? 07/24 Pickles AMPS +3 365, PMPS 285 - dosing help: relapsed, vetsulin to Lantus

picklesmom

picklesmom

Member Since 2020
Here's background from my post a few days ago - link

I got out my alpha trak today in preparation for tomorrow when I'll call my vet to request Lantus pens. I have vetsulin they gave me on Friday in the fridge but I understand Lantus is better so I'd like to do that instead. My SS is up to date for today's tests. First one was via foot pad bc I was feeling anxious, but he was so good about letting me use his ear for the second one.

So here are my questions:
  • I was very comfortable with the test, feed, wait, shoot protocol of vetsulin when he was diagnosed back in 2020. How does lantus differ?
  • Assuming his pretest number is around 285 again tomorrow before dinner, what dose of lantus should I give?
  • I'm obviously very sad that he relapsed after 2 years OTJ. Is there any chance he could go into remission again? Back when he was originally diagnosed he was drinking/peeing like crazy and that's not the case now. Also his PS#s were around 450 back then, today it was 285. This gives me some hope that he's not "too far gone".. is this a fair assumption?
  • The vet did show me he had some swollen gums, so maybe it was that? Should I focus on the teeth now or try and get started on the diabetes then figure out the teeth? I know teeth issues can cause a relapse.
  • My family and I will be out of town this wednesday and thursday for a pre-op appt for my son's heart surgery. We leave like 4am on wednesday. My plan is to leave out a lot of wet food for him and then my mom will stop by after work around 6pm to feed him again. Should I skip the Lantus knowing 12 hours wouldn't have lapsed since the night before? And then have my mom dose him that night? My mom would sleep over wednesday night so she can do the morning shot on Thursday. I'm not confident she'll manage getting a pre-shot test however..
 
Welcome to LLB. The main reasons for cats falling out of remission are dental issues and infection so you are correct about that. How soon would you be able to schedule a dental? You have a lot on your plate right now with your son needing surgery. When would you be giving insulin and how early would the shot be? Generally we don’t shoot more than 30 minutes early especially without data as to how lantus works for him. So I would skip the shot that morning. Will you be back by Thursday night?
Lantus is dose based upon how low it takes your cat and not preshots. You test before shots to make sure the bg is not too low to shoot. Then you feed to make sure your cat will eat and then shoot right away. The whole thing takes 5-15 minutes. Lantus onsets, kicks in, around +2-3. Being a depot insulin it takes 5-7 days for the initial depot to build and to know how he’s doing on the dose. After that it depends which method you follow as to how often you increase and when to decrease the dose. You can read all about this on the stickies at the top of this forum. We suggest when new not to shoot under 200 without asking for advice.

Given the situation I am thinking it best to start with a dose of .5 and maybe even leave out some young again in case his bg drops. I’m going to discuss with a few others and get back to you.

@Bron and Sheba (GA) @Wendy&Neko @Bandit's Mom
 
tiffmaxee said:
Welcome to LLB. The main reasons for cats falling out of remission are dental issues and infection so you are correct about that. How soon would you be able to schedule a dental? You have a lot on your plate right now with your son needing surgery. When would you be giving insulin and how early would the shot be? Generally we don’t shoot more than 30 minutes early especially without data as to how lantus works for him. So I would skip the shot that morning. Will you be back by Thursday night?
Lantus is dose based upon how low it takes your cat and not preshots. You test before shots to make sure the bg is not too low to shoot. Then you feed to make sure your cat will eat and then shoot right away. The whole thing takes 5-15 minutes. Lantus onsets, kicks in, around +2-3. Being a depot insulin it takes 5-7 days for the initial depot to build and to know how he’s doing on the dose. After that it depends which method you follow as to how often you increase and when to decrease the dose. You can read all about this on the stickies at the top of this forum. We suggest when new not to shoot under 200 without asking for advice.

Given the situation I am thinking it best to start with a dose of .5 and maybe even leave out some young again in case his bg drops. I’m going to discuss with a few others and get back to you.

@Bron and Sheba (GA) @Wendy&Neko @Bandit's Mom
Click to expand...
Thank you for the response!
The vet I just went to might be able to do it soon, but I didn't love them. They pushed vetsulin and looked at me like I was crazy when I mentioned home testing. I have a "second opinion" type appointment with a specialty cat vet about 30 mins away on August 12. Ideally this vet would do any dental work and not the original vet. In general, 8am and 8pm works best for us. Yes, I'd be home thursday night.
 
Sounds like a vet who thinks cats are small dogs. I hope you like the next one but don’t be surprised if even a cats only vet isn’t up on fd. It that vet is good fir everything else we can help you with fd.
 
Some of the BGs in the SS are quite low considering you are using an alpha track meter. It’s really only in the beginning of the SS and the last day where the BGs have been high enough to start insulin. You do have a lot on your plate at the moment with your sons heart surgery…..are you going to be away for a length of time?
Because you are not going to be there to monitor the BGs , I hesitate to suggest starting insulin just yet. Have you tested the urine for ketones? I would suggest testing for ketones with a bottle of ketostix and if there are none, to hold off on the insulin for a few days until you are back, and can monitor the BGs, to start lantus.
I think getting the teeth treated should be a priority.
ETA…I now realise most of the BGs in the SS were not recent so the above information is incorrect…please disregard
 
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tiffmaxee said:
Sounds like a vet who thinks cats are small dogs. I hope you like the next one but don’t be surprised if even a cats only vet isn’t up on fd. It that vet is good fir everything else we can help you with fd.
Click to expand...
Yea I’m honestly not expecting much. This will be the 5th vet I’ve gone to in the past 2 years. But yea at some point I’ll just settle.
 
Bron and Sheba (GA) said:
Some of the BGs in the SS are quite low considering you are using an alpha track meter. It’s really only in the beginning of the SS and the last day where the BGs have been high enough to start insulin. You do have a lot on your plate at the moment with your sons heart surgery…..are you going to be away for a length of time?
Because you are not going to be there to monitor the BGs , I hesitate to suggest starting insulin just yet. Have you tested the urine for ketones? I would suggest testing for ketones with a bottle of ketostix and if there are none, to hold off on the insulin for a few days until you are back, and can monitor the BGs, to start lantus.
I think getting the teeth treated should be a priority.
Click to expand...
My SS is confusing because I only started using it really once he was going into remission back in 2020. So everything but the last line is old. I’ll be away for 2 days. I just ordered ketostix with amazon one day shipping. Any tips for getting urine to test?
 
picklesmom said:
My SS is confusing because I only started using it really once he was going into remission back in 2020. So everything but the last line is old. I’ll be away for 2 days. I just ordered ketostix with amazon one day shipping. Any tips for getting urine to test?
Click to expand...
Can you put a line before the current 2022 tests please on the SS so there is no confusion, thanks:)
Here is a link to collecting urine HERE
 
Thanks much better thank you, although I should have picked up on the dates.
I agree with Elise on 0.5 units. I would skip the Wednesday morning dose.
 
Bron and Sheba (GA) said:
Thanks much better thank you, although I should have picked up on the dates.
I agree with Elise on 0.5 units. I would skip the Wednesday morning dose.
Click to expand...
I was finally able to fill his lantus and I started giving it this morning. His glucose was highest yet this morning - 404 (alpha trak). I still gave only .5. Is this right? Also, I'm assuming this is the SLGS method? should I plan to do a curve in a week? I'm nervous about that as I still struggle with just the preshot checks. Would it make sense to ask the vet to put a libre on him next friday?
 
Have you thought about using a human meter? They are much cheaper to run than a pet meter and the test strips are far cheaper.
Test before every insulin dose to see it is safe to give the dose and if you can get a test in during each cycle, that will be excellent data, as the dose is based on the lowest point in the cycle, not the preshot number.
Yes, that is good you gave 0.5 units. Stay with that dose for 5 to 7 days unless the BG drops under 90, and then you would reduce the dose. Here are the two DOSING METHODS
Have a look to see which one suits you better. When you decide, can you put that information into the SS and the signature please so we can see it…thanks:)
Keep practising the preshot tests and the mid cycle tests. It takes time so don’t worry.are you giving a treat with every test?
If you like, you could ask the vet to put on a libre for the first two weeks as you practise doing the BG tests.
Post every day so we can see your progress. I’m really glad you have swapped to Lantus.
 
Bron and Sheba (GA) said:
Have you thought about using a human meter? They are much cheaper to run than a pet meter and the test strips are far cheaper.
Test before every insulin dose to see it is safe to give the dose and if you can get a test in during each cycle, that will be excellent data, as the dose is based on the lowest point in the cycle, not the preshot number.
Yes, that is good you gave 0.5 units. Stay with that dose for 5 to 7 days unless the BG drops under 90, and then you would reduce the dose. Here are the two DOSING METHODS
Have a look to see which one suits you better. When you decide, can you put that information into the SS and the signature please so we can see it…thanks:)
Keep practising the preshot tests and the mid cycle tests. It takes time so don’t worry.are you giving a treat with every test?
If you like, you could ask the vet to put on a libre for the first two weeks as you practise doing the BG tests.
Post every day so we can see your progress. I’m really glad you have swapped to Lantus.
Click to expand...

Yes - I just got a human meter from Diathrive. I got it because of the cost and it requires 0.4 sample. I tested it on myself and it has a different test strip than the alpha trak where it shows you a window that you need to fill fully with blood. I thought I was using a big enough sample and it would only fill half way. It still gave me a result but in the owners manual it said you should retest if the blood didnt fill the whole window. This is why I just stuck with the alpha trak for now. Though this morning my poke got a ton of blood, which I'm not used to. I must have actually poked the right spot for once...

I read through the dosing methods and honestly can't tell the big difference between them. If I did TR, do I need to test multiple times a day forever? Or is this just to start? If it's forever I think I need to do the SLGS.

Yes, I'm giving a treat (Young again kibble) with each test.
 
Did you also get u-100 insulin syringes?

Just asking out of an abundance of caution since Vetsulin and Lantus are different strengths (u-40 vs u-100) and therefore require different syringes.
 
With TR you won’t need to test multiple times every cycle once you learn how she responds to insulin. People do TR with a full time job and we even have a thread about that. It gives the best chance at remission especially if you start with it.
 
tiffmaxee said:
With TR you won’t need to test multiple times every cycle once you learn how she responds to insulin. People do TR with a full time job and we even have a thread about that. It gives the best chance at remission especially if you start with it.
Click to expand...
I'd like to do that then. But shouldn't I be starting with a higher dose than .5? Based on the link above he'd start at at least 1?
 
picklesmom said:
Even if it's just 2-3 pieces after a test? What's the reasoning behind that?
Click to expand...
No kibble at all youri f you want to follow TR , to tell you the truth I don't know why
@tiffmaxee
Get some freeze dried treats instead

You can give her any freeze dried treats for a snack
most members give freeze dried treats , they are low carb, you can probably find them in some local pet stores also
I did a search for you on here and copied what some members said they use,

When testing you can give them a treat so they will associate after testing they will get a reward, any freeze dried treats are ok such as
PureBites Freeze-Dried Cat Treats with Chicken Breast 2.3 oz ()https://www.amazon.com/dp/B071P





Also chewys has freeze dried treats also


The freeze dried treats you can get at petsmart, petco and order from chewy. Purebites is popular (cheaper if you buy the dog food ones). My crew like vital essentials it's dehydrated freeze dried raw comes in flavors

freeze dried minnows, made by Vital Essentials. I also buy the ones made for dogs. They're the same as the freeze dried minnows for cats. just cheaper. They also carry other freeze dried treats. I ordered mine through Amazon.

I think the vital essentials are more of a crunchy texture than the purebites

If you cat likes any of these you can buy the bigger bags for dogs they are the same ,you will get more for your money just break then up into smaller pieces
.

You can Google freeze dried treats and see what other ones there are and different flavors
Just make sure that is the only ingredient in them meaning turkey, chicken, minnows etc

Here is another one , I see you can get these in different flavors also just look
You may have to break any freeze dried treats in half if they are too big
https://www.amazon.com/Vital-Essent...ocphy=9003521&hvtargid=pla-630511512365&psc=1

Flavor Name: Duck Liver
Ahi Tuna
  • Chicken
  • Chicken Giblets
  • Chicken Hearts
  • Duck Liver
  • Minnows
  • Rabbit
Here is another one
You can give her any freeze dried treats for a snack
most members give freeze dried treats , they are low carb, you can probably find them in some local pet stores also
I did a search for you on here and copied what some members said they use,

When testing you can give them a treat so they will associate after testing they will get a reward, any freeze dried treats are ok such as
PureBites Freeze-Dried Cat Treats with Chicken Breast 2.3 oz ()https://www.amazon.com/dp/B071P

Also chewys has freeze dried treats also


The freeze dried treats you can get at petsmart, petco and order from chewy. Purebites is popular (cheaper if you buy the dog food ones). My crew like vital essentials it's dehydrated freeze dried raw comes in flavors

freeze dried minnows, made by Vital Essentials. I also buy the ones made for dogs. They're the same as the freeze dried minnows for cats. just cheaper. They also carry other freeze dried treats. I ordered mine through Amazon.

I think the vital essentials are more of a crunchy texture than the purebites

If you cat likes any of these you can buy the bigger bags for dogs they are the same ,you will get more for your money just break then up into smaller pieces
.

You can Google freeze dried treats and see what other ones there are and different flavors
Just make sure that is the only ingredient in them meaning turkey, chicken, minnows etc

Here is another one , I see you can get these in different flavors also just look
You may have to break any freeze dried treats in half if they are too big
https://www.amazon.com/Vital-Essent...ocphy=9003521&hvtargid=pla-630511512365&psc=1

Flavor Name: Duck Liver
Ahi Tuna
  • Chicken
  • Chicken Giblets
  • Chicken Hearts
  • Duck Liver
  • Minnows
  • Rabbit
Here is another one Halo Live A Littles
https://www.amazon.com/s?k=halo liv a littles&gclid=EAIaIQobChMIqM3npIiF-AIVEYnICh2PtQK6EAAYAyAAEgL--PD_BwE&hvadid=176944855419&hvdev=t&hvlocphy=9003521&hvnetw=g&hvqmt=e&he

https://www.amazon.com/Halo-Littles...ords=halo live a little&qid=1653847544&sr=8-1

Looks like they have other flavors also
 
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