We're back from the falls - sorry long

Hi all,

We were coming up on our 1 year OTJ anniversary, but now we are starting all over. I'm hoping it may be transient, I'll explain below.

Last time Harley was on Vetsulin, this time he is on Lantus. I've updated his ss and included the daily Vet info in the comments.

Last Wednesday I had to go out of town for work. Monday night my kitty sitter cancelled on me so Tuesday afternoon I had to board him at the Vet Clinic. He was skeert bad, they scrapped his teeth and said that he had givgivitus, his gums were bleeding and they said that they would give him an antibiotic since they messed with his teeth. They insisted on updating his vacinations since he was being boarded. I left his food with instructions on how much water to add, etc.

Here is how his week went:
Day 1 (afternoon only) - He didn't eat, he didn't pee, he didn't poop.
Day 2 - He didn't eat, he peed in the morning but not in the evening, he didn't poop all day.
Day 3 - He didn't eat, he peed in the morning but not in the evening, he didn't poop all day. They started
Cyproheptadine 2mg bid and gave him fluids.
Day 4 - He ate, he peed in the morning and in the evening, he didn't poop all day.
Day 5 - He ate, he peed in the morning, he didn't poop. I picked him up at 6pm.

I tested him when we got home he was 308, he ate really good and pooped twice.
pmps 325 - 1 unit Lantus
+1 - 261
+2 - 283
+3 - 238

6/6 amps 221 - 1 unit Lantus
+2 - 178
+4 - 131
+9 - 164
pmps 212 - What do I do now. Last time my no shoot number was 200, but a different insulin.

I've spent the weekend re-reading the info and reading up on Lantus. I'm hoping this is transient from the vet stress, messing with his teeth, antibiotic, vaccinations, etc.

Any suggestions or advise will be greatly appreciated.

If you're still reading this Thank you,
Robin & Harley

 

I sure don't know about lantus so I will leave that to those that do. But I would think with everything he went through it could be just a temp spike in his numbers. I will hold out hope that he will be back to normal in a few days after he has relaxed from all of that.

 

It looks to me like you have very good instincts, Rob, about these being stress-related numbers.

Your no shoot number on Lantus can be much lower than Vetsulin, given that Lantus generally does not drop cats like Vetsulin does. However, you need to be watchful in the +4 to +8 range to see how low he is going. That will tell you when it is appropriate to start lowering the dose to wean him off the insulin.

With a stress-induced transient state (which I believe you have) and no historical data on Lantus, if Harley were my cat, I would probably set a no-shoot line of 120. If it is under 120, I would do a food test--feed him and test 1 to 1.5 hours later to see whether his pancreas is producing insulin to bring him down. If the number then goes up and over 120, I would shoot him, again watching for the nadir and if it is under 50, reduce his next dose by .25U.

There is a protocol described in a sticky on the Lantus Insulin Support Group.

Good luck, and hopes for a short course of insulin.

 

I won't address the diabetes part, as the others already have.

Instead, I'd demand some answers from your vet about their treatment of your cat without your consent! Scraping his teeth? antibiotics? My vet would never do anything without consulting me, and neither should yours.

 

I thought this thread went missing because I couldn't find it again after I posted so I went over the Lantus group.

Thanks Venita, that's great advise. I'm still trying to wrap my head around how different Lantus is and shooting at lower numbers gives me the shakes. Especially since I work full time and can't do spot checks throughout the day.

Thanks Jill & Remi for the support, that is what I'm hoping happens too.

Thanks Jen & Squeak, we are seeing a new Vet on Saturday who is onboard with home testing, diet change, etc. She came highly recommended by one of the legends on this board. Thanks Carol & Charlie.

Robin