1-4-15 Update on Ozgood

Ozgood isn't doing so well again. He was on 3U of Lantus, but when his BG dropped so low we decreased it to 2.5U. That wasn't enough, so he's back to 3U again. This time around it seems like 3U isn't enough. He's been on 3U since the PM shot on 12-30-14. Including his AM shot this morning that makes 10 cycles on 3U. We haven't seen any BG numbers below 300.

He's lost 1 lb in the last month. Our vet did a full blood workup last week. Everything came back normal except his eosinophils (the vet said this can indicate an allergy or parasite). Everything looked fine with his pancreas except his B12 was a little low. He got a B12 injection yesterday, and he has to get 3 more over the next few weeks.

While his BG numbers haven't been great, they certainly haven't been as high as they used to be. I don't get the 1 lb weight loss with numbers that, compared to what he used to be, aren't horrible.

I want to increase the dose, but I don't want him to bottom out either. I'm scared nobody would be around to catch it if he dips real low.

 

Hi Alex, Happy New Year. Here is you last post: http://www.felinediabetes.com/FDMB/threads/12-16-ozgood-5-5-550.129995/

Do you have syringes with 1/2 unit markings? Normally we only increase in .25U amounts if kitty is getting nadirs less than 300, which Ozgood was doing on 2.5U. Yes, you do have to eyeball those .25U increases, but the 1/2 unit markings help. There are also some pictures of .25U in the New the Group Sticky which might help. I'm concerned, like you, that the 3.0U is too much. He was still getting some green numbers on the 2.5U. Maybe try 2.75 instead? Too much insulin can also show up as high flat numbers.

I'd also encourage to try as best you can to get those preshot numbers and most importantly, some spot checks at the night cycle. It's very possible that Ozgood is going low at night (as many cats do) and then bouncing during the day.

As for weight loss, that will still happen while he is getting the majority of his numbers over renal threshold (approximately low 200's).

 

hi Alex
i agree with Wendy too. if he were mine, i would try 2.75 . if you change dose by .5 you could possibly go right by the best dose. that's why it is best to only change by .25 at a time. and as Wendy suggested, it is important to get those preshot numbers. this helps to keep your kitty safe so you know if it's safe to give the shot. hope you get some better numbers soon. this sugar dance takes alot of patience. hang in there.

 

Happy new year! Yes, we have 1/2 unit syringes. Yes, Ozgood had some nadirs less than 200 on 2.5u. Then the next time he would be in the 400s. It's frustrating because he used to get in the 200s on 2.5 sometimes, and now he won't go below 300 on 3 units. I never knew too much insulin could show up as high flat numbers! So should we go to 2.75 tonight? We'll be dosing him in less than 30 minutes.

I will say a couple good things- yes he hasn't went below 300, but he hasn't went above 300 either. He's stayed relatively flat, even if high. No huge spikes like we used to see. The weight loss just floored me. I didn't expect him to lose that much. :/

 

I'd try the lower dose. You want to dose Lantus on how low a particular dose can take the cat. Discount the bounce cycles where they can be higher. Good luck!

 

Thanks. We'll try 2.75 tonight and see how it goes. I looked at the picture on dosing less than 1/2 units- I'll give it a shot!

 

I see why you're concerned. those pinky numbers stink, don't they?

just wondering - did you buy your new bottle of Lantus at a regular local pharmacy, or was it mail order? or has the vet repackaged insulin into their own vials for you? Much of the time when we're suspicious about the insulin being good, it's perfectly fine. But you've had nothing less than 239 on this lantus on either 2.5u or 3.0u. that seems a little odd to me.