New member, meet Scooby. Dose questions

[LizzyR]

Hello everyone, I am very new here. Last Saturday 7/24/21 we found scooby to have diabetes. He tested over 600 at the vet, big yikes. He stayed there 3 nights to get that down and came home 7/27, he already had FF at night for dinner so switching completely has been easy. They gave a prescription for Purina DM wet as well, but ive just been feeding FF pate. They also have him on Clavamox for UTI and Gabapentin for some back pain as he had some neuropathy.
They have him on Lantus 1u a day, 2 meals. I have a few tests on my spreadsheet and have recieved a 479 at what is +19 today( no food since +12). I do realize lantus is a depot and twice a day is considered the norm, im curious if breaking his dose into .5 twice a day would work better or if he's just in an adjustment period to starting insulin. He also seems pretty hungry and is quite underweight as I can feel his vertabre so I've been giving a smaller meal midday, it feels wrong to do everything against the vets advice but I want to do what's best for my baby. It's been a very stressful week and this higher number midcycle worries me he's not getting enough insulin in the 24 hour period. Thank you all for the help, I would've been so lost had I not found this forum

 

[Sienne and Gabby (GA)]

Welcome, Lizzy!!

I'm sorry no one responded sooner. For someone who is new to feline diabetes, congrats on getting Scooby's spreadsheet set up, home testing, and for having such good instincts!

Let me offer some thoughts. Feeding the FF is great as long as it's the pate-style ("Classics") or one of the other low carb varieties. This is a link to a chart of most of the canned foods available in the US that was put together by a vet, Lisa Pierson, DVM who has an interest in feline nutrition. We consider low carb (LC) to be under 10% but most members tend to give their cats food that's around 5% carb. You'll also want to have some medium carb (MC: 10 - 15%) and high carb (HC; over 15%) food on hand if you need to steer low numbers upward. If you haven't bought the prescription food, don't. There's nothing in the canned DM that's any better than FF and the dry is way high in carbs. FWIW, they are no longer considered "prescription" food since there's nothing special in the ingredients and the FDA told the pet food manufactures to knock it off.

You are correct -- Lantus needs to be dosed twice a day. You're getting good duration since you're seeing numbers in the 100s by your AM shot time. You're also seeing the insulin wear off by PMPS. Perhaps more importantly, by dosing only once per day, the depot will never form. So, despite having started insulin on 7/27, when you start dosing twice a day is when your cycle count for starting Lantus will begin. It takes 5 - 7 days for the depot to stabilize. I also agree that dropping the dose to 0.5u twice per day seems prudent.

You also do not need to feed your cat only twice a day. If your cat has been accustomed to grazing or getting more than two large meals, it's perfectly fine to feed more often. It's easer on a healing pancreas if you spread out the food aud it can be helpful with respect to offsetting fast drops in blood glucose levels.

One other observation -- Lantus dosing is based on the lowest number in the cycle. As such, the minimum number of tests you'll need to get is 4. You'll want to do what you're doing and test at shot time (AMPS and PMPS) and get at least one additional test each 12-hour cycle. I'd definitely suggest getting a "before bed" test every night. It will let you know if your cat is in safe numbers before you turn in for the night which is helpful since many cats experience lower numbers during the PM cycle.

 

[Ann & Sister]

Hello everyone, I am very new here. Last Saturday 7/24/21 we found scooby to have diabetes. He tested over 600 at the vet, big yikes. He stayed there 3 nights to get that down and came home 7/27, he already had FF at night for dinner so switching completely has been easy. They gave a prescription for Purina DM wet as well, but ive just been feeding FF pate. They also have him on Clavamox for UTI and Gabapentin for some back pain as he had some neuropathy.
They have him on Lantus 1u a day, 2 meals. I have a few tests on my spreadsheet and have recieved a 479 at what is +19 today( no food since +12). I do realize lantus is a depot and twice a day is considered the norm, im curious if breaking his dose into .5 twice a day would work better or if he's just in an adjustment period to starting insulin. He also seems pretty hungry and is quite underweight as I can feel his vertabre so I've been giving a smaller meal midday, it feels wrong to do everything against the vets advice but I want to do what's best for my baby. It's been a very stressful week and this higher number midcycle worries me he's not getting enough insulin in the 24 hour period. Thank you all for the help, I would've been so lost had I not found this forum

Welcome to FDMB!
Had one thought. You might consider giving Scooby a Vitamin B12 Methylcobalamin 5000mcg tablet daily for his neuropathy. Many members do this.
I have transdermal Gaba on hand but did not consider giving any to Sister. Truthfully, I did not think neuropathy was painful. Gonna give her some.
Your vet loses a few points with me. First, not being familiar enough with the different insulins to know that Lantus is usually administered twice daily. Second, prescribing Purina DM which has no magical anti-diabetes ingredients. Third, advising that Scooby eat only twice a day. (That's old advice. My 2018 vet advised that for a different cat. I no longer see that vet)
I know it feels "wrong" to ignore your vet's instructions. I have felt torn as well. Vets do not know everything about every illness. It is probably not possible.
The good news is that you are HERE where you will get the best advice. Well, usually.
Hugs,