Hello and request for advice for Shoes

Hello and thanks for this board and for all that you do. My cat Shoes was diagnosed Sept. 2015 and was put on Novolin N. Things went okay until Jan. 24, 2016 when he crashed while I was asleep and almost died. I had been reading this board for some time before this and had wanted to change insulins before but vet would not. Shoes then crashed again this week on Feb. 24. I had not left for work yet so I was able to stabilize him within 45 minutes then off to the vet we went. This time our vet did agree to change to Lantus. He started Shoes on 2 IU's the next morning. The bg numbers were fair and the nadir dropped to 189 and stayed fairly stable at just above 200 that day. He got another dose after 12 hours and his numbers stayed in the less than 200 range but the next morning, yesterday, his AMPS was 61.1 so he was not injected and monitored closely. The numbers jumped around quite a bit. They only got above 300 at 316 once. I was allowed to bring him home yesterday evening but instructed to check his bg at certain times and if his PMPS was not at least 200 or above to not give the insulin. His PMPS was 296 so I gave him a reduced dose of 1 iu and monitored him every 3 hours throughout the night. His numbers were higher on the 1 iu. He got another 1 iu this morning as his AMPS was 434. My question is this: How long does it take for the Lantus to start lowering his bg on a consistent basis? Obviously the 2 IU's dose was too high as it lasted 24 hours and caused the drop to 61.1 after less than 12 hours. My vet is a great vet, but we are in a small town and there are not many pet owners as anal as I am and willing to do whatever it takes to give my kitty the best possible care so our vet does not have a lot of experience with Lantus. My feeling is that we need to give the 1 unit dose several days to do its job before changing. Shoes now is fed a low carb diet. Any advice or suggestions would be greatly appreciated.

 

Welcome
Unlike N insulin, Lantus is a depot insulin and it take three days or so to build up.
I would continue with the 1 unit twice daily so yo get three days of one unit. Then if necessary increase by 1/4 unit or decrease if necessary.
You want the low point between shots to be 80-120 or so.

Also what are you feeding?

It would be better that in the future you post in the Health forum
http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/

 

Hello and Welcome,


You have come to the right place for advice, there are lots of experienced folk on the board that will help guide you through the dosing, their combined help and experience has been invaluable to George and me

We have a Lantus and Lev forum, and I would encourage you to post on there for advice, it's where all the Lantus folk hang out and it's a very active forum.
As Larry says Lantus is a depot insulin so it takes a few days to see the effect of a dose change, either an increase or a decrease, so you need to give the dose time to settle, it does best with consistent dosing. The stickies on the forum have great info on how best to use Lantus to help control our kitties BG, you have probably already read them but just wanted to direct you to them should you not have seen them first Lantus and Lev forum

It's great that you are home testing(by the way what type of meter are you using? feline or human?makes a difference numbers wise, most of us use human as it's cheaper), that's crucial to try and help our kitties, to make life simpler we all record our BG on a Spread Sheet and make it available to view by including a link in our signature, here's a link to how to set it up and link it in your signature. Setting up the Spreadsheet
If you have problems setting it up, just shout there are folk who can help you with that.

Hope to see you over at Lantus and Lev forum soon.

 

Thank you so much! I am feeding mostly Wellness. Just bought a variety of low carb foods for the day when Shoes decides he wants a different food. I bought Weruva, Fussie Cat, Cocolicious, and Natures' Logic. Use some FF classic pate on occasion.

 

Thank you! Yes, I have read every sticky item on the Lantus and Lev forum and the information is great there! I am using the Alpha Trak 2 meter. The ear sticks are much easier these days as Shoes is getting used to it. I will work on getting the spreadsheet and a signature set up over the weekend.

 

Reading you post I had a feeling you had.

I have the same 'problem' with my vet, she is great, caring and is there for me but we are in a small rural town in Spain and George is her only diabetic cat, the forum has been invaluable in helping us manage Georges BG, we would have been lost without it. At first she was skeptical, especially as she doesn't speak much English so accessing info on site was difficult for her, but that's not how she feels now.

Just a thought on Shoe's BG after his low yesterday of 61 on the alphatrak, it is quite possibly that he is bouncing, bouncing occurs when kitty drops fast or sees numbers lower than he is used to, the body reacts and the net effect is that BG levels rise to keep kitty safe from a 'perceived dangerous low' the bounce can last anything up to 6 cycles / 3 days, so don't be surprised if his numbers are high for a few days, I would probably hold steady with the dose until you are sure the bounce is over, but it will be easier to see what's going on once you get that spread sheet set up, just holler if you have any problems.

Another question, sorry, what syringes are you using? Do they have the 1/2 unit markings? this will make dosing easier as we normally do increases/decreases in 0.25 steps (but you probably know this already)

Gill

 

Just lost my reply. Not very good at this. Oh well. The 61.6 was at the Vet's office first thing yesterday a.m. at about 7:30 a.m. and was taken in the vein and put into the proper equipment there. I think you must be correct about the body reacting to that because the vet did not shoot him at all yesterday because of that reading and the numbers bounced around but not going over 300 but once. I brought him home and started testing with the Alpha Trak 2 during Friday night and today and the numbers were higher than expected at home. Just checked him again at 10:13 a.m. 3 hours after his am shot today and they were down to 227 so that's better. He is tired as am I after the testing during the night and early a.m. I can only monitor him this closely on the weekends as I work a full-time job M-F. I do come home at lunch daily to check on him.

Currently I am using the U 100 needles that don't have the half marks. I plan to get the others ASAP. Thanks so much for your help! Do you know how to get this moved over to the Health forum?

 

Don't think we can move it but if you post in either the health or Lantus forum then you can link this thread in the following way:

• copy the URL address of your thread in the browser onto your clipboard

• start a new thread on health

• say something like previous post here: (and highlight it)

• click on the paperclip icon above

• paste the url thread address into the box that appears

• and finally click insert and the link to this thread will be posted on your new thread.

That way folk can refer back to it. When we create a new thread, usually new day new thread, we always link previous day/ or the last post, that way makes it easy for folk to look through history, before offering assistance.

Hope that makes sense. (if you knew how much of a technophobe I am I have just surprised myself with that explanation LOL)

With those numbers falling it looks like the bounce might be clearing and you may even see a return to blue

Heads up when kitties clear bounce they can gather quite a bit of momentum, I would test him again at about +3.5 he has dropped some 200pts since his shot, that is quite a lot, if he continues at this rate (he may not) you may need to intervene.

Of course that fast drop may trigger a bounce so equally we could see him go up, he is a cat after all and it's in the FD manual to keep the beans on their toes

Post up on health and tag me you can tag someone by typing @ and then the user name for me @Gill & George

See you there

 

In joining FDMB methinks you may have found a spiritual home, Sandi. (If it's any comfort, I record everything I can think of for Saoirse every day and I reckon my vets think I'm totally bonkers. )


Mogs
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Mogs, if your vets think you are totally bonkers...THEY ARE BONKERS! You're the best catmom ever.

 

@Jeanne & Dottie -

There are many, many absolutely amazing cat moms and pops here - including your good self.




Mogs
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