New to this forum

Hi all

My male cat was diagnosed with Diabetes earlier this fall. I've been doing my own curves and bringing them in to the vet each week. I'm getting extremely discouraged. He is currently on 9 units of insulin twice daily. I did a 12 hour curve on him today and it started at about 25, the lowest reading was about 23 and at the end of the 12 hours showed HI on the glucometer which is above 33. I'm guessing that tomorrow he will be on 10 units. Does anyone have any idea of what might be going on with this cat? He lives with 3 other cats. He's a stray that I took in a few years ago. He goes outside when he wants to. I'm using mostly canned food with Purina DM dry. BTW we are in Canada.

Thanks.

Joanne

 

Joanne,

Welcome. What a frustrating ride you have been on. You have landed in a place where there are many folks with LOTS of experience with feline diabetes and many experienced high dose pet parents.

You are going to get lots of questions. Let's see if we can get some answered so folks with more experience than I can help you out.

The first is what dose did you start at? And how did you arrive at your current dose - meaning how often was the dose increased and by what increments? Does your cat have a history of Ketones or Ketoacidosis? Let's see if we can get some answered so folks with more experience than I can help you out.

There are several conditions that cause cats to require high doses - Acromegaly(SP?) is one. See the attached link for info on some of these conditions. viewtopic.php?f=12&t=375

And some cats just need higher doses but first you will want to make sure that you have not "missed" your cats correct dose by starting with too high of a dose or increasing too quickly.

ETA: Another question - What insulin are you currently using?

 

Hi

He started with 4 units once a day. He had a curve done at the animal hospital about 10 days later and was put on 4 units twice a day. A week to 10 days later he was put up to 5 units twice a day. Then I took over doing the curves every weekend. He was put up to 6 the next week, then 7 then 8 then 9. And now I'm pretty certain it will be 10 after tomorrow:-( Nothing was said by the vet about Ketones or Ketoacidosis. He was at the clinic last week to get a sterile urine sample to test for an underlying infection but I haven't gotten the results yet. He is on Canninsulin. He seems ok healthwise. He still wants to go the barn with me each day and lives to be outside. He has a ravenous appetite. He pees a lot and drinks a lot. His stool is extremely smelly.

Thanks.

Joanne

 

Joanne,

I am trying to get the attention of some more experienced members to help you out. 4 units is a high starting dose based on the experience of this board.

Generally, 1 unit is a good starting dose and then you "work" up to higher doses if necessary. It is possible that you have passed the appropriate dose for your cat and he is in rebound. I will try to find some links regarding rebound.

You are ahead of the game because you know how to home test and are doing curves.

I am glad you are testing for an underlying condition contributing to his high bg levels.

Hold on while I try to get more eyes on this thread.

 

hi there,

how much does he weigh?

did the vets find any other underlying health issue with him?

Unfortunately, if not, then they have started this cat on a dangerous high dose.

How much wet and dry food does he get daily?

 

Caninsulin User Guide

Joanne,

Here is a link to the Caninsulin User Guide which also contains some information on rebound.

viewtopic.php?f=19&t=302

When is your kitty due for the next shot of insulin?

BTW, what is your kitty's name? is it BarnBuddy?

 

Hi Joanne and welcome to FDMB.

It is great that you are testing Barnbuddy's blood sugar at home. Do you test every day, and could you publish the results?

There are tips in the TECH section on setting up a spreadsheet on Google docs and adding the URL to your signature.

sharing your results with us will help us to help you.

9 units is a pretty high dose for a cat -- starting at 4 units may have passed the best dose at the very start.

The liver can protect a cat from overdoses by dumping extra sugar into the blood to absorb the excess insulin - causing HI blood sugar readings even when you are giving a big dose. This is called REBOUND.

To do a rebound test, we suggest you cut the dose in half and test the blood sugar several times during the day (not necessarily a full curve. If during this rebound test, the blood sugar numbers are BETTER --- then yes, the dose was too high.

There are conditions that cause insulin resistance - the CyrusMishi&Angela's first post has a link. My Norton (now passed away) had Acromegaly and at one point, he was getting 13 units BID.

With Norton, we started at 1 unit twice per day. We went to the vet every week for a blood sugar check at peak time (for Norton, this was 7 hours after injection) and increased the dose gradually - no more often than once per week. When I did a rebound check with Norton (half dose for a couple of days), his BGs stayed HIGH.

Changing the diet to LOW CARB (grain free) canned food will help - but REDUCE the insulin dose first -- a food change can cause an almost IMMEDIATE reduction in insulin needs. (check "Janet & Binky's Food Charts" for carbohydrate % data and choose flavors with less than 10%)

Also, caninsulin is not the best insulin for cats. Do some research - many here use Lantus (glargine), Levemir (detemir) or PZI (a pet insulin that is better for cats).

I used PZI for Norton. Now for Tiggy, I'm using Levemir and love it.

How far are you from Michigan? The test for Acromegaly is only done in Michigan, and shipping the blood sample from Canada can be cost prohibitive. In the US, the test runs about $100 (the lab charges $44 and the vet adds on for blood draw, overnight cold shipping and office visit)

 

Hi Joanne and welcome. You've gotten great information already. I too was mom to a high dose kitty so of course your post caught my attention. We always like to be sure a kitty really IS a high dose kitty or if there is something else that has been missed.

Interestingly enough I recently (last week :smile: ) adopted a kitty on Vetsulin - supposedly needing 2units twice a day. This one was not being hometested at all. Of course we started that immediately. In one week already he is down to <1unit/day. Now I can't guarantee that is true with your kitty at all as YOU have been hometesting. But as others have said - starting at the higher dose you may have overshot the right dose for your best friend.

Vetsulin works pretty fast with a steep drop in the first several hours. Is there anyway you could share some of your nunbers that you have already? Even if you don't have them in a spreadsheet already. Some of us "old timers" are used to looking at things even without a spreadsheet.

May I also ask a few other questions about your kitty? How old is he? How much does he weigh? Has he lost weight at all or has his weight stayed stable thruout his diabetes? do you notice any other health issues with him - such as anything different with his breathing? Does he snore? Is his abdomen overly round?

Thanks for taking the time to work thru all this. I know it must seem like alot of first but we're here to help you.

We will all check back later. Take care of yourself too as your boy needs YOU! :YMHUG:

 

Hello and welcome.
You are already receiving lots of good advice.
I echo what others are saying and wondering about that high dose and the underlying reason why.
For the moment, please do not change anything about the way you are feeding him.

I would certainly introduce yourself on the high dose board as well as read through the info available on the caninsulin insulin support group.

Has your kitty ever experienced a hypo or lower numbers under 10 that you are aware of?
Do you see any unusual drops on occasion?

Can you confirm what type of syringes you are using to measure? u40s?

You will have people respond to that large dose with shock for sure and we do worry about kitties that were started at more than 1 unit and end up on high doses, but going back to the begining is not always the answer.

Hang in there, glad you found us. I am also in Canada, here on Vancouver island
Kimmee

 

Hi Joanne,

I echo what Patti has said regarding sharing your numbers (particularly +4-6)

This kind of dose is normally associated with an underlying condition like acromegaly.

I do think you need to do a rebound test but before doing that letting everyone see your numbers would give some useful clues.
Echo on the change of diet, but again not until we get an idea about your dosing.

You have to be mindful of ketoacidiosis when cutting doses, but I'm concerned your vet started you on 4u, especially if this was based on a fructosamine or bg test done at the vets (kitties bg's can go up by as much as 200 points at the vets-reaction to be stressed)

Do you have any ketodiastix?

I seriously would caution against any further increases until you can be sure he is indeed a high dose kitty.

I'm also going to cross post this on the caninsulin isg and PM sweetgrass who is one of the most knowledgeable about this insulin.
Also my time zone is about 8 hours ahead of you so I'm heading off. She is also in Canada.

I'll catch up with you tomorrow-sure hope everyone here can help.
Don't panic, he's been doing o.k so far but is ravenously hungry/thirsty because he's still so unregulated.

You've come to the right place for lots of help and support :smile:

 

Aha she's here :mrgreen:

In that case I will leave you in capable hands. :smile:

 

Joanne,

You are in very capable hands now. Whew!

Answer their questions, heed their advice and you will get BarnBuddy on the right track especially with your proactive approach.

Thanks, Ladies. Was way out of my comfort zone. nailbite_smile

 

OK I'm a little overwhelmed at the moment with all the responses. Trying to breath! I'll try to answer all the questions as best I can. First off I'm in Newfoundland Canada. I'm also in a small town and only have access to one vet. The cat's name is Buddy and he showed up at my barn about 6 years ago. It took me 2 years to get him to trust me. Then he moved in and took over I don't know how old he is. He weighs about 17 lbs. and not because he is obese...he's just a very big cat. Even his paws are huge. I noticed back in October that he was a little lethargic and not much interested in anything. So I took him to the vet. She checked his blood, etc and said that his BG was around 25. I also brought in a urine sample a few days later and again it showed around 25. I then began looking into diets and after about a week of trying to lower carbs I took him back and started him on insulin. They did the first few curves. My first curve was when he was on 6 2X daily. Here are the numbers.
HI 33+
29.1
17.3
26.6
27.8


Next curve
27.8
25.7
23.7
21.9
23.4
26.4
30.1
Put up to 7 X 2daily


Next curve
28.7
22.6
23.9
20.2
24.5
Put up to 8 X 2


Next curve
33.2
25.6
23.7
28.3
27.8
Put up to 9

Here are todays numbers
25.7
23.3
23.6
24.0
26.3
27.3
HI

These were all done at 2 hour intervals starting just before his morning shot. Some were 8 hour curves and some were 12.
For his diet he is getting low carb canned food 3 or 4 times a day. Purina DM dry is left out for him. I should say for them as that is what they are used to. I have a 19 year old Siamese who is used to free feeding and will only eat dry food.

I doubt if I've answered all the questions but my head is spinning. Thanks so much everyone for your help.

Joanne

 

Hi Joanne, thanks for posting those that does help.

I personally think it is worth investigating the idea that there may be other things like acromegaly at play here and the wonderful folks on this support forum ( high dose insulin support group) really know what they are talking about.

It is not unusual to hear that a kitty may need upwards of 12-15 units of insulin if this is the case.

I would not encourage a rebound test just yet. It must be very frustrating not being able to break through these highs.
Hang in there, people with personal experience dealing with just what you are seeing have already posted to you here and will be back to help.

meanwhile, the fundamental issue for me is that caninsulin has been recalled as it is showing to be faulty and creating huge inconsistencies in action.
Please discuss a possible switch with your vet, and knowing small towns as I do ( being an island girl) I would go in with lots of info as to how and why already printed up.
Lantus or levemir ay be a better option for you guys in the long run.

 

Oh Joanne,
You are doing GREAT! I know how overwhelming everything is at once! and sorry we throw so much at you. Buddy sure is one lucky guy to have you. Sounds like he has you wrapped around his "paw".

I'm at work right now so don't have alot of time to go thru all your numbers but thank you soo much for posting them. THAT will help soooo much! Kimmee I know will be able to jump on it - right Kimmee??!!! ;-) Plus me being in the States - I have to do a little math to convert your numbers to one I am quicker to understand. (We report ours just a little different - but no big deal - we all learn to read each others )

You mention that Buddy is a "big cat - not obese - just very big with huge paws". this alone does not really mean anything. It's just one of those things we'll keep filed away for right now along with him being a male cat and right now needing larger doses. Once we find out more about your guy than MAYBE these might be important.

You say you've had Buddy for 6 years but not exactly sure how old he is. Was he a kitten wwhen you found him or maybe a couple years old? I'm sorry to be a pest about this. It's just one more clue that could help us out. And when you think about it - again I hate to bother you - have you ever noticed him to snore - or has he ever lost weight during the diabetes or not at all?

Hang in there - take deep breaths. We will help you get all this worked out. It will take a little time but we will get you the help you need. FWIW - I live in a small town too - with one vet. Sounds tho like you have a good relationship with him/her.

Talk again soon!

 

Yes i am wandering if the insulin amount is what i can understand since i use u for units of insulin since i amm located in the US. And those Readings you getting are the measured in bg? I just switched all of my cats to wet food only. I would suggest it but i believe victoria would be helpful in that. I am going to post a health alert in the pzi forum if somebody else hasn't, they might not be able to understand the insulin you are using but they have helped me tremendously. Hang in there.

My cat was on pzi vet 3units 2x daily and was upped to 5 units 2x daily until now we are down to .5 unit 2x daily.

With the help of everyone here.

David

 

For those looking in.. the readings are an international measurement
for the American version multiply numbers by 18.

Here is the last curve with the math X18, done..
Next curve
28.7 - 516
22.6 -406
23.9 -430
20.2 -363
24.5 -441
Put up to 8 X 2

I think we were both posting at the same time Patti
You can see Buddy never dropped below the mid 300s.

Joanne, there is a test that can be done to show whether or not you are dealing with Acromegaly it is called the igf1 test.
I will find some more info for you.

 

Here you go, Patti.

Hopefully, I did this correctly. The quoting and the converting. Multiply by 18 to convert to US #'s - right?

 

Yup that is right, thanks

 

Most of us use the "other" BG scale, so we have to think twice to convert the scales... the factor is x 18 ... So when/if you look at other kittie's numbers, they will range from 50 to 600.

Normal range for cats is similar to humans -- 60 to 150 or in Canadian units --- 3.5 to 8.3 or so

Caninsulin (aka Vetsulin) does not last very long in cats - usually 8 to 10 hours. On the one hand, vets like to prescribe it or Humulin NPH because there is little to no risk of the dose overlapping. The injected insulin is completely gone before the next shot is due. The negative side of that is that the kitty tends to rollercoaster between highs and lows every day.

The other insulins I mentioned in my previous post last longer. So... it is more important to be testing blood sugar levels before every shot, because sometimes it may not be safe to inject more insulin.

Lantus and Levemir build up a "shed" or like a storage bank of insulin in the body --- so keeping the 12 hour dosing schedule is pretty important. If the time between shots is too long, some of the "storage shed" is used up -- and part of the next shot has to refill the shed. If you don't have any issues with the timing, then either of these insulins would be great -- they both have a pretty good chance of remission (diet controlled diabetes with no injected insulin)
Lantus is more fragile than Levemir -- usually the Lantus vial or pen (3ml vial) needs to be replaced after 4 weeks -- with Levemir, we have been able to use every drop without it losing effectiveness.

PZI is a very nice insulin if you are interested and able to shoot more frequently than twice per day. With Norton, we changed from BID (every 12 hours) to TID (approx every 8 hours) using a sliding scale --- meaning that we would test his blood sugar, and adjust the insulin dose according to a personalized dose scale. Lower BGs earned a lower dose, higher BGs earned a higher dose. PZI does NOT build up a storage shed, so adjusting the dose frequently is not a problem.

 

i figured that out after i replied to the post and saw that you are in canada. I almost had a heart attack at first. After experiencing 2 hypos in 2 weeks. I guess i just figure i don't want anyone to go thru that. I just remember how i felt.

I just had to go thru all of that. How frustrating. I don't use that insulin so, I don't think i would be of help.
I do know i was experiencing some of that because they mostly ate wet food but i always had dry food available, but when i pulled the dry food all togehter her bg #s went really low and I had to lower my insulin dosage. That is just my experience and i will not put dry food ever back in my house again.

There are a lot of links here about Feline nutrition and maybe someone can help us with that.

Just Remember if you decide to pull the dry food you have to lower the insulin dosage and watch yoour feline closely when the insulin has its nadir point.

 

But i don't know if that is how your insulin works.

 

The only lab in North America that does the IGF-1 test for Acromegaly is located in Michigan.

Here is the link-- print it and ask your vet about getting the test.
http://www.animalhealth.msu.edu/Bin/Cat ... st&Id=1401
They also do a test there for Insulin Autoimmune Antibodies (IAA) for another US$20 or so. Some cats have BOTH conditions but usually not -

Usually the price of the test in Canada is very high, but maybe if your vet can send the sample directly to this lab, it can save you some $$$$.

The test is $44 US, but by the time your vet charges you and the Canadian lab charges for forwarding the blood sample and shipping it at least twice...... some of our Canadian friends have had to pay several hundred$

One of them dug into the details with her vet --- the blood sample was sent to a Canadian lab who turned around and shipped the sample to the lab in Michigan. So when you have to pay double shipping and double profit margin / etc, the $$$$$$ get high in a hurry.

 

I just posted a link in the canninsulin forum. If somebody else did let me know and i will take me link off.

That way if they didn't have a link we might be able to get some users that can help.
David

 

Thanks everyone. I knew what had to be done but I'm supposed to be taking care of my patient here at work - luckily she is doing really good. but I didn't have time to be doing the math here but you all did it for me- yea!!! :mrgreen: THANK YOU!


Joanne - in the short time you've been on here - I know you are getting soooo much thrown at you. I really hate overwhelming you here. Kimmee (Sweetgrass) and I have been going over things together already. One of the things we're concerned about with your numbers is how "flat" they are. Usually with Vetsulin you see a steep drop within a few hours after a dose. THAT is how Vetsulin works. We don't see any of that with any of the doses you've been on with your boy. She has used Vetsulin ALOT and knows it's actions very well and is the moderator of that group. I am one of quite a few hi dose moms/dads. I know too that one of the things that you will here alot of is that the dry food will have to go and that can be the cause of the high BG's. However, Before we suggest anything else to you tonite - I think it mite be best if we wait and see if anymore of the hi dose family jumps in. This will give you some time to absorb everything here.

i promise we won't desert you - I just want to give you some time. I work tomorrow again but for sure will check in as again I am sure the others will too. Please just take some deep breaths. We WILL help you!

David - Kimmee - the moderator of caninsulin is involoved

 

Thanks Phoebe for posting all the acro stuff - I wasn't sure if I was jumping into that or not. Glad to see you're thinking of that too!!

 

Hi Joanne and welcome! I won't add any more to what the others have said, but want you to know that no matter what, you and Buddy are not alone. Even if he turns out not to be a high dose cat, you'll get help. We won't abandon you and will do everything we can to sort this out, ok?

For tonight, just breathe, absorb what you can, and ask whatever questions you need to ask. I know a lot has been thrown at you-- and the idea that there is something "wrong" with your boy can be pretty overwhelming. But just to let you know... what you may read about acromegaly is not exactly the truth. There is not a whole lot known (although we are fighting like crazy to change that!) about this condition... but my boy will reach 3 YEARS post diagnosis in just over a week. That's something we never, ever expected. Right now he isn't doing so well (he actually is off insulin--again), but I want you to know that an acro diagnosis is not as dire as it may seem. In some ways it is actually helpful because it allows you to know just why he needs more insulin than the average kitty and lets you know that you are not doing anything wrong.

(((((hugs))))) to you and Buddy... hope to hear from you soon.

 

Good morning

I've spent the whole night thinking about all of this and I must say the help and advice here is amazing. This is all really scary for me. I'm dreading dropping those numbers off at the clinic today. I will write out some of those concerns and questions. My vet knows me through horses and knows what I'm like with regards to looking for answers.

I've had Buddy living in the house with me for 4 years, ( can come and go), but he spent 2 years outside as a stray. I've never seen him as a kitten so he is at least 7 years old.

I don't test before each shot mainly because there's no way he can get hypoglycemia with numbers that high. And I thought that that was the only reason to test that much?

There are a few slight behaviour changes...he spends most of his time inside under the basement stairs instead of interacting with the rest of the household. He will sleep under the bed now instead of on it.

I'll try to answer some more questions later but right now it's off to the barn and work. Will check back later. Thank you guys so much!

Joanne

 

Glad to see you again!

Yes, it's a lot to take in and it can be very scary. When my Fletcher was diagnosed, there were only a couple that had been confirmed acrocats before him and Patti's Merlin and Steph's Phoebe got the results soon after, so we bonded and supported each other as best we could. Some days I think that was the most important thing: knowing we weren't alone. We'll be here for you, too.

As for testing, even with the numbers running high, there is ALWAYS a chance for hypo. And if the bgs did go too low and Buddy's body dumped glucose (glycogen?) to save him, the resulting high bgs could look like the insulin didn't do much, when in fact it did too much. We always do a preshot test to make sure the bgs are in fact high enough to safely shoot and get spotchecks to see what effect the insulin is having. Does that make sense?

He sounds like a really cool cat with a great mombean!

 

He's probably withdrawn a bit because he is not feeling very good. The good news is usually when you can get the Blood sugar under better control, he'll return to his normal self.

Can you post a picture of Buddy? I use www.flickr.com (free) and put a link here.

My Norton was a medium sized cat but had big feet (no extra toes - just big).

We came here to FDMB - like you - after treating for months and reaching a dose of 13units BID with only moderate impact on his BGs. He had also started exhibiting some new symptoms - walking in circles and keeping his head low like his neck hurt. After coming here to FDMB, we realized that he probably did have acromegaly - a brain tumor. We confirmed this diagnosis with the IGF-1 blood test and a visit to a neurologist.

This spreadsheet contains information about our Acro-cats. We collected this information because the Acromegaly (and excess growth hormone) can affect cats in many different ways --- so we were trying to establish similarities in the physical symptoms.
http://spreadsheets.google.com/ccc?key= ... dRWWTPIpRQ

 

Hi from Calgary

I understand the realities of being in a small town with only one vet, we see a lot of that and will try to be understanding of your situation. Before worrying about him having acromegaly though, I really just think that we've no clue unless that dose is dropped and proper testing is done, because starting at 4 units and moving upwards with testing at the clinic only/mostly is really so typical (unfortunately) and often but not always just indicates that the cat is being overdosed.

Hope we can helpy ou sort all of this out

Jen

 

Hello Joanne,

I don't post much anymore, but I am Heather/Boo and I don't want you to feel alone. I am going to publish my profile and spreadsheet for a few days, in case you want to take a look, then they will go *poof* again. Boo has acromegaly, but she was successfully treated at Colorado State University with stereotactic radiation surgery. Wendi/Milo is a Canadian that was also treated at CSU...while Milo is not off insulin, they think the acro has been fixed and now he's a "normal" diabetic.

I too would recommend that you get the IGF-1 and IAA tests. Michigan State University is the only place in North America (and I think the whole continent) that does these tests. You might be able to do it cheaper if you can work directly through them. It's possible that you could get your vet to prepare the samples (all they need to do is draw and spin the blood) and then you take care of the shipping and payment to MSU. It would be worth asking, because some vets charge quite a lot. There is no interpretation to be done on the results - they give you a number and if it's high enough, it's positive. There is also no treatment, besides keeping tight control of the diabetes and radiation surgery.

As far as testing...take a look at Boo's spreadsheet in February. She had very high numbers every day, and then all of a sudden, for no apparent reason, I came home to an 86 (4.7)...who knows how much lower she went that day. However, at the same time, she never, ever went dangerously low and her curves stayed pretty flat...I could shoot 10 u Lantus into the 100s and know she would be okay. Also, even though her numbers were very high, she never suffered from ketones (although acro cats can, I'm just not sure it's as prevalent). Boo did not have any readily "noticable" signs of acro, although Dr. Lunn @ CSU did think her forhead protruded and her paws were a bit larger than normal. She also snored.

Most of the acrocats on this board use Lantus or Levemir. They are "gentle" and last longer than the other insulins. And, I think they are over-the-counter in most of Canada, so you don't even need your vet's blessing.

Hopefully your baby doesn't have acro, but he has an awful lot of the "signs"...big paws, big cat, flat curve, etc.

Here are my links:
Profile: http://docs.google.com/View?id=ddp75qhh_337dgwcrjhb
SS: http://spreadsheets.google.com/pub?key= ... utput=html
Again, the links will be unpublished in a few days, so if you want to keep them, you'll either need to print or create a PDF (http://www.cutepdf.com will allow this if you don't have other software).



~extraneous material removed by Moderator

 

Dear Joanne,
It's so good to see you post again this AM. I can only imagine how overloaded all this information must be to you.

All of us hi dose moms always always hope we are wrong in our thoughts that acro is NOT the diagnosis. But with so many of us having that feeling that the warning signs are there - including Kimmee from the Vetsulin group feeling the same -it might be worth your while having the blood tests run sooner than later. Also - like others have suggested - looking into changing your insulin - regardless of the diagnosis - is another good step to take.

Whatever you decide we will help you work thru all this. Please let us know.

And we can't wait to see pictures of Buddy AND your horses!

 

Hi again

Well I dropped off the results of the curve today. So far I haven't heard from the vet. I had a list of questions for her regarding Rebound, acro, and Canninsulin. The clinic is closed for the day now so don't know if it's good or bad that I've heard nothing from her. Either she's offended by my questioning or she's looking for answers...could go either way:-/

I checked Buddy's BG before I gave him his shot this evening...it was 31.1. BTW to whoever asked...he does not snore. This acro thing sounds a lot like Cushings in horses. That's also a tumour on the Pituitary Gland and has to be diagnosed by a blood test called the ACTH that is drawn and spun and overnighted to a lab. I also have an Insulin Resistant horse. my cat is behaving a lot like him. He is constantly looking for something to eat. I was standing at the counter earlier cutting up an onion...he was at my feet putting his paws up like he was saying...whadya got? Whadya got??? I've had to take the bread for the birds off the ground as he was trying to eat that too! He has a ferocious appetite. BTW he also does not jump very high.

I'll try to get some pics to put up somewhere.

Thanks.

Joanne

 

Hi Joanne,

I've been calling in as the day goes on to see progress reports :mrgreen:

Shame the vet hasn't got back toyou, but hopefuly she will tomorrow.

Barnbuddy will continue to have a ferocious appetite if he's diabetes is unregulated because his body can't process his food properly (reminds me of childen with Prada Willi syndrome).

I'll leave it to the high dose moms to comment on the lack of snoring. It may just be one indicator that has been seen as a common denominator in a lot but not necessarily all high dose kitties here.

Look forward to the pics (you can do Avatar, but pic has to be real small, if you try to upload one it tells you by how much. I think Flickr may be a better way, especially if the horses are going to get a look in too :mrgreen: )

If you have any more questions whilst your waiting for your vet to get back to you, ask away..... here or on health (bit more traffic in terms of people who check in there)

 

Hi Joanne,
I had to smile reading your last post - wow you certainly fit in with the rest of us here - you taking care of all your other animals! :razz: We're all crazies here too! :mrgreen:

We do have cats too that get Cushings. What we've found since following them here in this group is that most of the time they are females. The difference we have seen is that they present alot of times with very thin skin and open wounds many times. :sad: I don't know if you've had time to read the "acro and other hi dose conditions" sticky but there is info in there about cushings too.

It's interesting that you mentioned too that Buddy doesn't like to jump hi. Something else that some acro cats have problems with is "arthritis" in their spines, joints from the bone overgrowth. Again - not to say that this is necessarily your buddy - it's just something again that you have now said that is yet another subtle symptom. Many of our acrokitties can't jump up on things anymore without needing "steps". They oftentimes may eventually need pain meds and many of us will add in some fish oil or other supplements to help them.

Just thought I'd say hello - and will check back on you later. :YMHUG:

 

Hello,
Cushings has similarities to acro, but I will let those who really get the science of it fill you in further.
However, having had that experience with Cushings will absolutely make figuring all this out a little easier. You sound like a terrific proactive caregiver to your furries. Your poor kitty is hungry as he is not processing food properly so I am sure you already are, but go ahead and give him that extra snack he is asking for.

I will also keep popping in and seeing how you are and don't be afraid to ask anything. This forum is amazing.
It takes time to sort it all out and insulin resistance without acro is certainly also possible.

Kimmee

 

What type of fish oil would be safe to give him? He always has access to food...he just seems to be drawn to the high carb stuff:-/
I have lots of pics of all the critters on Facebook

Joanne

 

cool - most of us are on Facebook too - phoebe basso if you want to send a FR

Salmon oil is probably the most commonly available but my cats turned up their noses - in Newfoundland, you may have more choices

 

Waving hello from Cape Breton!

Hello neighbour!

I'm in Cape Breton - I work about a mile from the NL ferries; can see them coming and going all day from my office window.

Of course, acromegaly is possible, but it is also very possible that you were simply started on way too high a dose, and increased too fast, and poor Buddy is now in chronic rebound (which sends the BGs higher and higher. The body tries to prevent a hypo crash by releasing stored glucose from the liver in response to too much insulin.) Oh- and yes (before your vet says otherwise) - high flat "curves" can indicate rebound.

Does Buddy have a double long coat? Tuft of fur in his ears and between his paws? In which case he could be part Maine Coon, and they are naturally BIG cats.

Are you checking for ketones? Were there ketones present at diagnosis? If not, reducing the dose may be a safe thing to do ... it's the only way to see if he is in rebound. It's also possible that Caninsulin is just not the insulin for him.

And yes- you can hypo him with these numbers, so testing before each shot is crucial. Especially if he IS in rebound, because if those stored sugars run out, he can crash. When you post a curve, just start with "AM PS" (which means morning preshot BG), and then +2, +4, +6, etc. (meaning 2, 4 and 6 hours post shot). Don't use "real times" since this is a global community and we span about 17 time zones. The way you posted your curve is great- just add the "times" in from of the BGs. And, as you have noticed, we tend to use the US values more here (we all just become bilingual! LOL!) because there are more Americans on the board- but don't worry about posting the metric values at first. We can 'translate'.

If you haven't please pop to the nearest drugstore and pick up a bottle of ketostix to watch for ketones.

And if you want to talk any time, I'm a phone call (or a ferry ride!) away! Just let me know.

In the meantime... read, read, read! You need to become the expert here, and we'll help you all the way we can.

Welcome aboard!

 

Hi Karen, It's good to see you post here.

Were you able to look at Joanne and Buddy's curves above? All those curves were done at home? And actually in hi dose group - we don't mind so much if people post in metric or American - we try to eventually get people to post them in both so we can have everyone rocognize it easily as we're such a "small" group.

Joanne - I'm on facebook too - patti fuchs

hope to hear from you today on how buddy is doing!

 

Those curves are definitely flat and high, but were done when he was at 6 units BID and free fed dry food. Is rebound not an option?

 

*Waving hi to Patti*

Yep, I saw the curves, but my concern is that he has never been on less than 4u BID ... I worry that he may be hi-dose by accident, versus hi-dose by necessity. If he is an acro-cat, then we can proceed. But if he's just been started too high and raised too fast, then we may have a problem. I do wish vets would stop dosing cats with these high initial amounts. Unless there is DKA or known Cushings/acro, it just confuses the picture. :sad:

If he is being overdosed, we need to be careful about the food, too ...

 

Karen and Jen
Your points are well taken but there are too many warning signs to too many of us hi dosers AND to Kimmee also who is well versed in Vetsulin.

I agree - Buddy went up quickly on Vetsulin and with being at the vet too and with there being dry food involved. HOWEVER, again being on Vetsulin (and I've had some experience with this insulin as I did use it for several months with Merlin initially) - this cat has completely flat curves, NO hypo's at all and is now on canned food, male, middle aged, large ( yes We don't know yet if it's maine coon but no mention yet and it's the standard statement of "always been large - not obese"), can't jump up hi now and is not an elderly cat, paws are large.

I'm not trying to argue and As I ALWAYS say - we hope we are ALWAYS WRONG! But unfortunately a high percentage of the time - we are sadly right. The subtle signs - the little things that the owners let slip out about their cats - are often the things that clue us in that this is what is wrong with these cats.

Too many of us in the past have gone thru all this dose cutting and having worked up on the dose too fast, etc, only to prolong just getting the test. And then in the end - this is what it is. In the meantime - the mom/dad is going crazy. We don't push everyone to do this. Only when there are these subtle clues.

Really we have to leave it up to Joanne herself to decide. We've laid out both sides of this coin for her. But one other thing I can say is that MOST moms/dads of these cats will come out and say that "I"ve always know there is something else wrong my kitty". Ask any one of us in this group or over on catacro.

 

Fair enough, Patti. As long as all options are being considered. ;-)

 

Morning Joanne

I have been thinking a lot about all the thoughts raised here and wanted to try and summarize and see what you felt you may want to do.

First thought:
1- high dose and high flat curves at 10 units BID, reasons for this could be
a-need for high doses due to underlying conditions ie: acromegaly
b- chronic rebound leading to insulin resistance as dose was started at much higher than normal at 4 units BID

2- how to approach this
a- continue with dosing as is, increasing until break through in levels ( requiring tests before each shot and spotchecks through the days, especially around 4-5 hours after shot when insulin peaks) and pursue tests to determine whether underlying condition is going on
b- reduce dose and do rebound check ( usually done by reducing by 50% for 2-3 days) and seeing if there is an overall reduction in levels letting you know less insulin is needed * ketone testing is a crucial part of this testing, should be done every day.

I am personally a bit inclined to think a rebound check would at least eliminate the questions many have around the dose. However it would be good to do this quickly and not hang on a reduced dose for long if no movement down in levels occurs.
Along with that and talking to your vet, you could at least know that higher doses are what is needed once that was done.
My hesitation is that if ( and I suspect it is ) a higher dose is the way to go, you have lost some momentum.
Having started with 4 units, it is really hard to know if less would have helped you guys or not.

I know it must be very confusing but I wanted to lay out options for you to think about. It is in your hands and I know it is a lot to consider.
Does all that I have said make sense?

My second thought would be to quickly follow up on further testing so you know what you are dealing with in terms of a diagnosis or not.
((hugs))

IMHO, and In my experience a dose this high, even at the 4 unit place, on this fast acting insulin, would have resulted in a drop in levels dramatically with this insulin early on in the diagnosis, that could have put your baby in harm's way, the fact that does not seem to have happened leads me to the idea that a higher dose is needed.
However, again, that rebound check would put that question to bed and allow us all to move forward under the assumption you are where you need to be.

I do not see the high dose group surrounding people and urging them to test for acro, without serious thought. This does not happen often here, but when it is suggested it comes from a place of love and understanding.

Kimmee

 

Hi again everyone.

Again, another load of info! Wow! I did not hear from the vet again today so I called just before the clinic closed. The vet tech said that they were probably waiting on the culture that was done on him last week. I hope this is what it is and not the vet getting offended by all the questioning:-/

I've heard nothing mentioned about Ketones from the vet. If I get another chance to ask questions of my vet I'll ask her. I'm hoping she will look at the questions in a positive light as the last time I spoke with her she seemed just as perplexed as I was. I will see if I can get some Ketostix.

Karen my cat has a very thick coat and all of the tufts that you mentioned. Someone once asked me if he was crossed with a Lynx. I've had Maine Coon mentioned several times as a possibility. For those of you who put me on FB today there are pics of him there. There are actually 2 big orange cats there...one is a young one named Gus that I took in a few months ago. (I have a soft spot for big orange tom cats!)

I tested him before his shot this evening and his BG was 32.7:-/

To whoever mentioned that Buddy was now on canned food ...no he isn't. I try to give him more canned than dry but he still has access to Purina DM. My 19 year old Siamese is preventing me from taking away dry food completely:-(

Joanne

 

Oh Joanne - and everyone else -
sorry that is me who is totally wrong then - about the canned vs. dry. duh! I only knew Purina DM as a canned product. I didn't know it as a dry product. please forgive me!

I hope you and Buddy are doing alright today tho!

 

So I had a call from the clinic today. The urine sample that they took last week and sent to the regular hospital is nowhere to be found. So now I have to drop him off at the animal hospital again tomorrow. Not a lot of trouble for me but God I hate putting him through that again:-( He gets soooo stressed out. I haven't been told to increase his dose yet.

I bought the Ketostix today...I'm half afraid to try them:-/ (Afraid of the result.)

I tested him again before his shot this evening and it's down a little...29.1. I have the Halo Liv a little treats now and he would kill for them. He actually followed me into the bathroom for his test this evening...knowing he was going to get a treat. At least there's something positive in the poor guys life:-/

Joanne

 

Why do you need to drop him off for a urine sample? Can't they take a sample via cytocentisis? That is the only way to get a sterile sample...

 

All I know is that they have to inject his full bladder to get a sample. I drop him off on the way to work and pick him up on the way home. I could easily get a sample in a container but that isn't what she wants.

Joanne