Simon's back (relapse)

Hi Everyone,

We're back..... Our 15-year old Simon has relapsed (damn)

We noticed creeping pu/pd over the last few months, and a bit of weight loss,
so I bought some strips and confirmed high 300's over a few days.

Vet (same one as before) said start on 3u SID Caninsulin, but said BID
would probably be necessary. He wants to see some regulation and curves before
we do a full blood panel for CRF, thyroid etc.

We have been giving our 3 cats some Nature's Variety Instinct Dry, but checked
Simon after introducing it and no apparent effects on BG. He's strictly wet food now.

I'd appreciate if you folks could have a look at his SS linked below.

Maybe it's because I'm 6 years older too, but I'm finding the process
"a little stressful" this time ;-)

I know I got a bit too aggressive... all advice welcome.

It's good to be back... well you know what I mean.

Edit: Considering Lantus/Levermir

History

Simon was DX November 2003. He was on Caninsulin 6u bid. He went
on honeymoon in September 2004, but relapsed Feb. 2005.

Simon's average PS after this relapse was 450 or so, this dropped to
low 300's on diet change alone (Feb.27 '05)

After a near hypo incident on 1u on March 9, 2005 Simon's been off the
juice since.

Thanks

Hi Bruce,
Sorry you've had to return, but there have been some advancements in feline diabetes treatments, so you will get the help Simon needs! Are you in Canada or Europe?

From his SS it looks like even 2U of Caninsulin is probably too much, but seems you're on top of that because you're lowering the dose. Great!

I hope you will use the resources here to investigate Lantus and Levemir. We have Insulin Support groups for each, although the Lantus group also helps Levemir users as they are similar. There are different stickies in each group, so be sure to read those and the subsequent links included.

Also, it might be helpful to visit the pet Diabetes Wiki: http://petdiabetes.wikia.com/wiki/Main_Page

At least you've got the home testing down, so that's one less thing to tackle right now!
Please ask questions if you are considering changing insulins. And we'd love to see a picture of Simon when you have time.

Thanks Vicky

I'm seriously considering the switch, probably to Levemir. I have been reading the groups,, and I must admit a gentler
curve is tremendously appealing. I'm in Canada, so I understand Lantus and Levemir are available w/o prescription.
I know for sure I can either online. .

I think I will lower his dose again, especially with the overnight shot coming. I just bought some U-100 syringes
so I'll be able to fine tune a little more. I was thinking of 4u caninsulin in the U-100 (1.6 U-40)

He was 139 at +6, so he's definitely heading back up. He just had some boiled chicken, I'm trying to not feed
him as much after peak, but appetite was never a problem of his (ex-22-pounder) and he can be persistent.

His picture should appear now if I did it right. (That's his new buddy Logan using him as a bed).



Thanks again
Bruce

I'm sorry, Bruce, yes your avatar is up and running. I confused you with the other poster I replied to who didn't have their avatar up. And to think I did that to another grey kitty! Simon is grey, right? Long hair or short hair?

You still remember your stuff, knowing to switch to U-100 syringes for fine-tuning the dose of a U-40 insulin. I'd say Simon is very lucky.

Yes, Levemir is very gentle, but can pack its own brand of punch. The key to the longer acting insulins is to not begin the dose too high, so that you don't cause soft rebounds, which we call bounces. A good plan might be to see at what dose he can regulate fairly well on Caninsulin, then once you decide to switch, begin even lower than that dose.

Yup, he's grey, and getting a bit greyer, like me, LOL.
Lovely silver effect on his paws... he has short, very thick fur.

I will stick with the Caninsulin for a while anyway. Right now I'm being subjected to a
very intense campaign to be fed, which I don't like to do so late in the curve. Simon likes numerous meals.
I'm hoping the Lev would make this easier too.

One big reason we experimented with the dry Instinct is that Justice (12-yr old civvie) and/or Simon
would often start their "I'm hungry" routine at 4 a.m............. But even tho it's very low-carb,
the hydration issue rules it out as a staple diet. Naturally they all love it.

To further complicate matters, we have another kitty coming, a 10-month old female tabby, a stray
who adopted us (I wonder why?). She's being neutered tomorrow and will arrive Wed. That'll make 4.

Thanks again Vicky

I didn't know if I should have posted this to the Levemir on Lantus forum, as we haven;t switched yet...

I'm going to be switching insulin early next week, I'm really not happy with Caninsulin, or it's future availability.

From what I see, Lantus seems to be more used here, but from what I've read Levemir may have some
advantages (doesn't burn, slightly less likely to cause major hypo, etc.). Being in Canada I can get either w/o prescription.

Simon weighs 12.8 pounds (5.82kg) at present. He's lost weight the last few months. Years ago he was a 22-pounder
on vet-supplied "weight control" dry food. I think his ideal weight would be 14-15 lbs, he's a big boy.

Any suggestions would be greatly appreciated, especially to starting dose. His SS is linked in sig.

Once we've switched, I'll of course post in the appropriate forum.

TIA
Bruce

I don't see any harm in posting in the lantus forum right now with 'dosing question', in the subject. You'll get more experienced Lantus / Levemir eyes on your post.

The other thing you can do is go to the first post in this thread and edit the subject line to include 'lantus/levemir dosing advice', so people know you have a specific question.

Good luck!

Thanks Cherie, I'll post over in the L groups.

Bruce

Bruce, in the Levemir Insulin Support Group we focus strictly on Levemir. If you have specific questions about it, you're welcome to ask there. Its use in cats is not as widely known as Lantus is in the veterinary communities, which is the only possible drawback I can see.

Thanks Vicky

Sorry, I forgot to check this thread again after I started a thread
in the Lantus forum, as that seemed the busiest.
Of course I got a wealth of great info, which I'm still absorbing. What concerns me most is that a real lot of the SS's I see show a lot of
overnight monitoring, and testing sometimes 15+ times a day, which is pretty daunting as I'll be going solo. One good thing about the caninsulin
is I know once nadir has passed and numbers are going up it's pretty safe call it a night. Dealing with still falling 40's at 4 a.m.... EEK
Or worse still sleeping through them.