8/28/2025 Bear PMPS 133 New Patient, repeated skips?

mathematicat

mathematicat

New Member
Hi, new here and learning a lot. Bear was diagnosed 8/16/25 and began Lantus 8/23/25 at 1 unit 2x a day. 8/26 I skipped AM dose as AMPS was 152 and reduced dose at evening to .75. 8/27 his PMPS was 192 so I skipped. Not sure if I should have done this so close to 200, but everywhere I look it says no shoot under 200. This morning I reduced to .5 unit and this evening his PMPS is 131. I know this is well within skip numbers, but is it healthy to skip 3 doses in 3 days? Each time I skip, his BG bounces up to high 300s. Looking for advice on how to stabilize and whether to skip again. This is my first post and I dont' know if my signature will show up so I'm also linking Bear's spreadsheet here.

Bear (Dagger Cat) 's Sugar Sheet
 
Hello and welcome. Normally we ask people to post on the Feline Health forum first, but it looks like you have most everything set up. With a couple exceptions. You aren't using our format for the spreadsheet, but rather one that a FB group not affiliated with us uses. The spreadsheet says you are using Vetsulin, the signature says you are using Lantus. Which is it? We also like to see the type of food being fed on the signature. Also, we like people to wait to post on the Lantus forum until they've decided which dosing method you'd like to use. The dosing method chosen is how we decide what to suggest to you. For example, on this forum, if people following Tight Regulation see a number under 150, they post and ask for help what to do. Above 150 they shoot.

Details on what should go in the signature and how to get a copy of our spreadsheet are in this post: New? How You Can Help Us Help You!

Can you tell me a bit about what led to Bear's diagnosis? Any other conditions present?
 
Hi, sorry about that, I did try to make an effort to post correctly but it looks like I failed to see some of the guidelines. I have added his food to my signature. He is using Lantus. I will get a spreadsheet set up for this forum ASAP, I was just hoping the one I had already available at the moment would have the information needed for my post, since I was a little worried about whether to give him insulin tonight (no longer an issue as that time has passed, I ended up giving him 0.25 units).

My vet prescribed 1 unit 2x a day, so that is what I started with. I had seen guidance online in some places not to shoot below 200 and others not to shoot below 150, and out of fear of hypo I had been following the 200 guideline until now (we are only on day 6). Tonight I was concerned about skipped a third dose and causing another drastic bounce, so I gave him the conservative .25 unit dose.

He was diagnosed because I took him to the vet to have his feet checked, since he was walking a bit flat footed. He also had lost a little weight. He was diagnosed with 450 glucose on 8/16/25. He did not have diabetes at his last blood panel in February (6 months ago). No other current conditions that I know of, but he had a urinary blockage in 2022. So far we haven't had another incidence.

Thanks for your time.

Edit to add: the spreadsheet in my signature is now updated to this forum's template.
 
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No worries, just trying to get things in your signature that we like to see, so you don't keep getting asked the same questions over and over.

You made a good call on the 0.25 units tonight. You will eventually be able to shoot those lower numbers when you have the data to do so. We do base dose change decisions on the nadirs (low points) and not the preshots, but in the beginning it's hard to get over the idea of shooting lower numbers. Lantus does a great job at keeping lower numbers low and flat, as you will eventually see. But for now, start with a lower dose and work your way up is a better way to go, as long as he hasn't tested positive for ketones or had DKA.

The flat footed feet is probably diabetic neuropathy. Methyl B12 can help with that, as well as getting him regulated. If you search the Feline Health forum you'll see lots of suggestions for brands to use.

Out of curiosity, what food was he eating before being diagnosed with feline diabetes?
 
He was mostly eating Fancy Feast or Friskies canned food, but several different varieties, some of which I now know are medium to high carb. He was also eating some prescription dry food, the Purina UR that he's been eating since 2022, but this was not his main food. Definitely more dry than he should have been eating though, as I now know! For a while I tried to keep him primarily on the Purina UR wet food, but he didn't love it so I was throwing a lot away (and it's so expensive), so I focused on keeping him hydrated. This is probably why I may not have noticed him drinking more water.

Interesting to know about the dosing decisions on nadirs. I guess deep down I know that, but like you said, as a newbie it's hard to shake the pre-test lower number nerves. I'm really happy to be seeing a lot less 300+ BG already, but super nervous as he drops into those low 100s too. What a rollercoaster!
 
Everyone has the fear of shooting lower numbers at first. And when you haven't seen them yet, or gotten a good idea how your cat is using the insulin or how he reacts to different levels or carbs, you are going in blind. Better to learn your cat reactions to insulin and carbs first, so you have to tools to handle lower numbers.

I had wondered if you were giving higher carb foods previously. Transitioning to low carb food can make a big difference is some cats. Keeping him hydrated will also be a benefit to his urinary system.
 
I do think switching to only low carb food is having an effect, I noticed that his BG started coming down some even before starting insulin, even though it was still high. I'm sure the original high number on his blood panel could also be from the stress of being at the vet, too. Well, thank you for your patient help! Having folks like you all to turn to for guidance makes this less scary.
 
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