Vetsulin since March. No change in BG - at 450s.

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Kerrison, Jul 9, 2018.

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  1. Kerrison

    Kerrison New Member

    Joined:
    Jul 9, 2018
    Newbie here, though I've been dealing with a diabetes regimen for 5 months.
    I will appreciate any thoughts/support you might have.

    I'll try to make this as brief as possible.

    End of June last year, I adopted Seely, from the local SPCA. He came with a small weepy pore on the bridge of his nose but a clean bill of health from the SPCA. Seely is of unknown age and breed- though he looks/feels like a Russian Blue. Over 10 and a LARGE cat (leggy and long- and was underweight at the SPCA at 14 pounds. He's 17 now and healthy for his proportions.) He was being fed Friskies at the SPCA.

    The pore on his nose turned into a nasty growth. My vet said "I don't think its cancer. Just get it removed when you can afford it." I was able to afford the surgery in February.

    He made it out of surgery fine but they did blood before the surgery-- his pre-surgery BG was 300. This was on a 12 hour fast.
    This was after a 2 hour car ride to the surgical center, so I chalk most of that up to stress. But the Vet diagnosed him as Diabetic with that blood reading.

    As well, the bioposy came back on his growth removal as Large Cell Lymphoma. I am not financially able to pursue Chemo plus - even if I did want to, I'd need to get his BG under control FIRST before they'd start treatment. Surgery did not get clean margins. The cancer is in his sinuses.

    All of the diabetes symptoms occurred AFTER his surgery. They are, I believe, a reaction to the anesthesia. Pre surgery: He would request play for 3 hours every day, snuggle every night under the covers. Now he has NO energy to play at all - not even bat at a string, and he overheats to the point of sprawling on the hard-wood to cool his body. He cannot snuggle b/c he gets too hot.




    Onto the diabetes...

    We started RX food immediately and my vet prescribed Vetsulin for him. We started at 2 units 2x daily. March 1.

    We tried all 3 Rx brands in my area for food, and he would ONLY eat the Purina Rx wet food. But he experienced GI upset on that food. Discomfort, constipation, bloating, etc. I finally started to give 1/2 Rx and 1/2 Friskies JUST to get him regular. He improved and finally started eating around the Rx and only eating the canned Friskies.
    So I'm not wasting $$ on the Rx anymore. It hurts his belly and he won't eat it. We're back to Friskies.

    I supplement his meals with chicken 2-3x a week to provide increased protein.
    I have asked my vet about home-cooking meals with Balance it and she has repeatedly said no.

    I have an Alphatrak 2 on loan from a friend and don't test daily anymore, b/c the readings don't really change! But I do test when he looks like he's abnormal and usually for a day or two after a 'bad day' just to watch it.

    His readings currently average 430-450 at mealtime/shot-time and about 10-20 points lower about an hour later. About 3 hours after shot time, its only about another 10-20 points down. So there's NO real impact from his shot.

    He is still on vetsulin at currently 6.5 units.
    I have asked the vet repeatedly if there's a different brand we can try (on passing suggestion from several vet tech friends.) She will not change his Rx.
    She said he will be declared IR at 10 units.

    He was initially flooding the litter box post-surgery. When his insulin is over 500 (which happens.) he sucks down water and floods the box. When his insulin is low 400s, he urinates like his normal. We have tested for DKA 2x on over 500 BG - no DKA.

    July 7th, he was in the kitchen waiting for me to put down his food, he turned around quickly and stumbled on his hind end. I've never seen him do this before. Scared the *** out of me. BG at 453

    July 8th- he had his food and his shot and about 5 minutes later, he came out of the kitchen looking glassy eyed and lay on the floor near my chair. His right front arm was twitching just a bit. It was noticeable like he was twitching his skin to get something off (thin: fast-twitch muscle on a horse trying to get a fly off.)

    I got on the floor with him. His respiration was quick and shallow but not scary. I started petting and he settled right down into normal resp. Arm stopped twitching. There was nothing visible to cause irritation.

    I tested his BG = 472. Waited an hour. BG = 460. He seemed fine in all other ways.

    This morning ,July 9, while walking on my bed to wake me up for food, his back leg stumbled again - I couldn't tell if he was lazy and drug the foot and it got hung up on the comforter- or if he is having balance problems.

    He is eating, drinking, peeing, pooping just fine. I can SOMETIMES inspire him to try to play. He purrs for attention, loves to hold hands and just 'be' with me. He gets brushed 2x a day and thinks that's the best thing ever. He's usually active about walking around the house,etc,
    but the last 48 hours he's been less 'walking around' and more 'lay on the floor and chill.'

    He does NOT feel well. He has NOT felt well since the surgery when his diabetes came on. We're at the point where I can tell what his BG is by his behavior/attitude and how hot his ears and arm pits are.

    I have an appointment tomorrow with a new vet who is open to a new insulin if she feels it appropriate.

    I am financially strapped so... the cost of Lantus (etc) is scary to me. It is especially MORE Scary if I will spend $300 on insulin only for this 'stumbling' and 'twitching' to be seizures and he'll be gone in a week.

    I don't want to euthanize at this point- that day is coming soon enough from the cancer. I don't want to speed it along b/c of the diabetes.

    HOWEVER if I'm misreading the signs, I need some impartial parties to tell me that. (That's you guys.)
    ...


    I ran home to check on him at lunch. His BG was 432- up from breakfast, of course. He's acting OK. Just a bit 'off' (like he's stoned or something.)
     
  2. Harley Baby & Michele

    Harley Baby & Michele Member

    Joined:
    Jun 3, 2018
    I am so sorry to hear about your struggles. Write down a list of questions for your new Vet visit. I tend to close up under stress and forget everything I wanted to ask. Below is a link to read about feline lymphoma. It does indicate that some of the symptoms Seely is having may be related to the cancer. I totally understand concerns about treatment costs. We can only do what we are able as bitter sweet as that may be. Love Seely and keep him comfortable. He is blessed to have found a home with you.


    http://www.theoncologyservice.com/assets/pdf/Handout-FelineLymphoma.pdf
     
  3. Harley Baby & Michele

    Harley Baby & Michele Member

    Joined:
    Jun 3, 2018
    FYI: if you decide to treat with Prednisone as suggested in that link above, be aware that Prednisone can shoot blood glucose very high. Please confirm that info with your Vet.
     
  4. Kerrison

    Kerrison New Member

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    Jul 9, 2018
    Exactly why we have not started that course, yet. Thank you for the reminder, though.

    The goal was to get his BG Under control then begin Prednisone.

    Unfortunately my vet has not been open to trying new insulin and I have been a bad mom by not switching vets sooner.
     
  5. Harley Baby & Michele

    Harley Baby & Michele Member

    Joined:
    Jun 3, 2018
    You are NOT a bad mom!! You are a wonderful person for adopting an adult cat and slightly less than perfect (nose wound) from a shelter.

    We should be able to rely on the recommendations, training and experiences of professionals (in any field). Unfortunately, we often come across professionals who do not give us the best advise or care. Who knows what the reason for that is. If/when you are ready to wander around this forum you will see that many people have been given bad advise by their Vets.

    I am newish to this forum and have received a tremendous amount of information and support. I encourage you to continue posting your questions and concerns as someone may be able to help.

    Also, notice that there are insulin specific forums if you have insulin questions.
     
  6. Kerrison

    Kerrison New Member

    Joined:
    Jul 9, 2018
    thank you.

    I guess I'm still unclear as to why his BG would rise AFTER giving insulin as it did for 4 hours this morning. He read in the 300s at breakfast and 400s at lunch. (This is not the first time that's happened.

    I just tested 6 hours later and his BG is holding at 432.

    Gave his insulin, food, and some snuggles. Not in that order.

    I hate watching my kiddo not feel good.
     
  7. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Have you had his teeth checked?

    The stumbling is neuropathy. That will get better with a combination of better numbers and adding b12 methylcobalamin supplements to the food. Many of us use the brand zobaline from Amazon.


    I think your cat may have glucose resistance and you haven't found the best dose yet....

    Can you please set up a spreadsheet like the one you see in our signatures? Here is the template. It will help us better see the numbers and what's going on.
    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

    The Friskies.... You are only serving pate, right? Nothing with gravy?
     
  8. Kerrison

    Kerrison New Member

    Joined:
    Jul 9, 2018
    I prefer to serve the pate. But he does protest and hunger strike until he gets gravy. Probably about twice a week.

    It doesn't seem to have a direct impact on his BG readings.
     
  9. Kerrison

    Kerrison New Member

    Joined:
    Jul 9, 2018
    The new vet was delightful. I felt "Heard" In a way I have not felt at my previous vet- and I had just chalked it up to me being ignorant. (You have horse issues? I can help. Small animal vet stuff? Baffling.)

    The vet's going to make some calls to get second opinions on which of the insulin options out there will be the most effective and the correct dosing. Her gut says Lantus/Glargine but she wants to get outside opinions to make sure. She wants to administer the first dose with him in the clinic so she can conduct a curve and make sure he doesn't go Hypo. (Something the previous vet didn't do. I got sent home with a vial, some needles, and instructions. This was before I had a monitor on hand, too. This now terrifies me.)

    She was very approachable and did say while it is possible the neuro symptoms from Sunday/monday are related to the cancer having spread, it is also possible that they're due to BG being unregulated. We will treat the BG and, assuming we can regulate it, we'll see if that prevents any future neuro symptoms. If so, that'll be indicative that it was BG related.

    Seely is feeling MUCH Better today vs yesterday. His walk is stronger and his attitude is back to normal. (Polite snark and sass but full of love.)

    ... despite his BG being 450 last night and 502 this morning. He feels better at 502. He's clearly crazy. But I'm still thankful he feels better. :)

    Vet is going out of town for a week but I suspect I'll know more before she leaves town and they can admin the insulin and the curve while she's not present and the other vet in practice can monitor.

    Fingers crossed.

    Now i have to figure out how to afford this stuff!!
     
  10. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Many here buy lantus from Canada from Marks Marine pharmacy for about half the price you get it in the US.
     
  11. Kerrison

    Kerrison New Member

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    Jul 9, 2018
    Thank you.

    I have also been told that there's a Walmart Pharmacy locally which will split the Lantus Pen box and sell individual pens. That, plus the lantus coupon I found online (which I hope works!) is what I'm going to try first.

    If the Lantus regulates him enough to continue on with the Rx, I'll start using the above mentioned place to save some $$. Thank you for the referral!
     
    JanetNJ likes this.
  12. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    With those kinds of numbers it sounds like he needs another dose increase.


    If it makes you feel better my cat didnt see any numbers in the 200's the first 2 months.
     
  13. Kerrison

    Kerrison New Member

    Joined:
    Jul 9, 2018
    Vet and I did discuss increasing his Vetsulin as opposed to the large cost concern of the Lantus. However his readings have been going UP steadily with every Vetsulin increase. (We started high 300s, now we're mid 400s and have been increasing from 2 units since March.) So if I bump him to 7 or 8 units (etc) then there's no indication the vetsulin will reduce his BG... hence why the current logic is to try a different insulin.

    The discussion today was that if Vetsulin was working even a hair, we'd we more likely to see numbers drop maybe 10 points consistently every increase. Not a huge drop in BG, but SOMETHING to acknowledge his body was processing it at all. Instead, the opposite is happening. We increase his insulin and the BG goes up. So his body is either probably not responding at all to the Vetsulin.

    Vetsulin is more affordable so I'd certainly prefer to try something cost effective, but I worry about the continued tax on his body being unregulated. He's just unhappy. :(
     
  14. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    If you get the lantus through marks it is more cost effective. You could get a years supply for about $160. I am talking about a dose increase in the meantime until you get it.

    Other conditions can cause the insulin to appear not to work. The past few weeks my own cat went from 2-3 units to needing 6.25 because she had a few bad teeth. (She's on vetsulin too) I had them extracted on Friday.... Today is my first full day home with her (she stayed at the vet while I was on vacation) and already I'm finding I need to lower her dose (going to give 5.25 tonight).
     
  15. Kerrison

    Kerrison New Member

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    Jul 9, 2018
    Sorry I didn't read that the first time!! *DOH!* SO sorry. :(

    Yes, but I'm due for a refill and almost out of insulin as it is b/c I kept getting delayed on my appointment.

    I'm in a pickle, sadly.
     
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