Changing insulin, needle sizes, food dance

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Mariette

Mariette

Member Since 2020
I am trying to navigate this new world and even though I've been reading a ton still have lots of questions. I hope it's okay to put them all together in one post.

Here's some background on Buddy:
https://www.felinediabetes.com/FDMB/threads/new-member-mariette-and-buddy-diagnosed-11-13.238819/

I've been planning on switching Buddy to Lantus and it finally arrived yesterday. I wanted to switch because I read that cats have a better chance of going into remission on Lantus. (I'm sure there's different opinions on that too) Unfortunately Buddy has not really responded to the ProZinc and I'm guessing he still needs a higher dose. Any opinions on switching at this stage? Little over two weeks on ProZinc. I have seen people recommend sticking it out for several months on a particular insulin, but will it cause any harm to switch at this stage?

And is it okay to switch to 3 units Lantus?
(I have bought the u-100 syringes as well)

I do think that Buddy's doing better overall in regards to drinking water, peeing and energy. But I'm frustrated that we're not seeing better glucose numbers yet.

Getting blood for the glucometer readings has become much easier, but the shots have not. Maybe even more difficult. Sometimes I'm lucky but it has also taken me an hour at times. He definitely notices the pinch of the needle. And I have to use some force to penetrate the skin. I think the scruff and upper back is quite scarred from many fights and parasites over the years. Forget the lower back. The skin immediately ripples when I just lightly graze that area. So I'm wondering what difference the needle gauges make. For his ears the thicker lancets is definitely better, but I wonder if I should try a thinner gauge for the needles. I've only used 29G. Will he feel 31G less? Could I have more trouble penetrating the skin with the 31G?

Then food is a great source of stress too. Buddy's now on wet low carb exclusively. He has to lose a lot of weight. He's 18.5 and has to get to 14. The vet wants him between 200-250 Calories a day. I am trying to get him in that range, but he's absolutely desperate for food. I try and space out the allotted amount during the day, but he cleans the plate immediately and asks for more. He just lies in front of the empty plate for hours. I'd feel more comfortable restricting his food if he didn't have diabetes but if he's not processing his food properly I'm afraid of causing harm by denying him food. Any thoughts or tips on how to approach his weight loss journey?

Thank you!
Mariette
 
Mariette said:
I am trying to navigate this new world and even though I've been reading a ton still have lots of questions. I hope it's okay to put them all together in one post.

Here's some background on Buddy:
https://www.felinediabetes.com/FDMB/threads/new-member-mariette-and-buddy-diagnosed-11-13.238819/

I've been planning on switching Buddy to Lantus and it finally arrived yesterday. I wanted to switch because I read that cats have a better chance of going into remission on Lantus. (I'm sure there's different opinions on that too) Unfortunately Buddy has not really responded to the ProZinc and I'm guessing he still needs a higher dose. Any opinions on switching at this stage? Little over two weeks on ProZinc. I have seen people recommend sticking it out for several months on a particular insulin, but will it cause any harm to switch at this stage?

And is it okay to switch to 3 units Lantus?
(I have bought the u-100 syringes as well)

I do think that Buddy's doing better overall in regards to drinking water, peeing and energy. But I'm frustrated that we're not seeing better glucose numbers yet.

Getting blood for the glucometer readings has become much easier, but the shots have not. Maybe even more difficult. Sometimes I'm lucky but it has also taken me an hour at times. He definitely notices the pinch of the needle. And I have to use some force to penetrate the skin. I think the scruff and upper back is quite scarred from many fights and parasites over the years. Forget the lower back. The skin immediately ripples when I just lightly graze that area. So I'm wondering what difference the needle gauges make. For his ears the thicker lancets is definitely better, but I wonder if I should try a thinner gauge for the needles. I've only used 29G. Will he feel 31G less? Could I have more trouble penetrating the skin with the 31G?

Then food is a great source of stress too. Buddy's now on wet low carb exclusively. He has to lose a lot of weight. He's 18.5 and has to get to 14. The vet wants him between 200-250 Calories a day. I am trying to get him in that range, but he's absolutely desperate for food. I try and space out the allotted amount during the day, but he cleans the plate immediately and asks for more. He just lies in front of the empty plate for hours. I'd feel more comfortable restricting his food if he didn't have diabetes but if he's not processing his food properly I'm afraid of causing harm by denying him food. Any thoughts or tips on how to approach his weight loss journey?

Thank you!
Mariette
Click to expand...
Happy to help in any way I can! (Full disclosure, I was incredibly frustrated by my guy’s continued high numbers, even at 4.5u, until just a couple days ago. Now we are AWAKE and looking at a dose decrease. IT IS POSSIBLE. I can link our threads here, so you can take a gander, if you’d like— let me know :cat::cat:
 
I’m a Lantus fan so glad you are switching. Looking at your spreadsheet I think it’s going to be a good switch for you. It’s best to use a human meter because our dosing methods were based upon them. It will be cheaper too. Have you read the dosing methods we use? You test enough for TR and it gives the best chance for remission.
 
Thank you all for the encouragement guys!

Thanks for your insight and tagging @Shelley & Jess :)
I'm holding on ProZinc for another day just to see what the numbers do. Also a little concerned that he might need a really high dose and in that case Lantus could get stingy from what I understand. It's a difficult decision.

@Emily Tuomey I'm so happy you have some good news for your guy. That's wonderful! It is comforting to see that it is possible. I might have to start increasing the dose a little more aggressively. I was trying to be careful and do small increments but might up 0.5 instead of 0.25 going forward.

Yeah it feels like I'm faciing a brick wall with Buddy. It was a difficult morning. He had his highest number yet, and my needle bent trying to push it through his skin. It was straight on, and just caved. That's a 29G needle so I'm guessing a no-go on the higher gauge.

Hi neighbor @tiffmaxee ! And thank you for your advice. I just got the Relion Prime and I will switch same time as when we switch to the Lantus. I've already taken a few measurements with the Relion and comparing that to the Alphatrak reading I get at the same time. The numbers are much closer than the readings I got comparing the previous human meter I had (ContourNext). I have some comparison numbers under the Remarks section. So I feel good about switching to the Relion.

I have read about the tight regulation and I saw that it is recommended to measure, feed and shoot in 10 minutes. That will be near impossible for us at this stage. When Buddy's hungry in the morning it takes a lot of coaxing to get him to sit still for the measure. And I haven't been able to shoot while he's eating. He needs to sit relaxed for me to be able to grab some skin. And that could take some time. I wonder if that's going to cause some problems with switching to Lantus. That I may not be able to shoot at exactly the designated time?
 
It takes about 20-30 minutes for the food to register so you can feed a little, test, and then feed more. He’s super hungry because of the high bg. Onset of Lantus isn’t for usually two hours.
 
Mariette said:
Thank you all for the encouragement guys!

Thanks for your insight and tagging @Shelley & Jess :)
I'm holding on ProZinc for another day just to see what the numbers do. Also a little concerned that he might need a really high dose and in that case Lantus could get stingy from what I understand. It's a difficult decision.

@Emily Tuomey I'm so happy you have some good news for your guy. That's wonderful! It is comforting to see that it is possible. I might have to start increasing the dose a little more aggressively. I was trying to be careful and do small increments but might up 0.5 instead of 0.25 going forward.

Yeah it feels like I'm faciing a brick wall with Buddy. It was a difficult morning. He had his highest number yet, and my needle bent trying to push it through his skin. It was straight on, and just caved. That's a 29G needle so I'm guessing a no-go on the higher gauge.

Hi neighbor @tiffmaxee ! And thank you for your advice. I just got the Relion Prime and I will switch same time as when we switch to the Lantus. I've already taken a few measurements with the Relion and comparing that to the Alphatrak reading I get at the same time. The numbers are much closer than the readings I got comparing the previous human meter I had (ContourNext). I have some comparison numbers under the Remarks section. So I feel good about switching to the Relion.

I have read about the tight regulation and I saw that it is recommended to measure, feed and shoot in 10 minutes. That will be near impossible for us at this stage. When Buddy's hungry in the morning it takes a lot of coaxing to get him to sit still for the measure. And I haven't been able to shoot while he's eating. He needs to sit relaxed for me to be able to grab some skin. And that could take some time. I wonder if that's going to cause some problems with switching to Lantus. That I may not be able to shoot at exactly the designated time?
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I use 28 gauge on Nico, and he’s a Maine Coon so he’s a big guy (although underweight atm), 30 was a no-go. And, I’m not an expert but the people here haven’t steered me wrong, and I’m so thankful they fast tracked Nico out of those SCARY-ASS black numbers. I soooooooooo understand that anxiety!!! Let me know how I can help. And, good luck Buddy!!
 
Mariette said:
@Emily Tuomey I'm so happy you have some good news for your guy. That's wonderful! It is comforting to see that it is possible. I might have to start increasing the dose a little more aggressively. I was trying to be careful and do small increments but might up 0.5 instead of 0.25 going forward.
Click to expand...
I know!! Isn't it great to see the wonderful job Emily is doing with Nico :)

Emily Tuomey said:
I’m so thankful they fast tracked Nico out of those SCARY-ASS black numbers.
Click to expand...
Emily is following the Prozinc MPM Dosing Method that allows for changing the doses faster than the Prozinc SLGS method (3 to 6 cycles as compared to weekly) And, the MPM method allows for larger increases (0.5u instead of 0.25u) if kitty is having nadirs over 200 mg/dL. More about the Prozinc Dosing methods can be found HERE
 
@Emily Tuomey where did you get the 28G syringes from? I want to try them out on Buddy. Hopefully it'll be easier to get through the thick skin. It's like trying to push through a solid leather belt!

Thank you @Shelley & Jess! MPM might be the way to go for us as well. I'm thinking it might be a good idea to keep him on the ProZinc for another week or so to just see if we can get some results. I'd feel great if I can just see a response. Right now it looks like the insulin is doing nothing.
 
Jess is thick skinned in the scruff and cause more resistance when trying to inject. I find it a lot smoother in the sides of her chest and side of her belly.
Have you seen this?
49823824412_72fd707b6e_o.jpg
 
Thank you @Shelley & Jess! I have seen that. I can't grab enough skin to lift on the flank or belly side. And he gets testy too. Hopefully when he starts losing weight more the skin will loosen a bit. But right now I'm only able to grab scruff area and sometimes above the shoulders, below the scruff. The lower back starts rippling if I just graze lower back.
I could work a bit at trying to desensitize the flanks. He's not used to being touched there. He's only had his first taste of human contact this year so I'm terrified of breaking that trust by hurting him.
 
Mariette said:
I could work a bit at trying to desensitize the flanks. He's not used to being touched there.
Click to expand...
I give it a nice little rub after I inject too, which he likes. I also count it down, like I would for a little kid. I’m convinced the flank is easier because he can see what I’m doing versus the scruff where it can be startling or unanticipated.. just my two cents.
 
Mariette said:
Thank you @Emily Tuomey! I'll try the flanks again :nailbiting:

Could you send me a link to the syringes you use please? I'm having an impossible time finding 28G u-40 syringes.
This is the only one I can track down:
https://www.adwdiabetes.com/product/18842/monoject-u40-pet-syringe-1cc-28g-1-2in-100ct
but it's 1ml.

Although if I have success in the flanks 29G may be okay.
Click to expand...
Sorry, apologies. We use 28G lancets and 29G syringes. We order from Chewy. But, try the flanks again. Lying down really helps too!
 
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