Newish member and first Hello

Hello! My sugar boy Cargo was diagnosed back in Sept of 2018 and yet I have only a few months ago found this site. We started our journey like so many others, scared and without a lot of guidance from the vet. After a LOT of trial and error, I have managed to get Cargo pretty close to remission - I think - and I'm hoping others who have achieved it can guide me the rest of the way. I'm very open to suggestions and techniques! We started out on ProZinc under advisement from our vet, as well as monthly curves. We adjusted each month and I started noticing he wasn't even close to being regulated. Fortunately he was the one to let us know we needed a new way of doing things and started getting aggressive at the vet - he wasn't having the 8-10 hours in a small scary cage anymore! So my vet said I needed to figure out how to do home testing. Wow was that scary at first - I didn't want to hurt my baby! But it turned out to be a blessing and now he's finally regulated!
After much research on my own, I decided to switch him to Lantus and his dosages have considerably (although slowly) decreased. Are we nearing the end? I'm to the point of occasionally skipping the shot but need advise on if I'm using the correct criteria to make that call each day.

Questions I have:
1. His nadir is only at +4 to+5, does this mean I need to switch to another insulin? If so, how do you determine which one?
2. I see many folks here are getting their Lantus from Canada. I'm located in the U.S., can I just order from a Canadian pharmacy's website?
3. I have been feeding half Darwin's Natural Selections raw diet and half Merrick's Purrfect Bistro (to give a variety of proteins since Darwin's only has 3). But it looks like there are other, lower carb foods such as FF that many seem to like. Should I change the food variable up right now if there are other variables, like shot or no-shot, in play? I don't want to send him into hypo.

Thank you so much for reading all of this! I hope to get to know you all better and help others along in their journeys!

Melinda

 

Hi Melinda and welcome to you and Cargo
Great you are home testing
We can certainly help you!
If you could set up our spreadsheet and fill out the last months data so we can see it, we will be able to help you a lot more. We are very data driven. If you have any trouble setting it up I’m sure @Bandit's Mom will help you with it.
Spreadsheet https://www.felinediabetes.com/FDMB/forums/spreadsheets-tech-support-testing-area.6/

Lantus is a great insulin for cats.
Are you giving Cargo a meal before the dose and then snacks throughout the day and evening?
Diabetic Cats do better with several smaller meals during the 24 hours instead of just 2 meals a day.
Suggestion.......feed meal at preshot then snacks at +2 and +5 both cycles. Or feed meal at preshot then snacks +3 and +6 both cycles.
Don’t feed for the 2 hours before the preshot BG as we don’t want the preshot BG to be food influenced.

yes you can order from Marks Marine Pharmacy in Canada that you may have seen in some of the posts here. You just need a script from your vet and send it to them, then post and they will send you the Lantus.

What are the carbs of the foods you are feeding at the moment. If they are under 10% that is OK Some diabetic cats seem to do best if the carbs are around 4%. It’s really a matter of trial and error really to see what works for your cat.

When you increase and decrease the dose, how much do you increase and decrease by?
We commend increasing and decreasing the dose by 0.25 units increments.

keep asking questions and again welcome!
Bron

 

Hi Bron!

I think I have Cargo's spreadsheet setup under my signature line. Please let me know if the link isn't working! I haven't done much data because prior to very recently we were just doing a once a month curve and adjusting by 0.5 units each time - sounds like that's maybe a bit much, oops! I have also created a tab for 2020 which shows his monthly curves from last year. But now I'm fine tuning and down to just 0.25 (very hard to see on the syringe!) and only when his numbers are above 150 or very close. Because he's only used to one curve per month, he's being very resistant to my poking prior to each shot now. Besides the 2 pre-shots, how many times per day should I be checking him?
I misspoke on Merrick's - it's good on carbs but low on protein and high in fat. I think I can do better with Fancy Feast or the like. But the Darwin's should be keeping his protein up.
Yes, I'm learning from here that the order seems to be test about a half hour prior to feeding, then feed, then shoot. But other than the occasional treat, I haven't been giving many snacks so thanks for that good suggestion!

Thanks for your quick response! I love the level of experience and compassion everyone has on this site. So cool!

Melinda

 

Yes I can see your SS thanks!

Here is a link to suitable foods.
Suitable foods https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Ae you giving him a treat after you test every time?
Here is a link to testing tips
https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

With the alphatrak meter you need to reduce the dose by 0.25 units if the BG drops under 68 if using the TR and 90 if using SLGS.
Lantus works best if you don’t chop and change the dose. It messes up the depot. (Lantus is a depot insulin).
So you need to stick to the same dose unless Cargo drops under 68(TR) 90 (SLGS)
Lantus is dosed on the nadir not the preshot number so that is why it is important that you get tests in during the cycles...both the am and the pm cycles. Cats often drop lower at night so it is good to get into the habit of getting a before bed test to see if Cargo is likely to drop lower over night. If he is dropping you will need to set the alarm and get up and test again.
When you did the curve on the 1/13 that was a good cycle and 0.5 units seemed to be a good dose. Then you dropped it to 0.25 units and then a few no shots and a few at 0.25 units. He looks like he is getting closer to remission but isn’t quite there.
The idea is to gradually lower your no shot number. At the moment sometimes you give a dose when he is in the 130s and other times you are skipping.

We like to see our cats in green numbers before we suggest an OTJ trial (no insulin trial) because you want your kitty to have a strong remission.
I would try 0.25 units for both cycles if the preshot is over 130 as long as you can monitor the cycle and have plenty of test strips and some higher carb food at home as well as some honey or Karo.
If you are unsure, you can stall, dont feed and test again in 20 minutes. And also post and ask for help.
Initially I would get a +1 and a +2 test just to see if he gets a food bump and when the onset of insulin is. Then if he isn’t dropping too much get a + 4 and +6 to see how he is responding to the dose. It takes lantus up to 6 doses for the full effect of that dose to be felt, so you need to hold that dose for at least 6 to 10 cycles unless he drops under 68 (TR) or 90 (SLGS) in which case you reduce the dose.
Once you know when the onset is you will test around +3 and +6 one day and maybe +2 and 5 another day or +3 and +7 another day but you need to test each day and also during the pm cycle.
Post each day so we can see how he is going and if you are concerned about anything, please ask about it

With Lantus we test/feed /shoot in the space of about 10 minutes. Lantus doesn’t onset for about 2 hours so the food has time to get into the system.
Do you have 1/2 unit syringes?

How does that sound?

 

I see you have decided to do SLGS method so that means you will hold the 0.25 unit dose for 7 days, unless he drops under 90 which case you reduce the dose, then you do a curve before increasing, but if you have been testing during the cycles as I suggested every day and at least one in the evening you won’t need to do the curve.

 

Oh wow, ok thank you! I will start back up onto a consistent 0.25 (and I hear Walmart has the needles that give half units so I'll buy some tomorrow) if the PS is above 130 as you said, and wait to see if it comes up if it's below that on cycles that I can. I have the rest of this month off so I should be able to monitor closely. However, I go back to work in February and I travel for a living - do you think it's realistic that he can get into remission by then? I know the answer is probably no, but one can hope! Otherwise I will probably have to err on the side of high BGs because my cat sitter doesn't do testing.
Honestly I'm scared to death of 68 or lower - he's been on the brink of hypo at 45. That's why I've been hesitant to shoot with these lower numbers. Maybe your snacks idea will help with that! Out of curiosity, what do you give as snacks? And are they in addition to a full dinner serving or should I reduce the dinner portion to compensate?

Thank you!
Melinda

 

In regards to food....divide the daily allocation up into a main meal and 2 or 3 snacks. The same with the evening meals and snacks.
Give about 50% to 60% at the main meal and use the other 50% to 40% for the snacks. Or you can change that % to what you think is best. So the snacks are proper normal low carb food. Snacks help to stop the numbers dropping too fast or too low...No guarantee but they help, and testing is your main way to keep Cargo safe.

With the alphatrak meter any BG below 68 is too low, so give some high carb food or Karo to bring the BG up over 68 again. And test again in 20 minutes to see the BG is coming back up.
A BG of 45 on the alphatrak meter is dangerously low so feed honey or Karo to bring back up amd test again in 20 minutes to see it is rising.

Try the 0.25 units and see how he goes. That is why I suggested to test at +1 and + 2 and a few other times for a while so we can see how he is on the 0.25 units. We certainly don’t want him dropping under 68. If he does, then the dose is too high.

Let’s see how he goes.......I can’t predict when he might go into remission. Every cat is different (ECID) and they are in charge of this...not us. We are just along got the ride!
When it is time for you to go away we can help you with an appropriate dose.

Remember......if you see him dropping low, you can feed him to help bring him up higher.

 

Mel, if you are doing the SLGS method you need to reduce the dose if you drop under 90 not 68..

 

Hi Mel,
Would you consider buying a human meter to test Cargo? The reason I ask it is, our dosing methods are based on the human meter and when you get down to low doses and lower BGs it is much easier and safer (in my opinion) if you are using a human meter as we know exactly where we are. With the pet meter we don’t have the equivalent numbers and it is just an estimate. I would feel much more comfortable helping you if you were using a human meter.
The ReliOn meter from Walmart is only around $25 I think and the test strips are very cheap. Let me know what you think.
Bron

 

The Relion Prime Meter is 9 dollars
17.88 for 100 test strips

 

Hi Mel,
You might mike to start posting over on the Lantus page now. Everyone over there uses Lantus or Levemir so can help you and you’ll get lots of support.
You start a new thread every day on the Lantus page and you put the date, cats name and AMPS and then something else if you want to ask a question etc
So 1/24 Cargo AMPS 200

 

Hi!

Ok I will start doing that as soon as I change meters so I don't confuse things. LOL!

Thanks Bron! I hope you're having a good day!
Melinda