10/19/18 - Just diagnosed - Question(s)

Hello,

Have only given one shot so far, just diagnosed 2 days ago. We were put on lantus, I will start testing tomorrow before shot at home. Tech seemed against it, haven't discussed with vet yet but I DO NOT feel comfortable not testing before giving insulin.

My question right now... I have done a lot of reading in this section of the form and still had one question... Our vet is starting Harley on 1 unit of Lantus for the full day... 24 hours... is this usual? Should I discuss this with him at the 7 day check up?

 

Lantus does not last 24 hours in a cat. Cats have faster metabolism then people. The typical starting dose is 0.5-1 unit twice a day.

 

Okay, I will bring this up to my vet. I honestly moved a few months ago. I had kept going to my old vet who is over an hour away but decided to go with the ones in town. They seemed great the first few times but now after his diagnosis and researching a bunch everything is completely off. I am thinking of calling our old vet back and asking her to see him again.

 

This is the link to our Lantus forum. So you can be more informed, read the yellow stickies at the top. They will tell you about that insulin and the two common dosing protocols.
http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

 

Hi Robin, Your concerns with the vets are valid. Unfortunately vets - although trained in many things for many animals are trained minimally when it comes to feline diabetes. I've read it time and time and time again here in this forum of poor advice from vets. Especially the comments about you not testing at home - either they don't think you're capable of testing or think perhaps that they can do it better (although more expensive). That is the number one thing you can do to protect your cat from having a hypoglycemic event. Insulin is a powerful medication - it takes time to work - and when it does work it can seriously affect your cat.

So you're doing the right thing - reading these comments - read those stickies - yes, it's a ton of information - and at first it's overwhelming. And sometimes downright upsetting - lots of people will ask you to do lots of things - with your posts and spreadsheets and on and on it goes. But try to be patient...everyone here means well and is here to help you. Not one person is getting paid for their time spent on this forum helping others.

So welcome to the forum. It's a great group of personalities. There are experts who've been doing this for years and years. You'll see who they are by their signatures (most of them say 'GA' next to their avatar) because those kitties have gone ahead...so they've been here for years...

You can ask for help with anything by posting in your thread (only one thread allowed per day)..like this '?' (the question mark from drop down menu on the far left) 10/19 Harley - help with setting up spreadsheet OR help with dosage...that kind of thing will get the attention of those members who are proficient at setting up spreadsheets, etc.

Welcome to the group - don't hesitate to ask questions in your thread

 

I hope I have this in the right section, the lantus section and yes so much information but such good information. I spent way too long staying up and reading well past my bedtime for work today, haha.

But I got a BG on him this morning with the meter and dosed him his 1unit until the vet opens today and I can discuss that with him.

I think I am getting the hang of putting his chart together, I had some good people last night show me those links to read and get started as well. Just putting the first results in now and publishing it so I can get it in my signature.

10/18/19
7:45am AMPS 379 , 1 unit given.

I'll actually be home today for a bit longer, and then again right around the 5 hour mark to test again.

 

Welcome to L&L land, everyone is awesome
When I doubt just ask

 

So glad to hear you are ignoring the tech and testing. I question how much experience your vet has with lantus when suggesting 24 hour dosing. Since you are feeding dry food I would read the yellow sticky SLGS as that is the protocols folks use here if they feed any dry. I’d consider trying canned food as it will be lower carb.

 

You already got some great advice here so I will only add welcome!

 

Welcome. You are off to a good start and doing well already.

As far as Lantus goes. For humans it is normally given once a day, However, cat metabolize a lot faster so dosing twice a day is the norm. Given benefit of doubt on vets side (Lord knows I've had disagreements with a few on FD) your vet just isn't up to speed. But with your help and information to back you up, you might be able to help him learn so his next patient will benefit.

Also, since vet isn't quite there yet, if you keep insulin in fridge it will last you many months, so pay no attention to the 28 days he will tell you. In addition, purchasing it from Canada (if your in the states) is so much cheaper. Something to keep in mind.

 

Thank you for all the welcomes!

Would it be wrong of me to contact my old vet via email and let her know what is going on and get her input? I still will talk to this vet, but I just want to get a feel for our old vet and her knowledge on FD. I feel though, it'll be a lot more, they are a great clinic that keeps up to date on everything. I just don't want to ruin the relationship with anyone either.

 

This site has helped me tremendously. I am still new too. Keep coming back for questions- it is worth it.

 

I don't think it will hurt. You could ask what their view is on FD and using Lantus. Get a feel on how they might treat it.

 

Thank you, will reach out to our old vet here shortly.

Question:

When giving lantus and using the SLGS method with kibble what is best to feed? I read that small free feeding doesn't hurt that much during this method? That is what Harley is use to, specially through the evening. But since DX I have been feeding him twice a day. Morning and Evening. He seems okay but still seems to be very frantic and hungry when I wake up. If there is any of his 3/4 cup left after his dinner could I leave it out for him?

P.S. He was on a kibble his whole life, we switched to a purina d/m kibble without research first per our vet. Since already switching that I want to keep him on it for awhile since it is significantly lower than his old food anyway, get us both stable and comfortable with this and then look into switching him to a wet food. But I brought home both a bag of purina d/m kibble and d/m soft.

 

Smaller more frequent meals are better if you can manage it. Something to consider is freeze dried complete meals. They can be pricey but will provide the crunch and nutrients required.

 

Good plan as lower carb food just might bring him into lower numbers. Many become diet controlled and off insulin with that one change. I tho k feeding more often is better for many reasons. I fed Max several small meals but he was eating canned. Free feeding is fine. Until you know how he is reacting to the changes it’s best to hold food 2 hours before insulin. That’s only at the beginning.

 

Do you mean eat and then wait 2 hours?



_____

Also with my wonky schedule I work (full time student, full time internship, trying to work PT too) I never had a good moment to call the vet and when I did it was the last thing on my mind (was testing / care taking). So I sent an email tonight to the vet who DXed. I just explained that I really like to do my research when it comes to my pets and with my personal history with Lantus I know it is given q 12 hours and that he wrote the RX for 1u a day. I asked if they wanted me to change this because I was at home testing since I could not get myself to give him an injection without knowing what his levels were so I didn't bottom him out. I explained with the at home testing I was seeing his BG's spike to his pre-shot levels at about the 12 to 13 hour mark and staying just as high throughout the night until his morning dose of insulin.

1. I am hoping they respond well to me questioning his RX instructions
2. I am hoping they respond well to me testing at home when they told me no
3. I am hoping this all goes smoothly so I don't have to go back to the other vet. They are over an hour away at *so* much more money. BUT if 1 and 2 don't go well, I will be switching him back to his old vet.

 

As far as the 2 hours, pick up his food 2 hours before shot time, so that when you take his BG ( blood glucose) test,it isnt food influenced. Sort of like a fasting test. Both at AM & PM shot times. So around 15-20 minutes before his shot time, take his BG test, feed and shoot,of course depending on his BG number,that's where the experts come in if you need help should his numbers be low. Someone can correct me if I'm wrong, but, that is the way I do it. All usually within 15-20 minutes.But, pick up his food,2 hours before shot time.

 

Thank you Cindy&Taco! That makes sense.

 

Also, for when he starts going into lower numbers,it's kind of beneficial to test him 1 hour before shot time @ +11,that way you have time to try and get help or make a plan,so that you're not surprised at the last minute. Just a tip

 

Welcome to the group!

At some point, you may want to consider transitioning Harley to a lower carbohydrate, canned food diet. The DM dry food is more of a medium carb food vs. low carb. In addition, dry food is not particularly good for cats. Cats are obligate carnivores and do not need carbs. They also need moisture in their food. Cats have a very limited thirst drive and in the wild, get water mostly from their prey. Dry food is, well, dry!

If you've not seen it, there is a wonderful website written by a vet on feline nutrition. There is also a food chart on the site that was recently updated that contains information on the nutritional value (carbs, etc) for most of the canned foods that are available.

Please let us know if you have questions. The people here are very generous with their knowledge and are very willing to help.

 

I hope you get a satisfactory to your email. If not you can always use the close vet for everything but diabetes dosing and get help here. The was hesitant to listen to folks here at first but soon realized it was a good idea. My vet was great and soon handled all Max’s other issues and left the dosing to me. He was knowledgeable but never had dosed by less than .50 increments.