New member question

Hi! My name is Willow, and ten year-old cat Junior was diagnosed with diabetes in March. After being diagnosed I enrolled him in a clinical trial for oral insulin, which lasted for 6 months. During that time I would give him one dose of oral insulin in his breakfast in the morning (I am not sure the amount of insulin that I was giving him per dose, but it was based on his weight.)

While on the trial I did not do any home testing, and took him in for a glucose curve every two weeks for the first 3 months, and after that I would take him in once per month to get his levels tested. During this time his numbers were all between 100-140. The trial ended on 25 Sept 2020, and I was told to test his glucose 5 days later, and if his numbers were high then they would consider that he is not in remission, at which time I was supposed to begin insulin.

Five days after the trial ended I tested his glucose with an AlphaTrak2 meter, and it was around 250. I brought him in to my vet the following day, they tested his glucose again, and it was around the same- 250. She instructed me to get a fasted glucose number on him, so the next morning I tested him after not giving him dinner the night before or breakfast, and it was around 300. At that point she prescribed me Lantus, and told me to fill the prescription and bring him in for a demo on how to give him insulin.

However--- during the time between me getting the fasted glucose level and her telling me that he would need to be put on insulin, to the time when I actually got the insulin and took him in for the demo- I switched him to a strictly wet food diet twice per day. Prior to making this switch he has been free feeding dry food for his whole life. I did a lot of research which indicated that wet food is the best choice for diabetic cats, and that switching to a completely wet food diet can make a big impact on his glucose levels.

Yesterday I took him in to the vet for the insulin demo. I was instructed to give him 1 unit of insulin the following morning (today) with breakfast, and then 1 unit at dinner. I told the vet tech who was giving the demo that I had switched him to a completely wet food diet within the past week and a half since he was prescribed insulin, and he acknowledged that wet food is a better option for cats, but told me that it shouldn't have anything to do with my giving him the 1 unit (starting today.)

This morning out of curiosity I decided to check his levels, as his water consumption has been normal and I have not found excessive amounts of pee in the litter box (both of these which were what led me to get him tested back in March.) This is to say- he is acting completely normal. First this thing morning, prior to feeding him breakfast, I tested and it was at 155. I fed him a can of food, and tested him again about 35 minutes later, and his levels were 160. Based on this I did not feel comfortable giving him insulin, and I did not want to consult the vet about it because I was worried that they would tell me to give it to him anyway, because that is what they had told me to do yesterday.

So my question is: Should I go ahead with the 1 unit? Thanks so much!

 

We don't advise me people with little data to give insulin under 200. Good thing you tested. You may have to start with less than 1 unit.

 

He said Lantus above

 

If you could set up you signature that would be great

• On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
  • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
  • Add any other text, such as
  • Caregiver & kitty's name (optional)
  • DX: Date
  • Name of Insulin
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
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tap on your avatar where it says your name ,then hit profile page ,tap on that ,then go up to the very top, upper right hand side and tap on your name ,it will bring down a drop box, tap on signature, the signature will be under settings, tap on the signature then and you can start to add what I posted above, make sure you hit save ,
Welcome to the best place you could ever be and an awesome group of people


Tyler/ 12yr / Dx 9/2018 /Vetsulin 9-2018-12-2018 RELION PRIME LANTUS started on 12/30/1

 

If you have any BG numbers to fill in on your SS that would be a good start

 

I would continue to test the BG before normal meal times and again about three hours later for a few days to see what his BG is doing and document in the SS
Wet low carb food certainly does make a difference as to how much insulin is needed.
Post on here each day with the results and we can help you with if insulin is needed.

In the meantime I would buy a bottle of Ketostix from a pharmacy or Walmart and test the urine for ketones which can form in diabetic cats especially if no insulin is given. your boy may not need insulin but the only way to tell is to test.
As an insurance policy I would test for ketones. Make sure you read the result exactly 15 seconds later against the colours on the side of the bottle. It’s a simple test.

 

Hey all! Thanks so much for your responses. I did download/set up the spreadsheet, so I will input his numbers starting tomorrow and post them here. I will also set up my signature- thanks! I will also pick up the ketostix today, thank you. For now I will not give him any insulin and will check his insulin at mealtimes and then 3 hours later. I will update tomorrow. Thanks!

 

William --

Welcome to FDMB!

Just out of curiosity, what canned food are you feeding Junior? Not all canned food is created equally. You want to feed your kitty a low carbohydrate, canned food. You'll be surprised at how high in carbs some canned foods are! This is a list of many of the canned foods that are available in the US. We consider low carb as below 10%, although most of the members here probably feed their cat food that is roughly around 5% carb.

 

Am I the only one really curious about the oral insulin ?

 

Yep, me too.

I was wondering whether it was testing something new or whether it was a trial with the likes of glipizide (not an actual insulin).

@WILLOW RANISAVLJEVIC can you give us a bit more info about where the trial took place and what product was being tested? Curious minds want to know.

 

Hey! Since I'm new to this I am still figuring out this message board, so I will just reply this way:

The food I am feeding him now is Fancy Feast Classic Pate. He has a poultry allergy, so I am basically sticking to the seafood and beef options, and I am familiar with the food chart and have looked up all of the carbohydrate percentages, and these seem to fit the bill. Thanks! I am open to recommendations though, although both of my cats seem to like this food. I am giving them each 2 of the small cans per day.

As for the oral insulin- this was a trial out of a vet clinic in Seattle. They are doing it in multiple locations throughout the US, and since it is in the clinical trial phase it is not available for sale yet. It was called Bravo! I do believe that it was actual insulin, although they didn't give me a ton of information on the actual drug itself. However, the bottle did say insulin on it when I had the medication here.

Overall I think that the trial was a good option for me because I was new to the idea of taking care of a diabetic cat, and it is making the transition easier having had 6 months of giving him a daily medication. I also had to incorporate wet food into his diet during the trial because he absolutely would NOT eat the liquid insulin without me putting it into a can of wet food. It had a pretty strong smell, and they said that I could give it to him directly in his mouth, but he just threw it up immediately afterwards.

If anyone has other questions about it let me know- I still have all of the paperwork on it and everything.

https://diabetescatstudy.com/

 

Thanks for the info and link — it was enlightening.

From the veterinarian side of that website (emphasis mine):

Q4: What is the investigational medication?
The active ingredient in the product being tested is an oral anti-diabetic medication, but the name of the drug will only be made public if approved by the FDA-CVM. (The test medication is NOT insulin.)

 

Wow Thank you Willow and extra sweet Junior! and
WELCOME TO OUR FAMILY

We look forward to getting to know you both
jeanne

 

Hey! I did the signature and linked the spreadsheet- so let me know if it is good! And you're welcome for the info on the study!

I checked his levels before breakfast this morning and he was at 137. So I am still going to refrain from giving him insulin, and am wondering if I should call my vet to let them know that I have not started yet. I will check again at +3 and update.

 

Signature and spreadsheet all looking A-OK, Willow.

It's never any harm to touch base with the vet when a lot of things are in flux.


Mogs
.

 

Hi all! Does anyone have second to look at my spreadsheet and let me know if you still think I am doing the right thing by not giving him insulin? It was high yesterday, and I had accidentally left the dog's dry food out (we are all new to this whole meal-feeding thing) all night, so I am wondering if he ate that at night and that is why he was higher at night and in the morning. Anyway, I have a few readings on there and still have not given him insulin- so just let me know what you think! Thanks.

 

I cannot give dosing advice but...I think numbers would be a lot higher if he ate dog kibble... even just a few pieces would make a difference.

 

Hmm, ok thanks! I'll keep monitoring for now and make sure to put the dog food up. Thanks!

 

Hello, I also can't give dose advice but wanted to point you in the right direction. On the main page there are sections for the specific insulin support groups. There is one for lantus. Someone on there will probably be able to better assist