Starting Lantus today

Discussion in 'Feline Health - (The Main Forum)' started by Cschwa17, Jun 2, 2019.

  1. Cschwa17

    Cschwa17 Member

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    Jan 21, 2018
    my cat Hobbes was diagnosed with Diabetes in January 2018. We gave her insulin, changed her food to FF classic, and used Zobaline for her legs. To our absolute shock, by June 2018, Hobbes no longer had Diabetes and her walking was back to normal. We continued to, and still dofeed her FF classic. Hobbes was absolutely in good health.

    My wife and I had a baby 8 weeks ago and the schedule here has been nutty. Hobbes gets up with us around the clock and we were giving her more kibble as a snack a bunch during the night and day. About a cup or cup and a half.

    About two weeks ago I noticed larger amounts of pee in litterbox. She was also needing her water dish filled more frequently. I was finally able to check her urine today with the Ketone stick and it was between 500 & 1000. I immediately scheduled a vet appt. for Monday.

    I’m assuming they will tell us to start insulin and that she has diabetes. Is this most likely my reality again? Is there any chance that with the life change in our house the levels are off? I feel awful for Hobbes that we’ll have to start this again. I hope i wasn’t overfeeding her and caused this.
     
  2. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Was the dry food low carb? Once a cat is a diabetic, it is a diabetic for life even if it goes into remission, and needs to always be given a low carb wet diet.
    Can you tell me if the Ketostix strip result was a trace, moderate or large?
    Anything above a trace needs a vet visit now.
    Does Hobbes seem well or lethargic, and is he eating well?
    Try and add some water to his low carb wet food to add fluids. It is very important he is eating well ... low carb... and getting enough fluids.
    Does he have an infection at the moment? UTI? Or needs a dental?
    If he does have ketones and is peeing more and drinking more it does sound like he will need more insulin.
     
    Last edited: Jun 2, 2019
  3. Cschwa17

    Cschwa17 Member

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    The dry food Hobbes snacks on is Hills m/d glucose weight management. Her main food is FF classic but I think I’ve been sprinkling too much kibble as in between “snack” meals.

    The Ketostix strip was brown. Im not sure what you mean by a “trace”?

    Hobbes is not showing the signs I noticed in 2018 of lethargy or walking on her hocks. I just noticed more water drinking recently and increased and more begging for food, and more pee in litterbox. No problem eating, but she in constantly begging for food all day.

    We are seeing the vet tomorrow 2pm.

    Attached is picture of Ketostix that got me worried...

    Thanks for the help!
     

    Attached Files:

  4. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    dose this dip stick measures for Urine Glucose too?
    It looks like mine Bayer KetoDiasticks.
    If it is so what I see is Ketones - the lower nude colored square is either Negative or at the lowest level called "Trace".
    The 2nd box - the upper one, colored brown in your picture - is the Urine Glucose level and looks like it is Hi. My cat gets High UG when she is above 170 for awhile on the human meter.
    The UG trash-hold varies per cat.

    It is very important to take the read as per instruction - 15 sec to check Ketones and 30 sec for UG.
    A bit longer and the reagent box starts to darken and can potentially give you false positive.

    Any test above the smallest, the Trace amount of Ketones calls for vet visit asap.
    Adding extra water to cat's food helps then flush ketones out.
    Many people here add a tablespoon of warm water per feeding as a prevention.
     
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  5. Larry and Kitties

    Larry and Kitties Well-Known Member

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    It looks like you have the keto-Diastix
    The pad at the end is for glucose and you said it is 500-1000 which is like it is in your photo.
    The other pad is for ketones with units trace (5 mg/dL) to Large (80-160 mg/dL). As Tanya said you have to read the pads at the prescribed times, if read later they turn darger More glucose/more ketones).
     
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  6. Cschwa17

    Cschwa17 Member

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    Yeah, I read the stick wrong, The Ketones were Trace, and the Glucose was about 500. Can this be curbed by sticking to FF classic diet only? I will add the water to her food but she drinks so much lately. I am going to the vet tomorrow to get her checked out.
     
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  7. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    LC alone may not be enough.
    glucose starts to appear in urine if cats BG above this particular cat's renal trashhold.
    Finding the insulin dose that keeps a cat below that level is what works.

    UG has long term complication but does not constitute an immediate danger.Unlike ketones.
    It is possible to control BG with LC food alone for some cats but not all of them.

    With ketone suspicion I am afraid you may need to start home testing to track the BG levels an to adjust the dose according to your made at home tests. Home tests tend to be more accurate as it is stress free. At vet's many cats have elevated BG due to stress.
     
  8. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I’m glad you sorted out the ketones measurement.
    MD Hills dry is around 16% carbs, even though it is meant for diabetics so I would not use it. Too high. Stay with low carb wet and find another low carb treat.
    See how the BSL goes without any dry but keep monitoring the ketones. If the BSL doesn’t return to normal don’t leave restarting insulin. A vet visit will be warranted.
     
  9. Cschwa17

    Cschwa17 Member

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    Im at the vet now, they took Hobbes for blood/urine. She is out of remission and we’ll be starting insulin. I’ll supply all the info when I speak to vet in a few minutes. Prior to taking Hobbes in the back for tests, the vet started to talk to me about going on an m/d glucose kibble diet and I mentioned that I dont want to do kibble, I’ll stick with the FF Classic and she told me “i’m wrong”. I think its amazing that this forum is saving cats lives with real live information. Why do vets not understand the food situation?
     
  10. majandra

    majandra Well-Known Member

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    If it makes you feel any better, I had a panic attack when I used my first ketodiastix strip- I read the wrong square just like you!
     
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  11. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Vets don’t get much training in cat nutrition and what they do get is given by the big manufacturers of cat food so of course they think that their food is best. At the beginning of Sheba’s FD journey I was also told if I mixed the M/D canned food with some raw chicken I would be putting everything out of balance for the diabetes, which is complete rubbish. The M/D kibble is like giving a diet of food bordering on a high carb diet. Stick to your instincts and feed a low carb wet diet. I’m sorry your kitty has come out of remission.
     
  12. Cschwa17

    Cschwa17 Member

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    Ok, so I spoke to the Vet today and after getting blood tests and Urine. The Vet told me that there are no Ketones. There is glucose, and she has a UTI. They are putting the cat on pills for the UTI infection. They are giving me Lantis Insulin and said to start the cat on 4units, twice a day to start. In January 2018 I used Lantis insulin and smaller doses. The Vet said that since Hobbes was 14lbs last time, that she needs this insulin and this higher dose because she now weighs 19lbs. What do we all think? I have to go pick up the stuff soon. Is the UTI the cause and maybe she doesn't have diabetes or it doesn't work like that?
     
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  13. majandra

    majandra Well-Known Member

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    Bumping your post- make sure to not give any insulin before getting some advice. That dose is way too high to start!
     
  14. Cschwa17

    Cschwa17 Member

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    Thank you. Seemed high to me too! Is there any reason why the vet would give me Lantis over Prozinc this time around?
     
  15. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Did you test the blood sugars last time? If not I would recommend you do. You can buy a human meter (ReliOn) from Walmart or other human ones from a pharmacy. It is far safer for Hobbes.
    4 units is far too much. I would start on 1 unit and work your way up in 1/4 units increments if necessary, even though Hobbes weighs more now. . Did the vet say what the BSL was?
    Lantus is a great insulin for cats. You will need to hold the initial dose for at least 5 days before increasing ( if necessary), unless the blood sugar drops too low in which case you would reduce the dose.
    A uti can raise the BSL in a diabetic cat but UTIs don’t cause diabetes. Best way to monitor things and see how he’s responding is to test the blood sugars. If you haven’t tested before we can help you.
    Keep asking questions. We are happy to help.
     
    Last edited: Jun 4, 2019
  16. Cschwa17

    Cschwa17 Member

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    Here is a page from her report today from the urine check, I can supply more if needed. I guess I will start with a low dose of the insulin, I'm not doing 4 units twice a day...
     

    Attached Files:

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  17. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    275 is higher than normal but not excessively high. Are you happy to Test the blood sugars? It would be much safer for
    Hobbes.
    Have you stopped the dry food? It might be worth while stopping the dry altogether and tested the blood sugar again before starting the insulin. But don’t leave it too long starting the insulin if it is needed.
     
  18. Cschwa17

    Cschwa17 Member

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    Jan 21, 2018
    I cut dry food Monday. Giving her 6 oz of wet food per day now, spread out over 4 feedings. I can’t get the insulin until Thursday cause it needs to be ordered so I can test her Thursday before moving forward with Insulin. I’ll definitely start the UTI medication though tomorrow morning. Is that ok?
     
  19. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Yes start the antibiotics now. Can you start testing blood sugars now? It will give us a better idea of how she is going.
     
  20. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    Jan 8, 2019
    I just wanted to pop in and say congrats on your new baby, I’m sorry Hobbes is out of remission but glad you came here for help. This place saved my cat’s life! It looks like you are on a good track so far. And I agree, I would never start out on 4u.

    As @Bron and Sheba has mentioned, home testing can make a huge difference so if you’re able to do that, that would be ideal. It gets easier and becomes part of the regular pattern of the day.

    I’m glad you are cutting the dry food. Best wishes for Hobbes going forward!!
     
  21. Cschwa17

    Cschwa17 Member

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    Thank you!
     
  22. Cschwa17

    Cschwa17 Member

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    Jan 21, 2018
    I will start blood testing tomorrow, and will start the antibiotics. Ill post test results. How long after she eats should I test?
     
  23. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Test before she eats and again 3 hours later. We have a great spreadsheet you might like to use. It will make things much easier for you and us as it’s very easy to read and use. I’ll give you the link. If you have any trouble setting it up post and we will help.
    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
     
  24. majandra

    majandra Well-Known Member

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    Just curious, did the vet mention anything about why the bloodwork was abnormal? Is that normal for uti?
     
  25. Larry and Kitties

    Larry and Kitties Well-Known Member

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    I do not see anywhere in the thread where Cschwa17 said the bloodwork was abnormal. The urine analysis points to UTI because microscopic analysis found cocci (bacteria) in the urine.
     
  26. Cschwa17

    Cschwa17 Member

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    Jan 21, 2018
    Vet didnt say anything about bloodwork being abnormal, should I attach the whole report they sent me? Would that help? Is there any chance that the UTI is causing these readings, and she does not have Diabetes? I am going to attempt to get a blood test now from the Hobbes. Fingers crossed!!
     
  27. majandra

    majandra Well-Known Member

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    It's the bottom portion of the file you already attached- it could very well be because of the diabetes and UTI though. Rhubarb's was a bit out of whack cause of diabetes. I can't remember if she had bloodwork when she had uti.

    Sorry if I added more confusion to things!
     
  28. Cschwa17

    Cschwa17 Member

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    Jan 21, 2018
    I just did the blood test and I got a reading of 360. This is not good?
     
  29. Cschwa17

    Cschwa17 Member

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    Jan 21, 2018
    here is the whole report...
     

    Attached Files:

  30. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

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    That would be considered hyperglycemia or diabetic range. Normal on a vet is recommended to be between 72 and 180 on the article I was just reading, or on a human meter maybe 50-150 would be similar. How is Hobbes acting today? What has been fed or any other meds given? It’s not good but it could also be worse and be much higher. It does point to diabetes though, if that is what you are asking.
     
  31. Cschwa17

    Cschwa17 Member

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    Jan 21, 2018
    she has ate 3 oz of fancy feast classic. Last fed around 10am. I just did the test a few minutes ago. I am going to get the Lantus insulin today and start tonight. Should I just start with 1 unit day and night for now? We agree that the 4 units twice a day is insane right?
     
  32. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I would start at 1 unit twice a day. Test before every shot and again during the cycle around 4to 7 hours after the shot. Vary the times as you go along.
     
  33. Cschwa17

    Cschwa17 Member

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    Jan 21, 2018
    ok, so i picked up the Lantus Insulin, they gave me 100Insulin Syringes for U-100 insulin. I have leftover U-40 syringes from last go around. With the vet telling me I need 4 units twice a day, and me deciding to only give 1 unit, does it matter which syringes I use? Do I need to use the U-100 with the Lantus? I am hoping to give her the first shot tonight at 6pm. I just want to make sure I am giving the right dose and using the correct syringe (if it matters). Also the Vet is saying that Lantus is a better insulin for the cat with better results which is why she says to start at 4 units. We feel confident with 1 unit? Thank you!
     
  34. CandyH and Catcat

    CandyH and Catcat Well-Known Member

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    Apr 23, 2019
    YES, it matters ! U-100 insulin, which Lantus is, needs to be given in U-100 syringes

    they aren't interchangeable -- U-40s are calibrated to dose U-40 insulin properly; U-100s are for dosing U-100 insulin

    experienced users would tell you to wrap those U-40 syringes up, put them where you'll never use them -- or sell/donate them to someone who needs them via the Supply Closet (forum here) or DCIN (diabetic cats in need)

    can't advise you on dosing, but matching the syringe type to the insulin type is crucial, at least at the beginning ..
     
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  35. Cschwa17

    Cschwa17 Member

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    Jan 21, 2018
    Can someone give me a recommendation on usage? The vet recommends 4units twice a day, am I really just giving 1 unit twice a day per your recommendations here?
     
  36. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Yes I would start on 1 unit twice a day and hold it for a week unless the numbers drop below 90 in which case you would reduce the dose.
    Can you set up a signature please which is the top right of this page under your user name. Click on it and choose signature. Tell us Hobbes name, date of diagnosis, weight, type of insulin and meter, any other health problems and meds and country you live in. Then save. This will appear below all your posts and will stop us asking you the same questions all the time. Helpers always look at that and the spreadsheet.
    If you could set up the spreadsheet that would be very helpful as well.
    Test before every shot to see it is safe to give the insulin and again about 4 to 6 hours later to see how low the insulin is taking Hobbes.
    If your Preshot is below 200 initially, don’t shoot, stall and don’t feed and test again 20 minutes later. Post and ask for help. Put ‘help with dose... stalling’, in your subject line. You can lower your Preshot number as you get more data as to how he reacts to the insulin.
    Keep asking questions
     
  37. Cschwa17

    Cschwa17 Member

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    Ok, thank you! I just added all that to my signature. Does it show up properly? I am about to take her glucose, then depending on the # will give her insulin. Do I change the subject name now?
     
  38. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Yes can see signature!
    Don’t change the subject line to what I suggested unless you are needing to stall and ask for help.
    Although you could change it to ‘ starting lantus today’ and people will know at a glance what is happening.
     
  39. Cschwa17

    Cschwa17 Member

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    Thank you. I just did a BG test and it was 367. I just injected her with 1unit of Lantus. I will test again in 3/4 hours.
     
  40. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Well done!! Doses are 12 hours apart.
    Lantus is a depot insulin so it will take at least 3 days(6 cycles) before the depot fills and you see the full effect of the dose. Also Lantus is a hormone so doesn’t act like ordinary medications so it sometimes takes a while for the cat to get used to it so don’t be discouraged if you don’t see a huge response immediately.
    Here is the link to the spreadsheet
    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
     
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  41. Cschwa17

    Cschwa17 Member

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    I appreciate all the help!! Is there any specific reason why the vet prescribed Lantus this time rather than prozinc which I used previously? Are there big differences?
     
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  42. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Have a look at the yellow stickies at the top of the Lantus page that I will link below. There is one on getting started and another one on two different methods we use to give the insulin. One is Start Low Go Slow (SLGS) and the other is Tight Regulation(TR). Have a look at those and see which one would suit you better. The TR requires more testing and faster increases. It just depends which one you feel more comfortable with. And you can always start with one and swap at any time.
    Once we get you set up and running you will be able to swap over to the Lantus page to post each day. The people there all use Lantus or levemir ( similar. Insulin) and are very supportive and knowledgeable
    http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/
     
  43. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    The Prozinc is an in and out insulin meaning one dose doesn’t effect the next whereas Lantus is a depot insulin and one dose can effect others.
    I have never used Prozinc but I know with Lantus you can eventually shoot lower numbers and it can have a lovely flat curve once kitty is regulated. It is a great insulin and very suitable for cats. Hobbes should do well on it.
    Does that make sense?
     
  44. Cschwa17

    Cschwa17 Member

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    Jan 21, 2018
    Ok, its been chaos over here with a new baby and all!! I tested Hobbes again and her BG is 173. Still giving her 1 unit of Lantus since Friday night June 7th. Seems like we are headed in right direction. What are any next steps? Thanks for all the help!!!!!
     
  45. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I can imagine the chaos with a new baby and a diabetic cat! What great beans you are being to Hobbes. How old is your baby?

    Have you been able to set up the spreadsheet yet? If you are having trouble someone can help. It is a really good tool and we look at it each time we help you so if you could possibly get it set up it would be appreciated.

    Are you testing during the cycle to see how low the insulin it taking Hobbes.? We change the dose on what the nadir is (lowest point in the cycle) not the preshot. So if you can get a test in around +4 to +7 ( take it at different times each day).
    And getting a before bed test is a good idea as a lot of cats drop lower at night. If the before bed test is lower than the preshot you may need to test further. Ask if in doubt.
    Do you leave some food out for Hobbes overnight.?
    We also recommend feeding a few meals during the day and night..... for example, feed at preshot and then again around +3 and +5 or whatever times suit you. If Hobbes is not a grazer you might like to get her an autofeeder so she can have a couple of feeds overnight.,
    Hobbes is gorgeous, she reminds me of a cat I had called Ming.
     
  46. Cschwa17

    Cschwa17 Member

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    Jan 21, 2018
    Today I got a reading of 136, I gave her the insulin at 7:30am, and just tested at 2:55.
     
  47. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Until you get the spreadsheet up and running it is very hard to help as we can’t see all the numbers together in Relation to each other.
     

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