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AmandaBrook

AmandaBrook

Member Since 2021
New to this group by way of FB. My Brooklyn, 11 was diagnosed w/ diabetes a year ago. Her numbers were controlled until recently. Diagnosed a month ago with pancreatitis. I was told there are no treatments for her type. I did give her subcutaneous for 10 days.

Brooklyn was at 2 units once a day of Toujeo until pancreatitis. She happily wears a Libre. (Love to find a discount on Libre). She is now on 5 units once a day and her curves are improving. Brooklyn is also on generic Lyrica for neuropathy pain. Although she just stopped using the stairs I'm not certain she needs it and may ween her off as it's only been 3 days on it. She still jumps off and on my bed. Her Dr did suggest acupuncture but I cannot afford to do that @ $130 twice a week.

Food: Purina DM and transitioning her to wet food (not fun). She's not my only kitty in the house. Ivan is 3 and is happy eating whatever I offer. I'm hoping to find good wet food that is mild for her pancreatitis.
 
Pancreatitis inflammation makes the bg's go really bonkers and you can expect that for a very long time.

Glad to see you though and Welcome.


Also new member @YvonneHills seem to use both Toujeo and Libre. Perhaps you can support eachother.
 
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Hi and welcome.
Are you able to set up a spreadsheet and enter the BG numbers please?
We will be able to help you more of we can see a SS.
Here is a link to setting up the SS https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Toujeu is a very concentrated insulin so I would think that 2 units is a big dose.
I will tag @Sienne and Gabby (GA) as I think she know about Toujeu.

Pancreatitis is treated with pain medication, antinausea medication and subQ fluids until it settles down. Some cases settle within a day or two but others take longer. Once it has settled down the BGs should also return to what they were before. That is my experience.
She may have some neuropathy in her legs from the high BGs. Getting her into better numbers will help that and you can also give Methyl B12 tablets. One brand is Zobaline sold by lifelong.com
Getting her into low carb wet food will also help lower the BGs.

Do you have a hypo kit set up in case of low numbers. There is a link to setting up a hypo kit within this linkhttps://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
 
Thank you for the responses.
Yes, 5 units are high but she is wearing a Libre. Her increases were 1 unit at a time for 7 days at a time. She's only injected once a day. If there was no progress Dr had me increase a unit. When I do this I am home 2-3 days with her.
Thankfully she hasn't had typical signs of Pancreatitis but a test showed high numbers. When she was diagnosed last April her pancreas numbers weren't checked. My gut says she's had it this whole time. I'm surprised that I wasn't told to change her diet before we started insulin. She was 478 back then.
I do have pancake syrup on hand but so far she's never gotten under 180's.

When her numbers were high 400's she would eat wet food easily. I jumped on the wagon to get her used to it. Now that her numbers are in mid 300's her finicky self is back. However, I did find Applaws topper that gets her to eat the wet food but read Carageenen is bad?

That spreadsheet setup looks a bit overwhelming right now. I think the app I have for libre has spoiled me.
 
@AmandaBrook i am going to ask @Bandit's Mom to help you with the Spreadsheet as it is important we can see the BGs.
Are you happy with using Toujeo.?
Would you consider swapping to Lantus which is a similar insulin bit not as strong as Toujeo and it may be easier to regulate your kitty.
 
Just to add to Bron's information, most cats need to be dosed twice a day. Toujeo is three times as concentrated as Lantus. Regardless of the concentration, the duration is the same. While the package insert will say either form of glargine is dosed once a day, that information is appropriate to humans. A cat's metabolism is much faster than ours, hence the twice a day dosing. If you're using a Libre, you are probably seeing the insulin wear off at around the 12 hour point and the vet is increasing based on that information. I've come across only one research article comparing Lantus with Toujeo. It's from this month and as such, the pdf isn't available yet. The abstract indicates that they had a sample of 7 cats. The two insulins performed similarly with regard to duration -- both were dosed once a day and neither insulin lasted anywhere near 24 hours. The only difference appears to be that the curve for Toujeo was flatter. However, the abstract does not provide sufficient information about the methodology or about limitations of the study. Personally, with only 7 cats, I would not be jumping to recommend Toujeo.

Increasing the dose of Toujeo by one unit is the equivalent of increasing a Lantus dose by 3 units. The most rigorous and best researched dosing protocol for Lantus (Tight Regulation Protocol) for cats indicates that doses should be increased by 0.25 - 0.5u. I've attached a copy of the original article. One thing to keep in mind is that there is research supporting the use of Lantus in cats. There is only one article investigating the u se of Toujeo (the one I mentioned above) and it's from this month.

There is a huge risk of overdosing your cat using Toujeo. It's hard enough to measure a 0.25u dose using Lantus.. It would be next to impossible to do this with Toujeo.
 

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Sienne and Gabby (GA) said:
Just to add to Bron's information, most cats need to be dosed twice a day. Toujeo is three times as concentrated as Lantus. Regardless of the concentration, the duration is the same. While the package insert will say either form of glargine is dosed once a day, that information is appropriate to humans. A cat's metabolism is much faster than ours, hence the twice a day dosing. If you're using a Libre, you are probably seeing the insulin wear off at around the 12 hour point and the vet is increasing based on that information. I've come across only one research article comparing Lantus with Toujeo. It's from this month and as such, the pdf isn't available yet. The abstract indicates that they had a sample of 7 cats. The two insulins performed similarly with regard to duration -- both were dosed once a day and neither insulin lasted anywhere near 24 hours. The only difference appears to be that the curve for Toujeo was flatter. However, the abstract does to provide sufficient information about the methodology or about limitations of the study. Personally, with only 7 cats, I would not be jumping to recommend Toujeo.

Increasing the dose of Toujeo by one unit is the equivalent of increasing a Lantus dose by 3 units. The most rigorous and best researched dosing protocol for Lantus (Tight Regulation Protocol) for cats indicates that doses should be increased by 0.25 - 0.5u. I've attached a copy of the original article. One thing to keep in mind is that there is research supporting the use of Lantus in cats. There is only one article investigating the u se of Toujeo (the one I mentioned above) and it's from this month.

There is a huge risk of overdosing on your cat using Toujeo. It's hard enough to measure a 0.25u dose using Lantus.. It would be next to impossible to do this with Toujeo.
Click to expand...

I agree people are different. I had diabetes and it does not feel great. I did email the Vet asking if I could split the dosage back down to 2 units and try twice a day but she wasn't for it. I am seeing that her #'s are more stable and not so up and down. I never increase her dosage unless I can be home with her a minimum of 2 days, all day. She was on 2 units daily until pancreatitis hit which is new for her. I'm really trying to focus on changing her food before I tell the Dr what I would like to do. I've also brought up Methyl B12 and she said once you have neuropathy you can't get rid of it. Which I know is true but we're talking quality of life. I've been giving her generic Lyrica but I'm not sure that's great either.
 
Bron and Sheba (GA) said:
@AmandaBrook i am going to ask @Bandit's Mom to help you with the Spreadsheet as it is important we can see the BGs.
Are you happy with using Toujeo.?
Would you consider swapping to Lantus which is a similar insulin bit not as strong as Toujeo and it may be easier to regulate your kitty.
Click to expand...
I'm going to take another look at the spreadsheet. Yes, I am open to it but picking my battles. I'm really working on Brooklyn's diet and adding Methyl B12 (after I get more info). Next will be discussing other options for insulin. I would think twice a day better myself. Dr thinks it "may help or may harm" - I think if I were able to go into the Dr w/ her it would be different. My reg Vet is not at the practice anymore and Covid we have to leave our pets. I'm just glad she gave me everything I needed to treat at home bc Brooklyn does NOT do well w/ the stress. She only trusts her family.
 
Hi Amanda,
Your vet is incorrect about neuropathy. I have seen many cats fully recover from diabetic neuropathy once the BGs are under control, including my own cat Sheba who had it quite badly. She would slip and slide when she walked on wooden floors, couldn’t walk up stairs, couldn’t jump on a chair and had to stop every few steps to rest before continuing. She fully recovered. Was again walking normally, able to jump, walk up stairs etc.
I used Zobaline from life link.com

Does your vet realise that cats’ metabolism is much faster than humans and they need the twice a day insulin for it to be effective.
Sienne is extremely experienced with all things feline diabetes so you can trust what she tells you.
I do understand how hard it is with Covid and not being able to talk face to face....it’s very frustrating to say the least!
 
Bron and Sheba (GA) said:
Hi Amanda,
Your vet is incorrect about neuropathy. I have seen many cats fully recover from diabetic neuropathy once the BGs are under control, including my own cat Sheba who had it quite badly. She would slip and slide when she walked on wooden floors, couldn’t walk up stairs, couldn’t jump on a chair and had to stop every few steps to rest before continuing. She fully recovered. Was again walking normally, able to jump, walk up stairs etc.
I used Zobaline from life link.com

Does your vet realise that cats’ metabolism is much faster than humans and they need the twice a day insulin for it to be effective.
Sienne is extremely experienced with all things feline diabetes so you can trust what she tells you.
I do understand how hard it is with Covid and not being able to talk face to face....it’s very frustrating to say the least!
Click to expand...


I just completed the spreasheet. I do have prior to April. Maybe I should add the previous 2 weeks? That is wonderful news about your kitty! I will look into ordering Zobaline. My understanding is you can't overdose so I reg dose should be sufficient?
 
I can see the spreadsheet. That is great. Very helpful. Yes if you can add more information it all helps.
If you look at the SS you can see that Brooklyn is responding to the insulin but is getting nothing for the other 12 hours so by the time the AMPS dose comes around again she is high again.
If you look at some of the other peoples SS you will see that when you give the insulin each 12 hourly, the BGs start to come down as the body has insulin in the body all the time.
Are you able to take the odd reading in the pm cycle so we can see what is happening?
Another thing to consider is the body needs insulin for other things apart from bringing the BGs down. It is needed for the cells to utilise the glucose in the food.

Yes give the Zobaline as directed. I just sprinkled it on top of her food and she didn’t seem to notice it.
But for the neuropathy to improve you will need to also get those BGs down to more normal numbers.
 
Bron and Sheba (GA) said:
I can see the spreadsheet. That is great. Very helpful. Yes if you can add more information it all helps.
If you look at the SS you can see that Brooklyn is responding to the insulin but is getting nothing for the other 12 hours so by the time the AMPS dose comes around again she is high again.
If you look at some of the other peoples SS you will see that when you give the insulin each 12 hourly, the BGs start to come down as the body has insulin in the body all the time.
Are you able to take the odd reading in the pm cycle so we can see what is happening?
Another thing to consider is the body needs insulin for other things apart from bringing the BGs down. It is needed for the cells to utilise the glucose in the food.

Yes give the Zobaline as directed. I just sprinkled it on top of her food and she didn’t seem to notice it.
But for the neuropathy to improve you will need to also get those BGs down to more normal numbers.
Click to expand...
Just added all the info I have on her BG. I will make a point to try and do her reading 12 hrs after her AM. I've been so paranoid about her going low w/ the 5 units that I do scan her often. Might as well get our $ worth. Now I'm seeing how to really get better info from her readings! Finally feeling like I am doing everything I can for her thanks to this group!
 
Bron and Sheba (GA) said:
Amanda, here is someone else who recently started on Toujeo and has swapped over to Lantus. She was giving the Toujeo twice a day.
Not sure if you have seen these two threads
Keep posting each day so we can see how we can help you.
https://www.felinediabetes.com/FDMB/threads/re-toujeo-insulin-pens-libre.245467/

https://www.felinediabetes.com/FDMB/threads/help-dosing-advice-for-simon-needed.245677/
Click to expand...
Yes, I had answered questions regarding the Libre for her. I'm very tempted today to break up Brooklyn's dosing to twice a day down to 4 units- since I use pen vs syringe. Since she's not dipping low I feel I could do this w/out fear of her going hypo.
 
I've stayed on once a day Tuejeo and changed her food. Her numbers are way better! I'm just not sure when I can lower insulin. She's at 135 2 hr after eating but her shot is now due.
 
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