Pattheteacher25
Member Since 2025
@Christie & Maverick his numbers are increasing , even when the insulin dose is 4. Is it normal ?https://docs.google.com/spreadsheet...5nqgugPq1wqx8xeENXA9Dltkuis/edit?usp=drivesdk
Patricia&Garcia struggling to keep him healthy. ( Garcia the cat)
- Thread starter Pattheteacher25
- Start date
Christie & Maverick
Member Since 2017
Here is your previous post for continuity
New member looking for advice
His numbers really aren’t increasing if you take into consideration 20% meter variance, he’s just staying in the higher ranges where he’s gotten very comfortable, this is what Marje had referred to in your previous post as glucose toxicity, and it quite often takes a few increases to get BG numbers to break through.
Please also keep getting a before bed test, just so we can be sure he’s not actually dropping lower at night.
Has his previous ear infection completely cleared up now? Are you still giving any medication for that? Hang in there, Patricia, I know it is very worrisome when the BG values don’t seem to improve much, please also keep testing for ketones. How has Garcia been doing, has his diarrhea resolved? Is he still eating ok?
New member looking for advice
His numbers really aren’t increasing if you take into consideration 20% meter variance, he’s just staying in the higher ranges where he’s gotten very comfortable, this is what Marje had referred to in your previous post as glucose toxicity, and it quite often takes a few increases to get BG numbers to break through.
Please also keep getting a before bed test, just so we can be sure he’s not actually dropping lower at night.
Has his previous ear infection completely cleared up now? Are you still giving any medication for that? Hang in there, Patricia, I know it is very worrisome when the BG values don’t seem to improve much, please also keep testing for ketones. How has Garcia been doing, has his diarrhea resolved? Is he still eating ok?
CORKY
Member Since 2023
What is Garcia's diet? have you tested for ketones? these are two of the frequent reasons for continuous high BG's, or there could be a UTI. also most of the time is their diet, diabetic cats need to have a wet can diet between 0-10% carbs, cats cannot digest carbs, so if you are feeding kibbles and free feeding this is probably the reason, and again there could be other issues I have not mentioned as well, I see you are using Lantus, so I will tag a member that is familiar with Lantus and can help you better, my Corky uses Lantus, I do not give dosing advice, and I am not familiar with the protocols for Lantus.
PS
after posting this, the previous post showed up, so I see that Garcia is having digestion problems , and an infection as well, Marje has super knowledge and I see she gave yu advice as well, hope both issues have been resolved
PS
after posting this, the previous post showed up, so I see that Garcia is having digestion problems , and an infection as well, Marje has super knowledge and I see she gave yu advice as well, hope both issues have been resolved
Pattheteacher25
Member Since 2025
http://Thread 'New member looking for advice'
Garcia is on a homemade cooked diet no carbs . His ear infection is cleared , his dhiarrea disappeared and he is eating , drinking and doing his usual routine . He is not and has never been a playful cat but I can tell he is feeling well because if he isn’t he hides in a wardrobe . He isn’t doing that , he is being sociable even with our dog.
@Christie & Maverick Hi, sorry for the delay in answering ( I was giving classes)
Garcia is on a homemade cooked diet no carbs . His ear infection is cleared , his dhiarrea disappeared and he is eating , drinking and doing his usual routine . He is not and has never been a playful cat but I can tell he is feeling well because if he isn’t he hides in a wardrobe . He isn’t doing that , he is being sociable even with our dog.
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CORKY
Member Since 2023
Christie & Maverick
Member Since 2017
Excellent, I am glad to hear that Garcia is feeling well, that is definitely important! If you can keep getting a test or two this am cycle and a before bed test tonight, we can consider another increase tomorrow. As I said earlier, the before bed is very helpful so we can be sure that he’s not getting into lower numbers at night then going higher during the day. I don’t think he is, but I always feel better seeing those before bed tests at night.
Pattheteacher25
Member Since 2025
I’ll do so
Christie & Maverick
Member Since 2017
Great, thank you! Give Garcia a few belly rubs for me 
. I’ll keep watching the spreadsheet for updates later, and of course you can post as well with the tests if you have the time.
. I’ll keep watching the spreadsheet for updates later, and of course you can post as well with the tests if you have the time.
Pattheteacher25
Member Since 2025
Christie & Maverick
Member Since 2017
Hi Patricia, based on the last few days of testing, I’d go up to 4.5u today.
Pattheteacher25
Member Since 2025
Thanks . I’ll do that .
Hi Patricia
You & Christie have been doing great. I was hoping he’d start to break through this resistance by now.
Two questions:
1. How long after he was diabetic was he tested for acro? Do you have those test results?
2. Did they also test him for IAA (insulin auto antibodies). IAA can occur at any time and it causes antibodies to bind with the insulin so it’s not all available for use by Garcia. It is self-limiting after typically a year but if it’s diagnosed, there are things we can do to help break through it sooner.
We usually don’t recommend testing for either high dose condition until the dose gets to 6u twice a day. But it would be great to know if and when he was already tested and what the results were.
Pattheteacher25
Member Since 2025
@Marje and Gracie . @Christie & Maverick Hi, Garcia was diagnosed early days in December 2024. He was tested for acromegaly in February . I don’t know if he was tested for IAA.
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Thank you for that. Sometimes you can test too early for acro and even if they have it, it won’t show up yet.
If we get to 6u bid with no improvement, I’d suggest having him tested again and be sure they also test for IAA.
And just a gentle reminder to please not miss any before bed tests at night.
I saw you shot late one night and we need to show that on the SS. How late did you shoot and what was his PMPS? With Lantus, a late shot acts as a dose reduction so he’s playing catch up on that for a bit.
Pattheteacher25
Member Since 2025
Any time I shoot I pre test, should I put that info in any other way?
On 9/7, there is no PMPS. If the +1 was his PS because you shot an hour late, you would still put it in the PMPS column like this:
370 @ +13. That tells us you shot one hour late. Then all of your tests will go in the normal columns because every test is from how long since you shot. For example, a +5 when you shoot at +13 is still five hours since you shot just like a +5 would be if you shot on time.
Thank you. Best to always read back through the posts before posting to see what has already been covered. It’s why previous posts are linked…so members can quickly access and read back through. Also, the diet is in the signature block.
And there was no need to tag Sienne. Also reading back, you could have seen I told Patricia that Christie, a very experienced member would be helping in my absence. Moderators can be busy with many things on the board and there are many members who are extremely knowledgeable and can help with dosing. Christie is one of them.
Can you tell me the exact date he started insulin (not diagnosis date), and the date of the blood draw for the acromegaly test. In a study by the Royal Vet Clinic, one third of cats tested falsely negative for acromegaly if they were tested earlier than 73 days after starting insulin, but later were positive. We have seen this happen on FDMB.
Pattheteacher25
Member Since 2025
@Wendy&Neko Hi . We began with Lantus on 8th December . And he was tested for acromegalia last days of January. I got an appointment with a “specialist in diabetes “ that I left after 3 appointments when he told me diet wasn’t a priority when I asked him if I had to stop feeding him with kibble. He said the insulin was the only solution .
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Thanks for the information. Your spreadsheet says he was diagnosed 10th of December, so I had assumed he had started insulin after that. Knowing the exact "last days of January would be useful, but even if it was the 8th of December (a Sunday?) and the 31st of January, that means the testing was done 55 days after insulin was started. Well before the 73 days that it is recommended waiting before testing. As Marje suggested above, he probably should be retested at some point. If positive, there are treatments and there is a team at University of Buenos Aires who are leading researchers in this area.
Pattheteacher25
Member Since 2025
@Wendy&Neko Do you know who they are? My sister is a researcher for the University of Buenos Aires for dentistry so perhaps she knows them .
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School of Vet Medicine. Here is a paper by them so you have some of the names:
Pattheteacher25
Member Since 2025
@Marje and Gracie @Wendy&Neko @Christie & Maverick good morning . Garcia’ number today is 222!! Should I give him 4,5 of Lantus ? Or should I adjust the dose ?
Please hold the dose at 4.5. This is great!
Christie & Maverick
Member Since 2017
Wonderful to finally see something other than red and pink!
Pattheteacher25
Member Since 2025
Great , thanks
Our goal in fast-tracking was to get him to a dose where we started seeing numbers below 300. Mission accomplished! That doesn’t mean you won’t see higher numbers again….you will. And he will likely need more dose increases. But we stop the fast-tracking and allow the Lantus depot a little more time once we see below 300.
If you haven’t already, now would be the time to look at the two methods of regulation we have for the long duration insulins like Lantus and decide which you want to follow because the consistency and guidance of a specific method will help get him where he needs to be. Arbitrary dosing won’t do that. Our goal is to get him to a dose where his BGs during a cycle are between 50-120 on a human meter.
If you can follow the tight regulation program, it will allow us to increase the dose faster than start low go slow. Dose increases are usually after every six cycles if the nadirs are below 300 but above 120 and increases are 0.25u. If the nadir is above 300, we increase by 0.5u, and we can go back to fast-tracking if we need to.
For now, we should give him six full cycles at 4.5u twice a day and see how he does. Once you decide which dosing method you want to use, I’d like to have you move to the Lantus/Levemir/Biosimilars Insulin Support Group (ISG) on this board so more Lantus users will also have their eyes on Garcia’s SS and can help.
In the meantime, if you have any urgent questions and it is middle of the night in the US, you can change your subject line in this thread by using the dropdown menu on the far right in your first post of the thread and selecting “edit thread”. For this morning, you could have changed it to “Urgent need dosing advice please” and used the “?” Prefix. We have members who are on all night as they live in other countries around the world. Once the question is answered, you can change the thread title back and remove the prefix.
Were you able to shoot on time this morning? If not, how late?
Last note: “housekeeping”. Please fix the SS for the PM dose on 9/7 as I explained above so we know you shot late. Keeping the SS up-to- date is helpful especially if you wake up to a much lower number than expected. Have a great day.
If you haven’t already, now would be the time to look at the two methods of regulation we have for the long duration insulins like Lantus and decide which you want to follow because the consistency and guidance of a specific method will help get him where he needs to be. Arbitrary dosing won’t do that. Our goal is to get him to a dose where his BGs during a cycle are between 50-120 on a human meter.
If you can follow the tight regulation program, it will allow us to increase the dose faster than start low go slow. Dose increases are usually after every six cycles if the nadirs are below 300 but above 120 and increases are 0.25u. If the nadir is above 300, we increase by 0.5u, and we can go back to fast-tracking if we need to.
For now, we should give him six full cycles at 4.5u twice a day and see how he does. Once you decide which dosing method you want to use, I’d like to have you move to the Lantus/Levemir/Biosimilars Insulin Support Group (ISG) on this board so more Lantus users will also have their eyes on Garcia’s SS and can help.
In the meantime, if you have any urgent questions and it is middle of the night in the US, you can change your subject line in this thread by using the dropdown menu on the far right in your first post of the thread and selecting “edit thread”. For this morning, you could have changed it to “Urgent need dosing advice please” and used the “?” Prefix. We have members who are on all night as they live in other countries around the world. Once the question is answered, you can change the thread title back and remove the prefix.
Were you able to shoot on time this morning? If not, how late?
Last note: “housekeeping”. Please fix the SS for the PM dose on 9/7 as I explained above so we know you shot late. Keeping the SS up-to- date is helpful especially if you wake up to a much lower number than expected. Have a great day.
Pattheteacher25
Member Since 2025
Hi Marje. First of all thank you for being there . I gave him the shot only 40 minutes later than his shot time . He vomited before the insulin shot , after that he ate normally again . But now he is trying to pee and he can’t . I took him to the vet. His bladder is normal size , not full , he thinks it’s an ideopathic cystitis , he treated him with neural therapy and gave him a shot of Artrosan . (
Cats
Artrosan®, developed by Konig, is a pentosan polysulfate sodium (PPS)-based medication indicated for the treatment of interstitial cystitis. It acts as a urothelial cytoprotective agent, adhering to the surface of the ureothelium, complementing the defective glycosaminoglycan layer.) He also gave me CYSTAID CAPSULES to give him one per day with his food. He thinks the cystitis is an ideopathic , due to a stressful situation.
My second cat was diagnosed with idiopathic cystitis one week after Neko's diabetes diagnosis. 
Guess he was jealous of the attention. He was on something similar to Artrosan, but what was available in Canada. The biggest thing that helped him was going to a low carb, low phosphorus diet, with plenty of water added. I fed raw, but it didn't have to be that. I also put Feliway diffusers where he liked to hang out.
Next time you are at the vet, get them to show you where the bladder is so you can check it yourself.
Guess he was jealous of the attention. He was on something similar to Artrosan, but what was available in Canada. The biggest thing that helped him was going to a low carb, low phosphorus diet, with plenty of water added. I fed raw, but it didn't have to be that. I also put Feliway diffusers where he liked to hang out.Next time you are at the vet, get them to show you where the bladder is so you can check it yourself.
Pattheteacher25
Member Since 2025
Great advice about the bladder ! Thank you
You’re welcome. Forty minutes late is ok so I’m glad you shot. Generally, if it’s more than two hours, we skip. If you have to shoot late more than about 30/40 minutes, best to tag someone for help as it’s important for the next shot to be 12 hours later. Then we have methods to get him worked back to his normal shot time.
My Gracie also had sterile interstitial cystitis. If you can get D-mannose there, it’s also helpful.
Could you please update the SS? Thank you.
Pattheteacher25
Member Since 2025
Good Sunday !! I hope you are enjoying it. I have decided to go with the tight regulation program.
What should I do with today’s shot ?
CORKY
Member Since 2023
Christie & Maverick
Member Since 2017
Hi Patricia-since you have decided to follow TR, and since there has only been one nadir under 300 over the last six cycles, with all other nadirs above 300, you can increase to 5u.