Unstable diabetes

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Andreea&Tilica

Andreea&Tilica

Member Since 2017
Hi to all! I'm a new member. My cat Tilica a male 13 years old was diagnosed with diabetes 3 months ago . I started with insulin Humalog mix 25 but didn't work, Mixtrad 30 too. From the late November I have used Lantus but still isnt'working, sometimes his BG higher values are >500 mg/dl . It's very strange that after the insulin shoot BG increases. For example today at 9 AM preshoot insulin BG was 344 mg/dl 2 hours later 328 mg/dl and after another 3 hours rosed up at 383!! In the meanwhile he ate 20 g Royal Diabetic.
What cand I do? I need your advices , please.
Andreea from Romania
 
Welcome.
Lantus is a good insulin, better than the other ones you tried.
Most of us here test our cat's blood glucose at home using a human meter. We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
The information provided in the spreadsheet will allow us to see what is happening to BG at the various times after shot
What are you feeding? A low-carb canned is best. No reason for a prescription food.
You may have to provide some info on what yo are feeding since it may not be available in the USA where most of us reside.
Here is a link to home testing blood sugar
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
 
I agree with what Larry says-- I wonder whether some of what you are seeing is due to carbs in the food? I'm not familiar with the food you named-- is it dry or canned? Very few dry foods are appropriate for diabetics (even if the vet sells them to you as such!).

The spreadsheet is a great tool for getting all the test info in one place-- we're all very practiced at looking at spreadsheets and picking out patterns. If you need help setting it up, just let us know!

One more question: what is the dose of Lantus that you are currently using?
 
Thanks, I teste the BG at home too, with a human meter and it seems that his dose 5 ui/day isn't working. His feed is Royal canin diabetic or Hills m/d 70g/day administrated in 5-6 meals. I have to start usig that spreadsheet but today his BG increases after administration of Lantus:
- 09 am 344mg/dl 2ui shoot
- 11 am 328mg/dl
- 14 am 383mg/dl
I'am afraid to increase the dose , one month ago after the evening shoot 3 ui, in the morning the BG was only 42 mg/dl.

 
Hi Nan, his dose is 5 ui Lantus and he eats only dry food for diabetes: Hills m/d or Royal canin diabetic 18% carbs.
 
Andreea said:
Hi Nan, his dose is 5 ui Lantus and he eats only dry food for diabetes: Hills m/d or Royal canin diabetic 18% carbs.
Click to expand...
Hi Andreea,
You said the dose is 5 units of Lantus per day, 2 u in the morning and 3 u at night. Am I correct? What dose of Lantus was your cat started on? You said you are feeding dry food that's supposed to be for diabetics. Are you testing BG (no food before) before the AM and PM injections? I'm asking these questions to make sure I understand.

I don't use Lantus but what I'm going to say applies to all diabetic cats:
  1. we strongly recommend feeding only low carb wet food because almost every type of dry food will keep their BG higher, even diabetic prescription dry food
  2. you must test before each shot to see if the planned dose is too high or not
  3. you need to test about half way through the time between shots to see how low the BG goes
  4. a dose that's too low and a dose that's too high can look the same. A too high dose can cause the cat to release extra glucose from what's stored in the liver to compensate for a big drop from too much insulin.
  5. it's best to start on a low dose of insulin like 1 unit twice a day and raise it slowly by small fractions (example 0.25 u) so you don't go right past the good dose.
I suggest that you go post now on the Lantus and Levemir forum too. There are many experienced people there who can guide you through the Lantus dosing problems.
 
Larry and Kitties said:
A flat curve like that can mean that the dose is too high.
Is the RC/Hills food dry like I think it is?

This low BG to me could confirm that 2 units is too high
Click to expand...

Hi Larry,
Do you think that 2 ui twice a day it's too high? When I shooted 3 ui his glycemia was 450 mg/dl, the vet said me that his pancreas still produces sometimes a little amount of insulin, that's way hypoglycaemia occured. Yesterday in the evening 9PM before the second shoot his BG was 320mg/dl , it's very strange this curve . In the first 5 hours the BG level rises after that in the next 7 hours goes down..
About foood.. He eatsonly dry food dor diabetics wirh 18% carbs because he doesn't like wet food .
 
Kris & Teasel said:
Hi Andreea,
You said the dose is 5 units of Lantus per day, 2 u in the morning and 3 u at night. Am I correct? What dose of Lantus was your cat started on? You said you are feeding dry food that's supposed to be for diabetics. Are you testing BG (no food before) before the AM and PM injections? I'm asking these questions to make sure I understand.

I don't use Lantus but what I'm going to say applies to all diabetic cats:
  1. we strongly recommend feeding only low carb wet food because almost every type of dry food will keep their BG higher, even diabetic prescription dry food
  2. you must test before each shot to see if the planned dose is too high or not
  3. you need to test about half way through the time between shots to see how low the BG goes
  4. a dose that's too low and a dose that's too high can look the same. A too high dose can cause the cat to release extra glucose from what's stored in the liver to compensate for a big drop from too much insulin.
  5. it's best to start on a low dose of insulin like 1 unit twice a day and raise it slowly by small fractions (example 0.25 u) so you don't go right past the good dose.
I suggest that you go post now on the Lantus and Levemir forum too. There are many experienced people there who can guide you through the Lantus dosing problems.
Click to expand...

Hi Kris, I use 5 units per day, split in 2 ui in the morning and 3ui at night, or the other way round 3 ui in the morning and 2 ui in the evening depending on the BG level. If in the norning the bg is > 360 I shot 3 ui and at night only 2 units. Two months ago I started on 4 units per day but his BG stayed high >400 mg/dl.
Every day I check his BG before shot but the cat doesn't eat 1-2 hours before. I have to feed him 1-2 hous before testing BG becuase he becomes very hungry even if he eats about 40-50 g dry food untill that moment. The food manufacturer reccommends 65-70g per day for a 5 kg cat.
You are right about wet food but my cay doesn't like it, he has never eaten it. I have to try to make him eat wet food.
I have another problem about siringes in my country I can't find siringes with which I can measure 0,5 or 0,25 units, there are only 1 unit measurement.
 
Andreea said:
Hi Kris, I use 5 units per day, split in 2 ui in the morning and 3ui at night, or the other way round 3 ui in the morning and 2 ui in the evening depending on the BG level. If in the norning the bg is > 360 I shot 3 ui and at night only 2 units. Two months ago I started on 4 units per day but his BG stayed high >400 mg/dl.
Every day I check his BG before shot but the cat doesn't eat 1-2 hours before. I have to feed him 1-2 hous before testing BG becuase he becomes very hungry even if he eats about 40-50 g dry food untill that moment. The food manufacturer reccommends 65-70g per day for a 5 kg cat.
You are right about wet food but my cay doesn't like it, he has never eaten it. I have to try to make him eat wet food.
I have another problem about siringes in my country I can't find siringes with which I can measure 0,5 or 0,25 units, there are only 1 unit measurement.
Click to expand...
Thanks for the information, Andreea. I suggest that you go to the Lantus forum to post there. You need help from those very experienced people. Some of what they will say will be:
  • Lantus works best when you give the same dose twice a day. The dose is changed only every 3 days usually unless you're just starting on Lantus. Then the same dose is given for 5 to 7 days. They'll explain it to you.
  • You must work on getting your cat to eat low carbohydrate wet food only.
  • You'll have more difficulty with small dose fractions if you can't get syringes with half unit marks. There are no syringes that have 0.25 u marks so people "eyeball" those doses.
I suggest you go visit the Lantus forum now so you can start helping your kitty today. :)
 
Hi Larry, it's clear I have to change the dry food with wet food and must learn tha cat to eat it. When it happens that his BG is 200-250 I shot only 1 unit but after 12 hours the level jumps over 400 mg/dl. Larry you are right I think too that I have to increase to 2.5 ui but I haven't got a suitable siringe as I already said.
This evenig his BG was 308 so that I shot 2 ui.
 
Andreea said:
Hi Larry, it's clear I have to change the dry food with wet food and must learn tha cat to eat it. When it happens that his BG is 200-250 I shot only 1 unit but after 12 hours the level jumps over 400 mg/dl. Larry you are right I think too that I have to increase to 2.5 ui but I haven't got a suitable siringe as I already said.
This evenig his BG was 308 so that I shot 2 ui.
Click to expand...
I think it's possible to "eyeball" half way between 2 u and 3 u on your syringes. Later when you're good at that you can learn to eyeball 0.25 u and 0.75 u. If those are the only syringes you can get you have to make them work. :)
 
Kris & Teasel said:
I think it's possible to "eyeball" half way between 2 u and 3 u on your syringes. Later when you're good at that you can learn to eyeball 0.25 u and 0.75 u. If those are the only syringes you can get you have to make them work. :)
Click to expand...

Hi Kris,
It's very difficult to estimate 0.50 or 0.25 ui because the space between the marks is very tiny. I use a human siringe because pet siringes are not marketed...:(. I have only 3 siringes for vet use made in Germany, a vet gave them to me. They have only 0.3ml and the space between the marks is a little bit "larger" which would teach me to eyeball at least 0.5 half a space.
 
Andreea said:
Hi Kris,
It's very difficult to estimate 0.50 or 0.25 ui because the space between the marks is very tiny. I use a human siringe because pet siringes are not marketed...:(. I have only 3 siringes for vet use made in Germany, a vet gave them to me. They have only 0.3ml and the space between the marks is a little bit "larger" which would teach me to eyeball at least 0.5 half a space.
Click to expand...
I understand. Yes, the insulin syringes we use are 0.3 mL capacity so there is enough space to eyeball fractions of a dose. Is it possible for you to order syringes from out of the country or are there too many border restrictions? Can your vet order in what we call U100 syringes with 0.3 mL capacity?

Here's something else: could you put some coloured water into one of your syringes, carefully let out small drops and count how many come out between two syringe marks? That might give you a way to get dose fractions with practice. For example, if you get three drops between marks you can get 0.33 unit or if you only get 2 drops you can dose in half units. With practice you might be able to control the drop size quite well. Just an idea ...
 
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Kris & Teasel said:
Your kitty is very cute, Andreea. :)
Click to expand...

Thanks Kris :cat:, all of them are cute.
Today at 9 am hsi BG was 395 again therefore I shot 3 ui. After 3 days with a lower levels 300-350 this BG rises although I shot the same dose during these days , the same amount of food. I saw Teasel's levels on your spreadsheet, his values reach allmost 400 mg/dl but go down to 200 which is OK.
I'll try to complete for Tilica a spreadsheet too, but it's unpleasent to prik him every 2 hours:(. Speaking about priks I'll start to practice eyeballing 0.5 ui with the siringe 100 ui with 0.3 ml. I sent you 2 photos of siringe I was talking about.
 

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Andreea said:
Thanks Kris :cat:, all of them are cute.
Today at 9 am hsi BG was 395 again therefore I shot 3 ui. After 3 days with a lower levels 300-350 this BG rises although I shot the same dose during these days , the same amount of food. I saw Teasel's levels on your spreadsheet, his values reach allmost 400 mg/dl but go down to 200 which is OK.
I'll try to complete for Tilica a spreadsheet too, but it's unpleasent to prik him every 2 hours:(. Speaking about priks I'll start to practice eyeballing 0.5 ui with the siringe 100 ui with 0.3 ml. I sent you 2 photos of siringe I was talking about.
Click to expand...
Yes, these are standard U100 insulin syringes with 0.3 mL capacity. If they had half unit marks they would be easier to use for you but you can still learn to eyeball half way between marks.

I want to remind you of something that's important when using Lantus: your doses must be the same AM and PM for at least several days. It's a depot insulin which means that part of every dose is stored under the kitty's skin and is released slowly. If the doses vary AM to PM or day to day, the depot is depleted or overfilled and that can have a significant effect on how the dose you give will work. Did your vet explain this?

Would you be willing to set up the spreadsheet we use here? It can be seen by all the forum members and that's how we're able to offer advice on dosing, etc. The instructions are here:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
If you need help, there are people here who can assist or even set it up for you. Let me know.

Teasel is on a different insulin, It's called ProZinc and works differently from Lantus. He's also a very "bouncy" cat so his BG goes up and down more than it should. Once you get organized with a spreadsheet and testing, you can post on the "Lantus and Levemir" forum where there are many very experienced people who can help you use this type of insulin better for your lovely kitty.

So - important points:
  1. no dry food, low carb wet food only
  2. test AM and PM before feeding and injecting and at least one other time in between or before going to bed
  3. set up a spreadsheet and put in all the data you have so far, including at different doses
  4. don't vary the dose so much (Lantus users can explain a lot more about this)
  5. practice eyeballing half and even quarter units on your U100 syringes (get more of those if you can or, better yet, ones with half unit marks. Ask your vet.).
I hope this helps you. :) Also - you don't need to prick your kitty's ear every 2 hours every day. Most of the time 3 tests a day will be enough to know how the insulin is working.
 
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I see that you posted on the L&L forum. I put in the link to this thread so they can read our "conversation". You do very well in English, Andreea! Please ask if I use a word or expression you don't understand. :)
 
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