? Should we take Kitty OFF the insulin?

[Carina Josefine]

Kitty want about a year otj, but a little while ago we noticed she was peeing outside the box and was REALLY hungry all the time. Most likely a chaest infection has bumped her out of remission, as she also started coghing around the same time. A week ago she started antibiotics (Baytril).

As Kitty has a history of pancratitis folowing unregulated blood sugar, the ve suggested we started on insulin sooner rather than later. So we did.

A few days later, she seems to be a bit of a mess, probably due to us. We held 0.1 the dosage for 6 cycles, not 7-10 days (as I know now that we should have done). To me it looked like too little, but input on Facebook suggest it was avtually too much, and instead of going up to 0.25 we should have taken her off it completely.

Any thoughts on this?

If we do, how long would she have to stay OFF the insulin, to see if we should start back up?

What can expect for the next days, if we do? Will she rise before she might stabilize?

Her sheet is in the signature

I appreciate all input. It was this input that got her into remission the first time around.

 

[Sienne and Gabby (GA)]

By any chance, did your vet get a fructosamine level? With a cat that's been OTJ, getting the fructosamine would have been helpful in order to know if numbers were elevated due to an infection along with stress related to being at the vet's office. The fructosamine gives you an average over a period of 2 - 3 weeks so you would know if numbers had been rising prior to the infection.

I'm not in agreement with the recommendations you received on Facebook. (Please keep in mind that there are a large number of people with limited experience who post on FB and many have no experience with Lantus. They rarely look at spreadsheets.)

With numbers in the 300s starting on 12/12, it suggests that insulin was needed. Generally, if a cat has an infection that's causing numbers to be higher than usual, as the antibiotic kicks in, numbers come back down. What makes Kitty's spreadsheet a bit harder to interpret is that some cats have a marked response to Lantus although the good numbers may be temporary.

I would suggest sticking with the current dose so you have a better handle on what the numbers look like. Let's evaluate in a couple of days. If nadirs are 200 or above, you'll want to hold the 0.1u dose for a total of 6 cycles and if under 200, hold for 10 cycles.

 

[Carina Josefine]

By any chance, did your vet get a fructosamine level? With a cat that's been OTJ, getting the fructosamine would have been helpful in order to know if numbers were elevated due to an infection along with stress related to being at the vet's office. The fructosamine gives you an average over a period of 2 - 3 weeks so you would know if numbers had been rising prior to the infection.

I'm not in agreement with the recommendations you received on Facebook. (Please keep in mind that there are a large number of people with limited experience who post on FB and many have no experience with Lantus. They rarely look at spreadsheets.)

With numbers in the 300s starting on 12/12, it suggests that insulin was needed. Generally, if a cat has an infection that's causing numbers to be higher than usual, as the antibiotic kicks in, numbers come back down. What makes Kitty's spreadsheet a bit harder to interpret is that some cats have a marked response to Lantus although the good numbers may be temporary.

I would suggest sticking with the current dose so you have a better handle on what the numbers look like. Let's evaluate in a couple of days. If nadirs are 200 or above, you'll want to hold the 0.1u dose for a total of 6 cycles and if under 200, hold for 10 cycles.

Thank you so much for giving me your thoughts.

It was high, the fructosamine. But it usually is with infections in her, and she never shows symphtoms untill she had them in the body for quite a while. So it doesn't help us much. I tested her at home or a couple of days before going to the vets, so I know the vet visit did not affect it.

Last night we bumped her up to 0.25 (it was today I got the recommendation to take her off it). So that is two shots with 0.25. Should we hold this dosage? Sorry for the inconsistency, making it hard to give advice.

I think the idea was that too much insulin also can look like "not enough".

 

[Wendy&Neko]

I think the idea was that too much insulin also can look like "not enough"

I wish people would stop blindly repeating that old chestnut. If people start at an appropriate dose, test to see what is happening with a dose, and increase by safe amounts, then it’s not too much insulin. The “too much” situation happens if people start at too high a dose, don’t test enough and increase by too much. None of which is an issue for you. What you are probably seeing is a bounce from the greens a couple days ago. Bounces can take six cycles to resolve.

I would stick with the 0.25 units for now, let the depot build with consistent dosing, unless kitty tells you this is too much insulin.

 

[Carina Josefine]

I wish people would stop blindly repeating that old chestnut. If people start at an appropriate dose, test to see what is happening with a dose, and increase by safe amounts, then it’s not too much insulin. The “too much” situation happens if people start at too high a dose, don’t test enough and increase by too much. None of which is an issue for you. What you are probably seeing is a bounce from the greens a couple days ago. Bounces can take six cycles to resolve.

I would stick with the 0.25 units for now, let the depot build with consistent dosing, unless kitty tells you this is too much insulin.

Thank you so much for your input. It is sure confusing. Everyone is making sense in what they are saying. I just want to do right my Kitty.