Duration of impact of reducing carbs and what dose to give if late due to missing kitty?

Pabs&Ro

Pabs&Ro

Member Since 2020
I have two questions one about food and one about holidays please

1. Food. Pabay's diet was changed when he went onto feringa cold pressed - a reduction in carbs by over 4%. Despite the UTI (antibiotics commenced yesterday) his BG is slowly dropping over time even though I have not increased the dose. In your experience for how long does a change in diet impact the BG before it levels off?
2. Holidays. We are due to go on holiday and despite Pabay's love of our camper van he can't come sea kayaking. I have a super vet nurse that looks after him but she is worried about one aspect of Lantus. Pabay is usually around for his jabs but what if he comes in late? Should he have no insulin because of the overlap risk or a token dose? What do experienced lantus users do if they have to give a late injection because of a missing kitty?

I attach the previous threads for consistency. Many thanks.



https://www.felinediabetes.com/FDMB/threads/04-23-transition-to-lantus.246499/#post-2784089
 
A sea kayaking holiday sounds fun! Been a few years but I have done the same, also without the cat.:)

Pabay is overdue for his increase. A 4% change in carbs is not a huge difference. Manufacturing differences can make a couple % differences from lot to lot anyway. I don't see any significant drop in his numbers and you want his nadirs from 90 to 149, you have a ways to go. It's time to increase.

With Lantus, you have a bit of wiggle room. We say you can move the shot 1/2 hour once per day, or 15 minutes per cycle. If the vet nurse is a little late one shot and it's more than 1/2 hour, could she come a bit later the next shot and gradually move it back to the normal time?
 
Pabs&Ro said:
Sorry - being a bit dense here. How do I copy the link into a new thread as I have some questions? Thanks.
Click to expand...
Go to the browser URL at the top of your window, highlight it, and copy it (copying can be done many ways but depends on your device...if you need help, just let us know what device you are using - e.g., smart phone, computer, etc.). Once copied, you start your new post and paste it inside it.

To find your previous posts, click on your username in the top right of the webpage and then click on "Your content" - then you can find the last thread you posted.

Hope that helps that one part :bighug: have a wonderful time on holiday.
 
Wendy&Neko said:
A sea kayaking holiday sounds fun! Been a few years but I have done the same, also without the cat.:)

Pabay is overdue for his increase. A 4% change in carbs is not a huge difference. Manufacturing differences can make a couple % differences from lot to lot anyway. I don't see any significant drop in his numbers and you want his nadirs from 90 to 149, you have a ways to go. It's time to increase.

With Lantus, you have a bit of wiggle room. We say you can move the shot 1/2 hour once per day, or 15 minutes per cycle. If the vet nurse is a little late one shot and it's more than 1/2 hour, could she come a bit later the next shot and gradually move it back to the normal time?
Click to expand...
Sorry my husband is away so latest data is on mmol tab sorry. In the blue today which is rare. I know he needs an increase but not before we are back from our hols.
 
I "read" mmol/L - 185 is still too high for a nadir. And as you say, it is rare. How long until you leave for the holiday? Just wondering if you would have time to increase and see it's effects before you go. We would avoid a dose that gives greens, but I'm not sure the increase would do that.
 
We were supposed to do the increase today but with the uti and antibiotics we have delayed. Yes 185 is high in theory but with Pabay's history it is low for him. If we had increased today we would have just had time but not now. We are doing another curve on Saturday so we are 4 days later than we wanted to be. I have to be certain he will not have clinical or biochemical hypo. It is too much responsibility to pass onto a carer as it will happen when no one is home. Too frightening for me and I would not enjoy my hols for worrying. What dose would you say would avoid the green please? A fat 1.5?
 
Pabs&Ro said:
What dose would you say would avoid the green please? A fat 1.5?
Click to expand...
There is no way to know without trying. If you have 4 days before you leave (or ? days), you could increase tonight and see what numbers it brings, then back off the dose before you go. It's too hard to say what dose will work to give you numbers you want. Insulin is a hormone, not a drug. It's not like you add a little bit and the numbers get that much better. You have to keep increasing until you get the dose that fits.

The other thing that happens when you hold a dose too long is glucose toxicity. Sounds worse than it is, but it means their body gets used to higher numbers and it'll take even more insulin to break through.
 
Thanks Wendy,

I appreciate your considered opinion and your time in considering Pabay's situation.

Last night because of time lag I had already dosed him with the normal dose. His pre-shot reading was quite low so I made yesterday into a full curve. It was pretty good through the night too. I have had a long chat with the senior internal medicine vet that has overall responsibility for Pabay today. Apparently there is no research into how long a low carb diet takes to have a complete impact and there is no research being undertaken. In humans it takes 2 to 3 weeks to have a full impact. Pabay is only two weeks into a change so, and because of the circumstances, we have decided to leave the dose where it is until after our holiday.

I appreciate what you say about glucose toxicity but Pabay has been diabetic since June 2018 so another couple of weeks realistically is unlikely to have an impact. Also the figures have a general downward trajectory - and he is a happy cat. He has even put on weight which is fabulous.

Your views do inform my decisions. I consider everything and weigh it up before deciding. Thanks from both of us.
 
Our experience here, on probably hundreds of cats who have transitioned from high carb to low carb diets, is that you start to see changes in blood sugar within 3-4 days. As an extreme example, look at Scooter's spreadsheet. On February 18, Linda removed dry food from the house. She has many cats, and thought old man Scooter couldn't get to the dry. Apparently he could. The night of February 18th the numbers started down. February 19th was his last dose of insulin. 5.5 units to nothing in 24 hours.
 
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