9/12 Tucker AMPS 304, +4 209, +9 124 , PMPS 88 (held dose), +2 191

Hello all,

Needing some dosing advice for my new start diabetic Tucker. Vet recommended starting at 1.5u twice a day. Was hesitant as that is higher than other two diabetic cats I have had previously and this is a new vet. (It has been years since they passed--both we got into remission).

I held his dose tonight as he is still dropping 12 hours after his am dose. Has anyone had this happen that far out of dosing? (I will test later tonight again for my own piece of mind). He was 360 at diagnosis (both at vet office and home testing later that evening to confirm).

He is currently underweight at just over 5 kg (big boy). I know we ideally should hold steady for at least 6 cycles but I am getting nervous as he only had 2 doses and is still dropping this far out (1st dose was at 2:30pm yesterday (only time I could show other caregivers proper injection technique--we are planning on 8am/8pm from this am onwards).

Thank you for any advice--feeling a bit rusty in my diabetic cat skills

 

The 4.9 (88) is too low to shoot.
Can you get another test in? On occasion, Lantus lasts longer than 12 hours.

Waving to you from central Ontario.

 

Welcome!

Have you fed dinner yet? If not, we can try a "stall" for 30 mins to see if he's starting to come up again so that you can shoot. That said, I wouldn't be surprised if you end up skipping tonight, as he's been dropping steadily all day... As long as there is no DKA/ketones in his history, he should be fine to skip.

We don't have a lot of data for dosing advice yet-- the 1.5U is a tad high for an underweight 5kg cat, but not excessively so.

Can you give us a little more history? Any recent food changes?

As an anecdote, my kitty Amber's very first Lantus shot brought her down to green, then she didn't see another green number almost two months. So there's one example of an oddly strong first reaction to Lantus!

Even if you don't shoot, it would be good to get at least one more test tonight, to see where he goes from here.

 

@Chris & China (GA) or @Marje and Gracie can set up a second spreadsheet in World numbers for you. It helps to have both sets – what you (and your vet) are used to reading and what most people here are used to looking at.

 

He ate some canned LC food at +9, and then I also fed him his usual LC canned supper at PMPS when I tested and got the 88. I will test again here shortly and can again later tonight depending on what numbers he shows. He has no history of DKA/ketones. Previous to the change to all LC wet food he was on free feeding dry and LC wet once a day and the odd mouse. We switched him to canned food only about a full day before we got to the vet (I took him to the vet because he experienced significant, rapid weight loss over the past two weeks and he has had no other health issues at all--we suspected diabetes so we did change his diet but only a day or so before his vet appointment was he fully off dry food). Vet initially wanted to use glipizide but I balked at that after I had time to get home and do more research on it.

Thanks for the spreadsheet suggestions--I made a second spreadsheet with world numbers as that will probably make things easier looking at his numbers

 

What time zone are you in? Again, it helps to put it in your signature.
Do let us know how long after the PMPS the next test occurs.

 

Another wave from Ontario.... in Toronto.

Just checking to see how Tucker and you are doing.

 

Well he is back up to 191 at +2 after when his PM dose was "due" . (I think in the future I should re-test sooner after he eats). Considering doing a smaller token dose (0.5 or less) tonight so he isn't without until tomorrow morning but haven't decided for certain.

I am thinking 1.5u twice a day is maybe just too much to start with and might reduce to 1unit twice a day starting tomorrow AM and see how that goes. I am just so nervous about missing a low with him.

 

I think dropping him back to 1u is a great idea. Not sure if you used Lantus with your other kitties but it takes a few days to fill the depot and that drop today into the night cycle suggests it would be safer to drop to 1u and hold that dose for now to allow the depot to fill and see how Tucker reacts. Not sure if you were here at FDMB before but there are 2 dosing methods we use. You can read about them in the stickies on Lantus forum and then decide whether you'd prefer to follow Start Low, Go Slow (SLGS) to Tight Regulation (TR).

 

Glad to see he's coming up some. I agree, dropping back the dose tomorrow seems wise. I wouldn't do the token dose tonight, I don't think he needs it and it will just confuse things.

If he went from free-feeding dry to all-wet so recently, his insulin needs may have dropped quite a bit. It can take a few days for the influence of the dry to leave the system, so he might just now be finishing the transition.

 

I think I'd just skip the shot tonight and start again tomorrow. You've fed him and until you get more data I wouldn't chance shooting any insulin.

 

Thanks all . We will start at 1 unit twice a day tomorrow with regular readings to see how things go. He certainly is already feeling better with his blood sugar a bit lower than pre-diagnosis

 

I’m not sure why his SS is only showing two lines. If you’d like me to fix this for you and make sure the World/US conversions are working correctly, please send me a PM by clicking on. “Marje and Gracie” to the left under Gracie’s avatar and then select “start a conversation”. I’d be happy to help you.

 

How's Tucker this morning?

 

He has bounced way up from his PMPS yesterday and me holding his dose and at +4 today from his am dose was 401. I will start a new thread here shortly with his numbers from today

 

Likely a bounce from that low yesterday....totally frustrating but normal and all you can do is ride it out.