What is wrong with my cat? (again)

[sofapup]

My Levon is stressing out my vet. That can't be a good thing, right?
(This isn't all on my spread sheet, sorry.)

Levon is on 1/2 unit 2X day. A "normal" test result is somewhere in the low 300's. Increasing insulin as far as 1 unit 2X/day results in him bottoming out (60s to 70s). Fructosamine tests show him very uncontrolled, even when he seems to be keeping steady on his daily tests. He eats Weruva b.f.f. 2X/day, and Fancy Feast 1X. Once, he was in remission for over a year.

We visited the vet yesterday because he has been losing weight steadily for the last few months. He tells me he is starving all the time, but won't finish his b.f.f. Too fishy, he says. His blood tests all came back normal today. I'm switching him to all Fancy Feast, cuz he loves it, and always finishes it. Next step will be a curve, then tummy ultrasound, but, really! Why is this cat so darned frustrating?????

What makes a kitty so sensitive to insulin? How can a special needs cat decide that he can be picky about his food? How can I spend $240 on blood tests that come back NORMAL? Why does the most wonderful cat in the world keep threatening to break my heart?
I don't really think you guys can solve this for me, but venting is generally helpful.

 

[JanetNJ]

Please try to always get an am and pm test. There's too many missing pieces to this puzzle. If 0.5 is not enough, but 1 is too much, try 0.75. I'm no lAntus expert though. For dosing advice from lantus users, write on the lantus forum

 

[Veronica & Babu-chiri]

There's too little information on your spreadsheet if you have more tests please put them in itt so that we can get an idea of what's going on specially the more recent ones

Were your tests done at home or at the vet? You do not need the blood glucose test done at the vet you could test him at home (click on the link on Janet's signatures that is a great video on how it's done)

Losing weight despite eating a lot and being hungry all the time are signs of unregulated diabetes ( and if his "normal" values are around 300 those are not normal values and he is unregulated)

Lantus requieres consistency to work properly, that means finding a dose you can give every 12 hours and you need to keep the same dose before changing it at least 3 days if your are following the Tight regulation or for 7 days depending on the protocol you are following ( take a look at some information about lantus in the lantus forum http://www.felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/ ) unless he goes below 90 at any time then you reduce de dose by 0.25 units

 

[Veronica & Babu-chiri]

What makes a kitty so sensitive to insulin?

Is not so much as they being sensitive thing is, insulin is a hormone so is not a set dose like the meds, blood glucose levels get affected by everything that he eats, feels, what he does if he's sick, etc

How can a special needs cat decide that he can be picky about his food?

He's just being a cat, special needs or not just we do not notice they being picky so much when they are healthy or normal

How can I spend $240 on blood tests that come back NORMAL?

If all his blood tests came normal with the exception of his blood glucose levels and all they are going to check is doing a curve you could do that at home

 

[sofapup]

I did apologize, right off, that not all my info is on my spreadsheet. But irl we are very consistent. Food amount. meal times, insulin shots on time and precise. I just use the ss as a place to make notes. It's been a while since I added anything, like his latest weight (9.6#) Levon is just a kitty who stays high when his dose is low, and crashes when his dosage is raised a tiny bit. He gets good food and care. My problem is that he has become so important in my life. It's scary when you have something to lose

 

[Veronica & Babu-chiri]

I did apologize, right off, that not all my info is on my spreadsheet. But irl we are very consistent. Food amount. meal times, insulin shots on time and precise. I just use the ss as a place to make notes. It's been a while since I added anything, like his latest weight (9.6#) Levon is just a kitty who stays high when his dose is low, and crashes when his dosage is raised a tiny bit. He gets good food and care. My problem is that he has become so important in my life. It's scary when you have something to lose

Is clear that you love him and that of course makes you worry even more but hang in there things get easier and more in control eventually and we get it that sometimes is hard to keep up with things is just that is hard to try and see what's going on with him with out information, his dose may need an adjustment ( maybe in even smaller amounts than 0.25 maybe 0.1 unit ) he could be a diver ( he goes very low very easily and sometimes quickly) which means he will probably be bouncing later on ( a very high number or at least higher than normal) , there are some things you could do to help him not drop too much but we need some information to try and see what's going on.

 

[Squeakycats]

I will be very interested to hear any tips anyone has for sofapup and Levon! I feel like something similar is happening with my kitty, also on Lantus. All of his food is very low carb; he can't get into anything else. I'm very careful when measuring insulin and usually very consistent about getting it 12 hours apart. There have been no big changes in our collective lives--no moving, new jobs, new pets, etc. I've gotten him into remission twice in the past, but now he's just all over the map. His typical pre-shot number is between 250 and 300, and he'll go through long stretches where maybe 225 is as low as he seems to go (I test at various points during the day whenever I can, so I feel like I have a little bit of a clue what's going on...though not as much as I would like). I'll then bump his dose up by .25 units and he'll get down into the mid-100's, and I'll think "Yay! We found the dose he needs! I may never get him into remission or tightly regulated again, but maybe I can keep him below 200!"

And then after maybe a day or so, one of two things happens--he either goes back up again, or he crashes without warning--this most recent time, into the 40's. So then I reduce the dose (I gave 1 unit an hour later than usual following the most recent crash, because he had risen to around 70 and I didn't want to just skip...), and the whole game begins again.

Once in a while he goes to almost 400 pre-shot; I assume those are bounces, but I can't be sure, because any crash that preceded them must have happened while I was at work or sound asleep. He's usually extremely good about waking me when he's going low...I guess I should be getting up in the middle of the night like I did when we were first doing TR, just to routinely test, but it's so hard the next day.

(I haven't updated my spreadsheet in a long time--I'm just keeping a notebook and have been so busy I've never felt like I could sit down for the hours it will probably take now to get all the data transferred over. I know that I need to; reading about this idea of "divers" is giving me the necessary motivation!)

@sofapup I sympathize so much, and I hope that you find a good strategy for Levon! He is a beautiful kitty, and I'm sure he doesn't mean to stress his mom out so much!

 

[Veronica & Babu-chiri]

I will be very interested to hear any tips anyone has for sofapup and Levon! I feel like something similar is happening with my kitty, also on Lantu

I suggest you post the question for Misha on the lantus forum

 

[HereKittyKittyKitty]

When my cat was not eating enough and was crying all the time, I figured he was hungry. I started giving him Orijen Regional Red and Beef treats (the cat and dog versions are the same, but the dog is bigger pieces and cheaper per ounce) before each meal. Solved the problem, he eats more of his 9 Lives, and he even put back on the weight he lost before being diagnosed with diabetes. In all fairness, he has supplemented from time to time with mouse (brrrrrrrrrrrrrrrrrrrrr!)