6/25 Bob AMPS=500 Newbie dose help

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Lkldcatlady

Lkldcatlady

Member Since 2013
Not sure if I'm in the right place (tight regulation vs. relaxed) but I really need some advice. I've been getting lots of help on the health forum, but figure it can't hurt to post here too. If you look at Bob's spreadsheet, he was switched from ProZinc to Lantus not too long ago. After learning about how to do things on this site, my vet obviously had no clue while Bob was on ProZinc and raised his doses way too much way too fast. I took him to a specialist (internal mediciine vet specializing in diabetes) and she switched him to Lantus starting at 2 units (he was on 5 of ProZinc at that time). She did multiple tests and an ultrasound and feels like he just has "regular" diabetes - it's not caused by some underlying condition. I am just really not understanding his crazy numbers. They just don't make sense to me. Is this common? I hear people on other posts saying things like "I know 2 units is alot of insulin" and that freaks me out because I had Bob on 5 of prozing and we are now on 2.75 of lantus and I don't see any improvement at all. :cry:
 
Re: Lantus advice

Hi guys and welcome to lantus land! I'm not familiar at all with the old insulin you were using, and I'm not much of a dose advisor, but I am sure others will be along soon to help figure out the best dosage amount for Bob .. I did check out his SS and I can see one thing right off the bat, when using lantus, usually we increase by .25 amounts, and you went from 2u to 2.5u .. We like the smaller dose increases because we just might miss their best dose by going in half unit increases .. Bob's numbers are high, but he did throw out some nice blues and greens so that is promising! You'll find a ton of helpful people here on this forum, and a ton of helpful information so stick around, ask questions and make yourself at home :-D
 
Re: Lantus advice

Welcome Dara!!

It's not uncommon for a cat to need as much Lantus as the insulin the kitty was switched from. The advantage of what you're doing with Lantus now is that you are adjusting the dose in a systematic way so you don't miss what is a good dose for Bob.

Given that Bob's nadirs are still over 300, we typically suggest that you increase the dose by 0.5u every 6 cycles/3 days. Once you start seeing nadirs that are below 300, you adjust the dose in 0.25u increments. Tight Regulation is a bit more aggressive than the approach used on the Relaxed board. However, it is a safe approach that has impressive research to support it's use. You'll also find that this Board is a lot busier than Relaxed so there are usually people around if you need help.
 
Re: Lantus advice

Thanks guys - it's been kind of hard because my regular vet AND the specialist I am seeing are both against my testing so often. They think I should only test when I notice abnormal behavior (i.e. WHEN IT'S TOO LATE!) and it's been very frustrating. They believe I am stressing him out. I'm not a doctor, but testing at home and starting low and going slow make a heck of alot of sense to me.

PeterDevonMocha said:
I did check out his SS and I can see one thing right off the bat, when using lantus, usually we increase by .25 amounts, and you went from 2u to 2.5u ..
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To be honest, I increased from 2.0 to 2.5 because I could barely read the needle markings. Now I have a needle that has .5 unit markings and it makes it easier to see.


Sienne and Gabby said:
Given that Bob's nadirs are still over 300, we typically suggest that you increase the dose by 0.5u every 6 cycles/3 days. Once you start seeing nadirs that are below 300, you adjust the dose in 0.25u increments.
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So, I think today is Bob's third day on 2.75. You think I should move him to 3.25 tomorrow? When the specialist told me to increase from 2 to 3, that night he went down REALLY fast. I was getting 95 (on an alphatrak) at 3 hours after his shot and I made him eat some more food. Then we went back down to 2 units.

Sienne and Gabby said:
It's not uncommon for a cat to need as much Lantus as the insulin the kitty was switched from.
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That's good to know. I just read something about chronic insulin overdose and I was afraid that might be happening here because my original vet started high and increased very quickly with his insulin.
 
Re: Lantus advice

When switching insulin, the prior dose is taken into account. There is a weight based formula for the initial dose of Lantus BUT prior dose is a factor in that decision.

You do not have to increase by 0.5u if you're uncomfortable with a more aggressive approach. What is more important, IMHO, is that you increase the dose every 6 cycles until you start seeing better numbers.

As for the vet and testing, who says you need to tell the vet how much you test. I've had a similar discussion with my vet and I simply said that we'd have to agree to disagree. That Gabby is my cat and I know how she responds to insulin. Testing is my only way to keep her safe given her proclivity to take nose dives. Since the vet isn't available 24/7, I' was opting for safety first. There wasn't much my vet could say in response.
 
Re: Lantus advice

Oh, I remember those vet days all too well. I think we all do. My vet wanted me to bring in Blackie to get tested, and so we did, practically each weekend for about a couple of months. Eventually, we stopped as it was adding up to almost $100/month just in testing alone. Then someone on here messaged me, and offered to help me home test. I'm glad that I allowed it, and she and I are good friends now. Back then, my vet wasn't on board with using Lantus as the preferred insulin, either. I was using ProZinc, and Blackie was on the worst possible food for carbs imaginable (Hill's Prescription type). Yep, those were the days, and those days I don't wish to repeat ever again, I tell you. :lol:

As time goes on, you'll get used to everything on here, and you'll also get familiar with how your kitty reacts to dose/food adjustments. Some cats react more quickly than others to things. The only thing is... whatever you decide to do, be it food and/or dose adjustments, you may or may not experience some bouncing from either or both of those. Some cats don't react at all, whereas some do (like my Blackie... I have to do things in stages with her as I've learned over the last 3 years :lol:... I can't do things like food and dose adjustments at the same time, so I see-saw them, like I'm doing right now).

Anyway, enough of talking about Blackie. I want to welcome you to this wonderful board, and you'll get the hang of things on here. Just hang in there, and try not to get too discouraged. Welcome! :-D
 
Re: Lantus advice

Sienne and Gabby said:
You do not have to increase by 0.5u if you're uncomfortable with a more aggressive approach. What is more important, IMHO, is that you increase the dose every 6 cycles until you start seeing better numbers.
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No, I'm fine with the .5 increase. I'm ready to see some other colors on his SS!

Angela & Blackie & 7 Others said:
Oh, I remember those vet days all too well. I think we all do. My vet wanted me to bring in Blackie to get tested, and so we did, practically each weekend for about a couple of months. Eventually, we stopped as it was adding up to almost $100/month just in testing alone. Then someone on here messaged me, and offered to help me home test. I'm glad that I allowed it, and she and I are good friends now. Back then, my vet wasn't on board with using Lantus as the preferred insulin, either. I was using ProZinc, and Blackie was on the worst possible food for carbs imaginable (Hill's Prescription type). Yep, those were the days, and those days I don't wish to repeat ever again, I tell you.
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I can relate!! I'm in over $2,000 already and it's only been 8 weeks. Thought I should mention, Bob is still eating purina DM dry (I know!). However the specialist thinks he MAY have lower bowel disease causing his extreme pickiness. I've tried everytghing but the only thing he will eat is tuna and then just licks it and walks away. She says it's more important he eats and I agree. I just can't plop down the wet food, shoot him ful of insulin and leave for 12 hours. Anyway, just FYI - I know this board is for Lantus chats only.
 
Re: Lantus advice

Food issues are very important, too. Dry DM is way high in carbs and is probably why you're not seeing movement in Bob's numbers. Have you read Lisa Pierson's site on feline nutrition?

If you HAVE to give dry, have you looked into Young Again? It's lower in carbs and, unlike DM, has decent ingredients.

I don't know that I've heard of GI problems causing pickiness. It can cause a cat to feel lousy and not want to eat but that not eating would include dry food. Perhaps you can ask your vet to explain this in more detail. If the vet gets into the fiber issue, I would suspect that s/he is not current in his/her approach.
 
Re: Lantus advice

Welcome, uh, ……… we talk about everything here! Lantus, food, poo, anything and everything relating to our sugar babies. ;-)

I was just going to ask about the food! I saw in your signature that you are feeding Purina DM and I saw a mention of a cup measurement in your Health post. The high carbs are definitely a factor in his high BGs.

Purina DM is 18% carbs which is considered a high carb food, plus …… dry food is bad for the kidneys cats get most of their water from their food not from drinking water),…… plus the ingreedients are cr*p!
Ingredients (Dry)
Poultry by-product meal, soy protein isolate, corn gluten meal, soy flour
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Nothing in the first 5 ingredients is good nutrition for a cat, …… PLUS, it is way overpriced!

I know you said he is a dry food addict, it will be hard but you should be able to get him transitioned. You will waste a lot of cans of food though! :roll: In the meantime there are other dry food which are better, lower in carbs. EVO is one and I heard about a new one and will try to find it for you.

Chin up!
 
Re: Lantus advice

Here is a link to Dara and Bob's latest post from Feline Health with a bit of background and some more suggestions she was given over there today. http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=98430&p=1053337#p1053337

And her original thread from Feline Health. http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=97617&view=unread#unread

I said this in another person's thread over in Feline Health a few days ago.
It's not just the quality of the dry food, but the carb content which will make a difference. There are a couple of dry foods that are lower carb than the Orijen you bought and might help a great deal with the BG control for a diabetic cat.

1. Natura/Innova Evo Cat & Kitten 8% carb but it has been hit by another recall.
2. Young Again Zero Carb, mail order only, expensive, some cats refuse to eat the different sized chunks, a couple of cats have achieved remission on this dry food. Manufacturer claims 0% carb but carb calculators indicate 5%
3. Nature's Variety Raw Instinct chicken 7%
4. Wellness Core Grain-Free Original Formula (tan gold bag)11%

Most dry foods are coated with animal digest and that is what cats love the taste of. There is a product called Fortiflora that you can buy to sprinkle on the canned food. Similar to the animal digest coating of the dry foods and cats love the taste.
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Re: Lantus advice

Sienne and Gabby said:
I don't know that I've heard of GI problems causing pickiness. It can cause a cat to feel lousy and not want to eat but that not eating would include dry food. Perhaps you can ask your vet to explain this in more detail. If the vet gets into the fiber issue, I would suspect that s/he is not current in his/her approach.
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The specialist said when she did Bob's ultrasound, his lymph nodes near his lower intestines looked a little larger than normal. She said nothing to worry about now, but it good point to the lower bowel problem and that can cause cats to be picky. I don't know....I believed her because she's the doctor! She's a specialist (and pricey, I might add) I would hope that she knows what she's talking about, but I guess she may not be up-to-date on things....

Ann & Tess said:
I know you said he is a dry food addict, it will be hard but you should be able to get him transitioned. You will waste a lot of cans of food though! In the meantime there are other dry food which are better, lower in carbs. EVO is one and I heard about a new one and will try to find it for you.
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HAHA - I do have bags of all those foods at home (believe me, when I say I've tried everything - I have)

I've tried the young again (no go!), and I was in the process of mixing the EVO with the DM to get them switched over and it was almost like Bob's numbers went up so I got scared and just started giving him the DM by itself again. I did base my decision to leave him on the dry, #1 because of his extreme pickiness and #2 because I read on the AHAA guidelines that they consider "low" carbohydrate to be 5% to 25%. "ultra low" to be less than 5%. Hector and Penelope love whatever food i put out - they love the canned, they love the EVO, they love the Young Again and poor Bob just looks depressed and goes back to his bed and looks sad without eating. :cry:

Sienne and Gabby said:
If the vet gets into the fiber issue, I would suspect that s/he is not current in his/her approach.
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Unfortunately, my vet did mention "fiber" so that's a little distressing.

Sienne and Gabby said:
Food issues are very important, too. Dry DM is way high in carbs and is probably why you're not seeing movement in Bob's numbers. Have you read Lisa Pierson's site on feline nutrition?
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I have read the food information at catinfo.org and I would LOVE to switch Bob to the canned and have tried all the things on her site with not much luck. I just don't feel comfortable trying to starve him into eating the canned when I'm not home the majority of the day and he needs his insulin. I really want to switch him to the EVO because it seems to be a quality food with good ingredients. I hate reading the back of the purina bag - it makes me sick! I'm lucky because all 3 of my kitties have always loved water and don't seem to have an issues drinking a good amount each day so that's not something I worry about too much. I think I"m going to give the EVO dry another shot - it has less carbs so you don't think it would cause his numbers to go up for any reason, do you?
 
Re: Lantus advice

Have you considered feeding raw? The test I used to see if Tess would eat raw was to just cut a few small chunks of chicken (about half inch) and offer them to her. She gobbled it up!

Try Fortiflora too! It's a probiotic, but flavored w/ the same animal digest that they use to coat dry food to entice cats to eat what they normally would reject. If that were not all over the DM Bob would want no part of it!

Also try crushing some of the DM and sprinkling it over the canned food.
 
Re: Lantus advice

Ann & Tess said:
Have you considered feeding raw? The test I used to see if Tess would eat raw was to just cut a few small chunks of chicken (about half inch) and offer them to her. She gobbled it up!

Try Fortiflora too! It's a probiotic, but flavored w/ the same animal digest that they use to coat dry food to entice cats to eat what they normally would reject. If that were not all over the DM Bob would want no part of it!

Also try crushing some of the DM and sprinkling it over the canned food.
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I've never tried to the raw food, but I've tried to give him cooked chicken and he acts like I'm trying to poison him. I just don't think I could do the raw food - there's alot I would do for my kitty, but I can't grind up raw critter parts. Yikes!

I did try the fortiflora and same issue. I almost wonder if it's a texture thing. He almost acts awkward trying to eat soft foods - it falls out of his mouth and then he stares at it. Not sure if he doesn't like the taste or the texture.

I think for now I will try the transition to the EVO dry and continue to increase by .5 and hopefully see something. If not seeing results, I would like to try the canned food again. It's just so nerve-wracking! ohmygod_smile
 
Maybe try a chunky consistency cat food? there was a post a while back on chunky food for a picky cat. I'll try to find it. Ok, here are some possibilities in chunky style. I consolidated it into a list.
Chunky style foods, low carb we think

1. Fancy Feast chunky turkey, chunky chicken
2. Nature's Variety is more chunky like the Merrick's or the FF Chunky.
3. Weruva's Paw Lickin' Chicken
4. Avoderm Chicken Chunks in Gravy
5. Stella and Chewys freeze dried dinner
6. Merrick Cowboy Cookout is somewhat chunky and low carb
7. Tiki Cat for the chunks, albeit pricey
8. wellness sells a chunk style brand in chicken and turkey in a minced, cubed and sliced low carb though?
9. Grammy's Pot Pie is pretty chunky.
10. Pro Plan turkey is a mince, so it has some texture
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Or try putting a bit of the pate on your finger and having him lick it off?

Is there any people food he likes and will fight you for to eat?

Crumble the freeze dried treats over the canned food. Wink loved the Halo Liv-a-littles freeze dried chicken and would eat some canned food if I crumbled those over the wet food.
 
Deb & Wink said:
Or try putting a bit of the pate on your finger and having him lick it off?
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Tried that and he just sniffs it. I did try putting some in his mouth one time because he wouldn't try it and I thought if he tasted it he wouldn't like it, but no luck with that either.

Deb & Wink said:
Is there any people food he likes and will fight you for to eat?
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He will fight for anything I have but when I put it in front of him, he won't touch it. If he does try to eat it (he seems to like McDonald chicken mcnuggets) he will eat one piece and it keeps falling out of his mouth and sometimes he will swallow it and sometimes he won't. I've put chicken and hamburger out for him and he doesn't like it. If I put tuna out he will lick it and every now and then eat a little. But he will NEVER eat a decent amount.

Deb & Wink said:
Maybe try a chunky consistency cat food? there was a post a while back on chunky food for a picky cat. I'll try to find it. Ok, here are some possibilities in chunky style. I consolidated it into a list.
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I'm happy to try anything - I'll give some of those a try. The one thing I tried he seemed to like a little more than anything else was Best Feline Friend canned food. I got it at a specialty pet food store. The only reason he liked it is because they have tuna in every variety. It looks like they put actual pieces of tuna on the top of the food. Once he licked that enough, he gave up. I also didn't want to feed him all that tuna - I did see somewhere they shouldn't eat fish all the time because of the mercury.
 
I offered to write up a transition plan for Bob in case he does not like the EVO right off the bat. The idea is to feed an amount of the higher carb food and slowly replace that with a lower carb dry food by changing the proportions. Since Bob is so resistant to any kind of canned food, for now we will be trying to get him on a lower carb dry food.

Transition plan for Bob.
You said Bob was eating 2/3 of a cup of food a day. I'll base the transition plan on that for now until we hear from the vet on Bob's weight.

Purina DM has 592 cals/cup - high calorie
EVO ??? has ??? cals/cup Might be more calories than he needs but we will adjust later. Let's get the food change in place.

There are 16 tablespoons (T) in a cup. About 11 in 2/3 of a cup. I double checked my copy of Joy of Cooking because I got it wrong last time I did this. ohmygod_smile

Day 1 - 10 T Purina DM, 1 T EVO
Day 2 - 9 T Purina DM, 2 T EVO
Day 3 - 7 T Purina DM, 4 T EVO
Day 4 - 6 T Purina DM, 5 T EVO
Day 5 - 4 T Purina DM, 7 T EVO
Day 6 - 2 T Purina DM, 9 T EVO
Day 7 - 1 T Purina DM, 10 T EVO
Day 8 - 11 T EVO Transition complete. If Bob cooperates. :-D

:?: Dara, would you please tell me which EVO dry food you have. Want to make sure I have the correct one to do my calculations.
 
Welcome to Lantus Land! Everyone is very helpful over here so you are in the right place. Just remember to put a ? in your subject when you have a question to ensure you get eyes on you.

Most of us post every day or every other day to keep everyone updated and always eyes on your cat.


Wendy
 
Welcome to LantusLand! You've gotten a ton of info, so I'll be brief. I can sympathize with your food situation, because I have 3 civvies (non-diabetics) who are dry food addicts. I tried all of Dr Lisa's tricks, too, and made up quite a few of my own, with no luck. They literally chose to starve themselves before eating it, so I understand what you've gone through with Bob. I pray they don't become diabetic. Fortunately Trixie, my diabetic, isn't picky and loves her low carbed canned.

I notice you have been trying to transition to EVO dry. Are you aware that EVO is under a recall right now, for possible salmonella contamination? I'm sorry I don't have any links handy, but I would look into it. I know my local Ma & Pop pet food store has pulled all EVO/Natura products indefinitely.

Have a great evening!!!
 
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