Kinda new, not totally.

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Charlie M

Charlie M

Member Since 2016
My husband has already introduced Smokey on here a little while ago. I have been on the facebook page for a little while now too. Smokey is a very gentle boy, and total sweat heart. But shy and a bit of a scaredy cat! He is more than just a pet he is a big part of our family, and owns a big chunk of our hearts!

Smokey has been on a 2 unit dose of Lantus twice a day for over 2 weeks. We started at 1, moved up to 1 1/2 after a week and a curve, then up to 2 after another week and at home curve. Random tests, have started showing some really unexpected results for us, but yesterday started showing what we were apparently supposed to be seeing with him. I am quite concerned about this sudden change...this long after being on the dose. We are doing at home curve tests, but only occasional daily tests the last couple days. We have currently decided just to do preshot test for now, we are expecting to do another curve this weekend (expecting to hear from our vet today what course she would like to take as his curve was not showing an atypical response, and wants to get additional advice from the rest of the team before proceeding any further. One course she was debating was doing another curve before making any changes, and after yesterday's unexpected results, Im hoping this is what she will choose to do) and I have high hopes!

We are currently not looking for dosing advise, we want to trust this to our vet...they have always given the best care I could have asked for. My main goal here is to get extra tips to make this easier, and try to understand what's going on with him, as we try to get this under control with out vet help.

He is currently on Purina D/M, he is currently mostly eating canned, a little dry. We have had some major not eating issues in the past (to the point of being on a feeding tube for months). We will feed the best we can with what he will eat, but since he's accepting this food, we won't mess with it except to encourage him to eat the wet as much as we can. He is current only eating a very small amount of the dry, if any some days right now! We're very proud of him for this ... After we adopted him, and he finally started eating, he used to gag and even throw up from even from the smell of wet food (took us over a year just to get him eating a small can of wet each day) ...so, this is a huge leap for him!
 
Hi Charlie and Smokey, welcome!

Charlie M said:
He is more than just a pet he is a big part of our family, and owns a big chunk of our hearts!
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I know the feeling, I have that same feeling (and I know a lot of other people on this forum have this to) :joyful:

I’m not using Lantus so I can’t give you tips but my good friend @Robin&BB (and the person who have helped me a lot with my kitty Baco) gives her kitty Bat Bat Lantus and she’s a real trooper and has been around for years.
She can give you some tips!

Hope everything works out for you and Smokey!:bighug:
 
Hello and welcome to the FDMB!
Charlie M said:
We are currently not looking for dosing advise, we want to trust this to our vet...they have always given the best care I could have asked for. My main goal here is to get extra tips to make this easier, and try to understand what's going on with him, as we try to get this under control with out vet help.
Click to expand...
I'm just about to start making dinner for my family, but since you're not looking for dosing advice thought I'd spend a few minutes putting together some information to help you understand Lantus use in cats.

Learn how YOUR kitty is responding to insulin:
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose in the cycle

The example below is the nice shallow curve you're working towards (it usually takes awhile to get to this point). A relatively flat cycle is the ultimate goal. The plus numbers (+1, +2, +3, etc.) indicate how many hours it's been since the shot).

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. You'll probably see an active cycle if the +2 is the same/similar or lower than the preshot number. Continue testing!
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

The most important points about Lantus use (which even many vets do not understand) is the effects of Lantus are cumulative and doses should be adjusted based on how low the dose takes your cat (the nadir). One dose builds upon the next and it takes at least 3 days (6 cycles) to "see" what a dose is capable of doing. This "cumulative effect" is characteristic of depot insulins (Lantus and Levemir). This article will go a long way in helping one understand the depot effect: Lantus & Levemir: What is the Insulin Depot?

You might also want to take a look at all the "Sticky" notes (highlighted in yellow) at the top of the Lantus/Levemir Insulin Support Group. You'll find a wealth of information... if I do say so myself. :D


FYI: I can see your spreadsheet! It looks like Smokey is doing well so far. Are you using a pet-specific meter?


Have to get started making dinner, but will check back later. Again, if you have specific questions after reading through the material, please post your questions on Health (the Main Forum) or in the Lantus/Levemir Insulin Support Group.
 
This is a wonderful site! I have been wondering around here most of the week. I've read a lot of the stickies, they have helped answer a lot of questions...especially when Smokey's not fitting what I've been reading, or heard in other places. I am a very slow reader, so most of this is taking me quite a while to get through.

The main thing that threw me was that his preshot numbers suddenly dropped like drastically! The vet had us doing his curve with no food after his preshot breakfast, so the lower numbers after a curve didn't mean anything to me (he would have missed 3-4 feeding in that time)(we have talked to the vet, and agreed that from now on he will be getting his normal meals through out his curve test from now on). His numbers when we test do reflect exactly what his body language is telling us, so I'm quite confident the high numbers preshot were his norm. I'm confused as to why it would take over 2 weeks to start seeing things levelling out, and how it could just happen so suddenly.

This is just me thinking out loud now...
One thing I did read in another sticky was that the liver can play a big role in trying to stop the blood glucose from dropping...I think it was called nervousness liver? But, I was under the impression it didn't last more than a few days? When we first adopted Smokey he wasn't eating, we ended putting a feeding tube in. The vets were never able to give us an answer to what had actaully caused any of the problems because we had no prior info on him. In the end we treated for an enlarged lymphnode on the liver and fatty liver disease. He was in a perty bad state right from the day we adopted him. What I'm starting to think (from observing yesterday, and today) is maybe it's just how his liver deals with things, maybe he's just decided the BG can come down now? Maybe this is me just being stupid, I don't know?
 
Charlie M said:
I'm confused as to why it would take over 2 weeks to start seeing things levelling out, and how it could just happen so suddenly.
Click to expand...
Actually, you're seeing more progress in the 2 weeks Smokey has been on insulin than most. Your vet had you increasing the dose in increments of 0.5u which is more than we generally suggest. Luckily, your vet's method has worked for Smokey so far. However, it looks like you're getting closer to an optimum dose. You might want to talk to your vet about increasing in increments of 0.25 units or you'll run the risk of flying past his optimum dose... or worse, causing a hypo.

Suddenly seeing numbers even out is typical of Lantus use with cats. One can go along without seeing much happening and then, bam! All of a sudden the insulin is pulling the BG numbers down nicely. We see it happen all the time. The process can take months.

Just had another thought...
Most of us have links to our spreadsheets in our signature blocks. Take a look at them so you can get an idea of what happens with a cat on insulin.

Keep asking whatever questions you may have. There's a lot to digest. Your posts will get more attention and a variety of responses on Health and/or the Lantus & Levemir ISG.

Have a good evening! :)




 
Was already think we shouldn't go up more than 1/4 if anything. Especially now that we are seeing lower numbers at preshot. After today, I don't think I'd be comfortable upping his dose at all without another curve, just to see if the lower numbers have dropped much too. And I think it would give us a better idea of when he hits his lowest if he was eating during it, I don't totally trust the non eating curve for that.
 
Charlie M said:
Oh no, he's been at 2 units for over 2 weeks, he's been on insulin over a month now.
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You're seeing remarkable progress in the short time he's been on insulin. Take a look at other's spreadsheets. There are plenty of caregivers who would LOVE to see the progress you've seen already!
 
Not sure what happened there, my iPad doesn't quite like this site, it keeps refreshing and jumping.

I missed the second half of your response. That makes more sense!

So this really is a good sign! That is great to hear. The numbers look good now, but I would never have imagined they would just...poof...go to where they were supposed to for no reason!
 
I was actually quite glad you talked to me here, I'm still wanting to lay low for a bit...I really feel like an idiot, and a basket case right now! He really means so very much to us! and I don't want to miss something and loss him over something stupid!
 
Charlie M said:
I was actually quite glad you talked to me here, I'm still wanting to lay low for a bit...I really feel like an idiot, and a basket case right now!
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I'm afraid I can't stick around tonight. I have a couple of my younger grandchildren here and they wake up at the crack of dawn!
Don't worry. Post on Health or the L & L Insulin Support Group. Nobody bites and we all started out exactly where you are now! :)

 
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