Too much insulin???

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Rebecca88

Rebecca88

Member Since 2016
Hi. My cat Mercedes was diagnosed about 3 months ago. She was put on Prozinc which worked the first time only dropping her BG from over 400 to in the 80's. That was 3 months ago. Ever since then her readings have been in the 300's. My vet switched her to Lantus about 2 weeks ago. Started out at 5 units am and jumped her up to 10! Nothing pm. Saw him yesterday her BG was 339. Now he wants her on 16 units!!! 8 and 8. I personally think this is way too much. I've changed her diet and have an appt with a new vet on Saturday which was highly recommended. I can't wait! So far she is acting ok. She's eating and was even playing a little last night. The old vet seemed to not want to talk about diet at all and seemed a little annoyed that I was doing research. New vet will teach me to test at home I heard. Thank god! I'm just scared this dosage is way too high! I'm calling her in the morning to see what she thinks. It's all so confusing!
 
Rebecca,

Welcome. You've changed the diet and there has been a large dose increase, the glucose level can change drastically and put Mercedes in danger.

Please consider home testing immediately. There are videos here that can show you. Human meters can be purchased inexpensively. I worry waiting until Saturday could be to long.

Normally insulin in increased in .25u increments. Your doses are doubled. Please read all the informative stickies here. I will tag some more experienced people.
 
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Rebecca...please check all the "stickys" in the main forum and also the Lantus and Levemir forum. We usually start our cats out at 1 unit am and 1 unit PM and work up from there either using the Start Low, Go Slow method or Tight Regulation. I strongly recommend NOT doing Tight Regulation unless you are home testing, though.
 
Hello and welcome,
Hope you have had a chance to read the stickies on Lantus, they are full of useful info, I think we are all concerned about the amount of Lantus being given, it is unusual but not unheard of if your cat has a high dose condition.

How many units of Prozinc was your kitty on? usually when kitties have been on another insulin that is taken into account. Are you home testing or are these numbers just from your vet doing a curve?

Lantus is usually dosed every 12hours, for most cats this gives the best results. The dose does seem high for a starting dose but if this is similar to what she was on with prozinc it might not necessarily be to high for your kitty, there are some cats here that are high dose cats, has she had any tests for acro, IAA, cushings??

The best way for us to offer you better more specific advice would be to see her numbers on prozinc, and lantus whatever data you have is useful.

We usually record our data on spreadsheets most folk use the same one here is a link on how to set one up. Setting up SpreadSheet

If you need help with that please holler someone can help you set it up.

Are the numbers you are quoting pre shot numbers? or are they midcycle numbers?
How often are you testing?
 
Quite frankly that sort of dose increase could kill Mercedes, Without home-testing you have no idea how low the insulin is taking her. If she hits too low a number she could go into hypo (insulin shock) and this could be deadly. Tests done at the vet can be higher because of stress and do not show what is happening through the cycle (the time between shots) When a cat hits a lower number very often they will "bounce" up to higher numbers as a protective measure. If the test done at the vets was done during a bounce it would show artificially high numbers. Dosing changes need to be done only when regular monitoring is being done. AND starting out on Lantus at 5 units then 10 then 16 daily within 2 weeks is IMHO nothing short of criminal.
 
Gill & George said:
How many units of Prozinc was your kitty on? usually when kitties have been on another insulin that is taken into account. Are you home testing or are these numbers just from your vet doing a curve?

Lantus is usually dosed every 12hours, for most cats this gives the best results. The dose does seem high for a starting dose but if this is similar to what she was on with prozinc it might not necessarily be to high for your kitty, there are some cats here that are high dose cats, has she had any tests for acro, IAA, cushings??

The best way for us to offer you better more specific advice would be to see her numbers on prozinc, and lantus whatever data you have is useful.

We usually record our data on spreadsheets most folk use the same one here is a link on how to set one up. Setting up SpreadSheet

If you need help with that please holler someone can help you set it up.

Are the numbers you are quoting pre shot numbers? or are they midcycle numbers?
How often are you testing?
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Gill the vet has increased from 5 to 10 to 16 units daily all within 2 weeks!!!!
 
I agree your vet has no idea what he's doing. Normally doses are inceased slowly, definetly not doubled. You can go to wal-mart and get testing supplies (meter, test strips and lancets) for less than $30. Please don't continue to shoot that amount of insulin without any testing. We can teach you to test today.
 
Tuxedo Mom said:
Gill the vet has increased from 5 to 10 to 16 units daily all within 2 weeks!!!!
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Yes But was wondering if the cat was on much higher dose of Prozinc prior to making the swap to Lantus? I agree, if that is not the case it is a dangerous amount of insulin
 
Gill & George said:
Yes But was wondering if the cat was on much higher dose of Prozinc prior to making the swap to Lantus? I agree, if that is not the case it is a dangerous amount of insulin
Click to expand...


Even if the cat was on a higher Prozinc dose increasing Lantus that rapidly without proper testing is WRONG!

ETA Lantus acts differently than Prozinc and when starting it is suggested to hold the initial dose for at least one week before changing. Also one dosing that was suggested was 5 units once a day. That is not how Lantus is dosed for cats
 
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Rebecca

With a change in diet to low carb food, especially if you are changing from dry to all wet low carb, can drop numbers drastically on its own. One person here had their cat go off insulin all together in just over a week by changing from dry to low carb wet. That is how powerful diet changes can be in some cats

Increasing insulin at that rate without proper monitoring is very dangerous. At this point unless you start home monitoring it could be dangerous to give insulin at all since you have no idea how low it could be taking Mercedes . If you could pick up a glucose monitor and do home testing you will know how the insulin is working. Also if you could see if you could get an earlier appointment with the new vet that would be very helpful.
 
Rebecca88 said:
Originally she was on 5 units of Prozinc twice a day
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Thanks for that information. The dose increases with the Lantus are still far too much and too often. Lantus works different than Prozinc. Prozinc is and "in and out" insulin. You shoot it, it does its work then it is out of the system. Lantus is a "depot" insulin that acts similar to a slow-release medication. It takes about 3 days to build up the "depot". Small amounts of insulin are absorbed throughout the day from the depot. Normally when a cat is started on Lantus they hold the initial dose for 7-10 days so that the cat becomes "climatized" to it, then dose increases are done according the the readings done by monitoring.
 
Most US people here use the Relion meter. There are a couple of types but one that uses the smallest amount of blood is best.
 
@Rebecca88 The relion micro is good.

Before you give anymore insulin please try get a test. If you can't please pop on here and ask for advice. The title bar to the very left is a drop down box. Click the ? Then put something like need dose advice all in caps. Maybe an hour before shot time. The next shot should be 12 hrs after the first. I do think 8 u might still be to much.
 
Woodsywife said:
@Rebecca88 The relion micro is good.

Before you give anymore insulin please try get a test. If you can't please pop on here and ask for advice. The title bar to the very left is a drop down box. Click the ? Then put something like need dose advice all in caps. Maybe an hour before shot time. The next shot should be 12 hrs after the first. I do think 8 u might still be to much.
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Thank you. I just bought everything I need. Now I just need to watch a few videos on how to do this and when the best time to test her is.
 
Rebecca88 said:
Thank you. I just bought everything I need. Now I just need to watch a few videos on how to do this and when the best time to test her is.
Click to expand...

Normally test right before shot time. But I think it's best for today try to get a test 1 hour before. Then you open this thread, edit title bar and enter the reading. As well as the question ? I said earlier. I'm here in and out while doing my taxes.

Where are you located? What time would you be giving the insulin?
 
Woodsywife said:
Mary Ann who's sick? Yes I'm am around all day & night :(. Depressing isn't it. Smokey not feeling well either today.
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My sweet kitty is having a pancreatic attack so I am doing cerenia , bupe and syringing food and water and monitoring his levels since I am shooting strange doses based on his food consumption. He had his Sub Q at the vet yesterday but I might have to take him back tomorrow again. Plus I have had maybe 2 hours sleep so just a real yucky day around here. :(

Glad you will be around to help! :)
 
Woodsywife said:
Normally test right before shot time. But I think it's best for today try to get a test 1 hour before. Then you open this thread, edit title bar and enter the reading. As well as the question ? I said earlier. I'm here in and out while doing my taxes.

Where are you located? What time would you be giving the insulin?
Click to expand...
I'm in Tampa and she should receive her next dose at 7
 
Hi, Rebecca.

I was following your thread on Facebook and was asking where you had posted on FDMB.

I don't want to belabor the information you were getting on FB. There are a number of informational posts at the top of the Lantus and Levemir insulin support group that will help you to better understand the insulin and how it works.

  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in German and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
  • Start Low Go Slow: This is a less aggressive approach to dosing that has been used successfully on several of the FDMB boards. It is not backed up by research but, it works!
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot/shed: This is an important concept for understanding how Lantus works.
  • Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as what to do if you have an unexpectedly low pre-shot number or numbers are dropping during the cycle.
First things first, though. Getting a meter, learning to home test, and starting a spreadsheet will allow you to have much greater control over Mercedes diabetes. There's an overwhelming amount of information to wrap your head around but you'll be surprised as how quickly it becomes a routine.

The people here are wonderful and we will do everything we can to help you and answer your questions.



 
Now do you think I should stick with the Lantus or go back to the Prozinc?
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I'm a Lantus user so I'm biased. Regardless of which insulin you decide to use, I think you need to find a vet who knows how to treat feline diabetes. I'm not impressed by the recommendations you've been getting.
 
I am glad to see you here Sienne, I am about if I am needed, but I see you have this, I think Rebecca could do with your wealth of experience.
 
Rebecca88 said:
I'm in Tampa and she should receive her next dose at 7
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Good I'm in PA so same time zone. I also do 7/7 shots. I would stick with Lantus. Nothing wrong with Prozinc but she already has Lantus on board so stick with it.

Set your meter up. Even try a reading on yourself. You don't know how Mercedes will act with testing correct? You haven't done it yet.
 
Sienne and Gabby (GA) said:
Hi, Rebecca.

I was following your thread on Facebook and was asking where you had posted on FDMB.

I don't want to belabor the information you were getting on FB. There are a number of informational posts at the top of the Lantus and Levemir insulin support group that will help you to better understand the insulin and how it works.




    • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in German and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
    • Start Low Go Slow: This is a less aggressive approach to dosing that has been used successfully on several of the FDMB boards. It is not backed up by research but, it works!
    • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
    • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
    • Lantus depot/shed: This is an important concept for understanding how Lantus works.
First things first, though. Getting a meter, learning to home test, and starting a spreadsheet will allow you to have much greater control over Mercedes diabetes. There's an overwhelming amount of information to wrap your head around but you'll be surprised as how quickly it becomes a routine.

The people here are wonderful and we will do everything we can to help you and answer your questions.


Click to expand...

Thank you. It's hard for me to link on the kindle.
 
Woodsywife said:
Good I'm in PA so same time zone. I also do 7/7 shots. I would stick with Lantus. Nothing wrong with Prozinc but she already has Lantus on board so stick with it.

Set your meter up. Even try a ready on yourself. You don't know how Mercedes will act with testing correct? You haven't done it yet.
Click to expand...
Nope. Still reading all this info. It's so much to read and some of it is hard to understand. Especially the testing. When etc
 
If it's all reading like Greek, ask questions! We'll translate. Lantus is very different than Prozinc.

When your kitty was first diagnosed, did the vet tell you what her BG (blood glucose) numbers were? Do you have any idea what they are now?
 
Sienne and Gabby (GA) said:
If it's all reading like Greek, ask questions! We'll translate. Lantus is very different than Prozinc.

When your kitty was first diagnosed, did the vet tell you what her BG (blood glucose) numbers were? Do you have any idea what they are now?
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She was diagnosed about 3 months ago. Yesterday her reading was 339
 
Rebecca88 said:
Nope. Still reading all this info. It's so much to read and some of it is hard to understand. Especially the testing. When etc
Click to expand...

That's okay. Let's just try to get the testing done for now. It is the most important thing before her shot tonight. You do not want to give the 16 or even the 8u right now. Know food from 5 until after her test though.

Find a spot where you will test regularly. Table, lap, couch, floor etc. Rub her ears, talk to her give her a treat low carb if you have them. Get her use to you touching her ears. Can even warm them using an empty pill bottle with warm water. Some use a sock with rice in it warmed in microwave. Make sure it's not to hot.
 
Rebecca88 said:
She was diagnosed about 3 months ago. Yesterday her reading was 339
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She was started on Prozinc and the first injection went from over 400 to in the 80's. That was the lowest. It then went back to in the 300's. Even after he raised the Prozinc it only came down a little. So a couple weeks ago he switched to Lantus. She was on 10 units only once a day. But I did some research and also noticed her drinking more at night. So we took her last week her BG was 398. That's when he bumped it up to 8 and 8! Yesterday her BG was 339
 
Tuxedo Mom said:
My sweet kitty is having a pancreatic attack so I am doing cerenia , bupe and syringing food and water and monitoring his levels since I am shooting strange doses based on his food consumption. He had his Sub Q at the vet yesterday but I might have to take him back tomorrow again. Plus I have had maybe 2 hours sleep so just a real yucky day around here. :(

Glad you will be around to help! :)
Click to expand...

Poor kitty. Smokey was diagnosed Tuesday with pancreatitis and ibd. I'm just learning. He is not feeling well today. How are giving cerenia? I was told a few days on and few days off. I'm wondering if that's right. Today is an off day but I'm giving it because is definitely nausea.
 
Woodsywife said:
That's okay. Let's just try to get the testing done for now. It is the most important thing before her shot tonight. You do not want to give the 16 or even the 8u right now. Know food from 5 until after her test though.

Find a spot where you will test regularly. Table, lap, couch, floor etc. Rub her ears, talk to her give her a treat low carb if you have them. Get her use to you touching her ears. Can even warm them using an empty pill bottle with warm water. Some use a sock with rice in it warmed in microwave. Make sure it's not to hot.
Click to expand...
She is very comfortable in the kitchen by the window. She actually jumps up on the table to get her shot
 
We use a particular language to describe test times. AMPS and PMPS are your AM and PM Pre-Shot test readings. Any time after a PS time, is referred to as +time. So, 2 hours after shot time is +2, 5 hours after is +5, 6-1/2 hours is +6.5, etc. So the reading yesterday was how many hours after you shot?

The reason this isn't trivial is that dosing with Lantus is based on the lowest point in the cycle (i.e., the "nadir"). It's going to be important to figure out how your cat is reacting to the quantity of insulin your giving.

It's not unusual for a cat's numbers to bounce into a high range after you see a low. It's a built in protective mechanism. With Lantus, we wait for a bounce to clear to see how the insulin is working. The issue with the dose is that you can get high numbers both because you're not giving enough insulin and when you're giving too much insulin.
 
Sienne and Gabby (GA) said:
We use a particular language to describe test times. AMPS and PMPS are your AM and PM Pre-Shot test readings. Any time after a PS time, is referred to as +time. So, 2 hours after shot time is +2, 5 hours after is +5, 6-1/2 hours is +6.5, etc. So the reading yesterday was how many hours after you shot?

The reason this isn't trivial is that dosing with Lantus is based on the lowest point in the cycle (i.e., the "nadir"). It's going to be important to figure out how your cat is reacting to the quantity of insulin your giving.

It's not unusual for a cat's numbers to bounce into a high range after you see a low. It's a built in protective mechanism. With Lantus, we wait for a bounce to clear to see how the insulin is working. The issue with the dose is that you can get high numbers both because you're not giving enough insulin and when you're giving too much insulin.
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We saw the vet at 9:30. So 2 1/2 hours after her shot
 
Generally, your +2 number (with Lantus) is around the same as your pre-shot number. Numbers should drop until nadir and then begin to rise back up. If numbers drop low, drop fast, or there's a big difference in your numbers, it can trigger a bounce. If the only time you test is at pre-shot times, all you may see are the highs.

For example, Gabby was known to start a cycle in the 400s, drop to the 40s, and bounce back to the 400s by her next shot time. The drop into the 40s signals a dose reduction. If I hadn't been testing, I would have increased her dose. This is one of the reasons it's important to get those spot checks in.

When do you think you'll be able to get a meter?
 
Sienne, would you be able to help her with the dosage? Going from prozinc to 10u of lantus, I'm not sure where the dose should be at for tonight.
 
Sienne and Gabby (GA) said:
Generally, your +2 number (with Lantus) is around the same as your pre-shot number. Numbers should drop until nadir and then begin to rise back up. If numbers drop low, drop fast, or there's a big difference in your numbers, it can trigger a bounce. If the only time you test is at pre-shot times, all you may see are the highs.

For example, Gabby was known to start a cycle in the 400s, drop to the 40s, and bounce back to the 400s by her next shot time. The drop into the 40s signals a dose reduction. If I hadn't been testing, I would have increased her dose. This is one of the reasons it's important to get those spot checks in.

When do you think you'll be able to get a meter?
Click to expand...

She just picked up a meter.
 
Sienne and Gabby (GA) said:
Generally, your +2 number (with Lantus) is around the same as your pre-shot number. Numbers should drop until nadir and then begin to rise back up. If numbers drop low, drop fast, or there's a big difference in your numbers, it can trigger a bounce. If the only time you test is at pre-shot times, all you may see are the highs.

For example, Gabby was known to start a cycle in the 400s, drop to the 40s, and bounce back to the 400s by her next shot time. The drop into the 40s signals a dose reduction. If I hadn't been testing, I would have increased her dose. This is one of the reasons it's important to get those spot checks in.

When do you think you'll be able to get a meter?
Click to expand...
I already got one. Just got back. I'm trying to find a video on how to test on the ear. Unless it ok to test from her pad. All these reading times are very confusing. I'm trying to keep up with all the info.
 
Rebecca88 said:
I already got one. Just got back. I'm trying to find a video on how to test on the ear. Unless it ok to test from her pad. All these reading times are very confusing. I'm trying to keep up with all the info.
Click to expand...

You can test paw pad.

Everything is overwhelming right now. You are doing great. I think you need to concentrate on getting the home testing done now so you don't give to much insulin tonight. The rest we will talk you through step by step as you need. I will try to find the ear link for you.
 
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