? 3/9, Susie, 248 AMPS, 307 @+2, NOT HAPPY WITH LANTUS.

https://felinediabetes.com/FDMB/threads/3-8-susie-amps-247-276-3-311-7.244352/

Surprised to see Susie so high at +2 with the slight increase in insulin. New Dose Wonkiness?

UPDATE: I am not happy with the Lantus. Yes, it gets flatter curves and it is easy to see where her numbers could come down but she is not acting like herself. She did not come out of my bedroom once today. I honestly do not think she feels well. How much time do I give the Lantus before I have to, once again, decide on a different insulin? Did anyone else have this problem and have to switch? How many people out there found that Lantus was not the best insulin for their kitty? She has been on it a week and she had more energy on the Vetsulin. I am getting worried about her. Clinically, she is not urinating or drinking a lot but she has zero energy.

 

I think it's too early for NDW since you just increased this morning. It's possible she dipped lower last night and is bouncing. It's always a good idea to get a before going to sleep test even if you think they'll stay high. Good luck with the new dose.

 

Here is some information on New Dose Wonkiness. It usually shows up 24 hours after increasing.
Best of luck with the new dose!

 

Okay, thanks Carla. I didn't feel I needed another test because her numbers were so high but I should have gotten a "before bed" test. Thanks for the info.

 

These kitties can surprise us, so getting that extra test is a good idea for safety reasons.

 

Thank you for sending the link, Lyla.

 

I think it’s a bounce. When the +2 is lower than the preshot there’s a good chance that she went lower later in the cycle. If a lot lower I would set an alarm for +5-7.

 

Agree.

 

Thanks, Elise. Always learning.

 

Usually for Darcy and I that is true. When I increase, day 2 is his day to fly high (although lately he's been trying to challenge me on that and go high on day 1)

 

I think everyone is right. It was too soon to have been NDW. That high number just came out of the blue to me. Word has it that she went lower than expected last night in her night time cycle. Will do a +3 tonight before bed and see what is going on. If it is low I might set the alarm and get up at 11:15 (+6) to test.

 

I absolutely do not think it is the lantus that is the issue. I remember, and I looked, that her liver values are pretty high. They are higher than Gracie’s were and I hope your vet is addressing it. Susie should be on milk thistle at the very least but when Gracie’s liver values went up, they ultrasounded her. The other thing is the only value of Gracie’s that went up was her ALT and Susie’s AST and ALT are elevated. Her bilirubin is normal but on the higher normal side.

I absolutely would not increase her dose to 1.5u now. Also, with no tests last night at all, we have no idea if she dropped into blue numbers or not. If I’m giving dosing advice and it “might” be time for an increase (which it isn’t), if I see any cycles where there are no tests after the PS, I will not advise to increase. No one should. You have to have an idea of how low the current dose might be taking her before you increase and with a blank cycle, we don’t.

Since you are doing SLGS, you’ll have to hold the dose a week before increasing. If she drops below 90, decrease. Really.....she’s not eating dry food and you test enough to do TR. I’d absolutely be doing TR with Susie. She’ll get to better numbers faster.

 

My vet did do an ultrasound and xrays on Susie's abdomen last week. Said the liver and gallbladder looked fine. He also said he did not see the pancreas (?) which I thought was strange but my report did say "Acute pancreatitis is unlikely. Chronic pancreatitis is not excluded by a normal PrecisionPSL". Her EOS and ABS EOS were high and he thought she might have lung parasites so I spent a lot of money in a test to rule out parasites - which we did. He said the high ALT and AST could be from the diabetes and thinks once I get it regulated she might do better. I hope so as those elevated numbers do worry me. I will look into the milk thistle as I have read about it and the Denamarin. My concern with pills is that Susie swallows a lot and I don't know if there is something going on with her esophagus. I mentioned this to the vet and I thought he was going to ultrasound it too but he did not. I did a test last night at +2.75 (240) and again at +6 (235). Maybe she is going low much later at night. I guess I should try and get a +8 or +9.

I'll keep her at 1.25 units for the next 6 days and see how she does. Thanks for your support and bless you for helping out in your community with the COVID vaccines.

 

You can check Chico's spreadsheet to see his progress on Caninsulin/Vetsulin vs Lantus. You can see how did the 2U dose of Lantus work for him. I am not saying that this is a sign of remission, it might as well take years before remission or even it doesn't have to come but i would rather keep him on Lantus all his life with a much flatter curve than switch back to Caninsulin and see him fly from 500 to 100 almost every cycle he isn't bouncing. It takes a good dose for them to show results but i am sure Susie will get there as well, it just takes patience. If you want to speed it up you can try the TR instead of SLGS to get to a good dose faster, you can go back to SLGS as soon as you reach a good dose.

Good luck

 

Chico is doing better on the Lantus and it looks like the 2 units are a good place for him to be right now. I'm not sure I want to speed things up because she acts like she isn't feeling well these days. Will certainly consider switching to the TR but not just yet.

 

We are very happy with Chico's progress, even though yesterday he broke a 1 week streak of no reds)))

You take your time and don't do anything that you don't feel comfortable with, just wanted to to let you know that TR is not so scary as it might seem, as long as you monitor (which you already do) it is very safe, the only thing it would do, it would allow you to get to a better dose sooner.

Today Susie started with e lower PS than yesterday's +6, maybe she will go lower today I hope Susie starts feeling better as soon as possible

 

Hi Summer. I'm thinking of you and Susie. I believe it is possible that her elevated liver enzymes can be caused by the diabetes. I have researched it and see that is a possibility. In addition, I also read that the high cholesterol and triglycerides can likewise be caused by diabetes. I found some article indicating this last week, buy you were so overwhelmed at the time that I didn't want to dump more information on you. I do think it would be good to get Susie on a liver supplement, but I understand about the swallowing. Have you had to give her other pills, and did she have trouble swallowing them. I'm sure that you already know that you should never give a cat a pill without always giving them either a little bit of food or (if they won't eat) syringe a little water into them to make sure the pill goes all the way down. Does she seem to have any trouble with just normal swallowing during her meal times? Or is it just that she swallows a lot at other times? Is she purring when she does this? I do have cats that purr A LOT and they seem to produce a lot of saliva at that time and then swallow a lot.... sometimes they will make themselves choke even and start to cough.

Did your vet give you a detailed ultrasound report with any measurements or anything like that? Or did he/she just say that everything looked okay. I remember now about the pancreas.

So glad she doesn't have lung worms!

I hope Susie's BGs will come down soon (although to me they don't look too bad... I think you will be seeing some better numbers soon.)

 

Thanks, Marina. I hope she starts feeling better soon too.

 

I'm glad to hear that a lot of the elevated blood test might be due to the diabetes. I hope so. I asked for the ultrasound results and they sent me something I could not open. Will try again today. I also need to read about the high EOS and ABS EOS. Those are the results that lead my vet to think she might have lung parasites. She does cough/hack at times but less so than in the past. She swallows frequently but seems to eat just fine. I have never had to give her pills so I don't know how she would do with that. Can you recommend a good liver supplement? One with milk thistle? I think I might get the Denamarin but hate the thought of giving pills if something is wrong with her esophagus. I'll remember to make sure she has food in her belly first if I do end up getting pills. Sometimes she purrs when swallowing and other times not. No saliva that I see. She is a mystery cat that when I first rescued her from the shelter she had an unusual start with me. She has never urinated like a normal cat. Only puts out a tiny bit. That was before the diabetes which caused a lot of urine. She is more normal now. Her story from the beginning is a long one so I won't get into that now.

 

How is Susie doing today, Summer? I have to second the opinions to give the Lantus more time. For awhile, I wasn't able to see my Pearl's progress like I wanted, and I really doubted. Once she got to the ideal dose for her though - smooth sailing. Behavior incredibly improved too.

 

I've been using the Denamarin on Darcy, but he's able to swallow pills just fine. It's a round pill with a coating on it. Bless your heart for adopting Susie. How long have you had her?

 

I would agree that the elevated cholesterol and triglycerides can be due to diabetes. I’m a little more hesitant on whether the elevated liver values do as I’ve looked a hundreds and hundreds of labs on diabetic cats and the vast majority have normal liver values. If she was unregulated, I’d consider it more likely.

The Precision PSL was developed by Antech as a “kind of” response to IDEXX’s specfPL but it’s not a very accurate test. I wouldn’t rely on it.

I use Herbsmith’s milk thistle powder that I get from Chewy’s. It’s much easier to give than Denamarin and is the same effective ingredient. My cats are super easy to syringe so I do it that way as I want their food to taste like food. It might not have any taste to it but I don’t even risk it since they are easy to syringe and they think they are getting a treat.

You’re very welcome. Thank you...we are so happy to help do our part to fight this horrible pandemic.

 

Susie is still not herself. She does not leave my bedroom until late in the afternoon when she is hungry. I am worried about her but will try to be patient. I don't know what else to do after the blood/urinalysis, ultrasound, x-rays and fecal test. Thank you for asking, Margaret - and pretty Pearl.

 

Thanks for the tip on the milk thistle. I like that it is not a pill or a nasty tasting powder to put on the food. I'll check it out. I guess you give it to healthy cats too?

 

I forgot. With those elevated liver values, did they give Susie and antibiotic?

 

No they did not. I have contacted an Internist to see if I can afford him. I am not happy with my vet(s) although I think they are doing the best they can based on what they know. I'm heartbroken tonight. A 310 PMPS.

 

I feel your pain. Sorry about the 310. But it's really early days on the Lantus. I totally "get it."

 

Thank you, Suzanne. As they say "tomorrow is another day".

 

I see Susie had a better AMPS this morning. And you said she was more active last night. That’s a relief! I hope she is again today.

 

No, Suzanne. Susie's AMPS were better yesterday (207) than they were today (251). I really thought I was going to see "blue" at some point yesterday. She did have a good evening and was out more than she has been in a while. She is back to being lazy this morning but isn't that what kitties do? I think she feels better, though. Just looking at her and interacting with her. Susie is funny because she is more active the higher her glucose is. I think it is hunger. She still isn't eating her meals right away. She leaves a little and then will go back to it. I guess that is a good sign that she is not ravenous.

 

I got the results of the ultrasound unfortunately they sent the actual pictures - not a report. I would not know my head from my behind trying to read the actual pictures. Maybe they didn't do a report.

 

I misspoke when I said Susie did not get an antibiotic on 3/1. She was given an injection of Covenia but the vet said it was for the red spots on her belly.

 

I adopted Susie from our local humane society in April 2019. She did not have the diatetes at the time and was 7 years-old. I could not believe a kitty this pretty would still be waiting on an adopter after two weeks but I guess a lot of folks don't like the black and b/w cats.

 

Oh gosh, I have a special place in my heart for black and white cats. I have one little tuxedo cat, Bingley. I lost my Julius in January 4 of this year and he was a long haired black kitty with a little white bib. I've had quite a few black and white foster kittens this past year as well. Susie is indeed very pretty. Maybe it was because she was seven? Do you know how she came to be in the shelter?

 

Oh, yes. Convenia would not be the best antibiotic for an infection that might cause elevated liver enzymes, but it is effective on a skin infections, which may be why he wanted to give it to her for the red spots. I hope the spots are cleared up now. I'm not a fan of Convenia because once it's in there it will last for weeks, and if the cat has a negative reaction to it you cannot stop it like you can stop pills or liquid antibiotics immediately. But I know you don't want to give her pills right now. I hope her swallowing gets better, too.

 

Oh good grief! I know what you mean about those ultrasound photos! My vet usually brings out her I-pad and shows me what she sees on the ultrasounds -- and she'll explain them to me. In the pre-Covid days, she would let me come into the room and show me the images while she had the probe on my cats. It was very interesting, but it made me appreciate that it takes a lot of training to be able to read and interpret these things.

 

If I remember correctly, the people who dropped her off just said that there were personal reasons why they could not keep her. She had unusual urination habits at the time. She barely urinated at all which had me worried. I took her to my vet three days after adopting her and my vet was concerned there was a blockage somewhere although he could not see it on the ultrasound. He felt that Susie had been a medical problem for the previous owner and she was just dumped at the shelter. He was really upset because people will do this. She had surgery and no blockage was found but there was scar tissue - he thought from a previous surgery. Anyway, like you I have always loved the black and white kitties and even the black kitties. I always look for them first. I also lost a tuxedo a year ago. She was 18 and had been with me through so much. I'm sorry about Julius. I always say "the price of love is loss". They are always worth the pain of that loss.

 

Her red spots did clear up. He also gave me the panacur and wanted me to use it even though her fecal test showed no worms. For goodness sakes, if I am going to spend $146.00 or an expensive fecal test it better be accurate. I am not giving her the panacur.

 

Everything was easier at the vet in pre-Covid days. I don't get the luxury of going inside except the one time when they showed me how to test and shoot the insulin.

 

I'm so glad she has you now. I'm sorry about your kitty too. Yes, I wouldn't trade a day of life with my sweet babies, even though I know one day it is going to hurt an awful lot to say goodbye.