Decision: Insuline - to change or not to change?

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Maya & Neo, Sep 7, 2011.

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  1. Maya & Neo

    Maya & Neo Member

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    Aug 26, 2011
    Hi all,
    Just want to preface this by saying I realize my situation is uber complicated and I'm just looking for honest answers from people with a lot of experience. I promise I won't hold anyone personally responsible for any decision I made, and I wont come screaming at any of you, though I may come crying if the unthinkable happens.

    My situation in a nutshell:

    • * I'm leaving for a 2 month holiday in 7 days.
      * I have arranged for a place to stay for Neo & Groovy (they will have their own private rooms and access to the outdoors). Jasmien has confirmed it's no problem to give insulin shots, but she is currently on holiday so I can't get her to confirm she will be okay with doing blood tests until the 11th or 12th of September, when she's back (I'm flying out on the 15th).
      * Neo switched to low carb wet food only this past Sunday. He's been looking more chipper on it and is drinking less water and peeing less.
      * I found out yesterday afternoon that Neo's poo tested positive for some sort of bacteria so he's been started on penicillin today and will be on it for 5 days. Julia has pointed out that his infection is likely driving up his levels and once the infection is gone, the levels could drop dramatically.
      * Neo is currently on 5U of Caninsulin, 2x/day. His BG's are in his XLS, which I've linked to in my signature.

    So I've been chatting with Julia and the way I understand it, I have 2 choices. I'd really really appreciate it if you guys could chime in with what, based on your experience, would be the safest and best thing to do for Neo.

    Option 1: Stick with the wet food but make the switch to Lantus. Stick with a low dosage (1U?) for the entire time that I'm away, ask Jasmien to keep testing a minimum of 2x/day, each time before giving an injection, and if the BG is below 10 mmol/L ask her to call the vet and see what she should do. (or just skip the injection entirely?)

    Option 2: Put Neo back on his high carb dry food and stick with the current 5U of Caninsulin. Ask Jasmien to test 2x/day minimum, being injections, and again call or no injection if the level is below 10 mmol/L.

    Could I please have your honest opinion? I'm too new at this to have any kind of confidence in my decision, so I would really appreciate your thoughts. Sorry to be such a nuisance so early on. :cry:
     
  2. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    Re: Insuline - to change or not to change? Please help!

    I would opt for option #1. Jasmien must test before each shot and for some days (or nights) , mid-injection BGs should be taken. The vet should be called as necessary. also, are you available via email? If so, you should be be emailed daily and asked for guidance if immediate (from vet) is not required.

    I have catsat for this one woman who has one civi and one diabetic cat. One was for 1 /12 months and the other time for three weeks. I emailed her after each visit at first and then daily. The only problem was that at first the kitty wold not want to eat and I gave a reduced dose one or twice.
     
  3. Maya & Neo

    Maya & Neo Member

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    Aug 26, 2011
    Re: Insuline - to change or not to change? Please help!

    Thank you, Larry! I appreciate the feedback. One question - by mid-injections, do you mean 6 hours after injecting? I thought I read that's when the peak is with Lantus.

    I will have email and a phone while I'm away, and I'm planning on telling Jasmien that if she has any doubts, she's more than free to call my vet (who is available 24/7) and otherwise she can SMS me and I'll call her back straight away - so no phone bills for her to worry about.

    Neo's always had a more than healthy appetite, so I really hope that won't change when he goes to visit with Jasmien!

    And don't I wish I was living in the US right about now...
     
  4. KSAkitties

    KSAkitties Member

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    May 26, 2011
    Re: Insuline - to change or not to change? Please help!

    I would go for option #1. Feeding your kitty high carb dry food for the next two months IS REALLY NOT a good idea. High carb food is putting a lot of stress on your kitty's already compromised pancreas. Feeding Neo low carb wet food and changing his insulin from Canisulin to Lantus (or Levemir) as soon as possible may get Neo regulated or even OTJ before you come home from your trip! Please don't waste two months of precious time feeding Neo high carb DRY food and delay his chance of getting better quickly.


    Will Jasmien be willing to use FDMB, if she has an urgent dosing question, if you are not reachable (given the time difference while you are away.), or the vet is not available to help her immediately.
     
  5. Maya & Neo

    Maya & Neo Member

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    Aug 26, 2011
    Re: Insuline - to change or not to change? Please help!

    Thank you! I will tell Jasmien about FDMB, but her English isn't so good so I don't know how comfortable she will be.

    BUT my vet is always available 24/7 as they also do emergency services and they've told me a number of times they'd rather someone called 18times over nothing than not call the 1 time it really mattered. And they know Neo is going to stay with someone and that I'll be away and they said it was of course no problem for Jasmien to call about Neo. They wanted her to, actually.

    So thank you for the feedback!

    It sounds like you all will agree, but I appreciate all opinions, so please don't hesitate to add your voice.
     
  6. doombuggy

    doombuggy Well-Known Member

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    Apr 22, 2011
    Re: Insuline - to change or not to change? Please help!

    I agree with #1 also. I wish I could go on vacation for 2 months... :D
    When I went to Europe for 2 weeks last year (my dream vacation, sort of), I got a world phone from....shoot I forget.
    Here it is:
    http://brightroam.com/
     
  7. KSAkitties

    KSAkitties Member

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    May 26, 2011
    Re: Insuline - to change or not to change? Please help!

    That's very good that your vet is available 24/7. Is your vet knowledgable of the Lantus dosing protocol if you are changing Neo's insulin to Lantus before you leave? I am just concerned that most vets in Europe are using Cannisulin, and Cannisulin and Lantus are two very different insulins. You/Jasmien may get better dosing guidance for Lantus from the members at FDMB.
     
  8. Maya & Neo

    Maya & Neo Member

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    Aug 26, 2011
    Re: Insuline - to change or not to change? Please help!

    Hm. Very good point. That's one thing that I'm *not* sure of. I have a list of vets in Holland who do have cats on Lantus. I'll have to ask tomorrow if my vet has any on Lantus as well. If they change their mind and won't switch, then I'll probably try one of the vets on the list and still see if I can change, although I'm going to run out of time pretty quickly. I wish I had started asking questions here a lot sooner! But if wishes were pennies...

    Thank you too, doombuggy! I'll be working part of the time, but yes, it's great that I'll be away for so long. Thank you for the link, but I'm actually going to be in Japan for 2 months, so I've had to order a Japanese sim - otherwise it won't work. :)
     
  9. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

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    Dec 28, 2009
    Re: Insuline - to change or not to change? Please help!

    This is just a suggestion and I really hope some of the Lantus people will comment on this, but, I'm wondering if the Start Low Go Slow approach will be best to practice while you're gone, and then you can switch to the Lantus tight regulation protocol when you get back. SLGS is easier to understand, and will have you making less changes while you're away, but at the same time allowing some adjustments to help Neo. I know it recommends doing a curve every 1-2 weeks and you'll be lucky if Jasmien gets the two daily preshots, but if she can just get a mid-cycle number in there every once in a while, you could use that to raise/lower the dose instead. I know it's not ideal, but I think it would be better than sticking to 1u without an increase or decrease for 8 weeks. You'd also be able to guide Jasmien with it yourself if your vet won't get on board, and of course if you need help with it you can always get online and ask for help here.

    Edit: I would also suggest making adjustments in .25u instead of .5u increments depending on how high or low his BG is at the mid-cycle tests. .5u of Lantus can be a lot, so I think being conservative with the increases with limited data as long as there's no ketones would be safer.
     
  10. Jen & Squeak

    Jen & Squeak Well-Known Member

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    Dec 28, 2009
    Re: Insuline - to change or not to change? Please help!

    Julia, I would totally agree. I don't think that anyone should be suggesting the normal lantus protocol here. I think that 1 unit twice a day (unless numbers zoom) is the way to go. This is not the situation for trying to micromanage numbers, rather, keep the cat as safe and healthy as possible. Preshot tests and spotchecks inbetween to makesure that thigns don't go low should be more than sufficient (in my opinion anyways :mrgreen: )
     
  11. Maya & Neo

    Maya & Neo Member

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    Aug 26, 2011
    Re: Insuline - to change or not to change? Please help!

    Thanks, Julia & Jen! I was just starting to read protocols and wondering which one I was supposed to be concentrating on - the tight regulation didn't seem to fit the bill. The protocol sounds pretty straightforward - I think it's indeed a matter of whether Jasmien will test for me. I think if she's willing to test at all, she'll be willing to do 3x/day. I take it that should be AMPS, +6, and then PMPS?

    I have found a backup place for Neo to stay - it's a pension that is owned and run by a vet. He just wrote back to me tonight to say that he always has room for a diabetic cat, so that was a huge relief. It'll cost me an arm and a leg for Neo to stay there, but depending on how Jasmien reacts and our gut feeling, we may end up going with that place. At least that way I know he'll be fine (and hopefully better) when I get back!

    And if that doesn't work, I found yet another place (although I don't know about their availability) that's even MORE expensive, but they explicitly state on their website that they have experience with Lantus. But that place will cost me close to 1000EUR for the duration, so I really hope that Jasmien will test him. Otherwise it might be cheaper for me to fly one of you guys over for a holiday in the Netherlands! Free place to stay in exchange for a plane ticket and taking care of Neo. Any takers? :lol:
     
  12. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    Re: Insuline - to change or not to change? Please help!

    I just wanted to link your last major post on the topic - sometimes it helps people if they need to see what's already been talked about, plus it helps keep one person's story straight:

    http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=51399&p=554221#p554221

    i don't feel uber-qualified to answer your question, and really know nothing about caninsulin - but i don't think your #1 option is a terrible one. that's an unconvinced "maybe it would work even though it's not ideal." if you're going that route, having someone who understands how lantus works be the person jasmiene goes to - ie, the vet on call - would be essential.

    btw, maya, i posted in the condo called "missy's spreadsheet" and explained a bit to her on how it works, and insulin in general. maybe that would help you understand more about why we tweak the lantus dose all the time.
     
  13. Maya & Neo

    Maya & Neo Member

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    Aug 26, 2011
    Re: Insuline - to change or not to change? Please help!

    Thanks, Julie.

    I agree. Absolutely nothing about my situation right now is ideal. :( When I arranged everything for the trip in March of this year I had no idea I was going to be adopting a cat in April, much less that he was going to be diabetic. But I've got him now, and I love him so I've got to live with the consequences!

    Thank you very much for the link. I'll go read the thread in "missy's spreadsheet" now.
     
  14. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

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    Re: Insuline - to change or not to change? Please help!

    Yes, that would be about right, but if she could, have her vary the mid-cycle test between +4 and +7 each day. For example, Monday test at +6, Tuesday at +4, Wed. at +5, Thurs at+7, Fri +6 again, etc. Doesn't have to be strict, just somewhere in that range where she can manage to get one in. And it doesn't have to be the same cycle every day, either. She can grab it in either the AM or the PM cycle.

    I am so glad to hear you have another option (even if it's a bit pricy). As long as the person sitting is watching the diet and you're keeping in touch to make sure they're dosing safely and testing, I think Neo will be fine.
     
  15. Jennifer & Saima (GA)

    Jennifer & Saima (GA) Member

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    Aug 16, 2011
    Re: Insuline - to change or not to change? Please help!

    I am sorry to jump in OT on a 911 thread, but I just wanted to quickly say that I really admire how you are handling this. You are being proactive about trying to figure out what is best for your cat, and it looks like with the input you are getting here, you will come to a good decision and solution for him. I know this is a sticky situation, and I just wanted to wish you good luck.
     
  16. Maya & Neo

    Maya & Neo Member

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    Aug 26, 2011
    Re: Insuline - to change or not to change? Please help!

    Ah okay, that's very helpful - thank you!

    I will be testing again in another 10 minutes or so to see if that weird little dip raise dip repeats, but any ideas on why his BG seems to drop at +3, raise at +4, and then drop again at +5? Are the differences so small it's negligible? Or maybe that's something peculiar to Caninsulin? I read that the dip usually occurs something like +4 (+/- 1.9 hours), but I haven't read about that little hump in the readings....
     
  17. Maya & Neo

    Maya & Neo Member

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    Aug 26, 2011
    Re: Insuline - to change or not to change? Please help!

    Hi Saimasmom,
    Please don't apologize! I think it's wonderfully sweet of you to cheer me on when you're dealing with a big loss yourself. I don't know if I could handle it with such grace.

    Thank you for the kind words. I really appreciate it. I've been beating myself up over the situation and feeling like the world's worst pet guardian so it's great to hear I'm not a total ### for putting Neo into this situation!
     
  18. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Re: Insuline - to change or not to change? Please help!

    maya - a lot of people put their cats to sleep when they get the diagnosis. you're a hero for putting so much effort into finding a good situation. no beating you up is coming from here, that's for sure - i'm sending you a pat on the back.

    meters are legally allowed a 20% variation in numbers - so if you have a 100, an 80, then a 120, they're all basically the same numbers. what's most important is to be consistent on what meter you use (ie, don't switch brands back and forth randomly if you don't have a reason to need to) and to see the trends overall.
     
  19. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

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    Re: Insuline - to change or not to change? Please help!

    Stop it! I know we all felt this way when we showed up here, and you are being incredibly determined and invested in Neo's care. You are doing a wonderful job educating yourself (incredibly quickly, at that!) and Neo definitely loves and doesn't blame you. We do the best with the information we have available to us, and that's all we can do!
     
  20. Maya & Neo

    Maya & Neo Member

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    Re: Insuline - to change or not to change? Please help!

    Okay, okay, thanks guys. I'm not good at compliments so I'll try to stop beating myself up. Soo relieved that the panic today has gotten us a back-up at any rate, and a vet to boot!

    And thanks for the explanation on meters as well. Turns out the reading went back up again tonight anyway, so I guess the other day was an anomalie. I'm hoping to get another 12 hour curve tomorrow since I'm working from home.
     
  21. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

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    Re: Insuline - to change or not to change? Please help!

    Maya this is a small thing--I believe the 911 icon is usually reserved for medical emergencies. I know your situation is urgent, so you need advice quickly, but maybe you could remove that icon and Edit your subject line and add an URGENT! in there.
     
  22. Maya & Neo

    Maya & Neo Member

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    Re: Insuline - to change or not to change? Please help!

    Oh - I'm sorry! I'll do that right away.
     
  23. Maya & Neo

    Maya & Neo Member

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    Aug 26, 2011
    Re: URGENT: Insuline - to change or not to change? Please he

    All - I have another question. What is a "big" change, where BG's are concerned? I'm just looking at Neo's readings and PMPS to +6 he's dropped 6 mmol/L (108 mg/dl). That seems like a lot to me. Is it? Or not so much?
     
  24. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Re: URGENT: Insuline - to change or not to change? Please he

    that's perfectly ok. cats often reduce the swinging of their numbers as they become more regulated. think of it as a pendulum swinging back and forth. as they improve the swings are less.

    what you are concerned about is keeping him above 45-50mg/dL - i don't know what that translates to in mmol . . . but unless he's down below 50 at mid-cycle you're just gathering data at this point. if he was 50 at shot time, that's a different story. then we'd probably have you skip the shot.

    but a 108 at mid-cycle, that's totally fine. somehow there's a setting on your spreadsheet that can convert your numbers to mg - which is what we use here.
     
  25. Maya & Neo

    Maya & Neo Member

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    Re: URGENT: Insuline - to change or not to change? Please he

    Thanks Julie. There's another tab on my spreadsheet so that you can see the mg/dl values. Took me a couple of hours to see that myself the first time. :D

    And okay, I thought it also wasn't good for his numbers to swing up and down too much. The vet told me he should be between 5 and 8 mmol/L (90 - 144 mg/dl) so I know he's still quite a ways away from that.

    I was mostly trying to come up with arguments to tell my vet of why I want to switch to Lantus. :)
     
  26. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

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    Re: URGENT: Insuline - to change or not to change? Please he

    If I'm understanding correctly, he didn't go down to 108--there was a 108 point difference between the two tests.

    Yes, especially in the beginning you might see some rather large swings. Cats do something that we call "bouncing"--when they hit a normal-ish number their bodies don't recognize it as normal because they've had high BG for so long. The cat's liver will dump glucose into its system and create a high number. This also happens after hypo incidents when BG legitimately goes to low.

    Eventually, the cat's body will start recognizing normal numbers as normal and stop panicking and dumping glucose into the blood stream. That's usually when you reach regulation. That's also why daily mid-cycle tests are so important in determining dosing. Your cat might be dipping into hypoglycemic numbers mid-cycle, but still have very high preshot numbers. A bounce can last up to 72 hours, so you might see high numbers mid cycle for a few days before the BG dips low again.

    Right now you're not really seeing the dramatic highs and lows that are usually associated with Caninsulin, most likely because of the infection. Once that clears, you'll probably see some really high and really low numbers. In fact, I'm really concerned with you shooting 5u considering the diet change. That is a dangerous dose to shoot when you don't know what he'll do when the infection clears. I would really keep feeding him some dry until you get him switched to Lantus. Or lower the dose! I hate saying lower the dose before you test for ketones, though.
     
  27. Maya & Neo

    Maya & Neo Member

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    Re: URGENT: Insuline - to change or not to change? Please he

    Hi Julia,
    Yes, that's correct. It was a change of 108. My kerostix (or whatever they're called) arrived in the mail today so I'll try to see if I can catch some urine tomorrow. I'll be home for the next 4 days so I do think I'll notice anything but I'll try to figure something out once I talk to the vet tomorrow morning. I'm hoping that I'll be able to switch to Lantus as of tomorrow, which, from what I read, shouldn't be a problem (for Neo). Am I wrong?

    But I'll call the vet in the morning and check his pee sometime tomorrow. Or at least try to!
     
  28. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

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    Re: URGENT: Insuline - to change or not to change? Please he

    Wow, awesome that the ketone strips came today! In my opinion, I do not see a problem with switching insulins tomorrow. In fact, the more I think about it I am leaning towards the opinion that it's the right thing to do with the diet change and infection being treated. Just definitely make sure you are testing for ketones to make sure that a lower dose is the right starting point for him on Lantus.
     
  29. Maya & Neo

    Maya & Neo Member

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    Re: Insuline - to change or not to change? Please help!

    Well, I called the vet. He didn't seem overly impressed with me wanting to switch at first, but when I started explaining why I guess he figured out I wasn't an idiot who was just trying to change on a whim.

    Just one small setback - my regular vet is off today so he said he wanted me to discuss it with her so she was aware of the change. So I have to call back tomorrow morning, same time. :-| Hopefully she won't give me any trouble and starting tomorrow he will be on Lantus/Levemir. I told the vet today I didn't mind which, I just wanted a more gentle curve, longer lasting insulin.

    I think I'll go ahead and order the new needles and everything today, though. Otherwise I'm worried they won't get here before we leave.

    /sigh
     
  30. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

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    Re: Insuline - to change or not to change? Please help!

    Maya, I don't know how it is in the Netherlands, but in the US you can get the syringes at the same pharmacy where you get your insulin--in New York you need a prescription from your vet. So I would have the vet give you a prescription for them when they give you the prescription for the insulin and you can pick them up at the same time. Or, if you don't need a prescription you can just go to the pharmacy and buy them. That is an option for you so you can get started right away instead of waiting for them to come in the mail.

    The syringes you want to get are U-100 syringes: .3cc, 30gauge or 31guage, 8mm needles with half unit markings.
     
  31. Maya & Neo

    Maya & Neo Member

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    Re: Insuline - to change or not to change? Please help!

    Thanks, Julia! I'm not sure how it works here either. ^^; I checked on some Dutch forums and found sites where people seem to buy their syringes so I went ahead and ordered 200 today, just in case. But hopefully I'll get some from the vet to carry me over. Good point though - I guess I'll have to pick up the insulin from the apothecary instead of the vet once we switch - hadn't even thought of that!
     
  32. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Re: UPDATE: Insuline - to change or not to change? Please he

    sorry about that - when i read your post i understood it was a 108 pt change, not a BG of 108 - but i think i got interrupted in the middle and obviously by the time i finished i was acting like it was a BG of 108. ohmygod_smile

    this is what happens when you hit middle-age. it's a curse. it's like your brain has too many vents in it and when the wind blows . . . things fall out. :lol:
     
  33. Maya & Neo

    Maya & Neo Member

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    Aug 26, 2011
    Re: UPDATE: Insuline - to change or not to change? Please he

    Hi all!

    So I have some updates and would like some advice or maybe even the outlines of a plan, if it's not asking too much?

    1 - Jasmien called Lennart when she saw he had called, even though she was still away on holiday. He briefly explained that it was going to be more intensive than we had originally thought and that we were testing his BG's now, to which she replied, "Of course you are!" Good start, right? To cut to the chase, she said she would be happy to do testing on him as long as I would show her the ropes, which of course I will. And I think I can even ask her to go out and quickly peek in on him during the day and until she's more or less ready to go to bed to make sure he's okay. I was thinking every 2 hours or so? Too much? Too little?

    2 - I've also been asking on Dutch forums what people think, just to get some different perspectives and also because Caninsulin is used a lot over here (as you know). And I've now had one person tell me that it would be irresponsible of me to switch Neo to Lantus so shortly before I leave when I'm not going to be around for a long time. So my question is - what sort of plan would I have to ask Jasmien to stick to so that it won't be irresponsible? If you'd be so kind as to have a look at his sheet tonight, you'll see that this afternoon he was in the yellow's, but tonight, even after my husband gave him his insulin (I was out) his numbers haven't come down AT ALL. :( And something I forgot to mention earlier, but when I spoke to the other vet on the phone this morning, he mentioned that there was a note in Neo's chart that he had experienced Somogyi. Is that when the dose of insulin is too high? Or have I gotten that wrong?

    Either way, I am now pretty much guaranteed that I will have someone who will test Neo (minimal 3x/day) while we're away. I think I can get Jasmien to test even more often. Lennart tried testing Neo for the 2nd time ever tonight (while I was away) and he said it was really easy. So I guess my obsessive testing has been pretty good in a way - Neo's already used to the whole procedure, the little sweety. dancing_cat

    What do you guys think? I was really leaning toward switching to Lantus and going with the start low, go slow approach. Would 3x/day testing be enough? (AMPS, somewhere between +4 to +7, if I recall correctly what Julia was suggesting to me, and then PMPS)?

    Which is more irresponsible? To leave Neo on Caninsulin or to switch him to Lantus? Either way I have to leave, but I want to give him the biggest change to be fine and happy and have ZERO incidents while I'm away. Please help! :cry:


    P.S. I did the ketone testing today, and it came out "trace" - that's good, right? :)
     
  34. Maya & Neo

    Maya & Neo Member

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    Aug 26, 2011
    Re: UPDATE: Insuline - to change or not to change? Please he

    No worries, Julie! I'm no spring chicken myself. :) I was having enough trouble trying to convert all the mg/L - I must admit I prefer the smaller metric units! :D
     
  35. Jen & Squeak

    Jen & Squeak Well-Known Member

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    Dec 28, 2009
    Re: UPDATE: Insuline - to change or not to change? Please he

    Hi there

    I still think lantus is a much safer insulin for your cat than caninsulin and I do not feel it is irresponsible for you to change

    Second, I think testing 3 times a day is more than adequate. Honestly, not everyone can even manage that much, so 3 is great and will give you a good indication of how the lantus is working

    Third, if you got trace, try again just using water and compare the colours. Because trace is an indicator that you need to watch him like a hawk because you do not want to elevate past trace. Make sure he's getting enough food and water.

    Jen
     
  36. Maya & Neo

    Maya & Neo Member

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    Aug 26, 2011
    Re: UPDATE: Insuline - to change or not to change? Please he

    Thank you, Jen! Of course I'm happy you agree because that's how I feel (Lantus would be safer) and I definitely don't want to be irresponsible!

    And thanks for the tip about the strip! It was between negative and trace, so I will try to catch some more urine tomorrow and I will compare it again results with boiled water tomorrow when it's daylight again. The water here is unbelievably hard/chalky. I can't stand to drink it. Blech!

    He's getting plenty of food,I think. I just gave him a little snack again about an hour ago (just wet food, not treats) because he seems hungry. And he has 2 cat fountains to drink from so he's definitely not lacking for water! :)
     
  37. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    Re: UPDATE: Insuline - to change or not to change? Please he

    Lantus & Levemir: New to Group?

    Tight Regulation Protocol

    Dealing with Low Numbers

    New Dose Wonkiness

    maya, i think you're ok to switch too, but again, i don't know caninsulin, only lantus.

    if i were you, i'd make the switch now. I'd keep his spreadsheet up to date, i'd print out the links i've posted above. Those basically give all the information on using Lantus on a cat. If you made the switch asap, you'd have a few days to learn some. i'd start posting immediately in the Lantus forum and let people answer your questions all day and all night long until you go. then you can teach jasmiene as much as you know. you might have a fairly good dose figured out by then, although we always recommend petsitters decrease the dose.

    but if you've printed out all of those links and put them in a binder/folder for her, then written notes on the pages as you learn, she'll be equipped and be able to keep neo in good shape til you get back.

    i think testing 3 times a day is ok for the time being - along with a lowered dose and not trying to push neo towards going OTJ by sending his numbers low (which is what we do when we follow the tight regulation protocol.) we could make the goal BG higher and safer. i like the suggestion - i think maybe Julia made it earlier - to test mid-cycle at different random times, but always catching one test between 4-8 hours after his morning shot.
     
  38. Maya & Neo

    Maya & Neo Member

    Joined:
    Aug 26, 2011
    Re: UPDATE: Insuline - to change or not to change? Please he

    Hi Julie, thank you thank you for replying!

    I called the vet this morning trying to get them to switch me today, but he wants me to talk to my regular vet. FINE. So I am calling tomorrow morning to argue to change again. I will definitely print out the papers and put them in a binder for Jasmien. I still have to check with her to see how her English is, but hopefully it's good enough. I don't know.

    If I do switch, I will probably drive the people of Lantus land crazy with my questions. I am totally obsessing over this whole thing so I'm completely dedicated to doing as much as humanly possible before I fly out!

    Great that you agree! I totally trust Julia already, but of course it's nice to know other people agree!
     
  39. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    Re: UPDATE: Insuline - to change or not to change? Please he

    you know, i think you should just have all of the stickies, so here are the rest:

    Lantus, Proper Handling & Storage
    and just make sure to note - keep it in the fridge but don't let it freeze, don't shake or roll it, don't squirt any insulin back into the bottle, even to adjust the dose. squirt excess in the sink or a paper towel. these things will keep your bottle or pen lasting a long time, up to 6 months POSSIBLY. Lantus officially says 28 days after opened but we use it longer.

    Lantus Storage Shed
    an important thing to note there is that Lantus injects as a liquid and forms a microprecipitate (tiny crystals) which then slow release. that's why it's so gentle. what that means is that the first few days on lantus the "shed" is building and only some of the insulin is immediately available for use by the body. so we wait a few days every time a dose is changed for the shed to catch up with that change - then we can see what the dose does.

    it's not rocket science but you have to learn how it behaves. take a look - i just explained this stuff to maresydotes on Missy's Spreadsheet and perhaps it will make some sense to you.
     
  40. Jen & Squeak

    Jen & Squeak Well-Known Member

    Joined:
    Dec 28, 2009
    Re: UPDATE: Insuline - to change or not to change? Please he

    Hi Maya

    Take a deep breath :) I think you are awesome and likely Neo does as well :) but don't rush. While there are definitely things you can do to help Neo stabilize and get on the road to health, it isn't sprint and if you go too hard too fast, you could burn out and you could push things too far with him. Do what you can before you leave, certainly, but remember that each change you make (food, insulin, routine, etc.) can take time to show its full effect. Don't pile too much on at once.

    Jen
     
  41. Maya & Neo

    Maya & Neo Member

    Joined:
    Aug 26, 2011
    Re: UPDATE: Insuline - to change or not to change? Please he

    Hi guys,
    Thanks for the links and the kind words.

    Jen,
    What you mention - piling on too much, is actually exactly what I'm worried about and what Julia told me to ask everyone. I have just changed his diet on Saturday. Is it too soon to now change the type of insulin he's getting? I have no idea if changing the type of insulin matters. I would have thought not because it's a hormone, so it should be the same hormone, just slower acting, right? Of course, caninsulin is a bovine hormone (I believe) and Lantus is a human based on. Does that also make a difference? Is there a possibility that his body will think 'what the heck is this?!' and give a horrible reaction? :shock:
     
  42. Jen & Squeak

    Jen & Squeak Well-Known Member

    Joined:
    Dec 28, 2009
    Re: UPDATE: Insuline - to change or not to change? Please he

    I think that a few days to allow for the diet change is likely sufficient. I think that lantus and caninsulin are vastly different in their chemistries and how they affect the body, but my understanding of it all is pretty pedestrian. I do not think that his body will have a massive nasty reaction. Rather, I just want to caution you against trying too hard to understand and do everything all at once. The basics of a good insulin at a reasonable dose, food that is low in carbs and mod/high in protein and moisture, and hometesting, is really a great start. To illustrate my point...somehow I managed to get Squeak off of insulin on a much older type of insulin, not hometesting for the first couple of months, etc. etc. :lol:
     
  43. Maya & Neo

    Maya & Neo Member

    Joined:
    Aug 26, 2011
    Re: UPDATE: Insuline - to change or not to change? Please he

    Hi Jen,
    Okay, thank you. I guess it's only normal to be frustrated. I want "the" right answer and of course there are no guarantees! Doesn't stop me from wishing there was one, though. ;-)
     
  44. MommaOfMuse

    MommaOfMuse Well-Known Member

    Joined:
    May 26, 2010
    Re: UPDATE: Insuline - to change or not to change? Please he

    Maya,

    Yep, it is completely correct that we all started this journey overwhelmed and frustrated and wanting the "right" answer, but we also had to remember that we are talking cats here...and cats being cats there just is no hard and fast answers. What works for one, may not work for the next one, the only common points are, diet, insulin (start low, go slow) and home testing. Case in point I have two adopted diabetics...Maxwell and Musette...Maxwell had me spoiled, he was started on Lantus, and had his diet changed to low carb/high protein and in 2 weeks he was in remission where he has been for the last 10 months...then came Musette, I was absolutely positive that since I had figured out Maxwell so easily that Musette would be a breeze....Oh how wrong I was!

    Musette and I have been dancing for 2 months now, and we are finally getting to a good dose for her..same insulin, same food...completely different cat. Just when I think I have her all figured out she throws me a curve, but because I'm testing her before every shot and at least a couple spot checks a day, I can catch those curve balls before we have a problem. Like yesterday she gives me a perfect Lantus curve, so I think YAY! success, I have her on the exactly right amount...her numbers look beautiful, I get up this morning, her preshot is lower than yesterday again a big YAY! So I go ahead and give her the same amount as yesterday, but she doesn't start dropping as quickly as yesterday, which is fine...still a nice steady even drop....then comes her shot time for this evening...well...we are an hour past when she should have gotten her shot and she is too low to shoot, and still dropping, so now we are in a holding pattern for her to decide to start going back up, so I can go ahead and give her, her insulin...she has given me more grey hairs than 2 ex-husbands, 3 children and 7 grandkids...lol. But I love the little fuzz ball, so we just dance to her music, at least after 2 months we have gone from doing the tango to a waltz. :lol:

    Its great that you have someone to look after Neo while you are away that is willing to not only give him his shots but also test him a couple times a day, and should she need us, all she has to do is log on, I know you said her English isn't great, but we do have members all over the world and we are a friendly bunch, if we don't understand something, we will ask for an explanation. Heck, we do that alot for those that speak and write English fluently.. :D Even if she does nothing more than log on and put something like amps such and such number...shoot/don't shoot? Or +3 and a number...concern? We will figure it out or ask if we can't.

    Another thing if she is really worried about her English....As my son is married to a Polish girl who is pretty good with English now but in the beginning...Google Translate, & Babblefish.com helped us communicate. She would simple go to Babblefish, type what she wanted to say in German, then hit translate to English, and copy and paste the results to me, I would do the same in reverse from English to German....it wasn't a perfect translation but good enough to get our points across. Just thought I would throw that one out, just in case she runs into a situation where your vet is busy since they do emergency care and she can't get ahold of them, or needs a quick answer to something...it would be a tool for her to use even if her English is limited.

    Mel, Maxwell, Musette & The Fur Gang
     
  45. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    Re: UPDATE: Insuline - to change or not to change? Please he

    maya, i totally don't want to overwhelm you with too much information.

    my thought was if you're going to make the switch, it would be just as well to get it done. i realize you're waiting for the vet, of course.

    i'm just thinking of someone telling me to not put it on the petsitter to try to figure things out (i was contemplating using frozen pucks of food to leave out) - but to get as much as settled as possible before you hand things over. if you educate yourself in how lantus works you'll be able to teach her.
     
  46. bookw0rm

    bookw0rm Well-Known Member

    Joined:
    Aug 11, 2011
    Re: UPDATE: Insuline - to change or not to change? Please he

    About ketones:

    One trace reading is fine. Two days in a row is a problem.
    Anything more than trace is a problem.
    If it's a problem, see a vet as soon as possible.
    You don't want to wait and see, ketones can cause trouble very quickly.
     
  47. Maya & Neo

    Maya & Neo Member

    Joined:
    Aug 26, 2011
    Re: UPDATE: Insuline - to change or not to change? Please he

    hi all, my continued thanks for your support.

    @Mel, thanks for the story about Maxwell and Musette. It makes more sense to me when you put it that way. And indeed from day to day I get different reactions from Neo and I'm trying to figure out why or what I did differently when nothing comes to mind. And of course! There's Google translate - I will definitely mention that. That's a great idea - thank you!

    @Julie, thanks for trying not to overwhelm me. :) Just to make sure I understand, you're saying that if I can, switch it ASAP and then test like nuts on Neo so that I get as much figured out as possible (and a schedule more or less set) before he goes to visit Jasmien on Wednesday, correct?

    @bookw0rm, okay, thank you. I will test again today, and compare against water as well. I know yesterday was somewhere between negative and trace, and the instructions told me to check exactly after 15 seconds, so maybe I waited a touch too long. Well, at least I'll be home nearly all day today so I should be able to catch him peeing, no problem!

    This is a bit of a side step, but talking about not putting too much on the pet sitter (which I definitely don't want to do!), do you guys have tips for injecting when Neo doesn't feel much like eating, like this morning? Usually he scarfs down his food, but today he licked at it a bit and then looked at me. So I mashed some up in my fingers and he ate that fine for a bit. I could hear his tummy making those weird noises... the ones right before you have to use the bathroom? :cool: He just didn't seem to want to eat on his own. So I ended up mashing the food up more for him and then I tossed it in the microwave to heat up a bit (I thought maybe he was slightly congested and couldn't smell the food or something). He ate a tiny bit more and then flopped down on his side.

    So I thought, okay, maybe I can still give him his shot! (I can hear him eating now, btw. ;-) ) So I tried to tent some skin more down between his shoulder and side. That went fine, but when I tried to stick him, he got almighty upset with me. I went and dragged DH out of bed and he gently held Neo while I injected him, but I'm worried for Jasmien. Are there any tips to "train" Neo to tolerate injections? Ear pricking is absolutely no problem any more. He might not want to sit still for me, but he doesn't seem to care one iota how many time I have to prick him in order to get some blood. Injections are a totally different story, though. He lunges for me (which never hurts but is really scary for me when I have a big needle in my hand) if I prick him and he's not distracted and quite often even if he's eating he tries to step away to get away from the prick. If I try to pinch his skin a bit harder to maybe numb it, he gets irritated with just the pinching and walks away or pretends that he's going to bite me.

    Any thoughts on how I can get him either to behave a bit more like when he's getting tested, or how I could restrain him by myself without having to get DH to help? Jasmien does have a husband so I guess she can ask him for help if need be, but it would be great if I could make it easier on her.
     
  48. Maya & Neo

    Maya & Neo Member

    Joined:
    Aug 26, 2011
    Re: UPDATE: Insuline - to change or not to change? Please he

    Hm. I hope some of you guys are still awake, because I just got a post from a Dutch Lantus "expert" and what she writes is making my stomach turn. Thoughts please? Please excuse the rudeness if it comes across. The Dutch are notorious for not worrying about being "PC".

    Rough translation:
     
  49. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Re: UPDATE: Insuline - to change or not to change? Please he

    I agree with everyone that switching before you go is not irresponsible--I think the odds are that he'll respond better to the Lantus, and that there is less of a hypo risk on it. I actually think it's the safer decision than leaving him on a high dose of Caninsulin and dry food. I also agree that you want to make these changes as soon as possible--the more time you have to see him react, the better.

    I don't think you have to worry about him having a reaction to the Lantus, but still, I would urge you to make the switch as soon as you can before he goes to Jasmine. Lantus takes a few days to start working and you'll want to get an idea before you bring him to her.

    As for dosing, check out my previous suggestion in a prior post in this thread on the "Start Low, Go Slow" dosing guidelines. I think that will be your best bet while you're gone. And I think 3 times a day testing is great! If you can convince her to do a curve (every 2 hours for a cycle) once a week, or even every other week, that would be awesome, but I would leave that up to Jasmien with how much she is comfortable doing.

    I would be a little worried about Neo if he's inappetent. When cats stop eating it can be a sign of a bigger problem, so let's hope this was him just being picky. Are there any other types of cat food you can get that look like they are low carb? I know it's hard without having the carb content, but anything with no grains, rice, corn, soy, wheat, etc., should all be ok. I would get a variety of stuff. Some cats get a little picky now and then and want variety. It would good to have options for Jasmien, too. And if he doesn't like a kind you can always exchange it when you get back.

    Google translate has gotten SO much better than it used to be this year, so it might be a handy thing to show Jasmien if she needs advice. That's how I was able to research on insulin laws in the Netherlands for you. :D
     
  50. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Re: UPDATE: Insuline - to change or not to change? Please he

    What this person is not taking into account is that Neo has been on a dry diet and had an infection--which is likely responsible for keeping his BG high and needing the higher dose of Caninsulin. It is possible he is insulin resistance, which I did mention, but more times than not this is not the case when dry food and infection are still in play. What I am worried about happening while you are gone is that you have two dangerous possibilities happening with staying on the dry food/Caninsulin.

    1. The infection clears and his need for insulin drops dramatically--Caninsulin is notorious for causing huge swings. Now, this is based off of my research, not personal experience since I have only ever used Lantus. But in two rounds of treating Bandit with Lantus I've only ever had a hypo number twice--and both of those times it was a very mild hypo number, which we caught with testing (which Jasmien will be doing). I have no idea what this person is talking about when they say the BG swings like crazy on a low dose. What they might be referring to is the beginning stages of regulation. When a cat first reaches a normal number, because they are not used to that number, their liver will release glucose into the bloodstream and this will cause some dramatic ups and downs. However, this happens with ALL insulins, not just Lantus. In fact, my opinion is that the slower acting insulins like Lantus help this bouncing even out faster.

    2. You cannot leave him on a high dose of Caninsulin and low carb canned food, so you will have to continue the dry food. I don't think it's likely there will be any improvement in his numbers if you do this--the dry food will keep his BG high, and Caninsulin is not safe to give at that dose with a canned diet and an infection clearing.

    Like I said, this is nowhere near an ideal situation. If it were ideal, you would be able to switch and monitor and get him stabilized a bit before you left, so there is more risk involved. It could be that he's insulin resistant. But will leaving him on 5u of Caninsulin and a dry diet help improve that in a 2 month period? I don't think so. A switch to Lantus might keep him in the same numbers he's in, or send him higher, or show quite a bit of improvement. You can never predict what is going to happen which is why we test. But if Jasmien is monitoring three times a day, and she might even do a curve once a week, then I think you're in a safer situation with the Lantus. We are not recommending you jump into intensive control with tight regulation right now. I at least, think you should use the Start Low Go Slow method, which has far less of a chance of you reaching hypo numbers too soon. It does have a risk of the dose being to low, but you do have the option of raising it.
     
  51. Jen & Squeak

    Jen & Squeak Well-Known Member

    Joined:
    Dec 28, 2009
    Re: URGENT!! Insuline - to change or not to change? Please h

    Wow, what odd things to say about fdmb and lantus. Oh, and it isn't an american forum...we are international. I am from canada, for example, and we have members world wide!

    I would feel much safer giving lantus and barely testing than give caninsulin and test frequently. You do not have to test frequently with lantus but you can choose to if you want more data, just as you can with any other insulin. Lantus does not cause the swings that caninsulin can.

    Again, how odd!
     
  52. Maya & Neo

    Maya & Neo Member

    Joined:
    Aug 26, 2011
    Hi all,
    Thanks for the comments and sorry about the blunt Dutch post. I was a bit taken aback by what she wrote this morning - didn't mean to offend anyone, so I hope I didn't!

    Just to give an update...

    I have just come back from a visit to the vet - the new one I'm getting since my old one is leaving the practice. He went through their records all the way back to the beginning and we had a look at Neo's numbers and what dosage of Caninsulin he was on at those times. Although the numbers changed a little bit (lowest was 13.3, highest was 20.2 or so) he's pretty much been hanging out with the same BG for the last 4 months. We went back and forth, I asked a lot of questions and he said that he agreed something needed to change and he was happy to change to Lantus, but he wanted me to be the one behind the steering wheel. Because so much is going on right now, change in diet, infection, etc. he was very uneasy about then changing the insulin, especially when he was honest enough to say to me that he didn't have a lot of experience with it.

    So we're going to go back to the way things were, and we're going to stick with Caninsulin for the time being, but I'm still going to ask Jasmien to still check his BG 3x/day to make sure nothing changes. And once I'm back, we're going to get together and have another pow-wow, recheck all the numbers that Jasmien has collected for us and then come up with a plan. I'll take in the Tight Regulation protocol with him at that time too, and discuss that with him. And I'll probably be back then to bug you guys for advice.

    I hope I don't offend or upset anyone with this decision. I don't want anyone to think I'm making this decision lightly or that I don't appreciate your thoughts and advice. I really do! So I hope that's clear. Especially Julia- you've put so much time into me and Neo already. I really struggled with the decision and I do still think that it's best to switch to Lantus, but the timing isn't good. This is not me not trusting you guys! It's just that I think in the end, it's asking too much of Jasmien (and maybe Neo too).

    So I hope no one is upset with me. I think you all are a wonderful, dedicated bunch and I appreciate all the wonderful advice and suggestions I've gotten. And I'm going to follow your advice too! Just a bit later than I had originally planned. :)

    Thank you!
     
  53. Jen & Squeak

    Jen & Squeak Well-Known Member

    Joined:
    Dec 28, 2009
    You are his caregiver, you must do what you think is best and unless it is flagrantly dangerous I can't see why anyone would have issue, especially with the circumstances :)
     
  54. Maya & Neo

    Maya & Neo Member

    Joined:
    Aug 26, 2011
    Thanks for that, Jen. I just feel really guilty after bugging you guys so much! In a weird way I feel like I'm letting you guys down or something. But I always did have a guilty conscience. I hope everyone understands. :)
     
  55. MommaOfMuse

    MommaOfMuse Well-Known Member

    Joined:
    May 26, 2010
    Maya,

    As my own vet told me once and it applies to us here as well...Ultimately you are the one that holds the syringe, and know Neo the best...we can only tell you what we would do in any given situation, we can make suggestions but in the end, it is you that has to decide what is best for your boy! And if Canisulin is what your vet knows best, and Jasmein is going to be relying on them for help should she need it then that is probably the best course of action. Once you are back and life has returned to normal, then you can make the switch without having to worry about so many variables. Neo has already had a bunch of changes, and now Momma is going away for awhile, so baby steps really does make the most sense...afterall this isn't a sprint...its a marathon.

    Mel, Maxwell. Musette & The Fur Gang
     
  56. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

    Joined:
    Feb 17, 2011
    interesting post from the Dutch person - but first, maya, it's absolutely OK to continue as you have been doing. you don't have to worry about pleasing us, for one thing!! he's your cat! we're just trying to give you information as far as we know.

    regarding the things in the Dutch post - i can see some of what she's saying. the reference to the "scared of double digits" - it might be that what she's seen is a reference to posts of acro cats. it wouldn't apply to your situation at all, at least not at this stage you are in right now. likely your "higher than average" dose is directly related to the dry food. if a cat makes the switch to low carb canned food, has all possibilities of infection ruled out or treated and still needs a higher than average dose, or doesn't respond to increasing the dose of insulin, then we look at medical conditions that might need a high dose of insulin. that's not neo!

    however, those of us with cats with acromegaly, who have a high dose of insulin being injected into them are wary of letting them get too low. At least some of the time, a cat with acromegaly has a working pancreas. There isn't unity among us with acro cats on what the cut-off point would be for "too low" to have your cat go. it's a complex set of circumstances that we try to balance. to try to make the explanation simple - with a working pancreas if the cat eats high carb food the pancreas releases insulin to "treat" the carbs. so if your cat gets low and you give high carb food to pull it up, and the pancreas ALSO puts out insulin to reduce the carbs, you can get into a vicious cycle and have a hard time pulling the numbers up. I haven't had that happen. I have heard of people having it happen, though. the other thing with acromegaly - it is caused by a tumor on the pituitary gland that puts out a hormone that makes the insulin not be able to get into the cells. that tumor can switch on and off. what if it switches off today after you've injected, and all of a sudden all of the insulin is able to work? if you're injecting 25 - 50- 75 units of insulin into a cat, you're going to take it very seriously! you would be a fool not to. there are other factors, too, which can make one avoid lower numbers - so she may have seen some of that and thought that applies to the general philosophy of this board. if so, she misunderstood.

    in fact, the Lantus protocol we follow is a combination of the German Katzen Protocol and the Rand/Roomp (univ of Queensland, Australia) and Tilly Protocols, which are all very similar - likely they are doing the same things we are doing here. and this is an international forum - she's wrong about it being american. Probably most people on at any given time are from North America - but since i've been on (february) there have been a number of kitties from Australia and we have one right now from Hong Kong.

    you have put a lot of effort into figuring out what's best for Neo - kudos to you for being so devoted. it sounds like he'll be in good hands while you're gone. we'll look for your stories when you get back. have a great time.
     
  57. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    You need to do with what you think the best decision is, and if you truly feel that is staying the way he is while you're gone, then that is what you should do. Like I said in my other message, my concern with sticking to the Caninsulin is mainly with complications due to high BG while you're gone. I think the odds are pretty good that is BG will stay in the same range as it has so far on the Caninsulin/Dry Diet, which is a bit high. Please make sure there is a vet nearby, and that Jasmien is testing for ketones, and that if he's not eating right she doesn't shoot a full dose of insulin and takes him into the vet if the inappetence is for more than 24 hours, and that she's testing at least the preshots and +4s (although if she can get additional +2s that would be good as well, especially if there are eating issues). I would say these things are absolutely necessary if you're keeping him on the Caninsulin/dry food.

    Also, I would set up a feeding schedule so that you know Jasmien is going to feed him at the appropriate times to prevent hypos. This is a very important passage from the Caninsulin user guide that you should pay attention to:

     
  58. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Btw, I just checked out his spreadsheet and YAY no ketones! :D :D :D That was my big worry last night with his numbers and the infection and him not eating.

    Oh, one last thing about his care at Jasmiens--even though you should feed him the dry food because of the Caninsulin doesn't mean ALL his food has to be dry food. Some canned food mixed with water every now and then will help keep him hydrated (which can help prevent ketoacidosis), so you might want to think about feeding half canned and half dry, and mixing water with the canned to get as much moisture in him as possible.
     
  59. Maya & Neo

    Maya & Neo Member

    Joined:
    Aug 26, 2011
    Thanks, Julia! I had him on mixed dry and wet so I was indeed thinking about going back to that. He was actually on that for weeks (maybe even a month) before I switched him to just dry. Thanks for confirming it will probably be safe to do again!

    I think I gave him too much dinner tonight. Shame on me, but he wouldn't stop begging so I gave him 100g extra food than I normally would. And now his BG has shot right up.

    So I'd obviously better read up on how food affects BG and insulin!
     
  60. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Don't worry about feeding him extra! Unregulated cats should be given extra food if they want it. Their poor bodies are literally starving. The only thing you want to watch out for is making sure they're hungry and eating when the Caninsulin is in effect. So if you want to feed him extra just try and do it in the first half of the cycle when it will help control his BG better.
     
  61. Maya & Neo

    Maya & Neo Member

    Joined:
    Aug 26, 2011
    Ah ok, phew! His numbers have already come back down, so I wonder. Maybe he and Groovy were having a disagreement and I didn't notice? I will keep an eye on him, anyway. :)
     
  62. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    I don't know if you've seen this article comparing Lantus and PZI.
     

    Attached Files:

  63. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    That was the one article I knew I read and I was hunting everywhere for it but couldn't find access to it to send her. Thank you Sienne! I have it saved now. :)
     
  64. Maya & Neo

    Maya & Neo Member

    Joined:
    Aug 26, 2011
    I haven't, but I will be sure to read it tomorrow. Thank you!
     
  65. Dikkop & Mosje

    Dikkop & Mosje New Member

    Joined:
    Oct 3, 2010
    PZI is unavailable in the Netherlands. Just so you know, Maya!
     
  66. Maya & Neo

    Maya & Neo Member

    Joined:
    Aug 26, 2011
    Also very good to know. Thank you Dikkop & Mosje! :)
     
  67. Julia & Bandit (GA)

    Julia & Bandit (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    FYI, that article does discuss Lente insulins as well.
     
  68. Maya & Neo

    Maya & Neo Member

    Joined:
    Aug 26, 2011
    Yup, I read the article today and found it very interesting. Thank you!
     
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