Heidi & Petey

My name is heidi and I have a diabetic cat that I need help with ! His name is petey and it is very hard to control his BG numbers. They go anywhere from the 200"s up past the 500's. He is always starving as well, I try not to feed him more than 2 cans per day of the royal canin diabetic cat food. One can AM, one Can PM, he receives his lantus insulin shot right after. I need some help and words of wisdom !

 

Re: new to this message board!

Hi Heidi and Petey!

Welcome to FDMB. I'm sorry you have to be here, though. I have a kitty named Petey, too, although Jersey was my kitty with diabetes. After a couple of months on Lantus, she is now in remission. We're very fortunate to be one of the success stories of FDMB.

Before I bombard you with information, may I ask a few questions?

Are you testing Petey's sugar levels at home? If so, are you using a pet-specific meter or a human meter?
How long since Petey was diagnosed with diabetes/how long have you been giving him Lantus?

The answers to those questions will help me figure out exactly what type of information might be helpful to you at this point.
Shelly

 

Re: new to this message board!

I'm not sure your flavor of Royal Canin food is on Dr. Lisa's chart, but in general, they seem to run higher in carbs.

http://catinfo.org/docs/FoodChartPublic9-22-12.pdf

 

Re: new to this message board!

Welcome, Heidi! The people here are wonderful and very experienced in treating diabetic kitties. You will get help, but you need to answer the questions above so people know how to best help you.

I'm so glad that you decided to join us! Welcome! Things will get better!

 

Thank you so much everyone for your quick replies! I am beside myself and do not feel that my vet is helping at this point, even though she has saved his life. We are currently doing 4-5 units of lantus 2x per day...I do check his blood as much as I can with a human glucometer. we feed him the royal canin food for diabetes, there is really no flavor with this, just says diabetes. He also has a pancreas issue, so that is why he is always so hungry !

 

Re: new to this message board!

Thanks for providing the additional information, Heidi.

Okay, so we know that three things are really important when treating our diabetic kitties.

1. Home Testing: It sounds like you're already doing that, so that's great. Make sure that you always get a glucose check right before you give each shot. That number tells you if it's safe to give insulin or not. Getting some tests in between each cycle is also important. We base Lantus dosing on how low it brings a kitty. Lantus typically brings a kitty to his lowest point about 5 to 7 hours after the shot. If you can get some tests in right around those times, that will help give you an idea of how well the dose is working. Also, since you're using a human glucometer - you don't want a dose to take kitty below 50. If the kitty goes below 50, that is hypoglycemia territory and the dose needs to be reduced.

2. Food: Sue gave you the link to Dr. Pierson's food chart. That's a great resource. Diabetic cats need to eat a low-carb diet, just like human diabetics do. What you're looking for on Dr. Pierson's food chart is foods that are less than 10% carbs (look at the third column to see % carbs). Most dry foods are way too high in carbs for our kitties. Here's the catch - if you're going to switch to a low-carb food, you have to make sure you're monitoring closely. Once you get the high-carb food out of the system, the need for insulin can change drastically. We've had members who switched to low-carb cat food and within a day or two, their cats no longer needed insulin.

3. Good insulin: Lantus is one of the best available for diabetic cats, so it's great that you're using it. It does seem to be a high dose for Petey to be on, but some cats are big cats and need that much insulin. How did the vet determine the starting dose for Petey? (How often has the dose been changed?) We usually go by a weigh-based formula for starting dose and then gradually increase the dose (by about .25 units at a time) based on the nadir - the low point in the cycle.

I'm going to stop there so that you can add in additional information that you think might be helpful for us to know or to ask questions you have.

Shelly

 

Re: new to this message board!

Oops - sorry. One more thing I wanted to mention. Most diabetic cats are extremely hungry until their numbers get regulated. That's because their bodies can't properly use the energy in the food, so they need to eat more of it. A lot of people here recommend feeding several small meals a day rather than a few bigger ones; the smaller meals can be easier for the pancreas to handle.

 

Re: new to this message board!

So, should I feed petey in the middle of the day? but still give insulin morning and evening only? I am worried today since his numbers were 537 , which is crazy high! I am going to switch out his food, not going to give him the royal canin diabetes formula, something is not right and maybe that is it ! tell me what you think.

 

Re: new to this message board!

one more thing, he has had diabetes since at least january, since this is when he got very sick...

 

Re: new to this message board!

Petey has been on anywhere from 2-5 units. I recently started him on 5 since his #'s are so high. I am going to buy some very low carb food today. he is not a large cat, weighs 9 1/2 lbs.

 

Re: new to this message board!

Just from my experience, I would personally feed Petey more than twice a day. There are some different approaches for using Lantus. We have a forum called "Relaxed Lantus" and one called "Tight Regulation (TR)." I was a member of the TR forum; many people there broke up the meals into smaller portions and fed at each shot time, +1 (which is 1 hour past the shot time), +2 (which is two hours past the shot time), and +3 (which is three hours past the shot time). Others fed at different times. It's just something you'll have to experiment with over time to see what works best for Petey.

Before we change a whole bunch of stuff, how often are you testing each day? Do you always test each day? (or can you test each day?) People have different schedules and different abilities when it comes to testing, so knowing how often you do or can test will help ensure that we can keep Petey safe while you make changes.

Here's an example of how we might determine the starting dose for Petey:

There are a lot of variables that come into play when determining the starting dose, so don't think this is a "must-use" formula. It works for most kitties, though.

If you'll look at the bottom of our posts - at our "signatures" - you'll see that we use a spreadsheet here. It's a way for us to record the blood sugar numbers we are getting through home testing. That way, everyone can see what's going on with our kitties, and they can help give us dosing advice. It would be super-helpful if you could set one up and use it to record Petey's numbers. It might be that Petey is on too high of a dose and needs to be dropped down - or it could be that he needs a dose increase. If we can see all of the numbers you've gathered, that will really help us. If you are interested in setting up the spreadsheet, let me know. I'll send you some step-by-step instructions for it.

Thanks for letting me know he was diagnosed in January. That will help, too, when it comes time to making dosing decisions.

Finally, since Petey is showing high numbers, I would recommend testing for ketones. You can buy ketone test strips most places that carry diabetic testing supplies (e.g., Wal-Mart). Just hold the test strip under the urine stream to get a reading. If there is more than a trace of ketones, it will be important to let your vet know since it can be an emergency.

Okay....so what questions can we answer now?

 

Re: new to this message board!

Hi, Yes I would be interested in setting up a spread sheet..I actually do test for ketones. I have fluids to hydrate him if needed. Trying to avoid the vet, it has cost us over $10,000 . I guess he is real important to us..He is actually my sons cat that i am taking care of.

 

Re: new to this message board!

I've included the instructions below. If you have any problems, let us know. Once you get it set up, we'll help you figure out how to enter the numbers.

 

Re: new to this message board!

so now if I start giving petey small meals , do I need to give a shot after each time?

 

Re: new to this message board!

Good question! No. Only give two shots a day with Lantus. They should be given 12 hours apart. (Lantus lasts about 12 hours in our cats, so you don't want to give them closer than that.) What times do you currently give Petey his shots?

 

Re: new to this message board!

so what is considered a small meal ? Right now he gets a 3 oz can in the morning and a 3oz can for dinner.

 

Re: new to this message board!

To be quite honest, when Jersey was unregulated, I pretty much fed her however much she wanted. She was just a tad bit underweight, and she was starving. It was only later - after joining FDMB - that I found out she was literally starving because of her diabetes. I had erroneously followed my vet's advice to only feed two small meals a day, which wasn't enough in her case.

Anyway...because I didn't limit her food intake, I may not be the best person to offer advice about exactly how much to feed. Hopefully some others can offer their thoughts on it.

The food is definitely a big component, but I'm also pretty concerned about the dose size. If you can get some of the numbers posted, we can try to figure out if it's a safe dose.

 

Re: new to this message board!

i know that is what the vet said, only 2 meals per day. This cat is staving and i do know it is because his pancreas is not working properly. I feel that he is a little thin, especially when i compare him to my other cats! He just looks unhealthy to me. I am used to big robust cats! I went and bought low carb food today, so we will see if this makes a difference other than the royal cannin diabetic food my vet has him on.

 

Re: new to this message board!

Heidi,

How often are you testing Petey? Remember - when you make a switch to low-carb food, insulin needs can go down very rapidly. You want to be extremely careful and test often during this period. Otherwise, you may end up with a very scary hypoglycemic episode, which could be fatal. I don't say this to try to frighten you, but it's really important that you monitor closely. Here is a link to more information about hypoglycemia if you haven't already had a chance to see it: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887

Just to make sure I'm understanding (please correct me if I ever get anything wrong): Did your vet start the dose at 2 units and then you increased it on your own, or did your vet tell you to increase it to 5 units?

 

Re: new to this message board!

I've been looking back at the information you provided and used our online calculator to determine how much insulin we would have most likely recommended for Petey's starting weight. Based on the formula we use (that I mentioned above), it looks like Petey's starting dose would have been 1 unit. I'm very concerned that he's up to 5 units now and how that 5-unit dose was determined. Some kitties do need that much insulin. (One cat right now, for example, is getting about 40 units a day.) I'm just worried that Petey may have been started at a dose that was too high and is only getting higher. Even if you can't get the spreadsheet up and running today, could you tell us the numbers you've gotten recently during your tests? That would be really helpful in trying to figure out what is going wrong. Has Petey had DKA?

I hope others will be along soon to offer their advice, too.

 

Re: new to this message board!

petey started with 2 units of lantus insulin, than 3, 4 , 5, which i went up one unit myself.

 

Re: new to this message board!

Without knowing the BG before a shot and then periodically between shots with optimum of every two hours I really can't make any suggestions

 

Re: new to this message board!

i have been trying to upload the excel sheet, without any luck !

 

Re: new to this message board!

I see the spreadsheet (it is not clickable, I have to copy and paste the URL)
Is it true that 9/14 AMPS and +5 are both 433
and that 9/15 AMPS and +5 are both 266?
That seems strange.

 

Re: new to this message board!

Sorry to hear you've been having problems with the spreadsheet. I think you're close, though. You might try the following:

Go back to the user control panel, click on profile and then on edit signature. Then set up your spreadsheet link like this:

web address of your spreadsheet

I think it's the [*] in front of your web address right now that might be the problem.

Hope that helps!
Shelly

 

Re: new to this message board!

Hi again,

Here's an explanation of some of the "pieces" of the spreadsheet in case you're not sure how to enter information:

-The AMPS is the reading you get in the morning (AM) before giving insulin (pre-shot or PS).
-The U column after the AMPS column is where you put the dose you gave for the morning shot.
- The columns after that (+1, +2, etc.) are for the tests you get in between shots. For instance, if you check the blood sugar 4 hours after the morning shot, that would be recorded in the AM+4 column.
-The PMPS is the reading you get in the evening (PM) before giving insulin (PS).
- The U column after the PMPS column is where you put the dose you gave for the evening shot.
- The columns after that (+1, +2, etc.) are for the tests you get after the evening shot. For example, if you get a blood sugar check 2 hours after the evening shot, you would record it in the PM+2 column.

It took me quite a while to figure out the spreadsheet, so I know how frustrating it can be. If you have any questions about how to enter information, be sure to ask!

Shelly

 

Re: new to this message board!

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.

 

Re: new to this message board!

Welcome, Heidi! :YMHUG:

How are things going with you and Petey today? When you mention "pancreas issue," are you talking about pancreatitis or maybe EPI?

 

Re: new to this message board!

petey is doing ok, he does have a pancreas issue. His bg was 334 @ 8:00PM

 

Re: new to this message board!

The link for your spreadsheet works when copied and pasted into a browser. If you go to your User Control Panel signature, then select the link, click the URL button, then hit the Submit button, it will make it a proper hyperlink.

You might also add your and your cat's name, date of diagnosis, and insulin.

You're shooting 5 units a t a time?! It will keep your cat more stable if you give 2.5 units every 12 hours (the dose goes in the U columns). Lantus, Levemir, ProZinc and BCP PZI last no more than 12 hours in most cats, leaving the other 12 hours of the day uncontrolled. That could be part of why you are seeing such wide swings in numbers.

Another reason for high numbers is "bouncing". When insulin drops the glucose swiftly OR drops the level to one that hasn't been experienced in quite a while, the body reacts with compensatory hormones which release stored glucose (glycogen), which would protect the cat from hypoglycemia. It takes about 3 days for the bounce to clear.

Also, Lantus is dosed based on the nadir, the lowest glucose between shots. This typically happens around +5 to +7 hours after the shot. The times the pre-shot affect what you shoot are when it is too low to be safe - below 200 mg/dL for new folks without much data collected. As you get a couple of weeks of mid-cycle data, that may be lowered to 150 mg/dL, but you must get mid-cycle tests to be sure that will be safe.

 

Re: new to this message board!

I give 5 units every 12 hours... we have tried anywhere from 2- 5, 5 is working well with his high #'s for now...

 

Re: new to this message board!

How long have you been doing the 5 units?

 

Re: new to this message board!

for about 1month now

 

Would you please enter the evening doses on your spreadsheet from when you started giving them, so folks can see them more easily? Those go in the 2nd turquoise column.

 

petey had pretty high #'s this morning 498, wondering if my spreadsheet is visible? His #,s are so erratic. He is acting fine.

 

In your signature, you've got 2 links combined together, without having them inside the URL tabs.

Edit your profile signature as follows:
Delete the bracketed asterisks [*]
Look at the text after that and find the 2nd https. Delete from there to the end.
Highlight the remaining text.
Click the URL button at the top of the text entry box.
Click the Submit button at the bottom of the text entry box.

 

Hi Heidi,

I'm an experienced Lantus user and was asked to come take a peek at Petey's dosing situation. My kitty, punkin, was up to 15.5u per shot before i had him treated at Colorado State University for acromegaly.

Looking through this thread, i noticed

BJM explained a little bit about a bouncing to you - it's a little weird, but the blood sugar tests of a cat that doesn't have enough insulin can look a lot like a cat that is overdosed on insulin. The folks asking you questions are trying to figure out if Petey needs more or less insulin.

I see he was diagnosed in January. Do I understand correctly that his dose was increased in one unit increments? Do you have any of the dates, or can you ask the vet for dates and doses so we can recreate what's happened?

Is it possible for you to get a test between +3 and +8 for the next few cycles? That would be very helpful in figuring out a little more about what's going on in his body. You still want to get the preshot tests in, but if we could see how low he's getting in between the shots, that would be fantastic.

I'll keep watching for your posts in this thread. We can help you help untangle the puzzle and help petey. This is what we do - and we can teach you how to understand what you are seeing. Other people taught us, and we teach new people.

you're doing great, heidi - you've mastered hometesting, you've got a spreadsheet going, you've gotten him on low carb canned food and you've found a site full of people who understand feline diabetes. take a deep breath - the hardest part is done now. :YMHUG:

 

I do have a log, so do you need me to start a new spread sheet with the earlier #'S thank so much, I certainly do not want to be overdosing with insulin! He is not a typical diabetic cat, so I have been told. He has a pancreas issue as well. Most diabetic cats do, but his seems to be so much worse.

 

I realized I posted 2 spreadsheets, but not able to delete any of them, duh!!

 

Hi Heidi,

I'm glad Julie stopped by to share her thoughts with you; she was one of the many individuals here who helped me get Jersey into remission. You might want to go back and read through all of the posts here again. If you find questions that you haven't answered yet, it would be helpful to answer them. The more information you can give us, the more we'll be able to help you and Petey.

In terms of the spreadsheet, here's information that I posted previously that might help you get your link to display properly:

Remove all of the other "stuff" that's there - like the [*] and the existing web addresses.

Hope that helps.
Shelly

 

AH HA! I just saw his green preshot this morning of 92. And very important - within 4 hours he was over 300. He'll likely stay in high numbers now for a while. But that tells us that the 5.0u is not too high. In fact - that was great.

It was ok that you gave a reduced dose this morning, but if you want to work towards remission, let's teach you how to work with Lantus. Experienced Lantus users (not you at this time, but hopefully before too long) will shoot most numbers over 50 as long as they can monitor, they have enough strips for their meter & high carb food, and their cat is eating ok.

What is your goal for Petey, Heidi? Do you want to work towards remission? Newly diagnosed cats (under 1 year since diagnosis) have the best chance at becoming diet-controlled. Cats are unique in that their pancreas can heal if their blood sugar is kept in the normal, non-diabetic cat's range.

I'd invite you to post over on the Lantus Tight Regulation Insulin Support Group. There is a lot of traffic on there and a lot of experienced users who would keep an eye on you and help you learn what you need to know to get Petey regulated. That group is located here.

 

Go to the top left of the screen.
Click on User Control Panel.
Click on Profile
Click on Edit Signature
Find the 2nd http and delete the text from there to the end,

 

Thanks again for all of your info..Of course nothing would make me happier than if he could go into remission! I feel that would not happen with him, since his #'s are so erratic. Doing the best I can !

 

Hello Heidi,

Your spreadsheet is still not clickable.

Try and replace it with this.

Petey's SS

I know how you feel about remission. Take a look at Jacks numbers and then would you believe he is in remission ? 15th day...but still..

All the best!

 

This is what your signature looks like now:

This is what it should be:

 

could you please let me know if petey's spread sheet is visible? We seem to be doing better with our BG numbers, what are your thoughts?

 

Hello Heidi,

The link works but is not clickable.

Hello Heidi,

The link is still not clickable.

Cut and past the line I have below into your signature. Remove ONLY the (2) ? (Question marks).

[?url=https://docs.google.com/spreadsheet/ccc?key=0AojNpnN0rEeHdFF3bWdFYUxpRE1qb1BQX2k3elM5cWc&usp]Petey's numbers[/?url]

Let me know when it is done and I will test.

Kevin

 

Thank you! It is done!

 

You forgot the 2nd question mark

 

Ok sorry, I did the other question mark!

 

Hey Heidi,

Why is the first [ on the line above the text. It should all be on the same line.

I will cut and paste the line I created for you twice here. The first is what I sent. The second one, I took out the ?marks.

[?url=https://docs.google.com/spreadsheet/ccc?key=0AojNpnN0rEeHdFF3bWdFYUxpRE1qb1BQX2k3elM5cWc&usp]Petey's numbers[/?url]
Petey's numbers

Notice how the second one becomes a clickable link?

Try and get the whole line on 1 line as it does work.

Kevin

 

Heidi, you've done a great job at getting some extra tests in to help fill out the picture! What I can tell you is that this dose is pretty close for him. When a cat has pancreatitis it can cause an increased need for insulin. Hyperthyroid can do the same thing.

You said you didn't think he could go into remission, but I can assure you that we can't rule that out at this point. Most everyone comes in new with their blood sugar all over the place - his spreadsheet looks very normal for a cat new to diabetes.

If you DO want to work towards remission, you would want to get his blood sugar into a lower range than he's in now. When a cat's blood sugar is kept between 50-120 on a human glucometer, the cat's pancreas can heal. That's what the Tight Regulation support group is about - trying to keep cat's blood sugar tightly regulated in that 50-120 range so that if possible, the cat can go off of insulin and become diet controlled. If there is too much damage to the pancreas, keeping the blood sugar controlled at least protects the rest of the cat's body from the damages of high blood sugar.

Is there any possibility that Petey is getting into any dry food at all - any dry dog food? any dry cat food? what are you feeding him?

 

peteys' #'s are high between last night and this morning ! A little concerned

 

Heidi,

You are so close to getting the spreadsheet clickable in your signature.

You are missing the first bracket [

 

I feed petey one can of fancy feast, classic or flaked, in the morning, and 1 can fancy feast in the pm. Sometimes he does get into the other cats dry food, but I quickly catch him and of course pick it up. I was getting excited to see that his numbers were starting to be on the lower side, until last night. Thanks for your help!

 

Hello Heidi,

It is clickable now..Good job.........

 

hi heidi!

we've had people do experiments to see how their cats blood sugar responds to dry food. As few as 3 crunchies can send a cat's blood sugar soaring and it will stay high for the next day until the carbs work out of their system. Often people find the only way to prevent their cat from getting dry food is to transition all of the pets in the household to low carb canned food. It's better for them anyway. Dry food can easily have 50% carbs and a mouse, a cat's perfect food in nature, has about 3-7% carbs that come from whatever the grains in the mouse's stomach are. High carbs place a huge burden on a cat's pancreas, which is one reason why so many cats become diabetic now.

There is a great site, http://www.catinfo.org that is run by a vet who posts here on FDMB sometimes. Take a look at it and see what you think.

The reason i asked you about the dry food is because his dose suggests it. If you want to work towards remission, i would transition all of your cats to canned or raw food asap. The cost of feeding them canned food is nothing compared to the cost of keeping Petey on insulin for the rest of his life.

We have a member, Linda, whose kitty Scooter, went from 5.5u to off of insulin in a very long day and a half when the whole 13 cat household went off of dry food. Linda was pretty sure that Scooter wasn't getting any - he didn't seem interested in it. But the "proof is in the pudding" and when his blood sugar dropped after the dry food disappeared, it was obvious he'd been eating it every day.

Here's his spreadsheet. Look for February 19th - the day the dry food disappeared. Notice his colorful spreadsheet before Feb 19th, and what happened afterwards.

Kathy's Trey snuck into the dog food here - look at his spreadsheet for July 30th here when that happened.

 

One of my cats, sticks his nose up at wet food, I have tried all kinds ! I give him the indigo moon in a different room, but yes, I will admit, sometimes petey does get a mouthful. He even bit off the top of a hot dog roll after it popped up from the toaster, while my husband was on the computer. I call him the tazmanian devil. I am certainly going to try to totally limit the dry food, since i would be so happy if he went into remission. Thanks for your advice and help , as always!

 

hahahaha on the hot dog bun! high blood sugar makes them starving and willing to eat people food.

good luck - on that catinfo.org site there is an entire section on transitioning dry food addicts to canned food. one trick is to pulverize the dry food and sprinkle it on the wet. that works for a lot of cats.

you're welcome. when you're new you don't even know the questions to ask, or what things might be having a negative impact on your cat. i like to encourage hope for remission in people - the stats are 90%+ if you get with TR right away. We never know which cats will be the lucky ones, but i've seen many, many cats go off.

 

Thanks Julie, I will def. try this with the dry food ! His blood sugar is low this morning, 200! Very happy with that. Lets hope it stays this time.

 

When you get a chance, perhaps you might add a few more details to your signature.

Go to the top left of the screen.
Click on User Control Panel.
Click on Profile
Click on Edit Signature
A test box displays.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as
your name, cat's name,
city and state,
date of Dx (diagnosis)
insulin
meter
any other pertinent issues like food issues, allergies, IBD, etc.

 

this morning, peteys' blood sugar was low, so I skipped his shot...It was 85. I hope this is the right thing to do ! :?:

 

Just tested blood sugar again, 7 AM, about 1 hr later = 174, not sure about giving shot, since I did not give after breakfast at 5:45 AM, since his bg was so low ? confused_cat

 

Since Lantus likes to be consistent in dose and time, if you give a shot now, you've going to have to shift back to your regular time by 15 min per shot or 30 min total per day.

Whenever you get a really different number from what you've been seeing, retest. Sometimes, it is meter error

If it is still a low number and it is the pre-shot test, stall 30 minutes without feeding to see if it is going up. If rising, and over 150 mg/dL, it is probably safe to shoot. You're still starting out on Lantus, so we want you to have data to support shooting any lower before you try it. There are some folks who have that kind of data and "shoot low to stay low".

That really low number suggests to me that he may need a dose reduction of 0.25 units, which you'll need to eyeball as no syringe marks those.

That, or perhaps he vomited over night or had some other GI upset which dropped his glucose. Check around for any evidence of that.

 

i did retest right after and it was still low, i have no choice but to feed him, since he is crazy hungry. I realize I will have to give him a shot a little later. than normal. I did cut his dose in half, 2.5 after feeding him. He has not vomited at all during the night. I was not comfortable leaving for work without a shot. I knew it would be really high when i get home.

 

That is a reasonable compromise.

Lantus forms small crystals under the skin when injected. This is called the depot.These gradually dissolve and release the insulin to work. Some are left at the end of 12 hours in most cats, so the next shot has some overlapping effect on the glucose levels. It takes 5-7 days for the initial dose to stabilize the depot and 3-5 days to stabilize it for later dose adjustments.

You started off at a pretty high dose of 5 units on the spreadsheet. If this was his first insulin, that dose could be too high for him. It is usually calculated as follows:
Get his current weight in kilograms (pounds / 2.2)
Compare to his ideal weight in kilos.
Take the lower number.
Multiply by 0.25.
Round down to the nearest quarter unit. Compare that with where you started. How big a discrepancy is there between those numbers?

I'm thinking that 4 units tonight might be a good idea; 5 seems to be too much. You end up needing to skip after several days when the Lantus depot has built up. Lantus really likes consistent dosing as close to every 12 hours as possible.

Typically, you increase Lantus based on the nadir, the lowest glucose level after a shot. You evaluate this after 3-5 days of the same dose.
Whenever the glucose drops below 50 mg/dL, you earn a 0.25 unit dose reduction.

 

Thank you! My whole morning is consumed with Petey! I guess I will need to wait until about 7:30 ish.

 

I did not always give 5 units. Have been using lantus since May when he got really sick with high ketones! In and out of the vet and over notes in the er! I will lower to 4 units does 7:30 sound good ? His shot this morning was at8 am thanks for all of your info!

 

Yes, 7:30 sounds good.

Since he's had DKA, I suspect you test regularly for urine ketones, right? If you can swing it, you might want to get a NovaMax meter which can test for blood ketones and use it any time the urine ketones are positive, to get a more accurate level.

 

I so test for ketones when I catch him, a few x a week. I will look into that other meter
Thanks!

 

just tested petey= 322..2.5 units this morning @ 8 AM getting ready to feed him, should I keep the dose on the low side rather than 5 units ???

 

It is now about 7:30 PM

 

I received your reply a little late, of course the tazmanian devil can not wait to eat.! I ended up giving him 2.5 units @ about 7:30. This morning his fasting bg = 302- not terrible. I gave him something to eat, a small can of fancy feast, and will feed him a little at 7 :30, and try another 2.5 units. What do you think?

 

Please stick with the 2.5 unit dose for at least 3 full days before changing again, unless the glucose goes below 50 mg/dL on a human glucometer.

Please don't shoot below 150 mg/dL on a human glucometeruntil, with stable dosing for a full 3 days or more, you know it will be safe.

Please read over the Lantus Tight Regulation Protocol and ask any questions you may have.

 

I did give him 4 units, his bg was high @ 364

 

I M P O R T A N T

You need to keep the dose the same for 3 full days, no matter how high.
(Do test for ketones.)

Lantus is adjusted by the nadir - the lowest glucose after a shot.

Never increase the Lantus dose because of the pre-shot being higher.
Lantus doesn't work well that way because of the depot, the overlapping characteristic of the insulin.
Bouncing the dose around gives you erratic numbers.

 

ok, so this evening i gave him 4 units, and yes I do bounce around. should i keep it there or go lower for at least 3 days.? I get nervous when i see numbers that are 359 , like tonight. ????

 

If you look at his chart, I have had it at 5 units for a while and his #'s are still all over the place. Should I just give him less units. ? what do you think.?

 

Stick 4 units for a minimum of 3 full days unless he earns a reduction by going below 50 mg/dL.

High numbers aren't going to be the concern. LOW numbers are the concern. Cats can often tolerate high numbers for a while, though not forever.

Did you read the Lantus Tight Regulation Protocol?

 

I did read the lantus tight regulation , is 50 mg his bg levels? I assume it is. This morning his fasting bg is 195, still give him 4 units??

 

Yes, I meant 50 mg/dL. Divide by 18 if you need mmol/L.

See my signature link Glucometer Notes for some info on what various glucose numbers may mean.

Yes, stick with 4 units.

If his mid-cycle numbers go below 50 mg/dL, and intervene with 2 teaspoons of high carb gravy, wait 20 min, re-test. If still low, repeat. Do this until past nadir and rising and above 100 mg/dL. Note that high carb gravy/Karo syrup wears off fast.
Also, the next shot would get reduced by 0.25 units if he goes below 50 mg/dL.

 

just tested @ 8 AM & #'s are 277, so we are doing ok ! thank you so much for all your help all of the time!

 

It is normal for the glucose to rise a bit in the 2 hours after eating.

The mid-cycle, between +5 to +7 hour post shot, is where you want to watch for it getting too low.

What did you think about the Tight Regulation Protocol? Is that something you want to follow?

 

5:15 his #,s are 213, so far so good I will need to read the lantus again,