Your opinion of Eddie's numbers?

Check out spreadsheet below.

Eddie is a recently diagnosed diabetic. On vets orders he was started on lantus 5 u once a day and vet had him in for spot glucose checks every 5 days or so. By the second week I bought a monitor, started home testing and took things from there. I finally started giving lantus twice a day this week, hoping it would help even out his numbers, he is always higher in the morning and before his dinner than after and the evening BG numbers have been lover even without a second dose of insulin. Today I though I was on the right track. BG was 113 this am, I gave him 1/2 a unit then when i got home he was 167, I fed him and 2 hours later he was 94 and I gave him another 1/2 u Going to check him again before I head to bed. Tested, 74 and Eddie is eating his bedtime meal.

Is this just the usual action of lantus? Should I stay the course?

Other details, he was switched over to wet low carb food around Jan 1. He gets just a little low carb dry food occasionally. He is a tad overweight, should be around 14 or 15 pounds and he was 20 at last trip to the vet. I have no scale to check his (or my) weight with. Eddie is about 10 years old. He is big, orange, loud and has the figure of a seal.

 

Welcome to the FDMB and I am so glad you reduced Eddie's dose!!!

You are headed in the right direction since you have started hometesting, you are getting Eddie on a low-carb canned diet, and you have a spreadsheet.
Good job!!! It's best to gradually get him completely off the dry food; even the grain free varieties like Evo have too many carbs for diabetic cats.

Lantus likes consistency and so should be dosed twice a day, 12 hours apart with a consistent dose unless kitty throws you a low number that is not safe to shoot without more data. There are two protocols that can be followed for long duration insulins like lantus and levemir. One is the Tight Regulation Protocol and one is the Start Low, Go Slow Protocol.

The TR protocol was developed based upon the premise that a cat's pancreas may be able to heal and return to producing insulin if the cat's BG is kept in a normal range, ie, 50-120. caregivers following this protocol adjust insulin doses following the protocol guidelines, to aim for that range. in order to follow the TR protocol, caregivers need to test a minimum of preshot time (to determine if it's safe to give insulin) and again mid-cycle (to find the lowest point of the cycle in order to determine dosing). if the cat is likely to get into low numbers, then the caregiver needs to test enough to keep the cat safe. basic information on the TR is here TR. if you want to follow the TR protocol, we strongly encourage you to post daily in the Lantus TR insulin support forum for a while to learn more about how it all works.

The SLGS protocol has caregivers start with an initial dose based upon the BG at diagnosis and whether kitty has been transitioned to a wet low carb diet, hold that dose for a week or two while testing for ketones regularly, being consistent with food and shooting every 12 hours. Once a week a curve is done (test every 2 hours for one cycle) to check for the lowest point. The low number in that curve determines any dose change for the following week. Basic information on the SLGS protocol is here SLGS. If you want to follow the SLGS protocol, you can post for advice on the TR ISG, the Relaxed Lantus or Main health for guidance and support.

The AMPS number is often highest due to the dawn phenomenon. In regulating FDs, it is often the last number to come down.

We typically do not recommend that a new member shoot under 200 without some assistance from a member of the board as numbers can drop quickly or get very low. I see you shot a 94 tonight with .5u and I'm glad you got that pre-bedtime test to see that Eddie is at a safe number of 74. You are seeing some very nice numbers for him now. Please notice the links in my signature block for Handling Low Numbers and Dealing with Low Preshots. They will help to guide you through low numbers or preshots if no one responds right away when you get a low number.

We're glad you found us and let us know any other questions you have or how we can help you. It looks like switching Fast Eddie's diet has gone a long way towards getting him into normal numbers. Great job!!!!

 

I notice he was in the green before he got 0.5 U "tonight". How is he going? At 5.2 (94) I'd be worried about him getting too much lower...
Any more BG readings for PM of 23Jan? :?:

I'm also puzzled as to why it was so low just before his next dose. Was it a correct reading?

 

This is a new user who is not yet entirely following the regular Lantus protocols. She has been lucky not to send her cat into hypoglycemia so far. Her cat was recently changed to low carb foods and the doseage split into 2 shots. She may be giving insulin at too low levels, hence the low number at pre-shot. She is in the process of educating herself and refining her approach.

We'll hope she monitors for signs of hypoglycemia and has karo syrup or other high carb foods available if needed.

 

Hi there
Wondering how you are going? Testing looks like its going okay. Hope you're both doing well. Post again and let us know how things are going.

 

I updated Eddies spreadsheet this morning. I am also out of test strips, the last one in the pack was defective and would not work in the meter. Will get some later today. Eddie seems to be well.

I showed his spreadsheet to one of my coworkers who is "pre diabetic", she says the numbers that are high before meals that drop with no additional insulin are related to him fasting. Essentially, he needs to eat more often, so I am going to increase his meals from 3 to 4 times a day.

Still no luck finding insulin syringes in 1/2 units locally.

 

I'd question this. Here's an interesting study, Food intake and blood glucose in normal and diabetic cats fed ad libitum. Part of it involved a comparison of 12h fasting BG glucose numbers vs non fasting overnight and no significant difference was found (this part was just on diabetic cats). They also mention some studies on healthy cats with much longer fasts (see the discussion on pg 249/250 of the article) and the BG drop after long fasts was only really noticeable for extremely high carb diets. So I'd question that a few hours of fasting could cause those big drops like you had leading up to pmps on the 23rd.

I'd guess the long duration of lantus is probably a factor here. Here's a study on lantus administered to healthy cats over just one day Insulin glargine has a long duration of effect following administration either once daily or twice daily in divided doses in healthy cats. Note how late the nadirs can occur, at 1/day dosing they were from 8-16 hours in. So I'd suggest it's possible the morning shot may have been hitting it's full stride at amps+10-12 on the 23rd.

Just what it looks like to my inexperienced eyes, but I don't think cats can be viewed as little sharp furry people and we should be careful in our expectations that they'll respond to stuff the same way people do. I'm not at all saying you shouldn't move to 4 meals a day though (I also give my diabetic 4 meals a day).

 

I am a newbie, someone experienced will come along soon, but I have heard people recommending more frequent feeding.
So I have started giving my pair four meals a day, bfast 60g, lunch 30g, tea 60g, midnight meal 30g.
For a start, it keeps them from clawing the house down after a 12 hour fast. And Akbah's numbers are looking better lately too, could be due to a few things.