1/20 - New member, Brooke & Truffle switching to Lantus, once or twice a day?

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Trufflefluff

Trufflefluff

Member Since 2023
Hello, my name is Brooke and I am the owner of the sweetest kitty named Truffles! She was diagnosed as diabetic I would say around march of last year, this experience has been very difficult and emotional for me and tough on Truffles too but my girl is fighter! Truffles was on vetsulin up until about two weeks ago and we just started lantus! Our vet is wonderful person and actually gave us a pen for free to try out that someone had donated! We do use the U100 syringes to inject the insulin. On vetsulin truffles would usually take about 1.5 units and her numbers would constantly be all over the place (very dramatic highs to very lows) so we finally made the switch. Upon receiving the lantus the vet told me to start off at 2units once a day, I was not comfortable with that so we started off at 1 which was still way too much for her as she dropped below 50 within 6 hours or so. After reading information all of you have posted I started to give truffles .25 2x a day it seemed to have a much better impact at keeping her leveled. She stilled stayed mainly in the 200’s. After telling my vet about the 2x a day injections she strongly advised that I don’t do that because it’s not safe and with it being a long lasting insulin all she needed was once a day. Since then I have only been giving her 1/2 of a unit once and day and I am once again seeing that awful climb to the 400’s and maybe at best in the high 100’s around the 12 hour mark. Is it safe to give her the twice a day at a lower unit to keep the insulin working in her body? I don’t want to harm her but I just want her to feel better, she’s losing weight and I need her to gain it back, she’s down to about 6.9 pounds at this point and it breaks my heart! We also use a libre sensor so I can check at anytime, although we do still ear prick from time to time to compare the numbers. I am still new to lantus and I feel like I’m back to square one again, I just want her to be stabilized better. Truffles also eats fancy feasts naturals gravy and pate. Thank you, I look forward to your responses! :) I can also post truffles chart showing the 2x a day with .25 of lantus compared to the 1/2 once a day!
 
Hello and welcome. Sounds like you've got some great instincts. Humans get once a day Lantus. Cats have much faster metabolisms so we give them Lantus twice a day. If you only give once a day, the insulin will wear off long before the next shot. Which is what you've been seeing. My kitty started with Caninsulin too - that is what Vetsulin is called outside the US. Much happier when we switched to Lantus.

We'd love to see Truffle's blood sugar/blood glucose numbers. Most of us use a common format spreadsheet to share the numbers with others. Information on that and other information that can help us is in this post:
New? How You Can Help Us Help You!
 
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Welcome to FDMB.

There has been a good deal of research investigating the use of Lantus with cats. I've attached the earliest article that is the foundation research for the Tight Regulation Protocol with Lantus. It was published in 2009 in a leading veterinary journal. If your vet isn't familiar with the research, this is a good article to give her. In a few words, she's wrong. All diabetes management for cats is based on twice a day dosing due to a cat's fast metabolism. The American Animal Hospital Assn has published guidelines for the treatment of feline diabetes since 2018. This is a link to their guidelines and the recommendation is twice a day dosing. (I believe that Jason linked this in your PM thread. What I linked is a printable version.) As Wendy noted, your vet is likely looking at the dosing recommendations for humans, not cats.

What you're feeding Truffle sounds like it's all low carbohydrate. This is a link to a food chart with nutritional information -- including carbs. Since your kitty has lost weight, you may want to see if there's a low carb food that is higher in calories so you can help her to gain back some of that weight. Alternatively, you can feed her more often. Once Truffle's blood glucose levels are better regulated, she'll start to gain weight.
 

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Thank you all for the reply’s so far, it makes me feel better having others to reach out to as I have not met anyone who has a cat with diabetes so sometimes I feel like I’m all alone in this struggle. There are many times I’ve just cried because I feel so defeated but I will keep learning and doing my best for truffles and I won’t give up, I know we can get there. I’m still new to this website so I will post any information that you guys need in order to help you understand. I won’t bash my vet, if anything this lady has truly saved my cats life and has done a lot for me. She’s a low cost clinic and always puts truffles libre sensors on for free and has even had me come in on her days off to administer fluids for free for truffles, I even have her number so if I am worrried about something I text her and she reply’s right away! I won’t blame her for not being well versed in all subjects as I know she has to deal with so many other illnesses and medicines as well, if anything I do not mind teaching her more about lantus as I hope this will help her and other kitties who are diabetic in the future. I will look into some high calorie low carb foods, truffles has always been a picky eater and up until not long ago she’d rather starve than to eat pate or anything other than FF gravy’s. Yesterday truffles received 0.50U of lantus at 11:30 AM (I am a late riser) and last night I gave her 0.25U at 11:30 PM and her BG was roughly around 290, looks like she was under 180 from about 3AM-7AM this morning. Truffles has just finished eating at 11:30 AM today she is around 330 so I gave her 0.25U. I also try to feed truffles high protein snack through the day such a FF naturals chicken, salmon and tuna treats. Thank you all again for the responses so far, I am so happy to meet other people who love their kitties just as much as I do.
 
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As I had told Jason, my vet has openly told me that she does not have much experience with Lantus and Truffles is one of her first cats to use this insulin under her care, she did tell me she previously had a cat who already came to her using Lantus but apparently there was a lot of trouble trying to regulate it and the cat would constantly be in the high 500-600’s as this cat only revived it once a day as well! I don’t want to offend her by saying that she’s wrong and I’m right which I won’t, I just couldn’t possibly understand how any other insulin a cat would receive twice a day and with Lantus was only once and the numbers prove that 2x is the way to go, I am always safe and very much conscious of her numbers. Should I stay at the 0.25U if she is still around the 300’s pre shot? I don’t know if this insulin takes time to adjust and I don’t want to load her up with more just because I am not seeing results immediately, I am always safe with her dosages and what I feel is best. Also if truffles ever gets below 50 I have always just fed her FF gravy lovers to boost her back up and it does the job, I have never had to administer Karo syrup (which I am thankful for) I panic very easily lol.
 
Once we can see some of the blood sugar numbers you've been seeing, we'll be better able to help you with the dose. Since you have the Libre on and can track her, you can see how low she's going on a dose. With Lantus, we determine how to change the dose based on how low it's going. In the beginning, our more conservative dosing method would have you find a dose where her lows are in the range of 90-150.
 
Hey Brooke, keep up the good work.
Trufflefluff said:
As I had told Jason, my vet has openly told me that she does not have much experience with Lantus and Truffles is one of her first cats to use this insulin under her care, she did tell me she previously had a cat who already came to her using Lantus but apparently there was a lot of trouble trying to regulate it and the cat would constantly be in the high 500-600’s as this cat only revived it once a day as well! I don’t want to offend her by saying that she’s wrong and I’m right which I won’t, I just couldn’t possibly understand how any other insulin a cat would receive twice a day and with Lantus was only once and the numbers prove that 2x is the way to go, I am always safe and very much conscious of her numbers. Should I stay at the 0.25U if she is still around the 300’s pre shot? I don’t know if this insulin takes time to adjust and I don’t want to load her up with more just because I am not seeing results immediately, I am always safe with her dosages and what I feel is best. Also if truffles ever gets below 50 I have always just fed her FF gravy lovers to boost her back up and it does the job, I have never had to administer Karo syrup (which I am thankful for) I panic very easily lol.
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It's all good, Brooke. Don't stress on your Vet's lack of experience... as you put it, it sounds like she will learn from you & Truffles and that is great!

I highly respect my Vet, but there were definitely major items early on that I didn't agree with and was totally confused by that were contradictory to what I learned here and with my own independent research.

After educating myself some and going into a check-up appointment with complete confidence and sharing what I learned, the spreadsheet of how I am monitoring, and ALLLL the measures I have been doing to manage Kona, I think the Vet was taken back and now we are a team! I'm fully transparent, share information with every checkup, and the prescriptions/labs keep getting authorized. Some members have not had the best of luck with their Vets and they sometimes have the mentality of it's my way, or the highway. That's fine too, they find a different Vet and ultimately get the care they need.

It sounds like your Vet will be more on the supportive side, so that's good.

One day at a time! :bighug:
 
For your signature, you'll want to complete filling it out. For DX, that is the diagnosis date. You mentioned Truffles was diagnosed last year in March, so you'll want to update that to DX: 3/2023. Not sure what day...

Here is a draft example of what your sig should look like from what I pieced together in your post, please ensure it is accurate and add any health issues folks should know about that I have bolded below. I'm assuming you're going to start with Start Low, Go Slow as you're new to Lantus? https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

Brooke & Truffles / DX: 3/1/2023 / Lantus / Libre / LC wet Fancy Feasts Naturals gravy and pate / SLGS

  • Signature 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.
 
Hi Brooke and welcome!!!

I just have to say Truffles is the cutest :bighug::bighug::bighug:

Thank you for setting up your signature. If you could also setup a spreadsheet and plug in some of the libre numbers you have, that would be wonderful and it will helps us be able to give you dosing advice. There are many reasons for high numbers, including something called bouncing which typically happens after they have a low bg. We have 2 dosing methods we follow for Lantus here and how long you hold a dose depends on which you decide to follow. It can be 3 days or 7 days. The big exception here is if her bg drops below a certain number, which again depends on the method you follow. When that happens you immediately reduce the dose by 1/4 units. We mainly make all dosing adjustments here by 1/2 unit that way you don’t speed right past the ideal dose. Here’s the link to the Lantus forum. I suggest you read all the yellow sticky notes, especially the one on the dosing methods, which is the link Jason posted above: https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

you have very good instincts and im glad to hear you’re not feeding her only twice a day. Several meals or snacks throughout the day are easier on their pancreas and help avoid big sugar spikes.

I hear ya about the loneliness of it all. The support I got here was priceless to me, which is why I try to pay it forward as much as I can. The main thing to keep in mind is that feline diabetes is a marathon not a sprint. It may take some time, but you’ll get her regulated and we will help you!
 
Jason - Kona's Dad said:
For your signature, you'll want to complete filling it out. For DX, that is the diagnosis date. You mentioned Truffles was diagnosed last year in March, so you'll want to update that to DX: 3/2023. Not sure what day...

Here is a draft example of what your sig should look like from what I pieced together in your post, please ensure it is accurate and add any health issues folks should know about that I have bolded below. I'm assuming you're going to start with Start Low, Go Slow as you're new to Lantus? https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

Brooke & Truffles / DX: 3/1/2023 / Lantus / Libre / LC wet Fancy Feasts Naturals gravy and pate / SLGS

  • Signature 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.
Click to expand...
Kona is also the cutest!!! She looks a lot like Bobo he sticks his tongue out quite often
 
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Jason - Kona's Dad said:
For your signature, you'll want to complete filling it out. For DX, that is the diagnosis date. You mentioned Truffles was diagnosed last year in March, so you'll want to update that to DX: 3/2023. Not sure what day...

Here is a draft example of what your sig should look like from what I pieced together in your post, please ensure it is accurate and add any health issues folks should know about that I have bolded below. I'm assuming you're going to start with Start Low, Go Slow as you're new to Lantus? https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

Brooke & Truffles / DX: 3/1/2023 / Lantus / Libre / LC wet Fancy Feasts Naturals gravy and pate / SLGS

  • Signature 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.
Click to expand...

Yes! I have just completed the signature, I hope I did it right! I wanted to try and upload screenshots from my phone of truffles numbers from her libre account but for some reason I can’t figure out how to post it on here when I click upload file it doesn’t let me! If not, I will work on a spreadsheet of some sort to give everyone an idea of her numbers!
 
Ale & Bobo & Minnie (GA) said:
Hi Brooke and welcome!!!

I just have to say Truffles is the cutest :bighug::bighug::bighug:

Thank you for setting up your signature. If you could also setup a spreadsheet and plug in some of the libre numbers you have, that would be wonderful and it will helps us be able to give you dosing advice. There are many reasons for high numbers, including something called bouncing which typically happens after they have a low bg. We have 2 dosing methods we follow for Lantus here and how long you hold a dose depends on which you decide to follow. It can be 3 days or 7 days. The big exception here is if her bg drops below a certain number, which again depends on the method you follow. When that happens you immediately reduce the dose by 1/4 units. We mainly make all dosing adjustments here by 1/2 unit that way you don’t speed right past the ideal dose. Here’s the link to the Lantus forum. I suggest you read all the yellow sticky notes, especially the one on the dosing methods, which is the link Jason posted above: https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

you have very good instincts and im glad to hear you’re not feeding her only twice a day. Several meals or snacks throughout the day are easier on their pancreas and help avoid big sugar spikes.

I hear ya about the loneliness of it all. The support I got here was priceless to me, which is why I try to pay it forward as much as I can. The main thing to keep in mind is that feline diabetes is a marathon not a sprint. It may take some time, but you’ll get her regulated and we will help you!
Click to expand...


Well thank you very much, she’s my little poofy princess lol!

I was trying to post screenshots from my phone of her numbers but it won’t let me upload them :( I’ll try and workout a spreadsheet of some sort to give you and everyone else an idea! :) she’s almost at her +5 mark right now and libre is telling me she’s 217 so she’s ranging in the low 200’s (libre is usually about 5-7 points lower from what I’ve noticed)

I am so overwhelmed at the amount of responses and support I’ve received so far and I am so thankful for everyone here! This has definitely been a huge learning curve as I am still figuring new things out all the time, especially with the new insulin change I feel like I’m learning all over again but so far I am impressed with her chart and would like for her nadirs to get lower.♥️
 
We do have a common spreadsheet format we all use for the blood sugar numbers. Details in that thread I linked in post #2. Let us know if you need any help with this, we have people who are whizzes at the spreadsheets.

To add a picture, you have to copy and paste it to the text box. The Upload File button is currently not working.
 
Jason - Kona's Dad said:
Hey Brooke, keep up the good work.


It's all good, Brooke. Don't stress on your Vet's lack of experience... as you put it, it sounds like she will learn from you & Truffles and that is great!

I highly respect my Vet, but there were definitely major items early on that I didn't agree with and was totally confused by that were contradictory to what I learned here and with my own independent research.

After educating myself some and going into a check-up appointment with complete confidence and sharing what I learned, the spreadsheet of how I am monitoring, and ALLLL the measures I have been doing to manage Kona, I think the Vet was taken back and now we are a team! I'm fully transparent, share information with every checkup, and the prescriptions/labs keep getting authorized. Some members have not had the best of luck with their Vets and they sometimes have the mentality of it's my way, or the highway. That's fine too, they find a different Vet and ultimately get the care they need.

It sounds like your Vet will be more on the supportive side, so that's good.

One day at a time! :bighug:
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Thank you so much Jason for the warm welcomes and all the advice/information you’ve given so far! It’s been a big help!

I always always been 100% transparent with the vet as to what’s going on with Truffles and what I am doing insulin and care management wise as it wouldn’t help her to not give them the full rundown of everything. I’m hoping after they see my numbers and understand I am following safe protocols we can agree with each other but for now I knew I had to take things into my own hands and somewhat figure out what’s best for her. My vet and her team are truly amazing people and I don’t know what I’d do without them and she’s always very nice open to my suggestions. We’ll get there for sure!

I thought for sure when we started this journey almost a year ago we’d have everything figured out by now but that’s definitely not been the case but that’s okay because I am determined to get it right.
 
Wendy&Neko said:
We do have a common spreadsheet format we all use for the blood sugar numbers. Details in that thread I linked in post #2. Let us know if you need any help with this, we have people who are whizzes at the spreadsheets.

To add a picture, you have to copy and paste it to the text box. The Upload File button is currently not working.
Click to expand...


Okay great! Thank you so much for that, if her chart from my libre app seems confusing or needs more answers I can definitely make a spreadsheet! You’d think since im only 25 I’d be a technology wizard but I am getting more confused everyday with it lol.
 
Here and just to make it easier since we’ve thrown so many links at ya!

https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

You’ll see on my signature I’ve got their spreadsheets linked. As Wendy said, it’s the format we use and most of us are used to seeing the patterns in the color coded cells. You may hear us say something like nice blues and greens or she’s surfing those greens nicely ;) I wouldn’t be able to decipher a libre chart I’m afraid :nailbiting:
 
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This is what her libre chart looks like, she gets her shot at 11:30 everyday

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I will also say the more I play with her the lower she will go sometimes as I know exercise is very good for diabetics. I do have an automatic laser toy that goes off about every hour and I do have 3 other very playful cats. I do engage in playtime everyday with her, she isn’t a very old cat she’s only 7 years old, soon to be 8 this July!

Weird thing is my vet told me not to play with her too much because she might start producing her own insulin and go even lower in numbers which I thought was kinda strange.
 
Larry and Kitties said:
When/how often do you feed?
What was Lantus dose and how long on that dose?
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I feed her twice a day with FF pate (sometimes the natural gravy’s) and now I am starting to feed an extra can of FF pate throughout the day to help her gain weight back. Also FF naturals treat packs of salmon, chicken and tuna and she usually gets about 3 of those a day, it’s just a small piece of protein.

so right now I am giving her 0.25U 2x a day, she’s been on this dose for almost 2 weeks now, when my vet told me to stop the 2x injections of Lantus a day I did 0.50U once a day but only ended up doing that for 2 days as I could tell that was not helping her and she was starting to go into the 400’s again. So now we are back to 0.25U 2x a day. I was a little nervous with her shot tonight because her BG was around 214 and I didn’t know how low the 0.25U of Lantus would take her so I played it safe and gave her just tiny bit instead, kinda kicking myself though because she’s ranging in the 300’s at the moment but better safe than sorry.
 
Constantly feeding small meals throughout the day vuce onky two meals a day may level out BGs. Also, my experience with Libre is that at lower BGs the Libre read sugnufcanly lower that an ear stc wiuth human meter. Later the Libre 3 inducated 53 while the earstick w/human Relion Premier meter was 87. Tus, you may have room to increase dose a very little.
 
Larry and Kitties said:
Constantly feeding small meals throughout the day vuce onky two meals a day may level out BGs. Also, my experience with Libre is that at lower BGs the Libre read sugnufcanly lower that an ear stc wiuth human meter. Later the Libre 3 inducated 53 while the earstick w/human Relion Premier meter was 87. Tus, you may have room to increase dose a very little.
Click to expand...

That’s what I’m hoping to see is a more leveled out BG, initially I started just because she weighs 6.9 pounds compared to the 10-12 she used to weigh ):

I have never tested ears while her libre is telling me it’s a low number because I get extremely anxious and start to shake and I’m all around really bad in situations like that. I have done comparisons with the libre monitor vs ear prick on a normal day and it usually is about 5-7 points of a difference, the only time I got a 30 point difference is when her libre is first put on it still needs time to adjust and it will tell me to blood test to get more accurate results. It took me a very long time to ear prick just because truffles fights me A LOT, biting, scratching the whole ordeal. I’m becoming a little more comfortable with it the more I do it but at first I would shake so bad I couldn’t get the needle where it needed to be.

I remember the first day at the vet after she was diagnosed I had to come in and learn injections and blood testing I was ghost white, almost to tears and shook extremely bad.
 

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Ale & Bobo & Minnie (GA) said:
Are you always giving her a treat immediately after each test attempt?
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Yes I do, she’s a good cat but I’m still not the best at it so most of the time my partner does it and they do a way better job than me.I don’t ear prick everyday though. I test blood when her sensor fails or is dying and not giving me up to date results. I do understand Truffles frustration with me after being poked in the ear 4 different times (not always that many times but I’m still not the best), I would bite me too. Never harmful bites, just enough to say please stop.
 
Jason - Kona's Dad said:
How's the spreadsheet coming along? No pressure...., but some pressure. :p https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

It took me a couple weeks before I finally broke down and got it done, but it's really the best tool to get the eyes of the community on what's going on so we can support you and Truff the best, hands down.

View attachment 68896
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I will definitely work on it tomorrow I promise! To me the libre is easy to read but I understand not everyone is very familiar with it and if it helps you guys help me I will definitely do it!

She had a weird day today, a straight shot down to 160 about 4 hours after her shot then straight back up into the 300’s all day :( I don’t think she got into anything she wasn’t supposed to unless she drank my coffee when I wasn’t looking
 
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