Newly diagnosed kitty on high insulin dose

Hi everyone,

I made a post on the introduction board, but here is what Mitsy (age 9.5) is on. This diagnoses came after she was peeing on the floor, pawing around/dumping her water dish, not grooming, and acting zoned out for about a month (I took her in earlier but they chalked it up to "behavioral issues" the first time).

She was diagnosed Monday and was started on 2 units twice daily of Vetsulin. The vet had me drop her off daily for sugar testing/monitoring. He increased the dose to 3 units, and then finally on Wednesday night had me go up to 5 units.

I do agree that it's a little high - last night she seemed shaky after her dose so this morning I went down to 3.75 units. The vet said there was no need to home test her sugar - just take her off the insulin if she starts "acting weird" and bring her in. Of course I don't agree with that and am going to get a monitor this weekend. I have no experience testing sugar however so I am going to have to figure it out!

I do notice that she is VERY vocal for about a half hour after she gets her insulin. I don't know if that is normal or just something she is doing now since she was so zoned out for a month.

The good news is that she started peeing in the litterbox again and has continued for two days. So I know she is feeling better. I'm just concerned about the high dosage.

She now eats Fancy Feast pate at night and in the morning. My cats have always had access to dry food at all times, so I haven't taken it away yet (I have two cats total). Plus I didn't want to drastically change her diet until I get the monitoring device because I don't want her sugar to get too low - especially with this high dose of insulin.

I think that is everything in a nutshell. Thank you in advance for any advice, as I am totally new to diabetes!

Edit: I forgot to add that she is on Clavamox. He put her on that on Monday and said to use it until the bottle is gone. Also, when they thought it was behavioral issues, they had her on Amitriptyline. He told me just to stop that (which makes me a tad nervous since I am also on amitriptyline and tried to cold turkey it once and the withdrawal was TERRIBLE - but she was only on about 2 mg so hopefully she will be okay).

 

Welcome! I'm going to give you a "handout" I made for new members that summarizes a lot of key info. Read it through and ask a lot of questions:

It would help us if you set up your signature (light grey text under a post). Here's how: You've already started this. There are a few other helpful details to add.

• click on your name in the upper right corner of this page
• click on "signature" in the men that drops down
• type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.

Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and look at it before offering advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

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Here's the basic testing routine we recommend: Home testing is key to keeping kitty safe.

1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
3. do extra tests on days off to fill in the response picture
4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
5. post here for advice whenever you're confused or unsure of what to do.

This is useful: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

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Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high: This is a common phenomenon and can make it hard to evaluate a dose without testing data on a spreadsheet.

1. BG goes low OR lower than usual OR drops too quickly.
2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.

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Here are some tips on how to do urine ketone testing (VERY important if BG is high and kitty isn't eating well!): Highly recommended, especially if kitty isn't feeling well.

• put the end of the test strip right in his urine stream as he's peeing
• slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
• put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.

Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.

 

When Jaxa started on insulin we started at 2u and gradually the Vet was suggesting 5u; someone more experienced here will jump in and explain more thoroughly I'm sure, but I learned from the people here that it is better to go up in tiny increments (like 0.25u). It is super important to be home testing too. It sounds scarier than it is, and of course every cat is different, but home testing can save your cat's life. Some monitors and strips are not so expensive, and it is good to always have some extra test strips and lancets on hand just in case. It is good to have a Hypo kit prepped in advance too, and there is a stickied post with the details on what to do.

If you want to continue having dry kibble out for both cats there are a few low carb options, but they can be a little expensive. Young Again and Dr. Elsey's will both send free samples if you ask (and Dr. E has wet food too- they sent me a sample of wet and one of dry.)

When we first were diagnosed it was really overwhelming, but it does get better and pretty soon you know all the terms and what to do (or who to ask for help) in an emergency.

 

I would suggest dropping that dose to 1 unit until you get the hang of testing. It's better to be too high then too low. Here's our info on preparing for hypoglycemia.

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

I have a video in my signature showing how I test my cat CC at home

 

I agree! I did irreversible damage to my Woody after I was giving 13 units to him, per the vet's directions. The only way I didn't lose him was because I was free feeding Hills Prescription w/d. Please go down to 1unit until you get some numbers on a spreadsheet. I know it's hard to follow people's advice that you've never met, but I would have lost Woody if not for this group.

 

Do not stop dry food until you are testing, the blood sugar could plummet quickly. I would give less than 5 units since you notice some questionable symptoms.

Also so your aware Vetsulin at 5+ units can sting or burn. My previous kitty became aggressive on 5 units. Something to keep in back of your mind.

 

Hi Rosa! I saw Bron's tag on your intro post, so I came to find you here. It looks like you've gotten great info so far, so I won't repeat it. Please let us know what other questions you have. We're happy to help!

 

Question to you all - I was going to order the AlphaTrak meter until I saw the price of the test strips (yikes!). I know some people have said they use human meters...what meter(s) would you all recommend for home testing?

 

I use an Alphatrak and keep costs down by using insulinx strips part of the time. I get them on eBay for $10-12 for a box of 50.

Many on here use Walmart brand Relion micro or confirm meter.