Insulin not working

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Shawna&Red, Apr 21, 2010.

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  1. Shawna&Red

    Shawna&Red New Member

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    Apr 11, 2010
    Hello All - Red and I are new here and she has a problem that we hope you can help with. 2 months ago Red was diagnosed with Diabetes and she went on to insulin - 2 shots per day at 2 units. She was miserable and one Sunday evening I found her in a puddle of urine and poo dying as her blood sugar has gone down so low. She had also been puking all the time. I revived her with honey and the vet changed the insulin and down to 1 unit once a day. 2 Wednesdays ago I came home and she was in almost as bad shape. All this time she has been miserable with a glassy look to her eyes. I thought I'd need to put her down. But after the Wednesday, I took her off the insulin and she has been happy and eating well. BUT her blood sugar is still between 19 and 23 every day. I gave her .5 unit yesterday and was up most the night with her as she went way too low and was so weak again. She was 10.9 this morning but is back up to 22 now. I have no idea what to do and my vets are confounded. Do any of you have any advice? I just don't know what to do. Thank you for sharing. Best, Shawna & Red
     
  2. Jen & Squeak

    Jen & Squeak Well-Known Member

    Joined:
    Dec 28, 2009
    Shawna
    I am sorry that you are going through this! And poor kitty!

    We need a lot more info though first..

    1. how was she diagnosed?
    2. any complications?
    3. what insulin are you giving?
    4. what food are you feeding?
    5. What other testing results do you have so that we can help figure out how the insulin is working?

    Jen
     
  3. LynnLee + Mousie

    LynnLee + Mousie Well-Known Member

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    Dec 28, 2009
    hi there

    i want to add one more question to the ones Jen has already asked, can you possibly describe to us how much insulin you are drawing up into the syringe? what i mean is are you drawing up insulin let's say as deep as an eraser on a pencil or would you say like an inch or more deep? i just want to clarify that because we have seen people who weren't taught hands on or weren't taught properly or somehow ended up with wrong syringes and the problem was they were giving 20 units instead of 2
     
  4. squeem3

    squeem3 Well-Known Member

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    Dec 28, 2009
    Adding:

    Are you using U40 insulin syringes or U100 insulin syringes? It will say so right on the insulin syringe barrel as well as on the box of insulin syringes.

    The box will also give specs on the insulin syringes such as needle length (typically 1/2 inch or 5/16 inch), needle gauge (such as 29 gauge or 31 gauge), and insulin syringe capacity (max amount of insulin the insulin syringes can hold. 30 units aka 3/10 cc, 50 units aka 1/2 cc, or 100 units aka 1 cc).

    If you can provide at least the insulin syringe capacity and whether or not they are U40 or U100 it would be useful for members here to try to help you :smile:

    The markings on 50 unit U100 insulin syringe are slightly different from the markings on a 30 unit or 100 unit U100 insulin syringes and oftentimes newbies don't realize that there is a difference and sometimes that means the cat is getting twice as much insulin than prescribed which leads to hypoglycemia.
     
  5. Shawna&Red

    Shawna&Red New Member

    Joined:
    Apr 11, 2010
    Thank you Jen, Cindy and Squeem for replying. Red has been steady at 22 the past 2 days. So to answer your questions...
    - she was diagnosed as she was drinking tons of water and peeing like crazy - thru a blood test
    - except for drinking water, she seems fine and is eating well. She had kidney problems last September but her kidney levels are normal now. She was on low protein food and is now on diabetic (Purina) food.
    - She was on Porcine insulin (2 units in U40 syringe 2x/day) but was puking all the time and miserable. They put her on Lantus next that she almost died on at the same dose, so had her on 1 unit in 50 unit U100 syringe 2x/day (like maybe 2 mm - can barely see how much is in there) and she was still very distressed and glucose was dangerously low and high (1.4 to 30.5). That was what I gave her on Tuesday - but maybe around 1/2 a unit and she was still below where the machine could read her glucose and had to revive her with honey.

    When not on insulin her blood stays btwn 19 and 23 - and she is happy, purring, eats well but drinks and pees lots. Is that sustainable? I found Red as a street kitten in Hong Kong 16 years ago and we have been through much and many moves together - she is my rock. However, if it is her time I will learn to accept it but I don't think it is - nor do friends who see her. We just need to figure out this insulin piece.

    I really appreciate your help and caring. :YMHUG: Best, Shawna (and Red)
     
  6. Melanie and Smokey

    Melanie and Smokey Well-Known Member

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    Feb 24, 2010
    You are in the right place. The Lantus help around here is superb. You might want to take some time and read the sticky threads in the Lantus Support Group forum. There is a lot of information there on the process they use here to help you get your kitty regulated and maybe even off the juice. Setting up a spreadsheet like you see in many of outr signatures will help show the information you've gathered from testing so that they can help with a starting dose.
     
  7. Maggies Mom Debby

    Maggies Mom Debby Well-Known Member

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    Dec 28, 2009
    One thing that might help is a syringe change. You may be overdosing because you can't really tell how much is in the syringe. You need 3/10 mL/cc (30 units) syringes with half-unit markings. You'll be able to see the one unit (or half unit) dose ALOT better than in the 50unit syringe. You can get them at WalMart or order them from hocks.com.

    Once you have the syringes, you might need o reduce the dosage to a half unit. Finer doses are also possible. There is information on fine dosing on the petdiabetes wiki: http://petdiabetes.wikia.com/wiki/Fine_doses.
     
  8. Steve & Jock

    Steve & Jock Member

    Joined:
    Dec 29, 2009
    You'll get it! It sounds like the insulin is definitely working, but the dose isn't right and your diet is screwing things up too.

    To understand how food and insulin interact, watch the first half of this short video:

    http://www.novonordisk.com/diabetes/hcp ... ction.asp#

    It sounds to me like your problem is:
    1) Blood sugar swings from food are too dramatic (choose lower-carb food)
    2) Blood sugar swings from insulin are also too dramatic and not timed to go with swings from food (lower insulin dose)
    3) You're not taking frequent measurements of blood sugar at home so you can't see this happening. (watch the video). This stuff changes pretty frequently (every hour) and so you can easily be caught off-guard until you get to know the pattern.

    It is predictable though once you've adjusted diet and dose right! Keep it up!

    Steve
     
  9. squeem3

    squeem3 Well-Known Member

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    Dec 28, 2009
     
  10. alexanne

    alexanne Member

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    Mar 11, 2010
    My 14 year old Peachy was diagnosed with diabetes in February. I am so glad I was not faced with this complication. Peachy was put on Caninsulin - called Vetsulin in the US - I am from Canada. I was given the appropriate syringes U40 and instructed to give 1U twice daily - I followed this exactly and she is on Purina DM dry food - she is one of those cats who won't take canned food - been trying but no success - she will take sardines. Her condition immediately improved - she had gone down to about 5 lbs with excessive urination and at this date is her chubby 12 lbs. again, very lively and all functions going well. . The U40 syringe has marking in 1s - not halves as shown on the sample picture of syringe markings.

    When she was first diagnosed this site was and still is invaluable in providing support and answers. The suggestion was that Lantus would be a good product to use. I discussed this with the vet and we both agreed that since she was doing fine on Caninsulin there was no reason to change unless there was a problem.

    I find that too much information is almost as bad as too little. All cats are quite different and what works with one won't work with another - I can only state that what works with Peachy 14 years old - weighing 12 lbs. is as follows:

    Caninsulin
    40U syringe
    2U in the morning and 1U at night - that is a very small amount - the insulin should be only to the very first mark on the U40 Caninsulin syringe. It may seem small, but any more would be dangerous and when I give the 2U which was recommended when her weight went up - the syringe should only be exactly on the second mark - maybe even a smidgeon less, but definitely no more.

    Peachy is getting diabetic dry food Purina DM, but there are other brands for diabetic. Also if your cat will take tinned food there is a list on this site of all the tinned foods recommended for diabetic cats.

    In some cases the diabetic food alone can do the trick.


    This is what works for Peachy - you have to find out what works for your cat - maybe Lantus is the answer.

    Hope this may assist you - there doesn't seem to be any specific information from you as to the amount of insulin and the syringe type or the food. It is highly recommended to keep a chart on the daily readings - what food given - exactly how much insulin given etc. You will be able to get samples of the charts on this site.

    It is a strange situation that the insulin is causing this problem. Maybe a second opinion on the condition from another veterinarian doctor might be a good idea. You say the vet is puzzled by this - that makes me wonder about the vet.



     
  11. alexanne

    alexanne Member

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    Mar 11, 2010
    Meant to ask - where are you located - I am in Ontario, Canada. Some products are different in Canada and the US,
     
  12. Shawna&Red

    Shawna&Red New Member

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    Apr 11, 2010
    Thank you everybody! You have all been great. I'm also in Ontario. I will go to the vet for other needles tomorrow. She is on the DM food but her blood sugar is still around 20. I am just so afraid to give it to her now after even less than 1 unit on Tuesday put her in hypoglycemic state. At least now she is purring and happy looking - not the glassy-eyed miserable girl she was on insulin. I am so glad I found this group! Best, Shawna
     
  13. alexanne

    alexanne Member

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    Mar 11, 2010
    When you are at the vet have a discussion about the different insulins, Lantus, Caninsulin and I hadn't heard of the one you mentioned, but that doesn't mean anything because I didn't know of it. Caninsulin has it's own needles which are market in single units - the box says Caninsulin U40. There are no half units. You must use the Caninsulin needles for Caninsulin. I am told you have to use the needles marked in halves for the Lantus.

    I think you should have the vet instruct you as to the needles for the particular type of insulin she is giving you. Also using water you should show her what you are doing and how you are injecting - my vet demonstrated with an actual cat using water - it didn't hurt the cat in any way. It would be better to have a specific demonstration and write down the type of insulin and the needles used and also write every day exactly what you have done. I have a daily diary which gives the specific time and exact amount shot.

    I am concerned that there doesn't seem to be a specific name for the insulin you use and also very vague about the amount. As you see in my last post at the end I stated the type of insulin, the type of needles, the amount given exactly - the very first mark on the needle. I hope you can get clarity on that point.

    And as I said maybe a second opinion would be a good idea.

    Best wishes from Alexanne and Peachy (Peachy is the cat)
     
  14. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    It is desirable to use the human standard U100 insulin syringes with a U40 insulin such as Caninsulin in USA Caninsuline is labled as Vetsulin). However, a conversion factor must be uses. Filling a U100 syringe to the one unit marking with a U40 insulin results in only 0.4 units of insulin being in the syringe. Thus, with 1/2 unit marked U100 syringes one can easily dose 0.2 unit increments of a U40 insulin.

    From Shawna's descriptio: "She was on Porcine insulin (2 units in U40 syringe 2x/day) but was puking all the time and miserable." it sounds like she is using Caninsulins since Caninsulin is a porcine (pork) based U40 insulin.

     
  15. Vicky & Gandalf (GA) & Murrlin

    Vicky & Gandalf (GA) & Murrlin Well-Known Member

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    Dec 28, 2009
    Not true. Caninsulin or Vetsulin can be dosed with U100 syringes. Here is the conversion chart from main FD site: http://www.felinediabetes.com/insulin-conversions.htm
    Using U100 syringes with U40 insulin allows for more accurate small doses. Explanation here: http://www.felinediabetes.com/phorum5/r ... sg-1503274

    You also don't "have to" use half unit marked syringes with Lantus or Levemir, but because those insulins often require fine tuning of doses, the half unit markings make it much easier to determine doses such as 1.25 or 2.4, etc.

    Trying to eliminate confusion on these important points. Not knowing what the differences are can be harmful to your cat.
     
  16. Maggies Mom Debby

    Maggies Mom Debby Well-Known Member

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    Dec 28, 2009
    She said she had changed to Lantus.
     
  17. Shawna&Red

    Shawna&Red New Member

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    Apr 11, 2010
    What she was on (second one) was Lantus at one unit/day -u100- and she was still hypogylcemic. So I am scared to put her back on it at any dose and she seems happy and is purring and eating whereas she was miserable and puking on any type of insulin at any dose. I'd rather she have quality of life than be miserable and sick on insulin - I have her on the DM food and she likes it. Her blood seems to have stabilised at around 19-20 which is high but not the 30s or the 1s she had on insulin. I really appreciate all your help but I can't see a way to put her back on Lantus and not kill her or make her miserable. I thought there may be some natural way to treat her that would be on here - again thanks for all your care and concern. Best, Shawna and Red cat_pet_icon
     
  18. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    One unit bid may be too much but you can dose a lot less than one unit especially with syringes marked in 1/2 unit increments. Many caretakers here administer less than one unit of insulin twice daily. My Mitten get 0.2 units bid, Thunder 0.3 units, Smokey 0.6. My Twigie some times get as little as 0.1.
     
  19. Marvie and Tugger

    Marvie and Tugger Well-Known Member

    Joined:
    Dec 31, 2009
    It *is* possible to give much smaller doses than 1unit =) I'm currently giving Tugger .10 (which seems to be about three drops or so!) There are some pictures that would help you figure out the tiny doses and the folks here can help you too. They got me through it =) I've heard that some kitties just only need a drop or two twice a day. You might find that if you go that route, it might not be long before her pancreas kicks in and does all the work on it's own, it might just need a little help while it heals or something.

    Have you checked out the canned food tables ? You might find some less expensive low carb foods that Red would enjoy. It's usually recommended to feed 10% carbs or less and the DM food is 14% (makes no sense does it?? but there it is!) They say the ideal carb content is around 5% (I feed mostly 5% and under) I think that's what a mouse would be, so maybe you can find something Red would like in that range.
     
  20. Amanda

    Amanda Member

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    Mar 4, 2010
    If I were in your shoes I would start hometesting- I am sure at this point my cat would have gone hypoglycemic on me multiple times if I were shooting insulin blindly. We haven't determined yet if she is just sensitive to insulin or her pancreas is kicking in- either way even a half a unit is way too much for her. She gets roughly .10units twice a day...so just barely able to see the insulin drawn into the syringe. If you hometest you could give her a small dose of insulin and get a blood glucose reading every couple of hours. If you see her start to drop too low you can always feed her and test again 30 minutes later...that way she never gets to a dangerous point but you know if the dose was too much, too little or just right.
     
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