Cleo 6 months- Getting worried- BG #'s too high. Not responding

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Cleocatra, Feb 8, 2020.

  1. Cleocatra

    Cleocatra Member

    Joined:
    Feb 2, 2020
    I have a 10 y.o. black fixed female named Cleo. She's ~15 lbs. and should be more like 12-13 lbs. She seemed to gain weight and get a portly body 6 months after getting fixed. She had 4 litters in her first 4 years of life living as a garage stray. We got her in Sept. 2014.
    August 2019 we started Lantus after seeing excessive thirst, appetite and lethargy and hi BG#'s. Vet put her on Lantus- 1U morning 1U in evening. BG levels were in the 400's up into 500. We didn't get the tester until late December 2019. Every 6 weeks we were ramping up the insulin by 1U per day after talking to Vet. We are now at 5U in a.m., 4U in p.m.
    Her BG #'s range from 350-525. She really doesn't curve much. I'm using the Alphatrak. Vet put her on Purina dry DM 2/3 cup / day. She's still hungry so we give her some pellets in between morning & night feedings to keep her happy.
    I'm getting very worried--- Even tho we've ramped up the Lantus, the BG#'s are not coming down. She still drinks too much. Now her hind legs are getting wobbly and she's having trouble jumping and lays around a lot. When she pees or poops, her back legs get tired and she ends up squatting in the litter and gets pee/poop on her backside. I make sure to keep her clean all the time as she can make a mess every couple days.
    Talked to Vet today. Vet will probably recommend us to a specialist. It just seems the insulin is not doing anything. The poor cat just has no energy or stamina to walk around and be a cat. When she first showed diabetes, Vet said the blood test didn't show ketones. Wondering what's going on w/ this cat and why she's so insulin resistant.
    Thoughts???
     
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  2. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019
    Hi there. Sorry you find yourself in this situation. One thing I can tell you is while feeding a dry food it is harder to get our cats regulated. I think the dry DM is still higher in carbs than is recommended- around 16% or so making it more of a medium carb food. Do you think you would be able to try and offer your cat some of the canned food and maybe switch over maybe ? Plus, it's super pricey and they are more affordable options of a similar or better nutritional value.
    Here is an article comparison that talks about the carb content in that food from a veterinarian
    https://thefamilyvet.net/blog/2012/9/26/when-is-dm-not-dm.html

    How often are you checking BGs ? 5 units is a bit higher than I would think she needs to start...my cat weighed 13 lbs and we started at 1 unit twice a day. With Lantus being an insulin that builds up in a pets system- they usually recommend getting giving the same dose ....
    Have you told your vet about the weakness in the hindlimbs....the neuropathy ?
    You can ask about giving him methyl B-12 at home ?
    Some posts that discusses the weakness in hind area
    http://www.felinediabetes.com/FDMB/threads/feline-diabetic-neuropathy-weak-back-legs.178252/

    I know it's a lot of information , but I would try and read about insulin and caring for a diabetic cat below. It will help the folks here to help you

    http://www.felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/
     
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  3. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

    Joined:
    Dec 31, 2009
    Welcome, I’m so glad you’re here. It’s the best place you could possibly be to learn about Properly caring for your diabetic cat.

    please start here and read all information carefully. You will find instructions for getting a spreadsheet set up - please do so ASAP.

    I don’t mean to sound harsh however your vet has not done you any favors these last six months.

    Get some ketostix, Which can be found at any pharmacy, And start testing your kittys urine for the presence of ketones . At this point I would check daily.

    Do you think you can transition your cat to all wet Low carb food? That would be my first step. It can make all the difference in the world.

    however I feel that you are giving your cat a very high dose of insulin. And I feel that the dry food is inflating her BG making it necessary for the high dose of insulin. So you will need to proceed with caution - plenty of folks here to help guide you.

    Do yourself a favor, and get a human glucometer. Strips for a pet meter are very expensive and you’re going to need plenty of strips.

    Hang in there and hang in here. This is where you will find folks who know feline diabetes.
    :cool:
     
  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hello and welcome. I am glad to hear you are home testing. Your vet has had you increase by larger amounts than we would here, and also has you on a poor choice of food. But we can help you get it right. Meke sure you read the yellow starred Sticky Notes at the top of this forum.

    First step, I second Sandy's suggestion to set up a spreadsheet to record your blood sugar tests, so we can help you with dosing. Here are the instructions.
    FDMB Spreadsheet Instructions:
    • Please set up a Google Spreadsheet as soon as possible. Always keep spreadsheets up-to-date! Valuable time may be lost looking for information when a spreadsheet is not up to the minute.
    • If you have not been able to transition your kitty off of DRY food yet, please note it on your spreadsheet and in your signature. A dry food diet will often require higher doses of insulin to bring numbers down. Having this information plainly visible will help us help you.
    Understanding the Spreadsheet/Grid

    After you have that spreadsheet set up, we can talk about changing food. I wouldn't change food yet. We have seen cats have a huge reduction in insulin needed when they transition to low carb wet or raw food. But we need to do that transition in a safe manner.

    Any other medical conditions you know about? How are Cleo's teeth? Bad teeth can make it hard to regulate a cat. There are also a couple other conditions that can cause insulin resistance, but we don't consider those until the cat is on low carb food first.
     
  5. Cleocatra

    Cleocatra Member

    Joined:
    Feb 2, 2020
    thank you all for your prompt replies!! I've had this argument w/ my vet about dry vs. wet. I have several cans of the Purina DM wet. We tried to transition her over, gave her gooey poops and made a big mess on her fur. This was 2 months ago. Other people have told me the same thing about wet vs. dry carb factor, and I understand completely. The dry has some corn meal in it where the wet does not. I like my Vets (2 experienced ladies in Richardson, TX) but I'm starting to lose confidence. We've been treating this since August '19 and I'm not seeing any positive response to the insulin.
    AFA the dosing, we've ramped up the Lantus very slowly- about every 4 weeks vet said to increase by 1U. I've been testing since Dec. 24- that's when I got the Alphatrak. All along, thirst and peeing has not decreased. I only got a 350 reading once- almost always high 400's up to 550.
    Last night I discovered the methyl B12 treatment on this forum. Is there any possibility that it could have a counter-effect with other health issues or insulin? Or is it just a supplement?
     
    Last edited: Feb 9, 2020
    Reason for edit: edited "Alphatrak"
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  6. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    What other health issues are you dealing with?

    To the best of my knowledge, a B-vitamin shouldn't have a negative effect on much of anything. It's used as a supplement. B-vitamins, including methyl-B12 are water soluble. Whatever your cat's body doesn't need, is excreted. Many people here order Zobaline which is specifically formulated for diabetic cats. There's no sugar in the product.

    The DM kibble has more than corn meal. It also contains soy flour and corn starch. The other issue is that it is poultry by-products versus muscle meat. It's just not a good quality food. The FDA has been (sort of) cracking down on pet food companies marketing their products as "prescription." There is nothing prescription in DM. If Cleo has been eating dry food, if you abruptly transition to a canned food, it can cause some GI issues, like diarrhea. This is a link to a site on feline nutrition that's authored by a vet, Lisa Pierson, DVM. It may be something to suggest your vets read! There is also a section on transitioning a cat from dry to canned food.

    Given the amount of insulin you're giving, please do not make an abrupt transition to a low carb diet. Cleo is on a substantial amount of insulin. If you lower the carbs in her food, her numbers could plummet.
     
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  7. Cleocatra

    Cleocatra Member

    Joined:
    Feb 2, 2020
    Sienne- you are not the only person that has told me about the dry DM having more carbs than desired. I had this argument w/ my vet, and her response was, "This stuff was developed by Dr's. for diabetic cats. They spent millions of $$'s developing this food. Don't believe everything/everyone on the internet that says bad things about this food..."
    I'm not a vet so who am I to argue w/ a trained vet???
    Right after this conversation, I switch Cleo to the canned DM. She scarfed it down for a few days, seemed satisfied, her water intake reduced ~20%ish, then had gooey poops and made a big mess. Vet said probably because it was "more rich" than the dry, and probably because I fed her too much all at once.
    I understand the need for very low carbs and good meat protein for sugarcats. Vet said cats need a bit of grain or vegetable-based matter to provide taurine for the heart. Similar to the prey a cat would eat in the wild.
    So could I transition her over to the canned DM slowly throughout the day? Shouldn't matter since it's formulated for diabetes, right? I just tested this morning 15 minutes after she ate & had a 5U shot and I got 404.
     
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  8. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    I don't know of any animal in the wild that eat grains. They kill other prey - never to my knowledge have I seen a cat or other predator killing a shrub or wheat stalk...sometimes they chew on grass...but that not for nutrition...

    Vets just don't get the training that's needed to treat feline diabetes unless their endocrinologists who specialize in the disease - it's as simple as that - I know, hard to believe - my first vet said the same thing - don't go to the internet to treat your cat - he advised euthanasia instead...so much for that guy!
     
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  9. Cleocatra

    Cleocatra Member

    Joined:
    Feb 2, 2020
    To answer your other previous questions: Cleo does not have any teeth problems. She has a big belly. She seemed to gain this girth a few months after she was fixed at 4.5 years old. Her previous owner let her free-feed out in garage where she lived. So she's gained weight ever since we got her in Sept 2014. She's up to almost 16 lbs and she's not not a very big-framed cat. See photo. She's a habitual grass eater and before the diabetes dx, she would vomit after eating if I previously let her out and she snuck into the grass.
    A few years ago I know she got a steroid shot for some lower GI inflammation and she recovered completely.
     
  10. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Your vet is painfully ignorant about nutrition. Cats are obligate carnivores. They cannot digest plant matter. The only way they ingest plant matter in the wild is from the partially digested food in the gut of their prey. Taurine, which is very necessary for cat health, is in meat, poultry, and fish. It's also found in dairy but most cats are lactose intolerant.

    Take a look at the link to Dr. Lisa's page on feline nutrition. She's got a bias but she's also one of the few vets who's put a great deal of time into understanding feline nutrition. And, FWIW, why does your vet need to know what you're feeding your cat? I had the discussion about Rx food with my vet when I returned all of the Rx food and pointed out that Fancy Feast was better quality and lower in carbs and far less expensive. She didn't have much to support her argument about my using Rx food given that carbs are the issue with a diabetic cat.

    @Sue and Luci - any animal that's an omnivore may eat plant matter.
     
  11. Cleocatra

    Cleocatra Member

    Joined:
    Feb 2, 2020
    I know, I know- I've had this discussion w/ a friend who's a cat lady, & another who is well versed on FD, (but not a vet). Her name is Shannon Latzke and she gave me the same references to Dr. Pierson. I read it all and understand about nutrition etc.
    Last time early December I put her on the canned DM for a couple days, she started vomiting and feeling bad- vet said she's got an upset GI and gave some pills along w/ acid blocker (like tagamet etc) to get her to start eating regularly again. It seemed to resolve and she did better, but BG #'s and thirst were still too high.
    So now I'm noticing for the past 7 days, her hind legs are wobbly, I told vet yesterday and she said she might be muscle-wasting. Didn't say neuropathy, which is what I think it is since her BG has been so high for so long. Then she said she might be having the somagyi effect and might be getting too much insulin.
    I feel like I'm fighting a fire w/ gasoline on ship without a rudder!

    P.S. I ordered the methylB12 Zobaline from Amazon this morning.
     
    Last edited: Feb 9, 2020
    Reason for edit: added P.S.
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  12. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

    Joined:
    Jan 11, 2010
    It may be time to find a new vet! As I understand it, "Somagyi effect" was a old theory that had little data to support it and has since been debunked (@Sienne and Gabby (GA) can tell you more about it). Try some of the "classic paté" varieties of Fancy Feast. They are low in carbs and many of the people here have had good luck with them. My "Rusty" (lived to age 20) particularly liked the FF Turkey & Giblets classic feast. My cat "Gus" likes FF T&G a lot and also likes the Sheba Perfect Portions turkey and chicken patés. Gus is not diabetic, but after caring for diabetic cats for 14 years and making every mistake in the book, I look carefully at Dr. Pierson's charts to make sure that the food he gets is low carb. Follow her guidelines on how to transition a cat to low-carb wet food.

    Once you arrive at an appropriate dose, an appropriate diet, and get Cleo regulated on Lantus, it is highly possible that her leg problems will resolve. Keep in mind the old mantra that Feline Diabetes is a marathon, not a sprint. Read the "stickies" (informational posts at the top of the Lantus/Basaglar/Levemir forum), particularly the "New to the Group". There are many informed people here who will be able to guide you in this "journey". Don't despair!
    :bighug::bighug::bighug:
     
  13. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

    Joined:
    Dec 31, 2009
    Time for a different approach.

    Since February 2008, 437 diabetic kitties, including my Black Kitty, have gone into remission based on the methods recommended here. .

    Had I followed the advice of the vets, BK would have been PTS the week he was diagnosed.

    He was the last cat anyone thought would ever be regulated much less go into remission. But he did go into remission and stayed there for the rest of his life.

    You came here for help. You are receiving excellent information and recommendations based on experience from those of us who have been in the trenches.

    Don’t waste any more time. We know what we are talking about. Take the leap of faith. You will be glad you did.
     
  14. Sonia & Leo

    Sonia & Leo Well-Known Member

    Joined:
    May 24, 2018
    Hi, welcome to you and Cleo. My kitty had horrible neuropathy, he could hardly walk and the same as Cleo had trouble standing in his litter box. I stopped listening to my vet who thought he should be euthanized and I took advice from the experienced people here about testing and dosing. I started him on Zobaline and within months he was regulated and back to jumping and running around. Stay here, you will not regret it. :bighug:
     
  15. Cleocatra

    Cleocatra Member

    Joined:
    Feb 2, 2020
    Sonia, Sandy, Ella, Sienne, Sue (no guys in here?!): THANK YOU SO MUCH FOR YOUR SUPPORT TODAY!! I'm very frustrated and edgy rt now dealing w/ this cat. I can't keep waiting and doing nothing when I know there are other options and course corrections. I don't like to indict a dr. but when I feel like I'm not getting prompt, concise and relevant information on treatment, I start getting really angry. I HATE just sitting around waiting for half-baked information that I know is not working. It happens in the human medical world too. Too much nonchalant action or inaction is not the way to fix something.
    Last at 10:45am CST, Cleo was at 503. It's like her curve is higher in mid-day than lower eating the dry Purina DM food. That last few curves and tests, it seems baseline is around 400, and then goes up from there during the day after feedings.
     
  16. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Have you thought of trying wet food other than DM to see if Cleo can handle it? DM is liver based, could be a bit rich - again not the best ingredients for any cat. I fed a raw diet, which my girl really liked. An approach you can use is just tell the vet the cat no longer wants to eat the DM. After all, cats are known to be fussy. :cat: In Canada, I have been told vets get four hours of nutrition training, often by Hills. :rolleyes:

    I think we can all relate to some frustrations with our vet. I liked mine, had gone to her for years. But she still prescribed the wrong insulin at first. A locum Vet got me on Lantus. The first couple weeks I talked to my vet about the Lantus dose, then I just printed off the dosing methodology and told her I was following that. And gave her some printouts of the spreadsheet the first little while. Eventually our interaction about diabetes came down to her asking me the current dose, and that was it. I still dealt with her for everything else. My vet did not suggest PTS at first, I think she was just relieved when I said I wanted to treat the diabetes. I was also the first client to home test. We learned a lot together.
     
  17. Cleocatra

    Cleocatra Member

    Joined:
    Feb 2, 2020
    yes I think the DM has chicken hearts and liver, which might be why she had the poopies 2+ months ago when I tried switching. Starting today, we are transitioning her over, but slowly this time. And might try the recommended Fancy Feasts canned.
     
  18. Cleocatra

    Cleocatra Member

    Joined:
    Feb 2, 2020
    Here is curve yesterday 2/08/20 feeding all dry Purina DM:
    7:00am before 5U shot & DM dry food 441 | 10:30am 461 | 1:45p 477 | 5:45p 392 | 6:00p 4U shot & dry DM | 10:15p 559

    So today I tapered off the dry DM food to maybe 4 rounded tbsps all day of the Purina dry DM pellets. Gave her the canned Purina DM + some canned StarKist tuna in water (rinsed w/ warm water to remove excess salt).
    Here are BG#'s for today 2/09/20:
    7:45a 404 rt after 5U shot & 1/4 cup dry DM food.| 10:45a 503 |11:00a 2 tbsp canned DM food | 2:15p 324 | 6:00p 366 before dinner & 4U shot | 10:15p 472

    I know I'm inconsistent w/ my timing but it's close. Looks like we got a better drop in the afternoon today after giving her mostly canned food. Plus she hasn't been drinking and peeing as much since mid-afternoon.
    I will work toward getting her back on 100% canned food. We've got lots of the Purina DM canned and she used to eat the FancyFeast. I think that dry DM is just too much carbs even tho it's listed as only 13%.

    Seems her low point or nadir is mid afternoon.
     
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  19. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Do you need help getting a spreadsheet set up? We won’t be able to comment much without it. All I can say looking at both curves is ”the numbers are still too high”. Even in cats better regulated, there can be a lot of variability between cycles.
     
  20. Cleocatra

    Cleocatra Member

    Joined:
    Feb 2, 2020
    Cleo eating ~70% canned food, 30% dry Purina DM to help make the transition to all canned food. Right now, I'm giving her some drained tuna as a low-cal, no-carb supplement/snack. Have an appt w/ VCA Animal Diagnostic Clinic in Dallas, TX Thurs. 10am. Her BG#'s seem to be coming down a little since switching over to wet food but she still hits a 500 early or late. She was 401 this morning before shot & food. Gave her a some food at 11pm last night to stop from getting my ankles nipped!! This cat is very demanding! But her hind legs are still wobbly and we had a sh!t-show last night when she squatted down into the poop and then smeared it all over the house. Another trip to the bath tub at midnight. Sheesh!
     
  21. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Could you please start a new condo/thread today? A new post would start like this:

    Date / Cat Name / AMPS

    Thank you!
     
  22. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    I don't care about a new thread for today. What I do care about is a spreadsheet. Please get your spreadsheet set up and enter your data. This is the link (again) to the spreadsheet template. (<-- Click on the link in bold to the left.)
     

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