Hugo - pretty new here, AMPS 400s

liz king

liz king

Member Since 2020
So Hugo was diagnosed back in June, and started on Novolin. About a month in, the vet changed him to Lantus because we weren't getting anywhere.

Can someone just please glance at his SS and give opinions? I don't know if i should increase dose, or keep going and be patient. He is still no where near regulated.
 
liz king said:
So Hugo was diagnosed back in June, and started on Novolin. About a month in, the vet changed him to Lantus because we weren't getting anywhere.

Can someone just please glance at his SS and give opinions? I don't know if i should increase dose, or keep going and be patient. He is still no where near regulated.
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hi and welcome to the L&L forum. The best source for information on Feline Diabetes....the place you NEVER wanted to join.

Have you had a chance to look over the yellow stickies at the top of the L&L forum? They are valuable pages with information regarding different dosing methods. It's important to figure out a dosing method to follow. It helps us to better offer you advice.
 
Yes I think I am doing SLGS. But honestly at this point I just feel like I am throwing water on a fire, just trying to get his BG down by whatever means necessary. Im not holding out any hope of remission. I just want to manage his illness into a somewhat normal range.
 
I totally understand your frustration. My boys were on NPH(Novolin), one for ~5 yrs the other for a month. NPH is very hard hitting insulin. It's really not a good choice for cats. It would drop my boys #s by almost 1/2 w/i the first 2 hours, maintain "ok" #s for a couple more hours and then back up they went. It was ridiculous! Once we started Lantus I got 1 boy into remission(he was newly diagnosed) and the other was well regulated. You will be thrilled once you see the change start. But, it does take time to see results. the depot has to build which can take ~ a week. So, you generally don't see immediate results. But patience is key.

I'm going to ask that you make a notation on you SS when you began Lantus. Check out other peeps SSs how they indicated the switch. I made it very obvious on my SS.
So, it looks like you vet told you to start with the same dose of 5 units? If so, that's the first thing that needs to be changed. That is too much insulin. With NPH those doses may be needed but, generally not with Lantus/Levemir.
 
There's some things to know about Lantus. Unless your kitty is on a high dose due to certain medical conditions, dose changes are to be made in .25u increments. Lantus is also funny in that it doesn't like it's dose time messed with, unless done gradually and it doesn't like it's dose changed too fast. We hold our doses according to the protocol were following. With SLGS you hold your dose for 1 week, do a curve and adjust as needed.

So, I think your dose is probably too high. Someone else from the board can address that issue.
You need to hold your doses according to the method your following and adjust that dose following a curve, weekly.
Have i lost ya yet?
 
I just made the notation more obvious. And no, vet said start at 3. But I got impatient, I supposed, and raised it. I didn't know about the depot at the time. Don't you think his depot is filled by now? You actually think I need to go down, even with his BG being in the 400s most of the time?
 
liz king said:
You actually think I need to go down, even with his BG being in the 400s most of the time?
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We usually don't start that high. Heck in the veterinary physician desk reference(cheat book for vets...shhh don't tell;):p) only recommends 2 units starting out.
So Hugo's on LC canned food? I saw the Fancy feast notation but am unsure of the carb count. WE like to recommend under 10% carbs.

The depots probably established. The highs your seeing is probably some glucose toxicity resulting in insulin resistance. It's fairly common to see this in newly diagnosed cats.
I'm concerned that Hugo's on too high of a dose. I'm not one of the dosing gurus so, I'm going to tag some peeps that may be able to help guide you more with the dose. There are other medical conditions that can cause a cat to need high doses of insulin. I don't think you've reached that point. I'm thinking your seeing insulin resistance that will work itself out in time.;)

@Sue and Luci
@tiffmaxee
 
It seems that with Lantus and Levimir you transition from a different insulin at the same dose or very close. I’ve only used Lantus though.
So, change your subject to say asking for starting dose advice switching to Lantus from Novolin and add the ? prefix.
 
Hello there, is it possible to get a test at night? Often times our kitties do their best work at night ... I see that you haven't gotten a single after PM shot test...don't be discouraged...we'll find someone who might know more about glucose toxicity for you.

@Chris & China (GA) - do you know of someone who's dealt with this? Other suggestions for why this little furbaby doesn't appear to be responding to such a high dose right out of the gate...

Thank you!
 
Can you get some tests in at different points in the cycle during the day? That one blue at +6 makes me really wonder what's going on during the rest of the cycles.

As Sue said, it's just as important to get at least a "before bed" test on the PM cycle since most cats go lower at night.

Think of your spreadsheet like it's a puzzle. If the only pieces you fill in are the edges and one row down the middle, it's impossible to know what the picture is....by sprinkling pieces all over, the picture becomes easier and easier to see.

It's possible that Hugo is going to be a high dose cat and you may want to get him tested for acromegaly and IAA later (we don't suggest testing until they're over 6U and their dose has been raised correctly)...it's also possible he's getting too much insulin. More testing will help us know which is probably the truth.
 
I was just trying to be consistent in testing, and limit the torture of the poor boy. He handles his earsticks quite well, but still. I just took at PM +2, and it was 440. So they'res that. Do people think that I should actually go DOWN in units?
 
liz king said:
limit the torture of the poor boy
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I know it's hard, but you need to get this idea out of your head. The edges of the ear where we test have very few pain receptors so it really doesn't hurt him. Most cats aren't real happy about having their ears played with, but with the right treat, they quickly learn to get over it.

You're not testing him to hurt him....you're testing him to keep him safe and learn what's really going on inside his body.

See that pretty white kitty over to the left? That's my China....she was tested over 16,000 times and I bet you can't tell where I tested. She learned quickly that if she let me test her, she got a yummy piece of chicken and soon started to come running when I was getting the supplies out! If I had been "hurting" her, there's no way she would have done that. You can see on her spreadsheet how often she was tested (I'm an admitted test-o-holic)

liz king said:
Do people think that I should actually go DOWN in units?
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Yes, it's a possibility that he's getting too much insulin but without more testing, there's no way to know for sure yet. There are cats that just need that much insulin or that have one of the high dose conditions like acromegaly and/or IAA.
 
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