New member 12/1 - new to feline insulin

Hello,
A few months ago (around May) my cat was diagnosed with sone conditions enclosing diabetes. The vet said to do 1 unit of Lantis. We did that, took him to get a curve a few times which he hated, tried the Lebra which didn’t work, and now we have the home kit that we do a curve like every other weekend. The results are in the 600s for the most part. Since we started doing this at home around September the vet increased his dosage from 5 units to 9 today. On Facebook someone told her that was to high, but the vet said she has seen animals up to 15 units or more. Now she is worried we are doing the wrong thing.
Another problem with him is he doesn’t want to pee in the litter box. This we were told is normal for diabetic cats. Does anyone have any suggestions to get him back in the box? We have pads down but he goes though 4 or 5 a day. The litter is tidy cat instant action or the one with the black lid. Someone says the pellet litter so we may try and get that this weekend.
Any help from a person with more experience would be awesome cause we are out of ideas.
Louie is 14 years old and also has a heart condition. He eats purina weight management and hills light food with some crunchy urinary SO since that was part of his old diet.

Thanks in advance,
Steve

 

Hi and welcome Steve and your kitty..name?? I am so glad you have joined this forum.
There are lots of things we can help you with but first......
Please no not increase the dose from 5 to 9 units...that is insane and dangerous!
Yes there are some kitties that need more insulin but they have other conditions that makes the need for insulin greater. These conditions need to be tested for and confirmed. I think part of the reason your kitty is needing more insulin is because of the diet he is getting. More on this later...

Here is what I would do in this order

1. I would start hometesting the BGs before every dose of insulin and then again during the cycles. The reasons for this are...we need to see what the BG is before giving the dose to see it is safe to give it and then when you take the BG about 4 to 7 hours later, vary the times, we can see how well the dose is working. Lantus dosing is based on the nadir (lowest point in the cycle) not the preshot BG.
2. Set up a hypo kit if you have not already done so. I will put a link below with information to new members below and it is in that.
3. set up a spreadsheet and enter all the data so we can see it and help you with the dosing. We can't help without data. I am going to tag @Bandit's Mom and ask her to help you set up a spreadsheet asap so we can start seeing the BG numbers
4. Once we can see the BG numbers and what they are doing...I would recommend you change the food to a low carb wet diet. The food you are feeding is high carb and not suitable for diabetic cats. But please do not change the food over to low carb until you are doing regular home testing of the BGs and we can see the numbers and can guide you with the change over of food. If you change over now and still give the same dose, you risk a hypo.
5. I would recommend testing the urine for ketones. To do this you need a bottle of Ketostix which you can buy from Walmart of a pharmacy and follow directions on the bottle. There should be no ketones in the urine. If there is more than a trace, inform the vet.
6. Have you had the urine tested to see if he has a UTI?
7. When you are testing and giving the dose of insulin you do it in this order...test/feed/shoot
8. Are you giving snacks during the cycles as well as the preshot meal. We recommend giving 2 or 3 snacks during the first half of all cycles.

What type of glucose meter are you using?

HELP US HELP YOU has links to the hypo kit, spreadsheet, signature and more.
Keep asking questions. We are here to help you.
Bron

 

Hello. Thanks for the reply. This is a lot to go through. Real quick though the increase wasn’t all at once. It was gradual over the last couple months. Like every couple weeks by 1 unit.

 

We recommend increases of 0.25 unit increments so you don’t go past the best dose and it is much safer for the cat.
I would recommend you start testing every day so you can see what the insulin is doing. Only doing a curve every other weekend is missing a lot of data. And a cat can go from a BG of 600 to a hypo in a cycle (12hours).
Would you like some help with the spreadsheet?
I thought I had attached a food chart for you but didn’t. Here is the FOOD CHART
Look for foods that have carbs of 10% or under. Most of us feed 4 to 7% carbs.

 

1. we were not told to do it every day anymore so we don’t. They said a curve would be ok
2. We do not have a hypo kit. Didn’t get to see what is in that. They just said if he looked out of it rub syrup on his lips
3. We have spread sheet when he eats but since they said not to test everyday we haven’t added that
4. They said the weight management food was good for this. We can look into changing food.
5. We cdd as n try that too!
6. They have tested for uti multiple times. Always negative
7. We feed him then wait about 15 minutes to give shot. When we do the curve we go about every 2 hours starting 2 hours after he eats breakfast
8. He has his portion of crunchy food out all day. At meal time hr just wants soft food.

What type of glucose meter are you using? Alpha track that we got from chewy.
Thanks again for the help.

 

Would you be willing to look at testing before each dose and again during the cycle? Just testing every couple of weeks doesn’t really tell you what is happening for the other 13 days. He could be dropping low during those days. Every day is not the same as another when on insulin.

I would strongly recommend you set up a hypo kit. I’m glad you have honey but having some wet higher carb food is needed as well. Have a look at the hypo kit we have set up in the link I gave you. By the time a cat is showing signs of a hypo they are really low. By hometesting we can intervene before this with food and stop the BG dropping too low.

The spreadsheet I am talking about is for the BGs.

Weight management food is too high in carbs. It would be very risky to swap over to a low carb food without testing as it can drop the BG by 100 points.

With Lantus there is no need to wait after feeding to give the dose. Yes you are doing the curve correctly.

 

Welcome to FDMB!

I'd like to make a suggestion. Think about having a diabetic cat much like you'd think about having a young, diabetic child who really isn't old enough to communicate how he or she is feeling. You would have to rely of blood glucose tests to inform you if levels are either high or low. Any pediatrician/pediatric endocrinologist would insist that you test your child's blood glucose before you give insulin and likely that you test at least one other time between shots. Not testing before giving an injection risks giving insulin if numbers are low and you cause an episode of hypoglycemia. Having tests during the cycle informs you how low your dose of insulin is bringing your cat's numbers and whether you need to raise or lower a dose. In addition, having all of the data helps you to understand your cat's patterns of insulin response. Getting a curve every so often doesn't give you those data. For example, testing and seeing a 600 isn't truly informative. What were the numbers within the previous 3 days? Did your cat's numbers drop into a much lower range and what you're seeing is a reaction by your cat's liver and pancreas to the lower numbers. (As an example, my kitty started a cycle at 400. I tended to test a lot and found that her numbers dropped into the 40s and then bounced back to the 400s by the next shot time. If all I saw were the numbers in the 400s, I would have increased the dose. However, the drop to the 40s required a dose reduction.)

All of the foods you mentioned are high in carbohydrates. This is akin to feeding your diabetic cat a steady diet of cookies and ice cream. Cats are obligate carnivores and can't process carbs. In addition, carbs are basically sugar and that's the last thing any diabetic needs. It's also why you are seeing such high blood glucose numbers. There are excellent low carb foods. Further, canned food is much higher in moisture which is good for your cat. If you want to read more about feline nutrition, Lisa Pierson, DVM's website is an excellent resource. There is also a chart that's linked on the menu bar on the right that lists most of the canned foods available in the US along with information on the amount of carbohydrates.

How can we best help you get your cat's diabetes better managed?

 

I agree with what both Bron and Sienne already said about testing and the food being way too high in carbs. However, I wouldn’t make any diet changes until you’re home testing because that alone can drop his bg significantly especially on such a high dose. I understand the urge to follow your vet’s advice because we think of them as experts. Unfortunately, most vets out there are not caught up or up to date on how to best treat feline diabetes. I went through 3 vets before I found one that agreed I should be home testing. My Minnie was only regulated because of all the amazing advice I got on this forum. I don’t even like to think about what would have happened if I had relied on vets’ guidance alone.

Just wanted to give my feedback because I’ve been where you’re now thinking I can’t home test her daily, I’ll just do what the vet is saying. It’s easier and they know best so why not? Sadly, like many human doctors too, you end up having to do your own research and having to advocate for what’s best for your pet or child.

we can help you!!

 

Sorry it took so long to respond.

 

Hey, thanks for the info.
We were doing the test this way, like I said earlier, because that is what we were told.

The vet mentioned a diabetic food from purina. I think it was called DM. We didn't get any yet as we just got that info. I'll read through that link too.

The info I got has been good and anything else that we should know is also good.

One question about the testing is. You think I should do the test at least 3 times a day? How do you afford the test strips? Is there a way to get them cheaper then a dollar a piece?

 

The only way to get strips that are inexpensive to to not use an AlphaTrack! Many of the members here use the Walmart Relion brand meter. I believe the strips are under 20 cents each. Any human meter is fine and the strips are less costly than a pet-specific meter. You can price out strips online at ADW or by a Google search. Vets like the pet meters because the numbers are calibrated to be similar to a serum chemistry analyzer. The reality is that vets used human meters before pet meters became popular (and I'm guessing the vets don't realize what the strips cost).

The canned DM is an acceptable food carb-wise. It's not a particularly good food ingredient-wise. It's primarily meat by-products. For the price, there are far better quality canned foods that are low(er) in carbs.

 

Relion prime classic meter. 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

Relion prime classic test strips 17.88 for 100 strips
https://www.walmart.com/ip/ReliOn-Prime-Blood-Glucose-Test-Strips-100-Count/38423728

 

You should always test before giving insulin in the AM and PM to be sure the BG number is safe enough to shoot. Definitely get another test at mid cycle which would be at +6 for both cycles . It would be better to get some note tests in at different times to see how the insulin is working
Lantus kicks in for most cats around +2 so when possible grab a +2-3 test.

 

I used the ReliOn meter and strips. Most of us here do. It’s way more cost efficient and just as reliable.

can you do us a favor? If you can like our comments to let us know your read them, it would be super helpful so we don’t feel like we have to repeat the info. Thank you so much!

 

Sorry for not liking post. I have been reading everything!

Over the weekend we did a few test as per the vets request. All were super high again. We haven't heard back from them about what to do next.

Here they are:
10:37 am - 637
12:26 pm- 585
4:04 pm - 569
7:31 pm- 507
Insulin at 8:02 am and 8:13 pm
Food at 7:29 am and 7:35 pm

Do you guys have any recommendations to get him to start peeing in the litter box? Or is that just a lost cause until his high glucose is under control?

 

The best way to start to get your cat regulated to to transition to a lower carbohydrate food. Also, with Lantus, you do not need to feed your cat prior to giving insulin. Lantus doesn't start to kick in (i.e., "onset) for roughly 2 hours after you give an injection. It's peak action (i.e., nadir -- lowest numbers in the cycle) is roughly 6 hours from when you given an injection.

You could try Dr. Elsey's Cat Attract litter. That may help.

 

It took 4 months for my cat's blood glucose to become regulated. During that time he did not use the litterbox at all, pee or poo. When he was 2 weeks mostly in the greens, his neuropathy became much much better, and he started using the litterbox on his own again. We had done everything - UTI tests (negative), switched up boxes, had 2 boxes, 3 boxes in various parts of the house, switched litter...The only thing that we didn't do that was suggested was Prozac, in case the issue was behavioral. I really did think this was all related to diabetes, and the neuropathy that usually comes with it. Patience, as you're probably learning, is everything. I am sure once your kitty becomes better regulated, and therefore feels like himself again, you'll see results in the litterbox too BTW I'd still try Dr Elsey's Cat Attract.

 

Is he showing signs of neuropathy on his back legs? Minnie’s got so severe before she got regulated that she couldn’t make it into the litter box anymore so she also owed everywhere and I had pee pads all over the house. She recovered once her diabetes was regulated.

 

Hello. Sorry for the delay. I hope everyone had a great holiday. I got busy with the holidays then our other cat got sick.

Louie has been on the insulin since May. The peeing outside the box started out being rare until about September or October when it became never. If I put him in the box, he will jump out and then pee on the pee pads next to it.

I don't know what neuropathy is besides just googling it. He does get a little wobblily walking around, but he will jump from the ground to a bed or chair with no issues... or up and out over the litter box if I put him in.

We are slowly transitioning him to a different food, hopefully that helps.

We will probably get that ReliOn meter once we use the strips from the Alpha Trak.

Thanks Again!

 

I hope he’s feeling better! Neuropathy happens when the excess sugar in the cat’s blood starts to build up and attack, for lack of a better work, the nerves and it’s usually more pronounced on the back legs. It starts slow and then it gets more and more damaging. Keep an eye out for the wobbly back legs. If he pulls or ticks them under his behind before being able to sit down, it’s also a sign. It’s a great sign that he can jump and move around normally so nothing to worry about yet then. Not sure what is making him jump out of the litter box to use the pee pads. That’s puzzling. Have you switched litter or litter box recently?

 

I have not. It has been the same Tidy Cat he always used and the same boxes. Someone told us to try those pellets... he wanted none of that. I'll get that Doctor kind of litter next time I go out and see it.

His vet has him on gabapenton, i forgot to mention that, they said that could make him wobblily, but we do pay attention to his movements.

Thanks

 

Hi Steve,

Our kitty Ethan stopped going in his box right before he got diagnosed with diabetes in December- that was the major clue for us that something was seriously wrong with him. We tried putting the litter box wherever he was going, he would just go right beside it. We hadn't changed anything about his litter set-up and he never had issues before. He was peeing several times a day in our entryway or laundry room.

As soon as we got his blood glucose numbers lowered even a just a bit, he completely stopped peeing on the floor. We didn't have to change anything else to get him to go back to using the box, just getting those BG #s a bit lower for him. In hindsight, I think it was his way of trying to send a message to us that he was not feeling well.

Ethan is still not regulated, it is a work in progress and he has days with really high #s, but he has not peed outside of the box once since a few days after starting treatment with lantus insulin and the Purina DM pate (maybe not the absolute best or cheapest food available but its a really good start- and Ethan eats it no problem).

I'd echo the other comments above- home testing or monitoring is important to see how the blood glucose is changing during the day, to be able to get it stabilized. The numbers can change and turn dangerous extremely fast and by time any symptoms show up it could be very hard to correct. It will also help to get the dosing dialed in to get those #s down properly and alleviate the symptoms.

 

Hey,
After our last glucose curve for the vet they told us to increase the insulin again. He was in the 600's so they said to go from 10 to 11 units. We decided then to switch to the low carb food on the pdf you gave us. We do a test now before he eats and he is usually in the 400 or low 500's. So it seems that is going better. Thank You.

Since then he has taken up meowing starting at 6 am until he eats. Is that something you guys have experienced? After the first time we left him some food out, but he still does it and all the food isn't eaten.

We are also running out of our Alpha test strips so we are probably going to get that Walmart reader. Will the numbers be the same or is there some calculation that has to be done since that was made for human blood?