? What would you do?

Hello everyone - looking for some guidance.

I have read multiple threads here and website info elsewhere for my newly diagnosed (as in yesterday) 15 year old, Genghis. She's a spayed female I found as a stray about 13 years ago. Alas, she has been fed an inappropriate diet for most of her life and just yesterday turned up BG of 26 mmol/L or 468 for my American cousins. Vet started her on Purina DM and 2 units Caninsulin BID. She is showing signs of neuropathy, also.

I've been reading up on TR and the benefits of using a long-acting insulin like PZI (still trying to source this out of Canada) but if what I've read online is true, I can get Lantus OTC here in Canada. I will work on that or special-order PZI through my vet, if he's willing. I realize the Caninsulin is not the optimum choice but for the moment it's all I have.

That said, I need to know what to do for the moment. I have done the following:

1. Removed all dry food from her diet and replaced with low-carb canned as suggested on this site and elsewhere. She is eating reasonably well but seems like she wants to snack.
2. Given her a total of 3 injections (11 am yesterday, 11 pm last night and 10 am today, done without knowing her BG)
3. I purchased a home glucose monitor this afternoon - just can't fathom injecting her with insulin if I don't know her blood sugar -- and just took her BG pre-meal at 7.45 pm (she had not eaten since about 2:00 pm) Her readings were 9.3 (167.4) and 8.8 (158.4) - I took it twice, just to be sure (her poor ear - I'm such a novice!)
4. Her PU/PD seem reduced (cat box tells no lies!)

Am I right in thinking the diet has had a drastic impact on her BG and that I should reduce the prescribed 2 units? Or should I wait a bit since she's just eaten and take her BG again and dose her if it's up again?

Thanks for any input you can provide - it is much appreciated!

 

Welcome to the board. Sorry you had to come here but you will find a wonderful group of experts to help you on this journey. I am NOT one of the experts yet but I have a few months of experience under my belt and I continue to learn each and every day.

Bravo for home testing and your success so early in this journey. The readings you just got are pretty good but look a little low to me. Maybe Genghis is having a really good improvement from the diet change. Unfortunately I am not familiar with the insulin you are using but I think it's a little harsher and faster acting than the Lantus I use. I would definitely check Genghis' reading again before giving her any insulin. I think any reading under about 12mmol would give me cause to hold off although no insulin is not necessarily the right call either.

It's Father's Day and the board seems to be a little quieter than usual and I cannot give you dosing advise. Hopefully one of our "experts" will see your message soon and provide some guidance. Wait about an hour after she finished eating and see what her reading is then. Post that reading and I'll check back to see how she is doing and if anyone else has chimed in.

So you are in Canada! So am I. Yes you can get Lantus over the counter. If you choose to go that route, get the 3ml vials meant to be used in the pen but use syringes instead (get the 3/10ml/cc syringes as they have .5 u markings as that allows you to use 1/2 unit doses if need be. Although the Lantus folks would like us to believe that the insulin is only good for 28 days once put into use, folks here including myself, keep it in the fridge and often can use up a 3ml pen vial. It comes in a 5 pack. Just make sure the expiry date is a couple of years out.

 

Since she is newly diagnosed and you are just now testing, on top of switching her food, I would check her again +1 after meal and see where she is at. I don't think I would I would shoot tonight given that she is below 200.

 

200 mg/dL is about 11.1 mmol/L

Diet changes have reduced glucose levels between 100-300 mg/dL (5.55 - 16.65 mmol/L),

 

Thanks everyone for your replies! Mr WorfMen's Mom, you are right about Caninsulin - it's 30% fast acting and 70% long acting as far as I know.

I took her reading again and she is at 13.2 (238) so I think I will issue a half dose with some more food and take another reading tomorrow morning. I'm guessing her body is getting used to the insulin as well as adjusting to the improved diet. She was a champ for the blood-letting - I am so very impressed and happy for her, and grateful for her cooperation. I am also grateful for all the information on this board - had I not got the advice to get the glucose monitor, then surely she would have had too much insulin and risked going hypo.

Thanks also Mr WorfMen's Mom for the advice about the Lantus! That is invaluable. I will be talking to my vet when I take Genghis in to have her curve done - let's find out how progressive he is!

Thank you again, everyone.

 

BJM thanks for the Glucometer Notes link in your signature line - very helpful reading. I am encouraged by Genghis' progress so far. I will have to read the rest of your links tomorrow - my brain is a bit overloaded from a day of reading. Am I to understand that the 200 mg/dL being the "no shot limit" means that <= that reading I should not administer insulin, particularly one like Caninsulin? I also read your post over in the Caninsulin section about feeding 30 minutes prior and again at +2.5 to assist in countering the fast-action - thank you again for the notes.

 

You are so welcome. Again I don't want to be advising about doses due to my lack of knowledge with your insulin but if you give the 1/2 dose and more food, I would suggest testing at least once more before hitting the sack to make sure she is not dropping too fast. She is not that far over the 200mg (11.1mmol) no shoot number. I too could not imagine giving my cat insulin without testing so that retesting recommendation is from one OCD Mom to another.

 

That's great advice, MrWorfMen's Mom - and LOL @ OCD Mom. You've hit the nail on the head, there! How did you know?

Off to re-test in 30 minutes. And write it down in my new notebook…


<edit> Her reading before bed and one hour after shot is 11.2 - and she ate a bit more so hopefully she will stay levelled off. Thanks everyone.

 

There is a lot to learn, but you'll get it. There's nothing quite like the motivation of our 4 foots!