? To Shoot or Not to Shoot??? (Copied from the Feline Health Main Forum)

This is also posted in the Feline Health (Main Forum,) but my friends over there suggested I post it here because it is specifically re: Lantus and BG numbers.

Sorry to keep bugging everyone on here, but I'm just trying to be really proactive about this re: getting Sake into remission and OTJ (if possible.) I don't want to rush the process, but I just want to do the best thing for her.

So she has not had a shot since yesterday morning at 8:00am, when I gave her 1U w/Lantus pen (using the dialer.) It is now ~37+ hrs later, and she's got a BG of 154 at 13+. I'm about to give her a delayed dinner, but I'm just wondering if she needs any insulin at all??? I've got my low dose syringes now, so should I give her 1U, .5U, or nothing at all? What do you guys think??? Her Spreadsheet should be able to be viewed as well now. Thanks in advance

 

Hello! Looking at her spreadsheet, I would personally not give anything evening of 7th (I don't know where you are timezone wise). And depending on her numbers in the morning I might not give anything in the morning either. Are you able to test on 8th morning? That would be very helpful data.

Ideally you would try to test before each shoot, and once somewhere in the cycle, if you can. If you suspect she might be going off insulin, you definitely don't want to be giving insulin unless her preshot number is high enough. Getting too much insulin might also cause her to bounce, which will lead to inflated numbers for a few cycles.

So I'd head in the direction of not shooting, but getting enough tests that you have a good idea what her BG is doing without the shot.

Hope this helps!

 

Hello, and thanks for responding! I just did a BG on her (the first one of the day,) and she's at 257, 13+. Normally, I would not let her go so long w/o eating, but it took me forever to get a sample from her this morning, and I was already a bit late in getting up & moving, so her breakfast was extra late because of those 2 things combined. Anyway, it's been ~51 hrs since she's had any Lantus, and I just updated her Spreadsheet, so you can see where she's trending. We are in NC (EST.) That 257 is the highest number she's had in 2 weeks, since before she went on the Lantus.

 

It looks like 2U was probably too much so we need to get you shooting a dose you can give every 12 hours but keeps Sake safe. With her trending up, it's pretty obvious she's going to need some insulin for awhile anyway.

Usually we suggest cats start at .5 to 1U (depending on weight and which dosing method you decide on, Tight Regulation or Start Low, Go Slow)

Do you know how much Sake weighs? Have you read the "Sticky's" about Tight Regulation and SLGS and have a preference for a dosing method?

 

I agree with Chris, it looks like she does need some insulin.

TR requires the cat to be on wet low carb food only, and is a more "aggressive" dosing protocol, requiring more testing than SLGS. What you choose will depend on:
- how much you can test
- what food your cat is eating
- how tightly you want to regulate her BG

It would also be interesting, though, to see what happens to her BG if you feed her: does it come down after food? If you've fed her after that 257, could you get another test in to see what is happening?

 

Sake weighs 8 lbs. She is definitely sleepier today--doesn't seem to have as much energy. Do I need to wait until 7:30-8:00 (her usual dinner time) to give her any insulin, or should I just go ahead and do it now? I had planned on testing her again in about 2 hrs, but I might be able to get her to comply now since she's so sleepy.

 

*AAARRRGHHH... I am COMPLETELY and UTTERLY confused at this point! I just did another BG on her and it is now 110, 3.5+! So now what?! I thought for sure the number was going to be high like this morning, and instead it's back down to the low end again. Does this mean she does or does not need any insulin, and if so, should she get it now, or at dinner time? Her Spreadsheet has been updated as well. Thanks in advance

 

You may have a "sputtering" pancreas on your hands-- able to bring down BG somewhat on its own, or sometimes. See where she is at her usual pre-shot time before making any decisions about shooting or not. If she's below 200, I'd stall, don't feed her dinner (if you re-test BG, you don't want a food influence), and post again here for advice. Hopefully you'll get some timely responses in that case.

 

Her PMPS # is all the way up to 275, so I guess it's time to give her a shot. I'm going to give her .5U while eating. I guess we'll have to stay at .5U/b.i.d. until further notice. I really thought she might be able to come off of everything entirely, but I guess it's just too soon. One good thing though: I seem to finally have found the "sweet spot" on both ears, that does not involve her veins