8 weeks in after DKA/Diagnosis - Using Lantus and still in 400-500's

[Ginger Bryson-Harbin]

Greetings!
I am about to go to vet number 2 - My baby is on Lantus and she keeps upping his dose - he is now on 3 units of lantus and she told me that some cats can have up to 1 unit per lb - meaning he could have up to 14 units????!???
After DKA, he was not at lower doses long enough to determine if it was effective - every few days they would up it .5u His numbers these last few weeks have been higher than ever. He is on Fancy Feast Beef and Liver (97k/cal per can, 3%carbs). He gets fed 3 cans over 4 times / day and is STARVING all the time. It sees the higher the insulin dosage, the more lethargic he becomes. I curve at home and test blood ketones. His ketones are hovering at 0.9. I am attaching his chart. The FB group recommended I drop him to 1.5 and restart. I really trust the but I am scared to death. When I dropped him before, (3 weeks after DKA, hs ketones went to 2.0 Blood meter and trace urine).
I fell hopeless and that I am causing him more harm than good because he is just not regulating and I see story after story of remission.... I am happy for those babies. I just want to help mine.
I appreciate any feedback you might have that I can pass along to the 2nd vet.
Respectfully,
Ginger

 

[Deb & Wink]

Bumping for more eyes.

We don't all have Excel on our computers or smartphones or tablets.
So there might not be a lot of people that can open your attachment.

It's why we have our standardized spreadsheet as a google document.
Do you have this spreadsheet as a google sheet?

Different facebook groups have different spreadsheet versions.

I only found you as a member of the Feline Diabetes Support Group on facebook. That is not the same group that this message board is affiliated with. We are Feline Diabetes. This group. https://www.facebook.com/groups/felinediabetes/

Could you put that google version of the SS in your FDMB User ID signature please?

I see that Stacey Kotria, one of the moderators on the other facebook group, Feline Diabetes Support Group on facebook, advised you to lower the dose with a post DKA cat. That sounds like absolutely horrible advice in IMHO.

 

[Deb & Wink]

Ginger, take a deep, deep breath, take a few more. This is going to be even more stressful for you than what you have been experiencing.

Plus, with a recently DKA cat, you want to try and keep the BG numbers in a good range. Dropping the dose back to 1 unit risked the production of ketones AND did not get your cat out of those high black and red BG ranges.

You need to use TR (Tight Regulation) with a recently diagnosed cat that has also experienced DKA.
@Wendy&Neko
@Sienne and Gabby (GA)

When you have a chance, please comment on this thread.

 

[tiffmaxee]

I don’t know why you were told to drop the dose from 3 units to 2.5 but I don’t see a signature which would be helpful. What protocol are you following? You haven’t seen anything close to normal numbers or a reason to drop the dose that I can see.

 

[Tina Marie (GA) and Jan]

Hi Ginger,
It's great you stopped by (I do have Excel, so could look). Those numbers look like they are screaming for more insulin! You will be able to get very good advice and help here for Sir Thomas

 

[Sienne and Gabby (GA)]

As Deb mentioned it would be enormously helpful if you could copy your Excel data into the Google spreadsheet that we use. This is the link to the spreadsheet instructions.

I also agree with what others have posted. I would not decrease Sri Thomas' dose. Ketones are very tricky. They can zoom from trace to an emergency in a very short time. The basic recipe for ketones to develop is the presence of an infection or inflammation + not enough insulin + not enough calories. Given the recipe, give your kitty more food. You want to be feeing roughly 1.5 times his usual caloric intake. Until a cat is regulated, the kitty is going to be hungry! A kitty with a history of DKA and who's hungry, feed the cat!

Also, a cat will need the amount of insulin the cat needs. Some cats need a little bit. Some need more. Is you cat on any medications and are there any other medical issues beyond the DKA. Until we can all take a look at your data, I'm hesitant to make any observations about dose.