On Lantus about 4 weeks and ravenous appetite help!

[Mocha aka Cold Play]

I have a 9 year old who had sudden onset diabetes over 3 months from in range to 400 range thereafter. She was put on 1 unit 2x a day for a week and it went up, even though was on a 2% carb wet food 3 months prior to diabetes. She was then put on 1.5 units 2x a day. I can't get her filled. I have tried smaller portions as she seeks but she is at 3 (3oz) cans a day and I asked the vet, because she is barely 8lbs and needs to gain and her insulin is not regulated yet, how much to feed, I only get you can feed more than 2 cans.....so I give 3, but I am getting the look like her brain never knows she ate. As I understand, I am likely doing no favors to give her food everytime she seeks it to her contentment, because that will result in over urination and excess thirst (4 cans did) Correct? I would attempt to give her 1 can in the morning and one at lunch and one at night but I don't think it would satisfy her? Correct? This is a huge question for me. I don't understand how to best help her be comfortable while in transition. How long do cats take if on a low carb diet pre diabetes? She is barely 8lb because of a long gingivitis issue. The insulin shots are even difficult to find an area to pull the skin. ANY INPUT APPRECIATED. I am overwhelmed and it is only about 4 weeks. At her dental she was 599, but vet said to not be alarmed. Is it true STOMACH is most effective, as opposed to neck and above shoulders? Trying to maximize the lower dosages. Is there any wet food that is 2% that is under $1 a can?

 

[BJM]

Welcome to the message board, the best place you never wanted to be.

How did your cat get diagnosed? Was she given a steroid injection? (You indicated it was sudden?)

Injections may be given anywhere there is loose skin; I usually shot around the upper shoulders.

Until regulated, the cat will be hungry because there isn't enough insulin to get the glucose into the cells to work.

There are 4 things you'll need to manage your kitty's diabetes:

- You - without your commitment, the following won't work.

- Home blood glucose monitoring with an inexpensive human glucometer such as the WalMart Relion Confirm or Target Up and Up (the pet ones will break your budget!). This saves you the cost of going to the vet for curves and done regularly, removes the need for a fructosamine test. All of our insulin guidelines use human glucometer numbers for reference. Tests at home may be 100-180 mg/dL lower than at the vet.

- Low carb over the counter canned or raw diet, such as many Friskies pates. See Cat Info for more info. If already on insulin, you must be home testing before changing the diet. Food changes should be gradual to avoid GI upsets - 20-25% different food each day until switched. There are 2 low carb, dry, over the counter foods in the US - Evo Cat and Kitten dry found at pet specialty stores and Young Again 0 Carb found online. Some cats do better with mini-meals several times a day, so they don't get too hungry.

- A long-lasting insulin such as ProZinc, Lantus, BCP PZI, or Levemir. No insulin lasts 24 hours in the cat, so giving it every 12 hours is optimal for control.

 

[MaineLove]

A good beginning would be to start with setting up your spreadsheet. Go slow and read the information on the introduction to this site and lots of reading sticky's in the different forums. Set up a binder to help you with the concepts. Post your questions and they are many who will help you along the way. Many food options are given on Dr. Lisa's recommendation from the introduction to this site.

 

[Ann & Tess GA]

What food are you feeding? Just like w/ people it's the calories in the food not the volume that is important. Most cats need between 20 and 30 calories per pound a day. If she needs to gain weight you can feed more. So an 8 pound cat would need between 160 and 240 calories a day. Most Fancy Feast Classics are 80 to 90 calories a can, so 3 cans would be fine, but as BJM said without enough insulin, the energy can't get into the cells and the cat feels hungry.

Here's the link to Dr Lisa Pierson's food list.  http://catinfo.org/docs/FoodChartPublic9-22-12.pdf

If you have a food that your cat likes you can get a much better price buying it by the case online, chewy.com has the best prices I've seen and very prompt delivery.

 

[MaineLove]

Thanks, Ann for providing the link. Still trying to navigate and learn how to post on the site and get information posted.

 

[Sienne and Gabby (GA)]

Welcome to Lantus and Lev Land!

It's normal for a cat to have a ravenous appetite until the kitty gets better regulated. Insulin is what helps glucose get into the cells in order to provide energy. With diabetes, there's not enough insulin for the process to work efficiently -- the glucose is floating around in the blood stream vs getting into the cells. The result is weight loss despite eating a lot. Working on getting the numbers into a better place will help appetite issues enormously.

I'd suggest broadening out your selection of food. Below 5% carb should be fine and that will expand your range of choices. Lots of people feed Friskies and Fancy Feast.

If you can get your test data into a spreadsheet, that will allow us to give you more help. Here are the instructions for setting up your spreadsheet.

 

[Mocha aka Cold Play]

How did your cat get diagnosed? by blood draw for fatty liver developed from chronic gum gingivitis not responding to antibiotic.

Was she given a steroid injection? NO. When the 2nd blood draw was done to check the liver, it was fine 3 months later but the glucose was then from normal to 400, where it has stayed since every time they check. She only exhibited the signs of thirst but no excess litter. But, that was evident after insulin. If it was not for excess thirst and the urine streams that were common for many weeks after insulin, I would have doubted the testing for stress.

I wanted to home test with the urine litter strips but hard to find marketed anymore and not a good read apparently since not from blood.

I was giving upper to mid body but she is thin and it seems the last few days that in fact side of the stomach is better absorbed and reduces her hunger.

Do you agree NOT TO FEED THEM 4 cans (400 cal for an 8lb) because it created more thirst and more urine? 3 cans according to Purina would be for a 9lb cat, and I feel that giving her extra calories at that level is her best response.

I am committed, I am not able to work so I am constantly with her and even at early in the morning if she comes to me to eat, I attend to her needs so she does not feel she won't get fed.

I will look into this Thank you for specifics - Home blood glucose monitoring with an inexpensive human glucometer such as the WalMart Relion Confirm or Target Up and Up (the pet ones will break your budget!). This saves you the cost of going to the vet for curves and done regularly, removes the need for a fructosamine test. All of our insulin guidelines use human glucometer numbers for reference. Tests at home may be 100-180 mg/dL lower than at the vet.
How many times a day do you test?
Where do you test?
And, is there any adjustment added to compensate for using the human test vs the vet?

She was on low carb 3 months prior 2% wet, so her diet was to her advantage. Purina One Beyond Salmon. I think the mini meals is best because I doubt giving her bigger portions would satisfy her and she would overeat and push the glucose too high.

She is on Lantus 1.5 2x a day, 12 hours apart.

 

[Chris & China (GA)]

Do you agree NOT TO FEED THEM 4 cans

400 calories is a lot for an 8lb cat, but until her numbers are better controlled, she'll need to eat more than a normal cat. I've never heard of feeding too much causing more thirst/more urine. Right now, her body can't use the food she's eating, so she eats more to compensate and try to "feed" herself. Think of insulin as a "key"....it unlocks the door to the cells to let the glucose in. Without the right amount of insulin (keys) to open all the doors, the cells are starving, so she eats more and more. As she gets better regulated, her appetite should come down

How many times a day do you test?

ALWAYS before shooting to make sure they're high enough to give insulin, and then at least one mid-cycle test on the AM cycle (somewhere between +5 and +7) and at least a "before bed" test on the PM cycle to make sure it's safe to sleep without setting an alarm to get more tests in later. Most cats go lower at night, so it's important to always get that "before bed" test in...so we'd like to see at least 4 tests per day, but if you look at the spreadsheets in most of our signatures, you'll see a lot of us test a lot more often. There's no such thing as too much data and knowing your cat and exactly what's going on inside their body is the best way to know that what you're doing is working!

Edited to add...+5 to +7 is 5 to 7 hours after the shot. We use the + system here because we're all in different time zones. +3 is 3 hours after the last shot, +8 is 8 hours after the last shot, etc..Once you get past +11, you're onto the next cycle, so the whole thing starts over

Where do you test?

Along the edge of the ear in the "sweet spot". When you first start, it's best to start with smaller gauge lancets (like 25-28 gauge) which make a bigger "hole" than higher gauge lancets, but as you poke more and more, the ears will grow more capillaries into the area and will actually "learn to bleed" which will make it easier and easier to get blood.

Here's a pretty good video on "how to home test" but there are lots of them on YouTube:

And, is there any adjustment added to compensate for using the human test vs the vet?

The protocols we use here are all based on human numbers, so there's no need to adjust the numbers you get to compensate for the numbers you'd get using a pet meter (and will just confuse you to try). Most vets will tell you that you can't use a human meter, but there are hundreds (probably more like thousands) of people here who have used human meters for many years and they do just fine. What we look for are "patterns" ...is the current dose getting them into the range we want them in the majority of the time? That's what's important.

With Lantus, dosing is based on how LOW it takes them, not the Pre-shot numbers (but we always want to get a Pre-shot just to make sure they're high enough to shoot)