Help! Glucose level not decreasing

My baby, Punkin, has been on insulin for over two weeks. He takes 6 units 2x day. After days of testing his levels, the vet sent him home for a week. She wanted to give him a break from all the testing and time to adjust. I took him back today and the levels were as high as they were before the insulin. We have now increased to 7 units 2x day. She discussed some reasons for insulin resistance, but she doesn't seem quite sure what to do. She also mentioned putting him on the insulin that is derived from beef or pork rather than the "human" insulin he is taking now. She mentioned thyroid sometimes causes interference. He is also on thyroid meds, but those levels seem to be okay. I'm frustrated and afraid. If anyone has any info or experience along these lines, Punkin and I would love to hear from you.
Janine

Janine - I have no answers for you, but wanted you to know that I am thinking about you and Punkin. Here's wishing for the best!

Thank you Debr. You consideration is always appreciated. Hope everything going well with you and your babies.
Janine

Sorry that should have said "Debra". My fingers aren't cooperating tonight. Thanks again.

Janine...

I don't have any answers, being a new cat owner, but I send you love and light.

Hi Janine,

Sorry for the length of time it has taken for me to respond to this - I have a thousand excuses, but all of them are really boring - so I won't even go there. *smile*

First - feline diabetes is a VERY tricky disease. All cats respond differently to it and to the medications, such as insulin. I've had two diabetic Siamese cats over the past 5 years, and both were quite different in terms of how they responded to the disease, and both were different in which medications were effective.

Secondly, the regulation process can and often does take a while, so you need to be patient, sweetie. *gentle and reassuring pats on your arm* Two weeks into the process your vet should have drawn a complete blood panel as well as several glucose curves and was able to determine the right starting dose from those results. You will stick with the starting dose for 7 to 10 days - some more conservative vets even go two weeks - then you will make a change in either insulin dosage or food intake. Here in the beginning like you are, this change is most likely to be insulin and not food. This process continues until you reach an acceptable glucose number for most of the day - usually for cats you want that number to be in the 100 - 200 range. Your vet may strive for lower, but I found it is much better to be a little on the high side than to risk an insulin overdose, especially if you work outside the home and cannot always be there to monitor and observe your kitty for hypoglycemic symptoms. Once you've achieved an acceptable number for most of the day, you are said to have "regulated" the glucose levels. This can and most of the time does take more than two or even three dosage/food changes and of course at 7 to 10 days or even two weeks a pop, well, you do the math. *grin*

One thing to keep in mind, however, if your cat stresses the car ride and vet visit, ANY glucose reading obtained under stress will be elevated. Ask your vet if he/she will come by the house to obtain the sample. He/she can use the very same glucometers as human diabetics and achieve accurate results without putting your Punkin under any additional stress.

Which human insulin are you using? My Sadira was on Glipizide (oral antihyperglycemic) and got two pills per day, and Whitney was on Humulin U. Whitney received 3 units twice per day.

If your cat is overweight, ask the vet about changing his diet to a higher fiber/lower carb food such as Hill's Prescription w/d. Whitney needed to lose 3.5 pounds, so we began with this dry food (we went oh-but-soooooo-slowly with her) and I was able to reduce her insulin dosage by a marginal amount within a year and a half.

Now Janine - this is really important, so no matter what else you choose to remember out of this message, you make sure that you remember this, OK? I admire you so much for taking this on. It is obvious you love your cat deeply and take to heart the responsibility that goes along with treating a "Sugar-Kitty". It isn't easy. When friends or family members make insensitive comments about your choice, know that no matter what they say to you, a crazy cat lady in Virginia thinks you are a hero.

Learn all you can about this disease and it's treatment. Ask everyone you know - vets, techs, friends, family members, human doctors and nurses, EVERYONE for ANY info about it. There are lots of web sites devoted to Sugar Kitties on the Net, so do a search and find them. (I used to have a list - but the Great Hard Drive Crash of Early Spring 2001 disposed of a LOT of my resources *sigh*)

Hugs, and don't forget to breathe...email me anytime you want.

Gaye

Gaye,
Thank you so much for taking the time to write. I have calmed down a bit since first writing. I couldn't even sleep Friday night without dreaming about insulin. I have been reading everything I can find about this disease. I was aware that it could take some time to regulate, but I figured I didn't have to like it.

I was just a little confused and mystified as to why it "shot" backup to it's original levels. He has had some glucose curves and will go again this week for another. I hate putting him through this. It breaks my heart. We have gradually increased his units with each visit. The vet said after this week, we may have to look at reasons why he could be insulin resistant. Since the higher levels last week, he has started on w/d food - a step she was going to put off if she could. He has been overweight most of his life - well, that's what some would say - I just say he's big boned - of course, I use that excuse for myself with about as much success. He was 17lbs in July, but was only 14 at the time of the first blood test. He seems so little now. She still refers to him being overweight, however, I can't imagine him much smaller. He is a very large cat.

As far as stress, Punkin has never gotten too stressed over much of anything, thankfully. She didn't seem to think that was a factor.
However, I think he has figured out what's going to be happening when he gets dropped off now.

We are using Humulin U right now - 7 units 2x day. I did read that a NTIP (I think that's what it was called, I have it written down at work) is sometimes used for insulin resistance. He also has thyroid problems. This can be a cause of insulin resistance, but those levels have been under control. If fact, the last check they were low/normal.

Thank you so much for all your encouraging words. I do love him very deeply. There have been times over the past 4-5 years that I look at him and begin to cry thinking about the possibility of him not being around. He has been and is such a joy. My husband says that he would have to leave before Punkin, Jacob, or Rue(my dog) would...he's got that right. Your thoughtfulness means a great deal to me.

You're an angel
Janine:

I would like to thank all of you who have written and shown concern about my Punkin.
After severals curves and much anxiety for little Punkin, his blood glucose level is still high - over 500. The vet has decided that he doesn't need to come in for curves anymore because he is getting more and more stressed with each visit. Of course, the anxiety can cause the readings to be high. She is changing his insulin to a PZI insulin, and she wants me to monitor him with urine test strips. Has anyone ever done this? She said they can be used with the litter box, however, I have another kitty. Any suggestions/experiences from anyone
would be appreciated. Also, anyone know about the PZI insulin.

Thanks to everyone,
Janine

Janine - I am sorry that Punkin has not improved much.
I used urine test strips with my Doberman - but never with a kitty.
Good luck
Deb

Thanks Debra,
I just haven't quite figured out how I'm going to do it with another kitty. I used two litter boxes when I first got Jacob, but they both used it, too, so I went back to one. Right now I can tell which is Punkin's because there's such a large amount of it, but if his glucose comes down, (I pray it will) it will be more difficult to tell. He doesn't always use the box right now either. I use some bed pads around the box, and that will make it easy if he goes on those. I'm sure some of these wonderful experienced people on this site will have some suggestions. Thanks again.
Janine