New Member with Established Spreadsheet Seeking Guidance

Hello,

My cat Bea, who will be 15 in early July, was diagnosed January 2021 and her diabetes is believed to be steroid induced. She has small cell GI lymphoma (diagnosed May 2019) believed to be in remission at this time and she still needs to take a steroid to control GI issues. She is no longer on chemo. I am concerned because it seems like we are moving in the wrong direction after having what seemed to be early success managing her diabetes. Part of the success we have had seems attributable to having been able to reduce her steroid (dexamethasone) to the lowest dose possible. At one point her insulin was dropped to once per day in the evenings when she was taking her steroid (advised by internal med specialist because of steroid/BG rise link). Fructomsamine tests had indicated prolonged hypoglycemia and the vet thought she was heading into remission. A few weeks ago her appetite declined. She had an ultrasound that was normal and labs showed nothing obvious (kidneys, thyroid, I think just about everything was checked out). There were no obvious signs of her cancer having returned although that could be happening at the cellular level. I was advised to increase her steroid. That has helped her appetite a bit (it's not normal but is okay) but has caused her BG to rise and I'm worried about controlling her diabetes. I also never have any idea if her changes in appetite are attributable to the diabetes or the lymphoma. She is acting normal but drinking a lot of water. No vomiting or diarrhea. Her most recent increase to one unit of Lantus, twice per day, was initiated in the PM on 6/9. How long does it take to see a change in numbers after an increase like that and when should another increase be considered? I am also wondering if I should consider having a new insulin prescription filled before changing anything - I have a vial that is just under two months since I opened it and I do not see any indication of it being compromised, but wonder if lost efficacy could be a factor? Does anyone have any insight for me? I just lost a kitty 2 weeks ago and want to do all I can to keep this one healthy for as long as possible. Just worried because she responded to the insulin at diagnosis in January much better than now, even though we were at the same steroid dose. Here is her spreadsheet:

https://docs.google.com/spreadsheet...RqU5PiQvetGWQ/edit?ts=601240b2#gid=1526124902

Thank you!

 

Hi Kristen I will tag a member for you that might be able to help you out with what's going on with Lantus and SCL

Wendy, Kristen has a lot of info in the remarks column that might be helpful about the different doses she's been giving
At one point she was only giving it once per day PM. Per her vet, she explains why in her post
@Wendy&Neko

Thank you Wendy I didn't know who else to tag

 

https://felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

Here is the link to read all about Lantus
It should be given twice per day

 

Hang in there Kristen @Wendy&Neko will most likely be on here later

 

Thank you!

 

I forgot to say that I'm so sorry to hear about your other kitty , I know how you feel
I lost Tyler's brother Perry last Oct kidney failure. It's so hard I know.

 

I also recently introduced the dr elseys food and don’t know if that is a problem for her and causing her numbers to rise. I took it away for a couple days and it didn’t seem like her numbers were much better. She’s rejecting many my food offerings, has always loved kibble, and I need her eating so have continued giving it to her. She is losing weight and I don’t know if it’s the cancer or diabetes

 

I tagged Wendy because she has had 3 kitties with SCL

 

Thank you and I’m so sorry about your loss too. My other kitty passed from lymphoma and both of the cats I still have have SCL. Been trying to wrap my brain around that one, all of them having lymphoma.

 

Oh wow, thank you. As I just replied on the other comment, I had three with SCL up til two weeks ago when I lost one. Sorry to hear others have multiple cats with this condition too.

 

You have a lot to deal with, I'm so sorry. Just hang in there I know when Wendy see's I tagged her she'll reply

 

Have you talked to your vet about trying budesonide instead of dexamethasone? It's a more locally acting steroid that works mostly in the GI system and for many cats doesn't impact their blood sugar numbers. Neko was on budesonide because her heart could not handle prednisolone. It didn't impact her blood sugars.

I'm surprised your vet has stopped the chlorambucil. Normally kitties stay on it past remission.

As for increasing the Lantus dose, typically you should see what the 1 units dose can do after 3 days or six cycles.

 

@Wendy&Neko Thank you Wendy, her cat has been in 1 unit for 5 days so far do you think she should increase it ?

 

Kirsten, have you looked at the dosing methods we use over on the Lantus/Basaglar/Levemir forum? The answer to Diane's question depends which dosing method you'd like to follow. Your kitty needs an increase, the question is when.

 

https://felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

Here is the link to read all about Lantus
If you are feeding any kibble at all you have to follow SLGS dosing method
I see you said he is eating some kibble

Might be a good idea to set up your signature, it's at the end of everyone's post in gray

Click on your name upper right hand corner , a drop down will appear , tap in signature , fill out info

• On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback. There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.