Sudden return of symptoms and increase in BG?

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monty_dweezil (GA)

monty_dweezil (GA)

Member Since 2014
I am baffled by this latest development with Dweezil, as I wrote in another longer term thread.

What may be the reasons why a cat would have fair to good regulation for 1-2 months on 2 units of Lantus per day and a low carb diet, but then 2-3 weeks ago start showing symptoms of excessive drinking, sweet smelling urine, excessive hunger, and a slight (very slight) less in weight (1-2 pounds)???

Nothing has changed in terms of his diet or environment. We keep a detailed record of how much water is consumed twice a day, what foods he eats for all his meals, we measure his urine glucose 2-3 times everyday, and we are very aware of how he seems, as he is an indoor only cat.

It is just so confusing. The last time he went to the vet and his fructosamine results were good (fair to good control) and the vet was happy and didn't need to see him again for a while.

So why now has he gone backwards? We have given no fur shots. His diet is unchanged. There has been no added stress. Not even the stress of vet visits.

His reading is almost as high as it was when he was very first diagnosed back in December last year, and his symptoms are actually probably WORSE I'd say than they even were back then. He is certainly hungrier now than he was then.

I am just so scared to increase his dose (as per our vet's instructions) in case there IS something else going on and we fix it and then his dose is way too high.

We always inject around his shoulder blade fatty area there, as he doesn't notice us doing it and he got very touchy about us using his scruff / neck area after about a month. Could the insulin simply not be going in properly?? As I said, we always check for fur shots by gently stroking the area of injection and making sure it's dry and doesn't have that strong insulin smell.

And we're going away for a six week vacation in two weeks. :( :( :( :(
 
Pancreatitis
Developing food intolerance
Another condition developing.

Once something tips the balance, other things cascade, so the increase in glucose could just be a kitty cold.
 
Mmm, yes. It is just SO stressful as I don't want to increase the dosage and then have whatever has caused the issue to suddenly resolve itself, and then...danger zone, as the dosage is too high. But I also don't want to just leave him as he is now. His BG is just too high. Poor little boy.

Is it possible that some cats just develop a tolerance to insulin? Like drug users for instance, where they need more of the substance to have any effect? Can that even happen with insulin?
 
Yes, some cats do develop insulin resistance. I don't know if that's going to be the case for Dweezil or not but it is something to consider if he's suddenly needing a higher dose. I'd rule out infection or anything else first though - as you say, you don't want to increase the dose and then find that something resolves itself and he finishes up getting too much insulin.
 
Agreeing with everything said above. And it may well be that Dweezil has some other condition that is inflating the numbers (UTI and dental infections are common culprits).

However.....there is also the possibility that the current insulin dose is actually too high now, causing him to rebound. That could also cause high numbers. (I feel a bit bad suggesting this possibility because my recollection is that Dweezil is difficult to hometest(?), and hometesting would be really helpful in working out if that is the case....)

Eliz
 
Ok, so he's been on the new dose for one week and one day, and it seems to have made virtually no difference at all. Water consumption still high. Urine not as sweet smelling but pretty much the same high readings as before. What does this mean? Going from 1 to 2 units made a good difference. 2 units ongoing was working well. Then it stopped and 3 units has made no difference.

Could it be that when he got those really good almost normal numbers 2 months ago, we should have reduced the dose slightly? And because we didn't, 2 units ended up being too high and finally it began to produce symptoms again? And now 3 units of course is making it even worse?

Dweezy seems good in himself. Energetic, curious, etc. Sigh. Vet again on Friday.
 
It is almost finished actually. We have a new one to give the cattery next week while we're away.

There are no floaties at all and it looks clear and normal like it did when new.
 
Is he reward motivated at all? Treats, brushing, toys?
If yes, working on a behavior shaping program may be helpful.
Shaping is tiny steps along the way to a desired behavior. Work on 1 step at a time, for a good week or so, and reward the behavior when it occurs.
For example:
Step 1 might be getting him to come to a specific location where you hope to test him someday and reward him for coming.
{1 or more weeks of this}
Step 2 might be a short pet of the head and reward.
{1 or more weeks of this}
Step 3 might be a longer pet of the head and reward.
{1 or more weeks of this}
Step 4 might be a short massage of the ear and reward.
{1 or more weeks of this}
 
Hmm, yes. I actually tried this quite a while back. He loves "rewards" like brushing and treats but ONLY when it's not in association with something he doesn't want to do. Once he associates something unpleasant with it, he no longer has any motivation for the treats. At all. And sometimes he doesn't really care much for those things anyway, depending on his mood.

He is also easily distracted. He can be gobbling up his dinner, hears a noise somewhere and will walk off. Then it can be hard to re-capture his interest.
 
Maybe you could you try one of you holding and loving him up while one of you pokes his paw pad? They don't have much feeling in the pads, my Goof doesn't even blink when I test him there and the blood comes easily. I use a different pad each time.
 
We tried that too. He is a loving cat, but doesn't like to be held for longer than a few seconds. We used to try that and it made him very stressed. He HATES having his paws AND his ears touched.
 
Lantus works the best when the doses are adjusted in small (.25u-.5u) increments based off of daily tests. It is hard to tell if the dose is too high or too low without those daily tests--it's like trying to hit a bullseye with your eyes closed.

Many cats hate testing the first few weeks, but nearly all of them come around and accept it eventually. Bandit fought me tooth and nail the first few weeks, and I was convinced he'd never accept it. But I thought, "I HAVE to do this for him to get better, and that is the most important thing." We tested four to twelve times a day, and a few weeks later he was actually running to his basket when he heard the glucose meter click on! Now he'll flop down in front of me and start purring until I'm done with the test. This is the same cat that bit my hand so hard it bruised the first time I tested him (nervous, and without any kind of technique).

What I did with him (on my vet's advice after telling her it was impossible to test him) was put him in a fleece blanket lined basket slightly larger than him, and wrapped him up with another blanket so that only his head was sticking out, and then I'd do the ear pokes. Cats have very few nerve endings in their ears (less than people have in their fingertips), so it's not the ear pokes that bother them--it's restraining them and doing something new and strange, and sensing your fear and nervousness. So you want to get that drop of blood as quickly and easily as possible. Start out with 26g lancets--the 30-33g lancets that will come with meters are very difficult to get a drop of blood with. Warm the ear before you poke, and make sure you back the ear with a tissue or cottonball as you're poking. Apply pressure to the spot for 20 seconds after the poke to prevent bruising, and apply a tiny bit of neosporin + pain relief (ointment, not cream) afterwards. Most importantly, give a treat after every test, even if he won't eat it right away.

It's hard at first with some cats, but he'll accept it eventually once it becomes part of your daily routine (cats love routines, espeically when it concerns food!). It's just as important that you look at it as something that has to be done, whether he likes it or not, and take charge and not get flustered even when he's growling at you (which can be hard, I know!). Once you are more confident and take that step, trust me, he will sense it and stop freaking out on you. I was lucky that my vet was telling me back then I 100%, had to hometest or we wouldn't see good results with the Lantus, because it was dangerous and impossible to adjust the dose without curves at home. I'm not sure I would have stuck with it if she hadn't said that to me.

Best of luck! I know every cat is different, but I'm hoping you are able to find a technique that can work for you.
 
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Thank you!

We tried wrapping Dweezy with a blanket ages ago but it made him worse. He hates being restrained and won't get in the bed properly (legs askew, trying to get away, etc) won't get in a position whereby he CAN be properly wrapped, and certainly won't stay there!

I have been telling myself i MUST do this when we get back from our trip. Sigh. I just must.

Follow up vet visit yesterday. Had his blood test four hours after his insulin and the reading was 180.

So...it's doing something, even though in general i still consider the clinical symptoms not so good. Still increased water consumption, high appetite, etc. No sweet pee smell though and this morning for the first time in months, his urine glucose reading was just under the halfway mark.
 
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