6 weeks since treatment- no improvement

Hello! My 8 year old kitty Stasiu was diagnosed with diabetes almost 6 weeks ago. We started on Purina d/m dry and moist food and Lantus for insulin. I’ve been home monitoring from the start. We started at 1.25U Lantus twice daily and are already up to 4.7U twice daily. Glucoses are still in the 400s premeal and 4 hours postmeal. Today I changed him to Fancy Feast classics moist food to see if it will make a difference. Not sure why he is not responding to the Insulin so far. He is thin at 12lbs and still drinks a lot. Any advice would be welcomed as I feel like this isn’t working.

 

To understand what is happening we need to know specific BG values and when they were takes with regards to when the Lantus was injected. Many of us here enter the information in a Google Docs spreadsheet so it is viewable by othe4s here. Here is how to setup the spreadshee:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Here is some info on understanding the spreadsheet
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

 

Be careful. Fancy Feast will have a lot less carbs than the d/m dry, so that may cause a drop in glucose, and you are at a fairly high insulin dose. It's very important to monitor closely.

 

Hello and welcome! Excellent that you are doing home testing, and I agree, it would be helpful if you were able to set up your spreadsheet with that information. If you have a moment, we also suggest you set up your signature...here is the link to creating a FDMB profile

What meter are you using? Is it a pet meter or human meter?

As far as your current dose, that definitely concerns me. Your starting dose seems fine, but we normally do increases by 0.25u, the fact that you are up to 4.7u so quickly seems too high, but without seeing your numbers, it is hard for me to know for sure. What is important to understand is that with Lantus, we dose based on how low the dose is taking the cat. It may be that you are missing the "lows" and only seeing the higher numbers. I also agree with @FurBabiesMama - please be careful now that you have removed dry food. Dry food by its nature is very high carb, and may be the reason why you are not seeing much improvement in the numbers. We usually recommend feeding kitties foods that are less than 10% carb.

I don't want to overwhelm you with information, so when you are ready, please come and visit us on the Lantus SubForum. There are many experienced members who can answer any additional questions on dose and Lantus.

We also have information for folks who are new to the group which we call The Basics Sticky, which will help you get more familiar with the Lantus insulin, please have a look, that will get you started on some of the basics.

 

Thank you!
I will look into getting the spreadsheet together ASAP! Anything I can do to help me figure this out for my kitty is worth it!

 

Thank you for the advice! I changed his food knowing I’d be home for the day knowing this could cause a big swing.

 

Thank you for all the info! I am using the Alphatrax 2 meter for home testing and will
try to get the spreadsheet together ASAP.

 

If you run into difficulty, just holler. There are some spreadsheet savvy people here.

 

I just noticed in your original post that you are referring to premeal and postmeal readings. Does this mean you are feeding twice a day? The reason I mention it, is because many of us find that it is better for our kitties to have multiple meals a day. What I do is feed a larger breakfast and dinner portion, and then I have small snacks, three in the a.m. cycle, and three in the p.m. cycle. That's just what works for us, maybe you decide to do only 4 meals a day...just something to think about.

My boys used to be free-feeders, but with the switch to canned food, I needed to break up the meals somehow. I purchased a Petsafe Autofeeder which I really like, it has 5 compartments, and rotates on a set timer. I actually purchased two, one for my diabetic kitty and another for my non-diabetic cat. They love it, each go to their own feeder when it turns.

 

Yes- per my Vet's directions I only feed my cats, both diabetic and non-diabetic, twice a day. They were grazers, but I stopped that with this new diagnosis. They would love to eat more frequently, especially my diabetic cat wants to eat all the time! Maybe this would be an option for us!

 

Stasiu's Spreadsheet is officially available. Currently, he only eats twice a day. On days I work 12 hour shifts, sugars do not get checked post meal. I have only recently gotten good at getting blood for the sugar checks, so some days there are no values available. From the spreadsheet, it looks like we started to do better early on (300s), but then we increased the dose and it hasn't gotten any better. Maybe I need to back down the dose significantly?

 

Welcome to FDMB!

Just out of curiosity, what kind of syringes are you using? Lantus is a U100 insulin (this refers to its concentration) and you need U100 syringes. I've rarely seen doses that are in the increments you've noted on your spreadsheet.

Part of why you may not be seeing a response to Lantus is the dry food. It's very high in carbohydrates. I would monitor carefully as you are making a switch to low carb food. I'm presuming you're using the Fancy Feast pate style food. You have a lot of low carb foods to choose from. Lisa Pierson, DVM's website on feline nutrition has a food chart with carbohydrate values listed. She only lists canned foods. You want to select any food that is lower than 10% carb. Most of the people here used foods that are in the 4 - 6% range.

If your cats are use to free feeding, there is no reason to not continue to free feed. Many of us have used timed feeders to make sure food is available throughout the day for our cats. You do not want to feed Stasiu 2 hours prior to shot time -- you don't want food to influence your pre-shot numbers.

 

I am using BD Insulin Syringes for U-100 Insulin.
Capacity 3/10mL, Length 6mm, gauge 31.
They have 1/2 unit markings.

Sounds like I should change my feeding plan. Glad to hear more meals is acceptable!

 

To be completely honest, there is no one "right" way to do most of diabetes management. One thing you'll see us note a great deal -- every cat is different (ECID).

I'm relieve re. the syringes. How are you handling the increments you're dosing?

 

I text my vet every few days the numbers I’ve been getting and he tells me what dose to go to.

 

Just thinking out loud @Sienne and Gabby (GA) ...tonight's cycle might be interesting? Joanna, the numbers have been coming down today, I think I'd try and catch a couple of tests, maybe start with a +2. If the number is lower than tonight's preshot, it would be good to keep an eye on the cycle. Post on the Lantus sub group if you need any help. It is also possible that my senses are off...hence the reason to ask Sienne, since she's been here for a decade ...

 

He ate 4 hours ago and his sugar is now 308!

 

Thank you for posting another test, that looks fine, I had sure hoped you would see something in the 200s by +4. He may come down a little more but he is doing fine tonight. The dry food does take some time to clear the system as well.

 

All of this has been very helpful and encouraging- I was getting very discouraged and thinking none of this was going to work! Thank you so much!

 

You're welcome! I remember what it was like starting out, I felt very discouraged too, it just takes a little time and and a little help from the people here who understand diabetes in cats and believe me, you'll get there...just wait until you see your first blue

 

Today's pre-morning and dinner sugars were 508 and 519. I worked 12 hours today and was not able to do any post meal and insulin checks. Was hopeful after getting in the 300s yesterday- today, not so much.