? New to Lantus, new to wet food only, completely lost :(

I am desperately seeking advice from more experienced Lantus users. Emmitt was diagnosed two years ago and initially started on Prozinc. After about a year he was switched to Vetsulin (4 units BID). In October we started Lantus. I realize it can take a while to get the right dose with Lantus, but we weren't making progress at all, and my vet's only suggestion was to keep increasing the dose. We were up to 5 units BID, and nowhere near regulated. Desperate for more advice, I joined this forum and quickly learned the Purina DM food was not good for him, and I started to wean him off of it. He has always eaten Fancy Feast pate, but used to also graze on his dry food. Within two days off the dry food he was 74 (December 1st). I thought we were on our way to Easy Street. I could not have been more wrong. At first I lowered his dose to 3 units BID (his original starting dose on Lantus), so he would not get too low, but his readings were still high. I had read about rebound with Lantus and Somogyi, so I wondered if that's what was going on, so I thought I would go down to 1.5 and then bring him back up if needed, but it seems like he is not even responding to the insulin, no matter what dose he is at. Last night his pre-shot BG was 371, +3 was 350, +6 was 311. I'm not sure if I should stop it completely for a few days to see if he doesn't need any insulin at all or if I should be working back up towards 4-5 units, even after pulling the dry food from his diet. I'm afraid I totally screwed up by lowering his dose right after his diet change, but I was terrified of giving him too much. Since the diet change, we tried 3 units BID for 8 days and now 1.5 units BID for 7 days. If anyone has some time to look at his spreadsheet (I think I linked it correctly in my signature) and give me some advice, I'd be very grateful. Please forgive me for the spotty readings. I realize that more numbers would be more helpful, but I'm hoping someone may be able to provide some insight based on what I have provided, as well as this long-winded post. It seems wasteful (and depressing) to keep testing when his numbers only move between 300 and 400 I would be so, so grateful for any insight as to what might be going on or advice on what to do now. I'm completely stuck and frustrated. Thank you in advance.

 

At this point, there's just not enough data to give you much in the way of helpful advise.

I will say that although I understand why you reduced the dose, it's almost always a waste of time to do "rebound checks" and you just end up having to go right back up on the dose....and usually you end up having to go even higher because glucose toxicity has had time to set in.

It's possible Emmitt has a high dose condition that requires a higher dose than "most" cats, like acromegaly or IAA.....it's also possible that he just needs more than "most" cats. Each cat is an individual!!

I'd like to suggest you might want to go back up to 3U.....and get some more data on what's going on with Emmitt.

You need to always test before the shot.....and get at least 1 mid-cycle test on the AM cycle and at least 1 "before bed" test on the PM cycle. (if at all possible....if you work and can't get the mid-cycle tests on the AM cycle, it's even more important to get a couple of tests on the PM cycle)

If you hold that dose for at least 3 days and get some more testing in, we can see how he's doing at that point and give you more educated advice.

I suspect he may just be a "big gulper" or may need to be tested for one of the high dose conditions, but it's just too early to say.

Wish I had a better, easier answer for you! We all understand how frustrating this disease can be!!

 

Thank you so much for the advice. I really didn't know which way to turn. I will try the 3 units and get more testing. I am unable to get the mid-cycle AM test because of work, but I can typically get some more PM tests. I will try that and see where we go from here. I have long suspected he may have some underlying condition, as he has been hard (if not impossible) to regulate, but I will not give up hope. Thanks again!

 

Very handsome kitty

 

Welcome! You're in the right place for good advice. Nice job on the SS. At least you have some focus now with @Chris & China advice above - I agree you need to hold that dose for 3 days and then see if the numbers move at all. Eliminating dry food was an excellent move as well. I'm still perplexed as to why many vets want to sell you DM - it's not "Diabetic" - it's "Dietetic" and it's loaded with carbs for these diabetic cats...it takes time to get things to a place where you can see a trend/pattern...keep testing - especially pre shot and with Lantus at 2 hours post shot - not all kitties respond within two hours but many do. If you can get a 3+ or 4+ also very helpful - at some point you'll see the Lantus effect and the BG will drop down...might not be as much as you'd like but that'll be an indicator that the Lantus is working...keep testing...and feeding that low carb food. If you need the link to Dr. Elsie's food chart it's in my signature - I refer to it often when shopping for food and I mark all my cans on the bottom with the carb content - so I can tell what's Low, medium or high carb - not all wet food is created equally...

Beautiful kittie too

 

Hi and welcome to Lantus & Levemir Land - the nicest place you never wanted to be.

It's wonderful that you're testing at home. It's the best way to keep that handsome boy safe. You should know that we are very data-driven here, and we believe there is no such thing as too many tests (look at one of my boys' spreadsheets if you don't believe me). The more information you have, the better equipped you are to make a dosing decision. I understand that work prevents getting a lot of mid-day tests, but be sure to try to get a few on your days off.

Remember that Lantus is a hormone, not a drug, so cats respond differently to it, and once cat can respond one way one day and a different way the next. It keeps us on our toes, for sure. That's why we call this the sugar dance.

I agree with Chris that 1.5 does not look like enough insulin. I also agree that you should go back to 3 units and see how that goes over several days.

A few questions: How much does Emmitt weigh? Do you feel this is a good weight for him? Do you know what caused his diabetes (steroids, etc.)? It's uncommon, but not unheard of, for a cat so young to get FD. Where do you live (you can be as vague as you like - we just need to at least know your time zone)? Does Emmitt have any other conditions/illnesses and/or take any medications?

Lastly, here is a post we put together to help new members get comfortable with this Forum - kind of like an FAQ. Keep reading the stickies at the top of the page and keep asking questions. We love to help! We're glad you and Emmitt have joined our community.

 

I think so-thank you!

 

Thank you for the advice! Emmitt weighs 16.5 pounds. As you may be able to tell from his photo, he is a big boy-long legs, big paws. The vet feels maybe 13-14 pounds would be ideal, but she has not been concerned with his weight, as he doesn't have a big belly or anything-just 'big boned' I have no idea what caused his diabetes. He has no underlying conditions. Oddly enough, I had a 13-year-old female who had passed from diabetes about six months before he was diagnosed. He had only eaten mostly Evo and for a short time the DM food for two years prior to being diagnosed. It actually switched him off tap water after he was diagnosed-maybe something in the water? I have no idea how I got so lucky to have two diabetic cats so close together. At least with him I knew the signs right away-excessive thirst, hunger, etc. so I caught him earlier than his big sister. She had already quit eating and had a BG of over 700 by the time she was diagnosed. I nursed her back to health, and she did survive about two more years, but she never really thrived. I wish I had the information I have now, or she may still be here. I am determined to do better for him. We live in Wisconsin (Central Time zone). He was just in to the vet a few weeks ago and had clear blood work (kidney and liver function, etc.) and urinalysis. She told me other than his 505 fructosamine, he is completely healthy. Thanks again for all the support. I'm so glad to have found this site.

 

So glad to have you here! So when you catch you breath - you may want to look around in this forum - the Lantus and Lev forum - read some of the other member's condos (that's what they call the thread we post each day). So tomorrow you may want to start your thread like this: 12/19 Emmitt AMPS 123 or whatever his number is - that way each day when you post a new thread we'll be able to tell the date - you'll notice people post daily - just to let everyone know how things are going - the cats name and the AMPS - the starting point for the new day. You'll also notice that every post contains a url at the very top - that's the post from the day before - so we can all look back thru all your posts or just back a day or two by using those links...I hope you find this helpful. There's also a limit to one post per day - and there are little pull down tags on the left hand side you can use for emergencies or if you have a question (There's a question mark, a 911...you'll see it) Use those if you're in trouble and need help right away - as people get up and start reading the posts, they'll jump in and try to help in any way they can...you'll catch the eye of the experts and some who may just be there for support and well wishes...

It's really a nice big club of like minded individuals who are here to help and support you on this journey. Glad you caught this Emmett early. We're here to help

 

That's wonderful info-thank you! I will try to figure it all out I really appreciate the advice, on the kitty and the website! Everyone here really seems to know what they're doing. I'll stick out like a newbie for a bit, but I'll try to blend in as best I can. Hopefully someday I can help out others. I've got over four years of experience in dealing with diabetic kitties, but unfortunately a lot of it was misguided. I'm here to learn, and it seems like there are a lot of great teachers here!

 

We try...like a bunch of mama cats...we may 'swat' you now and then...or pick you up by the neck and carry you to safety There's a lot to this forum...but you'll catch on...no worries about being a newbie...we all were newbies once...I remember it very well...I was terrified! I had NO experience dealing with a diabetic cat...and no clue what I was doing... Lots of help here...

 

Looks like your handsome boy has extra toes!

 

He sure does. I love polydactyl kitties!!

 

Hello and welcome to the best place you never wanted to be.

Good to see a bit more data coming in. Soon we’ll be able to help you help Emmit..

I think the same could be said for many of us. My girl was on low carb food before she got diabetes. I too tied to figure out what it was that caused it. Took a while. Turns out it was a benign tumour on the pituitary gland, that resulted in acromegaly. The tumour puts put excess growth hormone, which in turn causes the diabetes and other symptoms eventually too. Not everyone can figure out the why. Best to focus on getting him into good BG numbers and especially below renal threshold as much as possible.