Recently Switched To Low Carb - Lantus Dosage Advice

Status
Not open for further replies.
Linds2225

Linds2225

Member Since 2014
Thanks in advance for any advice.

My question is, at what glucose readings should we reduce or not give the next lantus injection after a meal?

Background: Our diabetic cat was moved to the Hills Prescription W/D wet and dry food combo diet after being diagnosed with diabetes about two months ago. He eventually moved up to three units on the Lantus Pen with his glucose numbers steadily in the 325-425 range. After removing dry food from the diet a few weeks ago, the numbers moved to the 150-250 range almost immediately. However, he recently stopped eating the prescription wet food for several days, only eating a few tablespoons. We just moved him to Natural Balance, majority wet and a little dry, which is lower in carbs than Hills and he has been eating close to normal again.

This morning after he ate normally, he had a reading of 338. We started his insulin and gave him 3 units like before. When we got home from work, his reading was 151.

After he has eaten his meal (twice a day around 7:30 am & pm), we test his glucose everytime. If he reads in the 100's, should we still give him 3 units? Should we even still be giving him 3 units? How do we know when to lower it?

Vets have proven to be somewhat useless outside of consistent testing and prescription diet recommendations.
 
Hi Lindsay!

First, let's talk about diet...As you've seen, the right food can have a drastic effect on the numbers. There's absolutely no reason to feed expensive "prescription" diets. Getting any dry COMPLETELY out of the picture will help. We've had cats that ate as few as 2-3 kibbles and had their blood glucose go up 200+ points

There are only a few of the Natural Balance foods that are below 10% carbs. If you look at this Food Chart, you can find other foods that are under 10% carbs to try with Doobie BUT make sure you're home testing before lowering the carbs!

Next, we really need for you to start and keep a spreadsheet so we can see how Doobie is doing. Here's instructions on How to create a Spreadsheet . The spreadsheet is every bit as valuable a tool as insulin and the correct food is. It's the only way to really see the "patterns" we look for

3 units is a huge starting dose so it's impossible to know if he really needs that much, or he's actually getting too much without knowing what kind of readings he's getting and without having started at a dose that's based on his weight and slowly moving up as needed

Generally, we test/feed/shoot within about 5-10 minutes, and then give several mini-meals throughout the cycle, but taking food up 2 hours before the next shot so we get a Pre-shot test that's not influenced by food. Feeding ONLY twice/day is "old school" thinking. It's easier on the pancreas to deal with small meals spread out than it is for it to deal with 2 huge meals. It's only important that you make sure your cat is eating "normally" before shooting.

The general "rule" here is that when you're first starting out, if you get a pre-shot number under 150, you STALL (don't feed) and post asking for help. Make sure your subject line says something like "Stalling, need help" so people scanning the board will see it.

As you get more testing in, and learn more about how Doobie responds to both food and insulin, that "no-shot" limit gradually comes down. Once we have enough data on our cats, most of us will shoot anytime their BG is over 50 (on a human meter), but again, that's only after we've been testing long enough to really know what's going on inside our kitties.

Do you have any test results that you've been keeping track of somewhere and can put on our spreadsheet?
 
Hi,
I saw you have a few previous posts and I might be repeating some of previous comments but there was just too much to read quickly.

Chris just pointed out the food chart....
I have a sub list from that chart , it's everything on the master list that is 8% or less. http://www.felinediabetes.com/FDMB/threads/shortcut-shopping-list-all-8-or-less-updated.117688/

get rid of any dry..... there are only two dry foods for those who insist or who have a cat that refuses wet....
that's Young Again Zero Carb or Wysong Epigen 90..... I don't recommend Evo dry.... ( some others do)


Changing foods often drops numbers as you have seen.
I think I would start over.... probably with 1 unit.
And set up a spreadsheet..... everyone here is much better to give advice when they can see how Doobie is doing....


Keep posting daily.... we'll help you adjust dose..... up or down as needed.
maybe make that alpha trak meter in your signature a bit bolder...... so it stands out.


I agree that the 3 units is probably too high with a food change in play.
 
If you need help setting up the ss, just ask. There are several here who help others.
I'm not one of them but I can flag someone who can do it really quick for you.
 
Thanks.

In response to the previous quote: "Feeding ONLY twice/day is "old school" thinking. It's easier on the pancreas to deal with small meals spread out than it is for it to deal with 2 huge meals."

How do you accomplish this with a wet food only diet and go to work all day? How long does wet food stay good while sitting out? Are there automatic wet food feeders?

The good news is that Doobie grazes already, only eating in small portions across the day naturally.
 
I leave the food out for 10-12 hours at a time and they all graze.
Gracie is in her own area and generally finishes it before the next shot time.
 
I'm currently using the Petsafe 5 Automatic feeder which is popular here. There is a compartment below the tray where you can put a small ice pack, which I do because I'm serving raw. If you are just using wet food, you can either add water or put an ice cube on top. The water keeps it from getting crusty and you should be adding a bit of extra water to a diabetics food anyway. If Doobie grazes, you may not need an autofeeder. My Neko is a hoover so I have to space it out.
 
Hi and welcome,
It looks like you are using the Solostar pen and its needles. Because we do dose changes by .25 of a unit, we use the pen as a "mini vial" and draw insulin from it with syringes. (the needles that come with the pen are intended for humans, who typically have large doses measured in whole units). Take off the cap from the pen and you will see a small rubber gasket. You stick the needle of the syringe into the gasket and draw out the insulin. No need to "dial in" the dose. Get U100 insulin syringes with half-unit markings, 3/10cc, 31 gauge.
3 Units is a very large starting dose, and you will probably have to lower the dose when you complete the switch to low carb wet food.

Ella & Rusty
 
There's no problem with leaving canned food out for him to graze on. I also used the PetSafe 5 Compartment feeder but didn't have a blue ice that fit the compartment so i added an ice cube to each compartment. It keeps the food cold for a while and it also keeps it from drying out.

Great job getting started - there's a lot to starting out, but it gets infinitely easier. Your 3u dose is probably appropriate for dry food being in the diet - as you switch, he'll likely need less. To get a diabetic cat regulated, most people feed in the 5%ish carb range - anything under 10% is considered low carb, but there are many foods that fall i the 4-7% range. You don't need to get to zero or 1% carbs - that's not necessarily better than "some" carbs. Most people make the diet change about 25% every 3 or so days so you don't upset his tummy with new food and so there is time to adjust the insulin downward as you get tests that tell us it's needed.

Welcome to Lantus/Lev Land! Let us know how we can help you.
 
Thanks for the responses.

We picked up some Friskies Special Diet Turkey and Giblets on our way home from work. We intend to slowly work it in with just Natural Balance wet (what he's currently on) and remove any dry. We also plan on trying Wellness Turkey and EVO 95% chicken.
  • Any thoughts on these foods? Cost-effective strategies (buy larger cans or bulk)? Alternative foods that you've been successful with?
Our vet said his ideal weight should be 15 lbs therefore he needs 220 calories per day.

The catinfo site referred to on this forum uses the following formula:
Required calories per day = [13.6 X optimal lean body weight in pounds] + 70

This equation gives us 274 calories per day.
  • What is the best method to determine calories per day?
 
Also, in looking at the guaranteed analysis on the cans.

Friskies Special Diet:
  • 78% moisture, 10% protein, 6.5% fat, 0.5% Fiber, 2.8% ash, 0.2% potassium, 0.24% magnesium, and 0.05% taurine.
Natural Balance:
  • 78% moisture, 8.5% protein, 6.0% fat, 2.0% fiber, and 0.05% taurine
If at max the friskies is 3.5% carbs (ash + fiber) and the natural balance is at max 2.0% carbs, how could NB be worse given that these are percentages?
 
You can't go by the info on the cans because you need "As Fed" carbs. The can labels are useless for that.

I bought Punkin's Friskies SD Turkey & Giblets at Kmart. Only place in town that carried it. If you haven't looked there, you might try it. They're pretty cheap.

Changing over slowly is a good idea. Some cats get iffy tummy response if the food changes are too fast.

I'd start with either of those calorie formulas - choose one - and then weigh him once a week or so. If your goal is to have Doobie's weight be stable, adjust his volume of food to accomplish that. If he needs to lose any weight, do it very slowly. Cats can't lose weight quickly or they can develop fatty liver.
 
Thanks BJM, very handy. Although the "Dry Matter Carb %" section at the bottom says 8% and the 8 or less list posted above says Friskies should be 5%. Maybe I am reading/entering it wrong.

Doobie had some blood in his feces tonight. Should we be concerned?

We have a second opinion appointment with another vet on Friday after calling several vets and asking feline diabetes questions.

Also, are there any long term side effects of us poking his ear every day for the BG test?

Thanks, you all have been very helpful and worth twice what we've paid the vet.
 
Also, are there any long term side effects of us poking his ear every day for the BG test
Click to expand...

I hope not! I've been testing Gabby multiple times a day for over 5 yrs. She still seems to like me -- or she likes food and treats which is what she gets after a poke and her ear (since I test on one ear only) is none the worse for wear,
 
We learned on punkin's left ear and unfortunately, scarred it. i'm not sure what we did that was wrong but maybe it was just our ineptness. After about 6 months we moved to the right ear and stayed there for the rest of his life, about 2 years. you would never have known that we tested his ear. it was pristine - the vets always looked at it and marveled that they couldn't tell anything. I don't think punkin was unique here about this. We put neosporin ointment with pain relief on his ear every night and by morning it was healed again. On his lowest, worst days he got tested more than 20 times in one day.

the most important thing to do is to staunch the bleeding by applying pressure for a few seconds so it doesn't bruise. Doesn't take long and makes a huge difference.

Think about cats and fights - their ears must not feel too much because they always get the worst of fights. i think they're tougher than we think.

I'd ask about blood in the feces. Might be nothing, might be important. I wouldn't ignore it - since you've got a vet appt on Friday that would be a perfect time to ask.
 
Ella & Rusty & Stu(GA) said:
Hi and welcome,
It looks like you are using the Solostar pen and its needles. Because we do dose changes by .25 of a unit, we use the pen as a "mini vial" and draw insulin from it with syringes. (the needles that come with the pen are intended for humans, who typically have large doses measured in whole units). Take off the cap from the pen and you will see a small rubber gasket. You stick the needle of the syringe into the gasket and draw out the insulin. No need to "dial in" the dose. Get U100 insulin syringes with half-unit markings, 3/10cc, 31 gauge.
3 Units is a very large starting dose, and you will probably have to lower the dose when you complete the switch to low carb wet food.

Ella & Rusty
Click to expand...

Hi Lindsay

I just wanted to check that you saw the various comments on the dosage. I started my cat remi on 0.50 units of lantus twice a day and gradually increased by 0.25 with the help of the members on this board. Once I got to 1.25 units it was time for him to come back down the dosing scale. The starting dose was based upon his weight. How much does Doobie weigh?
 
Chris & China said:
We've had cats that ate as few as 2-3 kibbles and had their blood glucose go up 200+ points
Click to expand...

I am so glad I decided to read this condo today. I have been giving Sami one piece of Purina Kitten Chow when I test and give her shot. It isn't every time, but she is probably getting 3-4 pieces a day. I figured what could a few pieces really do. Do you think it is possible that this could be why she is not leveling out?
 
Some cats are very carb sensitive, so yes, even 4 pieces of kibble might affect her numbers.
You might try PurBites freeze-dried chicken as a treat. Get the dog size as it is more economical, then break a piece off for a treat. My cats all love them.
 
@BJM Thanks, I have tried that brand of freeze-dried chicken, and my cats didn't seem to like it. I will keep trying with the Whisker Smackers that I have.
 
I just ordered some Orijen Freeze Dried treats so we will see how those go over. If not I will try these. Thanks.
 
Thanks for checking in phlicka. Doobie is approximately 16 pounds now.

We are still mixing his food with both Friskies Special Diet and Natural Balance.

Any advice on how long it should take to get him to Friskies only?
 
Generally we say to switch out about 25% every 2-3 days until they're eating 100% of the "chosen" food, so for the first few days it's 25% new and 75% old

Next few days 50/50

Next few days 75%/25%

And then you're done!

If your cat has problems with diarrhea or upset tummy as you change foods, you'd want to do it slower
 
  • Like
Reactions: BJM
Hi everyone! Wanted to get some feedback on a few questions and to provide an update on Doobie.

For people who don't want to read the whole update, here are the questions:
  1. For the last two days, both cat's feces have turned a pale beige/grey color and Doobie has diarrhea. We switched to Friskies Special Diet wet food about a week ago. Any thoughts?
  2. Doobie is drooling recently. Any thoughts?
  3. What is an accurate calorie count or range per pound if you want to maintain weight? Our first vet told us 220 calories, cat info calculation is 274, and our new vet said 380-460. Confusing!

Over the last week, Doobie has had more energy than we have seen in months and sometimes is even seeking attention and being goofy again.

Last Friday (1/30) we took Doobie to a new vet and had a more informative experience. She told us that our current plan was headed in the right direction by moving to low carb wet food (not prescription) and decreasing the insulin. She warned there may be insulin depots from giving him 3 units.

Important to note is that we switched his food to full friskies special diet wet food from 1/2 - 1/2 with natural balance wet. Doobie has loved it but we are beginning to worry we switched too fast and the lower quality may be affecting both cat's stomachs.

As of Friday night, Doobies readings have been lower than we have ever experienced and we haven't been giving insulin often. See AM and PM pre-shot readings below. Sorry, excel is down...
  • 1/30: PM: 123
  • 1/31: AM: 166 (.5 unit) - PM: 119
  • 2/1: AM 131 - PM 118
  • 2/2: AM 117 - PM 139
  • 2/3: AM 136 - PM 120
  • 2/4: AM 138 - PM 134
  • 2/5: AM 153 (.5 unit) - PM 156 (.5 unit)
Thanks for all of your help and input. It's been appreciated very much.
 
The numbers you're getting are really pretty great!!

What's going to need to happen soon is that you find a dose that you can give every 12 hours, and then get a test before shots, and then at least 1 test mid-cycle on the AM cycle, and at least a "before bed" test on the PM cycle. Soon, patterns will start to show up that will tell you if you need to add more insulin, keep at the current dose, or kitty needs an increase.
 
Status
Not open for further replies.
Back
Top