Diabetic cat with low blood sugar. Anyone have experience with this?

ziggy'smom

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I'm trying to help a few cats who belongs to a guy who has difficulty caring for them. One of the cats is diabetic and is on insulin, 13 units twice a day. As I understand it he hasn't had his blood sugar checked in a while but did it last night and it was 45! He believes that the reason for the low reading is that he's getting too much insulin so he's planning to lower it to 8-9 units and see what happens with his levels.

I know very, very little about diabetes so I don't know if this is a good strategy or not. I of course suggested that he calls the vet but he didn't seem to eager about that idea. I'm pretty sure the vet won't be called.

So, since vet advice is not an option I thought I'd check here to see if someone is knowldgeable about diabetes in cats. Is lowering the insulin dose the way to go when the blood sugar levels are low? If so, is lowering it to 8-9 units maybe too much of a dip or is it okay (normal dose is 13)?

I'd really appreciate any insight on this issue.                                                                                                 
 

LTS3

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13 units?? That's a HUGE dose
Few diabetic cats need that much insulin uless they have acromegaly or Cushings disease as well. What insulin is it? How many hours after the insulin shot was the 45?

8 or 9 units may not make much of a difference. Personally I would drop that dose way back to 1 unit and test the blood glucose levels before every insulin shot and at least a few times in between to get an idea of how the insulin is working on blood glucose levels.

Have your friend join the FelineDiabetes.com message board for more help.
 

ruthm

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I strongly recommend the cat be checked out by a vet-- was this reading done on a human glucometer or a pet-specific meter (Alpha-Trak?)  Does your friend know how to feed high carb food to bring up the blood glucose to a safe level and to keep checking to make sure kitty is safe?   45 is way too low either way, the cat could be in danger of going hypo and that can be deadly.  I realize there is financial concern, please forward your friend this link and see if there are some resources to make it possible for a vet check.

http://www.thecatsite.com/a/no-money-for-vet-care-how-to-find-help-and-save-your-cats-life

I also second the recommendation to join Feline Diabetes Membership Board- knowledable people and a great place to learn,  but not a substitute for veterinary care.
 

LTS3

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I also second the recommendation to join Feline Diabetes Membership Board- knowledable people and a great place to learn,  but not a substitute for veterinary care.
I agree - the Internet is not a replacement for vet care. I hope I wasn't implying that in my post
Members of the FDMB can suggest a new diabetic-friendly vet if the OP's friend should need one. The board has members all over the world so there's likely someone who lives near the friend and has a good vet to recommend.

45 is low. If it was within a few hours after the insulin shot I would be immediately treating the cat for a hypo and frequently test the blood glucose until it goes up to a much safer level and talk to the vet about dropping the insulin dose. If the 45 was around the insulin nadir, I would still be concerned and would just monitor blood glucose levels closely. A 45 at insulin shot time is a "do not give any insulin" number. My diabetic cat once tested at 38 (!) just 3 hours after being given insulin on a level of over 300 (I think the dose was 3 units). He wasn't showing any signs of hypo but I had a feeling that something was "off" so I tested him and nearly freaked out over the 38. I got high carb food into him and tested every half hour until he went back up. I called the vet and we agreed to reduce the dose.

I hope the OP's friend will at least check out FDMB. It's a really helpful board
 
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ziggy'smom

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Thanks so much for the info. I've dealt with a lot of sick cats since I do rescue but I've never had a diabetic cat so I know next to nothing about it. I wonder if the dose he told me the cat takes is accurate. I wonder if it may actually be 1.3 units, not 13. Is that possible? The cat in question is very big, over 20 pounds, so I wonder if that has something to do with it.

The brand of insulin is Lantis. The owner gets the "pens" that humans use and draw up the dose from that with a smaller syringe. Each pen contain 3ml and it lasts for about 2 weeks, he says.

The 45 reading was taken 4 hours after he got his insulin. I take it that's pretty bad. How often should a diabetic cat have his blood sugar checked?

Unfortunately this owner is struggling with some kind of mental health problems and currently has no income at all. Both issues makes taking care of the cats difficult and they are not getting the care they need. He didn't take this cat to the vet until he had lost half his body weight and started to walk "like a rabbit". So unfortunately he won't take the cat to the vet now and wouldn't even call them yesterday. I just called them though and I'm waiting for them to call me back to answer some questions. I'm hoping that I will be able to help this cat. The owner is working with me on one of his other cats who also have health problems and so far that's going okay. It's not that he doesn't love and care about his cats. He does. He just seems incapable to take care of both them and himself. I'm doing what I can to intervene. The 45 reading has me very worried though. By what you guys are saying it sounds like it could be a major emergency. I wish I knew it was this serious yesterday. I hope the kitty is okay and that the vet calls me back soon!
 

LTS3

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Thanks so much for the info. I've dealt with a lot of sick cats since I do rescue but I've never had a diabetic cat so I know next to nothing about it. I wonder if the dose he told me the cat takes is accurate. I wonder if it may actually be 1.3 units, not 13. Is that possible? The cat in question is very big, over 20 pounds, so I wonder if that has something to do with it.

The brand of insulin is Lantis. The owner gets the "pens" that humans use and draw up the dose from that with a smaller syringe. Each pen contain 3ml and it lasts for about 2 weeks, he says.
It's not possible to measure 1.3 units with an insulin syringe. 1.5 units is the closest you can get with the half unit marked U100 insulin syringes. Can you go to your friend's house and see what line he draws the insulin to on the syringe? And confirm with the vet that the dose is 13 units twice a day.

Lantus is a great insulin to use. The pens are preferred over the 10 ml bottle since it's more cost effective. There is a protocol on how to use Lantus with cats. It's posted here on the FDMB board: http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/ There is another one but it's more for experienced owners with lots of blood glucose data than newbies. For most cats a pen lasts at least a month or two to the last drop. Maybe with your friend's huge dose it lasts only 2 weeks.

Lantus peaks around 6 hors after a shot so, yes, the 45 at 4 hours post insulin was serious. It's a good thing your friend caught it before it got any lower. At the very minimum the blood glucose level needs to be tested before every single insulin shot. That way you know what the level is and if it's at a safe enough level for any insulin to be given. Just because levels typically run high doesn't mean that you can blindly give insulin. Sometimes the cat will have an "off" day and throw a nice normal blood glucose level. You don't want to give insulin on a non-diabetic number. My diabetic cat was a pincuhion - I tested him several times daily
He didn't mind at all because he got yummy freeze dried treats as a reward.

The extra weight is a factor. If the cat can lose the weight slowly it would help the diabetes.

What is your friend feeding the cat? Dry food, even prescription ones, keeps blood glucose levels way too high. It's like a Human diabetic having a diet of only junky highly processed carb laden food and sugary snacks. The ideal diet to feed a diabetic cat is low carb canned food. There are many suitable commercial brands, such as Fancy Feast Classic and Wellness. If the diet needs to be changed, it must be done very slowly and the insulin dose needs to be reduced and the blood glucose levels must be closely monitored. A simple diet change can result in the blood glucose levels dropping a huge amount and the high insulin dose will result in an OD.
 
Unfortunately this owner is struggling with some kind of mental health problems and currently has no income at all. Both issues makes taking care of the cats difficult and they are not getting the care they need. He didn't take this cat to the vet until he had lost half his body weight and started to walk "like a rabbit".
The leg thing is called diabetic neuropathy. It can be treated with methyl B12. It has to be methyl B12 (methylcobalamin), not regular B12. The FDMB recommends this brand. Check with the vet before giving it to the cat.

Could you join the FDMB on your friend's behalf and get help that way?
 
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