Introducing Perry, 6/6 AMPS 218 | 6/5 AMPS 396

[Perry & Jenn]

Hi everyone, I've been mining the forums for information since late February, when Perry was diagnosed. Now that we're finally on Lantus, I needed a spreadsheet, so I had to join the forum!

Perry was already eating some low-carb wet food when he was diagnosed, so we got him off the kibble quickly and then waited to see whether he'd go into remission. He was up and down: a few urine test strips registering trace to +500, then a few clear, then a few at +250. Perry's a picky guy, so we do change his food up but always keep it below 5% carbs. (Dr. Lisa's list and the posts here about getting a picky cat to eat have been invaluable, thank you, everyone.)

I noticed Perry drinking more again the week before he went on Lantus. Our vet, who is fantastic by the way, decided to put him on one unit once a day to start. Four days later, he went in at +4 for a BG test and he was at 283. Vet decided to go to 1 unit of Lantus twice daily. That was two weeks ago.

I ordered an Alpha Trak 2 and started home testing last week, but not consistently, since I was still getting the hang of it. (Again, info here on the forum was invaluable.) Perry's thirst has been up for weeks at this point, and we were due for another check-in with the vet. Sunday night, I got my first successful drop from his ear just before his p.m. shot: 419. Yikes! The next morning, I didn't get a pre-insulin BG, but I did get one at +4: 311.

Then yesterday (Wednesday) morning, our sweet boy was very cranky. He didn't wake us up for food at 4:30 like he usually does, and he didn't want to eat breakfast. I got a BG: 396. After opening three cans, he finally decided to eat, so we gave him his 1u of Lantus ... and our very nice cat growled and then went and hid under the couch. We haven't had a DKA episode, thankfully, but I was pretty concerned at this point and ran him to the vet (after my husband lifted the couch so I could grab the kitty).

His usual vet wasn't in, but No. 2 vet immediately said, this cat is really constipated! We have two, so it can be hard to tell who's going, and we think they've both had some issues now that everyone is on the low-carb diet. The doc was like, hey it's not going to be pretty, but this cat needs an enema. He had trace ketones, but the vet was like, he is backed up enough to make him cranky, for sure.

Poor Perry came home smelling kind of poopy and with seriously ruffled feathers on his backside. He wouldn't let me help clean him up much--he was clearly hurting back there. Our vet called when she got in and recommended bumping Perry to 2u in the morning, still 1u of Lantus in p.m. With the high numbers and trace ketones, it made sense.

But then, this morning--once again, Perry didn't get us up to eat, but he was hungry at 5:45 when I got up--Perry's AMPS was 218. What?!? I decided to keep him at 1u for today. Is that because he hadn't eaten since 10 p.m.? Is that because the stress of being so constipated was finally off, and he was relaxing? Are we getting Lantus overlap? I don't know, but I'll test him this morning at 4+. Once again, I'm really glad I work at home so I can keep an eye on this guy.

(I just started the spreadsheet, and I'm still filling it out, so apologies for the lack of info there if you check it in my signature. I'm working on it.)

xo

 

[Sharon14]

Welcome! Yes constipation can raise numbers significantly. If Perry continues to have problems, you can add 1/8-1/4 tsp Miralax and extra water to his food. Some kitties will also eat plain canned pumpkin added to their food, which can help, but some cats won’t eat it. I think you should stick with 1u twice a day for now until you get more tests in, then go to either the Main Health Forum or the Lantus forum for dosing advice.

 

[Perry & Jenn]

Thanks Sharon! Update: Perry's +4 is 107. WOW. Really glad I didn't go for the 2u dose this morning!

One thing I was wondering was whether I could've posted this here and at the Lantus forum as well. Is that something people do, double post?

 

[Tracey&Jones (GA)]

Welcome!!! I am glad you stuck with the 1u. Yes, having the pipes backed up is not pretty in any stretch of the imagination!! Poor Perry.

You can post is both places and reference each other with a link. It is just hard with two posts as you may have people replying to both.

 

[Perry & Jenn]

Thanks Tracey! Yeah, really glad I stuck with the 1u. Next mission: Figure out how to make sure he doesn't get that backed up again.

 

[Sharon14]

Heres everything you want to know and more...
https://felineconstipation.org/

 

[Perry & Jenn]

This forum is THE BEST!

 

[Julie and Honey]

Welcome!

Looks like you already have some good info and experience.

I had the same issue with my cat going from dry food with fiber to low carb Fancy Feast pates. Problem is there is very little fiber in most low carb wet food. I add a couple spoonfuls of water to pate and also was using 1/8 teaspoon Miralax 2 x a day for several months and that seemed to fix the issue for her. Something changed in the last few weeks and she did not seem to need as much, now I am down to 1/8 teaspoon once a day and that seems to be working for her.

You can post basic health questions on the main Health Forum and post Lantus or dosing related on Lantus forum.

Would not recommend increasing dose until you have more data on current dose. I would post to Lantus board for help with dosing. They will recommend getting a curve after a week on the current dose. A curve is just testing every couple of hours over a 12 to 18 hour time period ( every 2 hours for 12 or every 3 hours for 18). People on Lantus board can help with any questions. Also, during the week if you can occasionally get a +6 during the day if you are home, that is generally, but not always the low point for a Lantus cycle. Also getting a reading a couple of hours after the PM shot to see how the night time is looking, cats tend to go lower at night. It is very possible you might be fine with current dose. If an increase is needed at some point, we normally increase by .25 increments. The reason is if you increase too much at a time you can miss the best dose for your cat and then they can end up on too high of a dose. By the way, 2 units twice a day is on the higher side for a recently diagnosed cat just starting on insulin, so would take it slow with the increasing.

 

[Perry & Jenn]

I had the same issue with my cat going from dry food with fiber to low carb Fancy Feast pates. Problem is there is very little fiber in most low carb wet food. I add a couple spoonfuls of water to pate and also was using 1/8 teaspoon Miralax 2 x a day for several months and that seemed to fix the issue for her. Something changed in the last few weeks and she did not seem to need as much, now I am down to 1/8 teaspoon once a day and that seems to be working for her.

I was wondering how much to dose as starting point for Miralax, so thank you, that's really helpful info.

 

[Julie and Honey]

Welcome!

Looks like you already have some good info and experience.

I had the same issue with my cat going from dry food with fiber to low carb Fancy Feast pates. Problem is there is very little fiber in most low carb wet food. I add a couple spoonfuls of water to pate and also was using 1/8 teaspoon Miralax 2 x a day for several months and that seemed to fix the issue for her. Something changed in the last few weeks and she did not seem to need as much, now I am down to 1/8 teaspoon once a day and that seems to be working for her.

You can post basic health questions on the main Health Forum and post Lantus or dosing related on Lantus forum.

Would not recommend increasing dose until you have more data on current dose. I would post to Lantus board for help with dosing. They will recommend getting a curve after a week on the current dose. A curve is just testing every couple of hours over a 12 to 18 hour time period ( every 2 hours for 12 or every 3 hours for 18). People on Lantus board can help with any questions. Also, during the week if you can occasionally get a +6 during the day if you are home, that is generally, but not always the low point for a Lantus cycle. Also getting a reading a couple of hours after the PM shot to see how the night time is looking, cats tend to go lower at night. It is very possible you might be fine with current dose. If an increase is needed at some point, we normally increase by .25 increments. The reason is if you increase too much at a time you can miss the best dose for your cat and then they can end up on too high of a dose. By the way, 2 units twice a day is on the higher side for a recently diagnosed cat just starting on insulin, so would take it slow with the increasing.

Just wanted to add here, I responded to post on Lantus forum about dose amounts. We refer to (1) unit twice a day as the cat being on (1) unit. When I responded here, I did not realize you were referring to a 2 unit dose actually being 1unit plus 1 unit, so 2 for the whole day. Just so in the future people understand what you mean. See below for clarification. Hope this makes sense.

1 unit am / 1 unit pm = we say cat is on 1 unit (not 2)
2 units am / 2 units pm = we say cat is on 2 units (not 4)

 

[Perry & Jenn]

Just wanted to add here, I responded to post on Lantus forum about dose amounts. We refer to (1) unit twice a day as the cat being on (1) unit. When I responded here, I did not realize you were referring to a 2 unit dose actually being 1unit plus 1 unit, so 2 for the whole day. Just so in the future people understand what you mean. See below for clarification. Hope this makes sense.

1 unit am / 1 unit pm = we say cat is on 1 unit (not 2)
2 units am / 2 units pm = we say cat is on 2 units (not 4)

That does make sense, thanks Julie! Hard to help when you don't know what someone is talking about, eh? I'm learning, I'll get there!

 

[Sharon14]

I was wondering how much to dose as starting point for Miralax, so thank you, that's really helpful info.

Miralax 1/8-1/4 tsp once or twice a day. If he’s going normally I’d do 1/8 once a day, but if it looks like he’s starting to have trouble or poop looks dry, up it to twice a day and increase as needed. Always add water to the food too.