9/10 Billo Day 1 on Lantus | AMPS 295/ +1 367

Hi everyone,

Billo started on Lantus this morning. Her BG at +1 is 367, which I understand it can be as Lantus does not work right away. I'm hoping that it goes down as the day passes. I will be monitoring her levels every hour to two hours.

I started the SLGS method, with 2.5u of Lantus this morning.

Thank you!

@Panic

 

Thanks for the tag!

Since you skipped last night the higher BG isn't surprising at all. Every 2 hours will be fine, Lantus is much gentler and slower than NPH.

 

Here is your info post. We link threads for continuity.

https://www.felinediabetes.com/FDMB...idance-using-novolin-nph.234953/#post-2631236

 

Definitely!

I should have linked that, thank you for looking out!

 

Welcome, Abdullah! Just wanted to say hello. Waving to you from Ontario.

If you've now decided to use Lantus and the SLGS dosing method, would you please indicate that in your signature and remove the info regarding Novolin, so that nobody gets confused. Your signature is the first place people will often look when trying to help you, followed by your spreadsheet. So you wanna make sure both are as accurate as possible.

Billo is beautiful. Looking forward to seeing how she does on the Lantus!

 

Done! My apologies for not changing it sooner. Thank you for the warm welcome and your kind words

 

One more thing for you! On your spreadsheet, try to add an extra row above today and put STARTED LANTUS or something along those lines so everyone can easily see where the transition happened.

 

Done! Thank youu!!

 

To make it a little more obvious:

Highlight the center cells (from +1 to +11), click Merge Cells at the top (it's two over from the Paint Bucket Fill). Then center it (button next to Merge Cells). I would bold it or make the font larger too. My SS has it super big, for example, but at long as it's easily noticeable that helps it from getting overlooked

 

I'm worried, Abdullah, that you do not have a vet onboard.
While Lantus is OTC for cats in Canada, that does not mean that it is not a major drug.
In other countries, a prescription for Lantus is required.

 

Not sure about the requirements for having a vet on board...my vet wanted me to use Novalin with Luci...I declined...most of the vets I've seen know so little about newer insulins...

Yes, for other things, not so much for diabetes.

 

Done!

I understand. I will talk to my vet again.


I apologize for a little delay in updating you guys, I was running errands. However I still got readings for Billo's BG.

at +1 it was 367
at +4 it was 279
at +it is 270

she did just eat about a half hour ago which might be the reason why it hasn't dropped too much since +4?

 

Initially, my vet had me using Caninsulin, this was when Billo was first diagnosed. He then switched us over to Novalin after doing a fructosamine and blood glucose test, he said that Billo stopped responding to Caninsulin and needed a different insulin. And then I find out that NPH is really strong and harsh, which brings me to present day lol

 

It IS unfortunate that 99.9% of vets know so very little about feline diabetes.

Personally I think you've done the right thing switching to Lantus. It's a much gentler, longer lasting insulin than Caninsulin or Novalin.

Perhaps you can inform your vet of your switch and show him your SS - if he's not impressed by those tests and all the data you've collected, move on to another vet.

I do not discuss Luci's diabetes with my vets - only minimally because I do tell them she has diabetes - and then I'm prepared to show them her SS - and most of them respond with wide eyes and say, wow...you're doing all that testing?

One told me a couple of Summers ago to call her for recommendations on managing Luci's dose...yeah, right. I said, thanks and that was that...I did not call her, nor do I intend to call her or anyone else regarding Luci's dose management.

I did however post and ask a ton of questions here - when to increase, when to reduce...you too can do just that. You'll learn a lot and your kitty will be better off for it in the long run!

Welcome to the best place you never wanted to be!!!

 

It sort of makes me sad knowing that's the reality of it. I wish I had known about these methods and home testing when Billo was first diagnosed, instead of blindly following everything my vet said.

Thank you so much! I honestly have learned so much over the last couple days from you all. I will forever be grateful for you guys!!

 

I agree with Red on this. Diabetes is a chronic condition and a cat needs to be registered with a vet. The vet needs to know all of the treatments that a cat is receiving when diagnosing and prescribing for other conditions - particularly in an emergency. It's also unfair on the vet to withhold critical information such as the insulin a cat is receiving. If a particular vet is not supportive, then another vet can hopefully be sought.

My two penn'orth.


Mogs
.

 

Mine too. Then I joined here and learned about Lantus and made the switch shortly thereafter. I also learned to home test from people on the board. My vet didn't want me to home test, just bring Butters in for him to do a fructosamine test every two weeks. Way too expensive and unnecessary in my opinion. Also said she would be way too difficult to ever regulate.

So check out Butters' spreadsheet and you can see how far she's come since I've been following one of the dosing methods and getting guidance here. I initially wavered back and forth between what my vet wanted me to do and what the dosing method said, for over a month from her diagnosis. When I finally decided I would stick with the board and the protocol, that's when her BG numbers really started to improve. This is an incredible place you've found. I am grateful for it every day.

ETA: My vet was aware of my Lantus use. That said, the vet ditched Butters due to her being a "tough FD case" and left us vetless.

 

I agree with Red on this. Diabetes is a chronic condition and a cat needs to be registered with a vet. In order to properly assess a cat and, as required, prescribe treatments for The vet needs to know all of the treatments that a cat is receiving when diagnosing and prescribing for other conditions - particularly in an emergency. It's also unfair on the vet to withhold critical information such as the insulin a cat is receiving. If a particular vet is not supportive, then another vet can hopefully be sought.

My two penn'orth.


Mogs
.[/QUOTE]


I agree with you. I will make sure that my vet and I are on the same page with Billo's health, and that he knows what kind of treatment she is receiving. Especially because if there is every an emergency (I certainly hope there isn't), he should be aware and there shouldn't be any miscommunication. I'll give him a call and see if I can sit down with him to discuss everything.

 

Perhaps your vet will work with you soon when Billo’s ss shows progress with Lantus. If so you can handle diabetes and your vet can handle any other medical issues. If not, time to change. I would want a vet that works with me and understands we are partners. I’m lucky to have that but I worry every year mine might retire. Just my two cents fwiw.

 

In these days of Covid when cats are taken by a vet tech or receptionist from a car in the parking lot into the vet clinic. The cat is seen by the vet. Treatment is given. And then the owner has a conversation over the phone with a vet tech.

I'd hate to see a vet give R or a double dose of a non-depot insulin because they did not knowing that a cat had switched insulins because the vet tech forgot to tell them or they were distracted while being told.

 

I think that's a good plan. I hope the discussion goes well. Perhaps you could use the following document as a basis for the discussion:

AAHA Diabetes Management Guidelines 2018

It's from a highly reputable professional source and it specifically recommends Lantus as a suitable insulin for diabetic cats.


Mogs
.

 

For info, I removed the gobbledigook from the above post (tired, didn't proof it properly before hitting Reply) but for some reason the forum software isn't displaying the reason for editing.


Mogs
.

 

I'd love to see that vet's face if they could see Butters' numbers now!




Mogs
.

 

Not to get too OT, but I've thought the same many times over, recently.

 

My first vet recommended euthanasia...saying she'd be too difficult to regulate, would pee all over the house and would hide from me when it was time for shots. Much less any information about testing.

Then I found this group...and I had a tough time deciding whether to listen to the people here OR do what he had suggested...I was very upset trying to figure it all out and made an appointment with him to sit down and talk about options.

I took him some printed materials from THIS group - he basically told me that I couldn't rely on the internet for reliable information...but he did finally reluctantly agree to give me a prescription for Novalin; told me to go to Walmart and get syringes...only did I learn from this group that I should also buy a BG meter and strips so that I could test - that didn't go well or easily either - but I was determined to try to help Luci.

Fast forward: Three years later.

We've seen several vets along the way...one did finally prescribe Lantus - and saw that I'd been testing at home - he said to keep it up...but also told me to go get the Rx filled; give her 2 units twice a day and come back next week for a fructosamine test.

We all have different experiences with vets. I'm not suggesting for a moment that you withhold information from your vet - but you also cannot rely on them to give you dosing advice that's based on as much knowledge as the folks in this group have! So many cats have been helped to live long and healthy lives AND many have gone into remission!

Your vet can certainly help and support you in other ways - but don't count on them to be a fount of information as far as FD. There is however always an outlier to that impression...some vets somewhere are very supportive, knowledgeable and helpful...but my experience has not been such...

Just my two cents worth

 

The decision to administer care without the supervision of your vet is definitely one that requires a lot of courage and strength. I'm so happy to hear that you took that decision for yourself and look how far you've come.

Being a part of this community online and having so many knowledgeable individuals, I think it's wise to use this as an opportunity to teach or allow for our vets to be aware of the growing research and the methods to treat/regulate diabetes, because they honestly might not even be aware of it. This is an opportunity to educate and potentially save other pet owners too that may feel as though they have no options in sight.

 

Billo's BG at +8 is 279, it has stayed around this range for the past couple hours. Is this normal?

 

Lantus' trademark is flat curves so looks normal to me at least. The depot will take some time to bring the numbers lower.

 

Yes, those are flat yellows. Perfectly normal.

Sometimes a long run of flat yellows can mean an active cycle to follow...but not always.

Just keep doing what you're doing...monitor and read as much as you can.

Look around at other people's condos and spreadsheets - there is a wealth of information on this forum - I found that was one of the most helpful ways to get to know what other people were dealing with and how they handled various scenarios...

You'll find with Lantus those nice flat rolling curves...not like those other insulins that you mentioned earlier - they tend to act quickly, bring kitty down fast and then boom, right back up when it wears off. Lantus cycles are supposed to last about 12 hours...you'll see over time, there's a drop off about two hours post injection...then a ride along hopefully some fairly flat numbers...and then it tends to lose efficacy as the 12 hours comes to an end. However, most importantly all cats are different. Some cats hit their lowest points on Lantus early, others late...some like Luci lose duration repeatedly..so we're trying a different insulin altogether...hoping for an even longer duration.

This is a marathon, not a sprint...it takes a while...but you guys will get the hang of it!

 

Sue recommended reading as much as you can, and I'd like to second that. If you haven't already, I highly recommend you read the New to the group? Start here. sticky. I still read it regularly. It gives you the low-down on how Lantus works, and will help you learn how to identify how Billo responds to it. If you are so inclined, give it a read through and ask questions.

 

Thank you so much for your support guys!

Billo's PMPS is 253, about to feed and shoot to respect the time constraint of Lantus!

 

Great first day!

 

Thank you everyone for helping me and staying by my side through my first day!!