Stripes is roller-coasting after 2 stable years

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lsweanor

Member Since 2013
Wow, I didn't know how lucky I was with Stripes (just turned 13, big male, gray tabby at ~18 lb) the past 2 years! He was diagnosed Sept 2010 and we put him on Humulin N (started at 4 units! 2x per day) that I dropped to 2.5 units and with feeding Hills MD wet and dry food (never liked the wet food much). I realize how lucky I was that he never crashed. Then our cat Suzie died from kidney failure August 2012, and thinking back I believe his diabetes started acting up again then. In January he began staggering a bit (loose in the hind quarters and couldn't jump onto the bed). I called the vet and they recommended dropping his insulin to 1 unit 2 x per day. Note I have never home-tested! I've been so stupid! I did this and he regained more control but began drinking and urinating copious amounts and he was not eating well. I called the vet and they said to bring him in for a blood test. His glucose was great at about 120 (this was a 1 time reading, not the fructosamine test) but he was showing initial signs of kidney disease. They switched me to KD dry and wet food and said to keep on the 1 unit 2x per day regiment. He ate well for a few days then refused to eat hardly anything but meat-based baby food and continued his drinking/urinating ways. I went back to the vet and asked for both blood work and a fructosamine test. Apparently his glucose levels have been all over the map, but his kidneys were now looking great. They switched him back to MD food and suggested giving 3 units of insulin the first eve and dropping it to 2 units thereafter. I did not give the 3 (too scary for me) but did start giving him the 2 units. After a week of this, he does not seem to be any better. That's how I finally got the smarts to find this site!! I am going out to buy a glucometer today and will start monitoring prior to each insulin injection. I'm wondering if Stripes was initially dosed too high causing insulin ineffectiveness, but I also think I should switch to a long-lasting insulin such as Lantus? I have also used short needles (3/8 inch) to inject the insulin... and am now thinking that it's not getting fully under the skin and thus causing poor insulin absorption? Should I switch to the 1/2 inch needles? I'm also thinking of testing him on the Fancy Feast in place of the MD wet food. Before his diagnosis I typically fed him Friskies dry food and canned pate. Note we also have his sister (Mirza) and she is healthy, active and quite lithe. Anyway, any advice would be most welcome. I am a bit overwhelmed with the information I am finding here, but also most grateful!! If we switch to a different insulin, is there a place to purchase it less expensively? We have amassed a lot of vet bills (most notably by our dog that has required $6000 worth of surgery) so any suggestions on that would be most appreciated. Sorry about the long posting...
Linda
 
hi Linda

welcome to FDMB!
I can't give dosing advice but we do generally recommend lantus, levemir or prozinc as being gentler and longer-lasting than humulin.
I believe the syringes are different though so you would need to buy new ones - someone can advise on that.

Glad his kidneys are looking better - not sure why they would improve though after only a few dyas on KD dry & wet food - again, someone else can step in there.

Pretty much everyone here feeds low carb wet food - this list can help you find good choices - look for <10% carbs. The Hills M/D is 15% carb.
http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

I lot of us feed Friskies pates or Fancy Feast classic pates - much cheaper than the vet-prescribed foods and just as good, if not better.
Also, dry food is not good for kidneys for any cat http://www.catinfo.org/.

Great that you're going to start testing - that will really help Stripes.
The Walmart Relion brand meters are good and the strips are reasonable - you may find you go through a lot ;-)

The staggering is probably neuropathy and is reversible - when his bg goes down, it will improve.
Methylcobalamin can help. There's one product specifically for cats: zobaline
 
Thank you so much for the info and advice! I'm heading to the store now to get the meter and wet food, and will talk with the vet about switching his insulin.
Linda
 
Your syringes are fine.....they would be the U-100 ones, hopefully the 3/10 cc ones? As for the short or long needles, we all have our likes. Me......I've always used the 1/2" needle. It would help if you did get a new supply when needed, of syringes with `1/2 unit markings on them also.

You've been very lucky with Stripes using N and not hometesting nailbite_smile Hopefully your vet will prescribe a better insulin. N really is no good for 99% of kitties and those started on it by a vet quickly end up going onto either a PZI, Lantus(Glargine) or Levemir.

Neuropathy will go away with better regulation and some help with the Methylcobalamin.Denise gave you the link on where to buy it. Don't bother asking the vet about it :lol: ....we've been teaching them over the years about Methyl.

Don't forget to come back and let us know about the insulin and if you need any help hometesting.
 
Thanks for the support; it's been such a huge help! I performed my first BG home test this eve. I ended up using 4 strips before getting enough blood on the stick for it to read a result. I got enough blood out of his ear, but Stripes would move his head too much and I would lose it before getting it to the stick. It went pretty well once I let Stripes stick his head in the Fancy Feast can. I really think I can do this because he never flinched from the sticks. His BG was even higher than the test I got back from the vet a week ago (499 versus 467). I'm still on 2 units of Humulin until I can get a few days worth of data to run by the vet. He's still weak and wobbly so I will check on the Methyl. Am I risking his health further by waiting a few days to make any changes in type and amount of insulin?? He is eating the Fancy Feast as if he's been starved for food. Should I immediately omit any of the old MD dry food from his diet and stick just with FF, or is that too radical?
 
How many hours after he was given insulin was the test run? If he is happy eating canned FF or Friskies now, it would be to his benefit to remove the MD dry but removing dry will probably lower his numbers quite a bit. How about removing a little each day and do tests to see how his numbers are?

Back in 2000 or 2001 when it came out on the board about dry food I took Baby's(GA) dry completely away. She was always given canned a.m. and p.m. and I left good dry food down for snacking ohmygod_smile
She dropped within 3 days from needing 3 units of Humulin U down to only 1 unit of U.

A lot of cats dx literally went into remission just from removing dry food......diet controlled.

Glad you are hometesting now and it will get easier every day. If need be, get that drop of blood on your fingernail and then sip it from there.
 
Fingernail trick for catching the blood worked great! Thanks for the tip! I think I made the first test at the wrong time last night (just before giving insulin), so this morning I fed him, gave the insulin ~10 min after eating, then tested about 10 min after that. His GB was 525!! Higher than last night prior to insulin injection. Did I give at wrong time this time, not wait long enough, or is it just not working? I'm going to test mid-day today (6 hrs post-shot) and see where he's at. He's eating well, but he really seems out of it. I have ordered some Zobaline.
 
It is better to test before feeding but if you have to test with his face in the FF can, then do it that way. Food won't affect it that quickly.

With N insulin you NEED to feed at least a 1/2 hr. before shooting. It is a fast acting insulin with short duration so food needs to be on board. So you would test him, feed him and then wait before shooting that insulin. N curves like the letter U. You get a reading, insulin starts working to bring numbers down, then insulin reaches the peak/nadir, poops out and numbers go back up.

N insulin doesn't have a very long duration time for keeping a cat down......L and U (both discontinued) were also Humulins. L had a much better duration and U was great. Cat would slowly go down, stay there for several hours, and then slowly go back up. You can feed all he wants if you find where the N peaks but feeding after peak there is no insulin working to keep numbers down.

Any chance of getting a better insulin for Stripes like a PZI or Lantus or Levemir? Whole new learning procedure if you do Lantus or Levemir but great insulins.
 
Got it. Test, feed, wait 1/2 hr and give insulin. THanks! Vet said to monitor a few days with present regiment before increasing insulin or attempting a switch (but I haven't seen the mid-day BG yet). I was planning on asking to switch to PZI if it will work for him. Lantus does sound like the best choice, but I'm hesitant because of cost.
 
With an N insulin, it lasts roughly 6-8 hours in most cats. This means you may have 4-6 hours of no insulin if you only give it twice a day.

Two methods to work around that (without changing the insulin):
1) pick up all food at +6 hours after the shot
2) dose 3 times a day at roughly 8 hour intervals

While the newer, longer-acting insulins may be more expensive, keep in mind that there are other costs to consider - complications from unregulated diabetes can be very costly (as in thousands) or even life-threatening.

Also, you may use a smaller dose of an insulin such as Lantus, compared to what you have to dose with an N insulin.
 
With Lantus, I've discovered a few effective cost-cutting methods.
  • Request a prescription for the Solostar Pens from the vet. Lantus can start losing its potency after 4-6 months (make sure you keep it refrigerated and there is no need to roll it!). Since the vial contains quite a lot more insulin, you end up losing quite a lot more insulin in comparison to the pen.
  • Sign up for the Lantus Savings Card online and print it out to take with you to the pharmacy.
  • Call around and find a pharmacy that will sell the Lantus pens individually (instead of in the box of 5). I had luck with my local Walmart, others have had luck with Mom&Pop pharmacies.
  • Make sure they also take the Solostar Savings Card (most all places should since it's a manufacturer's discount).
  • Finally, pay only $25 a pen, which will last you quite a few months (usually to the last drop).
 
Increasing that N insulin will bring the numbers down BUT it will not extend the duration. Hopefully vet will give you a better insulin to use.
 
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