"Newbie", Unregulated Cat need help please!

My cat Jessica has been diagnosed with diabetes in Mid February 2013 and was administrated 1 unit of Lantus once a day. On March 10, the Vet increased the dosage to 1 unit, twice a day. Everything was fine during the first few weeks until April 8,2013. She drunk a lot of water and urine a lot and was extremely hungry. I was thinking the insulin might had lost its potency because someone told me Lantus insulin can only last for 28 days after used. So, I bought a new Lantus Solastar on Friday April 12 and gave her the same dosage. However, the situation didn’t change much. She was still very thirty, pissed a lot and extremely hungry too. I brought her to the Vet on Sunday April 14. The Vet took some blood and tested for Fructosamine. I got the test result on Tuesday April 16. It was almost 569, much higher than 503 (normal range is 145-450 µmol/L) that was tested on March 23. I called the Vet and she told me to increase the dosage to 1.5 units, twice a day and will have the blood test few weeks later. Finally, I decided to test her blood glucose level on 04/16/2013, 3 hours after the insulin injection. It was 296. Her situation seem improved a little bit but her BC level still well above 200 most of the time. Can someone tell me what to do? I don’t want to cause further harm to her kidney because of my negligence & ignorance. Vets usually don’t encourage you to do your BC home test, because most of the Vets are business oriented. This is very unlucky for someone like me.
I’m deeply regretted I didn’t take BC home test myself and closely monitoring her BC level initial. I thought her BC level was under control. Besides, I am a full time worker and was unable to take frequent blood test during the day.
I still have questions: 1) Is it possible that the Lantus that I am using now has no impact on her anymore, that means, I have to change another type of insulin? (2) How do I know that the new Lantus Solastar that I bought has the potency that it supposed to have? May be the one that I bought has lost its effectiveness due to improper storage (too cold or too warm) since Lantus has to be stored under 36 to 46 F.
I really need your help. Thanks

 

Welcome to Lantus Land.

Your description of Jessica's experience is not unusual. It's often the case that vets don't encourage home testing because most people won't do it. That you have decided to home test will help you to get Jessica feeling better and give you more control over her diabetes. It's not an overnight process but you can get her numbers into a better range.

First, take some time and start to read the starred, sticky notes at the top of the Board. I would encourage you to start your reading with the New to the Group and the Tight Regulation Protocol stickies. There is a huge amount of information in those notes and they will help you to become more familiar with Lantus. For example, if you are careful with your insulin, you can get considerably more than 28 days use. I use a Solostar pen and get approximately 50 days of use from a pen. For people using a vial, they can get roughly 6 mos. of use. Unless you are having problems with your refrigerator, I would assume that any reputable pharmacy would keep their drugs requiring refrigeration stored properly. (Usually, this sort of thing is monitored by State agencies otherwise, people could become quite sick due to their taking bad drugs.)

Many of the members here either work or go to school (or both). Do the best you can with regard to testing. You always want to get a test before you give a shot. It's the only way to know if it's safe to give insulin.

Please let us know if you have questions. The people here are very generous with their time and information and we're all here to help you and Jessica.

 

As to your first question, it is certainly possible Lantus "has no impact on her anymore" but I don't think that is the case. You don't have very much data at this point using Lantus, and the data that you do have is not terrible! Especially when you consider that her values were in the 500's with the vet's testing. You're not at a high dose, and if you were to start changing doses based on testing values and the protocol, you will likely see Jessica continue to show nicer numbers. It can be challenging working full time, but it is possible.

As to your second question, we used a vial of Lantus for 5 months before Leo went OTJ and it was still working fine. We kept it in the fridge, in the original box, inside a coffee cup, on a shelf (not on the door where it can get banged around).

I would encourage you to test and keep at it. Around here it's called putting on your patience pants!

Welcome!

 

Welcome to LantusLand, the greatest place you never wanted to be. :lol: :lol: We are all pretty much cat crazy here and will do just about anything to help our cats. You might be better off starting in the Health forum, where things are a little more low key, and you can learn the fundamentals of testing and food. It sounds like you are already doing a great job with giving the shots. We are happy to help you here too, but we are a little more experienced and sometimes forget how overwhelming everything is with a newly diagnosed cat.

Everyone here uses a spreadsheet to enter their data. By having a common format, it's much easier to help someone with dosing advice. If you could set up a spreadsheet with as much information as you have, that would help immensely. Here are the instructions. Let us know if you have any questions or problems. We are happy to help.
Liz, Zener's other mom

 

She's got a spreadsheet going and has been testing and adding values for a month or so. Unless I am missing something, she needs to start getting pre-shot values consistently (sorry - I should have said that in my first post) and just continue what she is doing, while reading the stickies to understand better how the protocol works and think about how she can work that into her daily life. Getting those +4s and other mid-cycle tests is terrific.

 

I'm sorry! I'm blind. I see the spreadsheet link now. Great job with that! I agree with Lisa's suggestions about testing. I will add that we get a preshot test to make sure it is safe to shoot and a midcycle test to get an idea of the nadir (lowest point in the cycle). The nadirs are what guide the dosing decision (not the preshot value). It is a big adjustment to your life, so get what you can.
Liz

 

Are you using an insulin syringe to draw the insulin out of the Solostar pen? You need to for accuracy with those tiny doses that cats get. The dial in feature with those solostar pens does not work well to get a consistent dosage at those tiny amounts.

 

Thank you everybody. I will try my best to take more proshot number.
To answer Deb's question: Yes, I'm using BD U100 syringe with 1/2 unit mark.
Since my cat drinking such huge amount water. Will there be any permanent demage to her kidney? She always very hungry all the time, that's why I can't take much preshot number. She won't let me test her BG when she was very hungry. My plan is to give as much as she wants and take the test right after that.

 

Without the pre-shot numbers, we don't know how much the insulin is dropping her. You could try feeding Jessica a small amount, say a tablespoon of food, and then test as soon as she is finished eating that 1T. As long as you test within about 15-20 minutes of her starting to eat, then the BG number should not be food influenced. It takes about 30 minutes for wet food to have an impact on the BG numbers.

Do you think you could try that? Feed 1T, she finishes eating, you test immediately?

 

Water is good. If anything, it keeps the kidney's flushed. The drinking will begin to slow down once your cat gets better regulated.

The potential problem with feeding before you give a shot is that food can influence your pre-shot test number. How about giving a small snack at around +9? You'll probably need to get a timed feeder so you don't have to wake up at night and so food is available when you're at work. The snack may help to make Jessica less hungry right before shot time. Like with water, once numbers start to come down, the appetite issues will be less of a problem.

 

Just wanted to say welcome! And you're doing great! Everything is really overwhelming at first but you can do this. I am a sole care giver with a full time job. It's challenging but it can be done. In a short while everything will become normal and routine and it will surprise you to look back and see how far you've come along. Just take it one day at a time and slowly but surely it will all start to come together and make sense. The people here are WONDERFUL and always willing to help. Don't hesitate to ask anything. I am on my second round (after approx 1 year in remission) and I am still learning things based on the questions of others.

 

Glad to see you over here. I am thinking people are saying they need more data and Deb had a good point ie

I like the idea of feeding her her 2.5-3 hours before the shot ( timed feeder may help) and then a small amount just before you test, test her, then feed the rest.

I also think the insulin is fine but you havent found the right dose. Get a few preshot tests in the next few days and the guys here will be able to advise what to do next.

Wendy

 

Thank you everybody. Really appreciated. I took PS BG test right after the first feeding. It was 424. +4=242 & +5=294. I think +5 BG test was distorted since I gave here little chicken before the test.

 

Plain old chicken won't affect a test - it has no carbs. That's one of the reasons that we use chicken as a testing treat - it doesn't affect anything and it's generally a desired treat to get kitty to accept the testing more readily.

In that same vein, all tests will be "affected" by food, which is what's supposed to happen for all tests but pre-shot. The insulin offsets the increase in blood glucose that is caused by eating food carbs. Since the insulin has a longer onset time (5-7ish hours) that's why we feed earlier in the cycle, to balance the two out.

The only time you want to withhold food with carbs is 2-3 hours before testing time, because that needs to be uninfluenced by food ... a "fasting" value.

Good job on the preshot and +4/+5 ... now you can see the effect of the insulin, rather than just seeing the yellow around nadir. You don't need two tests so close together if the values are higher like that. With a 424 PS, you can wait until nadir (+5/+6) if your schedule permits, but what you tested is fine.

 

It would be good at this point for you to create a new post (Condo) each day for Jessica rather than re-using the same post. You can see from the other Condos how people are formatting the posts. Each day, create a new Condo with the date, kitty's name "AMPS" then the preshot value, then each additional test that you take ... just like the values in your SS. To add subsequent tests, edit the subject line of the "original" post that you created, not the subject line of any of the replies. Then people an quickly scan the condos and see how Jessica is doing, and give advice if they notice something you should consider. If you have questions like you did with this condo, you can click the "?" "Post icon" at the top and people will be able to see your question more quickly.

 

Lisa, I will do that. Could you explain "you can click the "?" "Post icon" at the top" to me? I don't understand what's that mean.

Thanks

 

When you create a post (or edit one), look at the top of the editing area. There is a row of icons for you to select. The first one on the left is "None", then the "911", then two candles, then a rainbow, and so on. Just to note: the candles and rainbow signify a kitty that has died. The 911 is for emergencies, possibly life threatening. See the ? icon? That's the one to use when you have a specific question.

You are doing a great job!
Liz

 

Thanks, got it.