important to know what the pre-shot reading is so you don't give insulin if the BG is too low for it and in the early days, we recommend no shot with any pre-shot reading under 200. It's also important to get readings during the peak action time of your insulin which would be around 5 to 7 hours post shot. Also what meter are you using....human or pet?
 
Thanks MrWorfmen's Mom, I am using the ReliOn Micro. I have tried all different times for monitoring and get readings of anywhere from 247 to 289. The vet has not encouraged monitoring at all--I'm doing it on my own only from being advised on this website. I will talk more with them about that on friday. He's getting 1 unit, every 12 hours. He was slumpy in his walk before but it was during his hyyperesthsia episodes--that's another story. I did order Zobaline, just today so will get that next week. I was thinking that too--that with all of the carbs he was getting in his crunchy food that this is a shock to his system--I took it away cold turkey 12 days ago. Thanks for the potassium hint--I will make sure that's tested as part of friday's testing.
 
Kudos to you for home testing. I would suggest you test him the next time you see him stumbling around or he gets that zombie look, just to be sure he is not going too low and you are not catching it with your random tests. The body defenses will kick in and pump glucagon into the bloodstream to elevate BG if the body senses BG dropping too much and that can sometimes make it look like the cat needs more insulin when in fact they need less. The fact that you just changed his food to low carb makes me wonder if his dose may need to be decreased now as diet changes can often have dramatic effects on the BG levels and in some cats it can even get them into remission.
 
Get Viggo's B12/folate checked by the vet as well as potassium levels. Even if you choose to supplement Zobaline it's valuable to get a benchmark of the B12 levels.

I'm with Linda re worrying about the dose now that you've changed Viggo over to low carb. She has given you great advice about testing - especially when Viggo seems out of it. As Linda recommends, try checking early in the cycle to see whether there might be a steep drop from PS to an early nadir; some cats can metabolise insulin very quickly early after the dose, hit an early nadir in a low value they're not used to and then the body's defences may kick in to drive numbers up quickly. There's no certainty about this but testing in the first few hours of the cycle may give you more idea of what could potentially be happening.

For info, BG numbers can fall dramatically after the switch from high to low carb food - usually in the first 48 hours or so but with the reduced carb load BG numbers may continue to show further marked improvements over several days following the diet change. If the pancreas doesn't need too much rest to recover some beta cell function and start secreting more insulin then it could sputter on and off unexpectedly. (Conjecture here: no way of definitively knowing what's happening but appropriate BG testing could provide more better information from which to deduce potential causes of Viggo's unusual clinical signs.)


Mogs
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How long ago did you stop the dry food cold turkey? As others said a dose change might be order. Getting a few tests in mid cycle especially when exhibiting the signs you stated.
 
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A thought: if Viggo's very lethargic mid-cycle but brighter and more alert when the dose is wearing off the type of insulin might be disagreeing with him.

Be sure to keep a daily journal of clinical signs - especially odd things. I think it advisable to let your vet know asap about Viggo's unusual behaviours/bearing and lethargy. It could be as simple as his body just getting used to the 'foreign' insulin but it's not a good idea to assume that nothing else is amiss.

Dose concerns and food change impact have been discussed above but here are other things to assess:

1. Is Viggo eating OK? (Too hungry/normal appetite/poor appetite?)

2. Is he negative for ketones? (Here's a forum sticky: Are you testing your cat for ketones? If not, do it!)

3. What are his water consumption and pee volume like? (Better/worse/the same since starting insulin?)

4. Is he properly hydrated? (Pull on the scruff of his neck and it should 'snap' back into place/check gums to see whether they're wet or sticky - sticky points to dehydration.)


Mogs
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Hi, thanks and sorry for my delayed response. I monitored him this morning and his BG was up to 316, but he would not eat so the vet advised me to not give him a shot. He was very very weak this morning, really could hardly stand at all. I will be going over all of his issues tomorrow at the vets. He's improved at the moment, ate a lot this afternoon, and got a shot. Viggo has another sad condition that I have been dealing with almost his whole life called Hyperesthesia Syndrome. It has evolved into almost a different disease at this point, and weakness in his legs has been part of it, it's just has never been this bad and for so long. I am trying to rule out any possible drug interactions before I think that he is having one of the worst episodes of FHS that he has ever had!
 
If Viggio were mine, I'd be inclined to reduce his insulin dose to be on the safe side. While the symptoms you are describing could be the FHS, they could also be indicative of hypoglycemia and if that's what's causing the problem, the worsening is even more worrisome as that could mean his body defence supply of glucagon is being taxed and it's becoming harder for his body to raise his BG when deemed necessary. I encourage you to discuss this with your vet on Friday. And please do let us know how your appt. goes.
 
Hi we are back from the appt with no clues. Took a couple of tests and I'll know more tomorrow and monday. The MAIN thing I learned, and I will make separate posting for this, is that the ReliOn Micro monitor calculated a BG of 100 LESS than the vets monitor. Not good.
 
The difference in the meter readings is not surprising at all. The vet is likely using a pet meter which is calibrated to read cat blood which has a composition different from human blood. The reference numbers on this site are all based on human meter readings and have been tested and proved to be safe. Your human meter will read lower than the vet's meter but using the references here, you will still know how Viggo is doing.

Did you discuss the dose of insulin with the vet? Are you testing Viggo before his shots to ensure it's safe to give him insulin? Are your pre-shot tests done after at least a 2 hour fasting period? Do you take readings during the expected nadir period only (between 5 and 7 hours post shot) or are they random?

Without further information, it's really difficult to offer much help. We'd be able to help you more if we could see the readings you are getting in relation to when Viggo gets his shot. We have a wonderful spreadsheet that we keep readings on and make available for anyone on the forum so the information is available should you need assistance. The instructions for the spreadsheet are HERE. And THIS document explains the format and how it is used.

If you need any help setting up the spreadsheet, just holler and we'll give you a hand. :)
 
I'm giving him Cerenia for the moment. Might end up getting an appetite stimulant tomorrow but I think he's a little better today already. He doesnt want to eat but if I hold the bowl under his chin he does. Thank you Critter Mom!
 
Viggo's Mom said:
He doesnt want to eat but if I hold the bowl under his chin he does.
Click to expand...
I think that some kitties feel reassured when we help them with their food. Can't beat love ... :)

Glad you're managing to get some bit of grub into him. Keeping a pancreatitis kitty eating slowly and steadily can help resolve the flare faster.

:bighug:


Mogs
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