Titans first BG curve at home

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MyTitan (GA)

MyTitan (GA)

Member Since 2017
. Hello all, I'm reposting a thread I started this morning 8/19. Couple of responses said to check in here instead as Titan is on Lantus. Suppose there is a learning curve for me too (pun intended)
Morning all, yesterday we completed Titans first BG curve at home. The results were not good but we were anticipating high numbers. We were really looking for a "curve" but I don't think one really showed up. A little background, Titan was Dx on June 27 and was started on 2 units 2x a day of Lantus . At two weeks we did a BG curve at the vet office and it was a flat curve of around 450. With Vet concurance we raised Titan to 3 then 4 units 2x a day over a two week period. Testing only with urine strips we saw no improvement. Decided maybe we were bouncing or having Symogyi effect so we elected to slowly back him down to 1 unit 2x a day and start over. On the way down his numbers really never changed much staying in the high 300's to mid 500's. After 10 days at 1 unit twice a day it wastyme for a curve. Our plan is to go slow and raise his insulin by small amounts. Our Vet said that she won't consider insulin resistance till he is at his body weight (13 lbs) of units 2x a day! That's 26 units OMG. Question: has anyone else experienced a similar issue and how did you resolve it? Take a peek at his spreadsheet and let us know your thoughts. He is still perky, eating, drinking lots and not minding his shots and ear pokes too much. Peace to all, Titans dad :)
 
Hello and welcome. Can you tell me a little bit more about Titan. Any other medical issues on diagnosis of FD? Are you feeding wet or dry food? The foods you mention come in both formats.

Your vet is a little out of date with high dose conditions that cause insulin resistance. So was mine. Neko had two high dose conditions, acromegaly (benign pituitary tumour sends out excess growth hormone causing diabetes)and IAA (insulin auto antibodies). She never got near her weight in dose. The most recent study on acromegaly showed 1 in 4 diabetic cats have it, some on as low a dose as 1 unit twice a day. I am not saying Titan has either, but those conditions can cause a need for higher doses. A cat needs however much insulin they need and ECID, each cat is different.

Is it possible for you to test at each preshot time? You do want to know it's safe to give insulin. I am pretty sure the return to a 1 unit dose is doing Titan no favours and he will have to go up in dose. Typically we go up in slower increments than whole units, so we don't bypass angood dose.
 
Hi and welcome to Lantus & Levemir Land - the nicest place you never wanted to be.

Like Wendy, I want to encourage you to ALWAYS test before shooting. FD can be very unpredictable, and I know you wouldn't want to put Titan's safety at risk by shooting when his BG is already low. It is also a good idea to get at least one mid-cycle test, especially at night as many cats go lower at night.

I also think 1 unit isn't enough, but the way your vet had you increase may have caused you to miss the purrfect dose. Here we do increases in .25 units at a time. Doesn't sound like much, but in a cat it can make a big difference. Depending on which protocol you follow - Tight Regulation or Start Low Go Slow, you increase after 3-5 days or 7 days. If you haven't already done so, I recommend you read the stickies at the top of the L&L page. There is a TON of info there that will help you to understand what's going on with Titan. It can be very overwhelming, so ask lots of questions. We've all been there.

Here is a post we put together to help new members get the most out of this forum: http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/ It's kind of an FAQ.

You're in the right place - we have lots of very experienced people here, and we love to help!
 
Thanks for responding, Titan is only getting wet food, we transitioned from a mix of wet/dry when he was Dx . After reading many posts and stickies here we "assumed" maybe we climbed too fast to 4 units 2x a day so elected to slowly reduce to one unit 2x and start back up SLOWLY to find his sweet spot. His acromegaly/hyperadreno test is in transit and we hope to have results next week. His other issues are that he has had PU surgery and hyperthyroidism which we treated with radiation.
As far as increasing dosage our plan is to increase the am shot .5 unit wait 6 cycles and if additional insulin is needed increase the pm shot by .5 unit for 6 cycles, check BG and then increase the am, i.e. Alternate each increase between am/pm. When we start to see numbers in the 200's I will go to .25 increases. We are getting better at blood draws so they will happen more frequently.
Thanks again for your input, looking forward to getting his BG numbers down to respectable numbers.
 
Thanks for the clarification on the food.

I would suggest also trying to get at least one cycle in the night time, maybe before you go to bed. Cats cycles a night are often quite different and lower than daytime cycles. We dose based on the low points, so those night time tests help catch them. My Neko often went lower at night then bounced during the day. If I'd only tested during the day I would have thought she needed an increase, when in fact she'd been earning reductions at night.

It's also better to keep to the same dose AM and PM, due to the nature of the Lantus depot. If you go six cycles and only see 300+, I would increase by 0.5 units both AM and PM. Titan is in really high numbers, you need to get him into better numbers as quickly as is safely possible.
 
Hello and welcome, I love this place. Marvin wouldn't be here without all the support and guidance I received here. If your kitty does have one of the high dose condition, there are quite a few of us here who can provide support. Wendy is one of the most knowledgeable member on those conditions.

Keep us up to date, and ask questions :bighug:
 
Sounds like you're opting for TR, which is great, especially if Titan is what we call "a big gulper". Increasing by .5 is what TR says when nadirs are over 300, so you're right on point there. :)

I want to reinforce what Wendy said about shooting the same dose am and pm. If you shoot two different doses, you are going to confuse the heck out of the depot, which is going to give you really crazy numbers. Please read this about the depot to help you understand why: http://www.felinediabetes.com/FDMB/threads/lantus-levemir-what-is-the-insulin-depot.150/
 
It's amazing that back in the early 90's we kept two diabetic brothers going for twelve years only using diastix's . Boy FD management has come a long way. I remember staring out on beef/pork insulin the changing over to humalog when the beef/pork was no longer available. Thanks for all your input, Titan is hanging in there but his momma is uber stressed! I will keep posting updates
 
MyTitan said:
It's amazing that back in the early 90's we kept two diabetic brothers going for twelve years only using diastix's . Boy FD management has come a long way. I remember staring out on beef/pork insulin the changing over to humalog when the beef/pork was no longer available. Thanks for all your input, Titan is hanging in there but his momma is uber stressed! I will keep posting updates
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I have a friend that had a diabetic cat that she never tested, and he lived for three or four years after FD diagnosis, died of something unrelated. I also have friends that feed their cats mostly cheap dry food and never have to take them to the vet for anything but vaccines. ECID.
 
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