Cat on insulin and changed diet registering very high numbers after two months

We have been trying to treat our cat for a couple months now. She has not responded at all to the insulin, and our curves have been relatively flat each time.
We started at 1 unit, moved to 2 units, moved to 3 units, and now the vet has recommended going back to 2 units.

our cat is peeing all over the house and we are starting to lose hope.
The cat has had urinary crystals since birth so they have always been on a C/D dry food. We have recently changed them to canned food when day was diagnosed with diabetes. evidence of crystals haven’t come back, but the blood sugar is still very high even with a wet food diet. On hour 11 she registered a 536 after not eating all day (since breakfast).

we really don’t know what to try at this point. She seems almost unresponsive to diet change and insulin. Please help!

 

Hello Nick, and welcome to the forum. I'm a newbie myself, so take what I say with a grain of salt. But maybe I can help until a more experienced member comes in. It's been a very busy day on the forum with a couple of emergencies going on, so bear with us.

My guess is that since the urinary crystals haven't come back, the peeing is from the diabetes. Does your cat have signs of weakness in the back legs? Has there been litter stuck to her back feet? Have you noticed her not jumping up as much? If she's having and leg weakness, she may be having trouble with the litter box. Try something with low sides and see if that helps.

Can you tell me what insulin she's on and what wet food you are feeding? The good thing is that wet food is better for a cat with crystal issues, even if it's not prescription wet food. So that works well with a diabetic diet. Are you testing her blood glucose at home with a meter? Are you feeding twice a day, or many small meals a day?

Don't give up! I'm sure there are things we can try to get you girl feeling better. We just need more information first. If you have the time, this link will show you how you can fill some things out so that we can help you help your girl. New? How You Can Help Us Help You

Yes, the high numbers are concerning, but this is a marathon, not a race. So try not to worry.

 

We are using Lantus insulin and friskies wet food.

I don’t know that there are any substantial leg pains as she specifically is jumping up on the bed and couch to pee.

we empty the litter box one to two times a day. Usually two. The two cats have three total boxes that stay very clean.

she gets two meals a day, at 6:00 am/pm with the insulin right after feeding.

we have done 5 or 6 total curves at home.

 

Dang. When's the last time the vet checked for a UTI? That bed and couch peeing sounds like possible UTI, though if she's been checked, I would have to say it might just be that she has to go so much from the diabetes. Cats can also pee places like that because they are trying to tell you they don't feel well.

Lantus insulin is one of the very best cat insulins, but not what I use. I will leave it to the Lantus veterans to give any dosing suggestions. Are you giving her a dose every 12 hours?

Now, lets talk food. Friskies pates can be awesome, but some of the Friskies are higher carb. There's a great food chart here that lists tons of wet cat food, and will tell you the percentage of calories from carbs, protein, and fat. The vet that made it suggests foods that are less than 10% calories from carbs, near or over 50% from protein and the rest from fat. Look up the flavors you've been feeding and see how they line up.

he next part of my suggestion involves the fact that Every Cat is Different. Look at what she's eating right now. Is it over 10% carb? If yes, then slowly switch her to lower carb. Is it in the 5-10% carb range? You might try switching to 0-3% and see if that makes a difference. Do the switch slowly, and make sure you test before each shot, because diet changes can drop blood sugar by over 100%. Is she already eating 0-3% calories from carbs? Then you might want to try upping her carbs to closer to 10%. Some diabetic cats do a little better if they have a little more carb in their food.

Is she getting into any dry food? Does she have high carb treats? Even a few bites of high carb food or treats can really raise BGL.

I forgot to add, with the urinary issues, the lower the phosphorous the better, and the food chart shows phosphorous levels too.

 

We’ve been giving a very small amount of the C/D still, it comes twice per day but our thought is it may help with the crystals. We have cut this out in the last two days though to see if it will help with her glucose numbers.

We are giving the pates which show numbers right in that range. A couple of them at 6%, but the rest of them are below 5% for carb.

compared to other foods, the phosphorous is fairly low too.
She is getting her dose every 12 hours with no more than +/- 30 minutes.

she was checked for a UTI near the beginning of the diabetes in November but we are taking her in again on Monday and will have her urine tested.

 

Was the C/D dry? If so, that could have been part of the problem with the numbers. I think you were smart to cut it out. Give it a few more days to see if cutting it's made a difference. And it's great you are getting her checked for a UTI. Not only can that cause the peeing problem, an infection can raise her blood sugar. I suggest carrying on for now, and find out about the possible UTI before making any further changes.

 

Will do. I’ll check back Monday.

 

One other possibility for the higher numbers is that you may have skipped over your optimal dose. It looks like you increased the dose by a unit each time. Dose increase should be between 1/4 to 1/2 unit at a time and if you are not following the tight regulation protocol, you would wait at least a week before increasing it again. If the dose is too high, the body tries to protect itself from becoming hypoglycemic by producing extra glucose. Once you know that any other medical issues have been treated, you can always start over with 1 unit. There are some cases where a high dose is needed, but most of the time it is due to medical issues such as an infection or dental disease or the optimal dose is lower than what is currently given.

 

Are you hometesting regularly or just on curve days? Sorry, it’s not clear to me.

Sometimes too much insulin looks like too little insulin — it’s impossible to tell which it is unless you arrived at a dose by methodically working up the dosing scale and collecting data. Jumping around on dose, especially by whole units, often slows down the regulation process. Vets like to recommend that but it’s usually not very efficient.

No judgement here, just trying to get a baseline understanding of your situation. Do you have any data we can see?

Edited to add: Also, I agree that it’s a good idea to check for a urinary tract infection. You might also want to try Dr. Elsey’s Cat Attract litter, which helps many cats restart using a litter box, and use an enzyme cleaner (such as Anti Icky Poo or Nature’s Miracle) on any areas the cat has hit so as to remove any lingering odor that will attract her back to the same spot again.

 

Sienne and Gabby (GA) has suggested that there are many more experienced users of Lantus on the Lantus ISG. You may want to think about posting over there.
Lantus / Basaglar (glargine) and Levemir (detemir)