? Day 5 on lantus. What now? Another low bgl.

Discussion in 'Feline Health - (The Main Forum)' started by CassWTribby, Dec 8, 2017.

  1. CassWTribby

    CassWTribby Member

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    Feb 7, 2017
    Hi again everyone,

    Feeling very frustrated. Day 5 of lantus and she's had high BGL levels past few days.
    Preshot 16.9
    Happy today she went 8.8 at 2 hrs +
    Now she's 2.4 at 4.5 hrs +
    She's been eating and I gave her honey and waiting to retest.

    Is she safe if her bgl goes up or is lantus low still going to drop her bgl in next hour?

    I need to get back to work.
    Is it wrong to want to quit your job to take care of your sugar cat?!
    I'm having severe bgl anxiety.
     
  2. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    The lantus depot is kicking in! She has earned a reduction it seems!

    Not sure where her nadir would be as she had a low at +7 the other day, which may mean it hasn't hit nadir yet.

    To be safe, I would test again. If she is going up, then don't give any food and test again in 20 mins. If she is still going up without food you may be out of the woods.

    I work, I am glad my DH was home to work through the low points.
     
  3. Nan & Amber

    Nan & Amber Well-Known Member

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    Wow! That's quite a drop!

    How much time before you have to get back to work? Ideally, you'd like to see a couple tests over 50 without food influence before leaving her. Hopefully she will oblige-- you're still well within the time period of lantus action.

    She will probably bounce to the moon after this-- let's just hope she gets started soon enough to give you some breathing space! :bighug:
     
  4. Nan & Amber

    Nan & Amber Well-Known Member

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    While we're waiting for the next test result (should be about that time, now?): one thing you can do the next time she has a big drop at +1 or +2 is to feed a small low-carb meal then (if you aren't already). Sometimes, that can slow them down and keep them away from the sharks.
     
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  5. CassWTribby

    CassWTribby Member

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    She ate from 2 hrs past til no. 45 mins after post she's 2.2.
    Trying not to have a heart Attack.
    Gave her more honey. Dry food.
     
  6. CassWTribby

    CassWTribby Member

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    30 mins til +6 hrs past hopefully that's the lowest
     
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  7. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    congrats on the reducie!
    Any BG updates?
     
  8. Tracey&Jones

    Tracey&Jones Well-Known Member

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    That 2.2 is about the same as before. Hope she starts going up on the next test.
     
  9. CassWTribby

    CassWTribby Member

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    Just found a canned food w gravy which is usually forbidden and she's happy gulping it down. Her poor ibs but bgl is much more important. At 12:30 EST she's +6 hours since shot.
    Will test in a few mins.
     
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  10. CassWTribby

    CassWTribby Member

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    2.6 and she's gobbling gravy. She'll probably bounce to the 20's. Geez!!

    She's safe now?
    We are 6 hrs past injection.
     
  11. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    I would wait another 30 min and retest to make sure she is going up. ETA: 2.6 is still below 50 in the US system.
    The dry if high carbs will be absorbed by then but the honey effect will be gone.
    Do you feed gravy alone or meat and gravy?
     
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  12. CassWTribby

    CassWTribby Member

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    Meat and gravy but she has no teeth so I'm not sure she eats much of the meat honestly.
    If I cannot get her regulated I don't know what I'll do. I just bought lantus and test strips and don't even want to talk about $$$$$. This isn't safe for her and I'm sure she feels awful.
    Should I put her back on Caninsulin or lower the lantus dose and see how she does for another week?
     
  13. Tracey&Jones

    Tracey&Jones Well-Known Member

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    She just started the Lantus and the depot on this dose is just filling up. I would reduce and see where that takes her.

    I am amazed at the affect the Lantus has had.
     
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  14. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    I would not do the change, frankly - she getting good response on Lantus and all you need is to take the dose reduction tonight, keep testing and then talk to a dose wiz on here.. Do yo have digital calipers, by any chance? It helps micro dosing. If not eye ball at your best between 0 and 0.25. Because she 's gone below 40 (2.2) you have to reduce.
     
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  15. CassWTribby

    CassWTribby Member

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    I'll test her again at 1pm est.
    Would sub q fluids help when she's hypo? She gets them daily to every other day.

    One more question... sorry.
    Should I reduce insulin again and give her it at her 12 hr mark or skip tonight and start again in the am. I'm off Sat so can do a proper curve.

    Now off to stress eat or drink an adult beverage....
     
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  16. Nan & Amber

    Nan & Amber Well-Known Member

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    Let's see where she is at the 12hr mark before deciding on shot or not. As others have said, she's definitely earned a reduction in dose!

    If anything, subq might reduce BG slightly (temporarily), so I wouldn't recommend it in the middle of a hypo. I'm glad she likes the gravy food-- that's a great tool to help bring her up!

    Hopefully she will be up some more at the next test. She's really keeping you hopping today!
     
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  17. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    not that I know...
    yes give a reduced dose tonight at +12 - if number is not too low, keep testing to be sure she is safe - the larger depot might be at play tonight even if you take reduction. Let the +2 test tell you what's going on - chances are she'll bounce and then you 'll need to hold the dose for another 6 cycles to let it clear.
    The +10 and/or +11 will help answer it. Are you able to take any of these tests?
     
  18. CassWTribby

    CassWTribby Member

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    I'm home by 5. She gets her dose at 6:30 and I'm off tomm so I can set an alarm and test at 5
    I was planning on a curve tomm but not sure if I'll have enough strips. Have some coming Mon or Tues.
     
  19. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    I meant the +10 or 11 tonight - like at 5:15 - 5:30 an hour or so before the PMPS. This way you could spot downward tendency and decide whether or not to shoot. Does it make sense? If she low at +11 but lower yet at PMPS (+12) then you probably want to skip. If numbers are coming up then the newly reduced dose is ok - but better post for advise , I am very cautious type...
    About the curve tomm: if she bounces no point in doing it, IMHO - you'll get high numbers which won't help anything. If she does bounce - save the strips.
     
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  20. CassWTribby

    CassWTribby Member

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    3.9 at 1pm est I left her food dry and canned. Heading back to work finally.
    I don't have the "I'm scared" feeling from her anymore. Just the "go away mom and please stop poking me" feeling.

    I'll test at 12hrs see where she is and reduce. Maybe wait til 13 hrs and test after.
    Thanks so much everyone.
     
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  21. CassWTribby

    CassWTribby Member

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    Yes I'm home just aft 4 for today's +11 and +12. I'll test at 5 and 6 then post. I'll reduce no matter what. I don't want to have to build a depot all over again. I'm running out of test strips so have to be careful until they arrive.

    Really hoping to continue lantus but a bit worried/freaked about it. I wonder if I can delay her prednisolone a bit so as to not affect her bgl during the next few days.. She's on a very low dose so shouldn't have any withdrawal.

    Off to read all the lantus info again.... Just in case it's something in doing. :(

    It scares me to think what woukd happen if I didn't stop by home this am.
     
    Last edited: Dec 8, 2017
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  22. CassWTribby

    CassWTribby Member

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    Checked her and she only went up to 15.8 so I gave her .05 of insulin or as close to 1/2 of .25 as I could get.

    She's not feeling well poor girl. Her tummy is sensitive to all the gravy etc she ate to get her bgl up today. I gave her some slippery elm gel and will keep a close eye on her. Not feeling so good myself either. I'm so glad I'm off tomm!

    Heading out to get some baby food and delicious cat food she can't resist.
     
  23. Kris & Teasel

    Kris & Teasel Well-Known Member

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    My kitty gets an upset tummy from high carb gravy food too. I now give him high carb cat treats (Temptations, etc.) when I want to get his BG up. Adding a little honey to his low carb food also works for him.
     
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  24. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Great report - thanks! The 15.8 (~285 in US) is so-so not bad! My Ducia after getting below 40 sky rockets, literally! (check the SS if you don't believe it).
    You've endured great stress today :blackeye::blackeye: - someone's life was at your hand whilst you were thinking you do not know what to do..horrible. I've being there, too. Horrible. And you have done so well, so very well!:) Make sure you'll keep the notes from today to use another day. (oh, yeah, it was not her last low number..;)).
    there are different types of gravy/ high carbs sources: the FF or Friskies go to corn glucose mostly - it makes many cats sick, very toxic and contain soy often, an allergen well known, however there are an alternative sources of high carbs - a potato, for instance, been one of them, and other veggy starches, too. I do not know of any brand deriving MC/ HC from potatoes or something else less harming than the corn glucose - you' ll have to research - but there definitely other sources/ commercial brands that might works easier on her tummy- maybe do post about it on the Health Forum? I bet great many ppl will be interested to learn...and, hopefully, as well great many have to share.

    Have you ever tried the Soulistic brand? It's from US...
    I often use Autumn Bounty Pouches - chicken in pumpkin soup - 9%?
    The same brand make cans in Moist and Tender series - like Chicken dinner 8% or a Lamb dinner - 6% - not for everyday, of course, but as a steering the numbers up food - why not?
    I have no idea if it is sold in Canada...I hope it is... since we can take advantage of your insulin's prices then you should be able to access our cat food market, or is it not so?.... :confused:.. I never knew what NAFTA gave us both..:confused::rolleyes:

    I hope you'll find something suitable quickly!

    Keep us posted and try to get some well deserved rest!

    PS. She might be feeling not well because of the up and down numbers - my kitty looks (and I suspect feels) horrible when she goes up and down a lot (esp below 40 in the US system)! It'll pass. I always think of an express elevator in Chicago Sears Tower - it takes you from the floor 94 down to the Lobby in 1 minute - I felt nauseous... and kinda knee-wobbled at first... I know my face looked just the same as my poor girl's does - sick. And then it was ok.:)
     
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  25. CassWTribby

    CassWTribby Member

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    Tribby has IBD and is very sensitive to carageen and guar gum so she will be in a flare from that until I get her settled. Cbd oil has helped amazing though in settling it down. I'm reducing her steroids. Just picked up some chicken and broth baby food. I may add a drop of honey as it is sugar free.
     
  26. CassWTribby

    CassWTribby Member

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    5.9 at 5 hrs post shot
    I have given her some FF w gravy and am leaving some out. I'll try to check her again in 1 hr. We are both exhausted!
    Alarm set early to get 11+ and 12+ post shot.
    Fingers crossed we have a good night.
     
  27. JL and Chip

    JL and Chip Member

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    Sorry to hear you're having such a rough start on Lantus. Like I said in my other post, Charlie was super sensitive to even small doses of Lantus so I can relate. Every cat reacts differently to Lantus so data is your friend --the more you can collect the better. Plus, you have a few additional variables in play with the pred. Even small doses of steroids can have a big impact.

    Sub-q fluids can actually lower BG so I'd definitely avoid administering them during a hypo. Over the years, I've sometimes opted to "time" giving fluids to when the BG was at high points in the cycle. We were also dealing with CRF and chronic pancreatitis so sub-Q fluids were standard fare. My personal experience was that 100 mls could drop BG by 50-75 points.

    As for high-carb food ... Charlie had IBD and couldn't tolerate gravy so we had to "make" our own high-carb food using his normal low-carb flavors and adding honey or Karo syrup. It wasn't ideal but preferable to flaring his IBD.

    Finally, some cats have a late nadir on Lantus...some even at +12 or +13. Again, data is your friend. It can take a while to sort it all out, but take a deep breath, force some patience, and tell yourself that it gets easier. Because it does. I often describe the early days of dealing with diabetes and/or an insulin change as like looking at an old Polaroid photo (does anyone even remember them??). Anyway, you snap the photo and out pops a solid gray sheet of paper ... then slowly, images begin to form on the page and soon things make sense.

    If you haven't already, you might want to read (or re-read) some of the Lantus stickies. They contain a lot of valuable information.
     
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  28. CassWTribby

    CassWTribby Member

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    So Tribby is not feeling well today. Ibd I think? Nausea? I gave her slippery elm gel. She's not eating so I syringe Fed her this am. Bgl is 14 ish . I'll test again at +

    Poor kitty. I hate when she's feeling bad. I'm hoping she will feel better as the day goes on. No diarrhea or gas which is surprising after eating FF with gravy yesterday.

    Any thoughts or suggestions are welcome.
     
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  29. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    :bighug:no suggestions, really, you are doing everything right.
    A thought: when Ducia only began to see lower numbers and/or to experience sudden and fast BG drops she felt and looked sickly. Slept and wasn't much interested in food.
    I was devastated. But then, as the time passed, her body "acclimatized" itself to the lower numbers and she was feeling, looking and behaving better and better every day. Now she looks sick when she has Pink range numbers...:rolleyes:
    I hope it is reaction to the low numbers - nothing more serious.
    In the US we have pet meds called Cerenia - is it available in Canada? It might help with nausea and appy restoration. Harmless and no side effects that I heard of.

    Maybe some of the fellow Canadians know of any Canadian version of Cerenia?
    @Kris & Teasel
    @Wendy&Neko
    @Tracey&Jones
     
  30. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Yes, we can get Cerenia from the vets here. Cerenia is contraindicated if there are liver issues (processed in the liver). Another med that targets different nausea receptors and may be better in some cases in ondansetron (Zofran is the brand name). That's a human med that you get a prescription from your vet. However, and this is the big one, please shop around for best prices. Zofran costs it's weight in gold, the generics are WAY cheaper. And you can get it on line at reasonable prices.

    My Neko used to feel off after getting FF gravy - she reacted poorly to wheat. I did try some of the canned foods with gravy made with potatoes. The one I used has gum in it, but FirstMate (made in BC) is a pate with wheat that is high carb with no gums. The chicken and turkey flavours are 19/20% carbs.
     
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  31. CassWTribby

    CassWTribby Member

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  32. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    What you describe sounds so much like Ducia when we have just started!
    I do hope it's the low BG levels visit that lasted several hours that makes her feel unwell.
    I'd observe her, let her rest and feed - assisted if needed so she can have the calories needed. If her condition worsens than a vet visit is due. So far I'd just keep on eye.
    Important side note - but easier said than done one! - try to be objective in your observations, do not let your worries and fear (natural completely under the circumstance) paint everything black... When I was looking at Ducia in very, very similar condition I used to think awful things, the worse case scenarios... none thanks haven turned out true....
    I see that she still lowers, but nicely. More tests later, unfortunately...

    It is good to have something for nausea and/ or vomit at home - just in case.... If possible at all maybe you can find some shop where any of the above listed by Wendy meds are sold at reasonable price? Or an online coupons? You 'll need just very little at a time once in 24 hours or as needed. Ducia takes 1/8 or 1/ 4 of 16 mg Cerenia - and only when I think she is nauseated... My 4 pills pack is 6 month old and still have 3 pills untouched.

    ETA: another thought: maybe you know friend of a friend who takes Zofran and will be willing to share a pack with you for a little $?
     
    Last edited: Dec 9, 2017
    Reason for edit: error
  33. CassWTribby

    CassWTribby Member

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    So I just syringe Fed Tribby a bit of warmed baby food mixed w water and she panicked.
    She's also laying still and her breathing is faster then normal. Can a bad hypo cause this?
    She's on my lap asleep now. I'm cooking a chicken and hoping to entice her with some later.

    No vet's are open near me. I just checked.
     
  34. Nan & Amber

    Nan & Amber Well-Known Member

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    Are you checking for ketones at all?
     
  35. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Her numbers today don't look like hypo. The numbers yesterday, while lower than we like to see for a cat on insulin, would not normally be hypo territory. Cats not on insulin can test in the 40's. Typically you wouldn't see hypo symptoms a day later. It could be a bad reaction to the gravy. I would see that a day later.
     
  36. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Do you mean yesterday's forties? No, I do not think so.
    What is the current BG level?
     
  37. CassWTribby

    CassWTribby Member

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    11.8 for last 2 tests at +6 and +7
     
  38. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Ok, flat is not bad at all and not too high after yesterday - but your SS says something else....maybe you can update it?

    A thought: when you syringe fed her - could some of the food got into her lungs?

    Keep an eye on breathing - hopefully she just does not like been fed this way - in that case the breathing should return to normal soon.
    Home cooked chicken is great idea.

    Like Nan posted I too would be checking for ketones - lost appy + highish numbers could be an early signal for its development...
     
  39. CassWTribby

    CassWTribby Member

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    She's 11.8 and holding with little food consumed today. Maybe she just has a bad tummy ache?
    I'll leave her to rest and maybe offer some plain chicken when I test before dosing tonight. Roasting a chicken for dinner and for Tribby.
    I don't think she is in danger for hypo at all today.
    No signs of ketones. She had fluids today already.

    Sorry I'm so worried. I'm dealing w my own health crisis this week and have been in constant pain. It wears you down and leaves you with less available to cope with. The treatment to shrink the stuff that needs to be surgically removed sooner then later is a strong synthetic hormone. I'm a mess!

    I know humans that are diabetic and they feel absolutely horrible after a hypo. Spend the next day in bed nausea and dizzy with weakness and just feeling horrible.

    I did find a vet clinic open 24 hrs about 30 mins away so if anything happens I have an option at least.

    Thanks everyone :(
     
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  40. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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  41. Nan & Amber

    Nan & Amber Well-Known Member

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    Oh, that is really rough, I'm so sorry you are having to go through this!!!!

    I hope Tribby feels better soon, so you don't have to worry quite so much about her. It is very understandable-- so hard to see them feeling yucky. It does sound like a combination of an upset tummy from the gravy and just feeling rotten from having BG yanked around. Hopefully it will pass soon so you can relax a bit and concentrate on your own healing!
     
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  42. CassWTribby

    CassWTribby Member

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    Careful! I might cry if you hug me!
     
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  43. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    I found that a good cry can sometimes be therapeutic - as odd as it sounds :rolleyes::)
    I hope things will get better for both of you soon.
     

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