Hungry all the time and still losing weight

[Ken S]

Sadie was diagnosed, 1/4/2020, she is a small framed kitty, who has been at her ideal weight 9lbs, for about the past 4 years.

We are on vetsulin 1 unit twice a day. Due to her recent weight loss, our vet has told us to feed her all the wet FF she wants. She will eat 8-10 cans in a 24 hour period.

My question is: how can 1 unit of vetsulin 2 times a day keep pace with this much food intake, even if it is low carb.

We made a visit today to the vet 2 hours after her AM injection and only about 1 hour after eating. Her BG was 256, the vet said that is a good number considering her time of the last injection and her last feeding.

She eats nearly every 2 hours, how can the vetsulin keep her BG in the good range, which I understand is 80-150. How can 256 be a good number? If this was a person, wouldn't that person give themselves an injection?

I am skeptical that her diabetes is being regulated at this time...

Any thoughts on this?

 

[Juls and Billy]

Hello Ken.

Honestly, if she is underweight, I think you should feed as much as she wants. Here's the thing, as long as her BGL is not regulated, she isn't getting everything out of her food that she should. Instead of being able to properly utilize all of those calories, a lot of them are going to end up in the litter box. Once her BGL is more regulated, and she gets back to a healthy weight, that's when you should consider limiting food.

Consider my cat Billy for comparison. (Keeping in mind that every cat is different.) He is fat. Super fat. 26 pounds. While we were working on getting him under regulation, we fed him whenever he was hungry. He is now in remission and still 26 pounds. Now that he's regulated, we are limiting Billy's food so we can get him to a healthier weight. Yes, we could have tried to do both at once, but we wanted to concentrate on the diabetes first. It was a personal choice. The calories he was eating did not effect his treatment in the way you are thinking, and while amount of dose can change over time, diabetics generally don't add additional doses.

With an underweight cat, I think feeding when hungry is super important. There are more experienced members than me though, and I'm sure they will be in to advise you.

It takes time to get regulated, and you are working with a handicap. Vetsulin is not the best choice of insulin for a cat. For the most part, Lantus or ProZinc are better choices. Lantus is a depot insulin and ProZinc is a longer lasting insulin than Vetsulin. Both seem to give cats a better chance at remission.

Not that all cats go into remission, though many do. A diabetic cat can have a long and healthy life even if they are on insulin for he rest of their lives.

I hope that helps. And you might want to take a look at this thread New? How you can help us help you! to see how you can get more detailed advise from members in the forum.

 

[Sienne and Gabby (GA)]

Juls gave a good explanation. Insulin is what helps to move the end product of metabolism (i.e., glucose) into the cells. If your cat's pancreas isn't producing its own insulin, the glucose is floating around in the blood stream and not getting into the cells. As a result, your cat is literally starving. It's why so many diabetic cats lose weight.

What a vet considers a "good" blood glucose (BG) range is typically higher than the range we shoot for. Regulation here means your cat is in normal BG range (i.e., 50 - 120) or at the very least, below renal threshold (roughly 200). Vets often don't encourage these lower numbers since they are concerned if a cat drops into a very low range. Frankly, we wouldn't encourage lower numbers unless you are home testing. And frankly, Vetsulin can slam numbers down quickly so I would urge you to consider home testing if you are not already doing so.

If I may offer a point for discussion with your vet. There are other insulins which are recommended for managing feline diabetes. Prozinc and Lantus have been recommended by the American Animal Hospital Assn in their guidelines for the treatment of diabetes for several years. (I linked the 2018 guidelines.) These two insulins are gentler and have a longer duration than Vetsulin. There is a good chance your cat will do better on either Prozinc or Lantus.

 

[Deb & Wink]

My question is: how can 1 unit of vetsulin 2 times a day keep pace with this much food intake, even if it is low carb.

It likely can't. But insulin being a hormone, it takes time to adjust and find the correct dose of insulin for your cat. Increasing the number of injections a day would be very dangerous, as the duration of Vetsulin in cats varies with each cat. Duration is usually somewhere in the 8-12 hour range. But you need to find the duration for YOUR cat. More shots of insulin a day, would mean some overlap and very dangerous chance of hypoglycemia.

Never give more insulin in the same dosing cycle. Never. Not even if you think you only partially injected the insulin or had a "Fur Shot", where some of the insulin went into the fur.

We made a visit today to the vet 2 hours after her AM injection and only about 1 hour after eating. Her BG was 256, the vet said that is a good number considering her time of the last injection and her last feeding.

Onset for Vetsulin varies for each cat. NO way to tell if the 2 hours after the insulin dose was given was the beginning of the onset time for Sadie or not. Plus, their would be some food influence, from her eating 1 hour earlier, in that test done at the vet. And very possibly some increase in BG readings due to "vet stress."

What was the blood glucose (BG) reading before you gave Sadie insulin for the morning?

256 is not a horrible number. It could be so high that it is over 500, 600, 700. Nor is that 256 the best it can be.

She eats nearly every 2 hours, how can the vetsulin keep her BG in the good range, which I understand is 80-150. How can 256 be a good number? If this was a person, wouldn't that person give themselves an injection?

NO. Not if they had already given themselves a shot of insulin for their predetermined shot time, (AM or PM). Not unless they want to risk overdosing themselves with insulin and causing hypoglycemia.

Vetsulin is going to have more of a V shaped curve. Dropping more steeply after the shot of insulin, maybe bobbling up a bit with a food spike, then going down a bit, a bit more, down more and then up a little bit with more food. Spiking back up more quickly after the middle of the cycle until the start of the next 12 hour period. The rising part of the V.

Feeding after about mid-cycle means the insulin has basically been "all used up" to process the food eaten earlier in the 12 hour cycle. If Sadie will eat more early in the cycle, say before +5 or +6, that could keep the BG readings from shooting back up in the last half of the cycle and being really high.

There is also bouncing to consider.

Treating feline diabetes is a slow and steady process. It took time for Sadie to become diabetic. It will take time to get her better.

Have you ever considered home testing?

 

[NancyF]

Thank you for this info. Georgie was a 30 lbs cat and we had been trying him to lose weight. Then suddenly he was losing weight so fast! That's when we took him to the vet and found out he was diabetic. The vet said he could eat as much as he wants, and that concerned me too. Shouldn't he be thinner? He's gained quite a bit of weight back quickly, and I was also wondering if I shouldn't be limiting his food intake. But was worried that if I did, he may go into insulin shock. He's on Caninsulin, but this forum seems to think it's not a great kind of insulin and I've already decided to talk to my vet about this on his next visit. I need to bring him in for his first curve test within the next couple if days and also intend on discussing home curve tests, for both our stress levels.

 

[Sienne and Gabby (GA)]

There are cats that do fine on Caninsulin/Vetsulin. As I noted, there are other insulins that the veterinary community recommends over Caninsulin.

If you're outside of the US, it's fairly common that vets will start a cat on Caninsulin. (And from the name, you have probably guessed that it was originally developed for dogs. Cats' metabolism is faster than dose which is why is not recommended these days.)