He was diagnosed in Mar, 2019. He started on 2 units. He got chemistry panels with >400 glucose. We increased to 4 units. We continued this moving to fructosamine tests. We increased 2 units at a time for the most part. His insulin resistance seems pretty strong. We just received blood and urine results. The blood glucose was 175 but he had 3+ urine glucose. This tells me he is constantly running high. If I am wrong, please correct.
His kidney numbers are normal. He has been on 8 units about 2 weeks. We were on 7 units before that. He was on his dose for a while before we increased (2,4,6,7,8). Each dose was much longer than one week, some for months.
This is the whole reason of trying a new insulin and Hill's md food. Using frisky pate didn't work on him. Hopefully, this will. He is fed independent of the others.
I understand home testing but we have 12 cats and that is the straw on the camel's back for my wife.
We raise doses by 0.25u at a time unless numbers are consistently over 300 for six cycles and then we raise by 0.5u or if the cat’s dose gets to 5u bid. Then we raise by about 10% of the current dose. So while the 2u “might” have been an appropriate starting dose for his size, raising by 2u each time was aggressive without knowing if that’s what he needed.
There is always a delay in the amount of glucose in urine from the blood glucose. Cats have variation for when they will spill glucose into the urine which we call “renal threshold”. Generally, most sources will say the renal threshold is at a BG of 250 on lab equipment. Several of us have monitored that and found that renal threshold might be as low as 150 on human glucometers. i know that’s kind of comparing apples to oranges but from all the comparisons I’ve seen between human and pet meters, 150 on a human meter would not be 250 or higher on lab equipment.
What that means is that Kandi could be doing what we call “bouncing” meaning his numbers go lower, his liver reacts by dumping hormones into his system which bring the BG up; he spills glucose into his urine. He drops again. This is a common phenomenon in cats and is normal. However, it’s critical to find out how low the dose is going that causes bouncing. Sometimes it’s really low (as in dangerously low) and other times it’s just lower than what the cat is normally used to (e.g. if his liver is “used to” 400s, lower could be low 200s or high 100s). Keep in mind that you cannot determine how low a BG is going by watching a cat. There were occasions when I tested my kitty and she was at 25 on a human meter and had absolutely
no symptoms of hypoglycemia. That means just because you haven’t seen any symptoms doesn’t mean that he hasn’t been low.
In addiiton, on this board, if we have a cat whose insulin has slowly and consistently been raised, once they get to 6u bid, we suggest strongly to the caregiver that they have them tested for high dose conditions like acromegaly and IAA. One of our members, another moderator, is the best versed I have come across in 9.5 years on high dose conditions. Has your vet even suggested testing for high dose conditions?
I understand your wife doesn’t want to hometest, but without that, we are not able to help you and I hate to say that but we won’t sacrifice your cat’s safety. We are not veterinarians and while we are very, very good (better than the majority of vets) at helping members get their cats well-regulated and many into remission, none of us can give you any kind of dosing advice without hometests. We can teach you to hometest; again, before I made any changes in insulin, I would get the spreadsheet up and running, get a human meter, corresponding strips, lancets, and start home testing. Once you have a little data on Vetsulin, then you’ll have a better idea what dose to use for PZ.
One other thing: we don’t suggest feeding Prescription foods and especially Prescription diabetes foods. I don’t know what you mean by “frisky pate”
didn’t work for him. Dr. Lisa Pierson is a feline veterinary nutritionist who works with us on this site from time to time; she has developed
food charts. She shows the Friskys pates as being what we would consider to be low carb and the Hills md as 13% calories from carbs which is a medium carb food. I will say that some cats do better with a food ranging in 6-10% calories from carbs. But I don’t know what didn’t work for Kandi with the Friskys pates. Can you be more specific?
