11/16 - Maui, AMPS 259, +7 359, Looking for Thoughts on His Spreadsheet

[Bdicologero]

Just looking for general dosing advice/thoughts on his spreadsheet. Some days (like today) we're not getting a curve with lower numbers after his shot. I've been following the SLGS dosing on here, not what my vet said, as they have only recommended prescription food before looking further into anything else (we have an appointment at a different vet next month.)

But in the meantime, is there anything I should change/start doing?

https://docs.google.com/spreadsheets/d/1QtJgnYO3FxYucnqrRNI3zK74G9FU0Rlv4QYPmmjxX34/edit?usp=sharing

 

[Wendy&Neko]

Hello and welcome to the L/L/B forum.

First thing, a curve is either testing every two hours (more frequent if under 100) for 12 hours, or testing every 3 hours over 18 hours. So you can ease off the testing. It looks like Maui is bouncing today, so not the best day for a curve anyway.

One suggestion I would make for adding to your routine, is to try to get a test every night, before you go to bed. If that test is at least 2 hours after his PM shot. Many cats go lower at night, so if you are home at night, that test before you turn out the lights will give us a clue as to what is happening that PM cycle. We determine how to change the dose based on nadirs, or how low the dose takes the cat, so any inside into the middle of the cycles is good data to have.

The +2 test is very often a good heads up on how the cycle will go. If it's higher than the preshot (like today), it's most likely a quiet or bounce cycle that doesn't need much monitoring. A "typical" Lantus cycle will have the +2 about the same as the preshot, and there will be some downward motion in the numbers. A +2 quite a bit lower than preshot is very active cycle that could need more monitoring. For example, see the AM cycle of 10/19.

 

[Bdicologero]

Hello and welcome to the L/L/B forum.

First thing, a curve is either testing every two hours (more frequent if under 100) for 12 hours, or testing every 3 hours over 18 hours. So you can ease off the testing. It looks like Maui is bouncing today, so not the best day for a curve anyway.

One suggestion I would make for adding to your routine, is to try to get a test every night, before you go to bed. If that test is at least 2 hours after his PM shot. Many cats go lower at night, so if you are home at night, that test before you turn out the lights will give us a clue as to what is happening that PM cycle. We determine how to change the dose based on nadirs, or how low the dose takes the cat, so any inside into the middle of the cycles is good data to have.

The +2 test is very often a good heads up on how the cycle will go. If it's higher than the preshot (like today), it's most likely a quiet or bounce cycle that doesn't need much monitoring. A "typical" Lantus cycle will have the +2 about the same as the preshot, and there will be some downward motion in the numbers. A +2 quite a bit lower than preshot is very active cycle that could need more monitoring. For example, see the AM cycle of 10/19.

Thank you so much! I have an appointment with a different vet but it's not until next month. My current vet just keeps telling us to go on the prescription food, and I just feel like I have so many questions about dosing him and if we should be worried about diabetes being a symptom of something more problematic given how unregulated he is or if this is normal for a diabetic cat. I also wonder if we should try a different insulin or what.

Also, wondering about his dosing in that according to the SLGS method we'd do a curve tomorrow where that's a week at this dose and then likely increase based on that? If his numbers are still high tomorrow should I increase the dose or wait until his vet appointment and hope this vet is more helpful? I know earlier on we held his doses too long because I didn't know any better

 

[Wendy&Neko]

Since you did the curve today, you don't have to do the curve tomorrow. If you are around and can get a spot test mid cycle, that would be good data. And enough to tell you what to do with the dose.

As far as what you want to do with dosing, that is your decision. Most people here find their vet isn't that helpful with dosing. They are pretty busy folk, and it's hard to get an answer in a timely manner.

When your vet mentions prescription food, just smile and nod. Tell him your cat won't eat it and leave it at that.

I have so many questions about dosing him and if we should be worried about diabetes being a symptom of something more problematic given how unregulated he is or if this is normal for a diabetic cat. I also wonder if we should try a different insulin or what.

Free to ask any questions, maybe we can help. Your cat did get to normal blood sugar values a couple weeks ago, so he's probably not too far from a better dose. Has a vet ever looked in his mouth and commented on his teeth? We find that needing a dental is one of the top reasons it's hard to get a cat regulated. Once you start following a dosing method, and increasing as per that method, you'll get to regulation sooner. You can always try a different insulin, but I'd give Lantus a bit more time with following a dosing method before trying another insulin. The only other insulin I'd suggest is Levemir. It's also long acting like Lantus.

 

[Bdicologero]

Since you did the curve today, you don't have to do the curve tomorrow. If you are around and can get a spot test mid cycle, that would be good data. And enough to tell you what to do with the dose.

As far as what you want to do with dosing, that is your decision. Most people here find their vet isn't that helpful with dosing. They are pretty busy folk, and it's hard to get an answer in a timely manner.

When your vet mentions prescription food, just smile and nod. Tell him your cat won't eat it and leave it at that.

Free to ask any questions, maybe we can help. Your cat did get to normal blood sugar values a couple weeks ago, so he's probably not too far from a better dose. Has a vet ever looked in his mouth and commented on his teeth? We find that needing a dental is one of the top reasons it's hard to get a cat regulated. Once you start following a dosing method, and increasing as per that method, you'll get to regulation sooner. You can always try a different insulin, but I'd give Lantus a bit more time with following a dosing method before trying another insulin. The only other insulin I'd suggest is Levemir. It's also long acting like Lantus.

Thanks so much! The vet did mention him needing a dental eventually during his last visit but they said they wanted to get his diabetes more regulated first (I wondered if it should go the other way around?)

He also has chin acne that is a bit of a mystery, something I'm going to ask the other vet about when he goes next month. Little blackhead looking dots. It coincided with an ear infection before which made our last vet think it was a food allergy. His ear infection cleared up with the drops they prescribed and his chin cleared up for a bit around that same time + with us wiping it every few days with other cleaner they gave us, but now it's back. We tried an elimination diet but other food made his numbers high so we're back on Fancy Feast.

Also wondering if we're feeding him too much/too little. We were feeding him 2.5 3 oz cans twice a day and the vet thought that was too much. I've been slowly feeding him more this week (like we used to when he was first diagnosed) because he's been acting ravenous for food again.

 

[Wendy&Neko]

You might want to see if the vet will send you to a dental specialist, if he/she is not willing to do the dental themselves. We often hear vets say they don't want to do a dental until the cat is regulated, but the cat can't get regulated without that dental. Dental specialist vets are used to working with more complicated cats, such as diabetics.

For the chin acne, make sure you aren't using plastic bowls. Metal or glass/ceramic are best. Bacteria lingers on plastic.

As far as how much to feed, a scale is the best judge of that. The vet can tell you what his ideal weight should be. This link to the catinfo website has more information. How much should I feed?

 

[Bdicologero]

You might want to see if the vet will send you to a dental specialist, if he/she is not willing to do the dental themselves. We often hear vets say they don't want to do a dental until the cat is regulated, but the cat can't get regulated without that dental. Dental specialist vets are used to working with more complicated cats, such as diabetics.

For the chin acne, make sure you aren't using plastic bowls. Metal or glass/ceramic are best. Bacteria lingers on plastic.

As far as how much to feed, a scale is the best judge of that. The vet can tell you what his ideal weight should be. This link to the catinfo website has more information. How much should I feed?

Thank you so much! His appointment at the new vet is Dec. 8, so I'll definitely ask about that when I go. For his plate, he eats off a Corelle plate like our regular dinnerware. I believe it's glass with whatever they use to make it "unbreakable" but maybe I'll put him back on a ceramic cat dish. If the chin acne is that easy of a fix and not a food allergy that would be great lol. I told our current vet he was eating 2.5 cans of Fancy Feast twice a day, already less than what the serving size on the can says, and she acted like that was a ton of food and we should cut back, but then he acts like he's starving. Will definitely see what the new vet says about his weight/food.