Hi all, Kabosu has been on Lantus for three weeks, and I am still not seeing much effect. He's already on 4U. I am not sure I am even seeing any nadirs. Looks like his BG just fluctuates around 400. He is currently on Sheba Fine Flakes in Jelly and Lilly's Kitchen Catch of the Day. Any advice? Previous post: https://www.felinediabetes.com/FDMB...amps-no-nadirs-below-300.242376/#post-2730919
Hi Dasha, Sorry to hear that kabosu is still running high. Has the food situation been sorted with your neighbour? The numbers suggest you probably will need to increase again. I do not have experience with high doses, so won't give an opinion, but I just wanted to ask about the food situation because his BG could stay very high if he has some kibble, and then can go through the floor if all of a sudden has a high dose and only low carb...
We're in the same boat. I'm just holding out that there's glucose toxicity to break through, and will "keep on keepin on". I very ignorantly tried a rebound check last year, so I at least know that doesn't work I believe around 5-6U is where they start to consider things like acro and IAA. My vet said 1U per kg body weight is when he starts looking to test for those.
We usually suggest to people that we get tests done for acromegaly and IAA (insulin auto antibodies) when the cat gets to 6 units, as we have had people get to 5.5 units and then the cat responds. On the other hand, both those conditions do not necessarily mean the cat needs higher doses. We've had cat diagnoses with acromegaly, IAA and Cushings (another less common secondary condition) at between 3-4 units. Can I ask what dose you shot AM of Feb 8th? The units cell is empty. If you skipped, could you put NS for no shot so we know it's deliberate. Curiously enough, Kabosu saw his lowest number on Lantus during that cycle. Any time you skip a shot or do a reduced dose, it messes with the depot and resets the cycle count before you can increase. Reminder: Counting Cycles It looks like you only held the 3.75 unit dose for 3 cycles before increasing, and only got mid cycle tests for two of those cycles. TR is more aggressive, but with that comes the need to test for safety. With nadirs over 300, you hold the dose for 6 cycles and increase by 0.5 units. Over 5 units total dose you change to 0.5 unit increases, unless you are tweaking a dose already seeing green nadirs.
Thank you all! I actually kept him inside for 3 days on low-carb wet food only, and that did not make any difference. Sorry to hear you are also struggling to get good insulin response. I will mention acro and IAA to my vet next time! Thank you! I still could not get syringes with 0.5 markings (although some are on the way), so 3.75s were really hard to measure. Sorry, there was no unit on Feb 8, just added it. It was 3.5. On that day I gave up controlling him all the time and just let him roam free outside. Then I went out to test him and got 13, which either was a mistake because the meter is sensitive to temperature change and it's quite cold outside, or maybe some exercise was good for Kabosu.
