Too much insulin?

[Bridgette 1]

Hi, im new to the group so please don't judge me. I have a 16yr old cat called Isis who's been diabetic for 6yrs. She's currently using 3.5 units of caninsulin and has been under excellent control for around 1yr. We have had no problems with her since she started treatment until a few days ago. I had a conversation with the vet asking if I could reduce her dosage as her condition had been under excellent control for a year, prior to thus she had only been in good control for 5gds years so I was sure she was going into remission. The vet refused to reduce her dose saying that if she were to go into remission then it would have been in the first year and he had not heard of it happening 6yrs later. 4 days ago, she started being abit sick and her stools were like soft patties. She hid away and refused to eat or drink anything so I assumed she just had a bad tummy. I stopped her insulin that evening due to her condition then the next day she was pretty much better except for the soft stools so I gave her her needle but dropped the dose to 2.5 unit's and she seemed fine until the next day when I put her on her usual dose of 3.5 at 7am. By 1.30pm, she suddenly started obsessively scenting everything in the room, I tried distracting her but she kept on sniffing. Suddenly out of the blue, she started very fast panting with her tongue out wich turned bright red! This went on for an hour, she lay on the floor and continued panting, I wondered if I had been right thinking she had indeed gone into remission and the 3.5 units the vet had ordered was wrong so I grabbed some honey and rubbed it on her tongue and made a honey water mix wich I used a syringe and fed her with. A half hour later, the panting stopped and she managed to stand up though she wobbled around for abit. She's now back to normal, she's eating, drinking and her stools have firmed up. I've got her on 1.5 units and so far so good. I cannot get her to the vets until next month when I get my benefit money so will have a blood glucose test done. My question is, should I keep her on 1.5 units or slowly put her back to the 3.5? I dont want to go through this experience again and it was horrific to experience

 

[Sienne and Gabby (GA)]

Well..... Remission typically happens sooner than 6 years but every cat is different (ECID is our abbreviation). However, it doesn't sound like you're home testing your cat's blood glucose. We strongly encourage caregivers to test their cat's blood glucose to avoid hypoglycemic episodes or ensure their cat's numbers aren't dropping too low. You may want to consider getting a glucometer since it will tell you where your cat's numbers are and may convince the vet that not every cat reads the "rule" book.

When you're able, make an appointment for lab work and have your vet at minimum, get a fructosamine test. This test is the kitty equivalent of a human hemoglobin A1c. The results give an average of blood glucose levels covering several weeks. If your cat has been in lower numbers, the fructosamine test will tell you (and your vet) that this is the case. Given what you're seeing, getting labs may not be a bad idea just to be sure that there's not anything else medical going on.

Everything you're describing sounds like your kitty's blood glucose levels dropped too low. My biggest concern is that you don't have any blood glucose values from testing your cat at home. Having that information guides us when someone had a question about what is going on with their cat. If it's possible, Walmart's Relion meter and strips are the least expensive around. It takes a bit of practice to get over the first few bumps of learning how to home test. By concern about dropping the dose from 3.5u to 1.5u is that if there's some underlying medical condition going on, it could leave your cat vulnerable to developing ketones. Ketones can result if there's an underlying infection or inflammation, isn't getting enough insulin, and isn'g eating enough calories. Ketones are truly scary and potentially dangerous. It doesn't sound like your cat has ketones. I think reducing the dose is OK but without knowing where your cat's numbers are, I'm reticent to suggest how large of a decrease is needed. We typically make dose adjustment is small amount but I can appreciate your concern. What about reducing by half of the 3.5u?

 

[squeem3]

What country are you located in? There may be better insulin choices you can ask the vet about, such as ProZinc and Lantus.

How did you know that blood glucose levels were in good control for 5 years? It doesn't sound like you are testing blood glucose levels at home.

 

[Bridgette 1]

My vet does a glucosamine test every 6 months over the 6yrs. She was only under moderate control for 5yrs but dropped to excellent over the last year wich I put down to feeding her 2 meaty snacks along with her 2 main meals. It was the last 2 tests that he said she was actually under extremely excellent control wich is why I suggested that she may be in remission as I wanted to drop her dose but he wouldn't because of the time limit. They don't like using human grade insulin and her diabetes was mild at the start hence the low dose of 3.5 units

 

[Sienne and Gabby (GA)]

I think you may mean a fructosamine test. Also 3.5u is not a particularly low dose.

Your cat may be well regulated. Tight regulation isn't the same as ready for remission.