Need some serious help with dosing

Hi, been here before. Life has been hectic and I've only just been able to get around to figuring out and inputting all the data into the spreadsheet.

Otto was diagnosed in June? I think. We were using Alphatrak 2, switched to a human meter, it is Freestyle something. I believe all the data I've put on the spreadsheet is from the Freestyle. There are some issues with the data, as my mother has been keeping track in a notebook, but sometimes makes some mistakes and it's been difficult to decipher in some parts. I also know we did a curve just a week or two ago before another dose increase, but that data has been lost in the wind I guess. We have consulted vet with each dose increase. Though vet recommended going up by 0.5 increments, I have learned from this forum to do 0.25.

He has been on Lantus this whole time. About two months ago he started getting exclusively canned food, no dry. He is currently now up to 5.0u of Lantus ... which from reading this forum is super high. We did multiple curves before this spreadsheet is filled out. I just only found the new notebook for the last two months. I do have records since his diagnoses though.

Start of this month he developed pretty bad neuropathy. His rear is almost completely useless, going to the litterbox is very difficult for him. Its so hard to see him struggle ...

TLDR:

• 7ish year old male cat
• Was obese most of his life but started losing weight - diagnosed with diabetes. He is a big cat.
• Started on something like 2.0u of Lantus, has went up to 5.0u as of today
• Wet food only. Has some fairly extreme intolerance to certain proteins so its been really difficult to find lower carb.
• Now has fairly bad neuropathy, has been getting B12 supplements for a month, no help
• Diagnosed since Juneish, but spreadsheet only shows last two months (we have been testing AMP and PMPS every single day though with curves before major dose changes).
• Gets fed about an hour before his injections, and sometime +5 in the afternoons.
• I have never, ever, ever, since his diagnoses, seen him get to an actual low number like the ones I've seen on here. He had dipped to I think 7.2 one reading. He wasn't sick, he didn't vomit or anything like that ... there's literally no rhyme or reason as to why it occurred.

This needs to change. He has done nothing but go downhill since his diagnoses. I will do anything recommended here. I know people usually say money is tight, but money is really tight right now, I cannot take him to the vet for further testing. I've been lucky enough as it is to avoid a trip to emergency with ketoacidosis ... so far. Please help. The vet seems absolutely useless. And when I told her he developed neuropathy to the point he needs to lay down for a break when he pees, she seemed like it was no big deal ... very frustrating. I am aware of bouncing ... I read the sticky about bouncing and quote "if the cat is unregulated and never has a BG reading below 200, you're probably not seeing rebound." So it doesn't seem likely.

I will be doing a curve tomorrow just to get some actual data on the spreadsheet. I sincerely apologize for any mistakes in the spreadsheet.



https://docs.google.com/spreadsheet...uLyV0IvVA4h8OOk7fHeSkovSGS4JqCUmQe4Dr/pubhtml

I'm in Canada so I use mmol, the US version is displaying a little wonky.

As you can see I did his curve today. If you can call it a curve. Its more of a flatline. Which any other curve this hasn't happened - I'm now even more confused.

 

Hi. I was catching up on the forum and saw this had fallen down the queue without a reply. I’m sorry I can’t offer advice but wanted to bump the post up in the hope that someone with experience with Lantus may see it and be able to help you and Otto. You might try posting in the Lantus forum if not.

I do wonder what food he is getting? I see he switched to all wet food, but there can be a LOT of variance in carbs in the different wet foods. E.g., our kitty gets 4% carb food, but we have cans of 13 and 20 in our “hypo kit” just in case her BG needs a jolt.

 

Here's what I see right off

You need to test more....curves only give us a picture of that day, that cycle.....without more testing, it's impossible to know what's going on with any degree of certainty. You need to test before every shot, and if at all possible, test at least once somewhere mid-cycle on the AM cycle, and at least a "before bed" test on the PM cycle.

Regarding the PM cycle.....most cats go lower at night and you're not testing at all on the PM cycle....get at least 1 test before bed. Without testing on the PM cycle, you're also missing half the data of what's going on with Otto.

You should do Pre-shot tests when he hasn't eaten for at least 2 hours...You say you feed an hour before shooting, so the PS tests you're getting are food-influenced. Take all food up at least 2 hours before shot time so that when you test, it's not a food-influenced number.

We Test/Feed/Shoot.….all within about 5-10 minutes. You Test (to make sure they're high enough for insulin) Feed (to make sure they're at least willing to eat) and Shoot.

With Lantus, it's not necessary that they eat before it's safe to shoot.....as long as they're willing to eat, you have about 2-3 hours before the shot starts to "kick in" so you have that time to have them eat more if they're not terribly hungry at shot time.

Try to get some more tests in over the next couple of days and let's see where you're at.

It's possible that Otto has a high dose condition and he may need higher doses than most of the cats you see here. We suggest testing for acromegaly and IAA when they get above 6 units.

You might want to send a PM to @Marje and Gracie and see if she can fix your spreadsheet so it works correctly on the US side. I know she's been seeing problems with the World spreadsheets and has been working on a fix.

 

Cross post on Lantus forum here http://www.felinediabetes.com/FDMB/...erious-help-curve-not-showing-a-curve.204007/

 

Hi, I do test before every single AMPS and PMPS shot. I have never once shot without testing. As for the before bed shot, he lives with my mother and she cannot test/inject him, so I need to do it. I'm already going there every 12 hours to test/shoot him. So as soon as I wake up in the morning and right before she goes to bed at night. But until this gets sorted out I will try to sneak there and test him before I go to bed probably 2-4 hours after his PM injection. And I have been trying to do a random test at some point in the day, but I honestly feel awful for poking his poor ears but I guess I need to be doing that to get a better picture of whats going on.

I will definitely make sure my mom is aware of the feeding protocol, this is probably influencing it like you said. I will gather more data over the next few days and update. I'd like to see him improving and not getting worse. I'm definitely going to be staying on top of the charting and tracking more than I have been. Thank you very much for your insightful reply.

Also to answer what food he is on, it is Royal Canin Diabetes canned food for probably 2-3 weeks. He was on prescription Hypo RC. We've been super lucky with the Diabetes formula as literally every other food (the ones I've researched and seen on here, Friskies, etc other low carb/high protein pet store foods) and they've all made him itch to the point he starts pulling his fur out, diarrhea, or even immediate vomiting (and yes this is with the proper slow introduction, mixing of the foods).

 

Yes, I didn't mean to imply that you weren't.....I was just giving you a breakdown of when/how often to test.

That will be very helpful.....Just something to keep in mind....IF that +2 is a lot lower than the Pre-shot, that's an early warning that he might be going a lot lower later in the cycle and it would be best to get another test in later (I know....it's not easy and a lot of us are very sleep deprived, especially until we learn how our cats respond)

That is a higher carb food, but if it's all you can use, we just have to work around it......it's kind of surprising that he tolerates it though since it doesn't have anything special in it. It's a pretty routine mix of pork, chicken and the usual garbage in the prescription foods like Wheat Gluten, Powdered Cellulose, Gelatin By-Products, Wheat Flour, Corn Starch Modified (Powdered Cellulose is one of my "pet peeve" ingredients.....that's just a nice way of saying it contains sawdust)

Have you ever tried a novel protein diet on Otto? Something like rabbit, venison, kangaroo, quail, buffalo?

 

Hi I updated the other thread today with some new information/curveballs and would appreciate any input. I'm trying my best

http://www.felinediabetes.com/FDMB/...urve-not-showing-a-curve.204007/#post-2268308

 

I had very good results with Zobaline for my diabetic kitty's rear leg neuropathy, it did take a few weeks, maybe a couple months before I saw improvement. Now she has no rear leg neuropathy. Some cats respond quicker than others. I hope this helps!

 

Hi I updated this in the Lantus section with over a week of more testing

http://www.felinediabetes.com/FDMB/...erious-help-curve-not-showing-a-curve.204007/

I would greatly appreciate input. I’m testing as often as I can I’m going through some difficult life stuff right now but I’m trying my best.

The more I look at his SS the more hopeless I feel. This has been going on for months and he’s only getting worse. I feel like I have to set myself some kind of deadline where I will force myself to put him to sleep before his disease makes that choice for me. ANY improvement at this stage or ANY direction in which to go in - dose increase or decrease or what, would mean the world to me and this cat.

I’m sorry for posting in both sections but I’m desperate for the puzzle pieces to fall into place somehow.