Insulin reduction symptoms

Hello, Everyone,

My 15 yr old cat, Sake was started on insulin a little over a week ago. Prior to going on the Lantus, her level was 364. Five days later, before we got the prescription, she had already gone down to 318, just from changing her diet to all wet, low carb food. After a week of being on 2U of Lantus every 12 hrs, her level went from 318 all the way down to 93, so the Vet reduced her Lantus dosage to 2U every 24 hrs because she said that the Lantus does not dispense well at 1U twice a day. Her appointment was in the morning that day, and when I got her home I fed her a LOT of food because the Vet said I could pretty much feed her as much as she wants to get some weight back on her. Shortly after I fed her, she started walking around the house, howling (like some cats do at night,) and she seemed to be a little less energetic/sleepier that day. At that point, she had not had her insulin since 8pm the night before, so about 15 hrs had passed. She wasn't super lethargic, or drinking a ton of water, or anything severe like that--she was just "different." I gave her the 2U at 8pm, as the Vet prescribed, and that night and since then, she's been fine.

I just wondered if it was normal for them to exhibit some unusual symptoms, or behavior after having their insulin dosages reduced? Has anyone else experienced this before? Thanks in advance.

 

Hi and welcome!

You've arrived at a great place with lots of very experienced people here that can help you.

Are you home testing ?

If not would you be willing to do it,?, I think is the best you can do to help your cat, and more importantly to keep him safe

In my experience it helps a lot to start learning about the insulin you are using, Lantus is a long lasting depot insulin, which means it takes a few hours after you shoot for it to start it's effect and it also forms a depot as the days pass by, both reasons why it works better if you keep your 12 hour schedule and if you keep the dose for a few cycles ( 12 hour periods ), also even though in humans Lantus is given once a day, cats work a little different their metabolism is faster than ours so they need the insulin every 12 hours .

Two units is a little high dose to start with so I do recommend you monitor her since going too low is very dangerous and she has already gone kind of low maybe you could talk to your vet about giving her 1 unit every 12 hours

It's ok to free feed her and if she's underweight to feed her as much as she wants, but we do recommend to withdraw the food 2 hours before her shoot so when you test before shooting the results won't be food influenced.

Once the kitties start getting low numbers some do tend to act a little bit under the weather sort to speak because their body is used to having high numbers and it has to get used to the lows but nothing mayor and after a while they start acting normal again

Here are some links with very good information regarding Lantus and the protocols we use here

http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/

http://www.felinediabetes.com/FDMB/threads/lantus-levemir-what-is-the-insulin-depot.150/

 

Lantus is meant to be dosed twice a day in cats. Not sure why he would recommend against 1 unit twice a day. That is the manufacturer recommended starting dose.

 

Hi, thank you for responding so quickly! I don't know exactly what my Vet's reasons are for choosing the dosing amounts/schedule that she did, but both of my cats go to a Cat Hospital, so I figured if anyone would know what's best for my kitties, they would. I did actually buy all of the necessary items to do home testing, and I attempted to do it last week, but it was an EPIC FAIL. I couldn't get enough of a blood droplet to form. I didn't specifically warm her ear up prior to then, and I also probably didn't use enough force with the lancet for fear of hurting her or puncturing her vein. She was also flailing about so much that even wrapped in a towel, between my knees on the bathroom rug, it was impossible. I think I'm going to get one of those Cat-in-the-Bag things, and see if that helps, since I'm the only adult in my household, and don't have anyone else to help me. I haven't given up yet! I've watched all of the videos, and I know I can do it, eventually...

I'm not free-feeding her. She's still mainly eating only twice a day. I've just increased the amounts of food per feeding. The Vet originally wanted her to only eat 160 kcal/day, but she's only 8 lbs, and has lost a lot of muscle so she needs at least 1-2 more lbs on her. Two yrs ago, she was a healthy 12 lbs, and in the past she's even been a bit of a fattie at 14-15 lbs, but that's when she was free feeding ("grazing") all day long. Since I started feeding her more, she isn't constantly begging me for food like she was, so that's good. Sometimes, I'll give her a smidge more food before I go to bed, just so she'll be comfortable throughout the night.

 

Hang in there is hard at the beginning but it does get better and easier to get the blood drop, take a look at JanetNJ video that is at the bottom of her signature is a very good one, also is very helpful to stablish a routine, first choose a location where you are confortable and turn this into the testing site, always use the same place, try getting him used to you handling his ears, so take him to the spot a few times and don't poke just rub his ears give him a reward ( this is very important always give him a reward ) and let him go that way he starts associating the spot and the ears with a good thing, and when you do test also give him a reward regardless if your test was succesfull.

Also don't be so afraid about hurting her I think they don't actually mind the actual poke so much ( I may be wrong is just an impression) is the handling of their ears what botters them, and also don't be so much worried about puncturing the vein is not that bad and nothing really dangerous happens but you will then get a lot of blood ( and I mean a lot ) so best not to do it but if it happens don't be scared just press the spot for a while and clean the mess ( try not to test on your good clothes just in case)

 

If she's underweight feed her as much as she wants, just no food at least 2 hours prior to the preshot test so the number is not food influenced. What are you feeding?

No insulin lasts 24 hours in a cat which is why it's dosed 2 times a day. Lantus can last 24 hours in a dog, but cats have a faster metabolism.

Testing can be hard the first week until the capillaries start to form. Warm the ear, use a 26 or 28 gauge lancet. They are thicker. You want to poke the very outside edge, not the vein ... And it's OK if you poke all the way through. I have a video in my signature showing how I test my cat CC at home.