Back on Lantus need help-long & complicated

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mikasmom

mikasmom

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Hi,
I am hoping to get some advice on dosage for Mika. She has been OTJ since last summer, but we had to start feeding her dry food because we tried everything else and that was the only option. What happened was in the fall she had some freaky neurologic problem-she was jumping up like never before, wouldn't sit still for more than a couple seconds, meowing frantically-wanting to run away. This is a completely docile cat. As a last hope they gave her some AB's and she actually went back to normal but would NOT touch wet food of any kind. It was as if she associated wet food with her problem. She would actually run away when she saw me with a plate of food. So we were really faced with giving her dry food or nothing else. She has been on EVO and sure enough her BG's are up in the 300's. It is a dilema because I know that having her on dry food is the worst thing for her diabetes. I have been giving her 1 container of FF Appetizers (tuna, chicken or salmon) in the morning and 1 in the evening before her shot so she is eating 6 oz. of wet per day, but free feeding EVO. She is also struggling with being very skinny and having her adrenal gland removed from Cushings over a year ago.

So here are my questions:
1. Can she ever be regulated on EVO dry?
2. How do I figure out her dosage with her free-feeding?
3. Is Lantus the best insulin for her?

As of this evening I decreased her dose from 2 units 2x a day to 1 unit because I started her on 0.5 but then increased her to 2 units and I think I went to fast :sad: I probably should've had her on a lower dose for longer, but I was over eager and increased her every week. I am thinking now if there is an adjustment period for even starting the insulin...
I am so confused and frustrated because her numbers are all over the place. We've had quite a load the last few months with me and my husband each having surgeries, our other cat having 2 surgeries and our one dog having spinal issues. I am really just hoping for some guidance from those who know more than me :smile:

Thanks so much!
Tammy
 
I cannot comment on the dry food. Your cat has to eat, and if dry is what accomplishes that then you work around it.

The trick (if you want to call it that) with dosing Lantus is to start low and get frequent spot checks. Also, no food two hours prior to AMPS/PMPS so you are not seeing a food spike. Looking at your spreadsheet I think you are correct about upping the dose incorrectly - not necessarily the length of time between changes, but the increments. It is recommended that Lantus be adjusted in increments of .25u at a time. Also Lantus will build up an overlap ("shed") that you have to take into consideration.

Open a daily thread ("Condo") and post numbers. Update as you get spot checks. Those who are most proficient with analysis and dosing will be able to help you tweak to the correct dose.

You'll be in the swing of things again before you know it!
 
(((Tammy))) I am sorry that Mika is back on insulin. It sounds like you have a lot on your plate with surgeries etc.
You said your vet gave her an AB for a neurological issue......did she have an infection?
I also looked at your ss and on 9/26 her bg was 167 which is a little high for and OTJ cat. Was that when she started the dry food. There were no tests done for a couple of months after that so I am thinking she has probably had diabetic numbers a few months before you started her back on Lantus.
I think her bg's may be all over the place as you say because you may have missed the optimal dose by jumping from .50u to 1.00u to 2.00 u. The best thing is to raise the dose by .25 increments instead of whole units. It does take time for the shed to be full. It might be a good idea to reread the stickies at the top of the page. It is a lot to remember.

Can she be regulated on Evo dry.....I know that there are cats that are regulated on dry but it is hard to do. The dry will keep her in higher numbers which in turn may keep her on a higher dose of insulin.
Many cats are free fed low carb wet food and are dosed the same way as any others....although it is best if there is no food 2 hours prior to her insulin shot.
If Mika did well on Lantus before I am sure it should be fine for her now. Are you using the old insulin or do you have a new script?

The FF appetizers are not as nutritious as the regular lc FF. They should not be used in place of a meal.

I hope more experienced people will chime in.
 
No advice for you Tammy, except to say that I'm sorry you had to start Mika back on insulin. I hope that you are able to work back to a good dose and get her numbers back down quickly. Do you happen to know the carb content of the appetizers? I don't know if using a food timer might be of use for you guys instead of free feeding. The most important thing is to make sure she gets her calories in and maintains her weight (or gains if she needs to), but a lot of people here have had good success with feeding frequent mini meals.
 
Hi Tammy...I am so sorry to hear of all your issues there.... :YMHUG: but welcome back...
I agree with Sherri that it's best if you just settle in and post a condo for Mika everyday again. Not sure what to think about the dry food also....but there are many people here who will have many ideas I am sure...this is the right place for you to be!

As Sherri says, you might have upped the dose too much with each increase and it might be possible that you passed over the correct dose. It might be 1.25u or 1.50u right? Maybe someone more experienced will add their thoughts.
Sorry you have to be back here but I am glad that you will be back on track again...
 
Hi Tammy. Sorry Mika is back to needing insulin.

One thought on the food issue, if she won't eat canned food, have you ever thought about trying her on a raw diet? There's info on Dr. Lisa's site about commercially prepared raw food or how to make your own. (I buy a pre-mix and grind my own chicken.) If this is a consideration, you may want to check into purchasing a small amount and see if Mika finds it palatable and if so, transition her over.

I have to agree with what everyone is suggesting. The jumps between doses were big leaps and you may have missed an optimal dose. I also think you will need more spot checks in order to get a better handle on what's going on with Mika's BG. It looks like there are days where you don't have pre-shot and mid-cycle tests. Mika could have had low numbers and you wouldn't know. With all that you've been juggling, some of this is understandable - it sounds like it's been a difficult couple of months.

There are many cats here who free feed but on canned food. Theoretically, it shouldn't have an effect on Mika's numbers. I think once you have the insulin better calibrated, it may make sense to see if the free feeding is a plus or not. Some cats do better with mini-meals throughout the cycle; others with food early in the cycle - it's really a matter of what seems to work best for your cat and how carb sensitive she may be.
 
Tammy--So sorry to hear all the troubles you have been having!! And Mika's problems, but I just feel there can be much improvement here..Maybe like what was said, you missed the right dose somewhere. My cats have always free fed on low carb food, & Moonie stays in decent numbers..But the mini meals may be a good alternative too--Hope we can help you find the way. Sending healing vibes to all of you!
 
Hi Tammy. I'm not going to repeat what everyone else has said here, but I wanted to say hello and tell you you how sorry I am to see that Mika is now back on the juice, but glad to see that you are here where you will get the help and support you need. Looks like you have your plate full and I hope that Mika will begin to feel better soon.
 
Hi Tammy and welcome back! Are you feeding the Innova EVO cat & kitten dry food? That was one of the things I got Morris to eat when he wouldn't eat anything last month. It's supposed to only have something like 3% carbs so I'm surprised that it affects the BG so much. I was going to suggest the raw also...saw that Sienne recommended that as well. But, as you know, the diabetes and treatment is secondary to the eating issue....they HAVE to eat so whatever it takes, that's the primary concern.

As everyone else has said, the hasty increases may have caused you to miss the best dose for Mika so why not just start over at 1.0, get frequent BG checks, and post a condo here each day so we can help you. It sounds to me like you need some shoulders to lean on for awhile. :YMHUG: ((((Tammy)))))
 
Hi All,
Thanks for the great information. I was definitely hasty in my dosages, so I am starting tonight with 1 unit and going to keep that for awhile to see where Mika is at. She is eating the EVO cat & kitten food (dry). I have been noticing her appetite for wet food increasing so that is hopeful. I am also feeding her some of her favorite flavors of low carb regular FF so that should be better than the appetizers. I didn't realize they aren't nutritional. A couple complications is that we have a civie who is highly allergic to the food Mika eats, so we have it in our bathroom with a gate that only Mika can fit through-normally. But our other cat has started squeezing through the gate to eat all of Mika's food. So now we don't know what to do to leave Mika's food out so she can free feed. We might have to just force the issue of feeding Mika many small meals of wet food again and just hope she'll eat enough that way. The problem is that she will NOT eat wet food that is not coaxed by us for her to eat it. We've tried to leave it out-as we do for our other cat-but she won't touch it.
The other issue is that I have ordered more strips and used my last one yesterday, so I am out of them at the moment--gosh I am failing all over the place!! I am kind of losing my mind with all of this :? !!
All of your suggestions make sense, so that is what I will do. I will start posting once I get some numbers to post. The good news is that our other cat, Nala, is feeling so much better after years of struggling with allergies in her ears and recently having 3 surgeries on her ears in 2 months (hematomas). Last night both kitties were laying next to each other which warmed my heart because Nala has been hissing at Mika since she got sick over a year ago and would not go near her.
thanks so much for your help :smile:

Tammy
 
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