2 units in a.m., 1.5 in evening?

Hi there,
I'm new here and I've found this page so helpful since Yukon (14) was diagnosed about 2 months ago. We're still working to get Yukon balanced out and find the dose that works best for her (two units Lantus 2x a day and her sugar dropped too low, 1 unit and her blood sugar was high, 1.5 it was still too high, but coming down.)

I was at the vet yesterday and he'd like me to adjust Yukie's dosage to 2 units in the a.m. and 1.5 units for her evening shot. Is this common? I wasn't able to find out online. I do trust my vet, but had not heard of doing this.

Thanks,
Ayne

 

No, Lantus works best on consistent dosing - same dose day and night.

But there are other things we can do to help regulate Yukon better. 84% of cats go into remission in the first six months if all your cards are in place so its not too late either - the keys are:

1. a good insulin like lantus (you got this already!)

2. blood glucose home testing ( to keep your cat safe and get a much better and cheaper idea of how the dose is working)

3. a low carb wet canned food like fancy feast classic pates or friskies pates ( critical: dont change food until you are home testing as the blood sugar can drop a lot and then the insulin will be too much)

So what food type/brand are you currently feeding?

Wendy

 

As Wendy mentioned, Lantus works best with consistent dosing, so you don't want to shoot a different amount at each shot. The only way to truly determine how a dose is effecting her blood sugar is by home-testing--vet testing is inaccurate because stress elevates a cat's blood glucose levels and falsely inflates the readings. With Lantus, you need a daily test mid-cycle to see how the insulin is effecting BG. When a cat first starts out on insulin, you have to work through what we call here "bouncing," or rebound hyperglycemia. This occurs because when the cat first starts out on insulin, their body (which has gotten used to high blood glucose levels) reacts to a normal blood sugar level as if their blood sugar is too low. So even though the dose is correct, you see a spike in their blood sugar levels for a bit as they adjust to the dose, and it can last for up to 72 hours. That's why daily home-testing is so important--it's impossible to determine if the dose is really too low unless you're catching the times when BG is actually in the normal-low range.

Also, because cats are smaller than dogs and people, they usually need finer dosing. We recommend most dose changes in .25u increments. If you need help on how to do .25u dosing with your syringe (because the smallest syringes you can get only have half-unit marks), there are some really helpful pictures here: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139

 

Thanks for the info, ladies.

Yukon is eating Purina DM wet food (1/2 can in am and pm) and Purina DM dry (1/8 cup 2x per day.)
I have tried to do monitoring at home, but so far I've had no luck. I'm continuing to try, but I find myself very stressed out and Yukon is so upset by it. She's fine when the vet does it, but she must pick up on my stress, and I usually wind up in tears. I've watched so many videos, again and again, but I can't seem to get it right. I wind up hurting her. I'll stick with her 1.5 dose and keep trying to test her. I really appreciate your input.

 

While you work on blood glucose testing, take a look at my signature link Secondary Monitoring Tools, particularly urine ketone testing. Ketones form from fat breakdown for calories. Too many may indicate diabetic ketoacidosis (DKA), a potentially fatal, expensive to treat complication of diabetes.

Others are some of the subtle signs vets ask you - hunger, thirst, urination, defecation, grooming, playing/activities, purring/contentment, etc.

 

Hello and welcome! It's great you're working towards home testing.

Probably you know this already from the videos, but are you warming the ear with something like a pill bottle filled with very warm water, or a rice sock? When I started doing that it made it a lot easier to get a blood drop from my Papaya's ear.

And I totally understand about the cat picking up on your stress - Papaya and I started out like that! I remember near the beginning getting up early for her shot, having such a battle with her because I was so stressed, and actually having to shut her in the bathroom for a few minutes while I laid down on the floor since I felt like I was going to pass out! Now she actually lies there and purrs while I warm up her ear and usually doesn't bat an eye when I do the blood testing.

I think the big turning point for me besides warming the ear was also just thinking that I needed to imitate the vet and be very matter-of-a-fact about it, not nervous with anticipation. It's totally no big deal when he does it, just prick, test . . . so I just had to mentally convince myself to approach Papaya with the same attitude. Easier said than done, I know, but it did work for us and I know you'll get the hang of it soon. Don't give up! Pretty soon you'll be giving pointers to new ones on the board!

All the best to you and Yukon!

 

Here are some great ear testing tips that might help. As to stress, I wrote this up a couple of months ago for another new member who was having quite a bit of difficulty and thought it might also help you not stress as much about it.

 

Hi Ayne!

Here is some of the info to get you started"

Ayne &Yukon (male, 14)
DX date 5/??/2013
Lantus w/ ? meter
Purina DM wet and dry

 

Hi there

Many people have issues testing at first and unfortunately kitty will pick up on your stress. So below is step by step/day by day . Q: Which meter are you using by the way?

Day 1 :Relax. Grab a herbal tea or a glass of wine to relax you. Read the tips provided above by KPassa. Then go and stroke Yukon round the ears and give him a treat. Repeat the ear stroking two times during the day.

Day 2. Check you have everything needed for testing i.e. something to warm the ear, something hard to put behind the ear to press against (a small flashlight would be ideal), wider lancets (28 or 29g - not the ones that you may get with the kit they are too small), treats. Go shopping if you dont have these. Repeat the ear stroking as per day 1.

Day 3 - More stroking for Yukon. Warm the ear with the warming device. Stroke the ears. Repeat a few times during the day. Get those ears nice and toasty. Give treat for both of you Practice poking a potato or piece of fruit with a lancet.

Day 4 - More stroking for Yukon. Time for first poky. Use the tips provided above by Kpassa. Try 3 times and give a treat to both of you even if you fail. Let us know how you did and if you got any blood or not. Try again tomorrow.

Day 5 - remember that some ears take a while to learn to bleed. Repeat day 4. If you have no success now you may wish to try using a lancet device, or switching to freehand depending on whichever you were using before

Sound like a plan?

Wendy