? Yesterday PMPS 598, today 184, no Lantus tonight

Hello! It's me again Could someone have a look at Sassu's spreadsheet? Any ideas? I will not give him any Lantus tonight no matter how you are going to convince me. I am just too afraid he might go too low. His +13 was lower than +8..... I was about to do his curve tomorrow, but now I do not know even if I can give him a shot in the morning.

 

The problem with skipping shots or not giving the same amount of insulin at shot times is that:

• the depot never stabilizes
• you see wide swings in your kitty's numbers

My prediction is that if you were to stall for 30 min., you might have a better idea of where numbers are going. It takes a couple of hours for Lantus to start working and you will be feeding. There's a good chance that the "blue" numbers will cause a bounce and numbers will end up being high at some point during the cycle. Given that it's the weekend, would there be a problem with your staying up, if necessary, to monitor Sassu's progress this cycle.

If you are nervous about seeing lower pre-shot numbers, one strategy is to lower the dose so you can shoot the same amount of insulin every cycle and not skip shots.

Also, have you had a chance to look at the Tight Regulation Protocol and the Start Low Go Slow approach and make a decision which method for dosing that you want to use?

 

I have. I am just not comfortable with the thought of him going hypo as I have no experience and he is not the kind of cat to whom I could just offer dinner and he would eat. He might just as well decide not to eat anything at all. At least he has not eaten since I got home. I only have honey at home to put on his fur in case of an emergency. Sassu has never been so low. Even when he starved himself for 4 days. I do not know what is going on with him. I can stay up until +2 or +4, but not longer.

 

It's entirely up to you. None of us are "comfortable" with a cat having symptoms of hypoglycemia. What I would urge you to think about, though, is there is a difference between a symptomatic hypoglycemic episode and being in low numbers. With the TR Protocol, a dose reduction is given if numbers drop below 50. I suspect the idea of seeing Sassu that low scares you. However, this dosing protocol was published in a leading veterinary journal and the research would never have been published if it put a kitty at risk. The purpose of testing is to keep your cat safe! Ultimately, you want to keep Sassu in healthy numbers or possibly into remission. The only way to do that is to shoot progressively lower numbers.

What I often suggest to members with a newly diagnosed cat is that you begin to think about what number you would be comfortable shooting. Usually, if someone plans to follow TR, we suggest they post and ask for help if the pre-shot number is under 150. There is usually someone here that will hang out with you to make sure that if you do shoot, your kitty is safe and they can coach you regarding how to steer the numbers with food. We don't let you fly solo the first couple of times.

Honey is fine to use as high carb. My kitty couldn't tolerate the gluten in HC food so I used either corn syrup or honey to steer her numbers. BTW, you don't put something sticky like honey on the cat's fur. You put a drop or two on the cat's LC food. It's far less messy that way.

 

The beauty of home testing is that you can keep him safe.....he's still got a long way to drop to be near "hypo" (less than 50) and as long as you're there and able to test, you're pretty much in control....Now just dropping below 50 doesn't mean there's an emergency....it's just the point at which you want to "take action" to keep him from dropping any lower. It's the "built in" safety point we use here.

We all totally understand your fear though.....Vets seem to really stress that "hypo" stuff, but mostly when they see it, it's due to the cat not being monitored at home and the caretaker blindly shooting.

Maybe you'd be more comfortable shooting a smaller dose so you can get in two shots per day? But if it were my cat, I'd go ahead and shoot the 3U tonight and test at +1 and +2 so if he starts to drop early, you have plenty of time to do something about it.

 

My cat never eats when I want him to. And he chooses what to eat and what not to eat. I always put sticky things on his fur if I want him to eat something - vitamins, medicine, hairball stuff. This is the only way to get him to eat it. He would NEVER eat anything like that from a food bowl. Even when it is with his favorite food. Another thing is that I cannot test him so often as the rest of you do. He hates it and I am sure it causes him lots of stress (which make numbers high). I am wondering what the normal glucose numbers for cats are? My vet said that anything between 5.5-16.8 (99-302).

 

I found this on the web: "Do not give any insulin if pet is already in the desired normal range of BG (~100-300 for diabetic cats, ~100-200 for diabetic dogs), unless your vet has specifically advised you what dosage to give at what BG number. DO NOT give insulin to a pet whose BG is below 100." Sugarcats.net
A lot of you are injecting their below 100 cats. According to this text I should not have been injecting tonight.

 

Hey Lilian, what you found on the web might not be specific to Lantus or Levemir. The only way to get you cat regulated and or OTJ (off insulin) is to consistently shoot safe numbers twice a day. The cut off for newly diabetic cats on Lantus for shooting insulin is 150. You hold the syringe. With your cat not always eating when you want him too is problematic.

When you get a chance, can you create a signature so put all pertinent information in it (see mine or others) It will help us help you and not have to ask the same questions over and over.

 

From what little I can find regarding that quote, it seems they were using an older insulin like Vetsulin or Caninsulin

 

What type of meter are you using, human or vet? Human meters usually read lower than the vet ones. That is why 50 is the cut off for not shooting.

I think you might be more comfortable with SLGS than TR. Whichever you follow your cat will do much better with finding a dose you can shoot every 12 hours. Just something to think about.

 

That quote applies to the older insulins that are not depot insulins, not Lantus or Levemir. They work differently. When the regular dose is given to a cat in normal blood sugar range, the depot insulins can often hold the blood sugar flat so it doesn't change much during the cycle. That's more comfortable for a diabetic.

It might comfort you to know that the Tight Regulation Protocol that most people on here follow is the only dosing protocol that's been published in professional veterinary journals for using Lantus or Levemir with diabetic cats. It's got a fairly long history and a lot of success with it. This is a synopsis of the study that is from the Journal of Feline Medicine and Surgery, August 2009 If one is going to use Lantus on a cat, this is the only dosing guide that's got research behind it.

I know you're afraid for Sassu. When one has a diabetic cat, one is always balancing out the fear of having the cat's blood sugar go too low with the fear of the damage that is caused by high blood sugar. Neither one is good. I got up every morning and hoped Punkin was still alive. We all understand that fear. But not treating a diabetic cat will cause them to starve. It's a terrible disease, but we are lucky to have insulin to treat it. When a cat's blood sugar is high, all the glucose (= nourishment) is floating about in their body fluids instead of nourishing them in their cells.

One last thought - if you are more comfortable with a non-depot insulin, where the dose is adjusted by the preshot number, you might want to consider ProZinc. I'm a big fan of the depot insulins because they provide the longest blood sugar control, but there are plenty of people who like ProZinc and whose cats do well on it. Just an idea.

Let us know how we can help you. We only have Sassu's best interests at heart.