Up from 4 to 5 units-Lantus (Scared)

I am so grateful to this forum and everyone on it!
I'm fairly "new" here. I've become more active here recently.
Taco's vet upped his Lantus from 4 now up to 5 units. It's because he had high fructosamine levels at recent blood test. I'm confused and afraid if he's potentially on remission the 5 units could potentially create a hypoglycemic episode. I'm truly scared to give him his morning shot and have to leave him. Thankfully I've been able to give him his morning shot and wait an hour to be with him/monitor him after.
Are there any non immediate signs of hypoglycemia and is it generally that a hypoglycemic episode happen hours after an insulin dosing or do hypoglycemic episodes generally only happen after the insulin shot,? Thank you! I'm learning so much here
Also a footnote I feed Taco at night then after he's eaten I give him his Lantus shot.
He routinely wakes me up around 2-3am and paws at my face bc he's very hungry He does this on the dot at 6:00 am also
Can anyone suggest why he seems to
Eat a good portion of dinner but then is ravenous at these times at night thank you!!

 

Hi! That’s a pretty big increase, we usually increase .25-.5 at a time. Are you home testing? That’s the best way to keep Taco safe from a hypo and to tell how well the Lantus is working. As for food, how often do you feed? Many of us feed several mini meals each day and that seems to help with the hunger. A autofeeder is a lifesaver for the extra meals.

 

Lantus usually onsets around 2-3hrs after the shot (it's not immediate), and usually reaches peak action around 5-7 hrs post-shot. Ravenous hunger is one of the signs of hypoglycemia, so it is possible that Taco is going low during the night. This isn't inconsistent with the high fructosamine value because fructosamine only shows the average pattern over time. If a cat goes low, often there's a response called "bouncing" that sends them shooting back up in BG, a reaction that can last for days. So, if that's happening, a cat can be spending most of the time high (and thus have a high fructosamine value) but still be going too low and be on too much insulin.

Like Sharon, I'm concerned about the latest increase, it's quite large. Do you home test at all? That's the best way to tell what's really going on with the insulin dose-- you really have to see the whole pattern, not the overall average like you do with fructosamine.

More hypoglycemia signs here: How to treat HYPOS - THEY CAN KILL! Print this Out!!

 

As a side note: I think the Royal Canin dry food (and maybe the wet, too, it varies by style, and I can't find "rabbit and pea" on Dr. Pierson's food chart, http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf) is pretty high in carbs. That's actually a good thing right now-- it might be what is allowing him to handle that insulin dose and keeping him safe. Whatever you do, don't change the food without home testing BG.

 

Thank you Sharon! Yes I do home ear prick testing. I'll try my best to do it tomorrow. If I could do it alone I'd test as often as he needs. But he hates it, becomes frantic agitated and gets adrenaline strength so it's not possible for me to test him alone. I've tried. Also he gets so frenzied in fear I'm afraid his BG increases from the stressful aspect of the test. I've had to pay (hire) friends to hold him. They're hard to find, friends who are not at work and have those testing times available throughout the day. I'm not making excuses at all but I feel stuck with this. I feel stuck and badly for not giving Taco the much needed testing.
I am very afraid of him becoming hypoglycemic This week of his increase from 4 to 5 units I've fed him given him insulin and stayed with him for an hour post shot to be alert to any hypoglycemic signs.
Sorry I went off. On a complete tangent. When I can be near him I feed him throughout the day he likes to have very small meals. When I'm not with him in the daytime I leave a bowl of dry food and some wet food. He never touches the wet food. I feed him mainly wet food in the am before him am shot.
He does wake me up at approx 3:00 am and pretty much always on the dot 6:00 am
He paws at my face while I'm sleeping and he seems ravenous.
?? Do you have that too? Ever?
And I bought an expensive timed feeder especially one that would be cautious of pets inhaling food bc when Taco's really hungry he inhales his dry food. I try to give him
More wet than dry food but he's very finicky and loves the dry food over wet. It's the Royal Canin rabbit & pea with no treats no other food sources (in case he has a food allergy. For his incessant itching his skin all over his body aggressive over grooming but most disturbing is his routine attacking his stomach.
In regards to timed feeder Yes! It's a great idea and thanks for mentioning it. Once his e collar is off I'd love to ask suggestions.
I did buy an (expensive) timed feeder but
I think bc of his soft e collar he has a hard time maneuvering to comfortably able to reach the food
So he doesn't eat the food it gets stale and I have to throw it out but worst of all he doesn't eat it while I'm not able to be with him .

 

Thanks Nan and Amber!
I'm going to wb to your post but I wanted to post the rabbit & pea royal Canin selected protein food

 

The dry food is also rabbit (pea is the secondary ingredient rabbit is the primary Ingredient) vet said rabbit and pea is ok to test for food allergy as rabbit is good to test for allergies

 

Rabbit is a good novel protein to start with but there are others....but the "pea" part makes those foods too high in carbs to be good for a diabetic.

There are some other canned foods that are rabbit based. You might want to see what you can find that's lower in carbs than the RC Duck & Pea

 

It’s so hard when your kitty isn’t cooperative! Have you tried to desensitize Taco to the testing? Choose the spot that will be your testing spot and take him there multiple times a day and just rub his ear, give him a treat and let him go. Try to relax yourself as well, some say that singing softly helps. When you both start relaxing you can start adding the actual test. As Chris said the food you’re feeding is probably too high in carbs, especially the dry, but don’t try any switches until you get testing down pat! As far as hungry in the middle of the night, my cat was like that early on, but doesn’t bother me at night any more. The autofeeder has helped with that.

 

Just FYI, the wet food is 15% carbs, and the dry is 44%!!!

 

Sean & Rufus thank u!!!!

 

Thank you Sharon!! Those ear prick tools sound amazing. I feel horrible for not testing him - none of my were available during the work weekday to hold him for this. Thank you!!

 

Thank you Nan & Amber! I so appreciate your time and care and knowledge! I don't doubt your experience and knowledge At all
I'm hesitant to ask the vet before I know more information (Not !!! That i would nor have I been hesitant to ask her about Tacos health) I only want to provide her with enough information for her to work with ...Can I ask you please: Along with Taco's high fructosamine levels at 4 units of Lantus he had a symptoms that seemed to point to not having enough insulin: he started to quickly progressively to pee much more in his litter box
When he's been regulated his peeing in litterbox is close to what a non diabetic cat would be. He's not overweight but he is 16 lb (vet says a good weight for him) do you think maybe he is ok for 5 units and the ravenous hunger is caused by something else?

 

It's really hard to say just from the external symptoms. Ravenous hunger can be caused by both too-low and too-high blood sugar. And there are other health conditions (hyperthyroid, for example) than can cause excessive hunger.

I really wouldn't want to make any firm statements about that dose without more direct information about Taco's patterns of blood glucose throughout the day. I am worried that that dose may be too high, but there's really no way to tell for sure until you are home testing. It can take a while for a cat to become acclimated to testing, but with patience and persistence you can get it.

Until then, I'd be very cautious about the increase, and keep a close eye on Taco's response. If in doubt, leave extra food out for him while you are gone (if the hunger is due to hypoglycemia, having food available when he goes low could be a lifesaver). And, as I said, definitely do not change his food to low-carb until you are home-testing.