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Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 30356
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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My cat was diagnosed with diabetes about 12 weeks ago and is

Resolved Question:

My cat was diagnosed with diabetes about 12 weeks ago and is taking caninsulin. He is 18 years old. my vet increased his insulin to 6 units per day. after his blood test came back as "poor control" he was on 4 units a day. He has started to lose even more weight and is always hungry and tries to take food off our plates. His thirst has decreased though. I think the insulin level is too high, he is depressed and sad. I do not know what to do. I am due to go back to the vets on Wednesday for more blood tests. I hope she does not increase the dose even more.
Submitted: 2 years ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 2 years ago.

Aloha! You're speaking with Dr. Michael Salkin

Leaving your cat with his vet for the day to have a glucose curve performed (serial blood sugar measurements throughout the day) will tell you if he's being overdosed. We look for a curve indicating the Somogyi effect - a profound drop in blood sugar (hypoglycemia) following insulin administration followed by an exaggerated rebound effect to hyperglycemia. Be sure that his vet also checks for hyperthyroidism - a very common cause of polyphagia (increased hunger) yet weight loss at his age - and a disease that can exist concomitantly with diabetes and make regulation of these cats quite difficult until the hyperthyroidism is well-controlled.

Please respond with further questions or concerns if you wish.

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Customer: replied 2 years ago.

He has already had a glucose curve. He gets too stressed, and the results are inaccurate that is why he goes back every 3 weeks to have blood tests to see how the insulin is working. He has also been checked for hyperthyroidism and does not have that either.

Expert:  Dr. Michael Salkin replied 2 years ago.
Thank you. Fructosamine testing is being used to monitor his glycemic control. That might have to suffice in stressed cats although I would allow him to relax in a darkened and quiet kennel for an hour until obtaining a drop of blood following your adminstering the insulin in the morning and then again 4-6 hours later to make sure the Somogy effect wasn't occurring. If not, he may simply require more insulin.

Please check what his T4 was. Hyperthyroidism is often underdiagnosed in our geriatric cats. Any T4 equal to or greater than 2.0 ug/dL (25.7 nmol/L) at his age suggests hyperthyroidism. These values are normal in younger cats; not so at his age.

Please continue our conversation if you wish.
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Expert:  Dr. Michael Salkin replied 2 years ago.
Thank you for your kind accept. I appreciate it.

I'm going to check back with you in a few days for an update. Feel free to return to our conversation - even after rating - prior to my contacting you if you wish.

Please disregard the info request.
Expert:  Dr. Michael Salkin replied 2 years ago.
May I have an update, please?