Help! Unregulated w/ higher dose of LANTUS

A few things, please read all of this if you are going to comment. I hate hearing 'no dry food!!!', when i know this, and she doesn't eat dry food any longer and that is stated in the info posted below. Secondly, I am a medical student, so I do know a lot about DM. Obviously, I need help regulating my cat, but a lot of things don't need to be explained.
*However*, I don't know much about her having *too much insulin* and thus, putting out higher numbers. THIS IS WHY I NEED HELP!
....I use the freestyle freedom lite meter

Here is some brief background info, in sequence of events:

- 11/24/09: Wednesday diagnosed with DM after being rushed to the ED w/ DKA and diagnosed with pancreatitis
- Discharged 5 days later on Lantus 1U BID, eating wellness CORE dry and wellness grain-free wet
- Wednesday's numbers were semi-great, about ~250 AMPS/PMPS, ~120 nadir
- ~1 week after discharge, Wednesday did not like the new dry food and began vomiting it up for 2 days. 2nd day I took her to the vet and she decided to switch her to ID wet/dry diet. MUCH higher carbs....she was worried if she wasn't eating, she couldn't get insulin, etc.
- Wednesday's BG increased to ~325 AMPS, ~200 nadir...obviously because this food was awful for a diabetic cat!
- She was on the food for a few weeks, I don't want to get into why, but she was eating on this food and the vet and I figured we would deal with the higher numbers.
- I increased insulin 0.5 units to 1.5U BID, not knowing this could have been too much too quickly.

NOW...

- Wednesday is off the ID for about 1 month now. She ONLY eats wellness wet food, though she has been able to sneak into the other cats' dry food...a HUGE problem.
- Her numbers are ALWAYS in the mid-high 300's AMPS/PMPS, with very little change at nadir (maybe high 200's)
- Shs has been at 400-440 several times, usually due to me being late with insulin, or her sneaking into the cats' dry food (this has recently been solved, but it took me awhile to get really strict with the other cats). Sometimes it is in the 400s and I don't know why.
- Her dose is now 2U BID

I have gotten MUCH more strict about her not being able to eat the other cats' food, and I do see a decrease in number, now she is around ~320 AMPS, but her nadir is never where it should be.

Here is her SS: http://spreadsheets.google.com/pub?key= ... utput=html

I am frustrated and don't know what to do. She has had blood work and does not have acute pancreas issues (plus, no clinical signs), her numbers should not be this high with the wet food and the insulin....I don't think anyway.
It is a mess!!!
Any ideas? Should I start from scratch at 1U, since she was doing fine, and I assume the only reason her numbers started increasing was due to the high carb food? (even though I really only had a week to chart the low numbers, since she started the ID food 1 week after her discharge.)

Thanks, sooo sooo much,

Alexia & Wednesday

 

Re: Unregulated w/ higher dose of LANTUS

Hi

just talking out loud...the 1.5u is from november...and currently on 2u...

You have a good amount of data and that is really good.

couple of things I see in ur ss, is on 01/30 u shot an extra dose of 0.5u on top of the AMPS and PMPS - is this correct?
and on 01/26 and 01/27 u have shot outside the 12/12 schedule....

not sure if uv heard this, but Lantus works best if consistent, that is on a 12/12 BID schedule...
there are ways to safely make up early shots and late shots.

You might want to re-read the information threads in the lantus forum, I know you were in that forum earlier this year.
They follow the Tilly Protocol, if ur interested.

Hope that helps, I can't advised u specifically on dosing but only can share with you what I have learned.

 

Re: Unregulated w/ higher dose of LANTUS

The 1.5U started in mid-December, maybe later. she was on that ID diet for so long, and I finally got sick of the high numbers and decided to increase the dose. It didn't really help her by increasing it!

I will look into safer ways to make up for being late. You are right, that is what happened. I got off the schedule, and I noticed her numbers went up while I was trying to get back on track.
Besides this, she is still too high.
I just don't know what to do.

I think I gave her a bad injection today, because her numbers are climbing!!! She hasn't even had any bad food, and since her AMPS her numbers are INCREASING!
Ridiculous.

Thanks again.....

 

Re: Unregulated w/ higher dose of LANTUS

Hi Alexia,

May I also add that it is important to stick with as close a 12/12 schedule as possible. Any changes to that schedule (aside from 15-30 minutes) can be considered a dose increase or decrease, depending if you shoot early or later.

Also, if you think you shot wrong (like a fur shot) - NEVER shoot again, rather note in on the ss (like you did) and wait until the next scheduled shot - the reason for this, is that it's possible you shot all or most of the dose successfully and if you re-shoot, you could overdose the cat.

I'm not a dosing expert, but given that your numbers are pink - I would suggest that you hold the 2 units for a few days, and keep to the 12/12 as best you can.

If you have a scheduling issue and can't shoot on time, please come to the Lantus forum and post and the people there will help you with scheduling and how best to make up the time difference. There are various ways to do it and depending on the situation, they can provide specific guidance.

As for food, without getting into the dry is bad discussion, the fact that feeding dry food and feeding the DM prescription food could be causing the higher BG's. Th DM is higher in carbs and the goal with diabetics is low carb not high carb. The dry food is also higher in carbs and again not a good choice for a diabetic.

I won't lecture on the dry, but will point out Dr. Lisa's website that if you haven't read it, you may want to. If you've already seen it, then just ignore this. http://www.catinfo.org/

May I also suggest that you visit the Lantus forum, post there and read the starred posts at the top of the page. It goes over everything you need to know about lantus, protocol, dosing, storage, handling, etc.

Hope this is helpful.

 

Re: Unregulated w/ higher dose of LANTUS

Thanks, Hillary!

Like I said, I do not feed her ANY dry. I was just saying that some people don't read the whole post and see I have actually cut out the dry food!
She eats exclusively Wellness wet food.

- A

 

Re: Unregulated w/ higher dose of LANTUS

This is so true! It's impossible to post without hearing about wet and/or hometesting even if you're already doing both of those things and say so in your post. This (and other things too) make me so wary of ever posting at all.

That said, I had a similar experience with my cat, where initially the small initial dosage gave him some great numbers, but then that stopped and he started climbing in numbers and in dosage (but for no obvious reason like pancreatitis, for example). Not all cats can stay with a small dose forever or for long... it just takes time to find that "right" dose. The wait can be very slow and frustrating, but as long as you're checking numbers, testing for ketones, and increasing slowly and in small steps, you should be OK until you find that magic dosage. Good luck!